|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
IP
|
$1,998.72
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,219.02 |
| Max. Negotiated Rate |
$1,798.85 |
| Rate for Payer: Aetna Commercial |
$1,698.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,544.61
|
| Rate for Payer: BCN Commercial |
$1,544.61
|
| Rate for Payer: Cash Price |
$1,598.98
|
| Rate for Payer: Cofinity Commercial |
$1,718.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,598.98
|
| Rate for Payer: Healthscope Commercial |
$1,798.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,499.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,698.91
|
| Rate for Payer: PHP Commercial |
$1,698.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,399.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,738.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,219.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,758.87
|
| Rate for Payer: UHC Core |
$1,668.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,499.04
|
|
|
HC BI V PACEMAKER
|
Facility
|
IP
|
$27,388.65
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$16,704.34 |
| Max. Negotiated Rate |
$24,649.78 |
| Rate for Payer: Aetna Commercial |
$23,280.35
|
| Rate for Payer: BCBS Trust/PPO |
$21,165.95
|
| Rate for Payer: BCN Commercial |
$21,165.95
|
| Rate for Payer: Cash Price |
$21,910.92
|
| Rate for Payer: Cofinity Commercial |
$23,554.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,910.92
|
| Rate for Payer: Healthscope Commercial |
$24,649.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,541.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23,280.35
|
| Rate for Payer: PHP Commercial |
$23,280.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,172.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,828.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16,704.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,102.01
|
| Rate for Payer: UHC Core |
$22,869.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,541.49
|
|
|
HC BI V PACEMAKER
|
Facility
|
OP
|
$27,388.65
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,504.80 |
| Max. Negotiated Rate |
$24,649.78 |
| Rate for Payer: Aetna Commercial |
$23,280.35
|
| Rate for Payer: Aetna Medicare |
$7,121.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,558.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,558.95
|
| Rate for Payer: BCBS Complete |
$10,955.46
|
| Rate for Payer: BCBS MAPPO |
$6,847.16
|
| Rate for Payer: BCBS Trust/PPO |
$21,294.68
|
| Rate for Payer: BCN Commercial |
$21,294.68
|
| Rate for Payer: BCN Medicare Advantage |
$6,847.16
|
| Rate for Payer: Cash Price |
$21,910.92
|
| Rate for Payer: Cofinity Commercial |
$23,554.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,910.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,847.16
|
| Rate for Payer: Healthscope Commercial |
$24,649.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,541.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,189.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,874.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23,280.35
|
| Rate for Payer: PACE Senior Care Partners |
$6,504.80
|
| Rate for Payer: PACE SWMI |
$6,847.16
|
| Rate for Payer: PHP Commercial |
$23,280.35
|
| Rate for Payer: PHP Medicare Advantage |
$6,847.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,172.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,828.13
|
| Rate for Payer: Priority Health Medicare |
$6,847.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16,704.34
|
| Rate for Payer: Railroad Medicare Medicare |
$6,847.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,102.01
|
| Rate for Payer: UHC Core |
$22,869.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,847.16
|
| Rate for Payer: UHC Medicare Advantage |
$7,052.58
|
| Rate for Payer: VA VA |
$6,847.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,541.49
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
IP
|
$111.18
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$67.81 |
| Max. Negotiated Rate |
$100.06 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: BCBS Trust/PPO |
$85.92
|
| Rate for Payer: BCN Commercial |
$85.92
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cofinity Commercial |
$95.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.94
|
| Rate for Payer: Healthscope Commercial |
$100.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.50
|
| Rate for Payer: PHP Commercial |
$94.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.84
|
| Rate for Payer: UHC Core |
$92.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.38
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
OP
|
$111.18
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$100.06 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Aetna Medicare |
$28.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.74
|
| Rate for Payer: BCBS Complete |
$33.20
|
| Rate for Payer: BCBS MAPPO |
$27.80
|
| Rate for Payer: BCBS Trust/PPO |
$86.44
|
| Rate for Payer: BCN Commercial |
$86.44
|
| Rate for Payer: BCN Medicare Advantage |
$27.80
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cofinity Commercial |
$95.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.80
|
| Rate for Payer: Healthscope Commercial |
$100.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.38
|
| Rate for Payer: Mclaren Medicaid |
$31.62
|
| Rate for Payer: Meridian Medicaid |
$33.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.50
|
| Rate for Payer: PACE Senior Care Partners |
$26.41
|
| Rate for Payer: PACE SWMI |
$27.80
|
| Rate for Payer: PHP Commercial |
$94.50
|
| Rate for Payer: PHP Medicare Advantage |
$27.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.73
|
| Rate for Payer: Priority Health Medicare |
$27.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.81
|
| Rate for Payer: Railroad Medicare Medicare |
$27.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.84
|
| Rate for Payer: UHC Core |
$92.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.80
|
| Rate for Payer: UHC Medicare Advantage |
$28.63
|
| Rate for Payer: VA VA |
$27.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.38
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
IP
|
$274.36
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$167.33 |
| Max. Negotiated Rate |
$246.92 |
| Rate for Payer: Aetna Commercial |
$233.21
|
| Rate for Payer: BCBS Trust/PPO |
$212.03
|
| Rate for Payer: BCN Commercial |
$212.03
|
| Rate for Payer: Cash Price |
$219.49
|
| Rate for Payer: Cofinity Commercial |
$235.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.49
|
| Rate for Payer: Healthscope Commercial |
$246.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.21
|
| Rate for Payer: PHP Commercial |
$233.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.44
|
| Rate for Payer: UHC Core |
$229.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.77
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
OP
|
$274.36
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$65.16 |
| Max. Negotiated Rate |
$246.92 |
| Rate for Payer: Aetna Commercial |
$233.21
|
| Rate for Payer: Aetna Medicare |
$71.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.74
|
| Rate for Payer: BCBS Complete |
$109.74
|
| Rate for Payer: BCBS MAPPO |
$68.59
|
| Rate for Payer: BCBS Trust/PPO |
$213.31
|
| Rate for Payer: BCN Commercial |
$213.31
|
| Rate for Payer: BCN Medicare Advantage |
$68.59
|
| Rate for Payer: Cash Price |
$219.49
|
| Rate for Payer: Cofinity Commercial |
$235.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.59
|
| Rate for Payer: Healthscope Commercial |
$246.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.21
|
| Rate for Payer: PACE Senior Care Partners |
$65.16
|
| Rate for Payer: PACE SWMI |
$68.59
|
| Rate for Payer: PHP Commercial |
$233.21
|
| Rate for Payer: PHP Medicare Advantage |
$68.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.69
|
| Rate for Payer: Priority Health Medicare |
$68.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.33
|
| Rate for Payer: Railroad Medicare Medicare |
$68.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.44
|
| Rate for Payer: UHC Core |
$229.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.59
|
| Rate for Payer: UHC Medicare Advantage |
$70.65
|
| Rate for Payer: VA VA |
$68.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.77
|
|
|
HC BLADDER SCAN
|
Facility
|
IP
|
$150.14
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$91.57 |
| Max. Negotiated Rate |
$135.13 |
| Rate for Payer: Aetna Commercial |
$127.62
|
| Rate for Payer: BCBS Trust/PPO |
$116.03
|
| Rate for Payer: BCN Commercial |
$116.03
|
| Rate for Payer: Cash Price |
$120.11
|
| Rate for Payer: Cofinity Commercial |
$129.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.11
|
| Rate for Payer: Healthscope Commercial |
$135.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.62
|
| Rate for Payer: PHP Commercial |
$127.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.12
|
| Rate for Payer: UHC Core |
$125.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.60
|
|
|
HC BLADDER SCAN
|
Facility
|
OP
|
$150.14
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$35.66 |
| Max. Negotiated Rate |
$135.13 |
| Rate for Payer: Aetna Commercial |
$127.62
|
| Rate for Payer: Aetna Medicare |
$39.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.92
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$37.54
|
| Rate for Payer: BCBS Trust/PPO |
$116.73
|
| Rate for Payer: BCN Commercial |
$116.73
|
| Rate for Payer: BCN Medicare Advantage |
$37.54
|
| Rate for Payer: Cash Price |
$120.11
|
| Rate for Payer: Cash Price |
$120.11
|
| Rate for Payer: Cofinity Commercial |
$129.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.54
|
| Rate for Payer: Healthscope Commercial |
$135.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.60
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.62
|
| Rate for Payer: PACE Senior Care Partners |
$35.66
|
| Rate for Payer: PACE SWMI |
$37.54
|
| Rate for Payer: PHP Commercial |
$127.62
|
| Rate for Payer: PHP Medicare Advantage |
$37.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.62
|
| Rate for Payer: Priority Health Medicare |
$37.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.57
|
| Rate for Payer: Railroad Medicare Medicare |
$37.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.12
|
| Rate for Payer: UHC Core |
$125.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.54
|
| Rate for Payer: UHC Medicare Advantage |
$38.66
|
| Rate for Payer: VA VA |
$37.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.60
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.52 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.44
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS MAPPO |
$18.75
|
| Rate for Payer: BCBS Trust/PPO |
$58.31
|
| Rate for Payer: BCN Commercial |
$58.31
|
| Rate for Payer: BCN Medicare Advantage |
$18.75
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.75
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Mclaren Medicaid |
$9.52
|
| Rate for Payer: Meridian Medicaid |
$10.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PACE Senior Care Partners |
$17.81
|
| Rate for Payer: PACE SWMI |
$18.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: PHP Medicare Advantage |
$18.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Medicare |
$18.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: Railroad Medicare Medicare |
$18.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.75
|
| Rate for Payer: UHC Medicare Advantage |
$19.31
|
| Rate for Payer: VA VA |
$18.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.74 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$57.96
|
| Rate for Payer: BCN Commercial |
$57.96
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
IP
|
$122.08
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.46 |
| Max. Negotiated Rate |
$109.87 |
| Rate for Payer: Aetna Commercial |
$103.77
|
| Rate for Payer: BCBS Trust/PPO |
$94.34
|
| Rate for Payer: BCN Commercial |
$94.34
|
| Rate for Payer: Cash Price |
$97.66
|
| Rate for Payer: Cofinity Commercial |
$104.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.66
|
| Rate for Payer: Healthscope Commercial |
$109.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.77
|
| Rate for Payer: PHP Commercial |
$103.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.43
|
| Rate for Payer: UHC Core |
$101.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.56
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
OP
|
$122.08
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$28.99 |
| Max. Negotiated Rate |
$109.87 |
| Rate for Payer: Aetna Commercial |
$103.77
|
| Rate for Payer: Aetna Medicare |
$31.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.15
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$30.52
|
| Rate for Payer: BCBS Trust/PPO |
$94.92
|
| Rate for Payer: BCN Commercial |
$94.92
|
| Rate for Payer: BCN Medicare Advantage |
$30.52
|
| Rate for Payer: Cash Price |
$97.66
|
| Rate for Payer: Cash Price |
$97.66
|
| Rate for Payer: Cofinity Commercial |
$104.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.52
|
| Rate for Payer: Healthscope Commercial |
$109.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.56
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.77
|
| Rate for Payer: PACE Senior Care Partners |
$28.99
|
| Rate for Payer: PACE SWMI |
$30.52
|
| Rate for Payer: PHP Commercial |
$103.77
|
| Rate for Payer: PHP Medicare Advantage |
$30.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.21
|
| Rate for Payer: Priority Health Medicare |
$30.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.46
|
| Rate for Payer: Railroad Medicare Medicare |
$30.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.43
|
| Rate for Payer: UHC Core |
$101.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.52
|
| Rate for Payer: UHC Medicare Advantage |
$31.44
|
| Rate for Payer: VA VA |
$30.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.56
|
|
|
HC BLEEDING TIME
|
Facility
|
OP
|
$75.40
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: Aetna Commercial |
$64.09
|
| Rate for Payer: Aetna Medicare |
$19.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.56
|
| Rate for Payer: BCBS Complete |
$3.74
|
| Rate for Payer: BCBS MAPPO |
$18.85
|
| Rate for Payer: BCBS Trust/PPO |
$58.62
|
| Rate for Payer: BCN Commercial |
$58.62
|
| Rate for Payer: BCN Medicare Advantage |
$18.85
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.85
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.55
|
| Rate for Payer: Mclaren Medicaid |
$3.56
|
| Rate for Payer: Meridian Medicaid |
$3.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PACE Senior Care Partners |
$17.91
|
| Rate for Payer: PACE SWMI |
$18.85
|
| Rate for Payer: PHP Commercial |
$64.09
|
| Rate for Payer: PHP Medicare Advantage |
$18.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.60
|
| Rate for Payer: Priority Health Medicare |
$18.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.99
|
| Rate for Payer: Railroad Medicare Medicare |
$18.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Core |
$62.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.85
|
| Rate for Payer: UHC Medicare Advantage |
$19.42
|
| Rate for Payer: VA VA |
$18.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.55
|
|
|
HC BLEEDING TIME
|
Facility
|
IP
|
$75.40
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$45.99 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: Aetna Commercial |
$64.09
|
| Rate for Payer: BCBS Trust/PPO |
$58.27
|
| Rate for Payer: BCN Commercial |
$58.27
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PHP Commercial |
$64.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Core |
$62.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.55
|
|
|
HC BLOOD CULTURE
|
Facility
|
IP
|
$95.78
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
30600072
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.42 |
| Max. Negotiated Rate |
$86.20 |
| Rate for Payer: Aetna Commercial |
$81.41
|
| Rate for Payer: BCBS Trust/PPO |
$74.02
|
| Rate for Payer: BCN Commercial |
$74.02
|
| Rate for Payer: Cash Price |
$76.62
|
| Rate for Payer: Cofinity Commercial |
$82.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.62
|
| Rate for Payer: Healthscope Commercial |
$86.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.41
|
| Rate for Payer: PHP Commercial |
$81.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.29
|
| Rate for Payer: UHC Core |
$79.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.84
|
|
|
HC BLOOD CULTURE
|
Facility
|
OP
|
$95.78
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
30600072
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.62 |
| Max. Negotiated Rate |
$86.20 |
| Rate for Payer: Aetna Commercial |
$81.41
|
| Rate for Payer: Aetna Medicare |
$24.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.93
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$23.94
|
| Rate for Payer: BCBS Trust/PPO |
$74.47
|
| Rate for Payer: BCN Commercial |
$74.47
|
| Rate for Payer: BCN Medicare Advantage |
$23.94
|
| Rate for Payer: Cash Price |
$76.62
|
| Rate for Payer: Cash Price |
$76.62
|
| Rate for Payer: Cofinity Commercial |
$82.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.94
|
| Rate for Payer: Healthscope Commercial |
$86.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.84
|
| Rate for Payer: Mclaren Medicaid |
$7.62
|
| Rate for Payer: Meridian Medicaid |
$8.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.41
|
| Rate for Payer: PACE Senior Care Partners |
$22.75
|
| Rate for Payer: PACE SWMI |
$23.94
|
| Rate for Payer: PHP Commercial |
$81.41
|
| Rate for Payer: PHP Medicare Advantage |
$23.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.33
|
| Rate for Payer: Priority Health Medicare |
$23.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.42
|
| Rate for Payer: Railroad Medicare Medicare |
$23.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.29
|
| Rate for Payer: UHC Core |
$79.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.94
|
| Rate for Payer: UHC Medicare Advantage |
$24.66
|
| Rate for Payer: VA VA |
$23.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.84
|
|
|
HC BLOOD DRAW IMPLANTED DEVICE
|
Facility
|
OP
|
$164.48
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
76100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.06 |
| Max. Negotiated Rate |
$148.03 |
| Rate for Payer: Aetna Commercial |
$139.81
|
| Rate for Payer: Aetna Medicare |
$42.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.40
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$41.12
|
| Rate for Payer: BCBS Trust/PPO |
$127.88
|
| Rate for Payer: BCN Commercial |
$127.88
|
| Rate for Payer: BCN Medicare Advantage |
$41.12
|
| Rate for Payer: Cash Price |
$131.58
|
| Rate for Payer: Cash Price |
$131.58
|
| Rate for Payer: Cofinity Commercial |
$141.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.12
|
| Rate for Payer: Healthscope Commercial |
$148.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.36
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$139.81
|
| Rate for Payer: PACE Senior Care Partners |
$39.06
|
| Rate for Payer: PACE SWMI |
$41.12
|
| Rate for Payer: PHP Commercial |
$139.81
|
| Rate for Payer: PHP Medicare Advantage |
$41.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.10
|
| Rate for Payer: Priority Health Medicare |
$41.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.32
|
| Rate for Payer: Railroad Medicare Medicare |
$41.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.74
|
| Rate for Payer: UHC Core |
$137.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.12
|
| Rate for Payer: UHC Medicare Advantage |
$42.35
|
| Rate for Payer: VA VA |
$41.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.36
|
|
|
HC BLOOD DRAW IMPLANTED DEVICE
|
Facility
|
IP
|
$164.48
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
76100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$100.32 |
| Max. Negotiated Rate |
$148.03 |
| Rate for Payer: Aetna Commercial |
$139.81
|
| Rate for Payer: BCBS Trust/PPO |
$127.11
|
| Rate for Payer: BCN Commercial |
$127.11
|
| Rate for Payer: Cash Price |
$131.58
|
| Rate for Payer: Cofinity Commercial |
$141.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.58
|
| Rate for Payer: Healthscope Commercial |
$148.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$139.81
|
| Rate for Payer: PHP Commercial |
$139.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.74
|
| Rate for Payer: UHC Core |
$137.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.36
|
|
|
HC BLOOD GAS PKG, CALC O2 SAT
|
Facility
|
OP
|
$173.50
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.24 |
| Max. Negotiated Rate |
$156.15 |
| Rate for Payer: Aetna Commercial |
$147.48
|
| Rate for Payer: Aetna Medicare |
$45.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.22
|
| Rate for Payer: BCBS Complete |
$20.20
|
| Rate for Payer: BCBS MAPPO |
$43.38
|
| Rate for Payer: BCBS Trust/PPO |
$134.90
|
| Rate for Payer: BCN Commercial |
$134.90
|
| Rate for Payer: BCN Medicare Advantage |
$43.38
|
| Rate for Payer: Cash Price |
$138.80
|
| Rate for Payer: Cash Price |
$138.80
|
| Rate for Payer: Cofinity Commercial |
$149.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.38
|
| Rate for Payer: Healthscope Commercial |
$156.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.12
|
| Rate for Payer: Mclaren Medicaid |
$19.24
|
| Rate for Payer: Meridian Medicaid |
$20.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.48
|
| Rate for Payer: PACE Senior Care Partners |
$41.21
|
| Rate for Payer: PACE SWMI |
$43.38
|
| Rate for Payer: PHP Commercial |
$147.48
|
| Rate for Payer: PHP Medicare Advantage |
$43.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.94
|
| Rate for Payer: Priority Health Medicare |
$43.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.82
|
| Rate for Payer: Railroad Medicare Medicare |
$43.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.68
|
| Rate for Payer: UHC Core |
$144.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.38
|
| Rate for Payer: UHC Medicare Advantage |
$44.68
|
| Rate for Payer: VA VA |
$43.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.12
|
|
|
HC BLOOD GAS PKG, CALC O2 SAT
|
Facility
|
IP
|
$173.50
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$105.82 |
| Max. Negotiated Rate |
$156.15 |
| Rate for Payer: Aetna Commercial |
$147.48
|
| Rate for Payer: BCBS Trust/PPO |
$134.08
|
| Rate for Payer: BCN Commercial |
$134.08
|
| Rate for Payer: Cash Price |
$138.80
|
| Rate for Payer: Cofinity Commercial |
$149.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.80
|
| Rate for Payer: Healthscope Commercial |
$156.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.48
|
| Rate for Payer: PHP Commercial |
$147.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.68
|
| Rate for Payer: UHC Core |
$144.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.12
|
|
|
HC BLOOD GAS PKG & DIRECT O2 SAT
|
Facility
|
OP
|
$184.31
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.77 |
| Max. Negotiated Rate |
$165.88 |
| Rate for Payer: Aetna Commercial |
$156.66
|
| Rate for Payer: Aetna Medicare |
$47.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.60
|
| Rate for Payer: BCBS Complete |
$61.04
|
| Rate for Payer: BCBS MAPPO |
$46.08
|
| Rate for Payer: BCBS Trust/PPO |
$143.30
|
| Rate for Payer: BCN Commercial |
$143.30
|
| Rate for Payer: BCN Medicare Advantage |
$46.08
|
| Rate for Payer: Cash Price |
$147.45
|
| Rate for Payer: Cash Price |
$147.45
|
| Rate for Payer: Cofinity Commercial |
$158.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.08
|
| Rate for Payer: Healthscope Commercial |
$165.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.23
|
| Rate for Payer: Mclaren Medicaid |
$58.13
|
| Rate for Payer: Meridian Medicaid |
$61.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$48.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.66
|
| Rate for Payer: PACE Senior Care Partners |
$43.77
|
| Rate for Payer: PACE SWMI |
$46.08
|
| Rate for Payer: PHP Commercial |
$156.66
|
| Rate for Payer: PHP Medicare Advantage |
$46.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.35
|
| Rate for Payer: Priority Health Medicare |
$46.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.41
|
| Rate for Payer: Railroad Medicare Medicare |
$46.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.19
|
| Rate for Payer: UHC Core |
$153.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.08
|
| Rate for Payer: UHC Medicare Advantage |
$47.46
|
| Rate for Payer: VA VA |
$46.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.23
|
|
|
HC BLOOD GAS PKG & DIRECT O2 SAT
|
Facility
|
IP
|
$184.31
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$112.41 |
| Max. Negotiated Rate |
$165.88 |
| Rate for Payer: Aetna Commercial |
$156.66
|
| Rate for Payer: BCBS Trust/PPO |
$142.43
|
| Rate for Payer: BCN Commercial |
$142.43
|
| Rate for Payer: Cash Price |
$147.45
|
| Rate for Payer: Cofinity Commercial |
$158.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.45
|
| Rate for Payer: Healthscope Commercial |
$165.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.66
|
| Rate for Payer: PHP Commercial |
$156.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.19
|
| Rate for Payer: UHC Core |
$153.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.23
|
|
|
HC BLOOD,OCLT,FECES IMMUNO SCREEN
|
Facility
|
IP
|
$30.68
|
|
|
Service Code
|
HCPCS G0328
|
| Hospital Charge Code |
30100000
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.71 |
| Max. Negotiated Rate |
$27.61 |
| Rate for Payer: Aetna Commercial |
$26.08
|
| Rate for Payer: BCBS Trust/PPO |
$23.71
|
| Rate for Payer: BCN Commercial |
$23.71
|
| Rate for Payer: Cash Price |
$24.54
|
| Rate for Payer: Cofinity Commercial |
$26.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.54
|
| Rate for Payer: Healthscope Commercial |
$27.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.08
|
| Rate for Payer: PHP Commercial |
$26.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.00
|
| Rate for Payer: UHC Core |
$25.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.01
|
|
|
HC BLOOD,OCLT,FECES IMMUNO SCREEN
|
Facility
|
OP
|
$30.68
|
|
|
Service Code
|
HCPCS G0328
|
| Hospital Charge Code |
30100000
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.29 |
| Max. Negotiated Rate |
$27.61 |
| Rate for Payer: Aetna Commercial |
$26.08
|
| Rate for Payer: Aetna Medicare |
$7.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.59
|
| Rate for Payer: BCBS Complete |
$13.99
|
| Rate for Payer: BCBS MAPPO |
$7.67
|
| Rate for Payer: BCBS Trust/PPO |
$23.85
|
| Rate for Payer: BCN Commercial |
$23.85
|
| Rate for Payer: BCN Medicare Advantage |
$7.67
|
| Rate for Payer: Cash Price |
$24.54
|
| Rate for Payer: Cash Price |
$24.54
|
| Rate for Payer: Cofinity Commercial |
$26.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.67
|
| Rate for Payer: Healthscope Commercial |
$27.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.01
|
| Rate for Payer: Mclaren Medicaid |
$13.32
|
| Rate for Payer: Meridian Medicaid |
$13.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.08
|
| Rate for Payer: PACE Senior Care Partners |
$7.29
|
| Rate for Payer: PACE SWMI |
$7.67
|
| Rate for Payer: PHP Commercial |
$26.08
|
| Rate for Payer: PHP Medicare Advantage |
$7.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.69
|
| Rate for Payer: Priority Health Medicare |
$7.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.71
|
| Rate for Payer: Railroad Medicare Medicare |
$7.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.00
|
| Rate for Payer: UHC Core |
$25.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.67
|
| Rate for Payer: UHC Medicare Advantage |
$7.90
|
| Rate for Payer: VA VA |
$7.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.01
|
|
