|
HC B CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
OP
|
$92.82
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000042
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$22.04 |
| Max. Negotiated Rate |
$83.54 |
| Rate for Payer: Aetna Commercial |
$78.90
|
| Rate for Payer: Aetna Medicare |
$24.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.01
|
| Rate for Payer: BCBS Complete |
$39.67
|
| Rate for Payer: BCBS MAPPO |
$23.20
|
| Rate for Payer: BCBS Trust/PPO |
$72.17
|
| Rate for Payer: BCN Commercial |
$72.17
|
| Rate for Payer: BCN Medicare Advantage |
$23.20
|
| Rate for Payer: Cash Price |
$74.26
|
| Rate for Payer: Cash Price |
$74.26
|
| Rate for Payer: Cofinity Commercial |
$79.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.20
|
| Rate for Payer: Healthscope Commercial |
$83.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.62
|
| Rate for Payer: Mclaren Medicaid |
$37.78
|
| Rate for Payer: Meridian Medicaid |
$39.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.90
|
| Rate for Payer: PACE Senior Care Partners |
$22.04
|
| Rate for Payer: PACE SWMI |
$23.20
|
| Rate for Payer: PHP Commercial |
$78.90
|
| Rate for Payer: PHP Medicare Advantage |
$23.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.75
|
| Rate for Payer: Priority Health Medicare |
$23.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.61
|
| Rate for Payer: Railroad Medicare Medicare |
$23.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.68
|
| Rate for Payer: UHC Core |
$77.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.20
|
| Rate for Payer: UHC Medicare Advantage |
$23.90
|
| Rate for Payer: VA VA |
$23.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.62
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
IP
|
$92.82
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000042
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$56.61 |
| Max. Negotiated Rate |
$83.54 |
| Rate for Payer: Aetna Commercial |
$78.90
|
| Rate for Payer: BCBS Trust/PPO |
$71.73
|
| Rate for Payer: BCN Commercial |
$71.73
|
| Rate for Payer: Cash Price |
$74.26
|
| Rate for Payer: Cofinity Commercial |
$79.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.26
|
| Rate for Payer: Healthscope Commercial |
$83.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.90
|
| Rate for Payer: PHP Commercial |
$78.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.68
|
| Rate for Payer: UHC Core |
$77.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.62
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
OP
|
$103.02
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000030
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$92.72 |
| Rate for Payer: Aetna Commercial |
$87.57
|
| Rate for Payer: Aetna Medicare |
$26.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.19
|
| Rate for Payer: BCBS Complete |
$16.60
|
| Rate for Payer: BCBS MAPPO |
$25.76
|
| Rate for Payer: BCBS Trust/PPO |
$80.10
|
| Rate for Payer: BCN Commercial |
$80.10
|
| Rate for Payer: BCN Medicare Advantage |
$25.76
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$88.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.76
|
| Rate for Payer: Healthscope Commercial |
$92.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.26
|
| Rate for Payer: Mclaren Medicaid |
$15.81
|
| Rate for Payer: Meridian Medicaid |
$16.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.57
|
| Rate for Payer: PACE Senior Care Partners |
$24.47
|
| Rate for Payer: PACE SWMI |
$25.76
|
| Rate for Payer: PHP Commercial |
$87.57
|
| Rate for Payer: PHP Medicare Advantage |
$25.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.63
|
| Rate for Payer: Priority Health Medicare |
$25.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.83
|
| Rate for Payer: Railroad Medicare Medicare |
$25.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.66
|
| Rate for Payer: UHC Core |
$86.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.76
|
| Rate for Payer: UHC Medicare Advantage |
$26.53
|
| Rate for Payer: VA VA |
$25.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.26
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
IP
|
$103.02
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000030
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$62.83 |
| Max. Negotiated Rate |
$92.72 |
| Rate for Payer: Aetna Commercial |
$87.57
|
| Rate for Payer: BCBS Trust/PPO |
$79.61
|
| Rate for Payer: BCN Commercial |
$79.61
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$88.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Healthscope Commercial |
$92.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.57
|
| Rate for Payer: PHP Commercial |
$87.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.66
|
| Rate for Payer: UHC Core |
$86.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.26
|
|
|
HC B CELL ACUTE LYMPH LEUK FISH
|
Facility
|
OP
|
$92.82
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000041
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$22.04 |
| Max. Negotiated Rate |
$83.54 |
| Rate for Payer: Aetna Commercial |
$78.90
|
| Rate for Payer: Aetna Medicare |
$24.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.01
|
| Rate for Payer: BCBS Complete |
$39.67
|
| Rate for Payer: BCBS MAPPO |
$23.20
|
| Rate for Payer: BCBS Trust/PPO |
$72.17
|
| Rate for Payer: BCN Commercial |
$72.17
|
| Rate for Payer: BCN Medicare Advantage |
$23.20
|
| Rate for Payer: Cash Price |
$74.26
|
| Rate for Payer: Cash Price |
$74.26
|
| Rate for Payer: Cofinity Commercial |
$79.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.20
|
| Rate for Payer: Healthscope Commercial |
$83.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.62
|
| Rate for Payer: Mclaren Medicaid |
$37.78
|
| Rate for Payer: Meridian Medicaid |
$39.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.90
|
| Rate for Payer: PACE Senior Care Partners |
$22.04
|
| Rate for Payer: PACE SWMI |
$23.20
|
| Rate for Payer: PHP Commercial |
$78.90
|
| Rate for Payer: PHP Medicare Advantage |
$23.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.75
|
| Rate for Payer: Priority Health Medicare |
$23.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.61
|
| Rate for Payer: Railroad Medicare Medicare |
$23.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.68
|
| Rate for Payer: UHC Core |
$77.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.20
|
| Rate for Payer: UHC Medicare Advantage |
$23.90
|
| Rate for Payer: VA VA |
$23.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.62
|
|
|
HC B CELL ACUTE LYMPH LEUK FISH
|
Facility
|
IP
|
$92.82
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000041
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$56.61 |
| Max. Negotiated Rate |
$83.54 |
| Rate for Payer: Aetna Commercial |
$78.90
|
| Rate for Payer: BCBS Trust/PPO |
$71.73
|
| Rate for Payer: BCN Commercial |
$71.73
|
| Rate for Payer: Cash Price |
$74.26
|
| Rate for Payer: Cofinity Commercial |
$79.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.26
|
| Rate for Payer: Healthscope Commercial |
$83.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.90
|
| Rate for Payer: PHP Commercial |
$78.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.68
|
| Rate for Payer: UHC Core |
$77.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.62
|
|
|
HC BCR / ABL FISH
|
Facility
|
IP
|
$128.52
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000024
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$78.38 |
| Max. Negotiated Rate |
$115.67 |
| Rate for Payer: Aetna Commercial |
$109.24
|
| Rate for Payer: BCBS Trust/PPO |
$99.32
|
| Rate for Payer: BCN Commercial |
$99.32
|
| Rate for Payer: Cash Price |
$102.82
|
| Rate for Payer: Cofinity Commercial |
$110.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.82
|
| Rate for Payer: Healthscope Commercial |
$115.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.24
|
| Rate for Payer: PHP Commercial |
$109.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.10
|
| Rate for Payer: UHC Core |
$107.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.39
|
|
|
HC BCR / ABL FISH
|
Facility
|
OP
|
$128.52
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000024
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$115.67 |
| Rate for Payer: Aetna Commercial |
$109.24
|
| Rate for Payer: Aetna Medicare |
$33.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.16
|
| Rate for Payer: BCBS Complete |
$16.60
|
| Rate for Payer: BCBS MAPPO |
$32.13
|
| Rate for Payer: BCBS Trust/PPO |
$99.92
|
| Rate for Payer: BCN Commercial |
$99.92
|
| Rate for Payer: BCN Medicare Advantage |
$32.13
|
| Rate for Payer: Cash Price |
$102.82
|
| Rate for Payer: Cash Price |
$102.82
|
| Rate for Payer: Cofinity Commercial |
$110.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.13
|
| Rate for Payer: Healthscope Commercial |
$115.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.39
|
| Rate for Payer: Mclaren Medicaid |
$15.81
|
| Rate for Payer: Meridian Medicaid |
$16.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.24
|
| Rate for Payer: PACE Senior Care Partners |
$30.52
|
| Rate for Payer: PACE SWMI |
$32.13
|
| Rate for Payer: PHP Commercial |
$109.24
|
| Rate for Payer: PHP Medicare Advantage |
$32.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.81
|
| Rate for Payer: Priority Health Medicare |
$32.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.38
|
| Rate for Payer: Railroad Medicare Medicare |
$32.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.10
|
| Rate for Payer: UHC Core |
$107.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.13
|
| Rate for Payer: UHC Medicare Advantage |
$33.09
|
| Rate for Payer: VA VA |
$32.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.39
|
|
|
HC BCR / ABL FISH CMPT1
|
Facility
|
IP
|
$103.02
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$62.83 |
| Max. Negotiated Rate |
$92.72 |
| Rate for Payer: Aetna Commercial |
$87.57
|
| Rate for Payer: BCBS Trust/PPO |
$79.61
|
| Rate for Payer: BCN Commercial |
$79.61
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$88.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Healthscope Commercial |
$92.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.57
|
| Rate for Payer: PHP Commercial |
$87.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.66
|
| Rate for Payer: UHC Core |
$86.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.26
|
|
|
HC BCR / ABL FISH CMPT1
|
Facility
|
OP
|
$103.02
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$92.72 |
| Rate for Payer: Aetna Commercial |
$87.57
|
| Rate for Payer: Aetna Medicare |
$26.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.19
|
| Rate for Payer: BCBS Complete |
$16.60
|
| Rate for Payer: BCBS MAPPO |
$25.76
|
| Rate for Payer: BCBS Trust/PPO |
$80.10
|
| Rate for Payer: BCN Commercial |
$80.10
|
| Rate for Payer: BCN Medicare Advantage |
$25.76
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$88.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.76
|
| Rate for Payer: Healthscope Commercial |
$92.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.26
|
| Rate for Payer: Mclaren Medicaid |
$15.81
|
| Rate for Payer: Meridian Medicaid |
$16.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.57
|
| Rate for Payer: PACE Senior Care Partners |
$24.47
|
| Rate for Payer: PACE SWMI |
$25.76
|
| Rate for Payer: PHP Commercial |
$87.57
|
| Rate for Payer: PHP Medicare Advantage |
$25.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.63
|
| Rate for Payer: Priority Health Medicare |
$25.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.83
|
| Rate for Payer: Railroad Medicare Medicare |
$25.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.66
|
| Rate for Payer: UHC Core |
$86.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.76
|
| Rate for Payer: UHC Medicare Advantage |
$26.53
|
| Rate for Payer: VA VA |
$25.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.26
|
|
|
HC BCR/ABL FISH CMPT 2
|
Facility
|
OP
|
$76.34
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.13 |
| Max. Negotiated Rate |
$68.71 |
| Rate for Payer: Aetna Commercial |
$64.89
|
| Rate for Payer: Aetna Medicare |
$19.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.86
|
| Rate for Payer: BCBS Complete |
$39.67
|
| Rate for Payer: BCBS MAPPO |
$19.08
|
| Rate for Payer: BCBS Trust/PPO |
$59.35
|
| Rate for Payer: BCN Commercial |
$59.35
|
| Rate for Payer: BCN Medicare Advantage |
$19.08
|
| Rate for Payer: Cash Price |
$61.07
|
| Rate for Payer: Cash Price |
$61.07
|
| Rate for Payer: Cofinity Commercial |
$65.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.08
|
| Rate for Payer: Healthscope Commercial |
$68.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.26
|
| Rate for Payer: Mclaren Medicaid |
$37.78
|
| Rate for Payer: Meridian Medicaid |
$39.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.89
|
| Rate for Payer: PACE Senior Care Partners |
$18.13
|
| Rate for Payer: PACE SWMI |
$19.08
|
| Rate for Payer: PHP Commercial |
$64.89
|
| Rate for Payer: PHP Medicare Advantage |
$19.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.42
|
| Rate for Payer: Priority Health Medicare |
$19.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.56
|
| Rate for Payer: Railroad Medicare Medicare |
$19.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.18
|
| Rate for Payer: UHC Core |
$63.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.08
|
| Rate for Payer: UHC Medicare Advantage |
$19.66
|
| Rate for Payer: VA VA |
$19.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.26
|
|
|
HC BCR/ABL FISH CMPT 2
|
Facility
|
IP
|
$76.34
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$46.56 |
| Max. Negotiated Rate |
$68.71 |
| Rate for Payer: Aetna Commercial |
$64.89
|
| Rate for Payer: BCBS Trust/PPO |
$59.00
|
| Rate for Payer: BCN Commercial |
$59.00
|
| Rate for Payer: Cash Price |
$61.07
|
| Rate for Payer: Cofinity Commercial |
$65.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.07
|
| Rate for Payer: Healthscope Commercial |
$68.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.89
|
| Rate for Payer: PHP Commercial |
$64.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.18
|
| Rate for Payer: UHC Core |
$63.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.26
|
|
|
HC BCR/ABL P210 QUANT
|
Facility
|
IP
|
$382.50
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000096
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$233.29 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Aetna Commercial |
$325.12
|
| Rate for Payer: BCBS Trust/PPO |
$295.60
|
| Rate for Payer: BCN Commercial |
$295.60
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cofinity Commercial |
$328.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.00
|
| Rate for Payer: Healthscope Commercial |
$344.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$325.12
|
| Rate for Payer: PHP Commercial |
$325.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$332.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.60
|
| Rate for Payer: UHC Core |
$319.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.88
|
|
|
HC BCR/ABL P210 QUANT
|
Facility
|
OP
|
$382.50
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000096
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$90.84 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Aetna Commercial |
$325.12
|
| Rate for Payer: Aetna Medicare |
$99.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.53
|
| Rate for Payer: BCBS Complete |
$127.05
|
| Rate for Payer: BCBS MAPPO |
$95.62
|
| Rate for Payer: BCBS Trust/PPO |
$297.39
|
| Rate for Payer: BCN Commercial |
$297.39
|
| Rate for Payer: BCN Medicare Advantage |
$95.62
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cofinity Commercial |
$328.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.62
|
| Rate for Payer: Healthscope Commercial |
$344.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.88
|
| Rate for Payer: Mclaren Medicaid |
$121.00
|
| Rate for Payer: Meridian Medicaid |
$127.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$325.12
|
| Rate for Payer: PACE Senior Care Partners |
$90.84
|
| Rate for Payer: PACE SWMI |
$95.62
|
| Rate for Payer: PHP Commercial |
$325.12
|
| Rate for Payer: PHP Medicare Advantage |
$95.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$332.78
|
| Rate for Payer: Priority Health Medicare |
$95.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.29
|
| Rate for Payer: Railroad Medicare Medicare |
$95.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.60
|
| Rate for Payer: UHC Core |
$319.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.62
|
| Rate for Payer: UHC Medicare Advantage |
$98.49
|
| Rate for Payer: VA VA |
$95.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.88
|
|
|
HC BCRABL RNA, CMPT 1
|
Facility
|
OP
|
$222.36
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
31000144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$52.81 |
| Max. Negotiated Rate |
$200.12 |
| Rate for Payer: Aetna Commercial |
$189.01
|
| Rate for Payer: Aetna Medicare |
$57.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.49
|
| Rate for Payer: BCBS Complete |
$112.24
|
| Rate for Payer: BCBS MAPPO |
$55.59
|
| Rate for Payer: BCBS Trust/PPO |
$172.88
|
| Rate for Payer: BCN Commercial |
$172.88
|
| Rate for Payer: BCN Medicare Advantage |
$55.59
|
| Rate for Payer: Cash Price |
$177.89
|
| Rate for Payer: Cash Price |
$177.89
|
| Rate for Payer: Cofinity Commercial |
$191.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.59
|
| Rate for Payer: Healthscope Commercial |
$200.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.77
|
| Rate for Payer: Mclaren Medicaid |
$106.89
|
| Rate for Payer: Meridian Medicaid |
$112.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$189.01
|
| Rate for Payer: PACE Senior Care Partners |
$52.81
|
| Rate for Payer: PACE SWMI |
$55.59
|
| Rate for Payer: PHP Commercial |
$189.01
|
| Rate for Payer: PHP Medicare Advantage |
$55.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.45
|
| Rate for Payer: Priority Health Medicare |
$55.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$135.62
|
| Rate for Payer: Railroad Medicare Medicare |
$55.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.68
|
| Rate for Payer: UHC Core |
$185.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.59
|
| Rate for Payer: UHC Medicare Advantage |
$57.26
|
| Rate for Payer: VA VA |
$55.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.77
|
|
|
HC BCRABL RNA, CMPT 1
|
Facility
|
IP
|
$222.36
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
31000144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$135.62 |
| Max. Negotiated Rate |
$200.12 |
| Rate for Payer: Aetna Commercial |
$189.01
|
| Rate for Payer: BCBS Trust/PPO |
$171.84
|
| Rate for Payer: BCN Commercial |
$171.84
|
| Rate for Payer: Cash Price |
$177.89
|
| Rate for Payer: Cofinity Commercial |
$191.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.89
|
| Rate for Payer: Healthscope Commercial |
$200.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$189.01
|
| Rate for Payer: PHP Commercial |
$189.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$135.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.68
|
| Rate for Payer: UHC Core |
$185.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.77
|
|
|
HC BCRABL RNA, CMPT 2
|
Facility
|
IP
|
$329.49
|
|
|
Service Code
|
CPT 81208
|
| Hospital Charge Code |
31000145
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$200.96 |
| Max. Negotiated Rate |
$296.54 |
| Rate for Payer: Aetna Commercial |
$280.07
|
| Rate for Payer: BCBS Trust/PPO |
$254.63
|
| Rate for Payer: BCN Commercial |
$254.63
|
| Rate for Payer: Cash Price |
$263.59
|
| Rate for Payer: Cofinity Commercial |
$283.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.59
|
| Rate for Payer: Healthscope Commercial |
$296.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.07
|
| Rate for Payer: PHP Commercial |
$280.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$289.95
|
| Rate for Payer: UHC Core |
$275.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.12
|
|
|
HC BCRABL RNA, CMPT 2
|
Facility
|
OP
|
$329.49
|
|
|
Service Code
|
CPT 81208
|
| Hospital Charge Code |
31000145
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$78.25 |
| Max. Negotiated Rate |
$296.54 |
| Rate for Payer: Aetna Commercial |
$280.07
|
| Rate for Payer: Aetna Medicare |
$85.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.97
|
| Rate for Payer: BCBS Complete |
$166.31
|
| Rate for Payer: BCBS MAPPO |
$82.37
|
| Rate for Payer: BCBS Trust/PPO |
$256.18
|
| Rate for Payer: BCN Commercial |
$256.18
|
| Rate for Payer: BCN Medicare Advantage |
$82.37
|
| Rate for Payer: Cash Price |
$263.59
|
| Rate for Payer: Cash Price |
$263.59
|
| Rate for Payer: Cofinity Commercial |
$283.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.37
|
| Rate for Payer: Healthscope Commercial |
$296.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.12
|
| Rate for Payer: Mclaren Medicaid |
$158.39
|
| Rate for Payer: Meridian Medicaid |
$166.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$86.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.07
|
| Rate for Payer: PACE Senior Care Partners |
$78.25
|
| Rate for Payer: PACE SWMI |
$82.37
|
| Rate for Payer: PHP Commercial |
$280.07
|
| Rate for Payer: PHP Medicare Advantage |
$82.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$286.66
|
| Rate for Payer: Priority Health Medicare |
$82.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.96
|
| Rate for Payer: Railroad Medicare Medicare |
$82.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$289.95
|
| Rate for Payer: UHC Core |
$275.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.37
|
| Rate for Payer: UHC Medicare Advantage |
$84.84
|
| Rate for Payer: VA VA |
$82.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.12
|
|
|
HC BCRABL RNA, QUAL
|
Facility
|
OP
|
$256.50
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000143
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$230.85 |
| Rate for Payer: Aetna Commercial |
$218.02
|
| Rate for Payer: Aetna Medicare |
$66.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.16
|
| Rate for Payer: BCBS Complete |
$127.05
|
| Rate for Payer: BCBS MAPPO |
$64.12
|
| Rate for Payer: BCBS Trust/PPO |
$199.43
|
| Rate for Payer: BCN Commercial |
$199.43
|
| Rate for Payer: BCN Medicare Advantage |
$64.12
|
| Rate for Payer: Cash Price |
$205.20
|
| Rate for Payer: Cash Price |
$205.20
|
| Rate for Payer: Cofinity Commercial |
$220.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.12
|
| Rate for Payer: Healthscope Commercial |
$230.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.38
|
| Rate for Payer: Mclaren Medicaid |
$121.00
|
| Rate for Payer: Meridian Medicaid |
$127.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$218.02
|
| Rate for Payer: PACE Senior Care Partners |
$60.92
|
| Rate for Payer: PACE SWMI |
$64.12
|
| Rate for Payer: PHP Commercial |
$218.02
|
| Rate for Payer: PHP Medicare Advantage |
$64.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.16
|
| Rate for Payer: Priority Health Medicare |
$64.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.44
|
| Rate for Payer: Railroad Medicare Medicare |
$64.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.72
|
| Rate for Payer: UHC Core |
$214.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.12
|
| Rate for Payer: UHC Medicare Advantage |
$66.05
|
| Rate for Payer: VA VA |
$64.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.38
|
|
|
HC BCRABL RNA, QUAL
|
Facility
|
IP
|
$256.50
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000143
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$156.44 |
| Max. Negotiated Rate |
$230.85 |
| Rate for Payer: Aetna Commercial |
$218.02
|
| Rate for Payer: BCBS Trust/PPO |
$198.22
|
| Rate for Payer: BCN Commercial |
$198.22
|
| Rate for Payer: Cash Price |
$205.20
|
| Rate for Payer: Cofinity Commercial |
$220.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.20
|
| Rate for Payer: Healthscope Commercial |
$230.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$218.02
|
| Rate for Payer: PHP Commercial |
$218.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.72
|
| Rate for Payer: UHC Core |
$214.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.38
|
|
|
HC BDIAL APTT
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$4.66
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$4.44
|
| Rate for Payer: Meridian Medicaid |
$4.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC BDIAL APTT
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC BDIAL DIRM
|
Facility
|
OP
|
$39.53
|
|
|
Service Code
|
CPT 85379
|
| Hospital Charge Code |
30500088
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.51 |
| Max. Negotiated Rate |
$35.58 |
| Rate for Payer: Aetna Commercial |
$33.60
|
| Rate for Payer: Aetna Medicare |
$10.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.35
|
| Rate for Payer: BCBS Complete |
$7.89
|
| Rate for Payer: BCBS MAPPO |
$9.88
|
| Rate for Payer: BCBS Trust/PPO |
$30.73
|
| Rate for Payer: BCN Commercial |
$30.73
|
| Rate for Payer: BCN Medicare Advantage |
$9.88
|
| Rate for Payer: Cash Price |
$31.62
|
| Rate for Payer: Cash Price |
$31.62
|
| Rate for Payer: Cofinity Commercial |
$34.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.88
|
| Rate for Payer: Healthscope Commercial |
$35.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.65
|
| Rate for Payer: Mclaren Medicaid |
$7.51
|
| Rate for Payer: Meridian Medicaid |
$7.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.60
|
| Rate for Payer: PACE Senior Care Partners |
$9.39
|
| Rate for Payer: PACE SWMI |
$9.88
|
| Rate for Payer: PHP Commercial |
$33.60
|
| Rate for Payer: PHP Medicare Advantage |
$9.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.39
|
| Rate for Payer: Priority Health Medicare |
$9.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.11
|
| Rate for Payer: Railroad Medicare Medicare |
$9.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.79
|
| Rate for Payer: UHC Core |
$33.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.88
|
| Rate for Payer: UHC Medicare Advantage |
$10.18
|
| Rate for Payer: VA VA |
$9.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.65
|
|
|
HC BDIAL DIRM
|
Facility
|
IP
|
$39.53
|
|
|
Service Code
|
CPT 85379
|
| Hospital Charge Code |
30500088
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$24.11 |
| Max. Negotiated Rate |
$35.58 |
| Rate for Payer: Aetna Commercial |
$33.60
|
| Rate for Payer: BCBS Trust/PPO |
$30.55
|
| Rate for Payer: BCN Commercial |
$30.55
|
| Rate for Payer: Cash Price |
$31.62
|
| Rate for Payer: Cofinity Commercial |
$34.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.62
|
| Rate for Payer: Healthscope Commercial |
$35.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.60
|
| Rate for Payer: PHP Commercial |
$33.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.79
|
| Rate for Payer: UHC Core |
$33.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.65
|
|
|
HC BDIAL F8A
|
Facility
|
OP
|
$65.64
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500091
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$59.08 |
| Rate for Payer: Aetna Commercial |
$55.79
|
| Rate for Payer: Aetna Medicare |
$17.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.51
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCBS MAPPO |
$16.41
|
| Rate for Payer: BCBS Trust/PPO |
$51.04
|
| Rate for Payer: BCN Commercial |
$51.04
|
| Rate for Payer: BCN Medicare Advantage |
$16.41
|
| Rate for Payer: Cash Price |
$52.51
|
| Rate for Payer: Cash Price |
$52.51
|
| Rate for Payer: Cofinity Commercial |
$56.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.41
|
| Rate for Payer: Healthscope Commercial |
$59.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.23
|
| Rate for Payer: Mclaren Medicaid |
$13.21
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.79
|
| Rate for Payer: PACE Senior Care Partners |
$15.59
|
| Rate for Payer: PACE SWMI |
$16.41
|
| Rate for Payer: PHP Commercial |
$55.79
|
| Rate for Payer: PHP Medicare Advantage |
$16.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.11
|
| Rate for Payer: Priority Health Medicare |
$16.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.03
|
| Rate for Payer: Railroad Medicare Medicare |
$16.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.76
|
| Rate for Payer: UHC Core |
$54.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.41
|
| Rate for Payer: UHC Medicare Advantage |
$16.90
|
| Rate for Payer: VA VA |
$16.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.23
|
|
