|
HC VARICELLA ZOSTER IGG
|
Facility
|
IP
|
$44.74
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
30200327
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.08 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: BCBS Trust/PPO |
$36.52
|
| Rate for Payer: BCN Commercial |
$34.58
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health HMO/PPO |
$38.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.37
|
| Rate for Payer: UHC Core |
$37.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.55
|
|
|
HC VARICELLA ZOSTER IGM
|
Facility
|
OP
|
$80.58
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
30200326
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.31 |
| Max. Negotiated Rate |
$72.52 |
| Rate for Payer: Aetna Commercial |
$68.49
|
| Rate for Payer: Aetna Medicare |
$20.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.18
|
| Rate for Payer: BCBS Complete |
$9.78
|
| Rate for Payer: BCBS MAPPO |
$20.14
|
| Rate for Payer: BCBS Trust/PPO |
$66.24
|
| Rate for Payer: BCN Commercial |
$62.65
|
| Rate for Payer: BCN Medicare Advantage |
$20.14
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$69.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.14
|
| Rate for Payer: Healthscope Commercial |
$72.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.44
|
| Rate for Payer: Mclaren Medicaid |
$9.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.15
|
| Rate for Payer: Meridian Medicaid |
$9.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.49
|
| Rate for Payer: Nomi Health Commercial |
$66.08
|
| Rate for Payer: PACE Senior Care Partners |
$19.14
|
| Rate for Payer: PACE SWMI |
$20.14
|
| Rate for Payer: PHP Commercial |
$68.49
|
| Rate for Payer: PHP Medicare Advantage |
$20.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.38
|
| Rate for Payer: Priority Health HMO/PPO |
$70.10
|
| Rate for Payer: Priority Health Medicare |
$20.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.99
|
| Rate for Payer: Railroad Medicare Medicare |
$20.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.91
|
| Rate for Payer: UHC Core |
$67.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.14
|
| Rate for Payer: UHC Exchange |
$20.14
|
| Rate for Payer: UHC Medicare Advantage |
$20.14
|
| Rate for Payer: UHCCP Medicaid |
$9.31
|
| Rate for Payer: VA VA |
$20.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.44
|
|
|
HC VARICELLA ZOSTER IGM
|
Facility
|
IP
|
$80.58
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
30200326
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$52.38 |
| Max. Negotiated Rate |
$72.52 |
| Rate for Payer: Aetna Commercial |
$68.49
|
| Rate for Payer: BCBS Trust/PPO |
$65.78
|
| Rate for Payer: BCN Commercial |
$62.27
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$69.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Healthscope Commercial |
$72.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.49
|
| Rate for Payer: Nomi Health Commercial |
$66.08
|
| Rate for Payer: PHP Commercial |
$68.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.38
|
| Rate for Payer: Priority Health HMO/PPO |
$70.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.91
|
| Rate for Payer: UHC Core |
$67.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.44
|
|
|
HC VARICELLA ZOSTER PCR CSF
|
Facility
|
IP
|
$109.24
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600167
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$71.01 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: BCBS Trust/PPO |
$89.17
|
| Rate for Payer: BCN Commercial |
$84.42
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.01
|
| Rate for Payer: Priority Health HMO/PPO |
$95.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.13
|
| Rate for Payer: UHC Core |
$91.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC VARICELLA ZOSTER PCR CSF
|
Facility
|
OP
|
$109.24
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600167
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.37 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna Medicare |
$28.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.14
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$27.31
|
| Rate for Payer: BCBS Trust/PPO |
$89.81
|
| Rate for Payer: BCN Commercial |
$84.93
|
| Rate for Payer: BCN Medicare Advantage |
$27.31
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.31
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.68
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: PACE Senior Care Partners |
$25.94
|
| Rate for Payer: PACE SWMI |
$27.31
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: PHP Medicare Advantage |
$27.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.01
|
| Rate for Payer: Priority Health HMO/PPO |
$95.04
|
| Rate for Payer: Priority Health Medicare |
$27.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.19
|
| Rate for Payer: Railroad Medicare Medicare |
$27.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.13
|
| Rate for Payer: UHC Core |
$91.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.31
|
| Rate for Payer: UHC Exchange |
$27.31
|
| Rate for Payer: UHC Medicare Advantage |
$27.31
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$27.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC VARICELLA ZOSTER VIRUS (VZV)
|
Facility
|
IP
|
$57.40
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600278
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.31 |
| Max. Negotiated Rate |
$51.66 |
| Rate for Payer: Aetna Commercial |
$48.79
|
| Rate for Payer: BCBS Trust/PPO |
$46.86
|
| Rate for Payer: BCN Commercial |
$44.36
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$49.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.92
|
| Rate for Payer: Healthscope Commercial |
$51.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.79
|
| Rate for Payer: Nomi Health Commercial |
$47.07
|
| Rate for Payer: PHP Commercial |
$48.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.31
|
| Rate for Payer: Priority Health HMO/PPO |
$49.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.51
|
| Rate for Payer: UHC Core |
$47.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.05
|
|
|
HC VARICELLA ZOSTER VIRUS (VZV)
|
Facility
|
OP
|
$57.40
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600278
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$51.66 |
| Rate for Payer: Aetna Commercial |
$48.79
|
| Rate for Payer: Aetna Medicare |
$14.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.94
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$14.35
|
| Rate for Payer: BCBS Trust/PPO |
$47.19
|
| Rate for Payer: BCN Commercial |
$44.63
|
| Rate for Payer: BCN Medicare Advantage |
$14.35
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$49.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.35
|
| Rate for Payer: Healthscope Commercial |
$51.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.05
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.07
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.79
|
| Rate for Payer: Nomi Health Commercial |
$47.07
|
| Rate for Payer: PACE Senior Care Partners |
$13.63
|
| Rate for Payer: PACE SWMI |
$14.35
|
| Rate for Payer: PHP Commercial |
$48.79
|
| Rate for Payer: PHP Medicare Advantage |
$14.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.31
|
| Rate for Payer: Priority Health HMO/PPO |
$49.94
|
| Rate for Payer: Priority Health Medicare |
$14.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.46
|
| Rate for Payer: Railroad Medicare Medicare |
$14.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.51
|
| Rate for Payer: UHC Core |
$47.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.35
|
| Rate for Payer: UHC Exchange |
$14.35
|
| Rate for Payer: UHC Medicare Advantage |
$14.35
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$14.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.05
|
|
|
HC VASCLAR EMBO OR OCCLUS DIALYSIS CIRCUIT W IMAGING
|
Facility
|
OP
|
$204.41
|
|
|
Service Code
|
CPT 36909
|
| Hospital Charge Code |
36100533
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$48.55 |
| Max. Negotiated Rate |
$183.97 |
| Rate for Payer: Aetna Commercial |
$173.75
|
| Rate for Payer: Aetna Medicare |
$53.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.88
|
| Rate for Payer: BCBS Complete |
$81.76
|
| Rate for Payer: BCBS MAPPO |
$51.10
|
| Rate for Payer: BCBS Trust/PPO |
$168.05
|
| Rate for Payer: BCN Commercial |
$158.93
|
| Rate for Payer: BCN Medicare Advantage |
$51.10
|
| Rate for Payer: Cash Price |
$163.53
|
| Rate for Payer: Cofinity Commercial |
$175.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.10
|
| Rate for Payer: Healthscope Commercial |
$183.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.75
|
| Rate for Payer: Nomi Health Commercial |
$167.62
|
| Rate for Payer: PACE Senior Care Partners |
$48.55
|
| Rate for Payer: PACE SWMI |
$51.10
|
| Rate for Payer: PHP Commercial |
$173.75
|
| Rate for Payer: PHP Medicare Advantage |
$51.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.87
|
| Rate for Payer: Priority Health HMO/PPO |
$177.84
|
| Rate for Payer: Priority Health Medicare |
$51.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.95
|
| Rate for Payer: Railroad Medicare Medicare |
$51.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.88
|
| Rate for Payer: UHC Core |
$170.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.10
|
| Rate for Payer: UHC Exchange |
$51.10
|
| Rate for Payer: UHC Medicare Advantage |
$51.10
|
| Rate for Payer: VA VA |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.31
|
|
|
HC VASCLAR EMBO OR OCCLUS DIALYSIS CIRCUIT W IMAGING
|
Facility
|
IP
|
$204.41
|
|
|
Service Code
|
CPT 36909
|
| Hospital Charge Code |
36100533
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$132.87 |
| Max. Negotiated Rate |
$183.97 |
| Rate for Payer: Aetna Commercial |
$173.75
|
| Rate for Payer: BCBS Trust/PPO |
$166.86
|
| Rate for Payer: BCN Commercial |
$157.97
|
| Rate for Payer: Cash Price |
$163.53
|
| Rate for Payer: Cofinity Commercial |
$175.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.53
|
| Rate for Payer: Healthscope Commercial |
$183.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.75
|
| Rate for Payer: Nomi Health Commercial |
$167.62
|
| Rate for Payer: PHP Commercial |
$173.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.87
|
| Rate for Payer: Priority Health HMO/PPO |
$177.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.88
|
| Rate for Payer: UHC Core |
$170.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.31
|
|
|
HC VASCULAR EMBOL/OCCLU W PRESSURE GEN CATH
|
Facility
|
IP
|
$33,420.00
|
|
|
Service Code
|
CPT C9797
|
| Hospital Charge Code |
36100635
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$21,723.00 |
| Max. Negotiated Rate |
$30,078.00 |
| Rate for Payer: Aetna Commercial |
$28,407.00
|
| Rate for Payer: BCBS Trust/PPO |
$27,280.75
|
| Rate for Payer: BCN Commercial |
$25,826.98
|
| Rate for Payer: Cash Price |
$26,736.00
|
| Rate for Payer: Cofinity Commercial |
$28,741.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26,736.00
|
| Rate for Payer: Healthscope Commercial |
$30,078.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25,065.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,407.00
|
| Rate for Payer: Nomi Health Commercial |
$27,404.40
|
| Rate for Payer: PHP Commercial |
$28,407.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21,723.00
|
| Rate for Payer: Priority Health HMO/PPO |
$29,075.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22,391.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29,409.60
|
| Rate for Payer: UHC Core |
$27,905.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25,065.00
|
|
|
HC VASCULAR EMBOL/OCCLU W PRESSURE GEN CATH
|
Facility
|
OP
|
$33,420.00
|
|
|
Service Code
|
CPT C9797
|
| Hospital Charge Code |
36100635
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,937.25 |
| Max. Negotiated Rate |
$30,078.00 |
| Rate for Payer: Aetna Commercial |
$28,407.00
|
| Rate for Payer: Aetna Medicare |
$8,689.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,443.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,443.75
|
| Rate for Payer: BCBS Complete |
$13,632.74
|
| Rate for Payer: BCBS MAPPO |
$8,355.00
|
| Rate for Payer: BCBS Trust/PPO |
$27,474.58
|
| Rate for Payer: BCN Commercial |
$25,984.05
|
| Rate for Payer: BCN Medicare Advantage |
$8,355.00
|
| Rate for Payer: Cash Price |
$26,736.00
|
| Rate for Payer: Cash Price |
$26,736.00
|
| Rate for Payer: Cofinity Commercial |
$28,741.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26,736.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,355.00
|
| Rate for Payer: Healthscope Commercial |
$30,078.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25,065.00
|
| Rate for Payer: Mclaren Medicaid |
$12,982.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,772.75
|
| Rate for Payer: Meridian Medicaid |
$13,632.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,608.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28,407.00
|
| Rate for Payer: Nomi Health Commercial |
$27,404.40
|
| Rate for Payer: PACE Senior Care Partners |
$7,937.25
|
| Rate for Payer: PACE SWMI |
$8,355.00
|
| Rate for Payer: PHP Commercial |
$28,407.00
|
| Rate for Payer: PHP Medicare Advantage |
$8,355.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,982.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21,723.00
|
| Rate for Payer: Priority Health HMO/PPO |
$29,075.40
|
| Rate for Payer: Priority Health Medicare |
$8,438.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22,391.40
|
| Rate for Payer: Railroad Medicare Medicare |
$8,355.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29,409.60
|
| Rate for Payer: UHC Core |
$27,905.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,355.00
|
| Rate for Payer: UHC Exchange |
$8,355.00
|
| Rate for Payer: UHC Medicare Advantage |
$8,355.00
|
| Rate for Payer: UHCCP Medicaid |
$12,982.71
|
| Rate for Payer: VA VA |
$8,355.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25,065.00
|
|
|
HC VASCULAR GRAFT
|
Facility
|
OP
|
$2,314.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27800033
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$549.67 |
| Max. Negotiated Rate |
$2,082.96 |
| Rate for Payer: Aetna Commercial |
$1,967.24
|
| Rate for Payer: Aetna Medicare |
$601.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$723.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$723.25
|
| Rate for Payer: BCBS Complete |
$925.76
|
| Rate for Payer: BCBS MAPPO |
$578.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.67
|
| Rate for Payer: BCN Commercial |
$1,799.45
|
| Rate for Payer: BCN Medicare Advantage |
$578.60
|
| Rate for Payer: Cash Price |
$1,851.52
|
| Rate for Payer: Cofinity Commercial |
$1,990.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,851.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$578.60
|
| Rate for Payer: Healthscope Commercial |
$2,082.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,735.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$607.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$665.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,967.24
|
| Rate for Payer: Nomi Health Commercial |
$1,897.81
|
| Rate for Payer: PACE Senior Care Partners |
$549.67
|
| Rate for Payer: PACE SWMI |
$578.60
|
| Rate for Payer: PHP Commercial |
$1,967.24
|
| Rate for Payer: PHP Medicare Advantage |
$578.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,504.36
|
| Rate for Payer: Priority Health HMO/PPO |
$2,013.53
|
| Rate for Payer: Priority Health Medicare |
$584.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,550.65
|
| Rate for Payer: Railroad Medicare Medicare |
$578.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,036.67
|
| Rate for Payer: UHC Core |
$1,932.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$578.60
|
| Rate for Payer: UHC Exchange |
$578.60
|
| Rate for Payer: UHC Medicare Advantage |
$578.60
|
| Rate for Payer: VA VA |
$578.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,735.80
|
|
|
HC VASCULAR GRAFT
|
Facility
|
IP
|
$2,314.40
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
27800033
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,504.36 |
| Max. Negotiated Rate |
$2,082.96 |
| Rate for Payer: Aetna Commercial |
$1,967.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,889.24
|
| Rate for Payer: BCN Commercial |
$1,788.57
|
| Rate for Payer: Cash Price |
$1,851.52
|
| Rate for Payer: Cofinity Commercial |
$1,990.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,851.52
|
| Rate for Payer: Healthscope Commercial |
$2,082.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,735.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,967.24
|
| Rate for Payer: Nomi Health Commercial |
$1,897.81
|
| Rate for Payer: PHP Commercial |
$1,967.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,504.36
|
| Rate for Payer: Priority Health HMO/PPO |
$2,013.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,550.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,036.67
|
| Rate for Payer: UHC Core |
$1,932.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,735.80
|
|
|
HC VASOACTIVE INTESTINAL PEPTIDE/VIP
|
Facility
|
OP
|
$84.27
|
|
|
Service Code
|
CPT 84586
|
| Hospital Charge Code |
30100456
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.01 |
| Max. Negotiated Rate |
$75.84 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna Medicare |
$21.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.33
|
| Rate for Payer: BCBS Complete |
$26.82
|
| Rate for Payer: BCBS MAPPO |
$21.07
|
| Rate for Payer: BCBS Trust/PPO |
$69.28
|
| Rate for Payer: BCN Commercial |
$65.52
|
| Rate for Payer: BCN Medicare Advantage |
$21.07
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$72.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.07
|
| Rate for Payer: Healthscope Commercial |
$75.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.20
|
| Rate for Payer: Mclaren Medicaid |
$25.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.12
|
| Rate for Payer: Meridian Medicaid |
$26.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: Nomi Health Commercial |
$69.10
|
| Rate for Payer: PACE Senior Care Partners |
$20.01
|
| Rate for Payer: PACE SWMI |
$21.07
|
| Rate for Payer: PHP Commercial |
$71.63
|
| Rate for Payer: PHP Medicare Advantage |
$21.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.78
|
| Rate for Payer: Priority Health HMO/PPO |
$73.31
|
| Rate for Payer: Priority Health Medicare |
$21.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.46
|
| Rate for Payer: Railroad Medicare Medicare |
$21.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.16
|
| Rate for Payer: UHC Core |
$70.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.07
|
| Rate for Payer: UHC Exchange |
$21.07
|
| Rate for Payer: UHC Medicare Advantage |
$21.07
|
| Rate for Payer: UHCCP Medicaid |
$25.54
|
| Rate for Payer: VA VA |
$21.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.20
|
|
|
HC VASOACTIVE INTESTINAL PEPTIDE/VIP
|
Facility
|
IP
|
$84.27
|
|
|
Service Code
|
CPT 84586
|
| Hospital Charge Code |
30100456
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.78 |
| Max. Negotiated Rate |
$75.84 |
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: BCBS Trust/PPO |
$68.79
|
| Rate for Payer: BCN Commercial |
$65.12
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$72.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Healthscope Commercial |
$75.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: Nomi Health Commercial |
$69.10
|
| Rate for Payer: PHP Commercial |
$71.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.78
|
| Rate for Payer: Priority Health HMO/PPO |
$73.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.16
|
| Rate for Payer: UHC Core |
$70.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.20
|
|
|
HC VASOPNEUMATIC TREATMENT
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
43000017
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$48.69 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: BCBS Trust/PPO |
$61.15
|
| Rate for Payer: BCN Commercial |
$57.89
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.69
|
| Rate for Payer: Priority Health HMO/PPO |
$65.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.92
|
| Rate for Payer: UHC Core |
$62.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.18
|
|
|
HC VASOPNEUMATIC TREATMENT
|
Facility
|
OP
|
$74.91
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
43000017
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$17.79 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna Medicare |
$19.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.41
|
| Rate for Payer: BCBS Complete |
$29.96
|
| Rate for Payer: BCBS MAPPO |
$18.73
|
| Rate for Payer: BCBS Trust/PPO |
$61.58
|
| Rate for Payer: BCN Commercial |
$58.24
|
| Rate for Payer: BCN Medicare Advantage |
$18.73
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.73
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: PACE Senior Care Partners |
$17.79
|
| Rate for Payer: PACE SWMI |
$18.73
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: PHP Medicare Advantage |
$18.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.69
|
| Rate for Payer: Priority Health HMO/PPO |
$65.17
|
| Rate for Payer: Priority Health Medicare |
$18.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.19
|
| Rate for Payer: Railroad Medicare Medicare |
$18.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.92
|
| Rate for Payer: UHC Core |
$62.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.73
|
| Rate for Payer: UHC Exchange |
$18.73
|
| Rate for Payer: UHC Medicare Advantage |
$18.73
|
| Rate for Payer: VA VA |
$18.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.18
|
|
|
HC VDRL SPINAL FLUID
|
Facility
|
OP
|
$35.37
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200216
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna Medicare |
$9.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.05
|
| Rate for Payer: BCBS Complete |
$3.24
|
| Rate for Payer: BCBS MAPPO |
$8.84
|
| Rate for Payer: BCBS Trust/PPO |
$29.08
|
| Rate for Payer: BCN Commercial |
$27.50
|
| Rate for Payer: BCN Medicare Advantage |
$8.84
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.84
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Mclaren Medicaid |
$3.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.28
|
| Rate for Payer: Meridian Medicaid |
$3.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: PACE Senior Care Partners |
$8.40
|
| Rate for Payer: PACE SWMI |
$8.84
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: PHP Medicare Advantage |
$8.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health HMO/PPO |
$30.77
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.70
|
| Rate for Payer: Railroad Medicare Medicare |
$8.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.13
|
| Rate for Payer: UHC Core |
$29.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.84
|
| Rate for Payer: UHC Exchange |
$8.84
|
| Rate for Payer: UHC Medicare Advantage |
$8.84
|
| Rate for Payer: UHCCP Medicaid |
$3.09
|
| Rate for Payer: VA VA |
$8.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC VDRL SPINAL FLUID
|
Facility
|
IP
|
$35.37
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200216
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: BCBS Trust/PPO |
$28.87
|
| Rate for Payer: BCN Commercial |
$27.33
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health HMO/PPO |
$30.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.13
|
| Rate for Payer: UHC Core |
$29.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC VDRL TITER CSF
|
Facility
|
IP
|
$75.48
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
30200397
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.06 |
| Max. Negotiated Rate |
$67.93 |
| Rate for Payer: Aetna Commercial |
$64.16
|
| Rate for Payer: BCBS Trust/PPO |
$61.61
|
| Rate for Payer: BCN Commercial |
$58.33
|
| Rate for Payer: Cash Price |
$60.38
|
| Rate for Payer: Cofinity Commercial |
$64.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.38
|
| Rate for Payer: Healthscope Commercial |
$67.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.16
|
| Rate for Payer: Nomi Health Commercial |
$61.89
|
| Rate for Payer: PHP Commercial |
$64.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.06
|
| Rate for Payer: Priority Health HMO/PPO |
$65.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.42
|
| Rate for Payer: UHC Core |
$63.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.61
|
|
|
HC VDRL TITER CSF
|
Facility
|
OP
|
$75.48
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
30200397
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$67.93 |
| Rate for Payer: Aetna Commercial |
$64.16
|
| Rate for Payer: Aetna Medicare |
$19.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.59
|
| Rate for Payer: BCBS Complete |
$3.34
|
| Rate for Payer: BCBS MAPPO |
$18.87
|
| Rate for Payer: BCBS Trust/PPO |
$62.05
|
| Rate for Payer: BCN Commercial |
$58.69
|
| Rate for Payer: BCN Medicare Advantage |
$18.87
|
| Rate for Payer: Cash Price |
$60.38
|
| Rate for Payer: Cash Price |
$60.38
|
| Rate for Payer: Cofinity Commercial |
$64.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.87
|
| Rate for Payer: Healthscope Commercial |
$67.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.61
|
| Rate for Payer: Mclaren Medicaid |
$3.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.81
|
| Rate for Payer: Meridian Medicaid |
$3.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.16
|
| Rate for Payer: Nomi Health Commercial |
$61.89
|
| Rate for Payer: PACE Senior Care Partners |
$17.93
|
| Rate for Payer: PACE SWMI |
$18.87
|
| Rate for Payer: PHP Commercial |
$64.16
|
| Rate for Payer: PHP Medicare Advantage |
$18.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.06
|
| Rate for Payer: Priority Health HMO/PPO |
$65.67
|
| Rate for Payer: Priority Health Medicare |
$19.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.57
|
| Rate for Payer: Railroad Medicare Medicare |
$18.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.42
|
| Rate for Payer: UHC Core |
$63.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.87
|
| Rate for Payer: UHC Exchange |
$18.87
|
| Rate for Payer: UHC Medicare Advantage |
$18.87
|
| Rate for Payer: UHCCP Medicaid |
$3.18
|
| Rate for Payer: VA VA |
$18.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.61
|
|
|
HC VEDOLIZUMAB
|
Facility
|
OP
|
$166.26
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100671
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$149.63 |
| Rate for Payer: Aetna Commercial |
$141.32
|
| Rate for Payer: Aetna Medicare |
$43.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.96
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$41.56
|
| Rate for Payer: BCBS Trust/PPO |
$136.68
|
| Rate for Payer: BCN Commercial |
$129.27
|
| Rate for Payer: BCN Medicare Advantage |
$41.56
|
| Rate for Payer: Cash Price |
$133.01
|
| Rate for Payer: Cash Price |
$133.01
|
| Rate for Payer: Cofinity Commercial |
$142.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.56
|
| Rate for Payer: Healthscope Commercial |
$149.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.69
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.64
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.32
|
| Rate for Payer: Nomi Health Commercial |
$136.33
|
| Rate for Payer: PACE Senior Care Partners |
$39.49
|
| Rate for Payer: PACE SWMI |
$41.56
|
| Rate for Payer: PHP Commercial |
$141.32
|
| Rate for Payer: PHP Medicare Advantage |
$41.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.07
|
| Rate for Payer: Priority Health HMO/PPO |
$144.65
|
| Rate for Payer: Priority Health Medicare |
$41.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.39
|
| Rate for Payer: Railroad Medicare Medicare |
$41.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.31
|
| Rate for Payer: UHC Core |
$138.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.56
|
| Rate for Payer: UHC Exchange |
$41.56
|
| Rate for Payer: UHC Medicare Advantage |
$41.56
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$41.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.69
|
|
|
HC VEDOLIZUMAB
|
Facility
|
IP
|
$166.26
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100671
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$108.07 |
| Max. Negotiated Rate |
$149.63 |
| Rate for Payer: Aetna Commercial |
$141.32
|
| Rate for Payer: BCBS Trust/PPO |
$135.72
|
| Rate for Payer: BCN Commercial |
$128.49
|
| Rate for Payer: Cash Price |
$133.01
|
| Rate for Payer: Cofinity Commercial |
$142.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.01
|
| Rate for Payer: Healthscope Commercial |
$149.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.32
|
| Rate for Payer: Nomi Health Commercial |
$136.33
|
| Rate for Payer: PHP Commercial |
$141.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.07
|
| Rate for Payer: Priority Health HMO/PPO |
$144.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.31
|
| Rate for Payer: UHC Core |
$138.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.69
|
|
|
HC VEDOLIZUMAB, ANTIBODY
|
Facility
|
OP
|
$131.58
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
30100683
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.21 |
| Max. Negotiated Rate |
$118.42 |
| Rate for Payer: Aetna Commercial |
$111.84
|
| 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 |
$10.72
|
| Rate for Payer: BCBS MAPPO |
$32.90
|
| Rate for Payer: BCBS Trust/PPO |
$108.17
|
| Rate for Payer: BCN Commercial |
$102.30
|
| Rate for Payer: BCN Medicare Advantage |
$32.90
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cofinity Commercial |
$113.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.90
|
| Rate for Payer: Healthscope Commercial |
$118.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.69
|
| Rate for Payer: Mclaren Medicaid |
$10.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.54
|
| Rate for Payer: Meridian Medicaid |
$10.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.84
|
| Rate for Payer: Nomi Health Commercial |
$107.90
|
| Rate for Payer: PACE Senior Care Partners |
$31.25
|
| Rate for Payer: PACE SWMI |
$32.90
|
| Rate for Payer: PHP Commercial |
$111.84
|
| Rate for Payer: PHP Medicare Advantage |
$32.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.53
|
| Rate for Payer: Priority Health HMO/PPO |
$114.47
|
| Rate for Payer: Priority Health Medicare |
$33.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.16
|
| Rate for Payer: Railroad Medicare Medicare |
$32.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.79
|
| Rate for Payer: UHC Core |
$109.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.90
|
| Rate for Payer: UHC Exchange |
$32.90
|
| Rate for Payer: UHC Medicare Advantage |
$32.90
|
| Rate for Payer: UHCCP Medicaid |
$10.21
|
| Rate for Payer: VA VA |
$32.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.69
|
|
|
HC VEDOLIZUMAB, ANTIBODY
|
Facility
|
IP
|
$131.58
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
30100683
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$85.53 |
| Max. Negotiated Rate |
$118.42 |
| Rate for Payer: Aetna Commercial |
$111.84
|
| Rate for Payer: BCBS Trust/PPO |
$107.41
|
| Rate for Payer: BCN Commercial |
$101.69
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cofinity Commercial |
$113.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.26
|
| Rate for Payer: Healthscope Commercial |
$118.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.84
|
| Rate for Payer: Nomi Health Commercial |
$107.90
|
| Rate for Payer: PHP Commercial |
$111.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.53
|
| Rate for Payer: Priority Health HMO/PPO |
$114.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.79
|
| Rate for Payer: UHC Core |
$109.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.69
|
|
