|
HC Z ITERPRET VISCERAL PTRA
|
Facility
|
IP
|
$3,775.49
|
|
| Hospital Charge Code |
32000272
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,454.07 |
| Max. Negotiated Rate |
$3,397.94 |
| Rate for Payer: Aetna Commercial |
$3,209.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,081.93
|
| Rate for Payer: BCN Commercial |
$2,917.70
|
| Rate for Payer: Cash Price |
$3,020.39
|
| Rate for Payer: Cofinity Commercial |
$3,246.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,020.39
|
| Rate for Payer: Healthscope Commercial |
$3,397.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,831.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,209.17
|
| Rate for Payer: Nomi Health Commercial |
$3,095.90
|
| Rate for Payer: PHP Commercial |
$3,209.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,454.07
|
| Rate for Payer: Priority Health HMO/PPO |
$3,284.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,529.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,322.43
|
| Rate for Payer: UHC Core |
$3,152.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,831.62
|
|
|
HC Z NEPHROSTOMY CATH
|
Facility
|
IP
|
$775.77
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200092
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$504.25 |
| Max. Negotiated Rate |
$698.19 |
| Rate for Payer: Aetna Commercial |
$659.40
|
| Rate for Payer: BCBS Trust/PPO |
$633.26
|
| Rate for Payer: BCN Commercial |
$599.52
|
| Rate for Payer: Cash Price |
$620.62
|
| Rate for Payer: Cofinity Commercial |
$667.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.62
|
| Rate for Payer: Healthscope Commercial |
$698.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$581.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$659.40
|
| Rate for Payer: Nomi Health Commercial |
$636.13
|
| Rate for Payer: PHP Commercial |
$659.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.25
|
| Rate for Payer: Priority Health HMO/PPO |
$674.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$519.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$682.68
|
| Rate for Payer: UHC Core |
$647.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$581.83
|
|
|
HC Z NEPHROSTOMY CATH
|
Facility
|
OP
|
$775.77
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200092
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$184.25 |
| Max. Negotiated Rate |
$698.19 |
| Rate for Payer: Aetna Commercial |
$659.40
|
| Rate for Payer: Aetna Medicare |
$201.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.43
|
| Rate for Payer: BCBS Complete |
$310.31
|
| Rate for Payer: BCBS MAPPO |
$193.94
|
| Rate for Payer: BCBS Trust/PPO |
$637.76
|
| Rate for Payer: BCN Commercial |
$603.16
|
| Rate for Payer: BCN Medicare Advantage |
$193.94
|
| Rate for Payer: Cash Price |
$620.62
|
| Rate for Payer: Cofinity Commercial |
$667.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.94
|
| Rate for Payer: Healthscope Commercial |
$698.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$581.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$659.40
|
| Rate for Payer: Nomi Health Commercial |
$636.13
|
| Rate for Payer: PACE Senior Care Partners |
$184.25
|
| Rate for Payer: PACE SWMI |
$193.94
|
| Rate for Payer: PHP Commercial |
$659.40
|
| Rate for Payer: PHP Medicare Advantage |
$193.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.25
|
| Rate for Payer: Priority Health HMO/PPO |
$674.92
|
| Rate for Payer: Priority Health Medicare |
$195.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$519.77
|
| Rate for Payer: Railroad Medicare Medicare |
$193.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$682.68
|
| Rate for Payer: UHC Core |
$647.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.94
|
| Rate for Payer: UHC Exchange |
$193.94
|
| Rate for Payer: UHC Medicare Advantage |
$193.94
|
| Rate for Payer: VA VA |
$193.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$581.83
|
|
|
HC ZONISAMIDE
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 80203
|
| Hospital Charge Code |
30100052
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$10.06
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$62.89
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$9.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: Meridian Medicaid |
$10.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Exchange |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.12
|
| Rate for Payer: UHCCP Medicaid |
$9.58
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC ZONISAMIDE
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 80203
|
| Hospital Charge Code |
30100052
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.72 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: BCBS Trust/PPO |
$62.45
|
| Rate for Payer: BCN Commercial |
$59.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC ZOSTER VACCINE (HZV) RECOMB ADJ, IM
|
Facility
|
IP
|
$174.79
|
|
|
Service Code
|
CPT 90750
|
| Hospital Charge Code |
63600123
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$113.61 |
| Max. Negotiated Rate |
$157.31 |
| Rate for Payer: Aetna Commercial |
$148.57
|
| Rate for Payer: BCBS Trust/PPO |
$142.68
|
| Rate for Payer: BCN Commercial |
$135.08
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cofinity Commercial |
$150.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.83
|
| Rate for Payer: Healthscope Commercial |
$157.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.57
|
| Rate for Payer: Nomi Health Commercial |
$143.33
|
| Rate for Payer: PHP Commercial |
$148.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.61
|
| Rate for Payer: Priority Health HMO/PPO |
$152.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.82
|
| Rate for Payer: UHC Core |
$145.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.09
|
|
|
HC ZOSTER VACCINE (HZV) RECOMB ADJ, IM
|
Facility
|
OP
|
$174.79
|
|
|
Service Code
|
CPT 90750
|
| Hospital Charge Code |
63600123
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.51 |
| Max. Negotiated Rate |
$157.31 |
| Rate for Payer: Aetna Commercial |
$148.57
|
| Rate for Payer: Aetna Medicare |
$45.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.62
|
| Rate for Payer: BCBS Complete |
$69.92
|
| Rate for Payer: BCBS MAPPO |
$43.70
|
| Rate for Payer: BCBS Trust/PPO |
$143.69
|
| Rate for Payer: BCN Commercial |
$135.90
|
| Rate for Payer: BCN Medicare Advantage |
$43.70
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cofinity Commercial |
$150.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.70
|
| Rate for Payer: Healthscope Commercial |
$157.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.57
|
| Rate for Payer: Nomi Health Commercial |
$143.33
|
| Rate for Payer: PACE Senior Care Partners |
$41.51
|
| Rate for Payer: PACE SWMI |
$43.70
|
| Rate for Payer: PHP Commercial |
$148.57
|
| Rate for Payer: PHP Medicare Advantage |
$43.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.61
|
| Rate for Payer: Priority Health HMO/PPO |
$152.07
|
| Rate for Payer: Priority Health Medicare |
$44.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.11
|
| Rate for Payer: Railroad Medicare Medicare |
$43.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.82
|
| Rate for Payer: UHC Core |
$145.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.70
|
| Rate for Payer: UHC Exchange |
$43.70
|
| Rate for Payer: UHC Medicare Advantage |
$43.70
|
| Rate for Payer: VA VA |
$43.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.09
|
|
|
HC Z RETRIEVAL SNARE
|
Facility
|
IP
|
$1,332.83
|
|
|
Service Code
|
HCPCS C1773
|
| Hospital Charge Code |
27200094
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$866.34 |
| Max. Negotiated Rate |
$1,199.55 |
| Rate for Payer: Aetna Commercial |
$1,132.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,087.99
|
| Rate for Payer: BCN Commercial |
$1,030.01
|
| Rate for Payer: Cash Price |
$1,066.26
|
| Rate for Payer: Cofinity Commercial |
$1,146.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,066.26
|
| Rate for Payer: Healthscope Commercial |
$1,199.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$999.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,132.91
|
| Rate for Payer: Nomi Health Commercial |
$1,092.92
|
| Rate for Payer: PHP Commercial |
$1,132.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$866.34
|
| Rate for Payer: Priority Health HMO/PPO |
$1,159.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$893.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,172.89
|
| Rate for Payer: UHC Core |
$1,112.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$999.62
|
|
|
HC Z RETRIEVAL SNARE
|
Facility
|
OP
|
$1,332.83
|
|
|
Service Code
|
HCPCS C1773
|
| Hospital Charge Code |
27200094
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$316.55 |
| Max. Negotiated Rate |
$1,199.55 |
| Rate for Payer: Aetna Commercial |
$1,132.91
|
| Rate for Payer: Aetna Medicare |
$346.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$416.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$416.51
|
| Rate for Payer: BCBS Complete |
$533.13
|
| Rate for Payer: BCBS MAPPO |
$333.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,095.72
|
| Rate for Payer: BCN Commercial |
$1,036.28
|
| Rate for Payer: BCN Medicare Advantage |
$333.21
|
| Rate for Payer: Cash Price |
$1,066.26
|
| Rate for Payer: Cofinity Commercial |
$1,146.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,066.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.21
|
| Rate for Payer: Healthscope Commercial |
$1,199.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$999.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$349.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$383.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,132.91
|
| Rate for Payer: Nomi Health Commercial |
$1,092.92
|
| Rate for Payer: PACE Senior Care Partners |
$316.55
|
| Rate for Payer: PACE SWMI |
$333.21
|
| Rate for Payer: PHP Commercial |
$1,132.91
|
| Rate for Payer: PHP Medicare Advantage |
$333.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$866.34
|
| Rate for Payer: Priority Health HMO/PPO |
$1,159.56
|
| Rate for Payer: Priority Health Medicare |
$336.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$893.00
|
| Rate for Payer: Railroad Medicare Medicare |
$333.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,172.89
|
| Rate for Payer: UHC Core |
$1,112.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$333.21
|
| Rate for Payer: UHC Exchange |
$333.21
|
| Rate for Payer: UHC Medicare Advantage |
$333.21
|
| Rate for Payer: VA VA |
$333.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$999.62
|
|
|
HC Z STENT URETERAL
|
Facility
|
IP
|
$1,212.86
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$788.36 |
| Max. Negotiated Rate |
$1,091.57 |
| Rate for Payer: Aetna Commercial |
$1,030.93
|
| Rate for Payer: BCBS Trust/PPO |
$990.06
|
| Rate for Payer: BCN Commercial |
$937.30
|
| Rate for Payer: Cash Price |
$970.29
|
| Rate for Payer: Cofinity Commercial |
$1,043.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$970.29
|
| Rate for Payer: Healthscope Commercial |
$1,091.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$909.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.93
|
| Rate for Payer: Nomi Health Commercial |
$994.55
|
| Rate for Payer: PHP Commercial |
$1,030.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.36
|
| Rate for Payer: Priority Health HMO/PPO |
$1,055.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$812.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,067.32
|
| Rate for Payer: UHC Core |
$1,012.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$909.64
|
|
|
HC Z STENT URETERAL
|
Facility
|
OP
|
$1,212.86
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.05 |
| Max. Negotiated Rate |
$1,091.57 |
| Rate for Payer: Aetna Commercial |
$1,030.93
|
| Rate for Payer: Aetna Medicare |
$315.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.02
|
| Rate for Payer: BCBS Complete |
$485.14
|
| Rate for Payer: BCBS MAPPO |
$303.22
|
| Rate for Payer: BCBS Trust/PPO |
$997.09
|
| Rate for Payer: BCN Commercial |
$943.00
|
| Rate for Payer: BCN Medicare Advantage |
$303.22
|
| Rate for Payer: Cash Price |
$970.29
|
| Rate for Payer: Cofinity Commercial |
$1,043.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$970.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.22
|
| Rate for Payer: Healthscope Commercial |
$1,091.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$909.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$348.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.93
|
| Rate for Payer: Nomi Health Commercial |
$994.55
|
| Rate for Payer: PACE Senior Care Partners |
$288.05
|
| Rate for Payer: PACE SWMI |
$303.22
|
| Rate for Payer: PHP Commercial |
$1,030.93
|
| Rate for Payer: PHP Medicare Advantage |
$303.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.36
|
| Rate for Payer: Priority Health HMO/PPO |
$1,055.19
|
| Rate for Payer: Priority Health Medicare |
$306.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$812.62
|
| Rate for Payer: Railroad Medicare Medicare |
$303.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,067.32
|
| Rate for Payer: UHC Core |
$1,012.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.22
|
| Rate for Payer: UHC Exchange |
$303.22
|
| Rate for Payer: UHC Medicare Advantage |
$303.22
|
| Rate for Payer: VA VA |
$303.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$909.64
|
|
|
HC Z TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$1,756.94
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$417.27 |
| Max. Negotiated Rate |
$1,581.25 |
| Rate for Payer: Aetna Commercial |
$1,493.40
|
| Rate for Payer: Aetna Medicare |
$456.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$549.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$549.04
|
| Rate for Payer: BCBS Complete |
$702.78
|
| Rate for Payer: BCBS MAPPO |
$439.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,444.38
|
| Rate for Payer: BCN Commercial |
$1,366.02
|
| Rate for Payer: BCN Medicare Advantage |
$439.24
|
| Rate for Payer: Cash Price |
$1,405.55
|
| Rate for Payer: Cofinity Commercial |
$1,510.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.24
|
| Rate for Payer: Healthscope Commercial |
$1,581.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,317.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$505.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.40
|
| Rate for Payer: Nomi Health Commercial |
$1,440.69
|
| Rate for Payer: PACE Senior Care Partners |
$417.27
|
| Rate for Payer: PACE SWMI |
$439.24
|
| Rate for Payer: PHP Commercial |
$1,493.40
|
| Rate for Payer: PHP Medicare Advantage |
$439.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.01
|
| Rate for Payer: Priority Health HMO/PPO |
$1,528.54
|
| Rate for Payer: Priority Health Medicare |
$443.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,177.15
|
| Rate for Payer: Railroad Medicare Medicare |
$439.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,546.11
|
| Rate for Payer: UHC Core |
$1,467.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$439.24
|
| Rate for Payer: UHC Exchange |
$439.24
|
| Rate for Payer: UHC Medicare Advantage |
$439.24
|
| Rate for Payer: VA VA |
$439.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,317.70
|
|
|
HC Z TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$1,756.94
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200097
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,142.01 |
| Max. Negotiated Rate |
$1,581.25 |
| Rate for Payer: Aetna Commercial |
$1,493.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,434.19
|
| Rate for Payer: BCN Commercial |
$1,357.76
|
| Rate for Payer: Cash Price |
$1,405.55
|
| Rate for Payer: Cofinity Commercial |
$1,510.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,405.55
|
| Rate for Payer: Healthscope Commercial |
$1,581.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,317.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,493.40
|
| Rate for Payer: Nomi Health Commercial |
$1,440.69
|
| Rate for Payer: PHP Commercial |
$1,493.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.01
|
| Rate for Payer: Priority Health HMO/PPO |
$1,528.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,177.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,546.11
|
| Rate for Payer: UHC Core |
$1,467.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,317.70
|
|
|
HC Z VACUUM BIOPSY DEVICE
|
Facility
|
IP
|
$646.29
|
|
| Hospital Charge Code |
27200129
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$420.09 |
| Max. Negotiated Rate |
$581.66 |
| Rate for Payer: Aetna Commercial |
$549.35
|
| Rate for Payer: BCBS Trust/PPO |
$527.57
|
| Rate for Payer: BCN Commercial |
$499.45
|
| Rate for Payer: Cash Price |
$517.03
|
| Rate for Payer: Cofinity Commercial |
$555.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$517.03
|
| Rate for Payer: Healthscope Commercial |
$581.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$484.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$549.35
|
| Rate for Payer: Nomi Health Commercial |
$529.96
|
| Rate for Payer: PHP Commercial |
$549.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.09
|
| Rate for Payer: Priority Health HMO/PPO |
$562.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$433.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$568.74
|
| Rate for Payer: UHC Core |
$539.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$484.72
|
|
|
HC Z VACUUM BIOPSY DEVICE
|
Facility
|
OP
|
$646.29
|
|
| Hospital Charge Code |
27200129
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$153.49 |
| Max. Negotiated Rate |
$581.66 |
| Rate for Payer: Aetna Commercial |
$549.35
|
| Rate for Payer: Aetna Medicare |
$168.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$201.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$201.97
|
| Rate for Payer: BCBS Complete |
$258.52
|
| Rate for Payer: BCBS MAPPO |
$161.57
|
| Rate for Payer: BCBS Trust/PPO |
$531.32
|
| Rate for Payer: BCN Commercial |
$502.49
|
| Rate for Payer: BCN Medicare Advantage |
$161.57
|
| Rate for Payer: Cash Price |
$517.03
|
| Rate for Payer: Cofinity Commercial |
$555.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$517.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.57
|
| Rate for Payer: Healthscope Commercial |
$581.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$484.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$185.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$549.35
|
| Rate for Payer: Nomi Health Commercial |
$529.96
|
| Rate for Payer: PACE Senior Care Partners |
$153.49
|
| Rate for Payer: PACE SWMI |
$161.57
|
| Rate for Payer: PHP Commercial |
$549.35
|
| Rate for Payer: PHP Medicare Advantage |
$161.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.09
|
| Rate for Payer: Priority Health HMO/PPO |
$562.27
|
| Rate for Payer: Priority Health Medicare |
$163.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$433.01
|
| Rate for Payer: Railroad Medicare Medicare |
$161.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$568.74
|
| Rate for Payer: UHC Core |
$539.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.57
|
| Rate for Payer: UHC Exchange |
$161.57
|
| Rate for Payer: UHC Medicare Advantage |
$161.57
|
| Rate for Payer: VA VA |
$161.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$484.72
|
|
|
HC Z VASCULAR CLOSURE
|
Facility
|
IP
|
$1,020.90
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200098
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.58 |
| Max. Negotiated Rate |
$918.81 |
| Rate for Payer: Aetna Commercial |
$867.76
|
| Rate for Payer: BCBS Trust/PPO |
$833.36
|
| Rate for Payer: BCN Commercial |
$788.95
|
| Rate for Payer: Cash Price |
$816.72
|
| Rate for Payer: Cofinity Commercial |
$877.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.72
|
| Rate for Payer: Healthscope Commercial |
$918.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.76
|
| Rate for Payer: Nomi Health Commercial |
$837.14
|
| Rate for Payer: PHP Commercial |
$867.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.58
|
| Rate for Payer: Priority Health HMO/PPO |
$888.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$898.39
|
| Rate for Payer: UHC Core |
$852.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.68
|
|
|
HC Z VASCULAR CLOSURE
|
Facility
|
OP
|
$1,020.90
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200098
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$242.46 |
| Max. Negotiated Rate |
$918.81 |
| Rate for Payer: Aetna Commercial |
$867.76
|
| Rate for Payer: Aetna Medicare |
$265.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$319.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$319.03
|
| Rate for Payer: BCBS Complete |
$408.36
|
| Rate for Payer: BCBS MAPPO |
$255.22
|
| Rate for Payer: BCBS Trust/PPO |
$839.28
|
| Rate for Payer: BCN Commercial |
$793.75
|
| Rate for Payer: BCN Medicare Advantage |
$255.22
|
| Rate for Payer: Cash Price |
$816.72
|
| Rate for Payer: Cofinity Commercial |
$877.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.22
|
| Rate for Payer: Healthscope Commercial |
$918.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$293.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.76
|
| Rate for Payer: Nomi Health Commercial |
$837.14
|
| Rate for Payer: PACE Senior Care Partners |
$242.46
|
| Rate for Payer: PACE SWMI |
$255.22
|
| Rate for Payer: PHP Commercial |
$867.76
|
| Rate for Payer: PHP Medicare Advantage |
$255.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.58
|
| Rate for Payer: Priority Health HMO/PPO |
$888.18
|
| Rate for Payer: Priority Health Medicare |
$257.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.00
|
| Rate for Payer: Railroad Medicare Medicare |
$255.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$898.39
|
| Rate for Payer: UHC Core |
$852.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.22
|
| Rate for Payer: UHC Exchange |
$255.22
|
| Rate for Payer: UHC Medicare Advantage |
$255.22
|
| Rate for Payer: VA VA |
$255.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.68
|
|
|
HC Z VENA CAVA FILTER
|
Facility
|
OP
|
$5,871.33
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,394.44 |
| Max. Negotiated Rate |
$5,284.20 |
| Rate for Payer: Aetna Commercial |
$4,990.63
|
| Rate for Payer: Aetna Medicare |
$1,526.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,834.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,834.79
|
| Rate for Payer: BCBS Complete |
$2,348.53
|
| Rate for Payer: BCBS MAPPO |
$1,467.83
|
| Rate for Payer: BCBS Trust/PPO |
$4,826.82
|
| Rate for Payer: BCN Commercial |
$4,564.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,467.83
|
| Rate for Payer: Cash Price |
$4,697.06
|
| Rate for Payer: Cofinity Commercial |
$5,049.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,697.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,467.83
|
| Rate for Payer: Healthscope Commercial |
$5,284.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,403.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,541.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,688.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,990.63
|
| Rate for Payer: Nomi Health Commercial |
$4,814.49
|
| Rate for Payer: PACE Senior Care Partners |
$1,394.44
|
| Rate for Payer: PACE SWMI |
$1,467.83
|
| Rate for Payer: PHP Commercial |
$4,990.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,467.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,816.36
|
| Rate for Payer: Priority Health HMO/PPO |
$5,108.06
|
| Rate for Payer: Priority Health Medicare |
$1,482.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,933.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,467.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,166.77
|
| Rate for Payer: UHC Core |
$4,902.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,467.83
|
| Rate for Payer: UHC Exchange |
$1,467.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,467.83
|
| Rate for Payer: VA VA |
$1,467.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,403.50
|
|
|
HC Z VENA CAVA FILTER
|
Facility
|
IP
|
$5,871.33
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,816.36 |
| Max. Negotiated Rate |
$5,284.20 |
| Rate for Payer: Aetna Commercial |
$4,990.63
|
| Rate for Payer: BCBS Trust/PPO |
$4,792.77
|
| Rate for Payer: BCN Commercial |
$4,537.36
|
| Rate for Payer: Cash Price |
$4,697.06
|
| Rate for Payer: Cofinity Commercial |
$5,049.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,697.06
|
| Rate for Payer: Healthscope Commercial |
$5,284.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,403.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,990.63
|
| Rate for Payer: Nomi Health Commercial |
$4,814.49
|
| Rate for Payer: PHP Commercial |
$4,990.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,816.36
|
| Rate for Payer: Priority Health HMO/PPO |
$5,108.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,933.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,166.77
|
| Rate for Payer: UHC Core |
$4,902.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,403.50
|
|
|
HEARING AID RESTOCKING FEE
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 00663
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$53.20 |
| Max. Negotiated Rate |
$86.45 |
| Rate for Payer: Aetna Medicare |
$66.50
|
| Rate for Payer: BCBS Complete |
$53.20
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.45
|
|
|
HEMORRHOIDECTOMY, INTERNAL, BY RUBBER BAND LIGATION(S)
|
Facility
|
OP
|
$678.18
|
|
|
Service Code
|
CPT 46221
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$645.84 |
| Max. Negotiated Rate |
$678.18 |
| Rate for Payer: BCBS Complete |
$678.18
|
| Rate for Payer: Mclaren Medicaid |
$645.84
|
| Rate for Payer: Meridian Medicaid |
$678.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.84
|
| Rate for Payer: UHCCP Medicaid |
$645.84
|
|
|
HEPARIN CELLSAVER SOLUTION (BLH INTRA-OP)
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
NDC 09900000709
|
| Hospital Charge Code |
151009
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$35.62 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna Medicare |
$39.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.88
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: BCBS MAPPO |
$37.50
|
| Rate for Payer: BCBS Trust/PPO |
$123.32
|
| Rate for Payer: BCN Commercial |
$116.62
|
| Rate for Payer: BCN Medicare Advantage |
$37.50
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.50
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.50
|
| Rate for Payer: Nomi Health Commercial |
$123.00
|
| Rate for Payer: PACE Senior Care Partners |
$35.62
|
| Rate for Payer: PACE SWMI |
$37.50
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: PHP Medicare Advantage |
$37.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.50
|
| Rate for Payer: Priority Health HMO/PPO |
$130.50
|
| Rate for Payer: Priority Health Medicare |
$37.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.50
|
| Rate for Payer: Railroad Medicare Medicare |
$37.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.00
|
| Rate for Payer: UHC Core |
$125.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.50
|
| Rate for Payer: UHC Exchange |
$37.50
|
| Rate for Payer: UHC Medicare Advantage |
$37.50
|
| Rate for Payer: VA VA |
$37.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HEPARIN CELLSAVER SOLUTION (BLH INTRA-OP)
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
NDC 09900000709
|
| Hospital Charge Code |
151009
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: BCBS Trust/PPO |
$122.44
|
| Rate for Payer: BCN Commercial |
$115.92
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.50
|
| Rate for Payer: Nomi Health Commercial |
$123.00
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.50
|
| Rate for Payer: Priority Health HMO/PPO |
$130.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.00
|
| Rate for Payer: UHC Core |
$125.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$21.71
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
112939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.16 |
| Max. Negotiated Rate |
$19.54 |
| Rate for Payer: Aetna Commercial |
$18.45
|
| Rate for Payer: Aetna Medicare |
$5.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.78
|
| Rate for Payer: BCBS Complete |
$8.68
|
| Rate for Payer: BCBS MAPPO |
$5.43
|
| Rate for Payer: BCBS Trust/PPO |
$17.85
|
| Rate for Payer: BCN Commercial |
$16.88
|
| Rate for Payer: BCN Medicare Advantage |
$5.43
|
| Rate for Payer: Cash Price |
$17.37
|
| Rate for Payer: Cofinity Commercial |
$18.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.43
|
| Rate for Payer: Healthscope Commercial |
$19.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.45
|
| Rate for Payer: Nomi Health Commercial |
$17.80
|
| Rate for Payer: PACE Senior Care Partners |
$5.16
|
| Rate for Payer: PACE SWMI |
$5.43
|
| Rate for Payer: PHP Commercial |
$18.45
|
| Rate for Payer: PHP Medicare Advantage |
$5.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.11
|
| Rate for Payer: Priority Health HMO/PPO |
$18.89
|
| Rate for Payer: Priority Health Medicare |
$5.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.55
|
| Rate for Payer: Railroad Medicare Medicare |
$5.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.10
|
| Rate for Payer: UHC Core |
$18.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.43
|
| Rate for Payer: UHC Exchange |
$5.43
|
| Rate for Payer: UHC Medicare Advantage |
$5.43
|
| Rate for Payer: VA VA |
$5.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.28
|
|
|
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$21.71
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
112939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.11 |
| Max. Negotiated Rate |
$19.54 |
| Rate for Payer: Aetna Commercial |
$18.45
|
| Rate for Payer: BCBS Trust/PPO |
$17.72
|
| Rate for Payer: BCN Commercial |
$16.78
|
| Rate for Payer: Cash Price |
$17.37
|
| Rate for Payer: Cofinity Commercial |
$18.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.37
|
| Rate for Payer: Healthscope Commercial |
$19.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.45
|
| Rate for Payer: Nomi Health Commercial |
$17.80
|
| Rate for Payer: PHP Commercial |
$18.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.11
|
| Rate for Payer: Priority Health HMO/PPO |
$18.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.10
|
| Rate for Payer: UHC Core |
$18.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.28
|
|
