|
HC CANNULA RETROGRADE
|
Facility
|
OP
|
$204.00
|
|
| Hospital Charge Code |
27000142
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$48.45 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Aetna Commercial |
$173.40
|
| Rate for Payer: Aetna Medicare |
$53.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.75
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCBS MAPPO |
$51.00
|
| Rate for Payer: BCBS Trust/PPO |
$158.61
|
| Rate for Payer: BCN Commercial |
$158.61
|
| Rate for Payer: BCN Medicare Advantage |
$51.00
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.00
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.40
|
| Rate for Payer: PACE Senior Care Partners |
$48.45
|
| Rate for Payer: PACE SWMI |
$51.00
|
| Rate for Payer: PHP Commercial |
$173.40
|
| Rate for Payer: PHP Medicare Advantage |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$177.48
|
| Rate for Payer: Priority Health Medicare |
$51.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.42
|
| Rate for Payer: Railroad Medicare Medicare |
$51.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.52
|
| Rate for Payer: UHC Core |
$170.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.00
|
| Rate for Payer: UHC Medicare Advantage |
$52.53
|
| Rate for Payer: VA VA |
$51.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.00
|
|
|
HC CANNULA RETROGRD 15 FR
|
Facility
|
IP
|
$304.91
|
|
| Hospital Charge Code |
27000447
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$185.96 |
| Max. Negotiated Rate |
$274.42 |
| Rate for Payer: Aetna Commercial |
$259.17
|
| Rate for Payer: BCBS Trust/PPO |
$235.63
|
| Rate for Payer: BCN Commercial |
$235.63
|
| Rate for Payer: Cash Price |
$243.93
|
| Rate for Payer: Cofinity Commercial |
$262.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.93
|
| Rate for Payer: Healthscope Commercial |
$274.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$259.17
|
| Rate for Payer: PHP Commercial |
$259.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$265.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.32
|
| Rate for Payer: UHC Core |
$254.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.68
|
|
|
HC CANNULA RETROGRD 15 FR
|
Facility
|
OP
|
$304.91
|
|
| Hospital Charge Code |
27000447
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$72.42 |
| Max. Negotiated Rate |
$274.42 |
| Rate for Payer: Aetna Commercial |
$259.17
|
| Rate for Payer: Aetna Medicare |
$79.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.28
|
| Rate for Payer: BCBS Complete |
$121.96
|
| Rate for Payer: BCBS MAPPO |
$76.23
|
| Rate for Payer: BCBS Trust/PPO |
$237.07
|
| Rate for Payer: BCN Commercial |
$237.07
|
| Rate for Payer: BCN Medicare Advantage |
$76.23
|
| Rate for Payer: Cash Price |
$243.93
|
| Rate for Payer: Cofinity Commercial |
$262.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.23
|
| Rate for Payer: Healthscope Commercial |
$274.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$80.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$259.17
|
| Rate for Payer: PACE Senior Care Partners |
$72.42
|
| Rate for Payer: PACE SWMI |
$76.23
|
| Rate for Payer: PHP Commercial |
$259.17
|
| Rate for Payer: PHP Medicare Advantage |
$76.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$265.27
|
| Rate for Payer: Priority Health Medicare |
$76.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.96
|
| Rate for Payer: Railroad Medicare Medicare |
$76.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.32
|
| Rate for Payer: UHC Core |
$254.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.23
|
| Rate for Payer: UHC Medicare Advantage |
$78.51
|
| Rate for Payer: VA VA |
$76.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.68
|
|
|
HC CANNULA VEIN GRAFT
|
Facility
|
OP
|
$34.50
|
|
| Hospital Charge Code |
27000096
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$31.05 |
| Rate for Payer: Aetna Commercial |
$29.32
|
| Rate for Payer: Aetna Medicare |
$8.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: BCBS Complete |
$13.80
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$26.82
|
| Rate for Payer: BCN Commercial |
$26.82
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$29.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$31.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.32
|
| Rate for Payer: PACE Senior Care Partners |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$29.32
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.02
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.04
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.36
|
| Rate for Payer: UHC Core |
$28.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$8.88
|
| Rate for Payer: VA VA |
$8.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.88
|
|
|
HC CANNULA VEIN GRAFT
|
Facility
|
IP
|
$34.50
|
|
| Hospital Charge Code |
27000096
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.04 |
| Max. Negotiated Rate |
$31.05 |
| Rate for Payer: Aetna Commercial |
$29.32
|
| Rate for Payer: BCBS Trust/PPO |
$26.66
|
| Rate for Payer: BCN Commercial |
$26.66
|
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$29.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.60
|
| Rate for Payer: Healthscope Commercial |
$31.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.32
|
| Rate for Payer: PHP Commercial |
$29.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.36
|
| Rate for Payer: UHC Core |
$28.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.88
|
|
|
HC CANNULA VENOUS RT PVC
|
Facility
|
IP
|
$84.00
|
|
| Hospital Charge Code |
27000681
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.23 |
| Max. Negotiated Rate |
$75.60 |
| Rate for Payer: Aetna Commercial |
$71.40
|
| Rate for Payer: BCBS Trust/PPO |
$64.92
|
| Rate for Payer: BCN Commercial |
$64.92
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$72.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.20
|
| Rate for Payer: Healthscope Commercial |
$75.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.40
|
| Rate for Payer: PHP Commercial |
$71.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.92
|
| Rate for Payer: UHC Core |
$70.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.00
|
|
|
HC CANNULA VENOUS RT PVC
|
Facility
|
OP
|
$84.00
|
|
| Hospital Charge Code |
27000681
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.95 |
| Max. Negotiated Rate |
$75.60 |
| Rate for Payer: Aetna Commercial |
$71.40
|
| Rate for Payer: Aetna Medicare |
$21.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.25
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS MAPPO |
$21.00
|
| Rate for Payer: BCBS Trust/PPO |
$65.31
|
| Rate for Payer: BCN Commercial |
$65.31
|
| Rate for Payer: BCN Medicare Advantage |
$21.00
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$72.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.00
|
| Rate for Payer: Healthscope Commercial |
$75.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.40
|
| Rate for Payer: PACE Senior Care Partners |
$19.95
|
| Rate for Payer: PACE SWMI |
$21.00
|
| Rate for Payer: PHP Commercial |
$71.40
|
| Rate for Payer: PHP Medicare Advantage |
$21.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.08
|
| Rate for Payer: Priority Health Medicare |
$21.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.23
|
| Rate for Payer: Railroad Medicare Medicare |
$21.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.92
|
| Rate for Payer: UHC Core |
$70.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.00
|
| Rate for Payer: UHC Medicare Advantage |
$21.63
|
| Rate for Payer: VA VA |
$21.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.00
|
|
|
HC CANNULA VEN SINGLE STAGE
|
Facility
|
OP
|
$72.00
|
|
| Hospital Charge Code |
27000263
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.10 |
| 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 |
$28.80
|
| 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: 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: 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 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 CANNULA VEN SINGLE STAGE
|
Facility
|
IP
|
$72.00
|
|
| Hospital Charge Code |
27000263
|
|
Hospital Revenue Code
|
270
|
| 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 CANNULA VEN SNGL STG RT ANG
|
Facility
|
OP
|
$96.00
|
|
| Hospital Charge Code |
27000267
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$86.40 |
| Rate for Payer: Aetna Commercial |
$81.60
|
| Rate for Payer: Aetna Medicare |
$24.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.00
|
| Rate for Payer: BCBS Complete |
$38.40
|
| Rate for Payer: BCBS MAPPO |
$24.00
|
| Rate for Payer: BCBS Trust/PPO |
$74.64
|
| Rate for Payer: BCN Commercial |
$74.64
|
| Rate for Payer: BCN Medicare Advantage |
$24.00
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cofinity Commercial |
$82.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$86.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.60
|
| Rate for Payer: PACE Senior Care Partners |
$22.80
|
| Rate for Payer: PACE SWMI |
$24.00
|
| Rate for Payer: PHP Commercial |
$81.60
|
| Rate for Payer: PHP Medicare Advantage |
$24.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.52
|
| Rate for Payer: Priority Health Medicare |
$24.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.55
|
| Rate for Payer: Railroad Medicare Medicare |
$24.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.48
|
| Rate for Payer: UHC Core |
$80.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.00
|
| Rate for Payer: UHC Medicare Advantage |
$24.72
|
| Rate for Payer: VA VA |
$24.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.00
|
|
|
HC CANNULA VEN SNGL STG RT ANG
|
Facility
|
IP
|
$96.00
|
|
| Hospital Charge Code |
27000267
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$58.55 |
| Max. Negotiated Rate |
$86.40 |
| Rate for Payer: Aetna Commercial |
$81.60
|
| Rate for Payer: BCBS Trust/PPO |
$74.19
|
| Rate for Payer: BCN Commercial |
$74.19
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cofinity Commercial |
$82.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.80
|
| Rate for Payer: Healthscope Commercial |
$86.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.60
|
| Rate for Payer: PHP Commercial |
$81.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.48
|
| Rate for Payer: UHC Core |
$80.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.00
|
|
|
HC CANNULA VEN TRIPLE STAGE
|
Facility
|
OP
|
$72.00
|
|
| Hospital Charge Code |
27000035
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.10 |
| 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 |
$28.80
|
| 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: 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: 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 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 CANNULA VEN TRIPLE STAGE
|
Facility
|
IP
|
$72.00
|
|
| Hospital Charge Code |
27000035
|
|
Hospital Revenue Code
|
270
|
| 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 CARB 10,11 EPXID
|
Facility
|
IP
|
$43.88
|
|
|
Service Code
|
CPT 80161
|
| Hospital Charge Code |
30100742
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.76 |
| Max. Negotiated Rate |
$39.49 |
| Rate for Payer: Aetna Commercial |
$37.30
|
| Rate for Payer: BCBS Trust/PPO |
$33.91
|
| Rate for Payer: BCN Commercial |
$33.91
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cofinity Commercial |
$37.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.10
|
| Rate for Payer: Healthscope Commercial |
$39.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.30
|
| Rate for Payer: PHP Commercial |
$37.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.61
|
| Rate for Payer: UHC Core |
$36.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.91
|
|
|
HC CARB 10,11 EPXID
|
Facility
|
OP
|
$43.88
|
|
|
Service Code
|
CPT 80161
|
| Hospital Charge Code |
30100742
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.42 |
| Max. Negotiated Rate |
$39.49 |
| Rate for Payer: Aetna Commercial |
$37.30
|
| Rate for Payer: Aetna Medicare |
$11.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.71
|
| Rate for Payer: BCBS Complete |
$14.44
|
| Rate for Payer: BCBS MAPPO |
$10.97
|
| Rate for Payer: BCBS Trust/PPO |
$34.12
|
| Rate for Payer: BCN Commercial |
$34.12
|
| Rate for Payer: BCN Medicare Advantage |
$10.97
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cofinity Commercial |
$37.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.97
|
| Rate for Payer: Healthscope Commercial |
$39.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.91
|
| Rate for Payer: Mclaren Medicaid |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$14.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.30
|
| Rate for Payer: PACE Senior Care Partners |
$10.42
|
| Rate for Payer: PACE SWMI |
$10.97
|
| Rate for Payer: PHP Commercial |
$37.30
|
| Rate for Payer: PHP Medicare Advantage |
$10.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.18
|
| Rate for Payer: Priority Health Medicare |
$10.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.76
|
| Rate for Payer: Railroad Medicare Medicare |
$10.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.61
|
| Rate for Payer: UHC Core |
$36.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.97
|
| Rate for Payer: UHC Medicare Advantage |
$11.30
|
| Rate for Payer: VA VA |
$10.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.91
|
|
|
HC CARBAMAZEPINE 10 11 EPOXIDE
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100022
|
|
Hospital Revenue Code
|
301
|
| 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 CARBAMAZEPINE 10 11 EPOXIDE
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100022
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.66 |
| 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 |
$11.29
|
| 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 |
$10.75
|
| Rate for Payer: Meridian Medicaid |
$11.29
|
| 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 |
$10.75
|
| 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 CARBAMAZEPINE 10 11 EPOXIDE CMPT
|
Facility
|
OP
|
$43.86
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100060
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.42 |
| Max. Negotiated Rate |
$39.47 |
| Rate for Payer: Aetna Commercial |
$37.28
|
| Rate for Payer: Aetna Medicare |
$11.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.71
|
| Rate for Payer: BCBS Complete |
$14.44
|
| Rate for Payer: BCBS MAPPO |
$10.96
|
| Rate for Payer: BCBS Trust/PPO |
$34.10
|
| Rate for Payer: BCN Commercial |
$34.10
|
| Rate for Payer: BCN Medicare Advantage |
$10.96
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$37.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.96
|
| Rate for Payer: Healthscope Commercial |
$39.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.90
|
| Rate for Payer: Mclaren Medicaid |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$14.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.28
|
| Rate for Payer: PACE Senior Care Partners |
$10.42
|
| Rate for Payer: PACE SWMI |
$10.96
|
| Rate for Payer: PHP Commercial |
$37.28
|
| Rate for Payer: PHP Medicare Advantage |
$10.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.16
|
| Rate for Payer: Priority Health Medicare |
$10.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.75
|
| Rate for Payer: Railroad Medicare Medicare |
$10.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.60
|
| Rate for Payer: UHC Core |
$36.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.96
|
| Rate for Payer: UHC Medicare Advantage |
$11.29
|
| Rate for Payer: VA VA |
$10.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.90
|
|
|
HC CARBAMAZEPINE 10 11 EPOXIDE CMPT
|
Facility
|
IP
|
$43.86
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100060
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.75 |
| Max. Negotiated Rate |
$39.47 |
| Rate for Payer: Aetna Commercial |
$37.28
|
| Rate for Payer: BCBS Trust/PPO |
$33.90
|
| Rate for Payer: BCN Commercial |
$33.90
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$37.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$39.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.28
|
| Rate for Payer: PHP Commercial |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.60
|
| Rate for Payer: UHC Core |
$36.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.90
|
|
|
HC CARBON DIOXIDE (BICARB)
|
Facility
|
OP
|
$21.22
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100133
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$19.10 |
| Rate for Payer: Aetna Commercial |
$18.04
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.78
|
| Rate for Payer: BCBS MAPPO |
$5.30
|
| Rate for Payer: BCBS Trust/PPO |
$16.50
|
| Rate for Payer: BCN Commercial |
$16.50
|
| Rate for Payer: BCN Medicare Advantage |
$5.30
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.30
|
| Rate for Payer: Healthscope Commercial |
$19.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.60
|
| Rate for Payer: Meridian Medicaid |
$3.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.04
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.30
|
| Rate for Payer: PHP Commercial |
$18.04
|
| Rate for Payer: PHP Medicare Advantage |
$5.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.46
|
| Rate for Payer: Priority Health Medicare |
$5.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.67
|
| Rate for Payer: UHC Core |
$17.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.30
|
| Rate for Payer: UHC Medicare Advantage |
$5.46
|
| Rate for Payer: VA VA |
$5.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC CARBON DIOXIDE (BICARB)
|
Facility
|
IP
|
$21.22
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100133
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.94 |
| Max. Negotiated Rate |
$19.10 |
| Rate for Payer: Aetna Commercial |
$18.04
|
| Rate for Payer: BCBS Trust/PPO |
$16.40
|
| Rate for Payer: BCN Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.04
|
| Rate for Payer: PHP Commercial |
$18.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.67
|
| Rate for Payer: UHC Core |
$17.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC CARBOXYHEMOGLOBIN
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
30100134
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.91 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: BCBS Trust/PPO |
$59.44
|
| Rate for Payer: BCN Commercial |
$59.44
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.37
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC CARBOXYHEMOGLOBIN
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
30100134
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.09 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.03
|
| Rate for Payer: BCBS Complete |
$9.55
|
| Rate for Payer: BCBS MAPPO |
$19.23
|
| Rate for Payer: BCBS Trust/PPO |
$59.80
|
| Rate for Payer: BCN Commercial |
$59.80
|
| Rate for Payer: BCN Medicare Advantage |
$19.23
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.23
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$9.09
|
| Rate for Payer: Meridian Medicaid |
$9.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.37
|
| Rate for Payer: PACE Senior Care Partners |
$18.27
|
| Rate for Payer: PACE SWMI |
$19.23
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.91
|
| Rate for Payer: Priority Health Medicare |
$19.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.91
|
| Rate for Payer: Railroad Medicare Medicare |
$19.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.23
|
| Rate for Payer: UHC Medicare Advantage |
$19.80
|
| Rate for Payer: VA VA |
$19.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC CARDIAC REH OP PH 2 WO MONITOR
|
Facility
|
IP
|
$194.03
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
94300007
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$118.34 |
| Max. Negotiated Rate |
$174.63 |
| Rate for Payer: Aetna Commercial |
$164.93
|
| Rate for Payer: BCBS Trust/PPO |
$149.95
|
| Rate for Payer: BCN Commercial |
$149.95
|
| Rate for Payer: Cash Price |
$155.22
|
| Rate for Payer: Cofinity Commercial |
$166.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.22
|
| Rate for Payer: Healthscope Commercial |
$174.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.93
|
| Rate for Payer: PHP Commercial |
$164.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.75
|
| Rate for Payer: UHC Core |
$162.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.52
|
|
|
HC CARDIAC REH OP PH 2 WO MONITOR
|
Facility
|
OP
|
$194.03
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
94300007
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$46.08 |
| Max. Negotiated Rate |
$174.63 |
| Rate for Payer: Aetna Commercial |
$164.93
|
| Rate for Payer: Aetna Medicare |
$50.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.63
|
| Rate for Payer: BCBS Complete |
$91.01
|
| Rate for Payer: BCBS MAPPO |
$48.51
|
| Rate for Payer: BCBS Trust/PPO |
$150.86
|
| Rate for Payer: BCN Commercial |
$150.86
|
| Rate for Payer: BCN Medicare Advantage |
$48.51
|
| Rate for Payer: Cash Price |
$155.22
|
| Rate for Payer: Cash Price |
$155.22
|
| Rate for Payer: Cofinity Commercial |
$166.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.51
|
| Rate for Payer: Healthscope Commercial |
$174.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.52
|
| Rate for Payer: Mclaren Medicaid |
$86.68
|
| Rate for Payer: Meridian Medicaid |
$91.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.93
|
| Rate for Payer: PACE Senior Care Partners |
$46.08
|
| Rate for Payer: PACE SWMI |
$48.51
|
| Rate for Payer: PHP Commercial |
$164.93
|
| Rate for Payer: PHP Medicare Advantage |
$48.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.81
|
| Rate for Payer: Priority Health Medicare |
$48.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.34
|
| Rate for Payer: Railroad Medicare Medicare |
$48.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.75
|
| Rate for Payer: UHC Core |
$162.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.51
|
| Rate for Payer: UHC Medicare Advantage |
$49.96
|
| Rate for Payer: VA VA |
$48.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.52
|
|
