|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
IP
|
$110.28
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.68 |
| Max. Negotiated Rate |
$99.25 |
| Rate for Payer: Aetna Commercial |
$93.74
|
| Rate for Payer: BCBS Trust/PPO |
$90.02
|
| Rate for Payer: BCN Commercial |
$85.22
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cofinity Commercial |
$94.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.22
|
| Rate for Payer: Healthscope Commercial |
$99.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.74
|
| Rate for Payer: Nomi Health Commercial |
$90.43
|
| Rate for Payer: PHP Commercial |
$93.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.68
|
| Rate for Payer: Priority Health HMO/PPO |
$95.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.05
|
| Rate for Payer: UHC Core |
$92.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.71
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
OP
|
$110.28
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.19 |
| Max. Negotiated Rate |
$99.25 |
| Rate for Payer: Aetna Commercial |
$93.74
|
| Rate for Payer: Aetna Medicare |
$28.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.46
|
| Rate for Payer: BCBS Complete |
$49.87
|
| Rate for Payer: BCBS MAPPO |
$27.57
|
| Rate for Payer: BCBS Trust/PPO |
$90.66
|
| Rate for Payer: BCN Commercial |
$85.74
|
| Rate for Payer: BCN Medicare Advantage |
$27.57
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cofinity Commercial |
$94.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.57
|
| Rate for Payer: Healthscope Commercial |
$99.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.71
|
| Rate for Payer: Mclaren Medicaid |
$47.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.95
|
| Rate for Payer: Meridian Medicaid |
$49.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.74
|
| Rate for Payer: Nomi Health Commercial |
$90.43
|
| Rate for Payer: PACE Senior Care Partners |
$26.19
|
| Rate for Payer: PACE SWMI |
$27.57
|
| Rate for Payer: PHP Commercial |
$93.74
|
| Rate for Payer: PHP Medicare Advantage |
$27.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.68
|
| Rate for Payer: Priority Health HMO/PPO |
$95.94
|
| Rate for Payer: Priority Health Medicare |
$27.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.89
|
| Rate for Payer: Railroad Medicare Medicare |
$27.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.05
|
| Rate for Payer: UHC Core |
$92.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.57
|
| Rate for Payer: UHC Exchange |
$27.57
|
| Rate for Payer: UHC Medicare Advantage |
$27.57
|
| Rate for Payer: UHCCP Medicaid |
$47.49
|
| Rate for Payer: VA VA |
$27.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.71
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
IP
|
$120.02
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$78.01 |
| Max. Negotiated Rate |
$108.02 |
| Rate for Payer: Aetna Commercial |
$102.02
|
| Rate for Payer: BCBS Trust/PPO |
$97.97
|
| Rate for Payer: BCN Commercial |
$92.75
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cofinity Commercial |
$103.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.02
|
| Rate for Payer: Healthscope Commercial |
$108.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.02
|
| Rate for Payer: Nomi Health Commercial |
$98.42
|
| Rate for Payer: PHP Commercial |
$102.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.01
|
| Rate for Payer: Priority Health HMO/PPO |
$104.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.62
|
| Rate for Payer: UHC Core |
$100.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.02
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
OP
|
$120.02
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.50 |
| Max. Negotiated Rate |
$108.02 |
| Rate for Payer: Aetna Commercial |
$102.02
|
| Rate for Payer: Aetna Medicare |
$31.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.51
|
| Rate for Payer: BCBS Complete |
$55.70
|
| Rate for Payer: BCBS MAPPO |
$30.00
|
| Rate for Payer: BCBS Trust/PPO |
$98.67
|
| Rate for Payer: BCN Commercial |
$93.32
|
| Rate for Payer: BCN Medicare Advantage |
$30.00
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cofinity Commercial |
$103.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.00
|
| Rate for Payer: Healthscope Commercial |
$108.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.02
|
| Rate for Payer: Mclaren Medicaid |
$53.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.51
|
| Rate for Payer: Meridian Medicaid |
$55.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.02
|
| Rate for Payer: Nomi Health Commercial |
$98.42
|
| Rate for Payer: PACE Senior Care Partners |
$28.50
|
| Rate for Payer: PACE SWMI |
$30.00
|
| Rate for Payer: PHP Commercial |
$102.02
|
| Rate for Payer: PHP Medicare Advantage |
$30.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.01
|
| Rate for Payer: Priority Health HMO/PPO |
$104.42
|
| Rate for Payer: Priority Health Medicare |
$30.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.41
|
| Rate for Payer: Railroad Medicare Medicare |
$30.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.62
|
| Rate for Payer: UHC Core |
$100.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.00
|
| Rate for Payer: UHC Exchange |
$30.00
|
| Rate for Payer: UHC Medicare Advantage |
$30.00
|
| Rate for Payer: UHCCP Medicaid |
$53.05
|
| Rate for Payer: VA VA |
$30.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.02
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
OP
|
$4,097.89
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$973.25 |
| Max. Negotiated Rate |
$3,688.10 |
| Rate for Payer: Aetna Commercial |
$3,483.21
|
| Rate for Payer: Aetna Medicare |
$1,065.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,280.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,280.59
|
| Rate for Payer: BCBS Complete |
$1,639.16
|
| Rate for Payer: BCBS MAPPO |
$1,024.47
|
| Rate for Payer: BCBS Trust/PPO |
$3,368.88
|
| Rate for Payer: BCN Commercial |
$3,186.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,024.47
|
| Rate for Payer: Cash Price |
$3,278.31
|
| Rate for Payer: Cofinity Commercial |
$3,524.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,278.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,024.47
|
| Rate for Payer: Healthscope Commercial |
$3,688.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,073.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,075.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,178.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,483.21
|
| Rate for Payer: Nomi Health Commercial |
$3,360.27
|
| Rate for Payer: PACE Senior Care Partners |
$973.25
|
| Rate for Payer: PACE SWMI |
$1,024.47
|
| Rate for Payer: PHP Commercial |
$3,483.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,024.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,663.63
|
| Rate for Payer: Priority Health HMO/PPO |
$3,565.16
|
| Rate for Payer: Priority Health Medicare |
$1,034.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,745.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,024.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,606.14
|
| Rate for Payer: UHC Core |
$3,421.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,024.47
|
| Rate for Payer: UHC Exchange |
$1,024.47
|
| Rate for Payer: UHC Medicare Advantage |
$1,024.47
|
| Rate for Payer: VA VA |
$1,024.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,073.42
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
IP
|
$4,097.89
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,663.63 |
| Max. Negotiated Rate |
$3,688.10 |
| Rate for Payer: Aetna Commercial |
$3,483.21
|
| Rate for Payer: BCBS Trust/PPO |
$3,345.11
|
| Rate for Payer: BCN Commercial |
$3,166.85
|
| Rate for Payer: Cash Price |
$3,278.31
|
| Rate for Payer: Cofinity Commercial |
$3,524.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,278.31
|
| Rate for Payer: Healthscope Commercial |
$3,688.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,073.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,483.21
|
| Rate for Payer: Nomi Health Commercial |
$3,360.27
|
| Rate for Payer: PHP Commercial |
$3,483.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,663.63
|
| Rate for Payer: Priority Health HMO/PPO |
$3,565.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,745.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,606.14
|
| Rate for Payer: UHC Core |
$3,421.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,073.42
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
OP
|
$7,692.24
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,826.91 |
| Max. Negotiated Rate |
$6,923.02 |
| Rate for Payer: Aetna Commercial |
$6,538.40
|
| Rate for Payer: Aetna Medicare |
$1,999.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,403.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,403.82
|
| Rate for Payer: BCBS Complete |
$3,076.90
|
| Rate for Payer: BCBS MAPPO |
$1,923.06
|
| Rate for Payer: BCBS Trust/PPO |
$6,323.79
|
| Rate for Payer: BCN Commercial |
$5,980.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,923.06
|
| Rate for Payer: Cash Price |
$6,153.79
|
| Rate for Payer: Cofinity Commercial |
$6,615.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,153.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,923.06
|
| Rate for Payer: Healthscope Commercial |
$6,923.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,769.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,019.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,211.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,538.40
|
| Rate for Payer: Nomi Health Commercial |
$6,307.64
|
| Rate for Payer: PACE Senior Care Partners |
$1,826.91
|
| Rate for Payer: PACE SWMI |
$1,923.06
|
| Rate for Payer: PHP Commercial |
$6,538.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,923.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,999.96
|
| Rate for Payer: Priority Health HMO/PPO |
$6,692.25
|
| Rate for Payer: Priority Health Medicare |
$1,942.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,153.80
|
| Rate for Payer: Railroad Medicare Medicare |
$1,923.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,769.17
|
| Rate for Payer: UHC Core |
$6,423.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,923.06
|
| Rate for Payer: UHC Exchange |
$1,923.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,923.06
|
| Rate for Payer: VA VA |
$1,923.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,769.18
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
IP
|
$7,692.24
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,999.96 |
| Max. Negotiated Rate |
$6,923.02 |
| Rate for Payer: Aetna Commercial |
$6,538.40
|
| Rate for Payer: BCBS Trust/PPO |
$6,279.18
|
| Rate for Payer: BCN Commercial |
$5,944.56
|
| Rate for Payer: Cash Price |
$6,153.79
|
| Rate for Payer: Cofinity Commercial |
$6,615.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,153.79
|
| Rate for Payer: Healthscope Commercial |
$6,923.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,769.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,538.40
|
| Rate for Payer: Nomi Health Commercial |
$6,307.64
|
| Rate for Payer: PHP Commercial |
$6,538.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,999.96
|
| Rate for Payer: Priority Health HMO/PPO |
$6,692.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,153.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,769.17
|
| Rate for Payer: UHC Core |
$6,423.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,769.18
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
OP
|
$2,229.12
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$529.42 |
| Max. Negotiated Rate |
$2,006.21 |
| Rate for Payer: Aetna Commercial |
$1,894.75
|
| Rate for Payer: Aetna Medicare |
$579.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$696.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$696.60
|
| Rate for Payer: BCBS Complete |
$605.86
|
| Rate for Payer: BCBS MAPPO |
$557.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,832.56
|
| Rate for Payer: BCN Commercial |
$1,733.14
|
| Rate for Payer: BCN Medicare Advantage |
$557.28
|
| Rate for Payer: Cash Price |
$1,783.30
|
| Rate for Payer: Cash Price |
$1,783.30
|
| Rate for Payer: Cofinity Commercial |
$1,917.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,783.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.28
|
| Rate for Payer: Healthscope Commercial |
$2,006.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,671.84
|
| Rate for Payer: Mclaren Medicaid |
$576.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$585.14
|
| Rate for Payer: Meridian Medicaid |
$605.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$640.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,894.75
|
| Rate for Payer: Nomi Health Commercial |
$1,827.88
|
| Rate for Payer: PACE Senior Care Partners |
$529.42
|
| Rate for Payer: PACE SWMI |
$557.28
|
| Rate for Payer: PHP Commercial |
$1,894.75
|
| Rate for Payer: PHP Medicare Advantage |
$557.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$576.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.93
|
| Rate for Payer: Priority Health HMO/PPO |
$1,939.33
|
| Rate for Payer: Priority Health Medicare |
$562.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,493.51
|
| Rate for Payer: Railroad Medicare Medicare |
$557.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,961.63
|
| Rate for Payer: UHC Core |
$1,861.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$557.28
|
| Rate for Payer: UHC Exchange |
$557.28
|
| Rate for Payer: UHC Medicare Advantage |
$557.28
|
| Rate for Payer: UHCCP Medicaid |
$576.97
|
| Rate for Payer: VA VA |
$557.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,671.84
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
IP
|
$2,229.12
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,448.93 |
| Max. Negotiated Rate |
$2,006.21 |
| Rate for Payer: Aetna Commercial |
$1,894.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,819.63
|
| Rate for Payer: BCN Commercial |
$1,722.66
|
| Rate for Payer: Cash Price |
$1,783.30
|
| Rate for Payer: Cofinity Commercial |
$1,917.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,783.30
|
| Rate for Payer: Healthscope Commercial |
$2,006.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,671.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,894.75
|
| Rate for Payer: Nomi Health Commercial |
$1,827.88
|
| Rate for Payer: PHP Commercial |
$1,894.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.93
|
| Rate for Payer: Priority Health HMO/PPO |
$1,939.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,493.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,961.63
|
| Rate for Payer: UHC Core |
$1,861.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,671.84
|
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
OP
|
$61,963.39
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$14,716.31 |
| Max. Negotiated Rate |
$55,767.05 |
| Rate for Payer: Aetna Commercial |
$52,668.88
|
| Rate for Payer: Aetna Medicare |
$16,110.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,363.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,363.56
|
| Rate for Payer: BCBS Complete |
$43,141.20
|
| Rate for Payer: BCBS MAPPO |
$15,490.85
|
| Rate for Payer: BCBS Trust/PPO |
$50,940.10
|
| Rate for Payer: BCN Commercial |
$48,176.54
|
| Rate for Payer: BCN Medicare Advantage |
$15,490.85
|
| Rate for Payer: Cash Price |
$49,570.71
|
| Rate for Payer: Cash Price |
$49,570.71
|
| Rate for Payer: Cofinity Commercial |
$53,288.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49,570.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,490.85
|
| Rate for Payer: Healthscope Commercial |
$55,767.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46,472.54
|
| Rate for Payer: Mclaren Medicaid |
$41,084.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16,265.39
|
| Rate for Payer: Meridian Medicaid |
$43,141.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,814.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52,668.88
|
| Rate for Payer: Nomi Health Commercial |
$50,809.98
|
| Rate for Payer: PACE Senior Care Partners |
$14,716.31
|
| Rate for Payer: PACE SWMI |
$15,490.85
|
| Rate for Payer: PHP Commercial |
$52,668.88
|
| Rate for Payer: PHP Medicare Advantage |
$15,490.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$41,084.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40,276.20
|
| Rate for Payer: Priority Health HMO/PPO |
$53,908.15
|
| Rate for Payer: Priority Health Medicare |
$15,645.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41,515.47
|
| Rate for Payer: Railroad Medicare Medicare |
$15,490.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54,527.78
|
| Rate for Payer: UHC Core |
$51,739.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,490.85
|
| Rate for Payer: UHC Exchange |
$15,490.85
|
| Rate for Payer: UHC Medicare Advantage |
$15,490.85
|
| Rate for Payer: UHCCP Medicaid |
$41,084.15
|
| Rate for Payer: VA VA |
$15,490.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46,472.54
|
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
IP
|
$61,963.39
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$40,276.20 |
| Max. Negotiated Rate |
$55,767.05 |
| Rate for Payer: Aetna Commercial |
$52,668.88
|
| Rate for Payer: BCBS Trust/PPO |
$50,580.72
|
| Rate for Payer: BCN Commercial |
$47,885.31
|
| Rate for Payer: Cash Price |
$49,570.71
|
| Rate for Payer: Cofinity Commercial |
$53,288.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49,570.71
|
| Rate for Payer: Healthscope Commercial |
$55,767.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46,472.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52,668.88
|
| Rate for Payer: Nomi Health Commercial |
$50,809.98
|
| Rate for Payer: PHP Commercial |
$52,668.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40,276.20
|
| Rate for Payer: Priority Health HMO/PPO |
$53,908.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41,515.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54,527.78
|
| Rate for Payer: UHC Core |
$51,739.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46,472.54
|
|
|
HC Z G J TUBE
|
Facility
|
OP
|
$1,530.89
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$363.59 |
| Max. Negotiated Rate |
$1,377.80 |
| Rate for Payer: Aetna Commercial |
$1,301.26
|
| Rate for Payer: Aetna Medicare |
$398.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$478.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$478.40
|
| Rate for Payer: BCBS Complete |
$612.36
|
| Rate for Payer: BCBS MAPPO |
$382.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,258.54
|
| Rate for Payer: BCN Commercial |
$1,190.27
|
| Rate for Payer: BCN Medicare Advantage |
$382.72
|
| Rate for Payer: Cash Price |
$1,224.71
|
| Rate for Payer: Cofinity Commercial |
$1,316.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.72
|
| Rate for Payer: Healthscope Commercial |
$1,377.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,148.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$401.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$440.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,301.26
|
| Rate for Payer: Nomi Health Commercial |
$1,255.33
|
| Rate for Payer: PACE Senior Care Partners |
$363.59
|
| Rate for Payer: PACE SWMI |
$382.72
|
| Rate for Payer: PHP Commercial |
$1,301.26
|
| Rate for Payer: PHP Medicare Advantage |
$382.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.08
|
| Rate for Payer: Priority Health HMO/PPO |
$1,331.87
|
| Rate for Payer: Priority Health Medicare |
$386.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,025.70
|
| Rate for Payer: Railroad Medicare Medicare |
$382.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,347.18
|
| Rate for Payer: UHC Core |
$1,278.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.72
|
| Rate for Payer: UHC Exchange |
$382.72
|
| Rate for Payer: UHC Medicare Advantage |
$382.72
|
| Rate for Payer: VA VA |
$382.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,148.17
|
|
|
HC Z G J TUBE
|
Facility
|
IP
|
$1,530.89
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$995.08 |
| Max. Negotiated Rate |
$1,377.80 |
| Rate for Payer: Aetna Commercial |
$1,301.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,249.67
|
| Rate for Payer: BCN Commercial |
$1,183.07
|
| Rate for Payer: Cash Price |
$1,224.71
|
| Rate for Payer: Cofinity Commercial |
$1,316.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.71
|
| Rate for Payer: Healthscope Commercial |
$1,377.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,148.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,301.26
|
| Rate for Payer: Nomi Health Commercial |
$1,255.33
|
| Rate for Payer: PHP Commercial |
$1,301.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.08
|
| Rate for Payer: Priority Health HMO/PPO |
$1,331.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,025.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,347.18
|
| Rate for Payer: UHC Core |
$1,278.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,148.17
|
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
OP
|
$1,223.34
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$290.54 |
| Max. Negotiated Rate |
$1,101.01 |
| Rate for Payer: Aetna Commercial |
$1,039.84
|
| Rate for Payer: Aetna Medicare |
$318.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.29
|
| Rate for Payer: BCBS Complete |
$489.34
|
| Rate for Payer: BCBS MAPPO |
$305.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,005.71
|
| Rate for Payer: BCN Commercial |
$951.15
|
| Rate for Payer: BCN Medicare Advantage |
$305.83
|
| Rate for Payer: Cash Price |
$978.67
|
| Rate for Payer: Cofinity Commercial |
$1,052.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$978.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.83
|
| Rate for Payer: Healthscope Commercial |
$1,101.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$917.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,039.84
|
| Rate for Payer: Nomi Health Commercial |
$1,003.14
|
| Rate for Payer: PACE Senior Care Partners |
$290.54
|
| Rate for Payer: PACE SWMI |
$305.83
|
| Rate for Payer: PHP Commercial |
$1,039.84
|
| Rate for Payer: PHP Medicare Advantage |
$305.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$795.17
|
| Rate for Payer: Priority Health HMO/PPO |
$1,064.31
|
| Rate for Payer: Priority Health Medicare |
$308.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$819.64
|
| Rate for Payer: Railroad Medicare Medicare |
$305.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,076.54
|
| Rate for Payer: UHC Core |
$1,021.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.83
|
| Rate for Payer: UHC Exchange |
$305.83
|
| Rate for Payer: UHC Medicare Advantage |
$305.83
|
| Rate for Payer: VA VA |
$305.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$917.50
|
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
IP
|
$1,223.34
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$795.17 |
| Max. Negotiated Rate |
$1,101.01 |
| Rate for Payer: Aetna Commercial |
$1,039.84
|
| Rate for Payer: BCBS Trust/PPO |
$998.61
|
| Rate for Payer: BCN Commercial |
$945.40
|
| Rate for Payer: Cash Price |
$978.67
|
| Rate for Payer: Cofinity Commercial |
$1,052.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$978.67
|
| Rate for Payer: Healthscope Commercial |
$1,101.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$917.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,039.84
|
| Rate for Payer: Nomi Health Commercial |
$1,003.14
|
| Rate for Payer: PHP Commercial |
$1,039.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$795.17
|
| Rate for Payer: Priority Health HMO/PPO |
$1,064.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$819.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,076.54
|
| Rate for Payer: UHC Core |
$1,021.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$917.50
|
|
|
HC Z HEMODIALYSIS BARD
|
Facility
|
IP
|
$1,583.13
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,029.03 |
| Max. Negotiated Rate |
$1,424.82 |
| Rate for Payer: Aetna Commercial |
$1,345.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,292.31
|
| Rate for Payer: BCN Commercial |
$1,223.44
|
| Rate for Payer: Cash Price |
$1,266.50
|
| Rate for Payer: Cofinity Commercial |
$1,361.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,266.50
|
| Rate for Payer: Healthscope Commercial |
$1,424.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,187.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,345.66
|
| Rate for Payer: Nomi Health Commercial |
$1,298.17
|
| Rate for Payer: PHP Commercial |
$1,345.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,029.03
|
| Rate for Payer: Priority Health HMO/PPO |
$1,377.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,060.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,393.15
|
| Rate for Payer: UHC Core |
$1,321.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,187.35
|
|
|
HC Z HEMODIALYSIS BARD
|
Facility
|
OP
|
$1,583.13
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$375.99 |
| Max. Negotiated Rate |
$1,424.82 |
| Rate for Payer: Aetna Commercial |
$1,345.66
|
| Rate for Payer: Aetna Medicare |
$411.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$494.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$494.73
|
| Rate for Payer: BCBS Complete |
$633.25
|
| Rate for Payer: BCBS MAPPO |
$395.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,301.49
|
| Rate for Payer: BCN Commercial |
$1,230.88
|
| Rate for Payer: BCN Medicare Advantage |
$395.78
|
| Rate for Payer: Cash Price |
$1,266.50
|
| Rate for Payer: Cofinity Commercial |
$1,361.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,266.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$395.78
|
| Rate for Payer: Healthscope Commercial |
$1,424.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,187.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$415.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$455.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,345.66
|
| Rate for Payer: Nomi Health Commercial |
$1,298.17
|
| Rate for Payer: PACE Senior Care Partners |
$375.99
|
| Rate for Payer: PACE SWMI |
$395.78
|
| Rate for Payer: PHP Commercial |
$1,345.66
|
| Rate for Payer: PHP Medicare Advantage |
$395.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,029.03
|
| Rate for Payer: Priority Health HMO/PPO |
$1,377.32
|
| Rate for Payer: Priority Health Medicare |
$399.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,060.70
|
| Rate for Payer: Railroad Medicare Medicare |
$395.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,393.15
|
| Rate for Payer: UHC Core |
$1,321.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$395.78
|
| Rate for Payer: UHC Exchange |
$395.78
|
| Rate for Payer: UHC Medicare Advantage |
$395.78
|
| Rate for Payer: VA VA |
$395.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,187.35
|
|
|
HC Z HYPERGLIDE OCCL BALLOON C
|
Facility
|
OP
|
$2,218.93
|
|
|
Service Code
|
HCPCS C2628
|
| Hospital Charge Code |
27200089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$527.00 |
| Max. Negotiated Rate |
$1,997.04 |
| Rate for Payer: Aetna Commercial |
$1,886.09
|
| Rate for Payer: Aetna Medicare |
$576.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$693.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$693.42
|
| Rate for Payer: BCBS Complete |
$887.57
|
| Rate for Payer: BCBS MAPPO |
$554.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,824.18
|
| Rate for Payer: BCN Commercial |
$1,725.22
|
| Rate for Payer: BCN Medicare Advantage |
$554.73
|
| Rate for Payer: Cash Price |
$1,775.14
|
| Rate for Payer: Cofinity Commercial |
$1,908.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,775.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$554.73
|
| Rate for Payer: Healthscope Commercial |
$1,997.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,664.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$582.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$637.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,886.09
|
| Rate for Payer: Nomi Health Commercial |
$1,819.52
|
| Rate for Payer: PACE Senior Care Partners |
$527.00
|
| Rate for Payer: PACE SWMI |
$554.73
|
| Rate for Payer: PHP Commercial |
$1,886.09
|
| Rate for Payer: PHP Medicare Advantage |
$554.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,442.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,930.47
|
| Rate for Payer: Priority Health Medicare |
$560.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,486.68
|
| Rate for Payer: Railroad Medicare Medicare |
$554.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,952.66
|
| Rate for Payer: UHC Core |
$1,852.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$554.73
|
| Rate for Payer: UHC Exchange |
$554.73
|
| Rate for Payer: UHC Medicare Advantage |
$554.73
|
| Rate for Payer: VA VA |
$554.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,664.20
|
|
|
HC Z HYPERGLIDE OCCL BALLOON C
|
Facility
|
IP
|
$2,218.93
|
|
|
Service Code
|
HCPCS C2628
|
| Hospital Charge Code |
27200089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,442.30 |
| Max. Negotiated Rate |
$1,997.04 |
| Rate for Payer: Aetna Commercial |
$1,886.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,811.31
|
| Rate for Payer: BCN Commercial |
$1,714.79
|
| Rate for Payer: Cash Price |
$1,775.14
|
| Rate for Payer: Cofinity Commercial |
$1,908.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,775.14
|
| Rate for Payer: Healthscope Commercial |
$1,997.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,664.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,886.09
|
| Rate for Payer: Nomi Health Commercial |
$1,819.52
|
| Rate for Payer: PHP Commercial |
$1,886.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,442.30
|
| Rate for Payer: Priority Health HMO/PPO |
$1,930.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,486.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,952.66
|
| Rate for Payer: UHC Core |
$1,852.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,664.20
|
|
|
HC ZIKA VIRUS MAC ELISA IGM
|
Facility
|
OP
|
$187.68
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000148
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.18 |
| Max. Negotiated Rate |
$168.91 |
| Rate for Payer: Aetna Commercial |
$159.53
|
| Rate for Payer: Aetna Medicare |
$48.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.65
|
| Rate for Payer: BCBS Complete |
$12.79
|
| Rate for Payer: BCBS MAPPO |
$46.92
|
| Rate for Payer: BCBS Trust/PPO |
$154.29
|
| Rate for Payer: BCN Commercial |
$145.92
|
| Rate for Payer: BCN Medicare Advantage |
$46.92
|
| Rate for Payer: Cash Price |
$150.14
|
| Rate for Payer: Cash Price |
$150.14
|
| Rate for Payer: Cofinity Commercial |
$161.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.92
|
| Rate for Payer: Healthscope Commercial |
$168.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.76
|
| Rate for Payer: Mclaren Medicaid |
$12.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.27
|
| Rate for Payer: Meridian Medicaid |
$12.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.53
|
| Rate for Payer: Nomi Health Commercial |
$153.90
|
| Rate for Payer: PACE Senior Care Partners |
$44.57
|
| Rate for Payer: PACE SWMI |
$46.92
|
| Rate for Payer: PHP Commercial |
$159.53
|
| Rate for Payer: PHP Medicare Advantage |
$46.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.99
|
| Rate for Payer: Priority Health HMO/PPO |
$163.28
|
| Rate for Payer: Priority Health Medicare |
$47.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.75
|
| Rate for Payer: Railroad Medicare Medicare |
$46.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.16
|
| Rate for Payer: UHC Core |
$156.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.92
|
| Rate for Payer: UHC Exchange |
$46.92
|
| Rate for Payer: UHC Medicare Advantage |
$46.92
|
| Rate for Payer: UHCCP Medicaid |
$12.18
|
| Rate for Payer: VA VA |
$46.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.76
|
|
|
HC ZIKA VIRUS MAC ELISA IGM
|
Facility
|
IP
|
$187.68
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000148
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$121.99 |
| Max. Negotiated Rate |
$168.91 |
| Rate for Payer: Aetna Commercial |
$159.53
|
| Rate for Payer: BCBS Trust/PPO |
$153.20
|
| Rate for Payer: BCN Commercial |
$145.04
|
| Rate for Payer: Cash Price |
$150.14
|
| Rate for Payer: Cofinity Commercial |
$161.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.14
|
| Rate for Payer: Healthscope Commercial |
$168.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.53
|
| Rate for Payer: Nomi Health Commercial |
$153.90
|
| Rate for Payer: PHP Commercial |
$159.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.99
|
| Rate for Payer: Priority Health HMO/PPO |
$163.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.16
|
| Rate for Payer: UHC Core |
$156.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.76
|
|
|
HC ZIKA VIRUS, PCR, SERUM
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000150
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$169.06 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: BCBS Trust/PPO |
$212.32
|
| Rate for Payer: BCN Commercial |
$201.01
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health HMO/PPO |
$226.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC ZIKA VIRUS, PCR, SERUM
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000150
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.10 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna Medicare |
$67.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.28
|
| Rate for Payer: BCBS Complete |
$38.95
|
| Rate for Payer: BCBS MAPPO |
$65.03
|
| Rate for Payer: BCBS Trust/PPO |
$213.83
|
| Rate for Payer: BCN Commercial |
$202.23
|
| Rate for Payer: BCN Medicare Advantage |
$65.03
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.03
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Mclaren Medicaid |
$37.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.28
|
| Rate for Payer: Meridian Medicaid |
$38.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: PACE Senior Care Partners |
$61.77
|
| Rate for Payer: PACE SWMI |
$65.03
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: PHP Medicare Advantage |
$65.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health HMO/PPO |
$226.29
|
| Rate for Payer: Priority Health Medicare |
$65.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.27
|
| Rate for Payer: Railroad Medicare Medicare |
$65.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.03
|
| Rate for Payer: UHC Exchange |
$65.03
|
| Rate for Payer: UHC Medicare Advantage |
$65.03
|
| Rate for Payer: UHCCP Medicaid |
$37.10
|
| Rate for Payer: VA VA |
$65.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC ZIKA VIRUS, PCR, URINE
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000151
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.10 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna Medicare |
$67.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.28
|
| Rate for Payer: BCBS Complete |
$38.95
|
| Rate for Payer: BCBS MAPPO |
$65.03
|
| Rate for Payer: BCBS Trust/PPO |
$213.83
|
| Rate for Payer: BCN Commercial |
$202.23
|
| Rate for Payer: BCN Medicare Advantage |
$65.03
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.03
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Mclaren Medicaid |
$37.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.28
|
| Rate for Payer: Meridian Medicaid |
$38.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: PACE Senior Care Partners |
$61.77
|
| Rate for Payer: PACE SWMI |
$65.03
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: PHP Medicare Advantage |
$65.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health HMO/PPO |
$226.29
|
| Rate for Payer: Priority Health Medicare |
$65.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.27
|
| Rate for Payer: Railroad Medicare Medicare |
$65.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.03
|
| Rate for Payer: UHC Exchange |
$65.03
|
| Rate for Payer: UHC Medicare Advantage |
$65.03
|
| Rate for Payer: UHCCP Medicaid |
$37.10
|
| Rate for Payer: VA VA |
$65.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
