|
HC BARBITURATE URIN
|
Facility
|
IP
|
$95.40
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000137
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.18 |
| Max. Negotiated Rate |
$85.86 |
| Rate for Payer: Aetna Commercial |
$81.09
|
| Rate for Payer: BCBS Trust/PPO |
$73.73
|
| Rate for Payer: BCN Commercial |
$73.73
|
| Rate for Payer: Cash Price |
$76.32
|
| Rate for Payer: Cofinity Commercial |
$82.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.32
|
| Rate for Payer: Healthscope Commercial |
$85.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.09
|
| Rate for Payer: PHP Commercial |
$81.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.95
|
| Rate for Payer: UHC Core |
$79.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.55
|
|
|
HC BARBITURATE URINE CONFIRM
|
Facility
|
IP
|
$62.00
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
30100571
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.81 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Aetna Commercial |
$52.70
|
| Rate for Payer: BCBS Trust/PPO |
$47.91
|
| Rate for Payer: BCN Commercial |
$47.91
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$53.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.60
|
| Rate for Payer: Healthscope Commercial |
$55.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.70
|
| Rate for Payer: PHP Commercial |
$52.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.56
|
| Rate for Payer: UHC Core |
$51.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.50
|
|
|
HC BARBITURATE URINE CONFIRM
|
Facility
|
OP
|
$62.00
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
30100571
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.72 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Aetna Commercial |
$52.70
|
| Rate for Payer: Aetna Medicare |
$16.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.38
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$48.20
|
| Rate for Payer: BCN Commercial |
$48.20
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$53.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$55.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.70
|
| Rate for Payer: PACE Senior Care Partners |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Commercial |
$52.70
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.94
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.81
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.56
|
| Rate for Payer: UHC Core |
$51.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.50
|
| Rate for Payer: UHC Medicare Advantage |
$15.96
|
| Rate for Payer: VA VA |
$15.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.50
|
|
|
HC BARRIER ADHESION
|
Facility
|
OP
|
$578.39
|
|
|
Service Code
|
HCPCS C1765
|
| Hospital Charge Code |
27000463
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$137.37 |
| Max. Negotiated Rate |
$520.55 |
| Rate for Payer: Aetna Commercial |
$491.63
|
| Rate for Payer: Aetna Medicare |
$150.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$180.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$180.75
|
| Rate for Payer: BCBS Complete |
$231.36
|
| Rate for Payer: BCBS MAPPO |
$144.60
|
| Rate for Payer: BCBS Trust/PPO |
$449.70
|
| Rate for Payer: BCN Commercial |
$449.70
|
| Rate for Payer: BCN Medicare Advantage |
$144.60
|
| Rate for Payer: Cash Price |
$462.71
|
| Rate for Payer: Cofinity Commercial |
$497.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$462.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.60
|
| Rate for Payer: Healthscope Commercial |
$520.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$433.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$151.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$166.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$491.63
|
| Rate for Payer: PACE Senior Care Partners |
$137.37
|
| Rate for Payer: PACE SWMI |
$144.60
|
| Rate for Payer: PHP Commercial |
$491.63
|
| Rate for Payer: PHP Medicare Advantage |
$144.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$503.20
|
| Rate for Payer: Priority Health Medicare |
$144.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$352.76
|
| Rate for Payer: Railroad Medicare Medicare |
$144.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$508.98
|
| Rate for Payer: UHC Core |
$482.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.60
|
| Rate for Payer: UHC Medicare Advantage |
$148.94
|
| Rate for Payer: VA VA |
$144.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$433.79
|
|
|
HC BARRIER ADHESION
|
Facility
|
IP
|
$578.39
|
|
|
Service Code
|
HCPCS C1765
|
| Hospital Charge Code |
27000463
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$352.76 |
| Max. Negotiated Rate |
$520.55 |
| Rate for Payer: Aetna Commercial |
$491.63
|
| Rate for Payer: BCBS Trust/PPO |
$446.98
|
| Rate for Payer: BCN Commercial |
$446.98
|
| Rate for Payer: Cash Price |
$462.71
|
| Rate for Payer: Cofinity Commercial |
$497.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$462.71
|
| Rate for Payer: Healthscope Commercial |
$520.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$433.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$491.63
|
| Rate for Payer: PHP Commercial |
$491.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$503.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$352.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$508.98
|
| Rate for Payer: UHC Core |
$482.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$433.79
|
|
|
HC BARRX 360 EXPRESS CATH BALLOON
|
Facility
|
OP
|
$5,608.69
|
|
| Hospital Charge Code |
27200286
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,332.06 |
| Max. Negotiated Rate |
$5,047.82 |
| Rate for Payer: Aetna Commercial |
$4,767.39
|
| Rate for Payer: Aetna Medicare |
$1,458.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,752.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,752.72
|
| Rate for Payer: BCBS Complete |
$2,243.48
|
| Rate for Payer: BCBS MAPPO |
$1,402.17
|
| Rate for Payer: BCBS Trust/PPO |
$4,360.76
|
| Rate for Payer: BCN Commercial |
$4,360.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,402.17
|
| Rate for Payer: Cash Price |
$4,486.95
|
| Rate for Payer: Cofinity Commercial |
$4,823.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,486.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,402.17
|
| Rate for Payer: Healthscope Commercial |
$5,047.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,206.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,472.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,612.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,767.39
|
| Rate for Payer: PACE Senior Care Partners |
$1,332.06
|
| Rate for Payer: PACE SWMI |
$1,402.17
|
| Rate for Payer: PHP Commercial |
$4,767.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,402.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,926.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,879.56
|
| Rate for Payer: Priority Health Medicare |
$1,402.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,420.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,402.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,935.65
|
| Rate for Payer: UHC Core |
$4,683.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,402.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,444.24
|
| Rate for Payer: VA VA |
$1,402.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,206.52
|
|
|
HC BARRX 360 EXPRESS CATH BALLOON
|
Facility
|
IP
|
$5,608.69
|
|
| Hospital Charge Code |
27200286
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,420.74 |
| Max. Negotiated Rate |
$5,047.82 |
| Rate for Payer: Aetna Commercial |
$4,767.39
|
| Rate for Payer: BCBS Trust/PPO |
$4,334.40
|
| Rate for Payer: BCN Commercial |
$4,334.40
|
| Rate for Payer: Cash Price |
$4,486.95
|
| Rate for Payer: Cofinity Commercial |
$4,823.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,486.95
|
| Rate for Payer: Healthscope Commercial |
$5,047.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,206.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,767.39
|
| Rate for Payer: PHP Commercial |
$4,767.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,926.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,879.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,420.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,935.65
|
| Rate for Payer: UHC Core |
$4,683.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,206.52
|
|
|
HC BARRX 90 RFA FOCAL CATHETER
|
Facility
|
OP
|
$4,265.57
|
|
| Hospital Charge Code |
27200287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,013.07 |
| Max. Negotiated Rate |
$3,839.01 |
| Rate for Payer: Aetna Commercial |
$3,625.73
|
| Rate for Payer: Aetna Medicare |
$1,109.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,332.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,332.99
|
| Rate for Payer: BCBS Complete |
$1,706.23
|
| Rate for Payer: BCBS MAPPO |
$1,066.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,316.48
|
| Rate for Payer: BCN Commercial |
$3,316.48
|
| Rate for Payer: BCN Medicare Advantage |
$1,066.39
|
| Rate for Payer: Cash Price |
$3,412.46
|
| Rate for Payer: Cofinity Commercial |
$3,668.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,412.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,066.39
|
| Rate for Payer: Healthscope Commercial |
$3,839.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,199.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,119.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,226.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,625.73
|
| Rate for Payer: PACE Senior Care Partners |
$1,013.07
|
| Rate for Payer: PACE SWMI |
$1,066.39
|
| Rate for Payer: PHP Commercial |
$3,625.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,066.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,985.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,711.05
|
| Rate for Payer: Priority Health Medicare |
$1,066.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,601.57
|
| Rate for Payer: Railroad Medicare Medicare |
$1,066.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,753.70
|
| Rate for Payer: UHC Core |
$3,561.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,066.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,098.38
|
| Rate for Payer: VA VA |
$1,066.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,199.18
|
|
|
HC BARRX 90 RFA FOCAL CATHETER
|
Facility
|
IP
|
$4,265.57
|
|
| Hospital Charge Code |
27200287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,601.57 |
| Max. Negotiated Rate |
$3,839.01 |
| Rate for Payer: Aetna Commercial |
$3,625.73
|
| Rate for Payer: BCBS Trust/PPO |
$3,296.43
|
| Rate for Payer: BCN Commercial |
$3,296.43
|
| Rate for Payer: Cash Price |
$3,412.46
|
| Rate for Payer: Cofinity Commercial |
$3,668.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,412.46
|
| Rate for Payer: Healthscope Commercial |
$3,839.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,199.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,625.73
|
| Rate for Payer: PHP Commercial |
$3,625.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,985.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,711.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,601.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,753.70
|
| Rate for Payer: UHC Core |
$3,561.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,199.18
|
|
|
HC BARRX RFA
|
Facility
|
OP
|
$2,004.30
|
|
| Hospital Charge Code |
36000101
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$476.02 |
| Max. Negotiated Rate |
$1,803.87 |
| Rate for Payer: Aetna Commercial |
$1,703.66
|
| Rate for Payer: Aetna Medicare |
$521.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$626.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$626.34
|
| Rate for Payer: BCBS Complete |
$801.72
|
| Rate for Payer: BCBS MAPPO |
$501.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,558.34
|
| Rate for Payer: BCN Commercial |
$1,558.34
|
| Rate for Payer: BCN Medicare Advantage |
$501.08
|
| Rate for Payer: Cash Price |
$1,603.44
|
| Rate for Payer: Cofinity Commercial |
$1,723.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$501.08
|
| Rate for Payer: Healthscope Commercial |
$1,803.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,503.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$526.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$576.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,703.66
|
| Rate for Payer: PACE Senior Care Partners |
$476.02
|
| Rate for Payer: PACE SWMI |
$501.08
|
| Rate for Payer: PHP Commercial |
$1,703.66
|
| Rate for Payer: PHP Medicare Advantage |
$501.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,403.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,743.74
|
| Rate for Payer: Priority Health Medicare |
$501.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,222.42
|
| Rate for Payer: Railroad Medicare Medicare |
$501.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,763.78
|
| Rate for Payer: UHC Core |
$1,673.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$501.08
|
| Rate for Payer: UHC Medicare Advantage |
$516.11
|
| Rate for Payer: VA VA |
$501.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,503.22
|
|
|
HC BARRX RFA
|
Facility
|
IP
|
$2,004.30
|
|
| Hospital Charge Code |
36000101
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,222.42 |
| Max. Negotiated Rate |
$1,803.87 |
| Rate for Payer: Aetna Commercial |
$1,703.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.92
|
| Rate for Payer: BCN Commercial |
$1,548.92
|
| Rate for Payer: Cash Price |
$1,603.44
|
| Rate for Payer: Cofinity Commercial |
$1,723.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.44
|
| Rate for Payer: Healthscope Commercial |
$1,803.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,503.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,703.66
|
| Rate for Payer: PHP Commercial |
$1,703.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,403.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,743.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,222.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,763.78
|
| Rate for Payer: UHC Core |
$1,673.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,503.22
|
|
|
HC BARRX ULTRA LONG RFA FOCAL CATHETER
|
Facility
|
OP
|
$4,333.46
|
|
| Hospital Charge Code |
27200288
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,029.20 |
| Max. Negotiated Rate |
$3,900.11 |
| Rate for Payer: Aetna Commercial |
$3,683.44
|
| Rate for Payer: Aetna Medicare |
$1,126.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,354.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,354.21
|
| Rate for Payer: BCBS Complete |
$1,733.38
|
| Rate for Payer: BCBS MAPPO |
$1,083.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,369.27
|
| Rate for Payer: BCN Commercial |
$3,369.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,083.36
|
| Rate for Payer: Cash Price |
$3,466.77
|
| Rate for Payer: Cofinity Commercial |
$3,726.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,466.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,083.36
|
| Rate for Payer: Healthscope Commercial |
$3,900.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,250.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,137.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,245.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,683.44
|
| Rate for Payer: PACE Senior Care Partners |
$1,029.20
|
| Rate for Payer: PACE SWMI |
$1,083.36
|
| Rate for Payer: PHP Commercial |
$3,683.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,083.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,033.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,770.11
|
| Rate for Payer: Priority Health Medicare |
$1,083.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,642.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,083.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,813.44
|
| Rate for Payer: UHC Core |
$3,618.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,083.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,115.87
|
| Rate for Payer: VA VA |
$1,083.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,250.10
|
|
|
HC BARRX ULTRA LONG RFA FOCAL CATHETER
|
Facility
|
IP
|
$4,333.46
|
|
| Hospital Charge Code |
27200288
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,642.98 |
| Max. Negotiated Rate |
$3,900.11 |
| Rate for Payer: Aetna Commercial |
$3,683.44
|
| Rate for Payer: BCBS Trust/PPO |
$3,348.90
|
| Rate for Payer: BCN Commercial |
$3,348.90
|
| Rate for Payer: Cash Price |
$3,466.77
|
| Rate for Payer: Cofinity Commercial |
$3,726.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,466.77
|
| Rate for Payer: Healthscope Commercial |
$3,900.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,250.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,683.44
|
| Rate for Payer: PHP Commercial |
$3,683.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,033.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,770.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,642.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,813.44
|
| Rate for Payer: UHC Core |
$3,618.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,250.10
|
|
|
HC BARTONELLA HENSELAE CMPT
|
Facility
|
IP
|
$16.32
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200227
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.95 |
| Max. Negotiated Rate |
$14.69 |
| Rate for Payer: Aetna Commercial |
$13.87
|
| Rate for Payer: BCBS Trust/PPO |
$12.61
|
| Rate for Payer: BCN Commercial |
$12.61
|
| Rate for Payer: Cash Price |
$13.06
|
| Rate for Payer: Cofinity Commercial |
$14.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.06
|
| Rate for Payer: Healthscope Commercial |
$14.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.87
|
| Rate for Payer: PHP Commercial |
$13.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.36
|
| Rate for Payer: UHC Core |
$13.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.24
|
|
|
HC BARTONELLA HENSELAE CMPT
|
Facility
|
OP
|
$16.32
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200227
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.88 |
| Max. Negotiated Rate |
$14.69 |
| Rate for Payer: Aetna Commercial |
$13.87
|
| Rate for Payer: Aetna Medicare |
$4.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.10
|
| Rate for Payer: BCBS Complete |
$7.89
|
| Rate for Payer: BCBS MAPPO |
$4.08
|
| Rate for Payer: BCBS Trust/PPO |
$12.69
|
| Rate for Payer: BCN Commercial |
$12.69
|
| Rate for Payer: BCN Medicare Advantage |
$4.08
|
| Rate for Payer: Cash Price |
$13.06
|
| Rate for Payer: Cash Price |
$13.06
|
| Rate for Payer: Cofinity Commercial |
$14.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.08
|
| Rate for Payer: Healthscope Commercial |
$14.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.24
|
| Rate for Payer: Mclaren Medicaid |
$7.51
|
| Rate for Payer: Meridian Medicaid |
$7.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.87
|
| Rate for Payer: PACE Senior Care Partners |
$3.88
|
| Rate for Payer: PACE SWMI |
$4.08
|
| Rate for Payer: PHP Commercial |
$13.87
|
| Rate for Payer: PHP Medicare Advantage |
$4.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.20
|
| Rate for Payer: Priority Health Medicare |
$4.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.95
|
| Rate for Payer: Railroad Medicare Medicare |
$4.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.36
|
| Rate for Payer: UHC Core |
$13.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.08
|
| Rate for Payer: UHC Medicare Advantage |
$4.20
|
| Rate for Payer: VA VA |
$4.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.24
|
|
|
HC BARTONELLA HENSELAE IGG IGM
|
Facility
|
OP
|
$17.34
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200228
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Aetna Commercial |
$14.74
|
| Rate for Payer: Aetna Medicare |
$4.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.42
|
| Rate for Payer: BCBS Complete |
$7.89
|
| Rate for Payer: BCBS MAPPO |
$4.34
|
| Rate for Payer: BCBS Trust/PPO |
$13.48
|
| Rate for Payer: BCN Commercial |
$13.48
|
| Rate for Payer: BCN Medicare Advantage |
$4.34
|
| Rate for Payer: Cash Price |
$13.87
|
| Rate for Payer: Cash Price |
$13.87
|
| Rate for Payer: Cofinity Commercial |
$14.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.34
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.00
|
| Rate for Payer: Mclaren Medicaid |
$7.51
|
| Rate for Payer: Meridian Medicaid |
$7.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.74
|
| Rate for Payer: PACE Senior Care Partners |
$4.12
|
| Rate for Payer: PACE SWMI |
$4.34
|
| Rate for Payer: PHP Commercial |
$14.74
|
| Rate for Payer: PHP Medicare Advantage |
$4.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.09
|
| Rate for Payer: Priority Health Medicare |
$4.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.58
|
| Rate for Payer: Railroad Medicare Medicare |
$4.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.26
|
| Rate for Payer: UHC Core |
$14.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.34
|
| Rate for Payer: UHC Medicare Advantage |
$4.47
|
| Rate for Payer: VA VA |
$4.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.00
|
|
|
HC BARTONELLA HENSELAE IGG IGM
|
Facility
|
IP
|
$17.34
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200228
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.58 |
| Max. Negotiated Rate |
$15.61 |
| Rate for Payer: Aetna Commercial |
$14.74
|
| Rate for Payer: BCBS Trust/PPO |
$13.40
|
| Rate for Payer: BCN Commercial |
$13.40
|
| Rate for Payer: Cash Price |
$13.87
|
| Rate for Payer: Cofinity Commercial |
$14.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.87
|
| Rate for Payer: Healthscope Commercial |
$15.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.74
|
| Rate for Payer: PHP Commercial |
$14.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.26
|
| Rate for Payer: UHC Core |
$14.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.00
|
|
|
HC BASIC METABOLIC PANEL
|
Facility
|
OP
|
$31.22
|
|
|
Service Code
|
CPT 80048
|
| Hospital Charge Code |
30100010
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.24 |
| Max. Negotiated Rate |
$28.10 |
| Rate for Payer: Aetna Commercial |
$26.54
|
| Rate for Payer: Aetna Medicare |
$8.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.76
|
| Rate for Payer: BCBS Complete |
$6.56
|
| Rate for Payer: BCBS MAPPO |
$7.80
|
| Rate for Payer: BCBS Trust/PPO |
$24.27
|
| Rate for Payer: BCN Commercial |
$24.27
|
| Rate for Payer: BCN Medicare Advantage |
$7.80
|
| Rate for Payer: Cash Price |
$24.98
|
| Rate for Payer: Cash Price |
$24.98
|
| Rate for Payer: Cofinity Commercial |
$26.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.80
|
| Rate for Payer: Healthscope Commercial |
$28.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.42
|
| Rate for Payer: Mclaren Medicaid |
$6.24
|
| Rate for Payer: Meridian Medicaid |
$6.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.54
|
| Rate for Payer: PACE Senior Care Partners |
$7.41
|
| Rate for Payer: PACE SWMI |
$7.80
|
| Rate for Payer: PHP Commercial |
$26.54
|
| Rate for Payer: PHP Medicare Advantage |
$7.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.16
|
| Rate for Payer: Priority Health Medicare |
$7.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.04
|
| Rate for Payer: Railroad Medicare Medicare |
$7.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.47
|
| Rate for Payer: UHC Core |
$26.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.80
|
| Rate for Payer: UHC Medicare Advantage |
$8.04
|
| Rate for Payer: VA VA |
$7.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.42
|
|
|
HC BASIC METABOLIC PANEL
|
Facility
|
IP
|
$31.22
|
|
|
Service Code
|
CPT 80048
|
| Hospital Charge Code |
30100010
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.04 |
| Max. Negotiated Rate |
$28.10 |
| Rate for Payer: Aetna Commercial |
$26.54
|
| Rate for Payer: BCBS Trust/PPO |
$24.13
|
| Rate for Payer: BCN Commercial |
$24.13
|
| Rate for Payer: Cash Price |
$24.98
|
| Rate for Payer: Cofinity Commercial |
$26.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.98
|
| Rate for Payer: Healthscope Commercial |
$28.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.54
|
| Rate for Payer: PHP Commercial |
$26.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.47
|
| Rate for Payer: UHC Core |
$26.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.42
|
|
|
HC BASIC METABOLIC W ION CALCIUM
|
Facility
|
OP
|
$92.92
|
|
|
Service Code
|
CPT 80047
|
| Hospital Charge Code |
30100009
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.13 |
| Max. Negotiated Rate |
$83.63 |
| Rate for Payer: Aetna Commercial |
$78.98
|
| Rate for Payer: Aetna Medicare |
$24.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.04
|
| Rate for Payer: BCBS Complete |
$10.64
|
| Rate for Payer: BCBS MAPPO |
$23.23
|
| Rate for Payer: BCBS Trust/PPO |
$72.25
|
| Rate for Payer: BCN Commercial |
$72.25
|
| Rate for Payer: BCN Medicare Advantage |
$23.23
|
| Rate for Payer: Cash Price |
$74.34
|
| Rate for Payer: Cash Price |
$74.34
|
| Rate for Payer: Cofinity Commercial |
$79.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.23
|
| Rate for Payer: Healthscope Commercial |
$83.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.69
|
| Rate for Payer: Mclaren Medicaid |
$10.13
|
| Rate for Payer: Meridian Medicaid |
$10.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.98
|
| Rate for Payer: PACE Senior Care Partners |
$22.07
|
| Rate for Payer: PACE SWMI |
$23.23
|
| Rate for Payer: PHP Commercial |
$78.98
|
| Rate for Payer: PHP Medicare Advantage |
$23.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.84
|
| Rate for Payer: Priority Health Medicare |
$23.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.67
|
| Rate for Payer: Railroad Medicare Medicare |
$23.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.77
|
| Rate for Payer: UHC Core |
$77.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.23
|
| Rate for Payer: UHC Medicare Advantage |
$23.93
|
| Rate for Payer: VA VA |
$23.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.69
|
|
|
HC BASIC METABOLIC W ION CALCIUM
|
Facility
|
IP
|
$92.92
|
|
|
Service Code
|
CPT 80047
|
| Hospital Charge Code |
30100009
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.67 |
| Max. Negotiated Rate |
$83.63 |
| Rate for Payer: Aetna Commercial |
$78.98
|
| Rate for Payer: BCBS Trust/PPO |
$71.81
|
| Rate for Payer: BCN Commercial |
$71.81
|
| Rate for Payer: Cash Price |
$74.34
|
| Rate for Payer: Cofinity Commercial |
$79.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.34
|
| Rate for Payer: Healthscope Commercial |
$83.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.98
|
| Rate for Payer: PHP Commercial |
$78.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.77
|
| Rate for Payer: UHC Core |
$77.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.69
|
|
|
HC BASIC RAD DOSIMETRY
|
Facility
|
IP
|
$286.00
|
|
|
Service Code
|
CPT 77300
|
| Hospital Charge Code |
33300005
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$174.43 |
| Max. Negotiated Rate |
$257.40 |
| Rate for Payer: Aetna Commercial |
$243.10
|
| Rate for Payer: Aetna Commercial |
$359.80
|
| Rate for Payer: BCBS Trust/PPO |
$221.02
|
| Rate for Payer: BCBS Trust/PPO |
$327.13
|
| Rate for Payer: BCN Commercial |
$327.13
|
| Rate for Payer: BCN Commercial |
$221.02
|
| Rate for Payer: Cash Price |
$338.64
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cofinity Commercial |
$245.96
|
| Rate for Payer: Cofinity Commercial |
$364.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.80
|
| Rate for Payer: Healthscope Commercial |
$380.97
|
| Rate for Payer: Healthscope Commercial |
$257.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$359.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.10
|
| Rate for Payer: PHP Commercial |
$243.10
|
| Rate for Payer: PHP Commercial |
$359.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$296.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$368.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$258.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.50
|
| Rate for Payer: UHC Core |
$353.46
|
| Rate for Payer: UHC Core |
$238.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.48
|
|
|
HC BASIC RAD DOSIMETRY
|
Facility
|
OP
|
$423.30
|
|
|
Service Code
|
CPT 77300
|
| Hospital Charge Code |
33300005
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$89.01 |
| Max. Negotiated Rate |
$380.97 |
| Rate for Payer: Aetna Commercial |
$359.80
|
| Rate for Payer: Aetna Commercial |
$243.10
|
| Rate for Payer: Aetna Medicare |
$74.36
|
| Rate for Payer: Aetna Medicare |
$110.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$132.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$132.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.38
|
| Rate for Payer: BCBS Complete |
$93.46
|
| Rate for Payer: BCBS Complete |
$93.46
|
| Rate for Payer: BCBS MAPPO |
$105.82
|
| Rate for Payer: BCBS MAPPO |
$71.50
|
| Rate for Payer: BCBS Trust/PPO |
$222.36
|
| Rate for Payer: BCBS Trust/PPO |
$329.12
|
| Rate for Payer: BCN Commercial |
$329.12
|
| Rate for Payer: BCN Commercial |
$222.36
|
| Rate for Payer: BCN Medicare Advantage |
$71.50
|
| Rate for Payer: BCN Medicare Advantage |
$105.82
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cash Price |
$338.64
|
| Rate for Payer: Cash Price |
$338.64
|
| Rate for Payer: Cofinity Commercial |
$364.04
|
| Rate for Payer: Cofinity Commercial |
$245.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.82
|
| Rate for Payer: Healthscope Commercial |
$257.40
|
| Rate for Payer: Healthscope Commercial |
$380.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.48
|
| Rate for Payer: Mclaren Medicaid |
$89.01
|
| Rate for Payer: Mclaren Medicaid |
$89.01
|
| Rate for Payer: Meridian Medicaid |
$93.46
|
| Rate for Payer: Meridian Medicaid |
$93.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$111.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$359.80
|
| Rate for Payer: PACE Senior Care Partners |
$67.92
|
| Rate for Payer: PACE Senior Care Partners |
$100.53
|
| Rate for Payer: PACE SWMI |
$105.82
|
| Rate for Payer: PACE SWMI |
$71.50
|
| Rate for Payer: PHP Commercial |
$243.10
|
| Rate for Payer: PHP Commercial |
$359.80
|
| Rate for Payer: PHP Medicare Advantage |
$71.50
|
| Rate for Payer: PHP Medicare Advantage |
$105.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$296.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$368.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.82
|
| Rate for Payer: Priority Health Medicare |
$105.82
|
| Rate for Payer: Priority Health Medicare |
$71.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$258.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.43
|
| Rate for Payer: Railroad Medicare Medicare |
$105.82
|
| Rate for Payer: Railroad Medicare Medicare |
$71.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.68
|
| Rate for Payer: UHC Core |
$353.46
|
| Rate for Payer: UHC Core |
$238.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.82
|
| Rate for Payer: UHC Medicare Advantage |
$109.00
|
| Rate for Payer: UHC Medicare Advantage |
$73.64
|
| Rate for Payer: VA VA |
$105.82
|
| Rate for Payer: VA VA |
$71.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.48
|
|
|
HC BB-COMP-FRESH-FROZEN PLASMA EA
|
Facility
|
OP
|
$219.81
|
|
|
Service Code
|
HCPCS P9059
|
| Hospital Charge Code |
39000041
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$49.96 |
| Max. Negotiated Rate |
$197.83 |
| Rate for Payer: Aetna Commercial |
$186.84
|
| Rate for Payer: Aetna Medicare |
$57.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.69
|
| Rate for Payer: BCBS Complete |
$52.46
|
| Rate for Payer: BCBS MAPPO |
$54.95
|
| Rate for Payer: BCBS Trust/PPO |
$170.90
|
| Rate for Payer: BCN Commercial |
$170.90
|
| Rate for Payer: BCN Medicare Advantage |
$54.95
|
| Rate for Payer: Cash Price |
$175.85
|
| Rate for Payer: Cash Price |
$175.85
|
| Rate for Payer: Cofinity Commercial |
$189.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.95
|
| Rate for Payer: Healthscope Commercial |
$197.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.86
|
| Rate for Payer: Mclaren Medicaid |
$49.96
|
| Rate for Payer: Meridian Medicaid |
$52.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$186.84
|
| Rate for Payer: PACE Senior Care Partners |
$52.20
|
| Rate for Payer: PACE SWMI |
$54.95
|
| Rate for Payer: PHP Commercial |
$186.84
|
| Rate for Payer: PHP Medicare Advantage |
$54.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$191.23
|
| Rate for Payer: Priority Health Medicare |
$54.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.06
|
| Rate for Payer: Railroad Medicare Medicare |
$54.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.43
|
| Rate for Payer: UHC Core |
$183.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.95
|
| Rate for Payer: UHC Medicare Advantage |
$56.60
|
| Rate for Payer: VA VA |
$54.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.86
|
|
|
HC BB-COMP-FRESH-FROZEN PLASMA EA
|
Facility
|
IP
|
$219.81
|
|
|
Service Code
|
HCPCS P9059
|
| Hospital Charge Code |
39000041
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$134.06 |
| Max. Negotiated Rate |
$197.83 |
| Rate for Payer: Aetna Commercial |
$186.84
|
| Rate for Payer: BCBS Trust/PPO |
$169.87
|
| Rate for Payer: BCN Commercial |
$169.87
|
| Rate for Payer: Cash Price |
$175.85
|
| Rate for Payer: Cofinity Commercial |
$189.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.85
|
| Rate for Payer: Healthscope Commercial |
$197.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$186.84
|
| Rate for Payer: PHP Commercial |
$186.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$191.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.43
|
| Rate for Payer: UHC Core |
$183.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.86
|
|
