|
HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)
|
Facility
|
OP
|
$694.78
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
46000003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$165.01 |
| Max. Negotiated Rate |
$625.30 |
| Rate for Payer: Aetna Commercial |
$590.56
|
| Rate for Payer: Aetna Medicare |
$180.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.12
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$173.70
|
| Rate for Payer: BCBS Trust/PPO |
$540.19
|
| Rate for Payer: BCN Commercial |
$540.19
|
| Rate for Payer: BCN Medicare Advantage |
$173.70
|
| Rate for Payer: Cash Price |
$555.82
|
| Rate for Payer: Cash Price |
$555.82
|
| Rate for Payer: Cofinity Commercial |
$597.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$555.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.70
|
| Rate for Payer: Healthscope Commercial |
$625.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$521.08
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$182.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$590.56
|
| Rate for Payer: PACE Senior Care Partners |
$165.01
|
| Rate for Payer: PACE SWMI |
$173.70
|
| Rate for Payer: PHP Commercial |
$590.56
|
| Rate for Payer: PHP Medicare Advantage |
$173.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$486.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$604.46
|
| Rate for Payer: Priority Health Medicare |
$173.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$423.75
|
| Rate for Payer: Railroad Medicare Medicare |
$173.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$611.41
|
| Rate for Payer: UHC Core |
$580.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.70
|
| Rate for Payer: UHC Medicare Advantage |
$178.91
|
| Rate for Payer: VA VA |
$173.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$521.08
|
|
|
HC BRUCELLA ANTIBODY
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200236
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$64.80 |
| Rate for Payer: Aetna Commercial |
$61.20
|
| Rate for Payer: Aetna Medicare |
$18.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.50
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$18.00
|
| Rate for Payer: BCBS Trust/PPO |
$55.98
|
| Rate for Payer: BCN Commercial |
$55.98
|
| Rate for Payer: BCN Medicare Advantage |
$18.00
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$61.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.00
|
| Rate for Payer: Healthscope Commercial |
$64.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.00
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.20
|
| Rate for Payer: PACE Senior Care Partners |
$17.10
|
| Rate for Payer: PACE SWMI |
$18.00
|
| Rate for Payer: PHP Commercial |
$61.20
|
| Rate for Payer: PHP Medicare Advantage |
$18.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.64
|
| Rate for Payer: Priority Health Medicare |
$18.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.91
|
| Rate for Payer: Railroad Medicare Medicare |
$18.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.36
|
| Rate for Payer: UHC Core |
$60.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.00
|
| Rate for Payer: UHC Medicare Advantage |
$18.54
|
| Rate for Payer: VA VA |
$18.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.00
|
|
|
HC BRUCELLA ANTIBODY
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200236
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.91 |
| Max. Negotiated Rate |
$64.80 |
| Rate for Payer: Aetna Commercial |
$61.20
|
| Rate for Payer: BCBS Trust/PPO |
$55.64
|
| Rate for Payer: BCN Commercial |
$55.64
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$61.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.60
|
| Rate for Payer: Healthscope Commercial |
$64.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.20
|
| Rate for Payer: PHP Commercial |
$61.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.36
|
| Rate for Payer: UHC Core |
$60.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.00
|
|
|
HC BRUCELLA ANTIBODY CMPT
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200238
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.91 |
| Max. Negotiated Rate |
$64.80 |
| Rate for Payer: Aetna Commercial |
$61.20
|
| Rate for Payer: BCBS Trust/PPO |
$55.64
|
| Rate for Payer: BCN Commercial |
$55.64
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$61.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.60
|
| Rate for Payer: Healthscope Commercial |
$64.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.20
|
| Rate for Payer: PHP Commercial |
$61.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.36
|
| Rate for Payer: UHC Core |
$60.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.00
|
|
|
HC BRUCELLA ANTIBODY CMPT
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200238
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$64.80 |
| Rate for Payer: Aetna Commercial |
$61.20
|
| Rate for Payer: Aetna Medicare |
$18.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.50
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$18.00
|
| Rate for Payer: BCBS Trust/PPO |
$55.98
|
| Rate for Payer: BCN Commercial |
$55.98
|
| Rate for Payer: BCN Medicare Advantage |
$18.00
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$61.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.00
|
| Rate for Payer: Healthscope Commercial |
$64.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.00
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.20
|
| Rate for Payer: PACE Senior Care Partners |
$17.10
|
| Rate for Payer: PACE SWMI |
$18.00
|
| Rate for Payer: PHP Commercial |
$61.20
|
| Rate for Payer: PHP Medicare Advantage |
$18.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.64
|
| Rate for Payer: Priority Health Medicare |
$18.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.91
|
| Rate for Payer: Railroad Medicare Medicare |
$18.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.36
|
| Rate for Payer: UHC Core |
$60.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.00
|
| Rate for Payer: UHC Medicare Advantage |
$18.54
|
| Rate for Payer: VA VA |
$18.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.00
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna Medicare |
$13.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.25
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$40.43
|
| Rate for Payer: BCN Commercial |
$40.43
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.20
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.24
|
| Rate for Payer: Priority Health Medicare |
$13.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.71
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.76
|
| Rate for Payer: UHC Core |
$43.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.00
|
| Rate for Payer: UHC Medicare Advantage |
$13.39
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.71 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: BCBS Trust/PPO |
$40.19
|
| Rate for Payer: BCN Commercial |
$40.19
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.20
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.76
|
| Rate for Payer: UHC Core |
$43.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC BUNDLE OF HIS RECORDING
|
Facility
|
IP
|
$3,942.53
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
48100029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,404.55 |
| Max. Negotiated Rate |
$3,548.28 |
| Rate for Payer: Aetna Commercial |
$3,351.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,046.79
|
| Rate for Payer: BCN Commercial |
$3,046.79
|
| Rate for Payer: Cash Price |
$3,154.02
|
| Rate for Payer: Cofinity Commercial |
$3,390.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,154.02
|
| Rate for Payer: Healthscope Commercial |
$3,548.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,956.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,351.15
|
| Rate for Payer: PHP Commercial |
$3,351.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,430.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,404.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,469.43
|
| Rate for Payer: UHC Core |
$3,292.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,956.90
|
|
|
HC BUNDLE OF HIS RECORDING
|
Facility
|
OP
|
$3,942.53
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
48100029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$936.35 |
| Max. Negotiated Rate |
$5,144.02 |
| Rate for Payer: Aetna Commercial |
$3,351.15
|
| Rate for Payer: Aetna Medicare |
$1,025.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,232.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,232.04
|
| Rate for Payer: BCBS Complete |
$5,144.02
|
| Rate for Payer: BCBS MAPPO |
$985.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,065.32
|
| Rate for Payer: BCN Commercial |
$3,065.32
|
| Rate for Payer: BCN Medicare Advantage |
$985.63
|
| Rate for Payer: Cash Price |
$3,154.02
|
| Rate for Payer: Cash Price |
$3,154.02
|
| Rate for Payer: Cofinity Commercial |
$3,390.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,154.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$985.63
|
| Rate for Payer: Healthscope Commercial |
$3,548.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,956.90
|
| Rate for Payer: Mclaren Medicaid |
$4,899.07
|
| Rate for Payer: Meridian Medicaid |
$5,144.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,034.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,133.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,351.15
|
| Rate for Payer: PACE Senior Care Partners |
$936.35
|
| Rate for Payer: PACE SWMI |
$985.63
|
| Rate for Payer: PHP Commercial |
$3,351.15
|
| Rate for Payer: PHP Medicare Advantage |
$985.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,899.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,430.00
|
| Rate for Payer: Priority Health Medicare |
$985.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,404.55
|
| Rate for Payer: Railroad Medicare Medicare |
$985.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,469.43
|
| Rate for Payer: UHC Core |
$3,292.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$985.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,015.20
|
| Rate for Payer: VA VA |
$985.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,956.90
|
|
|
HC BUPIVACAINE 0.5 MG
|
Facility
|
OP
|
$1.48
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
25000016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1.33 |
| Rate for Payer: Aetna Commercial |
$1.26
|
| Rate for Payer: Aetna Medicare |
$0.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.46
|
| Rate for Payer: BCBS Complete |
$0.01
|
| Rate for Payer: BCBS MAPPO |
$0.37
|
| Rate for Payer: BCBS Trust/PPO |
$1.15
|
| Rate for Payer: BCN Commercial |
$1.15
|
| Rate for Payer: BCN Medicare Advantage |
$0.37
|
| Rate for Payer: Cash Price |
$1.18
|
| Rate for Payer: Cash Price |
$1.18
|
| Rate for Payer: Cofinity Commercial |
$1.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.37
|
| Rate for Payer: Healthscope Commercial |
$1.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.11
|
| Rate for Payer: Mclaren Medicaid |
$0.01
|
| Rate for Payer: Meridian Medicaid |
$0.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1.26
|
| Rate for Payer: PACE Senior Care Partners |
$0.35
|
| Rate for Payer: PACE SWMI |
$0.37
|
| Rate for Payer: PHP Commercial |
$1.26
|
| Rate for Payer: PHP Medicare Advantage |
$0.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.29
|
| Rate for Payer: Priority Health Medicare |
$0.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.90
|
| Rate for Payer: Railroad Medicare Medicare |
$0.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.30
|
| Rate for Payer: UHC Core |
$1.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.37
|
| Rate for Payer: UHC Medicare Advantage |
$0.38
|
| Rate for Payer: VA VA |
$0.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.11
|
|
|
HC BUPIVACAINE 0.5 MG
|
Facility
|
IP
|
$1.48
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
25000016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$1.33 |
| Rate for Payer: Aetna Commercial |
$1.26
|
| Rate for Payer: BCBS Trust/PPO |
$1.14
|
| Rate for Payer: BCN Commercial |
$1.14
|
| Rate for Payer: Cash Price |
$1.18
|
| Rate for Payer: Cofinity Commercial |
$1.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.18
|
| Rate for Payer: Healthscope Commercial |
$1.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1.26
|
| Rate for Payer: PHP Commercial |
$1.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.30
|
| Rate for Payer: UHC Core |
$1.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.11
|
|
|
HC BUPRENORPHINE & MET QUANT, UR
|
Facility
|
IP
|
$174.00
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30100598
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$106.12 |
| Max. Negotiated Rate |
$156.60 |
| Rate for Payer: Aetna Commercial |
$147.90
|
| Rate for Payer: BCBS Trust/PPO |
$134.47
|
| Rate for Payer: BCN Commercial |
$134.47
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cofinity Commercial |
$149.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.20
|
| Rate for Payer: Healthscope Commercial |
$156.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.90
|
| Rate for Payer: PHP Commercial |
$147.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.12
|
| Rate for Payer: UHC Core |
$145.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.50
|
|
|
HC BUPRENORPHINE & MET QUANT, UR
|
Facility
|
OP
|
$174.00
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30100598
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.32 |
| Max. Negotiated Rate |
$156.60 |
| Rate for Payer: Aetna Commercial |
$147.90
|
| Rate for Payer: Aetna Medicare |
$45.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.38
|
| Rate for Payer: BCBS Complete |
$69.60
|
| Rate for Payer: BCBS MAPPO |
$43.50
|
| Rate for Payer: BCBS Trust/PPO |
$135.28
|
| Rate for Payer: BCN Commercial |
$135.28
|
| Rate for Payer: BCN Medicare Advantage |
$43.50
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cofinity Commercial |
$149.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.50
|
| Rate for Payer: Healthscope Commercial |
$156.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.90
|
| Rate for Payer: PACE Senior Care Partners |
$41.32
|
| Rate for Payer: PACE SWMI |
$43.50
|
| Rate for Payer: PHP Commercial |
$147.90
|
| Rate for Payer: PHP Medicare Advantage |
$43.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.38
|
| Rate for Payer: Priority Health Medicare |
$43.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.12
|
| Rate for Payer: Railroad Medicare Medicare |
$43.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.12
|
| Rate for Payer: UHC Core |
$145.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.50
|
| Rate for Payer: UHC Medicare Advantage |
$44.80
|
| Rate for Payer: VA VA |
$43.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.50
|
|
|
HC BUPRENORPHINE SCRN URN
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000116
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.88 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$31.53
|
| Rate for Payer: BCN Commercial |
$31.53
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC BUPRENORPHINE SCRN URN
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000116
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.30 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$9.76
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$31.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$9.30
|
| Rate for Payer: Meridian Medicaid |
$9.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.51
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC BURN CARE LARGE
|
Facility
|
IP
|
$678.09
|
|
|
Service Code
|
CPT 16030
|
| Hospital Charge Code |
36100007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$413.57 |
| Max. Negotiated Rate |
$610.28 |
| Rate for Payer: Aetna Commercial |
$576.38
|
| Rate for Payer: BCBS Trust/PPO |
$524.03
|
| Rate for Payer: BCN Commercial |
$524.03
|
| Rate for Payer: Cash Price |
$542.47
|
| Rate for Payer: Cofinity Commercial |
$583.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$542.47
|
| Rate for Payer: Healthscope Commercial |
$610.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$508.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$576.38
|
| Rate for Payer: PHP Commercial |
$576.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$474.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$589.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$413.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$596.72
|
| Rate for Payer: UHC Core |
$566.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$508.57
|
|
|
HC BURN CARE LARGE
|
Facility
|
OP
|
$678.09
|
|
|
Service Code
|
CPT 16030
|
| Hospital Charge Code |
36100007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$161.05 |
| Max. Negotiated Rate |
$610.28 |
| Rate for Payer: Aetna Commercial |
$576.38
|
| Rate for Payer: Aetna Medicare |
$176.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$211.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$211.90
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$169.52
|
| Rate for Payer: BCBS Trust/PPO |
$527.21
|
| Rate for Payer: BCN Commercial |
$527.21
|
| Rate for Payer: BCN Medicare Advantage |
$169.52
|
| Rate for Payer: Cash Price |
$542.47
|
| Rate for Payer: Cash Price |
$542.47
|
| Rate for Payer: Cofinity Commercial |
$583.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$542.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.52
|
| Rate for Payer: Healthscope Commercial |
$610.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$508.57
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$178.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$194.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$576.38
|
| Rate for Payer: PACE Senior Care Partners |
$161.05
|
| Rate for Payer: PACE SWMI |
$169.52
|
| Rate for Payer: PHP Commercial |
$576.38
|
| Rate for Payer: PHP Medicare Advantage |
$169.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$474.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$589.94
|
| Rate for Payer: Priority Health Medicare |
$169.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$413.57
|
| Rate for Payer: Railroad Medicare Medicare |
$169.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$596.72
|
| Rate for Payer: UHC Core |
$566.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$169.52
|
| Rate for Payer: UHC Medicare Advantage |
$174.61
|
| Rate for Payer: VA VA |
$169.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$508.57
|
|
|
HC BURN CARE MEDIUM
|
Facility
|
OP
|
$521.51
|
|
|
Service Code
|
CPT 16025
|
| Hospital Charge Code |
36100006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$123.86 |
| Max. Negotiated Rate |
$469.36 |
| Rate for Payer: Aetna Commercial |
$443.28
|
| Rate for Payer: Aetna Medicare |
$135.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$162.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$162.97
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$130.38
|
| Rate for Payer: BCBS Trust/PPO |
$405.47
|
| Rate for Payer: BCN Commercial |
$405.47
|
| Rate for Payer: BCN Medicare Advantage |
$130.38
|
| Rate for Payer: Cash Price |
$417.21
|
| Rate for Payer: Cash Price |
$417.21
|
| Rate for Payer: Cofinity Commercial |
$448.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$417.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.38
|
| Rate for Payer: Healthscope Commercial |
$469.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$391.13
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$136.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$149.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$443.28
|
| Rate for Payer: PACE Senior Care Partners |
$123.86
|
| Rate for Payer: PACE SWMI |
$130.38
|
| Rate for Payer: PHP Commercial |
$443.28
|
| Rate for Payer: PHP Medicare Advantage |
$130.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.71
|
| Rate for Payer: Priority Health Medicare |
$130.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.07
|
| Rate for Payer: Railroad Medicare Medicare |
$130.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.93
|
| Rate for Payer: UHC Core |
$435.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.38
|
| Rate for Payer: UHC Medicare Advantage |
$134.29
|
| Rate for Payer: VA VA |
$130.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$391.13
|
|
|
HC BURN CARE MEDIUM
|
Facility
|
IP
|
$521.51
|
|
|
Service Code
|
CPT 16025
|
| Hospital Charge Code |
36100006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$318.07 |
| Max. Negotiated Rate |
$469.36 |
| Rate for Payer: Aetna Commercial |
$443.28
|
| Rate for Payer: BCBS Trust/PPO |
$403.02
|
| Rate for Payer: BCN Commercial |
$403.02
|
| Rate for Payer: Cash Price |
$417.21
|
| Rate for Payer: Cofinity Commercial |
$448.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$417.21
|
| Rate for Payer: Healthscope Commercial |
$469.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$391.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$443.28
|
| Rate for Payer: PHP Commercial |
$443.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.93
|
| Rate for Payer: UHC Core |
$435.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$391.13
|
|
|
HC BURN CARE SMALL
|
Facility
|
IP
|
$304.33
|
|
|
Service Code
|
CPT 16020
|
| Hospital Charge Code |
36100005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$185.61 |
| Max. Negotiated Rate |
$273.90 |
| Rate for Payer: Aetna Commercial |
$258.68
|
| Rate for Payer: BCBS Trust/PPO |
$235.19
|
| Rate for Payer: BCN Commercial |
$235.19
|
| Rate for Payer: Cash Price |
$243.46
|
| Rate for Payer: Cofinity Commercial |
$261.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.46
|
| Rate for Payer: Healthscope Commercial |
$273.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$258.68
|
| Rate for Payer: PHP Commercial |
$258.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$264.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.81
|
| Rate for Payer: UHC Core |
$254.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.25
|
|
|
HC BURN CARE SMALL
|
Facility
|
OP
|
$304.33
|
|
|
Service Code
|
CPT 16020
|
| Hospital Charge Code |
36100005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.28 |
| Max. Negotiated Rate |
$273.90 |
| Rate for Payer: Aetna Commercial |
$258.68
|
| Rate for Payer: Aetna Medicare |
$79.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.10
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$76.08
|
| Rate for Payer: BCBS Trust/PPO |
$236.62
|
| Rate for Payer: BCN Commercial |
$236.62
|
| Rate for Payer: BCN Medicare Advantage |
$76.08
|
| Rate for Payer: Cash Price |
$243.46
|
| Rate for Payer: Cash Price |
$243.46
|
| Rate for Payer: Cofinity Commercial |
$261.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.08
|
| Rate for Payer: Healthscope Commercial |
$273.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.25
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$79.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$258.68
|
| Rate for Payer: PACE Senior Care Partners |
$72.28
|
| Rate for Payer: PACE SWMI |
$76.08
|
| Rate for Payer: PHP Commercial |
$258.68
|
| Rate for Payer: PHP Medicare Advantage |
$76.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$264.77
|
| Rate for Payer: Priority Health Medicare |
$76.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.61
|
| Rate for Payer: Railroad Medicare Medicare |
$76.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.81
|
| Rate for Payer: UHC Core |
$254.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.08
|
| Rate for Payer: UHC Medicare Advantage |
$78.36
|
| Rate for Payer: VA VA |
$76.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.25
|
|
|
HC BURN R&B
|
Facility
|
IP
|
$7,293.00
|
|
| Hospital Charge Code |
20700001
|
|
Hospital Revenue Code
|
207
|
| Min. Negotiated Rate |
$1,577.95 |
| Max. Negotiated Rate |
$166,100.00 |
| Rate for Payer: Aetna Commercial |
$6,199.05
|
| Rate for Payer: Aetna Medicare |
$1,727.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,076.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,076.25
|
| Rate for Payer: BCBS MAPPO |
$1,661.00
|
| Rate for Payer: BCBS Trust/PPO |
$5,636.03
|
| Rate for Payer: BCN Commercial |
$5,636.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,661.00
|
| Rate for Payer: Cash Price |
$5,834.40
|
| Rate for Payer: Cash Price |
$5,834.40
|
| Rate for Payer: Cash Price |
$5,834.40
|
| Rate for Payer: Cofinity Commercial |
$6,271.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,834.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,661.00
|
| Rate for Payer: Healthscope Commercial |
$6,563.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,469.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,744.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,910.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,199.05
|
| Rate for Payer: PACE Senior Care Partners |
$1,577.95
|
| Rate for Payer: PACE SWMI |
$1,661.00
|
| Rate for Payer: PHP Commercial |
$6,199.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,661.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,105.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,344.91
|
| Rate for Payer: Priority Health Medicare |
$1,661.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,448.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,661.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,417.84
|
| Rate for Payer: UHC Core |
$6,089.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$166,100.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,710.83
|
| Rate for Payer: VA VA |
$1,661.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,469.75
|
|
|
HC BX VULVA PERINEUM ADDL LESION
|
Facility
|
OP
|
$219.48
|
|
|
Service Code
|
CPT 56606
|
| Hospital Charge Code |
76100202
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$52.13 |
| Max. Negotiated Rate |
$197.53 |
| Rate for Payer: Aetna Commercial |
$186.56
|
| Rate for Payer: Aetna Medicare |
$57.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.59
|
| Rate for Payer: BCBS Complete |
$87.79
|
| Rate for Payer: BCBS MAPPO |
$54.87
|
| Rate for Payer: BCBS Trust/PPO |
$170.65
|
| Rate for Payer: BCN Commercial |
$170.65
|
| Rate for Payer: BCN Medicare Advantage |
$54.87
|
| Rate for Payer: Cash Price |
$175.58
|
| Rate for Payer: Cofinity Commercial |
$188.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.87
|
| Rate for Payer: Healthscope Commercial |
$197.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$186.56
|
| Rate for Payer: PACE Senior Care Partners |
$52.13
|
| Rate for Payer: PACE SWMI |
$54.87
|
| Rate for Payer: PHP Commercial |
$186.56
|
| Rate for Payer: PHP Medicare Advantage |
$54.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$190.95
|
| Rate for Payer: Priority Health Medicare |
$54.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.86
|
| Rate for Payer: Railroad Medicare Medicare |
$54.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.14
|
| Rate for Payer: UHC Core |
$183.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.87
|
| Rate for Payer: UHC Medicare Advantage |
$56.52
|
| Rate for Payer: VA VA |
$54.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.61
|
|
|
HC BX VULVA PERINEUM ADDL LESION
|
Facility
|
IP
|
$219.48
|
|
|
Service Code
|
CPT 56606
|
| Hospital Charge Code |
76100202
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$133.86 |
| Max. Negotiated Rate |
$197.53 |
| Rate for Payer: Aetna Commercial |
$186.56
|
| Rate for Payer: BCBS Trust/PPO |
$169.61
|
| Rate for Payer: BCN Commercial |
$169.61
|
| Rate for Payer: Cash Price |
$175.58
|
| Rate for Payer: Cofinity Commercial |
$188.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.58
|
| Rate for Payer: Healthscope Commercial |
$197.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$186.56
|
| Rate for Payer: PHP Commercial |
$186.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$190.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.14
|
| Rate for Payer: UHC Core |
$183.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.61
|
|
|
HC C1 ESTERASE INHIBITOR FUNCTION
|
Facility
|
OP
|
$74.46
|
|
|
Service Code
|
CPT 86161
|
| Hospital Charge Code |
30200153
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: Aetna Medicare |
$19.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.27
|
| Rate for Payer: BCBS Complete |
$9.30
|
| Rate for Payer: BCBS MAPPO |
$18.62
|
| Rate for Payer: BCBS Trust/PPO |
$57.89
|
| Rate for Payer: BCN Commercial |
$57.89
|
| Rate for Payer: BCN Medicare Advantage |
$18.62
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.62
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Mclaren Medicaid |
$8.86
|
| Rate for Payer: Meridian Medicaid |
$9.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.29
|
| Rate for Payer: PACE Senior Care Partners |
$17.68
|
| Rate for Payer: PACE SWMI |
$18.62
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: PHP Medicare Advantage |
$18.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.78
|
| Rate for Payer: Priority Health Medicare |
$18.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.41
|
| Rate for Payer: Railroad Medicare Medicare |
$18.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.52
|
| Rate for Payer: UHC Core |
$62.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.62
|
| Rate for Payer: UHC Medicare Advantage |
$19.17
|
| Rate for Payer: VA VA |
$18.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
