|
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORE COLUMNS/GROUPS; WITH FISSURECTOMY
|
Facility
|
OP
|
$8,445.02
|
|
|
Service Code
|
CPT 46261
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$515.53 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,735.18
|
| Rate for Payer: BCN Commercial |
$1,735.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$567.08
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$515.53
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORE COLUMNS/GROUPS; WITH FISTULECTOMY, INCLUDING FISSURECTOMY, WHEN PERFORMED
|
Facility
|
OP
|
$8,445.02
|
|
|
Service Code
|
CPT 46262
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$569.35 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,024.38
|
| Rate for Payer: BCN Commercial |
$2,024.38
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$626.28
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$569.35
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SINGLE COLUMN/GROUP;
|
Facility
|
OP
|
$8,445.02
|
|
|
Service Code
|
CPT 46255
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$342.21 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,845.13
|
| Rate for Payer: BCN Commercial |
$2,845.13
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.43
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$342.21
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SINGLE COLUMN/GROUP; WITH FISSURECTOMY
|
Facility
|
OP
|
$8,445.02
|
|
|
Service Code
|
CPT 46257
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$398.74 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,735.18
|
| Rate for Payer: BCN Commercial |
$1,735.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$438.61
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$398.74
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SINGLE COLUMN/GROUP; WITH FISTULECTOMY, INCLUDING FISSURECTOMY, WHEN PERFORMED
|
Facility
|
OP
|
$8,445.02
|
|
|
Service Code
|
CPT 46258
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$469.25 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,735.18
|
| Rate for Payer: BCN Commercial |
$1,735.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$516.18
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$469.25
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
HEMORRHOIDECTOMY, INTERNAL, BY LIGATION OTHER THAN RUBBER BAND; 2 OR MORE HEMORRHOID COLUMNS/GROUPS, WITHOUT IMAGING GUIDANCE
|
Facility
|
OP
|
$8,445.02
|
|
|
Service Code
|
CPT 46946
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$361.65 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,735.80
|
| Rate for Payer: BCN Commercial |
$2,735.80
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.82
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$361.65
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
HEMORRHOIDECTOMY, INTERNAL, BY LIGATION OTHER THAN RUBBER BAND; SINGLE HEMORRHOID COLUMN/GROUP, WITHOUT IMAGING GUIDANCE
|
Facility
|
OP
|
$8,445.02
|
|
|
Service Code
|
CPT 46945
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$294.89 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$294.89
|
| Rate for Payer: BCN Commercial |
$294.89
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$354.99
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$322.72
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: VA VA |
$2,686.94
|
|
|
HEMORRHOIDECTOMY, INTERNAL, BY RUBBER BAND LIGATION(S)
|
Facility
|
OP
|
$2,807.55
|
|
|
Service Code
|
CPT 46221
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$182.89 |
| Max. Negotiated Rate |
$2,807.55 |
| Rate for Payer: Aetna Medicare |
$929.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,116.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,116.60
|
| Rate for Payer: BCBS Complete |
$502.74
|
| Rate for Payer: BCBS MAPPO |
$893.28
|
| Rate for Payer: BCBS Trust/PPO |
$637.45
|
| Rate for Payer: BCN Commercial |
$637.45
|
| Rate for Payer: BCN Medicare Advantage |
$893.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$893.28
|
| Rate for Payer: Mclaren Medicaid |
$478.80
|
| Rate for Payer: Mclaren Medicare |
$893.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$937.94
|
| Rate for Payer: Meridian Medicaid |
$502.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,027.27
|
| Rate for Payer: Nomi Health Commercial |
$1,875.89
|
| Rate for Payer: PACE Medicare |
$848.62
|
| Rate for Payer: PACE SWMI |
$893.28
|
| Rate for Payer: PHP Medicare Advantage |
$893.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$478.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,807.55
|
| Rate for Payer: Priority Health Medicare |
$893.28
|
| Rate for Payer: Priority Health Narrow Network |
$2,246.04
|
| Rate for Payer: Railroad Medicare Medicare |
$893.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.18
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$893.28
|
| Rate for Payer: UHC Exchange |
$182.89
|
| Rate for Payer: UHC Medicare Advantage |
$893.28
|
| Rate for Payer: UHCCP Medicaid |
$478.80
|
| Rate for Payer: VA VA |
$893.28
|
|
|
HEPARIN 1,000 UNIT/ML INJECTION-DIALYSIS ONLY
|
Facility
|
OP
|
$76.00
|
|
|
Service Code
|
HCPCS J1643
|
| Hospital Charge Code |
161517
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$68.40 |
| Rate for Payer: Aetna American Axle |
$49.40
|
| Rate for Payer: Aetna Commercial |
$64.60
|
| Rate for Payer: Aetna Medicare |
$38.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.40
|
| Rate for Payer: BCBS Complete |
$30.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.98
|
| Rate for Payer: BCN Commercial |
$0.98
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cofinity Commercial |
$53.20
|
| Rate for Payer: Cofinity Commercial |
$65.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.80
|
| Rate for Payer: Healthscope Commercial |
$68.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.60
|
| Rate for Payer: PHP Commercial |
$64.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.40
|
| Rate for Payer: Priority Health SBD |
$47.88
|
| Rate for Payer: UMR Bronson Commercial |
$28.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.00
|
|
|
HEPARIN 1,000 UNIT/ML INJECTION-DIALYSIS ONLY
|
Facility
|
IP
|
$76.00
|
|
|
Service Code
|
HCPCS J1643
|
| Hospital Charge Code |
161517
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$33.44 |
| Max. Negotiated Rate |
$68.40 |
| Rate for Payer: Aetna American Axle |
$49.40
|
| Rate for Payer: Aetna Commercial |
$64.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.40
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cofinity Commercial |
$53.20
|
| Rate for Payer: Cofinity Commercial |
$65.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.80
|
| Rate for Payer: Healthscope Commercial |
$68.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.60
|
| Rate for Payer: PHP Commercial |
$64.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.40
|
| Rate for Payer: Priority Health SBD |
$47.88
|
| Rate for Payer: UMR Bronson Commercial |
$33.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.00
|
|
|
HEPARIN 1,000 UNIT/ML INJECTION-DIALYSIS ONLY
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
161517
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.64 |
| Max. Negotiated Rate |
$50.40 |
| Rate for Payer: Aetna American Axle |
$36.40
|
| Rate for Payer: Aetna American Axle |
$64.84
|
| Rate for Payer: Aetna Commercial |
$47.60
|
| Rate for Payer: Aetna Commercial |
$84.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.84
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$79.80
|
| Rate for Payer: Cofinity Commercial |
$85.78
|
| Rate for Payer: Cofinity Commercial |
$69.82
|
| Rate for Payer: Cofinity Commercial |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$48.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.80
|
| Rate for Payer: Healthscope Commercial |
$50.40
|
| Rate for Payer: Healthscope Commercial |
$89.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.60
|
| Rate for Payer: PHP Commercial |
$84.79
|
| Rate for Payer: PHP Commercial |
$47.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.84
|
| Rate for Payer: Priority Health SBD |
$35.28
|
| Rate for Payer: Priority Health SBD |
$62.84
|
| Rate for Payer: UMR Bronson Commercial |
$24.64
|
| Rate for Payer: UMR Bronson Commercial |
$43.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.81
|
|
|
HEPARIN 1,000 UNIT/ML INJECTION-DIALYSIS ONLY
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
161517
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$50.40 |
| Rate for Payer: Aetna American Axle |
$36.40
|
| Rate for Payer: Aetna American Axle |
$64.84
|
| Rate for Payer: Aetna Commercial |
$84.79
|
| Rate for Payer: Aetna Commercial |
$47.60
|
| Rate for Payer: Aetna Medicare |
$28.00
|
| Rate for Payer: Aetna Medicare |
$49.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.84
|
| Rate for Payer: BCBS Complete |
$39.90
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.58
|
| Rate for Payer: BCBS Trust/PPO |
$0.58
|
| Rate for Payer: BCN Commercial |
$0.58
|
| Rate for Payer: BCN Commercial |
$0.58
|
| Rate for Payer: Cash Price |
$79.80
|
| Rate for Payer: Cash Price |
$79.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$85.78
|
| Rate for Payer: Cofinity Commercial |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$69.82
|
| Rate for Payer: Cofinity Commercial |
$48.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.80
|
| Rate for Payer: Healthscope Commercial |
$89.78
|
| Rate for Payer: Healthscope Commercial |
$50.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.79
|
| Rate for Payer: PHP Commercial |
$47.60
|
| Rate for Payer: PHP Commercial |
$84.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.84
|
| Rate for Payer: Priority Health SBD |
$62.84
|
| Rate for Payer: Priority Health SBD |
$35.28
|
| Rate for Payer: UMR Bronson Commercial |
$20.72
|
| Rate for Payer: UMR Bronson Commercial |
$36.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.00
|
|
|
HEPARIN 1000 UNITS/1000 ML 0.45% SODIUM CHLORIDE INTRA-CATHETER INFUSION (CATH LAB) (IV PREMIX)
|
Facility
|
OP
|
$44.50
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
301933
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$40.05 |
| Rate for Payer: Aetna American Axle |
$28.92
|
| Rate for Payer: Aetna Commercial |
$37.82
|
| Rate for Payer: Aetna Medicare |
$22.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.92
|
| Rate for Payer: BCBS Complete |
$17.80
|
| Rate for Payer: BCBS Trust/PPO |
$0.58
|
| Rate for Payer: BCN Commercial |
$0.58
|
| Rate for Payer: Cash Price |
$35.60
|
| Rate for Payer: Cash Price |
$35.60
|
| Rate for Payer: Cofinity Commercial |
$31.15
|
| Rate for Payer: Cofinity Commercial |
$38.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.60
|
| Rate for Payer: Healthscope Commercial |
$40.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.82
|
| Rate for Payer: PHP Commercial |
$37.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.92
|
| Rate for Payer: Priority Health SBD |
$28.04
|
| Rate for Payer: UMR Bronson Commercial |
$16.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.38
|
|
|
HEPARIN 1000 UNITS/1000 ML 0.45% SODIUM CHLORIDE INTRA-CATHETER INFUSION (CATH LAB) (IV PREMIX)
|
Facility
|
IP
|
$44.50
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
301933
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.58 |
| Max. Negotiated Rate |
$40.05 |
| Rate for Payer: Aetna American Axle |
$28.92
|
| Rate for Payer: Aetna Commercial |
$37.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.92
|
| Rate for Payer: Cash Price |
$35.60
|
| Rate for Payer: Cofinity Commercial |
$31.15
|
| Rate for Payer: Cofinity Commercial |
$38.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.60
|
| Rate for Payer: Healthscope Commercial |
$40.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.82
|
| Rate for Payer: PHP Commercial |
$37.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.92
|
| Rate for Payer: Priority Health SBD |
$28.04
|
| Rate for Payer: UMR Bronson Commercial |
$19.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.38
|
|
|
HEPARIN 1000 UNITS/1000 ML 0.9 % SODIUM CHLORIDE INTRA-CATHETER INFUSION (CATH LAB) (IV PREMIX)
|
Facility
|
IP
|
$355.00
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
300087
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$156.20 |
| Max. Negotiated Rate |
$319.50 |
| Rate for Payer: Aetna American Axle |
$230.75
|
| Rate for Payer: Aetna Commercial |
$301.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.75
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cofinity Commercial |
$248.50
|
| Rate for Payer: Cofinity Commercial |
$305.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$248.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.00
|
| Rate for Payer: Healthscope Commercial |
$319.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$248.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.75
|
| Rate for Payer: PHP Commercial |
$301.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.75
|
| Rate for Payer: Priority Health SBD |
$223.65
|
| Rate for Payer: UMR Bronson Commercial |
$156.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.25
|
|
|
HEPARIN 1000 UNITS/1000 ML 0.9 % SODIUM CHLORIDE INTRA-CATHETER INFUSION (CATH LAB) (IV PREMIX)
|
Facility
|
OP
|
$355.00
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
300087
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$319.50 |
| Rate for Payer: Aetna American Axle |
$230.75
|
| Rate for Payer: Aetna Commercial |
$301.75
|
| Rate for Payer: Aetna Medicare |
$177.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.75
|
| Rate for Payer: BCBS Complete |
$142.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.58
|
| Rate for Payer: BCN Commercial |
$0.58
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cofinity Commercial |
$248.50
|
| Rate for Payer: Cofinity Commercial |
$305.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$248.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.00
|
| Rate for Payer: Healthscope Commercial |
$319.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$248.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.75
|
| Rate for Payer: PHP Commercial |
$301.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.75
|
| Rate for Payer: Priority Health SBD |
$223.65
|
| Rate for Payer: UMR Bronson Commercial |
$131.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.25
|
|
|
HEPARIN 30,000 UNITS IN NS 1 LITER
|
Facility
|
IP
|
$95.70
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
180503
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$42.11 |
| Max. Negotiated Rate |
$86.13 |
| Rate for Payer: Aetna American Axle |
$62.20
|
| Rate for Payer: Aetna Commercial |
$81.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.20
|
| Rate for Payer: Cash Price |
$76.56
|
| Rate for Payer: Cofinity Commercial |
$66.99
|
| Rate for Payer: Cofinity Commercial |
$82.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.56
|
| Rate for Payer: Healthscope Commercial |
$86.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.34
|
| Rate for Payer: PHP Commercial |
$81.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.20
|
| Rate for Payer: Priority Health SBD |
$60.29
|
| Rate for Payer: UMR Bronson Commercial |
$42.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.78
|
|
|
HEPARIN 30,000 UNITS IN NS 1 LITER
|
Facility
|
OP
|
$95.70
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
180503
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$86.13 |
| Rate for Payer: Aetna American Axle |
$62.20
|
| Rate for Payer: Aetna Commercial |
$81.34
|
| Rate for Payer: Aetna Medicare |
$47.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.20
|
| Rate for Payer: BCBS Complete |
$38.28
|
| Rate for Payer: BCBS Trust/PPO |
$0.58
|
| Rate for Payer: BCN Commercial |
$0.58
|
| Rate for Payer: Cash Price |
$76.56
|
| Rate for Payer: Cash Price |
$76.56
|
| Rate for Payer: Cofinity Commercial |
$66.99
|
| Rate for Payer: Cofinity Commercial |
$82.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.56
|
| Rate for Payer: Healthscope Commercial |
$86.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.34
|
| Rate for Payer: PHP Commercial |
$81.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.20
|
| Rate for Payer: Priority Health SBD |
$60.29
|
| Rate for Payer: UMR Bronson Commercial |
$35.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.78
|
|
|
HEPARIN 3000 UNITS/L NS
|
Facility
|
OP
|
$69.92
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
168993
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna American Axle |
$45.45
|
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna Medicare |
$34.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$0.58
|
| Rate for Payer: BCN Commercial |
$0.58
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.45
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: UMR Bronson Commercial |
$25.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.44
|
|
|
HEPARIN 3000 UNITS/L NS
|
Facility
|
IP
|
$69.92
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
168993
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$30.76 |
| Max. Negotiated Rate |
$62.93 |
| Rate for Payer: Aetna American Axle |
$45.45
|
| Rate for Payer: Aetna Commercial |
$59.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.45
|
| Rate for Payer: Cash Price |
$55.94
|
| Rate for Payer: Cofinity Commercial |
$48.94
|
| Rate for Payer: Cofinity Commercial |
$60.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.94
|
| Rate for Payer: Healthscope Commercial |
$62.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.43
|
| Rate for Payer: PHP Commercial |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.45
|
| Rate for Payer: Priority Health SBD |
$44.05
|
| Rate for Payer: UMR Bronson Commercial |
$30.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.44
|
|
|
HEPARIN FLUSH (NICU)
|
Facility
|
IP
|
$7.20
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
500540
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$6.48 |
| Rate for Payer: Aetna American Axle |
$4.68
|
| Rate for Payer: Aetna Commercial |
$6.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.68
|
| Rate for Payer: Cash Price |
$5.76
|
| Rate for Payer: Cofinity Commercial |
$5.04
|
| Rate for Payer: Cofinity Commercial |
$6.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.76
|
| Rate for Payer: Healthscope Commercial |
$6.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.12
|
| Rate for Payer: PHP Commercial |
$6.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.68
|
| Rate for Payer: Priority Health SBD |
$4.54
|
| Rate for Payer: UMR Bronson Commercial |
$3.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.40
|
|
|
HEPARIN FLUSH (NICU)
|
Facility
|
OP
|
$7.20
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
500540
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$6.48 |
| Rate for Payer: Aetna American Axle |
$4.68
|
| Rate for Payer: Aetna Commercial |
$6.12
|
| Rate for Payer: Aetna Medicare |
$3.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.68
|
| Rate for Payer: BCBS Complete |
$2.88
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$5.76
|
| Rate for Payer: Cash Price |
$5.76
|
| Rate for Payer: Cofinity Commercial |
$5.04
|
| Rate for Payer: Cofinity Commercial |
$6.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.76
|
| Rate for Payer: Healthscope Commercial |
$6.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.12
|
| Rate for Payer: PHP Commercial |
$6.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.68
|
| Rate for Payer: Priority Health SBD |
$4.54
|
| Rate for Payer: UMR Bronson Commercial |
$2.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.40
|
|
|
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$26.83
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
112939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna American Axle |
$17.44
|
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: Aetna Medicare |
$13.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.44
|
| Rate for Payer: BCBS Complete |
$10.73
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Commercial |
$18.78
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.44
|
| Rate for Payer: Priority Health SBD |
$16.90
|
| Rate for Payer: UMR Bronson Commercial |
$9.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.12
|
|
|
HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$26.83
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
112939
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.81 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna American Axle |
$17.44
|
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.44
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Commercial |
$18.78
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.44
|
| Rate for Payer: Priority Health SBD |
$16.90
|
| Rate for Payer: UMR Bronson Commercial |
$11.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.12
|
|
|
HEPARIN (PORCINE) 10,000 UNIT/ML INJECTION SOLUTION
|
Facility
|
IP
|
$103.47
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
10177
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$45.53 |
| Max. Negotiated Rate |
$93.12 |
| Rate for Payer: Aetna American Axle |
$67.26
|
| Rate for Payer: Aetna American Axle |
$17.50
|
| Rate for Payer: Aetna American Axle |
$13.59
|
| Rate for Payer: Aetna American Axle |
$11.84
|
| Rate for Payer: Aetna American Axle |
$12.47
|
| Rate for Payer: Aetna American Axle |
$31.73
|
| Rate for Payer: Aetna Commercial |
$87.95
|
| Rate for Payer: Aetna Commercial |
$15.49
|
| Rate for Payer: Aetna Commercial |
$17.77
|
| Rate for Payer: Aetna Commercial |
$41.50
|
| Rate for Payer: Aetna Commercial |
$22.88
|
| Rate for Payer: Aetna Commercial |
$16.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.50
|
| Rate for Payer: Cash Price |
$21.54
|
| Rate for Payer: Cash Price |
$16.73
|
| Rate for Payer: Cash Price |
$82.78
|
| Rate for Payer: Cash Price |
$15.35
|
| Rate for Payer: Cash Price |
$14.58
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Commercial |
$23.15
|
| Rate for Payer: Cofinity Commercial |
$72.43
|
| Rate for Payer: Cofinity Commercial |
$17.98
|
| Rate for Payer: Cofinity Commercial |
$14.64
|
| Rate for Payer: Cofinity Commercial |
$13.43
|
| Rate for Payer: Cofinity Commercial |
$12.75
|
| Rate for Payer: Cofinity Commercial |
$15.67
|
| Rate for Payer: Cofinity Commercial |
$16.50
|
| Rate for Payer: Cofinity Commercial |
$88.98
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Cofinity Commercial |
$34.17
|
| Rate for Payer: Cofinity Commercial |
$18.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$18.82
|
| Rate for Payer: Healthscope Commercial |
$43.94
|
| Rate for Payer: Healthscope Commercial |
$24.23
|
| Rate for Payer: Healthscope Commercial |
$16.40
|
| Rate for Payer: Healthscope Commercial |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$93.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.31
|
| Rate for Payer: PHP Commercial |
$87.95
|
| Rate for Payer: PHP Commercial |
$15.49
|
| Rate for Payer: PHP Commercial |
$17.77
|
| Rate for Payer: PHP Commercial |
$22.88
|
| Rate for Payer: PHP Commercial |
$16.31
|
| Rate for Payer: PHP Commercial |
$41.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.73
|
| Rate for Payer: Priority Health SBD |
$16.96
|
| Rate for Payer: Priority Health SBD |
$13.17
|
| Rate for Payer: Priority Health SBD |
$65.19
|
| Rate for Payer: Priority Health SBD |
$11.48
|
| Rate for Payer: Priority Health SBD |
$12.09
|
| Rate for Payer: Priority Health SBD |
$30.76
|
| Rate for Payer: UMR Bronson Commercial |
$21.48
|
| Rate for Payer: UMR Bronson Commercial |
$8.02
|
| Rate for Payer: UMR Bronson Commercial |
$8.44
|
| Rate for Payer: UMR Bronson Commercial |
$11.84
|
| Rate for Payer: UMR Bronson Commercial |
$9.20
|
| Rate for Payer: UMR Bronson Commercial |
$45.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.60
|
|
