|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
IP
|
$6,493.43
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,519.43 |
| Max. Negotiated Rate |
$5,844.09 |
| Rate for Payer: Aetna Commercial |
$5,519.42
|
| Rate for Payer: BCBS Trust/PPO |
$5,362.92
|
| Rate for Payer: BCN Commercial |
$5,362.92
|
| Rate for Payer: Cash Price |
$5,194.74
|
| Rate for Payer: Cofinity Commercial |
$5,584.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,194.74
|
| Rate for Payer: Healthscope Commercial |
$5,844.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,870.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,519.42
|
| Rate for Payer: Nomi Health Commercial |
$5,324.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,870.07
|
| Rate for Payer: PHP Commercial |
$5,519.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,649.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,519.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,714.22
|
| Rate for Payer: UHC Core |
$5,422.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,870.07
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
OP
|
$6,493.43
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,144.79 |
| Max. Negotiated Rate |
$5,844.09 |
| Rate for Payer: Aetna Commercial |
$5,519.42
|
| Rate for Payer: Aetna Medicare |
$1,688.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,029.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,029.20
|
| Rate for Payer: BCBS Complete |
$1,201.93
|
| Rate for Payer: BCBS MAPPO |
$1,623.36
|
| Rate for Payer: BCBS Trust/PPO |
$5,338.25
|
| Rate for Payer: BCN Commercial |
$5,338.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,623.36
|
| Rate for Payer: Cash Price |
$5,194.74
|
| Rate for Payer: Cofinity Commercial |
$5,584.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,194.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,623.36
|
| Rate for Payer: Healthscope Commercial |
$5,844.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,870.07
|
| Rate for Payer: Mclaren Medicaid |
$1,144.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,704.53
|
| Rate for Payer: Meridian Medicaid |
$1,201.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,866.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,785.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,519.42
|
| Rate for Payer: Nomi Health Commercial |
$5,324.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,870.07
|
| Rate for Payer: PACE Senior Care Partners |
$1,542.19
|
| Rate for Payer: PACE SWMI |
$1,623.36
|
| Rate for Payer: PHP Commercial |
$5,519.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,623.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,144.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,649.28
|
| Rate for Payer: Priority Health Medicare |
$1,639.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,519.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,623.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,714.22
|
| Rate for Payer: UHC Core |
$5,422.01
|
| Rate for Payer: UHC Exchange |
$1,623.36
|
| Rate for Payer: UHC Medicaid |
$1,144.79
|
| Rate for Payer: UHC Medicare Advantage |
$1,623.36
|
| Rate for Payer: UHCCP Medicaid |
$1,144.79
|
| Rate for Payer: VA VA |
$1,623.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,870.07
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$78.70 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna Medicare |
$116.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.49
|
| Rate for Payer: BCBS Complete |
$82.62
|
| Rate for Payer: BCBS MAPPO |
$111.59
|
| Rate for Payer: BCBS Trust/PPO |
$366.97
|
| Rate for Payer: BCN Commercial |
$366.97
|
| Rate for Payer: BCN Medicare Advantage |
$111.59
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.59
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Mclaren Medicaid |
$78.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.17
|
| Rate for Payer: Meridian Medicaid |
$82.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$122.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PACE Senior Care Partners |
$106.02
|
| Rate for Payer: PACE SWMI |
$111.59
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: PHP Medicare Advantage |
$111.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.35
|
| Rate for Payer: Priority Health Medicare |
$112.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.68
|
| Rate for Payer: Railroad Medicare Medicare |
$111.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.81
|
| Rate for Payer: UHC Core |
$372.73
|
| Rate for Payer: UHC Exchange |
$111.59
|
| Rate for Payer: UHC Medicaid |
$78.70
|
| Rate for Payer: UHC Medicare Advantage |
$111.59
|
| Rate for Payer: UHCCP Medicaid |
$78.70
|
| Rate for Payer: VA VA |
$111.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$310.68 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: BCBS Trust/PPO |
$368.67
|
| Rate for Payer: BCN Commercial |
$368.67
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.81
|
| Rate for Payer: UHC Core |
$372.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
OP
|
$706.55
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$124.56 |
| Max. Negotiated Rate |
$635.89 |
| Rate for Payer: Aetna Commercial |
$600.57
|
| Rate for Payer: Aetna Medicare |
$183.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.80
|
| Rate for Payer: BCBS Complete |
$130.78
|
| Rate for Payer: BCBS MAPPO |
$176.64
|
| Rate for Payer: BCBS Trust/PPO |
$580.85
|
| Rate for Payer: BCN Commercial |
$580.85
|
| Rate for Payer: BCN Medicare Advantage |
$176.64
|
| Rate for Payer: Cash Price |
$565.24
|
| Rate for Payer: Cofinity Commercial |
$607.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$565.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.64
|
| Rate for Payer: Healthscope Commercial |
$635.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.91
|
| Rate for Payer: Mclaren Medicaid |
$124.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.47
|
| Rate for Payer: Meridian Medicaid |
$130.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$600.57
|
| Rate for Payer: Nomi Health Commercial |
$579.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.91
|
| Rate for Payer: PACE Senior Care Partners |
$167.81
|
| Rate for Payer: PACE SWMI |
$176.64
|
| Rate for Payer: PHP Commercial |
$600.57
|
| Rate for Payer: PHP Medicare Advantage |
$176.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$614.70
|
| Rate for Payer: Priority Health Medicare |
$178.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$491.76
|
| Rate for Payer: Railroad Medicare Medicare |
$176.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$621.76
|
| Rate for Payer: UHC Core |
$589.97
|
| Rate for Payer: UHC Exchange |
$176.64
|
| Rate for Payer: UHC Medicaid |
$124.56
|
| Rate for Payer: UHC Medicare Advantage |
$176.64
|
| Rate for Payer: UHCCP Medicaid |
$124.56
|
| Rate for Payer: VA VA |
$176.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.91
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
IP
|
$706.55
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$491.76 |
| Max. Negotiated Rate |
$635.89 |
| Rate for Payer: Aetna Commercial |
$600.57
|
| Rate for Payer: BCBS Trust/PPO |
$583.54
|
| Rate for Payer: BCN Commercial |
$583.54
|
| Rate for Payer: Cash Price |
$565.24
|
| Rate for Payer: Cofinity Commercial |
$607.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$565.24
|
| Rate for Payer: Healthscope Commercial |
$635.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$600.57
|
| Rate for Payer: Nomi Health Commercial |
$579.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.91
|
| Rate for Payer: PHP Commercial |
$600.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$614.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$491.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$621.76
|
| Rate for Payer: UHC Core |
$589.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.91
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
OP
|
$635.14
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$111.98 |
| Max. Negotiated Rate |
$571.63 |
| Rate for Payer: Aetna Commercial |
$539.87
|
| Rate for Payer: Aetna Medicare |
$165.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$198.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$198.48
|
| Rate for Payer: BCBS Complete |
$117.56
|
| Rate for Payer: BCBS MAPPO |
$158.78
|
| Rate for Payer: BCBS Trust/PPO |
$522.15
|
| Rate for Payer: BCN Commercial |
$522.15
|
| Rate for Payer: BCN Medicare Advantage |
$158.78
|
| Rate for Payer: Cash Price |
$508.11
|
| Rate for Payer: Cofinity Commercial |
$546.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.78
|
| Rate for Payer: Healthscope Commercial |
$571.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$476.36
|
| Rate for Payer: Mclaren Medicaid |
$111.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.72
|
| Rate for Payer: Meridian Medicaid |
$117.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$182.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$174.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.87
|
| Rate for Payer: Nomi Health Commercial |
$520.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$476.36
|
| Rate for Payer: PACE Senior Care Partners |
$150.85
|
| Rate for Payer: PACE SWMI |
$158.78
|
| Rate for Payer: PHP Commercial |
$539.87
|
| Rate for Payer: PHP Medicare Advantage |
$158.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$552.57
|
| Rate for Payer: Priority Health Medicare |
$160.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$442.06
|
| Rate for Payer: Railroad Medicare Medicare |
$158.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.92
|
| Rate for Payer: UHC Core |
$530.34
|
| Rate for Payer: UHC Exchange |
$158.78
|
| Rate for Payer: UHC Medicaid |
$111.98
|
| Rate for Payer: UHC Medicare Advantage |
$158.78
|
| Rate for Payer: UHCCP Medicaid |
$111.98
|
| Rate for Payer: VA VA |
$158.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$476.36
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
IP
|
$635.14
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$442.06 |
| Max. Negotiated Rate |
$571.63 |
| Rate for Payer: Aetna Commercial |
$539.87
|
| Rate for Payer: BCBS Trust/PPO |
$524.56
|
| Rate for Payer: BCN Commercial |
$524.56
|
| Rate for Payer: Cash Price |
$508.11
|
| Rate for Payer: Cofinity Commercial |
$546.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.11
|
| Rate for Payer: Healthscope Commercial |
$571.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$476.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.87
|
| Rate for Payer: Nomi Health Commercial |
$520.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$476.36
|
| Rate for Payer: PHP Commercial |
$539.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$552.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$442.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.92
|
| Rate for Payer: UHC Core |
$530.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$476.36
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
OP
|
$117.60
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.73 |
| Max. Negotiated Rate |
$105.84 |
| Rate for Payer: Aetna Commercial |
$99.96
|
| Rate for Payer: Aetna Medicare |
$30.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.75
|
| Rate for Payer: BCBS Complete |
$21.77
|
| Rate for Payer: BCBS MAPPO |
$29.40
|
| Rate for Payer: BCBS Trust/PPO |
$96.68
|
| Rate for Payer: BCN Commercial |
$96.68
|
| Rate for Payer: BCN Medicare Advantage |
$29.40
|
| Rate for Payer: Cash Price |
$94.08
|
| Rate for Payer: Cofinity Commercial |
$101.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.40
|
| Rate for Payer: Healthscope Commercial |
$105.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.20
|
| Rate for Payer: Mclaren Medicaid |
$20.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.87
|
| Rate for Payer: Meridian Medicaid |
$21.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.96
|
| Rate for Payer: Nomi Health Commercial |
$96.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.20
|
| Rate for Payer: PACE Senior Care Partners |
$27.93
|
| Rate for Payer: PACE SWMI |
$29.40
|
| Rate for Payer: PHP Commercial |
$99.96
|
| Rate for Payer: PHP Medicare Advantage |
$29.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.31
|
| Rate for Payer: Priority Health Medicare |
$29.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.85
|
| Rate for Payer: Railroad Medicare Medicare |
$29.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.49
|
| Rate for Payer: UHC Core |
$98.20
|
| Rate for Payer: UHC Exchange |
$29.40
|
| Rate for Payer: UHC Medicaid |
$20.73
|
| Rate for Payer: UHC Medicare Advantage |
$29.40
|
| Rate for Payer: UHCCP Medicaid |
$20.73
|
| Rate for Payer: VA VA |
$29.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.20
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
IP
|
$117.60
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$81.85 |
| Max. Negotiated Rate |
$105.84 |
| Rate for Payer: Aetna Commercial |
$99.96
|
| Rate for Payer: BCBS Trust/PPO |
$97.13
|
| Rate for Payer: BCN Commercial |
$97.13
|
| Rate for Payer: Cash Price |
$94.08
|
| Rate for Payer: Cofinity Commercial |
$101.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.08
|
| Rate for Payer: Healthscope Commercial |
$105.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.96
|
| Rate for Payer: Nomi Health Commercial |
$96.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.20
|
| Rate for Payer: PHP Commercial |
$99.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.49
|
| Rate for Payer: UHC Core |
$98.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.20
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
IP
|
$131.35
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$91.42 |
| Max. Negotiated Rate |
$118.22 |
| Rate for Payer: Aetna Commercial |
$111.65
|
| Rate for Payer: BCBS Trust/PPO |
$108.48
|
| Rate for Payer: BCN Commercial |
$108.48
|
| Rate for Payer: Cash Price |
$105.08
|
| Rate for Payer: Cofinity Commercial |
$112.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.08
|
| Rate for Payer: Healthscope Commercial |
$118.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.65
|
| Rate for Payer: Nomi Health Commercial |
$107.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.51
|
| Rate for Payer: PHP Commercial |
$111.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$114.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.59
|
| Rate for Payer: UHC Core |
$109.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.51
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
OP
|
$131.35
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.16 |
| Max. Negotiated Rate |
$118.22 |
| Rate for Payer: Aetna Commercial |
$111.65
|
| Rate for Payer: Aetna Medicare |
$34.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.05
|
| Rate for Payer: BCBS Complete |
$24.31
|
| Rate for Payer: BCBS MAPPO |
$32.84
|
| Rate for Payer: BCBS Trust/PPO |
$107.98
|
| Rate for Payer: BCN Commercial |
$107.98
|
| Rate for Payer: BCN Medicare Advantage |
$32.84
|
| Rate for Payer: Cash Price |
$105.08
|
| Rate for Payer: Cofinity Commercial |
$112.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.84
|
| Rate for Payer: Healthscope Commercial |
$118.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.51
|
| Rate for Payer: Mclaren Medicaid |
$23.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.48
|
| Rate for Payer: Meridian Medicaid |
$24.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.65
|
| Rate for Payer: Nomi Health Commercial |
$107.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.51
|
| Rate for Payer: PACE Senior Care Partners |
$31.20
|
| Rate for Payer: PACE SWMI |
$32.84
|
| Rate for Payer: PHP Commercial |
$111.65
|
| Rate for Payer: PHP Medicare Advantage |
$32.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$114.27
|
| Rate for Payer: Priority Health Medicare |
$33.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.42
|
| Rate for Payer: Railroad Medicare Medicare |
$32.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.59
|
| Rate for Payer: UHC Core |
$109.68
|
| Rate for Payer: UHC Exchange |
$32.84
|
| Rate for Payer: UHC Medicaid |
$23.16
|
| Rate for Payer: UHC Medicare Advantage |
$32.84
|
| Rate for Payer: UHCCP Medicaid |
$23.16
|
| Rate for Payer: VA VA |
$32.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.51
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
IP
|
$4,179.85
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,909.18 |
| Max. Negotiated Rate |
$3,761.86 |
| Rate for Payer: Aetna Commercial |
$3,552.87
|
| Rate for Payer: BCBS Trust/PPO |
$3,452.14
|
| Rate for Payer: BCN Commercial |
$3,452.14
|
| Rate for Payer: Cash Price |
$3,343.88
|
| Rate for Payer: Cofinity Commercial |
$3,594.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,343.88
|
| Rate for Payer: Healthscope Commercial |
$3,761.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,134.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,552.87
|
| Rate for Payer: Nomi Health Commercial |
$3,427.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,134.89
|
| Rate for Payer: PHP Commercial |
$3,552.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,636.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,909.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,678.27
|
| Rate for Payer: UHC Core |
$3,490.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,134.89
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
OP
|
$4,179.85
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$736.91 |
| Max. Negotiated Rate |
$3,761.86 |
| Rate for Payer: Aetna Commercial |
$3,552.87
|
| Rate for Payer: Aetna Medicare |
$1,086.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,306.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,306.20
|
| Rate for Payer: BCBS Complete |
$773.69
|
| Rate for Payer: BCBS MAPPO |
$1,044.96
|
| Rate for Payer: BCBS Trust/PPO |
$3,436.25
|
| Rate for Payer: BCN Commercial |
$3,436.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,044.96
|
| Rate for Payer: Cash Price |
$3,343.88
|
| Rate for Payer: Cofinity Commercial |
$3,594.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,343.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,044.96
|
| Rate for Payer: Healthscope Commercial |
$3,761.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,134.89
|
| Rate for Payer: Mclaren Medicaid |
$736.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,097.21
|
| Rate for Payer: Meridian Medicaid |
$773.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,201.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,149.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,552.87
|
| Rate for Payer: Nomi Health Commercial |
$3,427.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,134.89
|
| Rate for Payer: PACE Senior Care Partners |
$992.71
|
| Rate for Payer: PACE SWMI |
$1,044.96
|
| Rate for Payer: PHP Commercial |
$3,552.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,044.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$736.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,636.47
|
| Rate for Payer: Priority Health Medicare |
$1,055.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,909.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,044.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,678.27
|
| Rate for Payer: UHC Core |
$3,490.17
|
| Rate for Payer: UHC Exchange |
$1,044.96
|
| Rate for Payer: UHC Medicaid |
$736.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,044.96
|
| Rate for Payer: UHCCP Medicaid |
$736.91
|
| Rate for Payer: VA VA |
$1,044.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,134.89
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
IP
|
$7,846.08
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,460.87 |
| Max. Negotiated Rate |
$7,061.47 |
| Rate for Payer: Aetna Commercial |
$6,669.17
|
| Rate for Payer: BCBS Trust/PPO |
$6,480.08
|
| Rate for Payer: BCN Commercial |
$6,480.08
|
| Rate for Payer: Cash Price |
$6,276.86
|
| Rate for Payer: Cofinity Commercial |
$6,747.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,276.86
|
| Rate for Payer: Healthscope Commercial |
$7,061.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,884.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,669.17
|
| Rate for Payer: Nomi Health Commercial |
$6,433.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,884.56
|
| Rate for Payer: PHP Commercial |
$6,669.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,826.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,460.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,904.55
|
| Rate for Payer: UHC Core |
$6,551.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,884.56
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
OP
|
$7,846.08
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,383.26 |
| Max. Negotiated Rate |
$7,061.47 |
| Rate for Payer: Aetna Commercial |
$6,669.17
|
| Rate for Payer: Aetna Medicare |
$2,039.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,451.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,451.90
|
| Rate for Payer: BCBS Complete |
$1,452.31
|
| Rate for Payer: BCBS MAPPO |
$1,961.52
|
| Rate for Payer: BCBS Trust/PPO |
$6,450.26
|
| Rate for Payer: BCN Commercial |
$6,450.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,961.52
|
| Rate for Payer: Cash Price |
$6,276.86
|
| Rate for Payer: Cofinity Commercial |
$6,747.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,276.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,961.52
|
| Rate for Payer: Healthscope Commercial |
$7,061.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,884.56
|
| Rate for Payer: Mclaren Medicaid |
$1,383.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,059.60
|
| Rate for Payer: Meridian Medicaid |
$1,452.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,255.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,157.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,669.17
|
| Rate for Payer: Nomi Health Commercial |
$6,433.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,884.56
|
| Rate for Payer: PACE Senior Care Partners |
$1,863.44
|
| Rate for Payer: PACE SWMI |
$1,961.52
|
| Rate for Payer: PHP Commercial |
$6,669.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,961.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,383.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,826.09
|
| Rate for Payer: Priority Health Medicare |
$1,981.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,460.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,961.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,904.55
|
| Rate for Payer: UHC Core |
$6,551.48
|
| Rate for Payer: UHC Exchange |
$1,961.52
|
| Rate for Payer: UHC Medicaid |
$1,383.26
|
| Rate for Payer: UHC Medicare Advantage |
$1,961.52
|
| Rate for Payer: UHCCP Medicaid |
$1,383.26
|
| Rate for Payer: VA VA |
$1,961.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,884.56
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
OP
|
$2,273.70
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$400.85 |
| Max. Negotiated Rate |
$2,046.33 |
| Rate for Payer: Aetna Commercial |
$1,932.64
|
| Rate for Payer: Aetna Medicare |
$591.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$710.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$710.53
|
| Rate for Payer: BCBS Complete |
$420.86
|
| Rate for Payer: BCBS MAPPO |
$568.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,869.21
|
| Rate for Payer: BCN Commercial |
$1,869.21
|
| Rate for Payer: BCN Medicare Advantage |
$568.42
|
| Rate for Payer: Cash Price |
$1,818.96
|
| Rate for Payer: Cofinity Commercial |
$1,955.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,818.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$568.42
|
| Rate for Payer: Healthscope Commercial |
$2,046.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,705.28
|
| Rate for Payer: Mclaren Medicaid |
$400.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$596.85
|
| Rate for Payer: Meridian Medicaid |
$420.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$653.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$625.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,932.64
|
| Rate for Payer: Nomi Health Commercial |
$1,864.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,705.28
|
| Rate for Payer: PACE Senior Care Partners |
$540.00
|
| Rate for Payer: PACE SWMI |
$568.42
|
| Rate for Payer: PHP Commercial |
$1,932.64
|
| Rate for Payer: PHP Medicare Advantage |
$568.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,978.12
|
| Rate for Payer: Priority Health Medicare |
$574.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,582.50
|
| Rate for Payer: Railroad Medicare Medicare |
$568.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,000.86
|
| Rate for Payer: UHC Core |
$1,898.54
|
| Rate for Payer: UHC Exchange |
$568.42
|
| Rate for Payer: UHC Medicaid |
$400.85
|
| Rate for Payer: UHC Medicare Advantage |
$568.42
|
| Rate for Payer: UHCCP Medicaid |
$400.85
|
| Rate for Payer: VA VA |
$568.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,705.28
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
IP
|
$2,273.70
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,582.50 |
| Max. Negotiated Rate |
$2,046.33 |
| Rate for Payer: Aetna Commercial |
$1,932.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,877.85
|
| Rate for Payer: BCN Commercial |
$1,877.85
|
| Rate for Payer: Cash Price |
$1,818.96
|
| Rate for Payer: Cofinity Commercial |
$1,955.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,818.96
|
| Rate for Payer: Healthscope Commercial |
$2,046.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,705.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,932.64
|
| Rate for Payer: Nomi Health Commercial |
$1,864.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,705.28
|
| Rate for Payer: PHP Commercial |
$1,932.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,978.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,582.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,000.86
|
| Rate for Payer: UHC Core |
$1,898.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,705.28
|
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
IP
|
$63,202.66
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$43,989.05 |
| Max. Negotiated Rate |
$56,882.39 |
| Rate for Payer: Aetna Commercial |
$53,722.26
|
| Rate for Payer: BCBS Trust/PPO |
$52,199.08
|
| Rate for Payer: BCN Commercial |
$52,199.08
|
| Rate for Payer: Cash Price |
$50,562.13
|
| Rate for Payer: Cofinity Commercial |
$54,354.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50,562.13
|
| Rate for Payer: Healthscope Commercial |
$56,882.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47,402.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53,722.26
|
| Rate for Payer: Nomi Health Commercial |
$51,826.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47,402.00
|
| Rate for Payer: PHP Commercial |
$53,722.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54,986.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43,989.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55,618.34
|
| Rate for Payer: UHC Core |
$52,774.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47,402.00
|
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
OP
|
$63,202.66
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$11,142.63 |
| Max. Negotiated Rate |
$56,882.39 |
| Rate for Payer: Aetna Commercial |
$53,722.26
|
| Rate for Payer: Aetna Medicare |
$16,432.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,750.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,750.83
|
| Rate for Payer: BCBS Complete |
$11,698.81
|
| Rate for Payer: BCBS MAPPO |
$15,800.67
|
| Rate for Payer: BCBS Trust/PPO |
$51,958.91
|
| Rate for Payer: BCN Commercial |
$51,958.91
|
| Rate for Payer: BCN Medicare Advantage |
$15,800.67
|
| Rate for Payer: Cash Price |
$50,562.13
|
| Rate for Payer: Cofinity Commercial |
$54,354.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50,562.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,800.67
|
| Rate for Payer: Healthscope Commercial |
$56,882.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47,402.00
|
| Rate for Payer: Mclaren Medicaid |
$11,142.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,590.70
|
| Rate for Payer: Meridian Medicaid |
$11,698.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,170.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$17,380.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53,722.26
|
| Rate for Payer: Nomi Health Commercial |
$51,826.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47,402.00
|
| Rate for Payer: PACE Senior Care Partners |
$15,010.63
|
| Rate for Payer: PACE SWMI |
$15,800.67
|
| Rate for Payer: PHP Commercial |
$53,722.26
|
| Rate for Payer: PHP Medicare Advantage |
$15,800.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,142.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54,986.31
|
| Rate for Payer: Priority Health Medicare |
$15,958.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43,989.05
|
| Rate for Payer: Railroad Medicare Medicare |
$15,800.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55,618.34
|
| Rate for Payer: UHC Core |
$52,774.22
|
| Rate for Payer: UHC Exchange |
$15,800.67
|
| Rate for Payer: UHC Medicaid |
$11,142.63
|
| Rate for Payer: UHC Medicare Advantage |
$15,800.67
|
| Rate for Payer: UHCCP Medicaid |
$11,142.63
|
| Rate for Payer: VA VA |
$15,800.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47,402.00
|
|
|
HC Z G J TUBE
|
Facility
|
IP
|
$1,561.51
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,086.81 |
| Max. Negotiated Rate |
$1,405.36 |
| Rate for Payer: Aetna Commercial |
$1,327.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.65
|
| Rate for Payer: BCN Commercial |
$1,289.65
|
| Rate for Payer: Cash Price |
$1,249.21
|
| Rate for Payer: Cofinity Commercial |
$1,342.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,249.21
|
| Rate for Payer: Healthscope Commercial |
$1,405.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,171.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,327.28
|
| Rate for Payer: Nomi Health Commercial |
$1,280.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,171.13
|
| Rate for Payer: PHP Commercial |
$1,327.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,358.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,086.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,374.13
|
| Rate for Payer: UHC Core |
$1,303.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,171.13
|
|
|
HC Z G J TUBE
|
Facility
|
OP
|
$1,561.51
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$275.29 |
| Max. Negotiated Rate |
$1,405.36 |
| Rate for Payer: Aetna Commercial |
$1,327.28
|
| Rate for Payer: Aetna Medicare |
$405.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.97
|
| Rate for Payer: BCBS Complete |
$289.04
|
| Rate for Payer: BCBS MAPPO |
$390.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,283.72
|
| Rate for Payer: BCN Commercial |
$1,283.72
|
| Rate for Payer: BCN Medicare Advantage |
$390.38
|
| Rate for Payer: Cash Price |
$1,249.21
|
| Rate for Payer: Cofinity Commercial |
$1,342.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,249.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.38
|
| Rate for Payer: Healthscope Commercial |
$1,405.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,171.13
|
| Rate for Payer: Mclaren Medicaid |
$275.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.90
|
| Rate for Payer: Meridian Medicaid |
$289.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$429.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,327.28
|
| Rate for Payer: Nomi Health Commercial |
$1,280.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,171.13
|
| Rate for Payer: PACE Senior Care Partners |
$370.86
|
| Rate for Payer: PACE SWMI |
$390.38
|
| Rate for Payer: PHP Commercial |
$1,327.28
|
| Rate for Payer: PHP Medicare Advantage |
$390.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,358.51
|
| Rate for Payer: Priority Health Medicare |
$394.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,086.81
|
| Rate for Payer: Railroad Medicare Medicare |
$390.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,374.13
|
| Rate for Payer: UHC Core |
$1,303.86
|
| Rate for Payer: UHC Exchange |
$390.38
|
| Rate for Payer: UHC Medicaid |
$275.29
|
| Rate for Payer: UHC Medicare Advantage |
$390.38
|
| Rate for Payer: UHCCP Medicaid |
$275.29
|
| Rate for Payer: VA VA |
$390.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,171.13
|
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
IP
|
$1,247.81
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$868.48 |
| Max. Negotiated Rate |
$1,123.03 |
| Rate for Payer: Aetna Commercial |
$1,060.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,030.57
|
| Rate for Payer: BCN Commercial |
$1,030.57
|
| Rate for Payer: Cash Price |
$998.25
|
| Rate for Payer: Cofinity Commercial |
$1,073.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$998.25
|
| Rate for Payer: Healthscope Commercial |
$1,123.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$935.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,060.64
|
| Rate for Payer: Nomi Health Commercial |
$1,023.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$935.86
|
| Rate for Payer: PHP Commercial |
$1,060.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,085.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$868.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,098.07
|
| Rate for Payer: UHC Core |
$1,041.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$935.86
|
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
OP
|
$1,247.81
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$219.99 |
| Max. Negotiated Rate |
$1,123.03 |
| Rate for Payer: Aetna Commercial |
$1,060.64
|
| Rate for Payer: Aetna Medicare |
$324.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$389.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$389.94
|
| Rate for Payer: BCBS Complete |
$230.97
|
| Rate for Payer: BCBS MAPPO |
$311.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,025.82
|
| Rate for Payer: BCN Commercial |
$1,025.82
|
| Rate for Payer: BCN Medicare Advantage |
$311.95
|
| Rate for Payer: Cash Price |
$998.25
|
| Rate for Payer: Cofinity Commercial |
$1,073.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$998.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.95
|
| Rate for Payer: Healthscope Commercial |
$1,123.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$935.86
|
| Rate for Payer: Mclaren Medicaid |
$219.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$327.55
|
| Rate for Payer: Meridian Medicaid |
$230.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$358.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$343.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,060.64
|
| Rate for Payer: Nomi Health Commercial |
$1,023.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$935.86
|
| Rate for Payer: PACE Senior Care Partners |
$296.35
|
| Rate for Payer: PACE SWMI |
$311.95
|
| Rate for Payer: PHP Commercial |
$1,060.64
|
| Rate for Payer: PHP Medicare Advantage |
$311.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,085.59
|
| Rate for Payer: Priority Health Medicare |
$315.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$868.48
|
| Rate for Payer: Railroad Medicare Medicare |
$311.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,098.07
|
| Rate for Payer: UHC Core |
$1,041.92
|
| Rate for Payer: UHC Exchange |
$311.95
|
| Rate for Payer: UHC Medicaid |
$219.99
|
| Rate for Payer: UHC Medicare Advantage |
$311.95
|
| Rate for Payer: UHCCP Medicaid |
$219.99
|
| Rate for Payer: VA VA |
$311.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$935.86
|
|
|
HC Z HEMODIALYSIS BARD
|
Facility
|
IP
|
$1,614.79
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,123.89 |
| Max. Negotiated Rate |
$1,453.31 |
| Rate for Payer: Aetna Commercial |
$1,372.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,333.66
|
| Rate for Payer: BCN Commercial |
$1,333.66
|
| Rate for Payer: Cash Price |
$1,291.83
|
| Rate for Payer: Cofinity Commercial |
$1,388.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.83
|
| Rate for Payer: Healthscope Commercial |
$1,453.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,211.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,372.57
|
| Rate for Payer: Nomi Health Commercial |
$1,324.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,211.09
|
| Rate for Payer: PHP Commercial |
$1,372.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,404.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,123.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,421.02
|
| Rate for Payer: UHC Core |
$1,348.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,211.09
|
|
