|
HC TB TEST
|
Facility
|
IP
|
$24.97
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
30000069
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.38 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: BCBS Trust/PPO |
$20.62
|
| Rate for Payer: BCN Commercial |
$20.62
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Nomi Health Commercial |
$20.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.97
|
| Rate for Payer: UHC Core |
$20.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.73
|
|
|
HC TC 99M ABD PER STUDY
|
Facility
|
OP
|
$160.67
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300019
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$144.60 |
| Rate for Payer: Aetna Commercial |
$136.57
|
| Rate for Payer: Aetna Medicare |
$41.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.21
|
| Rate for Payer: BCBS Complete |
$29.74
|
| Rate for Payer: BCBS MAPPO |
$40.17
|
| Rate for Payer: BCBS Trust/PPO |
$132.09
|
| Rate for Payer: BCN Commercial |
$132.09
|
| Rate for Payer: BCN Medicare Advantage |
$40.17
|
| Rate for Payer: Cash Price |
$128.54
|
| Rate for Payer: Cofinity Commercial |
$138.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.17
|
| Rate for Payer: Healthscope Commercial |
$144.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.50
|
| Rate for Payer: Mclaren Medicaid |
$28.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.18
|
| Rate for Payer: Meridian Medicaid |
$29.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.57
|
| Rate for Payer: Nomi Health Commercial |
$131.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.50
|
| Rate for Payer: PACE Senior Care Partners |
$38.16
|
| Rate for Payer: PACE SWMI |
$40.17
|
| Rate for Payer: PHP Commercial |
$136.57
|
| Rate for Payer: PHP Medicare Advantage |
$40.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.78
|
| Rate for Payer: Priority Health Medicare |
$40.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.83
|
| Rate for Payer: Railroad Medicare Medicare |
$40.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.39
|
| Rate for Payer: UHC Core |
$134.16
|
| Rate for Payer: UHC Exchange |
$40.17
|
| Rate for Payer: UHC Medicaid |
$28.33
|
| Rate for Payer: UHC Medicare Advantage |
$40.17
|
| Rate for Payer: UHCCP Medicaid |
$28.33
|
| Rate for Payer: VA VA |
$40.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.50
|
|
|
HC TC 99M ABD PER STUDY
|
Facility
|
IP
|
$160.67
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300019
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$111.83 |
| Max. Negotiated Rate |
$144.60 |
| Rate for Payer: Aetna Commercial |
$136.57
|
| Rate for Payer: BCBS Trust/PPO |
$132.70
|
| Rate for Payer: BCN Commercial |
$132.70
|
| Rate for Payer: Cash Price |
$128.54
|
| Rate for Payer: Cofinity Commercial |
$138.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.54
|
| Rate for Payer: Healthscope Commercial |
$144.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.57
|
| Rate for Payer: Nomi Health Commercial |
$131.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.50
|
| Rate for Payer: PHP Commercial |
$136.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.39
|
| Rate for Payer: UHC Core |
$134.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.50
|
|
|
HC TC-99M AUTOL WBC DIAG PER DOSE
|
Facility
|
IP
|
$2,706.00
|
|
|
Service Code
|
HCPCS A9569
|
| Hospital Charge Code |
34300027
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,883.38 |
| Max. Negotiated Rate |
$2,435.40 |
| Rate for Payer: Aetna Commercial |
$2,300.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,234.89
|
| Rate for Payer: BCN Commercial |
$2,234.89
|
| Rate for Payer: Cash Price |
$2,164.80
|
| Rate for Payer: Cofinity Commercial |
$2,327.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,164.80
|
| Rate for Payer: Healthscope Commercial |
$2,435.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,029.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,300.10
|
| Rate for Payer: Nomi Health Commercial |
$2,218.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,029.50
|
| Rate for Payer: PHP Commercial |
$2,300.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,354.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,883.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,381.28
|
| Rate for Payer: UHC Core |
$2,259.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,029.50
|
|
|
HC TC-99M AUTOL WBC DIAG PER DOSE
|
Facility
|
OP
|
$2,706.00
|
|
|
Service Code
|
HCPCS A9569
|
| Hospital Charge Code |
34300027
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$477.07 |
| Max. Negotiated Rate |
$2,435.40 |
| Rate for Payer: Aetna Commercial |
$2,300.10
|
| Rate for Payer: Aetna Medicare |
$703.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$845.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$845.62
|
| Rate for Payer: BCBS Complete |
$500.88
|
| Rate for Payer: BCBS MAPPO |
$676.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,224.60
|
| Rate for Payer: BCN Commercial |
$2,224.60
|
| Rate for Payer: BCN Medicare Advantage |
$676.50
|
| Rate for Payer: Cash Price |
$2,164.80
|
| Rate for Payer: Cofinity Commercial |
$2,327.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,164.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$676.50
|
| Rate for Payer: Healthscope Commercial |
$2,435.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,029.50
|
| Rate for Payer: Mclaren Medicaid |
$477.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$710.33
|
| Rate for Payer: Meridian Medicaid |
$500.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$777.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$744.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,300.10
|
| Rate for Payer: Nomi Health Commercial |
$2,218.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,029.50
|
| Rate for Payer: PACE Senior Care Partners |
$642.67
|
| Rate for Payer: PACE SWMI |
$676.50
|
| Rate for Payer: PHP Commercial |
$2,300.10
|
| Rate for Payer: PHP Medicare Advantage |
$676.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,354.22
|
| Rate for Payer: Priority Health Medicare |
$683.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,883.38
|
| Rate for Payer: Railroad Medicare Medicare |
$676.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,381.28
|
| Rate for Payer: UHC Core |
$2,259.51
|
| Rate for Payer: UHC Exchange |
$676.50
|
| Rate for Payer: UHC Medicaid |
$477.07
|
| Rate for Payer: UHC Medicare Advantage |
$676.50
|
| Rate for Payer: UHCCP Medicaid |
$477.07
|
| Rate for Payer: VA VA |
$676.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,029.50
|
|
|
HC TC99M DTPA AEROSOL <=75 MCI
|
Facility
|
IP
|
$136.70
|
|
|
Service Code
|
HCPCS A9567
|
| Hospital Charge Code |
34300030
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$95.14 |
| Max. Negotiated Rate |
$123.03 |
| Rate for Payer: Aetna Commercial |
$116.19
|
| Rate for Payer: BCBS Trust/PPO |
$112.90
|
| Rate for Payer: BCN Commercial |
$112.90
|
| Rate for Payer: Cash Price |
$109.36
|
| Rate for Payer: Cofinity Commercial |
$117.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.36
|
| Rate for Payer: Healthscope Commercial |
$123.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.19
|
| Rate for Payer: Nomi Health Commercial |
$112.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.53
|
| Rate for Payer: PHP Commercial |
$116.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$118.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.30
|
| Rate for Payer: UHC Core |
$114.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.53
|
|
|
HC TC99M DTPA AEROSOL <=75 MCI
|
Facility
|
OP
|
$136.70
|
|
|
Service Code
|
HCPCS A9567
|
| Hospital Charge Code |
34300030
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$24.10 |
| Max. Negotiated Rate |
$123.03 |
| Rate for Payer: Aetna Commercial |
$116.19
|
| Rate for Payer: Aetna Medicare |
$35.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.72
|
| Rate for Payer: BCBS Complete |
$25.30
|
| Rate for Payer: BCBS MAPPO |
$34.17
|
| Rate for Payer: BCBS Trust/PPO |
$112.38
|
| Rate for Payer: BCN Commercial |
$112.38
|
| Rate for Payer: BCN Medicare Advantage |
$34.17
|
| Rate for Payer: Cash Price |
$109.36
|
| Rate for Payer: Cofinity Commercial |
$117.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.17
|
| Rate for Payer: Healthscope Commercial |
$123.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.53
|
| Rate for Payer: Mclaren Medicaid |
$24.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.88
|
| Rate for Payer: Meridian Medicaid |
$25.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.19
|
| Rate for Payer: Nomi Health Commercial |
$112.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.53
|
| Rate for Payer: PACE Senior Care Partners |
$32.47
|
| Rate for Payer: PACE SWMI |
$34.17
|
| Rate for Payer: PHP Commercial |
$116.19
|
| Rate for Payer: PHP Medicare Advantage |
$34.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$118.93
|
| Rate for Payer: Priority Health Medicare |
$34.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.14
|
| Rate for Payer: Railroad Medicare Medicare |
$34.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.30
|
| Rate for Payer: UHC Core |
$114.14
|
| Rate for Payer: UHC Exchange |
$34.17
|
| Rate for Payer: UHC Medicaid |
$24.10
|
| Rate for Payer: UHC Medicare Advantage |
$34.17
|
| Rate for Payer: UHCCP Medicaid |
$24.10
|
| Rate for Payer: VA VA |
$34.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.53
|
|
|
HC TC 99M MAA PER STUDY
|
Facility
|
IP
|
$140.39
|
|
|
Service Code
|
HCPCS A9540
|
| Hospital Charge Code |
34300017
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$97.71 |
| Max. Negotiated Rate |
$126.35 |
| Rate for Payer: Aetna Commercial |
$119.33
|
| Rate for Payer: BCBS Trust/PPO |
$115.95
|
| Rate for Payer: BCN Commercial |
$115.95
|
| Rate for Payer: Cash Price |
$112.31
|
| Rate for Payer: Cofinity Commercial |
$120.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.31
|
| Rate for Payer: Healthscope Commercial |
$126.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.33
|
| Rate for Payer: Nomi Health Commercial |
$115.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.29
|
| Rate for Payer: PHP Commercial |
$119.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$122.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.54
|
| Rate for Payer: UHC Core |
$117.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.29
|
|
|
HC TC 99M MAA PER STUDY
|
Facility
|
OP
|
$140.39
|
|
|
Service Code
|
HCPCS A9540
|
| Hospital Charge Code |
34300017
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$24.75 |
| Max. Negotiated Rate |
$126.35 |
| Rate for Payer: Aetna Commercial |
$119.33
|
| Rate for Payer: Aetna Medicare |
$36.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.87
|
| Rate for Payer: BCBS Complete |
$25.99
|
| Rate for Payer: BCBS MAPPO |
$35.10
|
| Rate for Payer: BCBS Trust/PPO |
$115.41
|
| Rate for Payer: BCN Commercial |
$115.41
|
| Rate for Payer: BCN Medicare Advantage |
$35.10
|
| Rate for Payer: Cash Price |
$112.31
|
| Rate for Payer: Cofinity Commercial |
$120.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.10
|
| Rate for Payer: Healthscope Commercial |
$126.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.29
|
| Rate for Payer: Mclaren Medicaid |
$24.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.85
|
| Rate for Payer: Meridian Medicaid |
$25.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.33
|
| Rate for Payer: Nomi Health Commercial |
$115.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.29
|
| Rate for Payer: PACE Senior Care Partners |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.10
|
| Rate for Payer: PHP Commercial |
$119.33
|
| Rate for Payer: PHP Medicare Advantage |
$35.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$122.14
|
| Rate for Payer: Priority Health Medicare |
$35.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.71
|
| Rate for Payer: Railroad Medicare Medicare |
$35.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.54
|
| Rate for Payer: UHC Core |
$117.23
|
| Rate for Payer: UHC Exchange |
$35.10
|
| Rate for Payer: UHC Medicaid |
$24.75
|
| Rate for Payer: UHC Medicare Advantage |
$35.10
|
| Rate for Payer: UHCCP Medicaid |
$24.75
|
| Rate for Payer: VA VA |
$35.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.29
|
|
|
HC TC 99M MDP PER STUDY
|
Facility
|
IP
|
$145.69
|
|
|
Service Code
|
HCPCS A9503
|
| Hospital Charge Code |
34300018
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$101.40 |
| Max. Negotiated Rate |
$131.12 |
| Rate for Payer: Aetna Commercial |
$123.84
|
| Rate for Payer: BCBS Trust/PPO |
$120.33
|
| Rate for Payer: BCN Commercial |
$120.33
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cofinity Commercial |
$125.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.55
|
| Rate for Payer: Healthscope Commercial |
$131.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Nomi Health Commercial |
$119.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.27
|
| Rate for Payer: PHP Commercial |
$123.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$126.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.21
|
| Rate for Payer: UHC Core |
$121.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.27
|
|
|
HC TC 99M MDP PER STUDY
|
Facility
|
OP
|
$145.69
|
|
|
Service Code
|
HCPCS A9503
|
| Hospital Charge Code |
34300018
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$25.69 |
| Max. Negotiated Rate |
$131.12 |
| Rate for Payer: Aetna Commercial |
$123.84
|
| Rate for Payer: Aetna Medicare |
$37.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.53
|
| Rate for Payer: BCBS Complete |
$26.97
|
| Rate for Payer: BCBS MAPPO |
$36.42
|
| Rate for Payer: BCBS Trust/PPO |
$119.77
|
| Rate for Payer: BCN Commercial |
$119.77
|
| Rate for Payer: BCN Medicare Advantage |
$36.42
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cofinity Commercial |
$125.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.42
|
| Rate for Payer: Healthscope Commercial |
$131.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.27
|
| Rate for Payer: Mclaren Medicaid |
$25.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.24
|
| Rate for Payer: Meridian Medicaid |
$26.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Nomi Health Commercial |
$119.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.27
|
| Rate for Payer: PACE Senior Care Partners |
$34.60
|
| Rate for Payer: PACE SWMI |
$36.42
|
| Rate for Payer: PHP Commercial |
$123.84
|
| Rate for Payer: PHP Medicare Advantage |
$36.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$126.75
|
| Rate for Payer: Priority Health Medicare |
$36.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.40
|
| Rate for Payer: Railroad Medicare Medicare |
$36.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.21
|
| Rate for Payer: UHC Core |
$121.65
|
| Rate for Payer: UHC Exchange |
$36.42
|
| Rate for Payer: UHC Medicaid |
$25.69
|
| Rate for Payer: UHC Medicare Advantage |
$36.42
|
| Rate for Payer: UHCCP Medicaid |
$25.69
|
| Rate for Payer: VA VA |
$36.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.27
|
|
|
HC TC 99M PERTECHNETATE PER MCI
|
Facility
|
OP
|
$48.56
|
|
|
Service Code
|
HCPCS A9512
|
| Hospital Charge Code |
34300029
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$8.56 |
| Max. Negotiated Rate |
$43.70 |
| Rate for Payer: Aetna Commercial |
$41.28
|
| Rate for Payer: Aetna Medicare |
$12.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.18
|
| Rate for Payer: BCBS Complete |
$8.99
|
| Rate for Payer: BCBS MAPPO |
$12.14
|
| Rate for Payer: BCBS Trust/PPO |
$39.92
|
| Rate for Payer: BCN Commercial |
$39.92
|
| Rate for Payer: BCN Medicare Advantage |
$12.14
|
| Rate for Payer: Cash Price |
$38.85
|
| Rate for Payer: Cofinity Commercial |
$41.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.14
|
| Rate for Payer: Healthscope Commercial |
$43.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.42
|
| Rate for Payer: Mclaren Medicaid |
$8.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.75
|
| Rate for Payer: Meridian Medicaid |
$8.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.28
|
| Rate for Payer: Nomi Health Commercial |
$39.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.42
|
| Rate for Payer: PACE Senior Care Partners |
$11.53
|
| Rate for Payer: PACE SWMI |
$12.14
|
| Rate for Payer: PHP Commercial |
$41.28
|
| Rate for Payer: PHP Medicare Advantage |
$12.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.25
|
| Rate for Payer: Priority Health Medicare |
$12.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.80
|
| Rate for Payer: Railroad Medicare Medicare |
$12.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.73
|
| Rate for Payer: UHC Core |
$40.55
|
| Rate for Payer: UHC Exchange |
$12.14
|
| Rate for Payer: UHC Medicaid |
$8.56
|
| Rate for Payer: UHC Medicare Advantage |
$12.14
|
| Rate for Payer: UHCCP Medicaid |
$8.56
|
| Rate for Payer: VA VA |
$12.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.42
|
|
|
HC TC 99M PERTECHNETATE PER MCI
|
Facility
|
IP
|
$48.56
|
|
|
Service Code
|
HCPCS A9512
|
| Hospital Charge Code |
34300029
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$33.80 |
| Max. Negotiated Rate |
$43.70 |
| Rate for Payer: Aetna Commercial |
$41.28
|
| Rate for Payer: BCBS Trust/PPO |
$40.11
|
| Rate for Payer: BCN Commercial |
$40.11
|
| Rate for Payer: Cash Price |
$38.85
|
| Rate for Payer: Cofinity Commercial |
$41.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.85
|
| Rate for Payer: Healthscope Commercial |
$43.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.28
|
| Rate for Payer: Nomi Health Commercial |
$39.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.42
|
| Rate for Payer: PHP Commercial |
$41.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.73
|
| Rate for Payer: UHC Core |
$40.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.42
|
|
|
HC TC 99M PYROPHOSPHATE PER STUDY UP TO 25 MILLICURIES
|
Facility
|
IP
|
$240.89
|
|
|
Service Code
|
CPT A9538
|
| Hospital Charge Code |
34300037
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$167.66 |
| Max. Negotiated Rate |
$216.80 |
| Rate for Payer: Aetna Commercial |
$204.76
|
| Rate for Payer: BCBS Trust/PPO |
$198.95
|
| Rate for Payer: BCN Commercial |
$198.95
|
| Rate for Payer: Cash Price |
$192.71
|
| Rate for Payer: Cofinity Commercial |
$207.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.71
|
| Rate for Payer: Healthscope Commercial |
$216.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.76
|
| Rate for Payer: Nomi Health Commercial |
$197.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.67
|
| Rate for Payer: PHP Commercial |
$204.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$209.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.98
|
| Rate for Payer: UHC Core |
$201.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.67
|
|
|
HC TC 99M PYROPHOSPHATE PER STUDY UP TO 25 MILLICURIES
|
Facility
|
OP
|
$240.89
|
|
|
Service Code
|
CPT A9538
|
| Hospital Charge Code |
34300037
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$42.47 |
| Max. Negotiated Rate |
$216.80 |
| Rate for Payer: Aetna Commercial |
$204.76
|
| Rate for Payer: Aetna Medicare |
$62.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75.28
|
| Rate for Payer: BCBS Complete |
$44.59
|
| Rate for Payer: BCBS MAPPO |
$60.22
|
| Rate for Payer: BCBS Trust/PPO |
$198.04
|
| Rate for Payer: BCN Commercial |
$198.04
|
| Rate for Payer: BCN Medicare Advantage |
$60.22
|
| Rate for Payer: Cash Price |
$192.71
|
| Rate for Payer: Cofinity Commercial |
$207.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.22
|
| Rate for Payer: Healthscope Commercial |
$216.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.67
|
| Rate for Payer: Mclaren Medicaid |
$42.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.23
|
| Rate for Payer: Meridian Medicaid |
$44.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$66.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.76
|
| Rate for Payer: Nomi Health Commercial |
$197.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.67
|
| Rate for Payer: PACE Senior Care Partners |
$57.21
|
| Rate for Payer: PACE SWMI |
$60.22
|
| Rate for Payer: PHP Commercial |
$204.76
|
| Rate for Payer: PHP Medicare Advantage |
$60.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$209.57
|
| Rate for Payer: Priority Health Medicare |
$60.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.66
|
| Rate for Payer: Railroad Medicare Medicare |
$60.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.98
|
| Rate for Payer: UHC Core |
$201.14
|
| Rate for Payer: UHC Exchange |
$60.22
|
| Rate for Payer: UHC Medicaid |
$42.47
|
| Rate for Payer: UHC Medicare Advantage |
$60.22
|
| Rate for Payer: UHCCP Medicaid |
$42.47
|
| Rate for Payer: VA VA |
$60.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.67
|
|
|
HC TC 99M SULFUR COLLOID PER STUDY
|
Facility
|
IP
|
$255.30
|
|
|
Service Code
|
HCPCS A9541
|
| Hospital Charge Code |
34300020
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$177.69 |
| Max. Negotiated Rate |
$229.77 |
| Rate for Payer: Aetna Commercial |
$217.00
|
| Rate for Payer: BCBS Trust/PPO |
$210.85
|
| Rate for Payer: BCN Commercial |
$210.85
|
| Rate for Payer: Cash Price |
$204.24
|
| Rate for Payer: Cofinity Commercial |
$219.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.24
|
| Rate for Payer: Healthscope Commercial |
$229.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.00
|
| Rate for Payer: Nomi Health Commercial |
$209.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.47
|
| Rate for Payer: PHP Commercial |
$217.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$222.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.66
|
| Rate for Payer: UHC Core |
$213.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.47
|
|
|
HC TC 99M SULFUR COLLOID PER STUDY
|
Facility
|
OP
|
$255.30
|
|
|
Service Code
|
HCPCS A9541
|
| Hospital Charge Code |
34300020
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$45.01 |
| Max. Negotiated Rate |
$229.77 |
| Rate for Payer: Aetna Commercial |
$217.00
|
| Rate for Payer: Aetna Medicare |
$66.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.78
|
| Rate for Payer: BCBS Complete |
$47.26
|
| Rate for Payer: BCBS MAPPO |
$63.83
|
| Rate for Payer: BCBS Trust/PPO |
$209.88
|
| Rate for Payer: BCN Commercial |
$209.88
|
| Rate for Payer: BCN Medicare Advantage |
$63.83
|
| Rate for Payer: Cash Price |
$204.24
|
| Rate for Payer: Cofinity Commercial |
$219.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.83
|
| Rate for Payer: Healthscope Commercial |
$229.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.47
|
| Rate for Payer: Mclaren Medicaid |
$45.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.02
|
| Rate for Payer: Meridian Medicaid |
$47.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.00
|
| Rate for Payer: Nomi Health Commercial |
$209.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.47
|
| Rate for Payer: PACE Senior Care Partners |
$60.63
|
| Rate for Payer: PACE SWMI |
$63.83
|
| Rate for Payer: PHP Commercial |
$217.00
|
| Rate for Payer: PHP Medicare Advantage |
$63.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$222.11
|
| Rate for Payer: Priority Health Medicare |
$64.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.69
|
| Rate for Payer: Railroad Medicare Medicare |
$63.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.66
|
| Rate for Payer: UHC Core |
$213.18
|
| Rate for Payer: UHC Exchange |
$63.83
|
| Rate for Payer: UHC Medicaid |
$45.01
|
| Rate for Payer: UHC Medicare Advantage |
$63.83
|
| Rate for Payer: UHCCP Medicaid |
$45.01
|
| Rate for Payer: VA VA |
$63.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.47
|
|
|
HC T CELL ACUTE LYMPH LEUK
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000133
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$25.34 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: BCBS Trust/PPO |
$30.07
|
| Rate for Payer: BCN Commercial |
$30.07
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.31
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.04
|
| Rate for Payer: UHC Core |
$30.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC T CELL ACUTE LYMPH LEUK
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000133
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna Medicare |
$9.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.38
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$9.10
|
| Rate for Payer: BCBS Trust/PPO |
$29.93
|
| Rate for Payer: BCN Commercial |
$29.93
|
| Rate for Payer: BCN Medicare Advantage |
$9.10
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.10
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.56
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.31
|
| Rate for Payer: PACE Senior Care Partners |
$8.65
|
| Rate for Payer: PACE SWMI |
$9.10
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: PHP Medicare Advantage |
$9.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.68
|
| Rate for Payer: Priority Health Medicare |
$9.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.34
|
| Rate for Payer: Railroad Medicare Medicare |
$9.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.04
|
| Rate for Payer: UHC Core |
$30.40
|
| Rate for Payer: UHC Exchange |
$9.10
|
| Rate for Payer: UHC Medicaid |
$6.42
|
| Rate for Payer: UHC Medicare Advantage |
$9.10
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: VA VA |
$9.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
OP
|
$120.98
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000040
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$21.33 |
| Max. Negotiated Rate |
$108.88 |
| Rate for Payer: Aetna Commercial |
$102.83
|
| Rate for Payer: Aetna Medicare |
$31.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.81
|
| Rate for Payer: BCBS Complete |
$22.39
|
| Rate for Payer: BCBS MAPPO |
$30.25
|
| Rate for Payer: BCBS Trust/PPO |
$99.46
|
| Rate for Payer: BCN Commercial |
$99.46
|
| Rate for Payer: BCN Medicare Advantage |
$30.25
|
| Rate for Payer: Cash Price |
$96.78
|
| Rate for Payer: Cofinity Commercial |
$104.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.25
|
| Rate for Payer: Healthscope Commercial |
$108.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.73
|
| Rate for Payer: Mclaren Medicaid |
$21.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.76
|
| Rate for Payer: Meridian Medicaid |
$22.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.83
|
| Rate for Payer: Nomi Health Commercial |
$99.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.73
|
| Rate for Payer: PACE Senior Care Partners |
$28.73
|
| Rate for Payer: PACE SWMI |
$30.25
|
| Rate for Payer: PHP Commercial |
$102.83
|
| Rate for Payer: PHP Medicare Advantage |
$30.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$105.25
|
| Rate for Payer: Priority Health Medicare |
$30.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.20
|
| Rate for Payer: Railroad Medicare Medicare |
$30.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.46
|
| Rate for Payer: UHC Core |
$101.02
|
| Rate for Payer: UHC Exchange |
$30.25
|
| Rate for Payer: UHC Medicaid |
$21.33
|
| Rate for Payer: UHC Medicare Advantage |
$30.25
|
| Rate for Payer: UHCCP Medicaid |
$21.33
|
| Rate for Payer: VA VA |
$30.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.73
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
IP
|
$120.98
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000040
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$84.20 |
| Max. Negotiated Rate |
$108.88 |
| Rate for Payer: Aetna Commercial |
$102.83
|
| Rate for Payer: BCBS Trust/PPO |
$99.92
|
| Rate for Payer: BCN Commercial |
$99.92
|
| Rate for Payer: Cash Price |
$96.78
|
| Rate for Payer: Cofinity Commercial |
$104.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.78
|
| Rate for Payer: Healthscope Commercial |
$108.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.83
|
| Rate for Payer: Nomi Health Commercial |
$99.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.73
|
| Rate for Payer: PHP Commercial |
$102.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$105.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.46
|
| Rate for Payer: UHC Core |
$101.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.73
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
IP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000029
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$74.60 |
| Max. Negotiated Rate |
$96.46 |
| Rate for Payer: Aetna Commercial |
$91.10
|
| Rate for Payer: BCBS Trust/PPO |
$88.52
|
| Rate for Payer: BCN Commercial |
$88.52
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Commercial |
$92.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Healthscope Commercial |
$96.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Nomi Health Commercial |
$87.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| Rate for Payer: PHP Commercial |
$91.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.32
|
| Rate for Payer: UHC Core |
$89.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.39
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
OP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000029
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$96.46 |
| Rate for Payer: Aetna Commercial |
$91.10
|
| Rate for Payer: Aetna Medicare |
$27.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.49
|
| Rate for Payer: BCBS Complete |
$19.84
|
| Rate for Payer: BCBS MAPPO |
$26.80
|
| Rate for Payer: BCBS Trust/PPO |
$88.11
|
| Rate for Payer: BCN Commercial |
$88.11
|
| Rate for Payer: BCN Medicare Advantage |
$26.80
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Commercial |
$92.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.80
|
| Rate for Payer: Healthscope Commercial |
$96.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.39
|
| Rate for Payer: Mclaren Medicaid |
$18.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.13
|
| Rate for Payer: Meridian Medicaid |
$19.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Nomi Health Commercial |
$87.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| Rate for Payer: PACE Senior Care Partners |
$25.46
|
| Rate for Payer: PACE SWMI |
$26.80
|
| Rate for Payer: PHP Commercial |
$91.10
|
| Rate for Payer: PHP Medicare Advantage |
$26.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.25
|
| Rate for Payer: Priority Health Medicare |
$27.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.60
|
| Rate for Payer: Railroad Medicare Medicare |
$26.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.32
|
| Rate for Payer: UHC Core |
$89.50
|
| Rate for Payer: UHC Exchange |
$26.80
|
| Rate for Payer: UHC Medicaid |
$18.90
|
| Rate for Payer: UHC Medicare Advantage |
$26.80
|
| Rate for Payer: UHCCP Medicaid |
$18.90
|
| Rate for Payer: VA VA |
$26.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.39
|
|
|
HC T CELL ACUTE LYMPH LEUK FISH
|
Facility
|
IP
|
$86.35
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000039
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$60.10 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: BCBS Trust/PPO |
$71.32
|
| Rate for Payer: BCN Commercial |
$71.32
|
| 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: Opus (Opus Packaging Group) HMA |
$64.76
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.10
|
| 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 T CELL ACUTE LYMPH LEUK FISH
|
Facility
|
OP
|
$86.35
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000039
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.22 |
| 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 |
$15.98
|
| Rate for Payer: BCBS MAPPO |
$21.59
|
| Rate for Payer: BCBS Trust/PPO |
$70.99
|
| Rate for Payer: BCN Commercial |
$70.99
|
| Rate for Payer: BCN Medicare Advantage |
$21.59
|
| 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 |
$15.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.67
|
| Rate for Payer: Meridian Medicaid |
$15.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$70.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.76
|
| 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 |
$15.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75.12
|
| Rate for Payer: Priority Health Medicare |
$21.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.10
|
| 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 Exchange |
$21.59
|
| Rate for Payer: UHC Medicaid |
$15.22
|
| Rate for Payer: UHC Medicare Advantage |
$21.59
|
| Rate for Payer: UHCCP Medicaid |
$15.22
|
| Rate for Payer: VA VA |
$21.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.76
|
|
