|
HC T4 TOTAL
|
Facility
|
IP
|
$46.92
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100435
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.50 |
| Max. Negotiated Rate |
$42.23 |
| Rate for Payer: Aetna Commercial |
$39.88
|
| Rate for Payer: BCBS Trust/PPO |
$38.30
|
| Rate for Payer: BCN Commercial |
$36.26
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$40.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.54
|
| Rate for Payer: Healthscope Commercial |
$42.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.88
|
| Rate for Payer: Nomi Health Commercial |
$38.47
|
| Rate for Payer: PHP Commercial |
$39.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.50
|
| Rate for Payer: Priority Health HMO/PPO |
$40.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.29
|
| Rate for Payer: UHC Core |
$39.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.19
|
|
|
HC T4 TOTAL ONLY
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100759
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.97 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$11.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.34
|
| Rate for Payer: BCBS Complete |
$5.22
|
| Rate for Payer: BCBS MAPPO |
$11.47
|
| Rate for Payer: BCBS Trust/PPO |
$37.73
|
| Rate for Payer: BCN Commercial |
$35.69
|
| Rate for Payer: BCN Medicare Advantage |
$11.47
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.47
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$4.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.05
|
| Rate for Payer: Meridian Medicaid |
$5.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: PACE Senior Care Partners |
$10.90
|
| Rate for Payer: PACE SWMI |
$11.47
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$11.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health HMO/PPO |
$39.93
|
| Rate for Payer: Priority Health Medicare |
$11.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.75
|
| Rate for Payer: Railroad Medicare Medicare |
$11.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.47
|
| Rate for Payer: UHC Exchange |
$11.47
|
| Rate for Payer: UHC Medicare Advantage |
$11.47
|
| Rate for Payer: UHCCP Medicaid |
$4.97
|
| Rate for Payer: VA VA |
$11.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC T4 TOTAL ONLY
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100759
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.84 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$37.47
|
| Rate for Payer: BCN Commercial |
$35.47
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$37.64
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health HMO/PPO |
$39.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC TACROLIMUS LEVEL
|
Facility
|
IP
|
$65.55
|
|
|
Service Code
|
CPT 80197
|
| Hospital Charge Code |
30100047
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.61 |
| Max. Negotiated Rate |
$58.99 |
| Rate for Payer: Aetna Commercial |
$55.72
|
| Rate for Payer: BCBS Trust/PPO |
$53.51
|
| Rate for Payer: BCN Commercial |
$50.66
|
| Rate for Payer: Cash Price |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$56.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.44
|
| Rate for Payer: Healthscope Commercial |
$58.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.72
|
| Rate for Payer: Nomi Health Commercial |
$53.75
|
| Rate for Payer: PHP Commercial |
$55.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.61
|
| Rate for Payer: Priority Health HMO/PPO |
$57.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.68
|
| Rate for Payer: UHC Core |
$54.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.16
|
|
|
HC TACROLIMUS LEVEL
|
Facility
|
OP
|
$65.55
|
|
|
Service Code
|
CPT 80197
|
| Hospital Charge Code |
30100047
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$58.99 |
| Rate for Payer: Aetna Commercial |
$55.72
|
| Rate for Payer: Aetna Medicare |
$17.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.48
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$16.39
|
| Rate for Payer: BCBS Trust/PPO |
$53.89
|
| Rate for Payer: BCN Commercial |
$50.97
|
| Rate for Payer: BCN Medicare Advantage |
$16.39
|
| Rate for Payer: Cash Price |
$52.44
|
| Rate for Payer: Cash Price |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$56.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.39
|
| Rate for Payer: Healthscope Commercial |
$58.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.16
|
| Rate for Payer: Mclaren Medicaid |
$9.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.21
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.72
|
| Rate for Payer: Nomi Health Commercial |
$53.75
|
| Rate for Payer: PACE Senior Care Partners |
$15.57
|
| Rate for Payer: PACE SWMI |
$16.39
|
| Rate for Payer: PHP Commercial |
$55.72
|
| Rate for Payer: PHP Medicare Advantage |
$16.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.61
|
| Rate for Payer: Priority Health HMO/PPO |
$57.03
|
| Rate for Payer: Priority Health Medicare |
$16.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.92
|
| Rate for Payer: Railroad Medicare Medicare |
$16.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.68
|
| Rate for Payer: UHC Core |
$54.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.39
|
| Rate for Payer: UHC Exchange |
$16.39
|
| Rate for Payer: UHC Medicare Advantage |
$16.39
|
| Rate for Payer: UHCCP Medicaid |
$9.93
|
| Rate for Payer: VA VA |
$16.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.16
|
|
|
HC T AND B CELL QUANTITATION
|
Facility
|
IP
|
$61.72
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200204
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.12 |
| Max. Negotiated Rate |
$55.55 |
| Rate for Payer: Aetna Commercial |
$52.46
|
| Rate for Payer: BCBS Trust/PPO |
$50.38
|
| Rate for Payer: BCN Commercial |
$47.70
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Healthscope Commercial |
$55.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: PHP Commercial |
$52.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health HMO/PPO |
$53.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.31
|
| Rate for Payer: UHC Core |
$51.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.29
|
|
|
HC T AND B CELL QUANTITATION
|
Facility
|
OP
|
$61.72
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200204
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.66 |
| Max. Negotiated Rate |
$55.55 |
| Rate for Payer: Aetna Commercial |
$52.46
|
| Rate for Payer: Aetna Medicare |
$16.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.29
|
| Rate for Payer: BCBS Complete |
$28.64
|
| Rate for Payer: BCBS MAPPO |
$15.43
|
| Rate for Payer: BCBS Trust/PPO |
$50.74
|
| Rate for Payer: BCN Commercial |
$47.99
|
| Rate for Payer: BCN Medicare Advantage |
$15.43
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.43
|
| Rate for Payer: Healthscope Commercial |
$55.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.29
|
| Rate for Payer: Mclaren Medicaid |
$27.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.20
|
| Rate for Payer: Meridian Medicaid |
$28.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: PACE Senior Care Partners |
$14.66
|
| Rate for Payer: PACE SWMI |
$15.43
|
| Rate for Payer: PHP Commercial |
$52.46
|
| Rate for Payer: PHP Medicare Advantage |
$15.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health HMO/PPO |
$53.70
|
| Rate for Payer: Priority Health Medicare |
$15.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.35
|
| Rate for Payer: Railroad Medicare Medicare |
$15.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.31
|
| Rate for Payer: UHC Core |
$51.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.43
|
| Rate for Payer: UHC Exchange |
$15.43
|
| Rate for Payer: UHC Medicare Advantage |
$15.43
|
| Rate for Payer: UHCCP Medicaid |
$27.28
|
| Rate for Payer: VA VA |
$15.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.29
|
|
|
HC T AND B CELL QUANTITATION CMPT1
|
Facility
|
OP
|
$76.86
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200206
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.25 |
| Max. Negotiated Rate |
$69.17 |
| Rate for Payer: Aetna Commercial |
$65.33
|
| Rate for Payer: Aetna Medicare |
$19.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.02
|
| Rate for Payer: BCBS Complete |
$35.67
|
| Rate for Payer: BCBS MAPPO |
$19.21
|
| Rate for Payer: BCBS Trust/PPO |
$63.19
|
| Rate for Payer: BCN Commercial |
$59.76
|
| Rate for Payer: BCN Medicare Advantage |
$19.21
|
| Rate for Payer: Cash Price |
$61.49
|
| Rate for Payer: Cash Price |
$61.49
|
| Rate for Payer: Cofinity Commercial |
$66.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.21
|
| Rate for Payer: Healthscope Commercial |
$69.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.65
|
| Rate for Payer: Mclaren Medicaid |
$33.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.18
|
| Rate for Payer: Meridian Medicaid |
$35.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.33
|
| Rate for Payer: Nomi Health Commercial |
$63.03
|
| Rate for Payer: PACE Senior Care Partners |
$18.25
|
| Rate for Payer: PACE SWMI |
$19.21
|
| Rate for Payer: PHP Commercial |
$65.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.96
|
| Rate for Payer: Priority Health HMO/PPO |
$66.87
|
| Rate for Payer: Priority Health Medicare |
$19.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.50
|
| Rate for Payer: Railroad Medicare Medicare |
$19.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.64
|
| Rate for Payer: UHC Core |
$64.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.21
|
| Rate for Payer: UHC Exchange |
$19.21
|
| Rate for Payer: UHC Medicare Advantage |
$19.21
|
| Rate for Payer: UHCCP Medicaid |
$33.97
|
| Rate for Payer: VA VA |
$19.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.65
|
|
|
HC T AND B CELL QUANTITATION CMPT1
|
Facility
|
IP
|
$76.86
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200206
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.96 |
| Max. Negotiated Rate |
$69.17 |
| Rate for Payer: Aetna Commercial |
$65.33
|
| Rate for Payer: BCBS Trust/PPO |
$62.74
|
| Rate for Payer: BCN Commercial |
$59.40
|
| Rate for Payer: Cash Price |
$61.49
|
| Rate for Payer: Cofinity Commercial |
$66.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.49
|
| Rate for Payer: Healthscope Commercial |
$69.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.33
|
| Rate for Payer: Nomi Health Commercial |
$63.03
|
| Rate for Payer: PHP Commercial |
$65.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.96
|
| Rate for Payer: Priority Health HMO/PPO |
$66.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.64
|
| Rate for Payer: UHC Core |
$64.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.65
|
|
|
HC T AND B CELL QUANTITATION CMPT2
|
Facility
|
OP
|
$61.72
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
30200202
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.66 |
| Max. Negotiated Rate |
$55.55 |
| Rate for Payer: Aetna Commercial |
$52.46
|
| Rate for Payer: Aetna Medicare |
$16.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.29
|
| Rate for Payer: BCBS Complete |
$28.64
|
| Rate for Payer: BCBS MAPPO |
$15.43
|
| Rate for Payer: BCBS Trust/PPO |
$50.74
|
| Rate for Payer: BCN Commercial |
$47.99
|
| Rate for Payer: BCN Medicare Advantage |
$15.43
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.43
|
| Rate for Payer: Healthscope Commercial |
$55.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.29
|
| Rate for Payer: Mclaren Medicaid |
$27.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.20
|
| Rate for Payer: Meridian Medicaid |
$28.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: PACE Senior Care Partners |
$14.66
|
| Rate for Payer: PACE SWMI |
$15.43
|
| Rate for Payer: PHP Commercial |
$52.46
|
| Rate for Payer: PHP Medicare Advantage |
$15.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health HMO/PPO |
$53.70
|
| Rate for Payer: Priority Health Medicare |
$15.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.35
|
| Rate for Payer: Railroad Medicare Medicare |
$15.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.31
|
| Rate for Payer: UHC Core |
$51.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.43
|
| Rate for Payer: UHC Exchange |
$15.43
|
| Rate for Payer: UHC Medicare Advantage |
$15.43
|
| Rate for Payer: UHCCP Medicaid |
$27.28
|
| Rate for Payer: VA VA |
$15.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.29
|
|
|
HC T AND B CELL QUANTITATION CMPT2
|
Facility
|
IP
|
$61.72
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
30200202
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.12 |
| Max. Negotiated Rate |
$55.55 |
| Rate for Payer: Aetna Commercial |
$52.46
|
| Rate for Payer: BCBS Trust/PPO |
$50.38
|
| Rate for Payer: BCN Commercial |
$47.70
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Healthscope Commercial |
$55.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: PHP Commercial |
$52.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health HMO/PPO |
$53.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.31
|
| Rate for Payer: UHC Core |
$51.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.29
|
|
|
HC T AND B CELL QUANTITATION CMPT3
|
Facility
|
IP
|
$61.72
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
30200203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.12 |
| Max. Negotiated Rate |
$55.55 |
| Rate for Payer: Aetna Commercial |
$52.46
|
| Rate for Payer: BCBS Trust/PPO |
$50.38
|
| Rate for Payer: BCN Commercial |
$47.70
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Healthscope Commercial |
$55.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: PHP Commercial |
$52.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health HMO/PPO |
$53.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.31
|
| Rate for Payer: UHC Core |
$51.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.29
|
|
|
HC T AND B CELL QUANTITATION CMPT3
|
Facility
|
OP
|
$61.72
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
30200203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.66 |
| Max. Negotiated Rate |
$55.55 |
| Rate for Payer: Aetna Commercial |
$52.46
|
| Rate for Payer: Aetna Medicare |
$16.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.29
|
| Rate for Payer: BCBS Complete |
$28.64
|
| Rate for Payer: BCBS MAPPO |
$15.43
|
| Rate for Payer: BCBS Trust/PPO |
$50.74
|
| Rate for Payer: BCN Commercial |
$47.99
|
| Rate for Payer: BCN Medicare Advantage |
$15.43
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.43
|
| Rate for Payer: Healthscope Commercial |
$55.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.29
|
| Rate for Payer: Mclaren Medicaid |
$27.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.20
|
| Rate for Payer: Meridian Medicaid |
$28.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$50.61
|
| Rate for Payer: PACE Senior Care Partners |
$14.66
|
| Rate for Payer: PACE SWMI |
$15.43
|
| Rate for Payer: PHP Commercial |
$52.46
|
| Rate for Payer: PHP Medicare Advantage |
$15.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health HMO/PPO |
$53.70
|
| Rate for Payer: Priority Health Medicare |
$15.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.35
|
| Rate for Payer: Railroad Medicare Medicare |
$15.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.31
|
| Rate for Payer: UHC Core |
$51.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.43
|
| Rate for Payer: UHC Exchange |
$15.43
|
| Rate for Payer: UHC Medicare Advantage |
$15.43
|
| Rate for Payer: UHCCP Medicaid |
$27.28
|
| Rate for Payer: VA VA |
$15.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.29
|
|
|
HC T AND B CELL QUANTITATION CMPT4
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 86356
|
| Hospital Charge Code |
30200512
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.50 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: BCBS Trust/PPO |
$24.49
|
| Rate for Payer: BCN Commercial |
$23.18
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.50
|
| Rate for Payer: Nomi Health Commercial |
$24.60
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO |
$26.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.40
|
| Rate for Payer: UHC Core |
$25.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC T AND B CELL QUANTITATION CMPT4
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 86356
|
| Hospital Charge Code |
30200512
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.12 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: Aetna Medicare |
$7.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.38
|
| Rate for Payer: BCBS Complete |
$20.33
|
| Rate for Payer: BCBS MAPPO |
$7.50
|
| Rate for Payer: BCBS Trust/PPO |
$24.66
|
| Rate for Payer: BCN Commercial |
$23.32
|
| Rate for Payer: BCN Medicare Advantage |
$7.50
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.50
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Mclaren Medicaid |
$19.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.88
|
| Rate for Payer: Meridian Medicaid |
$20.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.50
|
| Rate for Payer: Nomi Health Commercial |
$24.60
|
| Rate for Payer: PACE Senior Care Partners |
$7.12
|
| Rate for Payer: PACE SWMI |
$7.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: PHP Medicare Advantage |
$7.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO |
$26.10
|
| Rate for Payer: Priority Health Medicare |
$7.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.10
|
| Rate for Payer: Railroad Medicare Medicare |
$7.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.40
|
| Rate for Payer: UHC Core |
$25.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.50
|
| Rate for Payer: UHC Exchange |
$7.50
|
| Rate for Payer: UHC Medicare Advantage |
$7.50
|
| Rate for Payer: UHCCP Medicaid |
$19.36
|
| Rate for Payer: VA VA |
$7.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC TANGENTIAL BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$83.55
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
76100149
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$54.31 |
| Max. Negotiated Rate |
$75.19 |
| Rate for Payer: Aetna Commercial |
$71.02
|
| Rate for Payer: BCBS Trust/PPO |
$68.20
|
| Rate for Payer: BCN Commercial |
$64.57
|
| Rate for Payer: Cash Price |
$66.84
|
| Rate for Payer: Cofinity Commercial |
$71.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.84
|
| Rate for Payer: Healthscope Commercial |
$75.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.02
|
| Rate for Payer: Nomi Health Commercial |
$68.51
|
| Rate for Payer: PHP Commercial |
$71.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.31
|
| Rate for Payer: Priority Health HMO/PPO |
$72.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.52
|
| Rate for Payer: UHC Core |
$69.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.66
|
|
|
HC TANGENTIAL BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$83.55
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
76100149
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.84 |
| Max. Negotiated Rate |
$75.19 |
| Rate for Payer: Aetna Commercial |
$71.02
|
| Rate for Payer: Aetna Medicare |
$21.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.11
|
| Rate for Payer: BCBS Complete |
$33.42
|
| Rate for Payer: BCBS MAPPO |
$20.89
|
| Rate for Payer: BCBS Trust/PPO |
$68.69
|
| Rate for Payer: BCN Commercial |
$64.96
|
| Rate for Payer: BCN Medicare Advantage |
$20.89
|
| Rate for Payer: Cash Price |
$66.84
|
| Rate for Payer: Cofinity Commercial |
$71.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.89
|
| Rate for Payer: Healthscope Commercial |
$75.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.02
|
| Rate for Payer: Nomi Health Commercial |
$68.51
|
| Rate for Payer: PACE Senior Care Partners |
$19.84
|
| Rate for Payer: PACE SWMI |
$20.89
|
| Rate for Payer: PHP Commercial |
$71.02
|
| Rate for Payer: PHP Medicare Advantage |
$20.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.31
|
| Rate for Payer: Priority Health HMO/PPO |
$72.69
|
| Rate for Payer: Priority Health Medicare |
$21.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.98
|
| Rate for Payer: Railroad Medicare Medicare |
$20.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.52
|
| Rate for Payer: UHC Core |
$69.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.89
|
| Rate for Payer: UHC Exchange |
$20.89
|
| Rate for Payer: UHC Medicare Advantage |
$20.89
|
| Rate for Payer: VA VA |
$20.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.66
|
|
|
HC TANGENTIAL BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$275.71
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
76100148
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.48 |
| Max. Negotiated Rate |
$248.14 |
| Rate for Payer: Aetna Commercial |
$234.35
|
| Rate for Payer: Aetna Medicare |
$71.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.16
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$68.93
|
| Rate for Payer: BCBS Trust/PPO |
$226.66
|
| Rate for Payer: BCN Commercial |
$214.36
|
| Rate for Payer: BCN Medicare Advantage |
$68.93
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cofinity Commercial |
$237.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.93
|
| Rate for Payer: Healthscope Commercial |
$248.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.78
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.37
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.35
|
| Rate for Payer: Nomi Health Commercial |
$226.08
|
| Rate for Payer: PACE Senior Care Partners |
$65.48
|
| Rate for Payer: PACE SWMI |
$68.93
|
| Rate for Payer: PHP Commercial |
$234.35
|
| Rate for Payer: PHP Medicare Advantage |
$68.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.21
|
| Rate for Payer: Priority Health HMO/PPO |
$239.87
|
| Rate for Payer: Priority Health Medicare |
$69.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.73
|
| Rate for Payer: Railroad Medicare Medicare |
$68.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.62
|
| Rate for Payer: UHC Core |
$230.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.93
|
| Rate for Payer: UHC Exchange |
$68.93
|
| Rate for Payer: UHC Medicare Advantage |
$68.93
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$68.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.78
|
|
|
HC TANGENTIAL BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$275.71
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
76100148
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$179.21 |
| Max. Negotiated Rate |
$248.14 |
| Rate for Payer: Aetna Commercial |
$234.35
|
| Rate for Payer: BCBS Trust/PPO |
$225.06
|
| Rate for Payer: BCN Commercial |
$213.07
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cofinity Commercial |
$237.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.57
|
| Rate for Payer: Healthscope Commercial |
$248.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.35
|
| Rate for Payer: Nomi Health Commercial |
$226.08
|
| Rate for Payer: PHP Commercial |
$234.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.21
|
| Rate for Payer: Priority Health HMO/PPO |
$239.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.62
|
| Rate for Payer: UHC Core |
$230.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.78
|
|
|
HC TAVR CONVERTED TO ON-PUMP
|
Facility
|
OP
|
$6,525.68
|
|
| Hospital Charge Code |
27000703
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,549.85 |
| Max. Negotiated Rate |
$5,873.11 |
| Rate for Payer: Aetna Commercial |
$5,546.83
|
| Rate for Payer: Aetna Medicare |
$1,696.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,039.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,039.28
|
| Rate for Payer: BCBS Complete |
$2,610.27
|
| Rate for Payer: BCBS MAPPO |
$1,631.42
|
| Rate for Payer: BCBS Trust/PPO |
$5,364.76
|
| Rate for Payer: BCN Commercial |
$5,073.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,631.42
|
| Rate for Payer: Cash Price |
$5,220.54
|
| Rate for Payer: Cofinity Commercial |
$5,612.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,220.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,631.42
|
| Rate for Payer: Healthscope Commercial |
$5,873.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,894.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,712.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,876.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,546.83
|
| Rate for Payer: Nomi Health Commercial |
$5,351.06
|
| Rate for Payer: PACE Senior Care Partners |
$1,549.85
|
| Rate for Payer: PACE SWMI |
$1,631.42
|
| Rate for Payer: PHP Commercial |
$5,546.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,631.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,241.69
|
| Rate for Payer: Priority Health HMO/PPO |
$5,677.34
|
| Rate for Payer: Priority Health Medicare |
$1,647.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,372.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,631.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,742.60
|
| Rate for Payer: UHC Core |
$5,448.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,631.42
|
| Rate for Payer: UHC Exchange |
$1,631.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,631.42
|
| Rate for Payer: VA VA |
$1,631.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,894.26
|
|
|
HC TAVR CONVERTED TO ON-PUMP
|
Facility
|
IP
|
$6,525.68
|
|
| Hospital Charge Code |
27000703
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,241.69 |
| Max. Negotiated Rate |
$5,873.11 |
| Rate for Payer: Aetna Commercial |
$5,546.83
|
| Rate for Payer: BCBS Trust/PPO |
$5,326.91
|
| Rate for Payer: BCN Commercial |
$5,043.05
|
| Rate for Payer: Cash Price |
$5,220.54
|
| Rate for Payer: Cofinity Commercial |
$5,612.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,220.54
|
| Rate for Payer: Healthscope Commercial |
$5,873.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,894.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,546.83
|
| Rate for Payer: Nomi Health Commercial |
$5,351.06
|
| Rate for Payer: PHP Commercial |
$5,546.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,241.69
|
| Rate for Payer: Priority Health HMO/PPO |
$5,677.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,372.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,742.60
|
| Rate for Payer: UHC Core |
$5,448.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,894.26
|
|
|
HC TAVR VALVE LVL 37
|
Facility
|
OP
|
$37,500.00
|
|
| Hospital Charge Code |
27800353
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,906.25 |
| Max. Negotiated Rate |
$33,750.00 |
| Rate for Payer: Aetna Commercial |
$31,875.00
|
| Rate for Payer: Aetna Medicare |
$9,750.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,718.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,718.75
|
| Rate for Payer: BCBS Complete |
$15,000.00
|
| Rate for Payer: BCBS MAPPO |
$9,375.00
|
| Rate for Payer: BCBS Trust/PPO |
$30,828.75
|
| Rate for Payer: BCN Commercial |
$29,156.25
|
| Rate for Payer: BCN Medicare Advantage |
$9,375.00
|
| Rate for Payer: Cash Price |
$30,000.00
|
| Rate for Payer: Cofinity Commercial |
$32,250.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30,000.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,375.00
|
| Rate for Payer: Healthscope Commercial |
$33,750.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28,125.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,843.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,781.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,875.00
|
| Rate for Payer: Nomi Health Commercial |
$30,750.00
|
| Rate for Payer: PACE Senior Care Partners |
$8,906.25
|
| Rate for Payer: PACE SWMI |
$9,375.00
|
| Rate for Payer: PHP Commercial |
$31,875.00
|
| Rate for Payer: PHP Medicare Advantage |
$9,375.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24,375.00
|
| Rate for Payer: Priority Health HMO/PPO |
$32,625.00
|
| Rate for Payer: Priority Health Medicare |
$9,468.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25,125.00
|
| Rate for Payer: Railroad Medicare Medicare |
$9,375.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33,000.00
|
| Rate for Payer: UHC Core |
$31,312.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,375.00
|
| Rate for Payer: UHC Exchange |
$9,375.00
|
| Rate for Payer: UHC Medicare Advantage |
$9,375.00
|
| Rate for Payer: VA VA |
$9,375.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28,125.00
|
|
|
HC TAVR VALVE LVL 37
|
Facility
|
IP
|
$37,500.00
|
|
| Hospital Charge Code |
27800353
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24,375.00 |
| Max. Negotiated Rate |
$33,750.00 |
| Rate for Payer: Aetna Commercial |
$31,875.00
|
| Rate for Payer: BCBS Trust/PPO |
$30,611.25
|
| Rate for Payer: BCN Commercial |
$28,980.00
|
| Rate for Payer: Cash Price |
$30,000.00
|
| Rate for Payer: Cofinity Commercial |
$32,250.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30,000.00
|
| Rate for Payer: Healthscope Commercial |
$33,750.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28,125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31,875.00
|
| Rate for Payer: Nomi Health Commercial |
$30,750.00
|
| Rate for Payer: PHP Commercial |
$31,875.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24,375.00
|
| Rate for Payer: Priority Health HMO/PPO |
$32,625.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25,125.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33,000.00
|
| Rate for Payer: UHC Core |
$31,312.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28,125.00
|
|
|
HC TAVR VALVE LVL 40
|
Facility
|
IP
|
$40,625.00
|
|
| Hospital Charge Code |
27800354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26,406.25 |
| Max. Negotiated Rate |
$36,562.50 |
| Rate for Payer: Aetna Commercial |
$34,531.25
|
| Rate for Payer: BCBS Trust/PPO |
$33,162.19
|
| Rate for Payer: BCN Commercial |
$31,395.00
|
| Rate for Payer: Cash Price |
$32,500.00
|
| Rate for Payer: Cofinity Commercial |
$34,937.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32,500.00
|
| Rate for Payer: Healthscope Commercial |
$36,562.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30,468.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,531.25
|
| Rate for Payer: Nomi Health Commercial |
$33,312.50
|
| Rate for Payer: PHP Commercial |
$34,531.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26,406.25
|
| Rate for Payer: Priority Health HMO/PPO |
$35,343.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27,218.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35,750.00
|
| Rate for Payer: UHC Core |
$33,921.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30,468.75
|
|
|
HC TAVR VALVE LVL 40
|
Facility
|
OP
|
$40,625.00
|
|
| Hospital Charge Code |
27800354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,648.44 |
| Max. Negotiated Rate |
$36,562.50 |
| Rate for Payer: Aetna Commercial |
$34,531.25
|
| Rate for Payer: Aetna Medicare |
$10,562.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,695.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,695.31
|
| Rate for Payer: BCBS Complete |
$16,250.00
|
| Rate for Payer: BCBS MAPPO |
$10,156.25
|
| Rate for Payer: BCBS Trust/PPO |
$33,397.81
|
| Rate for Payer: BCN Commercial |
$31,585.94
|
| Rate for Payer: BCN Medicare Advantage |
$10,156.25
|
| Rate for Payer: Cash Price |
$32,500.00
|
| Rate for Payer: Cofinity Commercial |
$34,937.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32,500.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,156.25
|
| Rate for Payer: Healthscope Commercial |
$36,562.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30,468.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,664.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,679.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,531.25
|
| Rate for Payer: Nomi Health Commercial |
$33,312.50
|
| Rate for Payer: PACE Senior Care Partners |
$9,648.44
|
| Rate for Payer: PACE SWMI |
$10,156.25
|
| Rate for Payer: PHP Commercial |
$34,531.25
|
| Rate for Payer: PHP Medicare Advantage |
$10,156.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26,406.25
|
| Rate for Payer: Priority Health HMO/PPO |
$35,343.75
|
| Rate for Payer: Priority Health Medicare |
$10,257.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27,218.75
|
| Rate for Payer: Railroad Medicare Medicare |
$10,156.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35,750.00
|
| Rate for Payer: UHC Core |
$33,921.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,156.25
|
| Rate for Payer: UHC Exchange |
$10,156.25
|
| Rate for Payer: UHC Medicare Advantage |
$10,156.25
|
| Rate for Payer: VA VA |
$10,156.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30,468.75
|
|
