|
HC CAST TOTAL CONTACT
|
Facility
|
OP
|
$488.11
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
70000021
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$115.93 |
| Max. Negotiated Rate |
$439.30 |
| Rate for Payer: Aetna Commercial |
$414.89
|
| Rate for Payer: Aetna Medicare |
$126.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.53
|
| Rate for Payer: BCBS Complete |
$184.98
|
| Rate for Payer: BCBS MAPPO |
$122.03
|
| Rate for Payer: BCBS Trust/PPO |
$379.51
|
| Rate for Payer: BCN Commercial |
$379.51
|
| Rate for Payer: BCN Medicare Advantage |
$122.03
|
| Rate for Payer: Cash Price |
$390.49
|
| Rate for Payer: Cash Price |
$390.49
|
| Rate for Payer: Cofinity Commercial |
$419.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$390.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.03
|
| Rate for Payer: Healthscope Commercial |
$439.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$366.08
|
| Rate for Payer: Mclaren Medicaid |
$176.18
|
| Rate for Payer: Meridian Medicaid |
$184.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$414.89
|
| Rate for Payer: PACE Senior Care Partners |
$115.93
|
| Rate for Payer: PACE SWMI |
$122.03
|
| Rate for Payer: PHP Commercial |
$414.89
|
| Rate for Payer: PHP Medicare Advantage |
$122.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$424.66
|
| Rate for Payer: Priority Health Medicare |
$122.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$297.70
|
| Rate for Payer: Railroad Medicare Medicare |
$122.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.54
|
| Rate for Payer: UHC Core |
$407.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.03
|
| Rate for Payer: UHC Medicare Advantage |
$125.69
|
| Rate for Payer: VA VA |
$122.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$366.08
|
|
|
HC CAST TOTAL CONTACT
|
Facility
|
IP
|
$488.11
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
70000021
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$297.70 |
| Max. Negotiated Rate |
$439.30 |
| Rate for Payer: Aetna Commercial |
$414.89
|
| Rate for Payer: BCBS Trust/PPO |
$377.21
|
| Rate for Payer: BCN Commercial |
$377.21
|
| Rate for Payer: Cash Price |
$390.49
|
| Rate for Payer: Cofinity Commercial |
$419.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$390.49
|
| Rate for Payer: Healthscope Commercial |
$439.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$366.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$414.89
|
| Rate for Payer: PHP Commercial |
$414.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$424.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$297.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.54
|
| Rate for Payer: UHC Core |
$407.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$366.08
|
|
|
HC CAST WEDGE
|
Facility
|
IP
|
$351.62
|
|
|
Service Code
|
CPT 29740
|
| Hospital Charge Code |
70000019
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$214.45 |
| Max. Negotiated Rate |
$316.46 |
| Rate for Payer: Aetna Commercial |
$298.88
|
| Rate for Payer: BCBS Trust/PPO |
$271.73
|
| Rate for Payer: BCN Commercial |
$271.73
|
| Rate for Payer: Cash Price |
$281.30
|
| Rate for Payer: Cofinity Commercial |
$302.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.30
|
| Rate for Payer: Healthscope Commercial |
$316.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$298.88
|
| Rate for Payer: PHP Commercial |
$298.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$305.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.43
|
| Rate for Payer: UHC Core |
$293.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.72
|
|
|
HC CAST WEDGE
|
Facility
|
OP
|
$351.62
|
|
|
Service Code
|
CPT 29740
|
| Hospital Charge Code |
70000019
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$83.51 |
| Max. Negotiated Rate |
$316.46 |
| Rate for Payer: Aetna Commercial |
$298.88
|
| Rate for Payer: Aetna Medicare |
$91.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.88
|
| Rate for Payer: BCBS Complete |
$184.98
|
| Rate for Payer: BCBS MAPPO |
$87.90
|
| Rate for Payer: BCBS Trust/PPO |
$273.38
|
| Rate for Payer: BCN Commercial |
$273.38
|
| Rate for Payer: BCN Medicare Advantage |
$87.90
|
| Rate for Payer: Cash Price |
$281.30
|
| Rate for Payer: Cash Price |
$281.30
|
| Rate for Payer: Cofinity Commercial |
$302.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.90
|
| Rate for Payer: Healthscope Commercial |
$316.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.72
|
| Rate for Payer: Mclaren Medicaid |
$176.18
|
| Rate for Payer: Meridian Medicaid |
$184.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$92.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$298.88
|
| Rate for Payer: PACE Senior Care Partners |
$83.51
|
| Rate for Payer: PACE SWMI |
$87.90
|
| Rate for Payer: PHP Commercial |
$298.88
|
| Rate for Payer: PHP Medicare Advantage |
$87.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$176.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$305.91
|
| Rate for Payer: Priority Health Medicare |
$87.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.45
|
| Rate for Payer: Railroad Medicare Medicare |
$87.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.43
|
| Rate for Payer: UHC Core |
$293.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.90
|
| Rate for Payer: UHC Medicare Advantage |
$90.54
|
| Rate for Payer: VA VA |
$87.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.72
|
|
|
HC CAST WINDOW
|
Facility
|
OP
|
$190.11
|
|
|
Service Code
|
CPT 29730
|
| Hospital Charge Code |
70000018
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$45.15 |
| Max. Negotiated Rate |
$171.10 |
| Rate for Payer: Aetna Commercial |
$161.59
|
| Rate for Payer: Aetna Medicare |
$49.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.41
|
| Rate for Payer: BCBS Complete |
$108.53
|
| Rate for Payer: BCBS MAPPO |
$47.53
|
| Rate for Payer: BCBS Trust/PPO |
$147.81
|
| Rate for Payer: BCN Commercial |
$147.81
|
| Rate for Payer: BCN Medicare Advantage |
$47.53
|
| Rate for Payer: Cash Price |
$152.09
|
| Rate for Payer: Cash Price |
$152.09
|
| Rate for Payer: Cofinity Commercial |
$163.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.53
|
| Rate for Payer: Healthscope Commercial |
$171.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.58
|
| Rate for Payer: Mclaren Medicaid |
$103.36
|
| Rate for Payer: Meridian Medicaid |
$108.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$49.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.59
|
| Rate for Payer: PACE Senior Care Partners |
$45.15
|
| Rate for Payer: PACE SWMI |
$47.53
|
| Rate for Payer: PHP Commercial |
$161.59
|
| Rate for Payer: PHP Medicare Advantage |
$47.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.40
|
| Rate for Payer: Priority Health Medicare |
$47.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.95
|
| Rate for Payer: Railroad Medicare Medicare |
$47.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.30
|
| Rate for Payer: UHC Core |
$158.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.53
|
| Rate for Payer: UHC Medicare Advantage |
$48.95
|
| Rate for Payer: VA VA |
$47.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.58
|
|
|
HC CAST WINDOW
|
Facility
|
IP
|
$190.11
|
|
|
Service Code
|
CPT 29730
|
| Hospital Charge Code |
70000018
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$115.95 |
| Max. Negotiated Rate |
$171.10 |
| Rate for Payer: Aetna Commercial |
$161.59
|
| Rate for Payer: BCBS Trust/PPO |
$146.92
|
| Rate for Payer: BCN Commercial |
$146.92
|
| Rate for Payer: Cash Price |
$152.09
|
| Rate for Payer: Cofinity Commercial |
$163.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.09
|
| Rate for Payer: Healthscope Commercial |
$171.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$161.59
|
| Rate for Payer: PHP Commercial |
$161.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.30
|
| Rate for Payer: UHC Core |
$158.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.58
|
|
|
HC CATECHOLAMINE FRACTION URINE
|
Facility
|
OP
|
$59.16
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
30100139
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.05 |
| Max. Negotiated Rate |
$53.24 |
| Rate for Payer: Aetna Commercial |
$50.29
|
| Rate for Payer: Aetna Medicare |
$15.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.49
|
| Rate for Payer: BCBS Complete |
$19.57
|
| Rate for Payer: BCBS MAPPO |
$14.79
|
| Rate for Payer: BCBS Trust/PPO |
$46.00
|
| Rate for Payer: BCN Commercial |
$46.00
|
| Rate for Payer: BCN Medicare Advantage |
$14.79
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$50.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.79
|
| Rate for Payer: Healthscope Commercial |
$53.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.37
|
| Rate for Payer: Mclaren Medicaid |
$18.63
|
| Rate for Payer: Meridian Medicaid |
$19.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.29
|
| Rate for Payer: PACE Senior Care Partners |
$14.05
|
| Rate for Payer: PACE SWMI |
$14.79
|
| Rate for Payer: PHP Commercial |
$50.29
|
| Rate for Payer: PHP Medicare Advantage |
$14.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.47
|
| Rate for Payer: Priority Health Medicare |
$14.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.08
|
| Rate for Payer: Railroad Medicare Medicare |
$14.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.06
|
| Rate for Payer: UHC Core |
$49.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.79
|
| Rate for Payer: UHC Medicare Advantage |
$15.23
|
| Rate for Payer: VA VA |
$14.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.37
|
|
|
HC CATECHOLAMINE FRACTION URINE
|
Facility
|
IP
|
$59.16
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
30100139
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.08 |
| Max. Negotiated Rate |
$53.24 |
| Rate for Payer: Aetna Commercial |
$50.29
|
| Rate for Payer: BCBS Trust/PPO |
$45.72
|
| Rate for Payer: BCN Commercial |
$45.72
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$50.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.33
|
| Rate for Payer: Healthscope Commercial |
$53.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.29
|
| Rate for Payer: PHP Commercial |
$50.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.06
|
| Rate for Payer: UHC Core |
$49.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.37
|
|
|
HC CATECHOLAMINES RANDOM URINE
|
Facility
|
IP
|
$56.71
|
|
|
Service Code
|
CPT 82382
|
| Hospital Charge Code |
30100138
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.59 |
| Max. Negotiated Rate |
$51.04 |
| Rate for Payer: Aetna Commercial |
$48.20
|
| Rate for Payer: BCBS Trust/PPO |
$43.83
|
| Rate for Payer: BCN Commercial |
$43.83
|
| Rate for Payer: Cash Price |
$45.37
|
| Rate for Payer: Cofinity Commercial |
$48.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.37
|
| Rate for Payer: Healthscope Commercial |
$51.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.20
|
| Rate for Payer: PHP Commercial |
$48.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.90
|
| Rate for Payer: UHC Core |
$47.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.53
|
|
|
HC CATECHOLAMINES RANDOM URINE
|
Facility
|
OP
|
$56.71
|
|
|
Service Code
|
CPT 82382
|
| Hospital Charge Code |
30100138
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.47 |
| Max. Negotiated Rate |
$51.04 |
| Rate for Payer: Aetna Commercial |
$48.20
|
| Rate for Payer: Aetna Medicare |
$14.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.72
|
| Rate for Payer: BCBS Complete |
$21.15
|
| Rate for Payer: BCBS MAPPO |
$14.18
|
| Rate for Payer: BCBS Trust/PPO |
$44.09
|
| Rate for Payer: BCN Commercial |
$44.09
|
| Rate for Payer: BCN Medicare Advantage |
$14.18
|
| Rate for Payer: Cash Price |
$45.37
|
| Rate for Payer: Cash Price |
$45.37
|
| Rate for Payer: Cofinity Commercial |
$48.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$51.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.53
|
| Rate for Payer: Mclaren Medicaid |
$20.15
|
| Rate for Payer: Meridian Medicaid |
$21.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.20
|
| Rate for Payer: PACE Senior Care Partners |
$13.47
|
| Rate for Payer: PACE SWMI |
$14.18
|
| Rate for Payer: PHP Commercial |
$48.20
|
| Rate for Payer: PHP Medicare Advantage |
$14.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.34
|
| Rate for Payer: Priority Health Medicare |
$14.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.59
|
| Rate for Payer: Railroad Medicare Medicare |
$14.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.90
|
| Rate for Payer: UHC Core |
$47.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.18
|
| Rate for Payer: UHC Medicare Advantage |
$14.60
|
| Rate for Payer: VA VA |
$14.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.53
|
|
|
HC CATFISH IGE
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200480
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.55 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: BCBS Trust/PPO |
$55.18
|
| Rate for Payer: BCN Commercial |
$55.18
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.69
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.83
|
| Rate for Payer: UHC Core |
$59.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
HC CATFISH IGE
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200480
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna Medicare |
$18.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.31
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$17.85
|
| Rate for Payer: BCBS Trust/PPO |
$55.51
|
| Rate for Payer: BCN Commercial |
$55.51
|
| Rate for Payer: BCN Medicare Advantage |
$17.85
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.85
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.69
|
| Rate for Payer: PACE Senior Care Partners |
$16.96
|
| Rate for Payer: PACE SWMI |
$17.85
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: PHP Medicare Advantage |
$17.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.12
|
| Rate for Payer: Priority Health Medicare |
$17.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.55
|
| Rate for Payer: Railroad Medicare Medicare |
$17.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.83
|
| Rate for Payer: UHC Core |
$59.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.85
|
| Rate for Payer: UHC Medicare Advantage |
$18.39
|
| Rate for Payer: VA VA |
$17.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
HC CATH ATHRECT ROTATIONAL LVL 5
|
Facility
|
OP
|
$5,593.68
|
|
|
Service Code
|
HCPCS C1724
|
| Hospital Charge Code |
27200025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,328.50 |
| Max. Negotiated Rate |
$5,034.31 |
| Rate for Payer: Aetna Commercial |
$4,754.63
|
| Rate for Payer: Aetna Medicare |
$1,454.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,748.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,748.02
|
| Rate for Payer: BCBS Complete |
$2,237.47
|
| Rate for Payer: BCBS MAPPO |
$1,398.42
|
| Rate for Payer: BCBS Trust/PPO |
$4,349.09
|
| Rate for Payer: BCN Commercial |
$4,349.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,398.42
|
| Rate for Payer: Cash Price |
$4,474.94
|
| Rate for Payer: Cofinity Commercial |
$4,810.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,474.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,398.42
|
| Rate for Payer: Healthscope Commercial |
$5,034.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,195.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,468.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,608.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,754.63
|
| Rate for Payer: PACE Senior Care Partners |
$1,328.50
|
| Rate for Payer: PACE SWMI |
$1,398.42
|
| Rate for Payer: PHP Commercial |
$4,754.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,398.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,915.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,866.50
|
| Rate for Payer: Priority Health Medicare |
$1,398.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,411.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,398.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,922.44
|
| Rate for Payer: UHC Core |
$4,670.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,398.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,440.37
|
| Rate for Payer: VA VA |
$1,398.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,195.26
|
|
|
HC CATH ATHRECT ROTATIONAL LVL 5
|
Facility
|
IP
|
$5,593.68
|
|
|
Service Code
|
HCPCS C1724
|
| Hospital Charge Code |
27200025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,411.59 |
| Max. Negotiated Rate |
$5,034.31 |
| Rate for Payer: Aetna Commercial |
$4,754.63
|
| Rate for Payer: BCBS Trust/PPO |
$4,322.80
|
| Rate for Payer: BCN Commercial |
$4,322.80
|
| Rate for Payer: Cash Price |
$4,474.94
|
| Rate for Payer: Cofinity Commercial |
$4,810.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,474.94
|
| Rate for Payer: Healthscope Commercial |
$5,034.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,195.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,754.63
|
| Rate for Payer: PHP Commercial |
$4,754.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,915.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,866.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,411.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,922.44
|
| Rate for Payer: UHC Core |
$4,670.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,195.26
|
|
|
HC CATH BALLOON
|
Facility
|
OP
|
$1,289.14
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200001
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$306.17 |
| Max. Negotiated Rate |
$1,160.23 |
| Rate for Payer: Aetna Commercial |
$1,095.77
|
| Rate for Payer: Aetna Medicare |
$335.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$402.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$402.86
|
| Rate for Payer: BCBS Complete |
$515.66
|
| Rate for Payer: BCBS MAPPO |
$322.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,002.31
|
| Rate for Payer: BCN Commercial |
$1,002.31
|
| Rate for Payer: BCN Medicare Advantage |
$322.28
|
| Rate for Payer: Cash Price |
$1,031.31
|
| Rate for Payer: Cofinity Commercial |
$1,108.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,031.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.28
|
| Rate for Payer: Healthscope Commercial |
$1,160.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$966.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$338.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$370.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,095.77
|
| Rate for Payer: PACE Senior Care Partners |
$306.17
|
| Rate for Payer: PACE SWMI |
$322.28
|
| Rate for Payer: PHP Commercial |
$1,095.77
|
| Rate for Payer: PHP Medicare Advantage |
$322.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$902.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,121.55
|
| Rate for Payer: Priority Health Medicare |
$322.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$786.25
|
| Rate for Payer: Railroad Medicare Medicare |
$322.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,134.44
|
| Rate for Payer: UHC Core |
$1,076.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$322.28
|
| Rate for Payer: UHC Medicare Advantage |
$331.95
|
| Rate for Payer: VA VA |
$322.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$966.86
|
|
|
HC CATH BALLOON
|
Facility
|
IP
|
$1,289.14
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200001
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$786.25 |
| Max. Negotiated Rate |
$1,160.23 |
| Rate for Payer: Aetna Commercial |
$1,095.77
|
| Rate for Payer: BCBS Trust/PPO |
$996.25
|
| Rate for Payer: BCN Commercial |
$996.25
|
| Rate for Payer: Cash Price |
$1,031.31
|
| Rate for Payer: Cofinity Commercial |
$1,108.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,031.31
|
| Rate for Payer: Healthscope Commercial |
$1,160.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$966.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,095.77
|
| Rate for Payer: PHP Commercial |
$1,095.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$902.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,121.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$786.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,134.44
|
| Rate for Payer: UHC Core |
$1,076.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$966.86
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 1
|
Facility
|
IP
|
$145.26
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$88.59 |
| Max. Negotiated Rate |
$130.73 |
| Rate for Payer: Aetna Commercial |
$123.47
|
| Rate for Payer: BCBS Trust/PPO |
$112.26
|
| Rate for Payer: BCN Commercial |
$112.26
|
| Rate for Payer: Cash Price |
$116.21
|
| Rate for Payer: Cofinity Commercial |
$124.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.21
|
| Rate for Payer: Healthscope Commercial |
$130.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$123.47
|
| Rate for Payer: PHP Commercial |
$123.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.83
|
| Rate for Payer: UHC Core |
$121.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.94
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 1
|
Facility
|
OP
|
$145.26
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$130.73 |
| Rate for Payer: Aetna Commercial |
$123.47
|
| Rate for Payer: Aetna Medicare |
$37.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.39
|
| Rate for Payer: BCBS Complete |
$58.10
|
| Rate for Payer: BCBS MAPPO |
$36.32
|
| Rate for Payer: BCBS Trust/PPO |
$112.94
|
| Rate for Payer: BCN Commercial |
$112.94
|
| Rate for Payer: BCN Medicare Advantage |
$36.32
|
| Rate for Payer: Cash Price |
$116.21
|
| Rate for Payer: Cofinity Commercial |
$124.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.32
|
| Rate for Payer: Healthscope Commercial |
$130.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$123.47
|
| Rate for Payer: PACE Senior Care Partners |
$34.50
|
| Rate for Payer: PACE SWMI |
$36.32
|
| Rate for Payer: PHP Commercial |
$123.47
|
| Rate for Payer: PHP Medicare Advantage |
$36.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.38
|
| Rate for Payer: Priority Health Medicare |
$36.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.59
|
| Rate for Payer: Railroad Medicare Medicare |
$36.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.83
|
| Rate for Payer: UHC Core |
$121.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.32
|
| Rate for Payer: UHC Medicare Advantage |
$37.40
|
| Rate for Payer: VA VA |
$36.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.94
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 7
|
Facility
|
IP
|
$792.81
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$483.53 |
| Max. Negotiated Rate |
$713.53 |
| Rate for Payer: Aetna Commercial |
$673.89
|
| Rate for Payer: BCBS Trust/PPO |
$612.68
|
| Rate for Payer: BCN Commercial |
$612.68
|
| Rate for Payer: Cash Price |
$634.25
|
| Rate for Payer: Cofinity Commercial |
$681.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.25
|
| Rate for Payer: Healthscope Commercial |
$713.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$673.89
|
| Rate for Payer: PHP Commercial |
$673.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$554.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$689.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$483.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$697.67
|
| Rate for Payer: UHC Core |
$662.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.61
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 7
|
Facility
|
OP
|
$792.81
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.29 |
| Max. Negotiated Rate |
$713.53 |
| Rate for Payer: Aetna Commercial |
$673.89
|
| Rate for Payer: Aetna Medicare |
$206.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$247.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$247.75
|
| Rate for Payer: BCBS Complete |
$317.12
|
| Rate for Payer: BCBS MAPPO |
$198.20
|
| Rate for Payer: BCBS Trust/PPO |
$616.41
|
| Rate for Payer: BCN Commercial |
$616.41
|
| Rate for Payer: BCN Medicare Advantage |
$198.20
|
| Rate for Payer: Cash Price |
$634.25
|
| Rate for Payer: Cofinity Commercial |
$681.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.20
|
| Rate for Payer: Healthscope Commercial |
$713.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$208.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$227.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$673.89
|
| Rate for Payer: PACE Senior Care Partners |
$188.29
|
| Rate for Payer: PACE SWMI |
$198.20
|
| Rate for Payer: PHP Commercial |
$673.89
|
| Rate for Payer: PHP Medicare Advantage |
$198.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$554.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$689.74
|
| Rate for Payer: Priority Health Medicare |
$198.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$483.53
|
| Rate for Payer: Railroad Medicare Medicare |
$198.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$697.67
|
| Rate for Payer: UHC Core |
$662.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$204.15
|
| Rate for Payer: VA VA |
$198.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.61
|
|
|
HC CATHETER INTRADISCAL
|
Facility
|
IP
|
$1,502.05
|
|
|
Service Code
|
CPT C1754
|
| Hospital Charge Code |
27200357
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$916.10 |
| Max. Negotiated Rate |
$1,351.84 |
| Rate for Payer: Aetna Commercial |
$1,276.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,160.78
|
| Rate for Payer: BCN Commercial |
$1,160.78
|
| Rate for Payer: Cash Price |
$1,201.64
|
| Rate for Payer: Cofinity Commercial |
$1,291.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,201.64
|
| Rate for Payer: Healthscope Commercial |
$1,351.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,126.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,276.74
|
| Rate for Payer: PHP Commercial |
$1,276.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,306.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$916.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,321.80
|
| Rate for Payer: UHC Core |
$1,254.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,126.54
|
|
|
HC CATHETER INTRADISCAL
|
Facility
|
OP
|
$1,502.05
|
|
|
Service Code
|
CPT C1754
|
| Hospital Charge Code |
27200357
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$356.74 |
| Max. Negotiated Rate |
$1,351.84 |
| Rate for Payer: Aetna Commercial |
$1,276.74
|
| Rate for Payer: Aetna Medicare |
$390.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$469.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$469.39
|
| Rate for Payer: BCBS Complete |
$600.82
|
| Rate for Payer: BCBS MAPPO |
$375.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,167.84
|
| Rate for Payer: BCN Commercial |
$1,167.84
|
| Rate for Payer: BCN Medicare Advantage |
$375.51
|
| Rate for Payer: Cash Price |
$1,201.64
|
| Rate for Payer: Cofinity Commercial |
$1,291.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,201.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$375.51
|
| Rate for Payer: Healthscope Commercial |
$1,351.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,126.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$394.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$431.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,276.74
|
| Rate for Payer: PACE Senior Care Partners |
$356.74
|
| Rate for Payer: PACE SWMI |
$375.51
|
| Rate for Payer: PHP Commercial |
$1,276.74
|
| Rate for Payer: PHP Medicare Advantage |
$375.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,306.78
|
| Rate for Payer: Priority Health Medicare |
$375.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$916.10
|
| Rate for Payer: Railroad Medicare Medicare |
$375.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,321.80
|
| Rate for Payer: UHC Core |
$1,254.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$375.51
|
| Rate for Payer: UHC Medicare Advantage |
$386.78
|
| Rate for Payer: VA VA |
$375.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,126.54
|
|
|
HC CATHETERIZATION FOR COLLECTION OF SPECIMEN
|
Facility
|
IP
|
$29.58
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
30000114
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.04 |
| Max. Negotiated Rate |
$26.62 |
| Rate for Payer: Aetna Commercial |
$25.14
|
| Rate for Payer: BCBS Trust/PPO |
$22.86
|
| Rate for Payer: BCN Commercial |
$22.86
|
| Rate for Payer: Cash Price |
$23.66
|
| Rate for Payer: Cofinity Commercial |
$25.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.66
|
| Rate for Payer: Healthscope Commercial |
$26.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.14
|
| Rate for Payer: PHP Commercial |
$25.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.03
|
| Rate for Payer: UHC Core |
$24.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.18
|
|
|
HC CATHETERIZATION FOR COLLECTION OF SPECIMEN
|
Facility
|
OP
|
$29.58
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
30000114
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$26.62 |
| Rate for Payer: Aetna Commercial |
$25.14
|
| Rate for Payer: Aetna Medicare |
$7.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.24
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: BCBS MAPPO |
$7.40
|
| Rate for Payer: BCBS Trust/PPO |
$23.00
|
| Rate for Payer: BCN Commercial |
$23.00
|
| Rate for Payer: BCN Medicare Advantage |
$7.40
|
| Rate for Payer: Cash Price |
$23.66
|
| Rate for Payer: Cash Price |
$23.66
|
| Rate for Payer: Cofinity Commercial |
$25.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.40
|
| Rate for Payer: Healthscope Commercial |
$26.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.18
|
| Rate for Payer: Mclaren Medicaid |
$6.32
|
| Rate for Payer: Meridian Medicaid |
$6.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.14
|
| Rate for Payer: PACE Senior Care Partners |
$7.03
|
| Rate for Payer: PACE SWMI |
$7.40
|
| Rate for Payer: PHP Commercial |
$25.14
|
| Rate for Payer: PHP Medicare Advantage |
$7.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.73
|
| Rate for Payer: Priority Health Medicare |
$7.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.04
|
| Rate for Payer: Railroad Medicare Medicare |
$7.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.03
|
| Rate for Payer: UHC Core |
$24.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.40
|
| Rate for Payer: UHC Medicare Advantage |
$7.62
|
| Rate for Payer: VA VA |
$7.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.18
|
|
|
HC CATHETER NOS LVL 1
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$40.25 |
| Max. Negotiated Rate |
$59.40 |
| Rate for Payer: Aetna Commercial |
$56.10
|
| Rate for Payer: BCBS Trust/PPO |
$51.00
|
| Rate for Payer: BCN Commercial |
$51.00
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$56.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.80
|
| Rate for Payer: Healthscope Commercial |
$59.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.10
|
| Rate for Payer: PHP Commercial |
$56.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.08
|
| Rate for Payer: UHC Core |
$55.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.50
|
|
