|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
IP
|
$3,035.52
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,851.36 |
| Max. Negotiated Rate |
$2,731.97 |
| Rate for Payer: Aetna Commercial |
$2,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,345.85
|
| Rate for Payer: BCN Commercial |
$2,345.85
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cofinity Commercial |
$2,610.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,428.42
|
| Rate for Payer: Healthscope Commercial |
$2,731.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,276.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,580.19
|
| Rate for Payer: PHP Commercial |
$2,580.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,124.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,640.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,851.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,671.26
|
| Rate for Payer: UHC Core |
$2,534.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,276.64
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
OP
|
$3,035.52
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$720.94 |
| Max. Negotiated Rate |
$2,731.97 |
| Rate for Payer: Aetna Commercial |
$2,580.19
|
| Rate for Payer: Aetna Medicare |
$789.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$948.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$948.60
|
| Rate for Payer: BCBS Complete |
$1,957.20
|
| Rate for Payer: BCBS MAPPO |
$758.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,360.12
|
| Rate for Payer: BCN Commercial |
$2,360.12
|
| Rate for Payer: BCN Medicare Advantage |
$758.88
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cofinity Commercial |
$2,610.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,428.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$758.88
|
| Rate for Payer: Healthscope Commercial |
$2,731.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,276.64
|
| Rate for Payer: Mclaren Medicaid |
$1,864.00
|
| Rate for Payer: Meridian Medicaid |
$1,957.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$796.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$872.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,580.19
|
| Rate for Payer: PACE Senior Care Partners |
$720.94
|
| Rate for Payer: PACE SWMI |
$758.88
|
| Rate for Payer: PHP Commercial |
$2,580.19
|
| Rate for Payer: PHP Medicare Advantage |
$758.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,124.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,640.90
|
| Rate for Payer: Priority Health Medicare |
$758.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,851.36
|
| Rate for Payer: Railroad Medicare Medicare |
$758.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,671.26
|
| Rate for Payer: UHC Core |
$2,534.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$758.88
|
| Rate for Payer: UHC Medicare Advantage |
$781.65
|
| Rate for Payer: VA VA |
$758.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,276.64
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
IP
|
$3,035.52
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,851.36 |
| Max. Negotiated Rate |
$2,731.97 |
| Rate for Payer: Aetna Commercial |
$2,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,345.85
|
| Rate for Payer: BCN Commercial |
$2,345.85
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cofinity Commercial |
$2,610.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,428.42
|
| Rate for Payer: Healthscope Commercial |
$2,731.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,276.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,580.19
|
| Rate for Payer: PHP Commercial |
$2,580.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,124.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,640.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,851.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,671.26
|
| Rate for Payer: UHC Core |
$2,534.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,276.64
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
OP
|
$3,035.52
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$720.94 |
| Max. Negotiated Rate |
$2,731.97 |
| Rate for Payer: Aetna Commercial |
$2,580.19
|
| Rate for Payer: Aetna Medicare |
$789.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$948.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$948.60
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$758.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,360.12
|
| Rate for Payer: BCN Commercial |
$2,360.12
|
| Rate for Payer: BCN Medicare Advantage |
$758.88
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cofinity Commercial |
$2,610.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,428.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$758.88
|
| Rate for Payer: Healthscope Commercial |
$2,731.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,276.64
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$796.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$872.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,580.19
|
| Rate for Payer: PACE Senior Care Partners |
$720.94
|
| Rate for Payer: PACE SWMI |
$758.88
|
| Rate for Payer: PHP Commercial |
$2,580.19
|
| Rate for Payer: PHP Medicare Advantage |
$758.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,124.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,640.90
|
| Rate for Payer: Priority Health Medicare |
$758.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,851.36
|
| Rate for Payer: Railroad Medicare Medicare |
$758.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,671.26
|
| Rate for Payer: UHC Core |
$2,534.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$758.88
|
| Rate for Payer: UHC Medicare Advantage |
$781.65
|
| Rate for Payer: VA VA |
$758.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,276.64
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$13.27
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Meridian Medicaid |
$13.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC BILE BODY FLUID
|
Facility
|
OP
|
$37.90
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: Aetna Medicare |
$9.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.84
|
| Rate for Payer: BCBS Complete |
$1.68
|
| Rate for Payer: BCBS MAPPO |
$9.48
|
| Rate for Payer: BCBS Trust/PPO |
$29.47
|
| Rate for Payer: BCN Commercial |
$29.47
|
| Rate for Payer: BCN Medicare Advantage |
$9.48
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.48
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Mclaren Medicaid |
$1.60
|
| Rate for Payer: Meridian Medicaid |
$1.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PACE Senior Care Partners |
$9.00
|
| Rate for Payer: PACE SWMI |
$9.48
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: PHP Medicare Advantage |
$9.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
| Rate for Payer: Priority Health Medicare |
$9.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
| Rate for Payer: Railroad Medicare Medicare |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
| Rate for Payer: UHC Core |
$31.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.48
|
| Rate for Payer: UHC Medicare Advantage |
$9.76
|
| Rate for Payer: VA VA |
$9.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC BILE BODY FLUID
|
Facility
|
IP
|
$37.90
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$23.12 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: BCBS Trust/PPO |
$29.29
|
| Rate for Payer: BCN Commercial |
$29.29
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
| Rate for Payer: UHC Core |
$31.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
IP
|
$3,988.27
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,432.45 |
| Max. Negotiated Rate |
$3,589.44 |
| Rate for Payer: Aetna Commercial |
$3,390.03
|
| Rate for Payer: BCBS Trust/PPO |
$3,082.14
|
| Rate for Payer: BCN Commercial |
$3,082.14
|
| Rate for Payer: Cash Price |
$3,190.62
|
| Rate for Payer: Cofinity Commercial |
$3,429.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.62
|
| Rate for Payer: Healthscope Commercial |
$3,589.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,991.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,390.03
|
| Rate for Payer: PHP Commercial |
$3,390.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,791.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,469.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,432.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,509.68
|
| Rate for Payer: UHC Core |
$3,330.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,991.20
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
OP
|
$3,988.27
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$947.21 |
| Max. Negotiated Rate |
$5,211.10 |
| Rate for Payer: Aetna Commercial |
$3,390.03
|
| Rate for Payer: Aetna Medicare |
$1,036.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,246.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,246.33
|
| Rate for Payer: BCBS Complete |
$5,211.10
|
| Rate for Payer: BCBS MAPPO |
$997.07
|
| Rate for Payer: BCBS Trust/PPO |
$3,100.88
|
| Rate for Payer: BCN Commercial |
$3,100.88
|
| Rate for Payer: BCN Medicare Advantage |
$997.07
|
| Rate for Payer: Cash Price |
$3,190.62
|
| Rate for Payer: Cash Price |
$3,190.62
|
| Rate for Payer: Cofinity Commercial |
$3,429.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$997.07
|
| Rate for Payer: Healthscope Commercial |
$3,589.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,991.20
|
| Rate for Payer: Mclaren Medicaid |
$4,962.95
|
| Rate for Payer: Meridian Medicaid |
$5,211.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,046.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,146.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,390.03
|
| Rate for Payer: PACE Senior Care Partners |
$947.21
|
| Rate for Payer: PACE SWMI |
$997.07
|
| Rate for Payer: PHP Commercial |
$3,390.03
|
| Rate for Payer: PHP Medicare Advantage |
$997.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,962.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,791.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,469.79
|
| Rate for Payer: Priority Health Medicare |
$997.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,432.45
|
| Rate for Payer: Railroad Medicare Medicare |
$997.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,509.68
|
| Rate for Payer: UHC Core |
$3,330.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$997.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,026.98
|
| Rate for Payer: VA VA |
$997.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,991.20
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
IP
|
$459.89
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$280.49 |
| Max. Negotiated Rate |
$413.90 |
| Rate for Payer: Aetna Commercial |
$390.91
|
| Rate for Payer: BCBS Trust/PPO |
$355.40
|
| Rate for Payer: BCN Commercial |
$355.40
|
| Rate for Payer: Cash Price |
$367.91
|
| Rate for Payer: Cofinity Commercial |
$395.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.91
|
| Rate for Payer: Healthscope Commercial |
$413.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$390.91
|
| Rate for Payer: PHP Commercial |
$390.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$400.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$280.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.70
|
| Rate for Payer: UHC Core |
$384.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.92
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
OP
|
$459.89
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$109.22 |
| Max. Negotiated Rate |
$413.90 |
| Rate for Payer: Aetna Commercial |
$390.91
|
| Rate for Payer: Aetna Medicare |
$119.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$143.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$143.72
|
| Rate for Payer: BCBS Complete |
$183.96
|
| Rate for Payer: BCBS MAPPO |
$114.97
|
| Rate for Payer: BCBS Trust/PPO |
$357.56
|
| Rate for Payer: BCN Commercial |
$357.56
|
| Rate for Payer: BCN Medicare Advantage |
$114.97
|
| Rate for Payer: Cash Price |
$367.91
|
| Rate for Payer: Cofinity Commercial |
$395.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.97
|
| Rate for Payer: Healthscope Commercial |
$413.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$120.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$390.91
|
| Rate for Payer: PACE Senior Care Partners |
$109.22
|
| Rate for Payer: PACE SWMI |
$114.97
|
| Rate for Payer: PHP Commercial |
$390.91
|
| Rate for Payer: PHP Medicare Advantage |
$114.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$400.10
|
| Rate for Payer: Priority Health Medicare |
$114.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$280.49
|
| Rate for Payer: Railroad Medicare Medicare |
$114.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.70
|
| Rate for Payer: UHC Core |
$384.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.97
|
| Rate for Payer: UHC Medicare Advantage |
$118.42
|
| Rate for Payer: VA VA |
$114.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.92
|
|
|
HC BILIARY DUCT BALLOON DILATATIO
|
Facility
|
IP
|
$1,819.24
|
|
| Hospital Charge Code |
36000011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,109.55 |
| Max. Negotiated Rate |
$1,637.32 |
| Rate for Payer: Aetna Commercial |
$1,546.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,405.91
|
| Rate for Payer: BCN Commercial |
$1,405.91
|
| Rate for Payer: Cash Price |
$1,455.39
|
| Rate for Payer: Cofinity Commercial |
$1,564.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,455.39
|
| Rate for Payer: Healthscope Commercial |
$1,637.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,364.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,546.35
|
| Rate for Payer: PHP Commercial |
$1,546.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,582.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,109.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,600.93
|
| Rate for Payer: UHC Core |
$1,519.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,364.43
|
|
|
HC BILIARY DUCT BALLOON DILATATIO
|
Facility
|
OP
|
$1,819.24
|
|
| Hospital Charge Code |
36000011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$432.07 |
| Max. Negotiated Rate |
$1,637.32 |
| Rate for Payer: Aetna Commercial |
$1,546.35
|
| Rate for Payer: Aetna Medicare |
$473.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$568.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$568.51
|
| Rate for Payer: BCBS Complete |
$727.70
|
| Rate for Payer: BCBS MAPPO |
$454.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,414.46
|
| Rate for Payer: BCN Commercial |
$1,414.46
|
| Rate for Payer: BCN Medicare Advantage |
$454.81
|
| Rate for Payer: Cash Price |
$1,455.39
|
| Rate for Payer: Cofinity Commercial |
$1,564.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,455.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$454.81
|
| Rate for Payer: Healthscope Commercial |
$1,637.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,364.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$477.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$523.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,546.35
|
| Rate for Payer: PACE Senior Care Partners |
$432.07
|
| Rate for Payer: PACE SWMI |
$454.81
|
| Rate for Payer: PHP Commercial |
$1,546.35
|
| Rate for Payer: PHP Medicare Advantage |
$454.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,582.74
|
| Rate for Payer: Priority Health Medicare |
$454.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,109.55
|
| Rate for Payer: Railroad Medicare Medicare |
$454.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,600.93
|
| Rate for Payer: UHC Core |
$1,519.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$454.81
|
| Rate for Payer: UHC Medicare Advantage |
$468.45
|
| Rate for Payer: VA VA |
$454.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,364.43
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
30100118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$3.89
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$3.70
|
| Rate for Payer: Meridian Medicaid |
$3.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
30100118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC BILIRUBIN TOTAL
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
30100117
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$3.89
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$3.70
|
| Rate for Payer: Meridian Medicaid |
$3.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC BILIRUBIN TOTAL
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
30100117
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC BILIRUBIN TOTAL TRANSCUTANEOUS
|
Facility
|
OP
|
$46.55
|
|
|
Service Code
|
CPT 88720
|
| Hospital Charge Code |
30100694
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$41.90 |
| Rate for Payer: Aetna Commercial |
$39.57
|
| Rate for Payer: Aetna Medicare |
$12.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.55
|
| Rate for Payer: BCBS Complete |
$3.89
|
| Rate for Payer: BCBS MAPPO |
$11.64
|
| Rate for Payer: BCBS Trust/PPO |
$36.19
|
| Rate for Payer: BCN Commercial |
$36.19
|
| Rate for Payer: BCN Medicare Advantage |
$11.64
|
| Rate for Payer: Cash Price |
$37.24
|
| Rate for Payer: Cash Price |
$37.24
|
| Rate for Payer: Cofinity Commercial |
$40.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.64
|
| Rate for Payer: Healthscope Commercial |
$41.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.91
|
| Rate for Payer: Mclaren Medicaid |
$3.70
|
| Rate for Payer: Meridian Medicaid |
$3.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.57
|
| Rate for Payer: PACE Senior Care Partners |
$11.06
|
| Rate for Payer: PACE SWMI |
$11.64
|
| Rate for Payer: PHP Commercial |
$39.57
|
| Rate for Payer: PHP Medicare Advantage |
$11.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.50
|
| Rate for Payer: Priority Health Medicare |
$11.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.39
|
| Rate for Payer: Railroad Medicare Medicare |
$11.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.96
|
| Rate for Payer: UHC Core |
$38.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.64
|
| Rate for Payer: UHC Medicare Advantage |
$11.99
|
| Rate for Payer: VA VA |
$11.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.91
|
|
|
HC BILIRUBIN TOTAL TRANSCUTANEOUS
|
Facility
|
IP
|
$46.55
|
|
|
Service Code
|
CPT 88720
|
| Hospital Charge Code |
30100694
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.39 |
| Max. Negotiated Rate |
$41.90 |
| Rate for Payer: Aetna Commercial |
$39.57
|
| Rate for Payer: BCBS Trust/PPO |
$35.97
|
| Rate for Payer: BCN Commercial |
$35.97
|
| Rate for Payer: Cash Price |
$37.24
|
| Rate for Payer: Cofinity Commercial |
$40.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.24
|
| Rate for Payer: Healthscope Commercial |
$41.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.57
|
| Rate for Payer: PHP Commercial |
$39.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.96
|
| Rate for Payer: UHC Core |
$38.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.91
|
|
|
HC BILL ONLY URINE DRUG SCR8 AUTO
|
Facility
|
OP
|
$96.80
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000141
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$87.12 |
| Rate for Payer: Aetna Commercial |
$82.28
|
| Rate for Payer: Aetna Medicare |
$25.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.25
|
| Rate for Payer: BCBS Complete |
$48.15
|
| Rate for Payer: BCBS MAPPO |
$24.20
|
| Rate for Payer: BCBS Trust/PPO |
$75.26
|
| Rate for Payer: BCN Commercial |
$75.26
|
| Rate for Payer: BCN Medicare Advantage |
$24.20
|
| Rate for Payer: Cash Price |
$77.44
|
| Rate for Payer: Cash Price |
$77.44
|
| Rate for Payer: Cofinity Commercial |
$83.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.20
|
| Rate for Payer: Healthscope Commercial |
$87.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.60
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$48.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.28
|
| Rate for Payer: PACE Senior Care Partners |
$22.99
|
| Rate for Payer: PACE SWMI |
$24.20
|
| Rate for Payer: PHP Commercial |
$82.28
|
| Rate for Payer: PHP Medicare Advantage |
$24.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.22
|
| Rate for Payer: Priority Health Medicare |
$24.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.04
|
| Rate for Payer: Railroad Medicare Medicare |
$24.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.18
|
| Rate for Payer: UHC Core |
$80.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.20
|
| Rate for Payer: UHC Medicare Advantage |
$24.93
|
| Rate for Payer: VA VA |
$24.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.60
|
|
|
HC BILL ONLY URINE DRUG SCR8 AUTO
|
Facility
|
IP
|
$96.80
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000141
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$59.04 |
| Max. Negotiated Rate |
$87.12 |
| Rate for Payer: Aetna Commercial |
$82.28
|
| Rate for Payer: BCBS Trust/PPO |
$74.81
|
| Rate for Payer: BCN Commercial |
$74.81
|
| Rate for Payer: Cash Price |
$77.44
|
| Rate for Payer: Cofinity Commercial |
$83.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.44
|
| Rate for Payer: Healthscope Commercial |
$87.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.28
|
| Rate for Payer: PHP Commercial |
$82.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.18
|
| Rate for Payer: UHC Core |
$80.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.60
|
|
|
HC BILL ONLY URINE DRUG SCR8 MAN
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000135
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.30 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna Medicare |
$11.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.02
|
| Rate for Payer: BCBS Complete |
$9.76
|
| Rate for Payer: BCBS MAPPO |
$11.22
|
| Rate for Payer: BCBS Trust/PPO |
$34.89
|
| Rate for Payer: BCN Commercial |
$34.89
|
| Rate for Payer: BCN Medicare Advantage |
$11.22
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.22
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Mclaren Medicaid |
$9.30
|
| Rate for Payer: Meridian Medicaid |
$9.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PACE Senior Care Partners |
$10.66
|
| Rate for Payer: PACE SWMI |
$11.22
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.05
|
| Rate for Payer: Priority Health Medicare |
$11.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.37
|
| Rate for Payer: Railroad Medicare Medicare |
$11.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.22
|
| Rate for Payer: UHC Medicare Advantage |
$11.56
|
| Rate for Payer: VA VA |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC BILL ONLY URINE DRUG SCR8 MAN
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000135
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.37 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: BCBS Trust/PPO |
$34.68
|
| Rate for Payer: BCN Commercial |
$34.68
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC BILL ONLY URINE DRUG SCR AUTO
|
Facility
|
OP
|
$99.95
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000142
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.74 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna Commercial |
$84.96
|
| Rate for Payer: Aetna Medicare |
$25.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.23
|
| Rate for Payer: BCBS Complete |
$48.15
|
| Rate for Payer: BCBS MAPPO |
$24.99
|
| Rate for Payer: BCBS Trust/PPO |
$77.71
|
| Rate for Payer: BCN Commercial |
$77.71
|
| Rate for Payer: BCN Medicare Advantage |
$24.99
|
| Rate for Payer: Cash Price |
$79.96
|
| Rate for Payer: Cash Price |
$79.96
|
| Rate for Payer: Cofinity Commercial |
$85.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.99
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.96
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$48.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.96
|
| Rate for Payer: PACE Senior Care Partners |
$23.74
|
| Rate for Payer: PACE SWMI |
$24.99
|
| Rate for Payer: PHP Commercial |
$84.96
|
| Rate for Payer: PHP Medicare Advantage |
$24.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.96
|
| Rate for Payer: Priority Health Medicare |
$24.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.96
|
| Rate for Payer: Railroad Medicare Medicare |
$24.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.96
|
| Rate for Payer: UHC Core |
$83.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.99
|
| Rate for Payer: UHC Medicare Advantage |
$25.74
|
| Rate for Payer: VA VA |
$24.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.96
|
|
