|
HC VMA URINE
|
Facility
|
OP
|
$48.90
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100488
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: Aetna Medicare |
$12.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.28
|
| Rate for Payer: BCBS Complete |
$9.05
|
| Rate for Payer: BCBS MAPPO |
$12.22
|
| Rate for Payer: BCBS Trust/PPO |
$40.20
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: BCN Medicare Advantage |
$12.22
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.22
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.67
|
| Rate for Payer: Mclaren Medicaid |
$8.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.84
|
| Rate for Payer: Meridian Medicaid |
$9.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.67
|
| Rate for Payer: PACE Senior Care Partners |
$11.61
|
| Rate for Payer: PACE SWMI |
$12.22
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: PHP Medicare Advantage |
$12.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.54
|
| Rate for Payer: Priority Health Medicare |
$12.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.03
|
| Rate for Payer: Railroad Medicare Medicare |
$12.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.03
|
| Rate for Payer: UHC Core |
$40.83
|
| Rate for Payer: UHC Exchange |
$12.22
|
| Rate for Payer: UHC Medicaid |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$12.22
|
| Rate for Payer: UHCCP Medicaid |
$8.62
|
| Rate for Payer: VA VA |
$12.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.67
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
IP
|
$5,229.68
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,639.86 |
| Max. Negotiated Rate |
$4,706.71 |
| Rate for Payer: Aetna Commercial |
$4,445.23
|
| Rate for Payer: BCBS Trust/PPO |
$4,319.19
|
| Rate for Payer: BCN Commercial |
$4,319.19
|
| Rate for Payer: Cash Price |
$4,183.74
|
| Rate for Payer: Cofinity Commercial |
$4,497.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,183.74
|
| Rate for Payer: Healthscope Commercial |
$4,706.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,922.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,445.23
|
| Rate for Payer: Nomi Health Commercial |
$4,288.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,922.26
|
| Rate for Payer: PHP Commercial |
$4,445.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,549.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,639.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,602.12
|
| Rate for Payer: UHC Core |
$4,366.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,922.26
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
OP
|
$5,229.68
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$921.99 |
| Max. Negotiated Rate |
$4,706.71 |
| Rate for Payer: Aetna Commercial |
$4,445.23
|
| Rate for Payer: Aetna Medicare |
$1,359.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,634.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,634.28
|
| Rate for Payer: BCBS Complete |
$968.01
|
| Rate for Payer: BCBS MAPPO |
$1,307.42
|
| Rate for Payer: BCBS Trust/PPO |
$4,299.32
|
| Rate for Payer: BCN Commercial |
$4,299.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,307.42
|
| Rate for Payer: Cash Price |
$4,183.74
|
| Rate for Payer: Cofinity Commercial |
$4,497.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,183.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,307.42
|
| Rate for Payer: Healthscope Commercial |
$4,706.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,922.26
|
| Rate for Payer: Mclaren Medicaid |
$921.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,372.79
|
| Rate for Payer: Meridian Medicaid |
$968.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,503.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,445.23
|
| Rate for Payer: Nomi Health Commercial |
$4,288.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,922.26
|
| Rate for Payer: PACE Senior Care Partners |
$1,242.05
|
| Rate for Payer: PACE SWMI |
$1,307.42
|
| Rate for Payer: PHP Commercial |
$4,445.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,307.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$921.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,549.82
|
| Rate for Payer: Priority Health Medicare |
$1,320.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,639.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,307.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,602.12
|
| Rate for Payer: UHC Core |
$4,366.78
|
| Rate for Payer: UHC Exchange |
$1,307.42
|
| Rate for Payer: UHC Medicaid |
$921.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,307.42
|
| Rate for Payer: UHCCP Medicaid |
$921.99
|
| Rate for Payer: VA VA |
$1,307.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,922.26
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
IP
|
$2,555.24
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,778.45 |
| Max. Negotiated Rate |
$2,299.72 |
| Rate for Payer: Aetna Commercial |
$2,171.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,110.37
|
| Rate for Payer: BCN Commercial |
$2,110.37
|
| Rate for Payer: Cash Price |
$2,044.19
|
| Rate for Payer: Cofinity Commercial |
$2,197.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,044.19
|
| Rate for Payer: Healthscope Commercial |
$2,299.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,916.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,171.95
|
| Rate for Payer: Nomi Health Commercial |
$2,095.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,916.43
|
| Rate for Payer: PHP Commercial |
$2,171.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,223.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,778.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,248.61
|
| Rate for Payer: UHC Core |
$2,133.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,916.43
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
OP
|
$2,555.24
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$450.49 |
| Max. Negotiated Rate |
$2,299.72 |
| Rate for Payer: Aetna Commercial |
$2,171.95
|
| Rate for Payer: Aetna Medicare |
$664.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$798.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$798.51
|
| Rate for Payer: BCBS Complete |
$472.97
|
| Rate for Payer: BCBS MAPPO |
$638.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,100.66
|
| Rate for Payer: BCN Commercial |
$2,100.66
|
| Rate for Payer: BCN Medicare Advantage |
$638.81
|
| Rate for Payer: Cash Price |
$2,044.19
|
| Rate for Payer: Cofinity Commercial |
$2,197.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,044.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$638.81
|
| Rate for Payer: Healthscope Commercial |
$2,299.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,916.43
|
| Rate for Payer: Mclaren Medicaid |
$450.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$670.75
|
| Rate for Payer: Meridian Medicaid |
$472.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$734.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$702.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,171.95
|
| Rate for Payer: Nomi Health Commercial |
$2,095.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,916.43
|
| Rate for Payer: PACE Senior Care Partners |
$606.87
|
| Rate for Payer: PACE SWMI |
$638.81
|
| Rate for Payer: PHP Commercial |
$2,171.95
|
| Rate for Payer: PHP Medicare Advantage |
$638.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$450.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,223.06
|
| Rate for Payer: Priority Health Medicare |
$645.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,778.45
|
| Rate for Payer: Railroad Medicare Medicare |
$638.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,248.61
|
| Rate for Payer: UHC Core |
$2,133.63
|
| Rate for Payer: UHC Exchange |
$638.81
|
| Rate for Payer: UHC Medicaid |
$450.49
|
| Rate for Payer: UHC Medicare Advantage |
$638.81
|
| Rate for Payer: UHCCP Medicaid |
$450.49
|
| Rate for Payer: VA VA |
$638.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,916.43
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
IP
|
$267.46
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$186.15 |
| Max. Negotiated Rate |
$240.71 |
| Rate for Payer: Aetna Commercial |
$227.34
|
| Rate for Payer: BCBS Trust/PPO |
$220.90
|
| Rate for Payer: BCN Commercial |
$220.90
|
| Rate for Payer: Cash Price |
$213.97
|
| Rate for Payer: Cofinity Commercial |
$230.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.97
|
| Rate for Payer: Healthscope Commercial |
$240.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.34
|
| Rate for Payer: Nomi Health Commercial |
$219.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.59
|
| Rate for Payer: PHP Commercial |
$227.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$232.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.36
|
| Rate for Payer: UHC Core |
$223.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.59
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
OP
|
$267.46
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$47.15 |
| Max. Negotiated Rate |
$240.71 |
| Rate for Payer: Aetna Commercial |
$227.34
|
| Rate for Payer: Aetna Medicare |
$69.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.58
|
| Rate for Payer: BCBS Complete |
$49.51
|
| Rate for Payer: BCBS MAPPO |
$66.86
|
| Rate for Payer: BCBS Trust/PPO |
$219.88
|
| Rate for Payer: BCN Commercial |
$219.88
|
| Rate for Payer: BCN Medicare Advantage |
$66.86
|
| Rate for Payer: Cash Price |
$213.97
|
| Rate for Payer: Cofinity Commercial |
$230.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.86
|
| Rate for Payer: Healthscope Commercial |
$240.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.59
|
| Rate for Payer: Mclaren Medicaid |
$47.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.21
|
| Rate for Payer: Meridian Medicaid |
$49.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.34
|
| Rate for Payer: Nomi Health Commercial |
$219.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.59
|
| Rate for Payer: PACE Senior Care Partners |
$63.52
|
| Rate for Payer: PACE SWMI |
$66.86
|
| Rate for Payer: PHP Commercial |
$227.34
|
| Rate for Payer: PHP Medicare Advantage |
$66.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$232.69
|
| Rate for Payer: Priority Health Medicare |
$67.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.15
|
| Rate for Payer: Railroad Medicare Medicare |
$66.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.36
|
| Rate for Payer: UHC Core |
$223.33
|
| Rate for Payer: UHC Exchange |
$66.86
|
| Rate for Payer: UHC Medicaid |
$47.15
|
| Rate for Payer: UHC Medicare Advantage |
$66.86
|
| Rate for Payer: UHCCP Medicaid |
$47.15
|
| Rate for Payer: VA VA |
$66.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.59
|
|
|
HC VOLARA SUPPLY
|
Facility
|
OP
|
$284.58
|
|
| Hospital Charge Code |
27000712
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$50.17 |
| Max. Negotiated Rate |
$256.12 |
| Rate for Payer: Aetna Commercial |
$241.89
|
| Rate for Payer: Aetna Medicare |
$73.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.93
|
| Rate for Payer: BCBS Complete |
$52.68
|
| Rate for Payer: BCBS MAPPO |
$71.14
|
| Rate for Payer: BCBS Trust/PPO |
$233.95
|
| Rate for Payer: BCN Commercial |
$233.95
|
| Rate for Payer: BCN Medicare Advantage |
$71.14
|
| Rate for Payer: Cash Price |
$227.66
|
| Rate for Payer: Cofinity Commercial |
$244.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.14
|
| Rate for Payer: Healthscope Commercial |
$256.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.44
|
| Rate for Payer: Mclaren Medicaid |
$50.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.70
|
| Rate for Payer: Meridian Medicaid |
$52.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.89
|
| Rate for Payer: Nomi Health Commercial |
$233.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.44
|
| Rate for Payer: PACE Senior Care Partners |
$67.59
|
| Rate for Payer: PACE SWMI |
$71.14
|
| Rate for Payer: PHP Commercial |
$241.89
|
| Rate for Payer: PHP Medicare Advantage |
$71.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$247.58
|
| Rate for Payer: Priority Health Medicare |
$71.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.07
|
| Rate for Payer: Railroad Medicare Medicare |
$71.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.43
|
| Rate for Payer: UHC Core |
$237.62
|
| Rate for Payer: UHC Exchange |
$71.14
|
| Rate for Payer: UHC Medicaid |
$50.17
|
| Rate for Payer: UHC Medicare Advantage |
$71.14
|
| Rate for Payer: UHCCP Medicaid |
$50.17
|
| Rate for Payer: VA VA |
$71.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.44
|
|
|
HC VOLARA SUPPLY
|
Facility
|
IP
|
$284.58
|
|
| Hospital Charge Code |
27000712
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$198.07 |
| Max. Negotiated Rate |
$256.12 |
| Rate for Payer: Aetna Commercial |
$241.89
|
| Rate for Payer: BCBS Trust/PPO |
$235.03
|
| Rate for Payer: BCN Commercial |
$235.03
|
| Rate for Payer: Cash Price |
$227.66
|
| Rate for Payer: Cofinity Commercial |
$244.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.66
|
| Rate for Payer: Healthscope Commercial |
$256.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.89
|
| Rate for Payer: Nomi Health Commercial |
$233.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.44
|
| Rate for Payer: PHP Commercial |
$241.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$247.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.43
|
| Rate for Payer: UHC Core |
$237.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.44
|
|
|
HC VOLUME MEASUREMENT
|
Facility
|
IP
|
$20.06
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$13.96 |
| Max. Negotiated Rate |
$18.05 |
| Rate for Payer: Aetna Commercial |
$17.05
|
| Rate for Payer: BCBS Trust/PPO |
$16.57
|
| Rate for Payer: BCN Commercial |
$16.57
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cofinity Commercial |
$17.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.05
|
| Rate for Payer: Healthscope Commercial |
$18.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.05
|
| Rate for Payer: Nomi Health Commercial |
$16.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.04
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.65
|
| Rate for Payer: UHC Core |
$16.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.04
|
|
|
HC VOLUME MEASUREMENT
|
Facility
|
OP
|
$20.06
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$18.05 |
| Rate for Payer: Aetna Commercial |
$17.05
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.27
|
| Rate for Payer: BCBS Complete |
$3.71
|
| Rate for Payer: BCBS MAPPO |
$5.01
|
| Rate for Payer: BCBS Trust/PPO |
$16.49
|
| Rate for Payer: BCN Commercial |
$16.49
|
| Rate for Payer: BCN Medicare Advantage |
$5.01
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cofinity Commercial |
$17.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.01
|
| Rate for Payer: Healthscope Commercial |
$18.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.04
|
| Rate for Payer: Mclaren Medicaid |
$3.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: Meridian Medicaid |
$3.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.05
|
| Rate for Payer: Nomi Health Commercial |
$16.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.04
|
| Rate for Payer: PACE Senior Care Partners |
$4.76
|
| Rate for Payer: PACE SWMI |
$5.01
|
| Rate for Payer: PHP Commercial |
$17.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.45
|
| Rate for Payer: Priority Health Medicare |
$5.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.96
|
| Rate for Payer: Railroad Medicare Medicare |
$5.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.65
|
| Rate for Payer: UHC Core |
$16.75
|
| Rate for Payer: UHC Exchange |
$5.01
|
| Rate for Payer: UHC Medicaid |
$3.54
|
| Rate for Payer: UHC Medicare Advantage |
$5.01
|
| Rate for Payer: UHCCP Medicaid |
$3.54
|
| Rate for Payer: VA VA |
$5.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.04
|
|
|
HC VON WILLEBRAND ANTIGEN
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$48.01 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: BCBS Trust/PPO |
$56.97
|
| Rate for Payer: BCN Commercial |
$56.97
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.70
|
| Rate for Payer: UHC Core |
$57.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.73
|
|
|
HC VON WILLEBRAND ANTIGEN
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.16 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna Medicare |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.56
|
| Rate for Payer: BCBS Complete |
$12.77
|
| Rate for Payer: BCBS MAPPO |
$17.25
|
| Rate for Payer: BCBS Trust/PPO |
$56.71
|
| Rate for Payer: BCN Commercial |
$56.71
|
| Rate for Payer: BCN Medicare Advantage |
$17.25
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.25
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.73
|
| Rate for Payer: Mclaren Medicaid |
$12.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.11
|
| Rate for Payer: Meridian Medicaid |
$12.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$56.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PACE Senior Care Partners |
$16.38
|
| Rate for Payer: PACE SWMI |
$17.25
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: PHP Medicare Advantage |
$17.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.01
|
| Rate for Payer: Priority Health Medicare |
$17.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.01
|
| Rate for Payer: Railroad Medicare Medicare |
$17.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.70
|
| Rate for Payer: UHC Core |
$57.60
|
| Rate for Payer: UHC Exchange |
$17.25
|
| Rate for Payer: UHC Medicaid |
$12.16
|
| Rate for Payer: UHC Medicare Advantage |
$17.25
|
| Rate for Payer: UHCCP Medicaid |
$12.16
|
| Rate for Payer: VA VA |
$17.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.73
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
OP
|
$210.12
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.04 |
| Max. Negotiated Rate |
$189.11 |
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna Medicare |
$54.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.66
|
| Rate for Payer: BCBS Complete |
$38.89
|
| Rate for Payer: BCBS MAPPO |
$52.53
|
| Rate for Payer: BCBS Trust/PPO |
$172.74
|
| Rate for Payer: BCN Commercial |
$172.74
|
| Rate for Payer: BCN Medicare Advantage |
$52.53
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cofinity Commercial |
$180.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.53
|
| Rate for Payer: Healthscope Commercial |
$189.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.59
|
| Rate for Payer: Mclaren Medicaid |
$37.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.16
|
| Rate for Payer: Meridian Medicaid |
$38.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.60
|
| Rate for Payer: Nomi Health Commercial |
$172.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.59
|
| Rate for Payer: PACE Senior Care Partners |
$49.90
|
| Rate for Payer: PACE SWMI |
$52.53
|
| Rate for Payer: PHP Commercial |
$178.60
|
| Rate for Payer: PHP Medicare Advantage |
$52.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$182.80
|
| Rate for Payer: Priority Health Medicare |
$53.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.24
|
| Rate for Payer: Railroad Medicare Medicare |
$52.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.91
|
| Rate for Payer: UHC Core |
$175.45
|
| Rate for Payer: UHC Exchange |
$52.53
|
| Rate for Payer: UHC Medicaid |
$37.04
|
| Rate for Payer: UHC Medicare Advantage |
$52.53
|
| Rate for Payer: UHCCP Medicaid |
$37.04
|
| Rate for Payer: VA VA |
$52.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.59
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
IP
|
$210.12
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$146.24 |
| Max. Negotiated Rate |
$189.11 |
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: BCBS Trust/PPO |
$173.54
|
| Rate for Payer: BCN Commercial |
$173.54
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cofinity Commercial |
$180.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.10
|
| Rate for Payer: Healthscope Commercial |
$189.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.60
|
| Rate for Payer: Nomi Health Commercial |
$172.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.59
|
| Rate for Payer: PHP Commercial |
$178.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$182.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.91
|
| Rate for Payer: UHC Core |
$175.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.59
|
|
|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
IP
|
$97.80
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$68.07 |
| Max. Negotiated Rate |
$88.02 |
| Rate for Payer: Aetna Commercial |
$83.13
|
| Rate for Payer: BCBS Trust/PPO |
$80.77
|
| Rate for Payer: BCN Commercial |
$80.77
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cofinity Commercial |
$84.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.24
|
| Rate for Payer: Healthscope Commercial |
$88.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.13
|
| Rate for Payer: Nomi Health Commercial |
$80.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.35
|
| Rate for Payer: PHP Commercial |
$83.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.06
|
| Rate for Payer: UHC Core |
$81.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.35
|
|
|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
OP
|
$97.80
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.24 |
| Max. Negotiated Rate |
$88.02 |
| Rate for Payer: Aetna Commercial |
$83.13
|
| Rate for Payer: Aetna Medicare |
$25.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.56
|
| Rate for Payer: BCBS Complete |
$18.10
|
| Rate for Payer: BCBS MAPPO |
$24.45
|
| Rate for Payer: BCBS Trust/PPO |
$80.40
|
| Rate for Payer: BCN Commercial |
$80.40
|
| Rate for Payer: BCN Medicare Advantage |
$24.45
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cofinity Commercial |
$84.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.45
|
| Rate for Payer: Healthscope Commercial |
$88.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.35
|
| Rate for Payer: Mclaren Medicaid |
$17.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.67
|
| Rate for Payer: Meridian Medicaid |
$18.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.13
|
| Rate for Payer: Nomi Health Commercial |
$80.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.35
|
| Rate for Payer: PACE Senior Care Partners |
$23.23
|
| Rate for Payer: PACE SWMI |
$24.45
|
| Rate for Payer: PHP Commercial |
$83.13
|
| Rate for Payer: PHP Medicare Advantage |
$24.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.09
|
| Rate for Payer: Priority Health Medicare |
$24.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.07
|
| Rate for Payer: Railroad Medicare Medicare |
$24.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.06
|
| Rate for Payer: UHC Core |
$81.66
|
| Rate for Payer: UHC Exchange |
$24.45
|
| Rate for Payer: UHC Medicaid |
$17.24
|
| Rate for Payer: UHC Medicare Advantage |
$24.45
|
| Rate for Payer: UHCCP Medicaid |
$17.24
|
| Rate for Payer: VA VA |
$24.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.35
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
OP
|
$131.59
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$118.43 |
| Rate for Payer: Aetna Commercial |
$111.85
|
| Rate for Payer: Aetna Medicare |
$34.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.12
|
| Rate for Payer: BCBS Complete |
$24.36
|
| Rate for Payer: BCBS MAPPO |
$32.90
|
| Rate for Payer: BCBS Trust/PPO |
$108.18
|
| Rate for Payer: BCN Commercial |
$108.18
|
| Rate for Payer: BCN Medicare Advantage |
$32.90
|
| Rate for Payer: Cash Price |
$105.27
|
| Rate for Payer: Cofinity Commercial |
$113.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.90
|
| Rate for Payer: Healthscope Commercial |
$118.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.69
|
| Rate for Payer: Mclaren Medicaid |
$23.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.54
|
| Rate for Payer: Meridian Medicaid |
$24.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.85
|
| Rate for Payer: Nomi Health Commercial |
$107.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.69
|
| Rate for Payer: PACE Senior Care Partners |
$31.25
|
| Rate for Payer: PACE SWMI |
$32.90
|
| Rate for Payer: PHP Commercial |
$111.85
|
| Rate for Payer: PHP Medicare Advantage |
$32.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$114.48
|
| Rate for Payer: Priority Health Medicare |
$33.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.59
|
| Rate for Payer: Railroad Medicare Medicare |
$32.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.80
|
| Rate for Payer: UHC Core |
$109.88
|
| Rate for Payer: UHC Exchange |
$32.90
|
| Rate for Payer: UHC Medicaid |
$23.20
|
| Rate for Payer: UHC Medicare Advantage |
$32.90
|
| Rate for Payer: UHCCP Medicaid |
$23.20
|
| Rate for Payer: VA VA |
$32.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.69
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
IP
|
$131.59
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$91.59 |
| Max. Negotiated Rate |
$118.43 |
| Rate for Payer: Aetna Commercial |
$111.85
|
| Rate for Payer: BCBS Trust/PPO |
$108.68
|
| Rate for Payer: BCN Commercial |
$108.68
|
| Rate for Payer: Cash Price |
$105.27
|
| Rate for Payer: Cofinity Commercial |
$113.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.27
|
| Rate for Payer: Healthscope Commercial |
$118.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.85
|
| Rate for Payer: Nomi Health Commercial |
$107.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.69
|
| Rate for Payer: PHP Commercial |
$111.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$114.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.80
|
| Rate for Payer: UHC Core |
$109.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.69
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
OP
|
$99.76
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.59 |
| Max. Negotiated Rate |
$89.78 |
| Rate for Payer: Aetna Commercial |
$84.80
|
| Rate for Payer: Aetna Medicare |
$25.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.18
|
| Rate for Payer: BCBS Complete |
$18.47
|
| Rate for Payer: BCBS MAPPO |
$24.94
|
| Rate for Payer: BCBS Trust/PPO |
$82.01
|
| Rate for Payer: BCN Commercial |
$82.01
|
| Rate for Payer: BCN Medicare Advantage |
$24.94
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cofinity Commercial |
$85.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.94
|
| Rate for Payer: Healthscope Commercial |
$89.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.82
|
| Rate for Payer: Mclaren Medicaid |
$17.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.19
|
| Rate for Payer: Meridian Medicaid |
$18.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.80
|
| Rate for Payer: Nomi Health Commercial |
$81.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.82
|
| Rate for Payer: PACE Senior Care Partners |
$23.69
|
| Rate for Payer: PACE SWMI |
$24.94
|
| Rate for Payer: PHP Commercial |
$84.80
|
| Rate for Payer: PHP Medicare Advantage |
$24.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.79
|
| Rate for Payer: Priority Health Medicare |
$25.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.43
|
| Rate for Payer: Railroad Medicare Medicare |
$24.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.79
|
| Rate for Payer: UHC Core |
$83.30
|
| Rate for Payer: UHC Exchange |
$24.94
|
| Rate for Payer: UHC Medicaid |
$17.59
|
| Rate for Payer: UHC Medicare Advantage |
$24.94
|
| Rate for Payer: UHCCP Medicaid |
$17.59
|
| Rate for Payer: VA VA |
$24.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.82
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
IP
|
$99.76
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$69.43 |
| Max. Negotiated Rate |
$89.78 |
| Rate for Payer: Aetna Commercial |
$84.80
|
| Rate for Payer: BCBS Trust/PPO |
$82.39
|
| Rate for Payer: BCN Commercial |
$82.39
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cofinity Commercial |
$85.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.81
|
| Rate for Payer: Healthscope Commercial |
$89.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.80
|
| Rate for Payer: Nomi Health Commercial |
$81.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.82
|
| Rate for Payer: PHP Commercial |
$84.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.79
|
| Rate for Payer: UHC Core |
$83.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.82
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
IP
|
$132.65
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$92.32 |
| Max. Negotiated Rate |
$119.39 |
| Rate for Payer: Aetna Commercial |
$112.75
|
| Rate for Payer: BCBS Trust/PPO |
$109.56
|
| Rate for Payer: BCN Commercial |
$109.56
|
| Rate for Payer: Cash Price |
$106.12
|
| Rate for Payer: Cofinity Commercial |
$114.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.12
|
| Rate for Payer: Healthscope Commercial |
$119.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.75
|
| Rate for Payer: Nomi Health Commercial |
$108.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.49
|
| Rate for Payer: PHP Commercial |
$112.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$115.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.73
|
| Rate for Payer: UHC Core |
$110.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.49
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
OP
|
$132.65
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$23.39 |
| Max. Negotiated Rate |
$119.39 |
| Rate for Payer: Aetna Commercial |
$112.75
|
| Rate for Payer: Aetna Medicare |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.45
|
| Rate for Payer: BCBS Complete |
$24.55
|
| Rate for Payer: BCBS MAPPO |
$33.16
|
| Rate for Payer: BCBS Trust/PPO |
$109.05
|
| Rate for Payer: BCN Commercial |
$109.05
|
| Rate for Payer: BCN Medicare Advantage |
$33.16
|
| Rate for Payer: Cash Price |
$106.12
|
| Rate for Payer: Cofinity Commercial |
$114.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.16
|
| Rate for Payer: Healthscope Commercial |
$119.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.49
|
| Rate for Payer: Mclaren Medicaid |
$23.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.82
|
| Rate for Payer: Meridian Medicaid |
$24.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.75
|
| Rate for Payer: Nomi Health Commercial |
$108.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.49
|
| Rate for Payer: PACE Senior Care Partners |
$31.50
|
| Rate for Payer: PACE SWMI |
$33.16
|
| Rate for Payer: PHP Commercial |
$112.75
|
| Rate for Payer: PHP Medicare Advantage |
$33.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$115.41
|
| Rate for Payer: Priority Health Medicare |
$33.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.32
|
| Rate for Payer: Railroad Medicare Medicare |
$33.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.73
|
| Rate for Payer: UHC Core |
$110.76
|
| Rate for Payer: UHC Exchange |
$33.16
|
| Rate for Payer: UHC Medicaid |
$23.39
|
| Rate for Payer: UHC Medicare Advantage |
$33.16
|
| Rate for Payer: UHCCP Medicaid |
$23.39
|
| Rate for Payer: VA VA |
$33.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.49
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
OP
|
$129.01
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.74 |
| Max. Negotiated Rate |
$116.11 |
| Rate for Payer: Aetna Commercial |
$109.66
|
| Rate for Payer: Aetna Medicare |
$33.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.32
|
| Rate for Payer: BCBS Complete |
$23.88
|
| Rate for Payer: BCBS MAPPO |
$32.25
|
| Rate for Payer: BCBS Trust/PPO |
$106.06
|
| Rate for Payer: BCN Commercial |
$106.06
|
| Rate for Payer: BCN Medicare Advantage |
$32.25
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cofinity Commercial |
$110.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.25
|
| Rate for Payer: Healthscope Commercial |
$116.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.76
|
| Rate for Payer: Mclaren Medicaid |
$22.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.87
|
| Rate for Payer: Meridian Medicaid |
$23.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.66
|
| Rate for Payer: Nomi Health Commercial |
$105.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.76
|
| Rate for Payer: PACE Senior Care Partners |
$30.64
|
| Rate for Payer: PACE SWMI |
$32.25
|
| Rate for Payer: PHP Commercial |
$109.66
|
| Rate for Payer: PHP Medicare Advantage |
$32.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$112.24
|
| Rate for Payer: Priority Health Medicare |
$32.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.79
|
| Rate for Payer: Railroad Medicare Medicare |
$32.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.53
|
| Rate for Payer: UHC Core |
$107.72
|
| Rate for Payer: UHC Exchange |
$32.25
|
| Rate for Payer: UHC Medicaid |
$22.74
|
| Rate for Payer: UHC Medicare Advantage |
$32.25
|
| Rate for Payer: UHCCP Medicaid |
$22.74
|
| Rate for Payer: VA VA |
$32.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.76
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
IP
|
$129.01
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$89.79 |
| Max. Negotiated Rate |
$116.11 |
| Rate for Payer: Aetna Commercial |
$109.66
|
| Rate for Payer: BCBS Trust/PPO |
$106.55
|
| Rate for Payer: BCN Commercial |
$106.55
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cofinity Commercial |
$110.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.21
|
| Rate for Payer: Healthscope Commercial |
$116.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.66
|
| Rate for Payer: Nomi Health Commercial |
$105.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.76
|
| Rate for Payer: PHP Commercial |
$109.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$112.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.53
|
| Rate for Payer: UHC Core |
$107.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.76
|
|
