|
HC ACUTE MYELOID LEUKEMIA FISH
|
Facility
|
OP
|
$37.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100023
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$33.30 |
| Rate for Payer: Aetna Commercial |
$31.45
|
| Rate for Payer: Aetna Medicare |
$9.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.56
|
| Rate for Payer: BCBS Complete |
$16.60
|
| Rate for Payer: BCBS MAPPO |
$9.25
|
| Rate for Payer: BCBS Trust/PPO |
$28.77
|
| Rate for Payer: BCN Commercial |
$28.77
|
| Rate for Payer: BCN Medicare Advantage |
$9.25
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$31.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.25
|
| Rate for Payer: Healthscope Commercial |
$33.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.75
|
| Rate for Payer: Mclaren Medicaid |
$15.81
|
| Rate for Payer: Meridian Medicaid |
$16.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.45
|
| Rate for Payer: PACE Senior Care Partners |
$8.79
|
| Rate for Payer: PACE SWMI |
$9.25
|
| Rate for Payer: PHP Commercial |
$31.45
|
| Rate for Payer: PHP Medicare Advantage |
$9.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.19
|
| Rate for Payer: Priority Health Medicare |
$9.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.57
|
| Rate for Payer: Railroad Medicare Medicare |
$9.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.56
|
| Rate for Payer: UHC Core |
$30.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.25
|
| Rate for Payer: UHC Medicare Advantage |
$9.53
|
| Rate for Payer: VA VA |
$9.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.75
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH
|
Facility
|
IP
|
$37.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100023
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$22.57 |
| Max. Negotiated Rate |
$33.30 |
| Rate for Payer: Aetna Commercial |
$31.45
|
| Rate for Payer: BCBS Trust/PPO |
$28.59
|
| Rate for Payer: BCN Commercial |
$28.59
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$31.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.60
|
| Rate for Payer: Healthscope Commercial |
$33.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.45
|
| Rate for Payer: PHP Commercial |
$31.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.56
|
| Rate for Payer: UHC Core |
$30.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.75
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT
|
Facility
|
IP
|
$96.90
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100024
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$59.10 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: BCBS Trust/PPO |
$74.88
|
| Rate for Payer: BCN Commercial |
$74.88
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.36
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.27
|
| Rate for Payer: UHC Core |
$80.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.68
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT
|
Facility
|
OP
|
$96.90
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100024
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: Aetna Medicare |
$25.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.28
|
| Rate for Payer: BCBS Complete |
$16.60
|
| Rate for Payer: BCBS MAPPO |
$24.22
|
| Rate for Payer: BCBS Trust/PPO |
$75.34
|
| Rate for Payer: BCN Commercial |
$75.34
|
| Rate for Payer: BCN Medicare Advantage |
$24.22
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.22
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.68
|
| Rate for Payer: Mclaren Medicaid |
$15.81
|
| Rate for Payer: Meridian Medicaid |
$16.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.36
|
| Rate for Payer: PACE Senior Care Partners |
$23.01
|
| Rate for Payer: PACE SWMI |
$24.22
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: PHP Medicare Advantage |
$24.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.30
|
| Rate for Payer: Priority Health Medicare |
$24.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.10
|
| Rate for Payer: Railroad Medicare Medicare |
$24.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.27
|
| Rate for Payer: UHC Core |
$80.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.22
|
| Rate for Payer: UHC Medicare Advantage |
$24.95
|
| Rate for Payer: VA VA |
$24.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.68
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT2
|
Facility
|
IP
|
$90.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31100026
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$54.89 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: BCBS Trust/PPO |
$69.55
|
| Rate for Payer: BCN Commercial |
$69.55
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$77.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Healthscope Commercial |
$81.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: PHP Commercial |
$76.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.20
|
| Rate for Payer: UHC Core |
$75.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.50
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT2
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31100026
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$21.38 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: Aetna Medicare |
$23.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.12
|
| Rate for Payer: BCBS Complete |
$39.67
|
| Rate for Payer: BCBS MAPPO |
$22.50
|
| Rate for Payer: BCBS Trust/PPO |
$69.98
|
| Rate for Payer: BCN Commercial |
$69.98
|
| Rate for Payer: BCN Medicare Advantage |
$22.50
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$77.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.50
|
| Rate for Payer: Healthscope Commercial |
$81.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.50
|
| Rate for Payer: Mclaren Medicaid |
$37.78
|
| Rate for Payer: Meridian Medicaid |
$39.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: PACE Senior Care Partners |
$21.38
|
| Rate for Payer: PACE SWMI |
$22.50
|
| Rate for Payer: PHP Commercial |
$76.50
|
| Rate for Payer: PHP Medicare Advantage |
$22.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.30
|
| Rate for Payer: Priority Health Medicare |
$22.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.89
|
| Rate for Payer: Railroad Medicare Medicare |
$22.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.20
|
| Rate for Payer: UHC Core |
$75.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.50
|
| Rate for Payer: UHC Medicare Advantage |
$23.18
|
| Rate for Payer: VA VA |
$22.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.50
|
|
|
HC ACUTE RENAL DIALYSIS
|
Facility
|
OP
|
$770.29
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
82000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$182.94 |
| Max. Negotiated Rate |
$693.26 |
| Rate for Payer: Aetna Commercial |
$654.75
|
| Rate for Payer: Aetna Medicare |
$200.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$240.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$240.72
|
| Rate for Payer: BCBS Complete |
$481.33
|
| Rate for Payer: BCBS MAPPO |
$192.57
|
| Rate for Payer: BCBS Trust/PPO |
$598.90
|
| Rate for Payer: BCN Commercial |
$598.90
|
| Rate for Payer: BCN Medicare Advantage |
$192.57
|
| Rate for Payer: Cash Price |
$616.23
|
| Rate for Payer: Cash Price |
$616.23
|
| Rate for Payer: Cofinity Commercial |
$662.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$616.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.57
|
| Rate for Payer: Healthscope Commercial |
$693.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$577.72
|
| Rate for Payer: Mclaren Medicaid |
$458.41
|
| Rate for Payer: Meridian Medicaid |
$481.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$202.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$221.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$654.75
|
| Rate for Payer: PACE Senior Care Partners |
$182.94
|
| Rate for Payer: PACE SWMI |
$192.57
|
| Rate for Payer: PHP Commercial |
$654.75
|
| Rate for Payer: PHP Medicare Advantage |
$192.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$539.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$670.15
|
| Rate for Payer: Priority Health Medicare |
$192.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$469.80
|
| Rate for Payer: Railroad Medicare Medicare |
$192.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$677.86
|
| Rate for Payer: UHC Core |
$643.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.57
|
| Rate for Payer: UHC Medicare Advantage |
$198.35
|
| Rate for Payer: VA VA |
$192.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$577.72
|
|
|
HC ACUTE RENAL DIALYSIS
|
Facility
|
IP
|
$770.29
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
82000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$469.80 |
| Max. Negotiated Rate |
$693.26 |
| Rate for Payer: Aetna Commercial |
$654.75
|
| Rate for Payer: BCBS Trust/PPO |
$595.28
|
| Rate for Payer: BCN Commercial |
$595.28
|
| Rate for Payer: Cash Price |
$616.23
|
| Rate for Payer: Cofinity Commercial |
$662.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$616.23
|
| Rate for Payer: Healthscope Commercial |
$693.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$577.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$654.75
|
| Rate for Payer: PHP Commercial |
$654.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$539.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$670.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$469.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$677.86
|
| Rate for Payer: UHC Core |
$643.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$577.72
|
|
|
HC ACYLCARNITINES
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 82017
|
| Hospital Charge Code |
30100070
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.74 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$57.96
|
| Rate for Payer: BCN Commercial |
$57.96
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC ACYLCARNITINES
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 82017
|
| Hospital Charge Code |
30100070
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.45 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.44
|
| Rate for Payer: BCBS Complete |
$13.07
|
| Rate for Payer: BCBS MAPPO |
$18.75
|
| Rate for Payer: BCBS Trust/PPO |
$58.31
|
| Rate for Payer: BCN Commercial |
$58.31
|
| Rate for Payer: BCN Medicare Advantage |
$18.75
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.75
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Mclaren Medicaid |
$12.45
|
| Rate for Payer: Meridian Medicaid |
$13.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PACE Senior Care Partners |
$17.81
|
| Rate for Payer: PACE SWMI |
$18.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: PHP Medicare Advantage |
$18.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Medicare |
$18.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: Railroad Medicare Medicare |
$18.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.75
|
| Rate for Payer: UHC Medicare Advantage |
$19.31
|
| Rate for Payer: VA VA |
$18.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC ADALIMUMAB AB, S
|
Facility
|
IP
|
$202.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100666
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$123.20 |
| Max. Negotiated Rate |
$181.80 |
| Rate for Payer: Aetna Commercial |
$171.70
|
| Rate for Payer: BCBS Trust/PPO |
$156.11
|
| Rate for Payer: BCN Commercial |
$156.11
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cofinity Commercial |
$173.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.60
|
| Rate for Payer: Healthscope Commercial |
$181.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$171.70
|
| Rate for Payer: PHP Commercial |
$171.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.76
|
| Rate for Payer: UHC Core |
$168.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.50
|
|
|
HC ADALIMUMAB AB, S
|
Facility
|
OP
|
$202.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100666
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$181.80 |
| Rate for Payer: Aetna Commercial |
$171.70
|
| Rate for Payer: Aetna Medicare |
$52.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.12
|
| Rate for Payer: BCBS Complete |
$13.38
|
| Rate for Payer: BCBS MAPPO |
$50.50
|
| Rate for Payer: BCBS Trust/PPO |
$157.06
|
| Rate for Payer: BCN Commercial |
$157.06
|
| Rate for Payer: BCN Medicare Advantage |
$50.50
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cofinity Commercial |
$173.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.50
|
| Rate for Payer: Healthscope Commercial |
$181.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.50
|
| Rate for Payer: Mclaren Medicaid |
$12.75
|
| Rate for Payer: Meridian Medicaid |
$13.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$171.70
|
| Rate for Payer: PACE Senior Care Partners |
$47.98
|
| Rate for Payer: PACE SWMI |
$50.50
|
| Rate for Payer: PHP Commercial |
$171.70
|
| Rate for Payer: PHP Medicare Advantage |
$50.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.74
|
| Rate for Payer: Priority Health Medicare |
$50.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.20
|
| Rate for Payer: Railroad Medicare Medicare |
$50.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.76
|
| Rate for Payer: UHC Core |
$168.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.50
|
| Rate for Payer: UHC Medicare Advantage |
$52.02
|
| Rate for Payer: VA VA |
$50.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.50
|
|
|
HC ADALIMUMAB, S
|
Facility
|
OP
|
$295.00
|
|
|
Service Code
|
CPT 80145
|
| Hospital Charge Code |
30100704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.46 |
| Max. Negotiated Rate |
$265.50 |
| Rate for Payer: Aetna Commercial |
$250.75
|
| Rate for Payer: Aetna Medicare |
$76.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$92.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$92.19
|
| Rate for Payer: BCBS Complete |
$29.89
|
| Rate for Payer: BCBS MAPPO |
$73.75
|
| Rate for Payer: BCBS Trust/PPO |
$229.36
|
| Rate for Payer: BCN Commercial |
$229.36
|
| Rate for Payer: BCN Medicare Advantage |
$73.75
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cofinity Commercial |
$253.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.75
|
| Rate for Payer: Healthscope Commercial |
$265.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.25
|
| Rate for Payer: Mclaren Medicaid |
$28.46
|
| Rate for Payer: Meridian Medicaid |
$29.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$250.75
|
| Rate for Payer: PACE Senior Care Partners |
$70.06
|
| Rate for Payer: PACE SWMI |
$73.75
|
| Rate for Payer: PHP Commercial |
$250.75
|
| Rate for Payer: PHP Medicare Advantage |
$73.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$256.65
|
| Rate for Payer: Priority Health Medicare |
$73.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.92
|
| Rate for Payer: Railroad Medicare Medicare |
$73.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$259.60
|
| Rate for Payer: UHC Core |
$246.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.75
|
| Rate for Payer: UHC Medicare Advantage |
$75.96
|
| Rate for Payer: VA VA |
$73.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.25
|
|
|
HC ADALIMUMAB, S
|
Facility
|
IP
|
$295.00
|
|
|
Service Code
|
CPT 80145
|
| Hospital Charge Code |
30100704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$179.92 |
| Max. Negotiated Rate |
$265.50 |
| Rate for Payer: Aetna Commercial |
$250.75
|
| Rate for Payer: BCBS Trust/PPO |
$227.98
|
| Rate for Payer: BCN Commercial |
$227.98
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cofinity Commercial |
$253.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$265.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$250.75
|
| Rate for Payer: PHP Commercial |
$250.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$256.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$259.60
|
| Rate for Payer: UHC Core |
$246.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.25
|
|
|
HC ADAMTS13 ACTIVITY AND INHIBITOR PROFILE, PLASMA
|
Facility
|
IP
|
$157.60
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500106
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$96.12 |
| Max. Negotiated Rate |
$141.84 |
| Rate for Payer: Aetna Commercial |
$133.96
|
| Rate for Payer: BCBS Trust/PPO |
$121.79
|
| Rate for Payer: BCN Commercial |
$121.79
|
| Rate for Payer: Cash Price |
$126.08
|
| Rate for Payer: Cofinity Commercial |
$135.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.08
|
| Rate for Payer: Healthscope Commercial |
$141.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.96
|
| Rate for Payer: PHP Commercial |
$133.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.69
|
| Rate for Payer: UHC Core |
$131.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.20
|
|
|
HC ADAMTS13 ACTIVITY AND INHIBITOR PROFILE, PLASMA
|
Facility
|
OP
|
$157.60
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500106
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.77 |
| Max. Negotiated Rate |
$141.84 |
| Rate for Payer: Aetna Commercial |
$133.96
|
| Rate for Payer: Aetna Medicare |
$40.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.25
|
| Rate for Payer: BCBS Complete |
$23.91
|
| Rate for Payer: BCBS MAPPO |
$39.40
|
| Rate for Payer: BCBS Trust/PPO |
$122.53
|
| Rate for Payer: BCN Commercial |
$122.53
|
| Rate for Payer: BCN Medicare Advantage |
$39.40
|
| Rate for Payer: Cash Price |
$126.08
|
| Rate for Payer: Cash Price |
$126.08
|
| Rate for Payer: Cofinity Commercial |
$135.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.40
|
| Rate for Payer: Healthscope Commercial |
$141.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.20
|
| Rate for Payer: Mclaren Medicaid |
$22.77
|
| Rate for Payer: Meridian Medicaid |
$23.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.96
|
| Rate for Payer: PACE Senior Care Partners |
$37.43
|
| Rate for Payer: PACE SWMI |
$39.40
|
| Rate for Payer: PHP Commercial |
$133.96
|
| Rate for Payer: PHP Medicare Advantage |
$39.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.11
|
| Rate for Payer: Priority Health Medicare |
$39.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.12
|
| Rate for Payer: Railroad Medicare Medicare |
$39.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.69
|
| Rate for Payer: UHC Core |
$131.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.40
|
| Rate for Payer: UHC Medicare Advantage |
$40.58
|
| Rate for Payer: VA VA |
$39.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.20
|
|
|
HC ADAMTS 13 ANTIBODY
|
Facility
|
OP
|
$177.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000056
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$159.30 |
| Rate for Payer: Aetna Commercial |
$150.45
|
| Rate for Payer: Aetna Medicare |
$46.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.31
|
| Rate for Payer: BCBS Complete |
$13.38
|
| Rate for Payer: BCBS MAPPO |
$44.25
|
| Rate for Payer: BCBS Trust/PPO |
$137.62
|
| Rate for Payer: BCN Commercial |
$137.62
|
| Rate for Payer: BCN Medicare Advantage |
$44.25
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$152.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.25
|
| Rate for Payer: Healthscope Commercial |
$159.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.75
|
| Rate for Payer: Mclaren Medicaid |
$12.75
|
| Rate for Payer: Meridian Medicaid |
$13.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$46.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$150.45
|
| Rate for Payer: PACE Senior Care Partners |
$42.04
|
| Rate for Payer: PACE SWMI |
$44.25
|
| Rate for Payer: PHP Commercial |
$150.45
|
| Rate for Payer: PHP Medicare Advantage |
$44.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.99
|
| Rate for Payer: Priority Health Medicare |
$44.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.95
|
| Rate for Payer: Railroad Medicare Medicare |
$44.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.76
|
| Rate for Payer: UHC Core |
$147.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.25
|
| Rate for Payer: UHC Medicare Advantage |
$45.58
|
| Rate for Payer: VA VA |
$44.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.75
|
|
|
HC ADAMTS 13 ANTIBODY
|
Facility
|
IP
|
$177.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000056
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$107.95 |
| Max. Negotiated Rate |
$159.30 |
| Rate for Payer: Aetna Commercial |
$150.45
|
| Rate for Payer: BCBS Trust/PPO |
$136.79
|
| Rate for Payer: BCN Commercial |
$136.79
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cofinity Commercial |
$152.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.60
|
| Rate for Payer: Healthscope Commercial |
$159.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$150.45
|
| Rate for Payer: PHP Commercial |
$150.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.76
|
| Rate for Payer: UHC Core |
$147.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.75
|
|
|
HC ADAMTS 13 INHIBITOR
|
Facility
|
IP
|
$148.92
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30000055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$90.83 |
| Max. Negotiated Rate |
$134.03 |
| Rate for Payer: Aetna Commercial |
$126.58
|
| Rate for Payer: BCBS Trust/PPO |
$115.09
|
| Rate for Payer: BCN Commercial |
$115.09
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$128.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Healthscope Commercial |
$134.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$126.58
|
| Rate for Payer: PHP Commercial |
$126.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.05
|
| Rate for Payer: UHC Core |
$124.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.69
|
|
|
HC ADAMTS 13 INHIBITOR
|
Facility
|
OP
|
$148.92
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30000055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$134.03 |
| Rate for Payer: Aetna Commercial |
$126.58
|
| Rate for Payer: Aetna Medicare |
$38.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.54
|
| Rate for Payer: BCBS Complete |
$9.97
|
| Rate for Payer: BCBS MAPPO |
$37.23
|
| Rate for Payer: BCBS Trust/PPO |
$115.79
|
| Rate for Payer: BCN Commercial |
$115.79
|
| Rate for Payer: BCN Medicare Advantage |
$37.23
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$128.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.23
|
| Rate for Payer: Healthscope Commercial |
$134.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.69
|
| Rate for Payer: Mclaren Medicaid |
$9.50
|
| Rate for Payer: Meridian Medicaid |
$9.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$126.58
|
| Rate for Payer: PACE Senior Care Partners |
$35.37
|
| Rate for Payer: PACE SWMI |
$37.23
|
| Rate for Payer: PHP Commercial |
$126.58
|
| Rate for Payer: PHP Medicare Advantage |
$37.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$129.56
|
| Rate for Payer: Priority Health Medicare |
$37.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.83
|
| Rate for Payer: Railroad Medicare Medicare |
$37.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.05
|
| Rate for Payer: UHC Core |
$124.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.23
|
| Rate for Payer: UHC Medicare Advantage |
$38.35
|
| Rate for Payer: VA VA |
$37.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.69
|
|
|
HC ADAMTS ACTIVITY AND INHIB PROFILE
|
Facility
|
OP
|
$157.60
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500103
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.77 |
| Max. Negotiated Rate |
$141.84 |
| Rate for Payer: Aetna Commercial |
$133.96
|
| Rate for Payer: Aetna Medicare |
$40.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.25
|
| Rate for Payer: BCBS Complete |
$23.91
|
| Rate for Payer: BCBS MAPPO |
$39.40
|
| Rate for Payer: BCBS Trust/PPO |
$122.53
|
| Rate for Payer: BCN Commercial |
$122.53
|
| Rate for Payer: BCN Medicare Advantage |
$39.40
|
| Rate for Payer: Cash Price |
$126.08
|
| Rate for Payer: Cash Price |
$126.08
|
| Rate for Payer: Cofinity Commercial |
$135.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.40
|
| Rate for Payer: Healthscope Commercial |
$141.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.20
|
| Rate for Payer: Mclaren Medicaid |
$22.77
|
| Rate for Payer: Meridian Medicaid |
$23.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.96
|
| Rate for Payer: PACE Senior Care Partners |
$37.43
|
| Rate for Payer: PACE SWMI |
$39.40
|
| Rate for Payer: PHP Commercial |
$133.96
|
| Rate for Payer: PHP Medicare Advantage |
$39.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.11
|
| Rate for Payer: Priority Health Medicare |
$39.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.12
|
| Rate for Payer: Railroad Medicare Medicare |
$39.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.69
|
| Rate for Payer: UHC Core |
$131.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.40
|
| Rate for Payer: UHC Medicare Advantage |
$40.58
|
| Rate for Payer: VA VA |
$39.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.20
|
|
|
HC ADAMTS ACTIVITY AND INHIB PROFILE
|
Facility
|
IP
|
$157.60
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500103
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$96.12 |
| Max. Negotiated Rate |
$141.84 |
| Rate for Payer: Aetna Commercial |
$133.96
|
| Rate for Payer: BCBS Trust/PPO |
$121.79
|
| Rate for Payer: BCN Commercial |
$121.79
|
| Rate for Payer: Cash Price |
$126.08
|
| Rate for Payer: Cofinity Commercial |
$135.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.08
|
| Rate for Payer: Healthscope Commercial |
$141.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.96
|
| Rate for Payer: PHP Commercial |
$133.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.69
|
| Rate for Payer: UHC Core |
$131.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.20
|
|
|
HC ADAPT BARRIER RING
|
Facility
|
IP
|
$8.69
|
|
| Hospital Charge Code |
27100020
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$7.82 |
| Rate for Payer: Aetna Commercial |
$7.39
|
| Rate for Payer: BCBS Trust/PPO |
$6.72
|
| Rate for Payer: BCN Commercial |
$6.72
|
| Rate for Payer: Cash Price |
$6.95
|
| Rate for Payer: Cofinity Commercial |
$7.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.95
|
| Rate for Payer: Healthscope Commercial |
$7.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7.39
|
| Rate for Payer: PHP Commercial |
$7.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.65
|
| Rate for Payer: UHC Core |
$7.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.52
|
|
|
HC ADAPT BARRIER RING
|
Facility
|
OP
|
$8.69
|
|
| Hospital Charge Code |
27100020
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$7.82 |
| Rate for Payer: Aetna Commercial |
$7.39
|
| Rate for Payer: Aetna Medicare |
$2.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.72
|
| Rate for Payer: BCBS Complete |
$3.48
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCBS Trust/PPO |
$6.76
|
| Rate for Payer: BCN Commercial |
$6.76
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$6.95
|
| Rate for Payer: Cofinity Commercial |
$7.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$7.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7.39
|
| Rate for Payer: PACE Senior Care Partners |
$2.06
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Commercial |
$7.39
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.56
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.30
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.65
|
| Rate for Payer: UHC Core |
$7.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.17
|
| Rate for Payer: UHC Medicare Advantage |
$2.24
|
| Rate for Payer: VA VA |
$2.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.52
|
|
|
HC ADAPTER PERFUSION STERILE
|
Facility
|
OP
|
$90.00
|
|
| Hospital Charge Code |
27000677
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.38 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: Aetna Medicare |
$23.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.12
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCBS MAPPO |
$22.50
|
| Rate for Payer: BCBS Trust/PPO |
$69.98
|
| Rate for Payer: BCN Commercial |
$69.98
|
| Rate for Payer: BCN Medicare Advantage |
$22.50
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$77.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.50
|
| Rate for Payer: Healthscope Commercial |
$81.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: PACE Senior Care Partners |
$21.38
|
| Rate for Payer: PACE SWMI |
$22.50
|
| Rate for Payer: PHP Commercial |
$76.50
|
| Rate for Payer: PHP Medicare Advantage |
$22.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.30
|
| Rate for Payer: Priority Health Medicare |
$22.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.89
|
| Rate for Payer: Railroad Medicare Medicare |
$22.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.20
|
| Rate for Payer: UHC Core |
$75.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.50
|
| Rate for Payer: UHC Medicare Advantage |
$23.18
|
| Rate for Payer: VA VA |
$22.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.50
|
|
