|
HC CARDIOLIPIN AB IGA
|
Facility
|
OP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200146
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$45.15 |
| Rate for Payer: Aetna Commercial |
$42.64
|
| Rate for Payer: Aetna Medicare |
$13.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.68
|
| Rate for Payer: BCBS Complete |
$19.72
|
| Rate for Payer: BCBS MAPPO |
$12.54
|
| Rate for Payer: BCBS Trust/PPO |
$39.01
|
| Rate for Payer: BCN Commercial |
$39.01
|
| Rate for Payer: BCN Medicare Advantage |
$12.54
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.54
|
| Rate for Payer: Healthscope Commercial |
$45.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.63
|
| Rate for Payer: Mclaren Medicaid |
$18.78
|
| Rate for Payer: Meridian Medicaid |
$19.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: PACE Senior Care Partners |
$11.92
|
| Rate for Payer: PACE SWMI |
$12.54
|
| Rate for Payer: PHP Commercial |
$42.64
|
| Rate for Payer: PHP Medicare Advantage |
$12.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.65
|
| Rate for Payer: Priority Health Medicare |
$12.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.60
|
| Rate for Payer: Railroad Medicare Medicare |
$12.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.15
|
| Rate for Payer: UHC Core |
$41.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.54
|
| Rate for Payer: UHC Medicare Advantage |
$12.92
|
| Rate for Payer: VA VA |
$12.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.63
|
|
|
HC CARDIOLIPIN AB IGA
|
Facility
|
IP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200146
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$45.15 |
| Rate for Payer: Aetna Commercial |
$42.64
|
| Rate for Payer: BCBS Trust/PPO |
$38.77
|
| Rate for Payer: BCN Commercial |
$38.77
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Healthscope Commercial |
$45.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: PHP Commercial |
$42.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.15
|
| Rate for Payer: UHC Core |
$41.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.63
|
|
|
HC CARDIOLIPIN AB IGG
|
Facility
|
IP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200144
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$45.15 |
| Rate for Payer: Aetna Commercial |
$42.64
|
| Rate for Payer: BCBS Trust/PPO |
$38.77
|
| Rate for Payer: BCN Commercial |
$38.77
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Healthscope Commercial |
$45.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: PHP Commercial |
$42.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.15
|
| Rate for Payer: UHC Core |
$41.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.63
|
|
|
HC CARDIOLIPIN AB IGG
|
Facility
|
OP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200144
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$45.15 |
| Rate for Payer: Aetna Commercial |
$42.64
|
| Rate for Payer: Aetna Medicare |
$13.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.68
|
| Rate for Payer: BCBS Complete |
$19.72
|
| Rate for Payer: BCBS MAPPO |
$12.54
|
| Rate for Payer: BCBS Trust/PPO |
$39.01
|
| Rate for Payer: BCN Commercial |
$39.01
|
| Rate for Payer: BCN Medicare Advantage |
$12.54
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.54
|
| Rate for Payer: Healthscope Commercial |
$45.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.63
|
| Rate for Payer: Mclaren Medicaid |
$18.78
|
| Rate for Payer: Meridian Medicaid |
$19.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: PACE Senior Care Partners |
$11.92
|
| Rate for Payer: PACE SWMI |
$12.54
|
| Rate for Payer: PHP Commercial |
$42.64
|
| Rate for Payer: PHP Medicare Advantage |
$12.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.65
|
| Rate for Payer: Priority Health Medicare |
$12.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.60
|
| Rate for Payer: Railroad Medicare Medicare |
$12.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.15
|
| Rate for Payer: UHC Core |
$41.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.54
|
| Rate for Payer: UHC Medicare Advantage |
$12.92
|
| Rate for Payer: VA VA |
$12.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.63
|
|
|
HC CARDIOLIPIN AB IGM
|
Facility
|
OP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$45.15 |
| Rate for Payer: Aetna Commercial |
$42.64
|
| Rate for Payer: Aetna Medicare |
$13.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.68
|
| Rate for Payer: BCBS Complete |
$19.72
|
| Rate for Payer: BCBS MAPPO |
$12.54
|
| Rate for Payer: BCBS Trust/PPO |
$39.01
|
| Rate for Payer: BCN Commercial |
$39.01
|
| Rate for Payer: BCN Medicare Advantage |
$12.54
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.54
|
| Rate for Payer: Healthscope Commercial |
$45.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.63
|
| Rate for Payer: Mclaren Medicaid |
$18.78
|
| Rate for Payer: Meridian Medicaid |
$19.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: PACE Senior Care Partners |
$11.92
|
| Rate for Payer: PACE SWMI |
$12.54
|
| Rate for Payer: PHP Commercial |
$42.64
|
| Rate for Payer: PHP Medicare Advantage |
$12.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.65
|
| Rate for Payer: Priority Health Medicare |
$12.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.60
|
| Rate for Payer: Railroad Medicare Medicare |
$12.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.15
|
| Rate for Payer: UHC Core |
$41.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.54
|
| Rate for Payer: UHC Medicare Advantage |
$12.92
|
| Rate for Payer: VA VA |
$12.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.63
|
|
|
HC CARDIOLIPIN AB IGM
|
Facility
|
IP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$45.15 |
| Rate for Payer: Aetna Commercial |
$42.64
|
| Rate for Payer: BCBS Trust/PPO |
$38.77
|
| Rate for Payer: BCN Commercial |
$38.77
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Healthscope Commercial |
$45.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: PHP Commercial |
$42.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.15
|
| Rate for Payer: UHC Core |
$41.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.63
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
OP
|
$505.43
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$120.04 |
| Max. Negotiated Rate |
$454.89 |
| Rate for Payer: Aetna Commercial |
$429.62
|
| Rate for Payer: Aetna Medicare |
$131.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.95
|
| Rate for Payer: BCBS Complete |
$202.17
|
| Rate for Payer: BCBS MAPPO |
$126.36
|
| Rate for Payer: BCBS Trust/PPO |
$392.97
|
| Rate for Payer: BCN Commercial |
$392.97
|
| Rate for Payer: BCN Medicare Advantage |
$126.36
|
| Rate for Payer: Cash Price |
$404.34
|
| Rate for Payer: Cofinity Commercial |
$434.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.36
|
| Rate for Payer: Healthscope Commercial |
$454.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$379.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$132.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$429.62
|
| Rate for Payer: PACE Senior Care Partners |
$120.04
|
| Rate for Payer: PACE SWMI |
$126.36
|
| Rate for Payer: PHP Commercial |
$429.62
|
| Rate for Payer: PHP Medicare Advantage |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$439.72
|
| Rate for Payer: Priority Health Medicare |
$126.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$308.26
|
| Rate for Payer: Railroad Medicare Medicare |
$126.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$444.78
|
| Rate for Payer: UHC Core |
$422.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.36
|
| Rate for Payer: UHC Medicare Advantage |
$130.15
|
| Rate for Payer: VA VA |
$126.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$379.07
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
IP
|
$505.43
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$308.26 |
| Max. Negotiated Rate |
$454.89 |
| Rate for Payer: Aetna Commercial |
$429.62
|
| Rate for Payer: BCBS Trust/PPO |
$390.60
|
| Rate for Payer: BCN Commercial |
$390.60
|
| Rate for Payer: Cash Price |
$404.34
|
| Rate for Payer: Cofinity Commercial |
$434.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.34
|
| Rate for Payer: Healthscope Commercial |
$454.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$379.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$429.62
|
| Rate for Payer: PHP Commercial |
$429.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$439.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$308.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$444.78
|
| Rate for Payer: UHC Core |
$422.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$379.07
|
|
|
HC CARDIOPULMONARY EX TEST
|
Facility
|
OP
|
$1,100.68
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
46000007
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$205.90 |
| Max. Negotiated Rate |
$990.61 |
| Rate for Payer: Aetna Commercial |
$935.58
|
| Rate for Payer: Aetna Medicare |
$286.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$343.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$343.96
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$275.17
|
| Rate for Payer: BCBS Trust/PPO |
$855.78
|
| Rate for Payer: BCN Commercial |
$855.78
|
| Rate for Payer: BCN Medicare Advantage |
$275.17
|
| Rate for Payer: Cash Price |
$880.54
|
| Rate for Payer: Cash Price |
$880.54
|
| Rate for Payer: Cofinity Commercial |
$946.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$880.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.17
|
| Rate for Payer: Healthscope Commercial |
$990.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$825.51
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$288.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$316.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.58
|
| Rate for Payer: PACE Senior Care Partners |
$261.41
|
| Rate for Payer: PACE SWMI |
$275.17
|
| Rate for Payer: PHP Commercial |
$935.58
|
| Rate for Payer: PHP Medicare Advantage |
$275.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$957.59
|
| Rate for Payer: Priority Health Medicare |
$275.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$671.30
|
| Rate for Payer: Railroad Medicare Medicare |
$275.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$968.60
|
| Rate for Payer: UHC Core |
$919.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$275.17
|
| Rate for Payer: UHC Medicare Advantage |
$283.43
|
| Rate for Payer: VA VA |
$275.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$825.51
|
|
|
HC CARDIOPULMONARY EX TEST
|
Facility
|
IP
|
$1,100.68
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
46000007
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$671.30 |
| Max. Negotiated Rate |
$990.61 |
| Rate for Payer: Aetna Commercial |
$935.58
|
| Rate for Payer: BCBS Trust/PPO |
$850.61
|
| Rate for Payer: BCN Commercial |
$850.61
|
| Rate for Payer: Cash Price |
$880.54
|
| Rate for Payer: Cofinity Commercial |
$946.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$880.54
|
| Rate for Payer: Healthscope Commercial |
$990.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$825.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.58
|
| Rate for Payer: PHP Commercial |
$935.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$957.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$671.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$968.60
|
| Rate for Payer: UHC Core |
$919.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$825.51
|
|
|
HC CARDIOVERSION
|
Facility
|
IP
|
$1,174.36
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
48000002
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$716.24 |
| Max. Negotiated Rate |
$1,056.92 |
| Rate for Payer: Aetna Commercial |
$998.21
|
| Rate for Payer: BCBS Trust/PPO |
$907.55
|
| Rate for Payer: BCN Commercial |
$907.55
|
| Rate for Payer: Cash Price |
$939.49
|
| Rate for Payer: Cofinity Commercial |
$1,009.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$939.49
|
| Rate for Payer: Healthscope Commercial |
$1,056.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$880.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$998.21
|
| Rate for Payer: PHP Commercial |
$998.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$716.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,033.44
|
| Rate for Payer: UHC Core |
$980.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$880.77
|
|
|
HC CARDIOVERSION
|
Facility
|
OP
|
$1,174.36
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
48000002
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$278.91 |
| Max. Negotiated Rate |
$1,056.92 |
| Rate for Payer: Aetna Commercial |
$998.21
|
| Rate for Payer: Aetna Medicare |
$305.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$366.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$366.99
|
| Rate for Payer: BCBS Complete |
$448.28
|
| Rate for Payer: BCBS MAPPO |
$293.59
|
| Rate for Payer: BCBS Trust/PPO |
$913.06
|
| Rate for Payer: BCN Commercial |
$913.06
|
| Rate for Payer: BCN Medicare Advantage |
$293.59
|
| Rate for Payer: Cash Price |
$939.49
|
| Rate for Payer: Cash Price |
$939.49
|
| Rate for Payer: Cofinity Commercial |
$1,009.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$939.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.59
|
| Rate for Payer: Healthscope Commercial |
$1,056.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$880.77
|
| Rate for Payer: Mclaren Medicaid |
$426.93
|
| Rate for Payer: Meridian Medicaid |
$448.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$308.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$337.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$998.21
|
| Rate for Payer: PACE Senior Care Partners |
$278.91
|
| Rate for Payer: PACE SWMI |
$293.59
|
| Rate for Payer: PHP Commercial |
$998.21
|
| Rate for Payer: PHP Medicare Advantage |
$293.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$426.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.69
|
| Rate for Payer: Priority Health Medicare |
$293.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$716.24
|
| Rate for Payer: Railroad Medicare Medicare |
$293.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,033.44
|
| Rate for Payer: UHC Core |
$980.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$293.59
|
| Rate for Payer: UHC Medicare Advantage |
$302.40
|
| Rate for Payer: VA VA |
$293.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$880.77
|
|
|
HC CARDIOVERSION EXT
|
Facility
|
OP
|
$978.63
|
|
| Hospital Charge Code |
45000034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$232.42 |
| Max. Negotiated Rate |
$880.77 |
| Rate for Payer: Aetna Commercial |
$831.84
|
| Rate for Payer: Aetna Medicare |
$254.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$305.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$305.82
|
| Rate for Payer: BCBS Complete |
$391.45
|
| Rate for Payer: BCBS MAPPO |
$244.66
|
| Rate for Payer: BCBS Trust/PPO |
$760.88
|
| Rate for Payer: BCN Commercial |
$760.88
|
| Rate for Payer: BCN Medicare Advantage |
$244.66
|
| Rate for Payer: Cash Price |
$782.90
|
| Rate for Payer: Cofinity Commercial |
$841.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$782.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$244.66
|
| Rate for Payer: Healthscope Commercial |
$880.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$733.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$256.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$281.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$831.84
|
| Rate for Payer: PACE Senior Care Partners |
$232.42
|
| Rate for Payer: PACE SWMI |
$244.66
|
| Rate for Payer: PHP Commercial |
$831.84
|
| Rate for Payer: PHP Medicare Advantage |
$244.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$685.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$851.41
|
| Rate for Payer: Priority Health Medicare |
$244.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$596.87
|
| Rate for Payer: Railroad Medicare Medicare |
$244.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$861.19
|
| Rate for Payer: UHC Core |
$817.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$244.66
|
| Rate for Payer: UHC Medicare Advantage |
$252.00
|
| Rate for Payer: VA VA |
$244.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$733.97
|
|
|
HC CARDIOVERSION EXT
|
Facility
|
IP
|
$978.63
|
|
| Hospital Charge Code |
45000034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$596.87 |
| Max. Negotiated Rate |
$880.77 |
| Rate for Payer: Aetna Commercial |
$831.84
|
| Rate for Payer: BCBS Trust/PPO |
$756.29
|
| Rate for Payer: BCN Commercial |
$756.29
|
| Rate for Payer: Cash Price |
$782.90
|
| Rate for Payer: Cofinity Commercial |
$841.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$782.90
|
| Rate for Payer: Healthscope Commercial |
$880.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$733.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$831.84
|
| Rate for Payer: PHP Commercial |
$831.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$685.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$851.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$596.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$861.19
|
| Rate for Payer: UHC Core |
$817.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$733.97
|
|
|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$31.73 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$40.20
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$19.77
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$40.45
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$19.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.22
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.73
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.00
|
| Rate for Payer: UHC Medicare Advantage |
$13.40
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC CAREGIVER TRAINING 1ST 30 MIN
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
CPT 97550
|
| Hospital Charge Code |
42000065
|
| Min. Negotiated Rate |
$77.46 |
| Max. Negotiated Rate |
$114.30 |
| Rate for Payer: Aetna Commercial |
$107.95
|
| Rate for Payer: BCBS Trust/PPO |
$98.15
|
| Rate for Payer: BCN Commercial |
$98.15
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cofinity Commercial |
$109.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.60
|
| Rate for Payer: Healthscope Commercial |
$114.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$107.95
|
| Rate for Payer: PHP Commercial |
$107.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.76
|
| Rate for Payer: UHC Core |
$106.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.25
|
|
|
HC CAREGIVER TRAINING 1ST 30 MIN
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
CPT 97550
|
| Hospital Charge Code |
42000065
|
| Min. Negotiated Rate |
$30.16 |
| Max. Negotiated Rate |
$114.30 |
| Rate for Payer: Aetna Commercial |
$107.95
|
| Rate for Payer: Aetna Medicare |
$33.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.69
|
| Rate for Payer: BCBS Complete |
$50.80
|
| Rate for Payer: BCBS MAPPO |
$31.75
|
| Rate for Payer: BCBS Trust/PPO |
$98.74
|
| Rate for Payer: BCN Commercial |
$98.74
|
| Rate for Payer: BCN Medicare Advantage |
$31.75
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cofinity Commercial |
$109.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.75
|
| Rate for Payer: Healthscope Commercial |
$114.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$107.95
|
| Rate for Payer: PACE Senior Care Partners |
$30.16
|
| Rate for Payer: PACE SWMI |
$31.75
|
| Rate for Payer: PHP Commercial |
$107.95
|
| Rate for Payer: PHP Medicare Advantage |
$31.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.49
|
| Rate for Payer: Priority Health Medicare |
$31.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.46
|
| Rate for Payer: Railroad Medicare Medicare |
$31.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.76
|
| Rate for Payer: UHC Core |
$106.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.75
|
| Rate for Payer: UHC Medicare Advantage |
$32.70
|
| Rate for Payer: VA VA |
$31.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.25
|
|
|
HC CAREGIVER TRAINING EA ADDL 15 MIN
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 97551
|
| Hospital Charge Code |
42000066
|
| Min. Negotiated Rate |
$36.59 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: BCBS Trust/PPO |
$46.37
|
| Rate for Payer: BCN Commercial |
$46.37
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.80
|
| Rate for Payer: UHC Core |
$50.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.00
|
|
|
HC CAREGIVER TRAINING EA ADDL 15 MIN
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 97551
|
| Hospital Charge Code |
42000066
|
| Min. Negotiated Rate |
$14.25 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: Aetna Medicare |
$15.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.75
|
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: BCBS MAPPO |
$15.00
|
| Rate for Payer: BCBS Trust/PPO |
$46.65
|
| Rate for Payer: BCN Commercial |
$46.65
|
| Rate for Payer: BCN Medicare Advantage |
$15.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.00
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PACE Senior Care Partners |
$14.25
|
| Rate for Payer: PACE SWMI |
$15.00
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: PHP Medicare Advantage |
$15.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.20
|
| Rate for Payer: Priority Health Medicare |
$15.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.59
|
| Rate for Payer: Railroad Medicare Medicare |
$15.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.80
|
| Rate for Payer: UHC Core |
$50.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.00
|
| Rate for Payer: UHC Medicare Advantage |
$15.45
|
| Rate for Payer: VA VA |
$15.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.00
|
|
|
HC CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Facility
|
OP
|
$80.58
|
|
|
Service Code
|
CPT 99484
|
| Hospital Charge Code |
51000107
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$18.83 |
| Max. Negotiated Rate |
$72.52 |
| Rate for Payer: Aetna Commercial |
$68.49
|
| Rate for Payer: Aetna Medicare |
$20.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.18
|
| Rate for Payer: BCBS Complete |
$19.77
|
| Rate for Payer: BCBS MAPPO |
$20.14
|
| Rate for Payer: BCBS Trust/PPO |
$62.65
|
| Rate for Payer: BCN Commercial |
$62.65
|
| Rate for Payer: BCN Medicare Advantage |
$20.14
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$69.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.14
|
| Rate for Payer: Healthscope Commercial |
$72.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.44
|
| Rate for Payer: Mclaren Medicaid |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$19.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.49
|
| Rate for Payer: PACE Senior Care Partners |
$19.14
|
| Rate for Payer: PACE SWMI |
$20.14
|
| Rate for Payer: PHP Commercial |
$68.49
|
| Rate for Payer: PHP Medicare Advantage |
$20.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.10
|
| Rate for Payer: Priority Health Medicare |
$20.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.15
|
| Rate for Payer: Railroad Medicare Medicare |
$20.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.91
|
| Rate for Payer: UHC Core |
$67.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.14
|
| Rate for Payer: UHC Medicare Advantage |
$20.75
|
| Rate for Payer: VA VA |
$20.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.44
|
|
|
HC CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Facility
|
IP
|
$80.58
|
|
|
Service Code
|
CPT 99484
|
| Hospital Charge Code |
51000107
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$49.15 |
| Max. Negotiated Rate |
$72.52 |
| Rate for Payer: Aetna Commercial |
$68.49
|
| Rate for Payer: BCBS Trust/PPO |
$62.27
|
| Rate for Payer: BCN Commercial |
$62.27
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$69.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Healthscope Commercial |
$72.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.49
|
| Rate for Payer: PHP Commercial |
$68.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.91
|
| Rate for Payer: UHC Core |
$67.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.44
|
|
|
HC CARNITINE
|
Facility
|
IP
|
$58.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.37 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Aetna Commercial |
$49.30
|
| Rate for Payer: BCBS Trust/PPO |
$44.82
|
| Rate for Payer: BCN Commercial |
$44.82
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.40
|
| Rate for Payer: Healthscope Commercial |
$52.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.30
|
| Rate for Payer: PHP Commercial |
$49.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.04
|
| Rate for Payer: UHC Core |
$48.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.50
|
|
|
HC CARNITINE
|
Facility
|
OP
|
$58.00
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.45 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Aetna Commercial |
$49.30
|
| Rate for Payer: Aetna Medicare |
$15.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.12
|
| Rate for Payer: BCBS Complete |
$13.07
|
| Rate for Payer: BCBS MAPPO |
$14.50
|
| Rate for Payer: BCBS Trust/PPO |
$45.10
|
| Rate for Payer: BCN Commercial |
$45.10
|
| Rate for Payer: BCN Medicare Advantage |
$14.50
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$49.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.50
|
| Rate for Payer: Healthscope Commercial |
$52.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.50
|
| Rate for Payer: Mclaren Medicaid |
$12.45
|
| Rate for Payer: Meridian Medicaid |
$13.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.30
|
| Rate for Payer: PACE Senior Care Partners |
$13.78
|
| Rate for Payer: PACE SWMI |
$14.50
|
| Rate for Payer: PHP Commercial |
$49.30
|
| Rate for Payer: PHP Medicare Advantage |
$14.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.46
|
| Rate for Payer: Priority Health Medicare |
$14.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.37
|
| Rate for Payer: Railroad Medicare Medicare |
$14.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.04
|
| Rate for Payer: UHC Core |
$48.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.50
|
| Rate for Payer: UHC Medicare Advantage |
$14.94
|
| Rate for Payer: VA VA |
$14.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.50
|
|
|
HC CAR OBSERVATION PER HOUR
|
Facility
|
OP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$31.90 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna Medicare |
$34.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.98
|
| Rate for Payer: BCBS Complete |
$53.73
|
| Rate for Payer: BCBS MAPPO |
$33.58
|
| Rate for Payer: BCBS Trust/PPO |
$104.44
|
| Rate for Payer: BCN Commercial |
$104.44
|
| Rate for Payer: BCN Medicare Advantage |
$33.58
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.58
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PACE Senior Care Partners |
$31.90
|
| Rate for Payer: PACE SWMI |
$33.58
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: PHP Medicare Advantage |
$33.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.87
|
| Rate for Payer: Priority Health Medicare |
$33.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.93
|
| Rate for Payer: Railroad Medicare Medicare |
$33.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.21
|
| Rate for Payer: UHC Core |
$112.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.58
|
| Rate for Payer: UHC Medicare Advantage |
$34.59
|
| Rate for Payer: VA VA |
$33.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
