|
HC VOLUME MEASUREMENT
|
Facility
|
OP
|
$19.67
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.63 |
| Max. Negotiated Rate |
$17.70 |
| Rate for Payer: Aetna Commercial |
$16.72
|
| Rate for Payer: Aetna Medicare |
$5.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.15
|
| Rate for Payer: BCBS Complete |
$2.76
|
| Rate for Payer: BCBS MAPPO |
$4.92
|
| Rate for Payer: BCBS Trust/PPO |
$16.17
|
| Rate for Payer: BCN Commercial |
$15.29
|
| Rate for Payer: BCN Medicare Advantage |
$4.92
|
| Rate for Payer: Cash Price |
$15.74
|
| Rate for Payer: Cash Price |
$15.74
|
| Rate for Payer: Cofinity Commercial |
$16.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.92
|
| Rate for Payer: Healthscope Commercial |
$17.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.75
|
| Rate for Payer: Mclaren Medicaid |
$2.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.16
|
| Rate for Payer: Meridian Medicaid |
$2.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.72
|
| Rate for Payer: Nomi Health Commercial |
$16.13
|
| Rate for Payer: PACE Senior Care Partners |
$4.67
|
| Rate for Payer: PACE SWMI |
$4.92
|
| Rate for Payer: PHP Commercial |
$16.72
|
| Rate for Payer: PHP Medicare Advantage |
$4.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.79
|
| Rate for Payer: Priority Health HMO/PPO |
$17.11
|
| Rate for Payer: Priority Health Medicare |
$4.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.18
|
| Rate for Payer: Railroad Medicare Medicare |
$4.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.31
|
| Rate for Payer: UHC Core |
$16.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.92
|
| Rate for Payer: UHC Exchange |
$4.92
|
| Rate for Payer: UHC Medicare Advantage |
$4.92
|
| Rate for Payer: UHCCP Medicaid |
$2.63
|
| Rate for Payer: VA VA |
$4.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.75
|
|
|
HC VON WILLEBRAND ANTIGEN
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$43.96 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: BCBS Trust/PPO |
$55.21
|
| Rate for Payer: BCN Commercial |
$52.26
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC VON WILLEBRAND ANTIGEN
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.06 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$17.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.13
|
| Rate for Payer: BCBS Complete |
$17.42
|
| Rate for Payer: BCBS MAPPO |
$16.91
|
| Rate for Payer: BCBS Trust/PPO |
$55.60
|
| Rate for Payer: BCN Commercial |
$52.58
|
| Rate for Payer: BCN Medicare Advantage |
$16.91
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.91
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$16.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.75
|
| Rate for Payer: Meridian Medicaid |
$17.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: PACE Senior Care Partners |
$16.06
|
| Rate for Payer: PACE SWMI |
$16.91
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Medicare |
$17.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.31
|
| Rate for Payer: Railroad Medicare Medicare |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.91
|
| Rate for Payer: UHC Exchange |
$16.91
|
| Rate for Payer: UHC Medicare Advantage |
$16.91
|
| Rate for Payer: UHCCP Medicaid |
$16.59
|
| Rate for Payer: VA VA |
$16.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
IP
|
$206.00
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$133.90 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: BCBS Trust/PPO |
$168.16
|
| Rate for Payer: BCN Commercial |
$159.20
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.10
|
| Rate for Payer: Nomi Health Commercial |
$168.92
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.90
|
| Rate for Payer: Priority Health HMO/PPO |
$179.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.28
|
| Rate for Payer: UHC Core |
$172.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
OP
|
$206.00
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.31 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: Aetna Medicare |
$53.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.38
|
| Rate for Payer: BCBS Complete |
$23.43
|
| Rate for Payer: BCBS MAPPO |
$51.50
|
| Rate for Payer: BCBS Trust/PPO |
$169.35
|
| Rate for Payer: BCN Commercial |
$160.16
|
| Rate for Payer: BCN Medicare Advantage |
$51.50
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.50
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: Mclaren Medicaid |
$22.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.08
|
| Rate for Payer: Meridian Medicaid |
$23.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.10
|
| Rate for Payer: Nomi Health Commercial |
$168.92
|
| Rate for Payer: PACE Senior Care Partners |
$48.92
|
| Rate for Payer: PACE SWMI |
$51.50
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: PHP Medicare Advantage |
$51.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.90
|
| Rate for Payer: Priority Health HMO/PPO |
$179.22
|
| Rate for Payer: Priority Health Medicare |
$52.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.02
|
| Rate for Payer: Railroad Medicare Medicare |
$51.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.28
|
| Rate for Payer: UHC Core |
$172.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.50
|
| Rate for Payer: UHC Exchange |
$51.50
|
| Rate for Payer: UHC Medicare Advantage |
$51.50
|
| Rate for Payer: UHCCP Medicaid |
$22.31
|
| Rate for Payer: VA VA |
$51.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
IP
|
$95.88
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$62.32 |
| Max. Negotiated Rate |
$86.29 |
| Rate for Payer: Aetna Commercial |
$81.50
|
| Rate for Payer: BCBS Trust/PPO |
$78.27
|
| Rate for Payer: BCN Commercial |
$74.10
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cofinity Commercial |
$82.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.70
|
| Rate for Payer: Healthscope Commercial |
$86.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.50
|
| Rate for Payer: Nomi Health Commercial |
$78.62
|
| Rate for Payer: PHP Commercial |
$81.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.32
|
| Rate for Payer: Priority Health HMO/PPO |
$83.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.37
|
| Rate for Payer: UHC Core |
$80.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.91
|
|
|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
OP
|
$95.88
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.59 |
| Max. Negotiated Rate |
$86.29 |
| Rate for Payer: Aetna Commercial |
$81.50
|
| Rate for Payer: Aetna Medicare |
$24.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.96
|
| Rate for Payer: BCBS Complete |
$17.42
|
| Rate for Payer: BCBS MAPPO |
$23.97
|
| Rate for Payer: BCBS Trust/PPO |
$78.82
|
| Rate for Payer: BCN Commercial |
$74.55
|
| Rate for Payer: BCN Medicare Advantage |
$23.97
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cofinity Commercial |
$82.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.97
|
| Rate for Payer: Healthscope Commercial |
$86.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.91
|
| Rate for Payer: Mclaren Medicaid |
$16.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.17
|
| Rate for Payer: Meridian Medicaid |
$17.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.50
|
| Rate for Payer: Nomi Health Commercial |
$78.62
|
| Rate for Payer: PACE Senior Care Partners |
$22.77
|
| Rate for Payer: PACE SWMI |
$23.97
|
| Rate for Payer: PHP Commercial |
$81.50
|
| Rate for Payer: PHP Medicare Advantage |
$23.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.32
|
| Rate for Payer: Priority Health HMO/PPO |
$83.42
|
| Rate for Payer: Priority Health Medicare |
$24.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.24
|
| Rate for Payer: Railroad Medicare Medicare |
$23.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.37
|
| Rate for Payer: UHC Core |
$80.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.97
|
| Rate for Payer: UHC Exchange |
$23.97
|
| Rate for Payer: UHC Medicare Advantage |
$23.97
|
| Rate for Payer: UHCCP Medicaid |
$16.59
|
| Rate for Payer: VA VA |
$23.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.91
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
IP
|
$129.01
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$83.86 |
| Max. Negotiated Rate |
$116.11 |
| Rate for Payer: Aetna Commercial |
$109.66
|
| Rate for Payer: BCBS Trust/PPO |
$105.31
|
| Rate for Payer: BCN Commercial |
$99.70
|
| 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: PHP Commercial |
$109.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.86
|
| Rate for Payer: Priority Health HMO/PPO |
$112.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.44
|
| 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
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
OP
|
$129.01
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.31 |
| 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 |
$23.43
|
| Rate for Payer: BCBS MAPPO |
$32.25
|
| Rate for Payer: BCBS Trust/PPO |
$106.06
|
| Rate for Payer: BCN Commercial |
$100.31
|
| Rate for Payer: BCN Medicare Advantage |
$32.25
|
| Rate for Payer: Cash Price |
$103.21
|
| 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 |
$22.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.87
|
| Rate for Payer: Meridian Medicaid |
$23.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.66
|
| Rate for Payer: Nomi Health Commercial |
$105.79
|
| 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 |
$22.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.86
|
| Rate for Payer: Priority Health HMO/PPO |
$112.24
|
| Rate for Payer: Priority Health Medicare |
$32.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.44
|
| 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 Dual Complete DSNP |
$32.25
|
| Rate for Payer: UHC Exchange |
$32.25
|
| Rate for Payer: UHC Medicare Advantage |
$32.25
|
| Rate for Payer: UHCCP Medicaid |
$22.31
|
| Rate for Payer: VA VA |
$32.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.76
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
IP
|
$97.80
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$63.57 |
| Max. Negotiated Rate |
$88.02 |
| Rate for Payer: Aetna Commercial |
$83.13
|
| Rate for Payer: BCBS Trust/PPO |
$79.83
|
| Rate for Payer: BCN Commercial |
$75.58
|
| 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: PHP Commercial |
$83.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.57
|
| Rate for Payer: Priority Health HMO/PPO |
$85.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.53
|
| 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 PANEL CMPT1
|
Facility
|
OP
|
$97.80
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.94 |
| 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 |
$13.59
|
| Rate for Payer: BCBS MAPPO |
$24.45
|
| Rate for Payer: BCBS Trust/PPO |
$80.40
|
| Rate for Payer: BCN Commercial |
$76.04
|
| Rate for Payer: BCN Medicare Advantage |
$24.45
|
| Rate for Payer: Cash Price |
$78.24
|
| 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 |
$12.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.67
|
| Rate for Payer: Meridian Medicaid |
$13.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.13
|
| Rate for Payer: Nomi Health Commercial |
$80.20
|
| 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 |
$12.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.57
|
| Rate for Payer: Priority Health HMO/PPO |
$85.09
|
| Rate for Payer: Priority Health Medicare |
$24.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.53
|
| 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 Dual Complete DSNP |
$24.45
|
| Rate for Payer: UHC Exchange |
$24.45
|
| Rate for Payer: UHC Medicare Advantage |
$24.45
|
| Rate for Payer: UHCCP Medicaid |
$12.94
|
| Rate for Payer: VA VA |
$24.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.35
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
OP
|
$130.05
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.59 |
| Max. Negotiated Rate |
$117.05 |
| Rate for Payer: Aetna Commercial |
$110.54
|
| Rate for Payer: Aetna Medicare |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.64
|
| Rate for Payer: BCBS Complete |
$17.42
|
| Rate for Payer: BCBS MAPPO |
$32.51
|
| Rate for Payer: BCBS Trust/PPO |
$106.91
|
| Rate for Payer: BCN Commercial |
$101.11
|
| Rate for Payer: BCN Medicare Advantage |
$32.51
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Commercial |
$111.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.51
|
| Rate for Payer: Healthscope Commercial |
$117.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.54
|
| Rate for Payer: Mclaren Medicaid |
$16.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.14
|
| Rate for Payer: Meridian Medicaid |
$17.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: Nomi Health Commercial |
$106.64
|
| Rate for Payer: PACE Senior Care Partners |
$30.89
|
| Rate for Payer: PACE SWMI |
$32.51
|
| Rate for Payer: PHP Commercial |
$110.54
|
| Rate for Payer: PHP Medicare Advantage |
$32.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.53
|
| Rate for Payer: Priority Health HMO/PPO |
$113.14
|
| Rate for Payer: Priority Health Medicare |
$32.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.13
|
| Rate for Payer: Railroad Medicare Medicare |
$32.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.44
|
| Rate for Payer: UHC Core |
$108.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.51
|
| Rate for Payer: UHC Exchange |
$32.51
|
| Rate for Payer: UHC Medicare Advantage |
$32.51
|
| Rate for Payer: UHCCP Medicaid |
$16.59
|
| Rate for Payer: VA VA |
$32.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.54
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
IP
|
$130.05
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$84.53 |
| Max. Negotiated Rate |
$117.05 |
| Rate for Payer: Aetna Commercial |
$110.54
|
| Rate for Payer: BCBS Trust/PPO |
$106.16
|
| Rate for Payer: BCN Commercial |
$100.50
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Commercial |
$111.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Healthscope Commercial |
$117.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: Nomi Health Commercial |
$106.64
|
| Rate for Payer: PHP Commercial |
$110.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.53
|
| Rate for Payer: Priority Health HMO/PPO |
$113.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.44
|
| Rate for Payer: UHC Core |
$108.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.54
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
IP
|
$126.48
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$82.21 |
| Max. Negotiated Rate |
$113.83 |
| Rate for Payer: Aetna Commercial |
$107.51
|
| Rate for Payer: BCBS Trust/PPO |
$103.25
|
| Rate for Payer: BCN Commercial |
$97.74
|
| Rate for Payer: Cash Price |
$101.18
|
| Rate for Payer: Cofinity Commercial |
$108.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.18
|
| Rate for Payer: Healthscope Commercial |
$113.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.51
|
| Rate for Payer: Nomi Health Commercial |
$103.71
|
| Rate for Payer: PHP Commercial |
$107.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.21
|
| Rate for Payer: Priority Health HMO/PPO |
$110.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.30
|
| Rate for Payer: UHC Core |
$105.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.86
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
OP
|
$126.48
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.59 |
| Max. Negotiated Rate |
$113.83 |
| Rate for Payer: Aetna Commercial |
$107.51
|
| Rate for Payer: Aetna Medicare |
$32.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.52
|
| Rate for Payer: BCBS Complete |
$17.42
|
| Rate for Payer: BCBS MAPPO |
$31.62
|
| Rate for Payer: BCBS Trust/PPO |
$103.98
|
| Rate for Payer: BCN Commercial |
$98.34
|
| Rate for Payer: BCN Medicare Advantage |
$31.62
|
| Rate for Payer: Cash Price |
$101.18
|
| Rate for Payer: Cash Price |
$101.18
|
| Rate for Payer: Cofinity Commercial |
$108.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.62
|
| Rate for Payer: Healthscope Commercial |
$113.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.86
|
| Rate for Payer: Mclaren Medicaid |
$16.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.20
|
| Rate for Payer: Meridian Medicaid |
$17.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.51
|
| Rate for Payer: Nomi Health Commercial |
$103.71
|
| Rate for Payer: PACE Senior Care Partners |
$30.04
|
| Rate for Payer: PACE SWMI |
$31.62
|
| Rate for Payer: PHP Commercial |
$107.51
|
| Rate for Payer: PHP Medicare Advantage |
$31.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.21
|
| Rate for Payer: Priority Health HMO/PPO |
$110.04
|
| Rate for Payer: Priority Health Medicare |
$31.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.74
|
| Rate for Payer: Railroad Medicare Medicare |
$31.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.30
|
| Rate for Payer: UHC Core |
$105.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.62
|
| Rate for Payer: UHC Exchange |
$31.62
|
| Rate for Payer: UHC Medicare Advantage |
$31.62
|
| Rate for Payer: UHCCP Medicaid |
$16.59
|
| Rate for Payer: VA VA |
$31.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.86
|
|
|
HC VORICONAZOLE, S
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 80285
|
| Hospital Charge Code |
30100707
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: BCBS Trust/PPO |
$74.94
|
| Rate for Payer: BCN Commercial |
$70.94
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC VORICONAZOLE, S
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 80285
|
| Hospital Charge Code |
30100707
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.69
|
| Rate for Payer: BCBS Complete |
$20.58
|
| Rate for Payer: BCBS MAPPO |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$75.47
|
| Rate for Payer: BCN Commercial |
$71.37
|
| Rate for Payer: BCN Medicare Advantage |
$22.95
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.95
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$19.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.10
|
| Rate for Payer: Meridian Medicaid |
$20.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PACE Senior Care Partners |
$21.80
|
| Rate for Payer: PACE SWMI |
$22.95
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Medicare Advantage |
$22.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Medicare |
$23.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: Railroad Medicare Medicare |
$22.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.95
|
| Rate for Payer: UHC Exchange |
$22.95
|
| Rate for Payer: UHC Medicare Advantage |
$22.95
|
| Rate for Payer: UHCCP Medicaid |
$19.60
|
| Rate for Payer: VA VA |
$22.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC VULVECTOMY SIMPLE PARTIAL
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 56620
|
| Hospital Charge Code |
36100618
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,887.06 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna Medicare |
$2,065.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,482.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,482.98
|
| Rate for Payer: BCBS Complete |
$2,413.90
|
| Rate for Payer: BCBS MAPPO |
$1,986.38
|
| Rate for Payer: BCBS Trust/PPO |
$6,532.02
|
| Rate for Payer: BCN Commercial |
$6,177.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,986.38
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,986.38
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Mclaren Medicaid |
$2,298.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,085.70
|
| Rate for Payer: Meridian Medicaid |
$2,413.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,284.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,887.06
|
| Rate for Payer: PACE SWMI |
$1,986.38
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,986.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,298.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO |
$6,912.61
|
| Rate for Payer: Priority Health Medicare |
$2,006.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,323.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,986.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,992.07
|
| Rate for Payer: UHC Core |
$6,634.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,986.38
|
| Rate for Payer: UHC Exchange |
$1,986.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,986.38
|
| Rate for Payer: UHCCP Medicaid |
$2,298.80
|
| Rate for Payer: VA VA |
$1,986.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC VULVECTOMY SIMPLE PARTIAL
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 56620
|
| Hospital Charge Code |
36100618
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,164.59 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: BCBS Trust/PPO |
$6,485.94
|
| Rate for Payer: BCN Commercial |
$6,140.31
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,515.33
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO |
$6,912.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,323.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,992.07
|
| Rate for Payer: UHC Core |
$6,634.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC WALNUT IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200065
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC WALNUT IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200065
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC WALNUT TREE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200116
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC WALNUT TREE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200116
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC WASHED RED BLOOD CELLS
|
Facility
|
IP
|
$829.72
|
|
|
Service Code
|
HCPCS P9022
|
| Hospital Charge Code |
39000073
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$539.32 |
| Max. Negotiated Rate |
$746.75 |
| Rate for Payer: Aetna Commercial |
$705.26
|
| Rate for Payer: BCBS Trust/PPO |
$677.30
|
| Rate for Payer: BCN Commercial |
$641.21
|
| Rate for Payer: Cash Price |
$663.78
|
| Rate for Payer: Cofinity Commercial |
$713.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$663.78
|
| Rate for Payer: Healthscope Commercial |
$746.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$622.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$705.26
|
| Rate for Payer: Nomi Health Commercial |
$680.37
|
| Rate for Payer: PHP Commercial |
$705.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$539.32
|
| Rate for Payer: Priority Health HMO/PPO |
$721.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$555.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$730.15
|
| Rate for Payer: UHC Core |
$692.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$622.29
|
|
|
HC WASHED RED BLOOD CELLS
|
Facility
|
OP
|
$829.72
|
|
|
Service Code
|
HCPCS P9022
|
| Hospital Charge Code |
39000073
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$197.06 |
| Max. Negotiated Rate |
$746.75 |
| Rate for Payer: Aetna Commercial |
$705.26
|
| Rate for Payer: Aetna Medicare |
$215.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$259.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$259.29
|
| Rate for Payer: BCBS Complete |
$301.30
|
| Rate for Payer: BCBS MAPPO |
$207.43
|
| Rate for Payer: BCBS Trust/PPO |
$682.11
|
| Rate for Payer: BCN Commercial |
$645.11
|
| Rate for Payer: BCN Medicare Advantage |
$207.43
|
| Rate for Payer: Cash Price |
$663.78
|
| Rate for Payer: Cash Price |
$663.78
|
| Rate for Payer: Cofinity Commercial |
$713.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$663.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.43
|
| Rate for Payer: Healthscope Commercial |
$746.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$622.29
|
| Rate for Payer: Mclaren Medicaid |
$286.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$217.80
|
| Rate for Payer: Meridian Medicaid |
$301.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$238.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$705.26
|
| Rate for Payer: Nomi Health Commercial |
$680.37
|
| Rate for Payer: PACE Senior Care Partners |
$197.06
|
| Rate for Payer: PACE SWMI |
$207.43
|
| Rate for Payer: PHP Commercial |
$705.26
|
| Rate for Payer: PHP Medicare Advantage |
$207.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$539.32
|
| Rate for Payer: Priority Health HMO/PPO |
$721.86
|
| Rate for Payer: Priority Health Medicare |
$209.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$555.91
|
| Rate for Payer: Railroad Medicare Medicare |
$207.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$730.15
|
| Rate for Payer: UHC Core |
$692.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$207.43
|
| Rate for Payer: UHC Exchange |
$207.43
|
| Rate for Payer: UHC Medicare Advantage |
$207.43
|
| Rate for Payer: UHCCP Medicaid |
$286.94
|
| Rate for Payer: VA VA |
$207.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$622.29
|
|
