|
HC AMBIT PUMP
|
Facility
|
IP
|
$657.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27200396
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$457.27 |
| Max. Negotiated Rate |
$591.30 |
| Rate for Payer: Aetna Commercial |
$558.45
|
| Rate for Payer: BCBS Trust/PPO |
$542.62
|
| Rate for Payer: BCN Commercial |
$542.62
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cofinity Commercial |
$565.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$525.60
|
| Rate for Payer: Healthscope Commercial |
$591.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$492.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$558.45
|
| Rate for Payer: Nomi Health Commercial |
$538.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$492.75
|
| Rate for Payer: PHP Commercial |
$558.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$571.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$457.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$578.16
|
| Rate for Payer: UHC Core |
$548.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$492.75
|
|
|
HC AMIKACIN LEVEL
|
Facility
|
IP
|
$80.02
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
30100006
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.69 |
| Max. Negotiated Rate |
$72.02 |
| Rate for Payer: Aetna Commercial |
$68.02
|
| Rate for Payer: BCBS Trust/PPO |
$66.09
|
| Rate for Payer: BCN Commercial |
$66.09
|
| Rate for Payer: Cash Price |
$64.02
|
| Rate for Payer: Cofinity Commercial |
$68.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.02
|
| Rate for Payer: Healthscope Commercial |
$72.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.02
|
| Rate for Payer: Nomi Health Commercial |
$65.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.02
|
| Rate for Payer: PHP Commercial |
$68.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.42
|
| Rate for Payer: UHC Core |
$66.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.02
|
|
|
HC AMIKACIN LEVEL
|
Facility
|
OP
|
$80.02
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
30100006
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.11 |
| Max. Negotiated Rate |
$72.02 |
| Rate for Payer: Aetna Commercial |
$68.02
|
| Rate for Payer: Aetna Medicare |
$20.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.01
|
| Rate for Payer: BCBS Complete |
$14.81
|
| Rate for Payer: BCBS MAPPO |
$20.00
|
| Rate for Payer: BCBS Trust/PPO |
$65.78
|
| Rate for Payer: BCN Commercial |
$65.78
|
| Rate for Payer: BCN Medicare Advantage |
$20.00
|
| Rate for Payer: Cash Price |
$64.02
|
| Rate for Payer: Cofinity Commercial |
$68.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$72.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.02
|
| Rate for Payer: Mclaren Medicaid |
$14.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.01
|
| Rate for Payer: Meridian Medicaid |
$14.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.02
|
| Rate for Payer: Nomi Health Commercial |
$65.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.02
|
| Rate for Payer: PACE Senior Care Partners |
$19.00
|
| Rate for Payer: PACE SWMI |
$20.00
|
| Rate for Payer: PHP Commercial |
$68.02
|
| Rate for Payer: PHP Medicare Advantage |
$20.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.62
|
| Rate for Payer: Priority Health Medicare |
$20.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.69
|
| Rate for Payer: Railroad Medicare Medicare |
$20.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.42
|
| Rate for Payer: UHC Core |
$66.82
|
| Rate for Payer: UHC Exchange |
$20.00
|
| Rate for Payer: UHC Medicaid |
$14.11
|
| Rate for Payer: UHC Medicare Advantage |
$20.00
|
| Rate for Payer: UHCCP Medicaid |
$14.11
|
| Rate for Payer: VA VA |
$20.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.02
|
|
|
HC AMINO ACID FRACTIONATION
|
Facility
|
OP
|
$161.30
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100091
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.44 |
| Max. Negotiated Rate |
$145.17 |
| Rate for Payer: Aetna Commercial |
$137.10
|
| Rate for Payer: Aetna Medicare |
$41.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.41
|
| Rate for Payer: BCBS Complete |
$29.86
|
| Rate for Payer: BCBS MAPPO |
$40.33
|
| Rate for Payer: BCBS Trust/PPO |
$132.60
|
| Rate for Payer: BCN Commercial |
$132.60
|
| Rate for Payer: BCN Medicare Advantage |
$40.33
|
| Rate for Payer: Cash Price |
$129.04
|
| Rate for Payer: Cofinity Commercial |
$138.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.33
|
| Rate for Payer: Healthscope Commercial |
$145.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.97
|
| Rate for Payer: Mclaren Medicaid |
$28.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.34
|
| Rate for Payer: Meridian Medicaid |
$29.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.10
|
| Rate for Payer: Nomi Health Commercial |
$132.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.97
|
| Rate for Payer: PACE Senior Care Partners |
$38.31
|
| Rate for Payer: PACE SWMI |
$40.33
|
| Rate for Payer: PHP Commercial |
$137.10
|
| Rate for Payer: PHP Medicare Advantage |
$40.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$140.33
|
| Rate for Payer: Priority Health Medicare |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.26
|
| Rate for Payer: Railroad Medicare Medicare |
$40.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.94
|
| Rate for Payer: UHC Core |
$134.69
|
| Rate for Payer: UHC Exchange |
$40.33
|
| Rate for Payer: UHC Medicaid |
$28.44
|
| Rate for Payer: UHC Medicare Advantage |
$40.33
|
| Rate for Payer: UHCCP Medicaid |
$28.44
|
| Rate for Payer: VA VA |
$40.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.97
|
|
|
HC AMINO ACID FRACTIONATION
|
Facility
|
IP
|
$161.30
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100091
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$112.26 |
| Max. Negotiated Rate |
$145.17 |
| Rate for Payer: Aetna Commercial |
$137.10
|
| Rate for Payer: BCBS Trust/PPO |
$133.22
|
| Rate for Payer: BCN Commercial |
$133.22
|
| Rate for Payer: Cash Price |
$129.04
|
| Rate for Payer: Cofinity Commercial |
$138.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.04
|
| Rate for Payer: Healthscope Commercial |
$145.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.10
|
| Rate for Payer: Nomi Health Commercial |
$132.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.97
|
| Rate for Payer: PHP Commercial |
$137.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$140.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.94
|
| Rate for Payer: UHC Core |
$134.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.97
|
|
|
HC AMINO ACID QUANT CSF
|
Facility
|
IP
|
$238.77
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100093
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$166.18 |
| Max. Negotiated Rate |
$214.89 |
| Rate for Payer: Aetna Commercial |
$202.95
|
| Rate for Payer: BCBS Trust/PPO |
$197.20
|
| Rate for Payer: BCN Commercial |
$197.20
|
| Rate for Payer: Cash Price |
$191.02
|
| Rate for Payer: Cofinity Commercial |
$205.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.02
|
| Rate for Payer: Healthscope Commercial |
$214.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.95
|
| Rate for Payer: Nomi Health Commercial |
$195.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.08
|
| Rate for Payer: PHP Commercial |
$202.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$207.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.12
|
| Rate for Payer: UHC Core |
$199.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.08
|
|
|
HC AMINO ACID QUANT CSF
|
Facility
|
OP
|
$238.77
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100093
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.10 |
| Max. Negotiated Rate |
$214.89 |
| Rate for Payer: Aetna Commercial |
$202.95
|
| Rate for Payer: Aetna Medicare |
$62.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.62
|
| Rate for Payer: BCBS Complete |
$44.20
|
| Rate for Payer: BCBS MAPPO |
$59.69
|
| Rate for Payer: BCBS Trust/PPO |
$196.29
|
| Rate for Payer: BCN Commercial |
$196.29
|
| Rate for Payer: BCN Medicare Advantage |
$59.69
|
| Rate for Payer: Cash Price |
$191.02
|
| Rate for Payer: Cofinity Commercial |
$205.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.69
|
| Rate for Payer: Healthscope Commercial |
$214.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.08
|
| Rate for Payer: Mclaren Medicaid |
$42.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.68
|
| Rate for Payer: Meridian Medicaid |
$44.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.95
|
| Rate for Payer: Nomi Health Commercial |
$195.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.08
|
| Rate for Payer: PACE Senior Care Partners |
$56.71
|
| Rate for Payer: PACE SWMI |
$59.69
|
| Rate for Payer: PHP Commercial |
$202.95
|
| Rate for Payer: PHP Medicare Advantage |
$59.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$207.73
|
| Rate for Payer: Priority Health Medicare |
$60.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.18
|
| Rate for Payer: Railroad Medicare Medicare |
$59.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.12
|
| Rate for Payer: UHC Core |
$199.37
|
| Rate for Payer: UHC Exchange |
$59.69
|
| Rate for Payer: UHC Medicaid |
$42.10
|
| Rate for Payer: UHC Medicare Advantage |
$59.69
|
| Rate for Payer: UHCCP Medicaid |
$42.10
|
| Rate for Payer: VA VA |
$59.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.08
|
|
|
HC AMINO ACID QUANT RANDOM URINE
|
Facility
|
OP
|
$217.55
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100092
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.35 |
| Max. Negotiated Rate |
$195.79 |
| Rate for Payer: Aetna Commercial |
$184.92
|
| Rate for Payer: Aetna Medicare |
$56.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.98
|
| Rate for Payer: BCBS Complete |
$40.27
|
| Rate for Payer: BCBS MAPPO |
$54.39
|
| Rate for Payer: BCBS Trust/PPO |
$178.85
|
| Rate for Payer: BCN Commercial |
$178.85
|
| Rate for Payer: BCN Medicare Advantage |
$54.39
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cofinity Commercial |
$187.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.39
|
| Rate for Payer: Healthscope Commercial |
$195.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.16
|
| Rate for Payer: Mclaren Medicaid |
$38.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.11
|
| Rate for Payer: Meridian Medicaid |
$40.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.92
|
| Rate for Payer: Nomi Health Commercial |
$178.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.16
|
| Rate for Payer: PACE Senior Care Partners |
$51.67
|
| Rate for Payer: PACE SWMI |
$54.39
|
| Rate for Payer: PHP Commercial |
$184.92
|
| Rate for Payer: PHP Medicare Advantage |
$54.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$189.27
|
| Rate for Payer: Priority Health Medicare |
$54.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.41
|
| Rate for Payer: Railroad Medicare Medicare |
$54.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.44
|
| Rate for Payer: UHC Core |
$181.65
|
| Rate for Payer: UHC Exchange |
$54.39
|
| Rate for Payer: UHC Medicaid |
$38.35
|
| Rate for Payer: UHC Medicare Advantage |
$54.39
|
| Rate for Payer: UHCCP Medicaid |
$38.35
|
| Rate for Payer: VA VA |
$54.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.16
|
|
|
HC AMINO ACID QUANT RANDOM URINE
|
Facility
|
IP
|
$217.55
|
|
|
Service Code
|
CPT 82139
|
| Hospital Charge Code |
30100092
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$151.41 |
| Max. Negotiated Rate |
$195.79 |
| Rate for Payer: Aetna Commercial |
$184.92
|
| Rate for Payer: BCBS Trust/PPO |
$179.67
|
| Rate for Payer: BCN Commercial |
$179.67
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cofinity Commercial |
$187.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.04
|
| Rate for Payer: Healthscope Commercial |
$195.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.92
|
| Rate for Payer: Nomi Health Commercial |
$178.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.16
|
| Rate for Payer: PHP Commercial |
$184.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$189.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.44
|
| Rate for Payer: UHC Core |
$181.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.16
|
|
|
HC AMINOLEVULINIC ACID URINE
|
Facility
|
IP
|
$89.47
|
|
|
Service Code
|
CPT 82135
|
| Hospital Charge Code |
30100089
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.27 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: BCBS Trust/PPO |
$73.89
|
| Rate for Payer: BCN Commercial |
$73.89
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Nomi Health Commercial |
$73.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.10
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.73
|
| Rate for Payer: UHC Core |
$74.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
HC AMINOLEVULINIC ACID URINE
|
Facility
|
OP
|
$89.47
|
|
|
Service Code
|
CPT 82135
|
| Hospital Charge Code |
30100089
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.77 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: Aetna Medicare |
$23.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.96
|
| Rate for Payer: BCBS Complete |
$16.56
|
| Rate for Payer: BCBS MAPPO |
$22.37
|
| Rate for Payer: BCBS Trust/PPO |
$73.55
|
| Rate for Payer: BCN Commercial |
$73.55
|
| Rate for Payer: BCN Medicare Advantage |
$22.37
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.37
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: Mclaren Medicaid |
$15.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.49
|
| Rate for Payer: Meridian Medicaid |
$16.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Nomi Health Commercial |
$73.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.10
|
| Rate for Payer: PACE Senior Care Partners |
$21.25
|
| Rate for Payer: PACE SWMI |
$22.37
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: PHP Medicare Advantage |
$22.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.84
|
| Rate for Payer: Priority Health Medicare |
$22.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.27
|
| Rate for Payer: Railroad Medicare Medicare |
$22.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.73
|
| Rate for Payer: UHC Core |
$74.71
|
| Rate for Payer: UHC Exchange |
$22.37
|
| Rate for Payer: UHC Medicaid |
$15.77
|
| Rate for Payer: UHC Medicare Advantage |
$22.37
|
| Rate for Payer: UHCCP Medicaid |
$15.77
|
| Rate for Payer: VA VA |
$22.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
HC AMIODARONE/CORDARONE LEVEL
|
Facility
|
IP
|
$43.13
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100287
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.02 |
| Max. Negotiated Rate |
$38.82 |
| Rate for Payer: Aetna Commercial |
$36.66
|
| Rate for Payer: BCBS Trust/PPO |
$35.62
|
| Rate for Payer: BCN Commercial |
$35.62
|
| Rate for Payer: Cash Price |
$34.50
|
| Rate for Payer: Cofinity Commercial |
$37.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.50
|
| Rate for Payer: Healthscope Commercial |
$38.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.66
|
| Rate for Payer: Nomi Health Commercial |
$35.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.35
|
| Rate for Payer: PHP Commercial |
$36.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.95
|
| Rate for Payer: UHC Core |
$36.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.35
|
|
|
HC AMIODARONE/CORDARONE LEVEL
|
Facility
|
OP
|
$43.13
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100287
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$38.82 |
| Rate for Payer: Aetna Commercial |
$36.66
|
| Rate for Payer: Aetna Medicare |
$11.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.48
|
| Rate for Payer: BCBS Complete |
$7.98
|
| Rate for Payer: BCBS MAPPO |
$10.78
|
| Rate for Payer: BCBS Trust/PPO |
$35.46
|
| Rate for Payer: BCN Commercial |
$35.46
|
| Rate for Payer: BCN Medicare Advantage |
$10.78
|
| Rate for Payer: Cash Price |
$34.50
|
| Rate for Payer: Cofinity Commercial |
$37.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.78
|
| Rate for Payer: Healthscope Commercial |
$38.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.35
|
| Rate for Payer: Mclaren Medicaid |
$7.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.32
|
| Rate for Payer: Meridian Medicaid |
$7.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.66
|
| Rate for Payer: Nomi Health Commercial |
$35.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.35
|
| Rate for Payer: PACE Senior Care Partners |
$10.24
|
| Rate for Payer: PACE SWMI |
$10.78
|
| Rate for Payer: PHP Commercial |
$36.66
|
| Rate for Payer: PHP Medicare Advantage |
$10.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.52
|
| Rate for Payer: Priority Health Medicare |
$10.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.02
|
| Rate for Payer: Railroad Medicare Medicare |
$10.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.95
|
| Rate for Payer: UHC Core |
$36.01
|
| Rate for Payer: UHC Exchange |
$10.78
|
| Rate for Payer: UHC Medicaid |
$7.60
|
| Rate for Payer: UHC Medicare Advantage |
$10.78
|
| Rate for Payer: UHCCP Medicaid |
$7.60
|
| Rate for Payer: VA VA |
$10.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.35
|
|
|
HC AMITRIPTYLINE
|
Facility
|
OP
|
$44.74
|
|
|
Service Code
|
CPT 80335
|
| Hospital Charge Code |
30100563
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.89 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: Aetna Medicare |
$11.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.98
|
| Rate for Payer: BCBS Complete |
$8.28
|
| Rate for Payer: BCBS MAPPO |
$11.19
|
| Rate for Payer: BCBS Trust/PPO |
$36.78
|
| Rate for Payer: BCN Commercial |
$36.78
|
| Rate for Payer: BCN Medicare Advantage |
$11.19
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.19
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.55
|
| Rate for Payer: Mclaren Medicaid |
$7.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.74
|
| Rate for Payer: Meridian Medicaid |
$8.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.55
|
| Rate for Payer: PACE Senior Care Partners |
$10.63
|
| Rate for Payer: PACE SWMI |
$11.19
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: PHP Medicare Advantage |
$11.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.92
|
| Rate for Payer: Priority Health Medicare |
$11.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.14
|
| Rate for Payer: Railroad Medicare Medicare |
$11.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.37
|
| Rate for Payer: UHC Core |
$37.36
|
| Rate for Payer: UHC Exchange |
$11.19
|
| Rate for Payer: UHC Medicaid |
$7.89
|
| Rate for Payer: UHC Medicare Advantage |
$11.19
|
| Rate for Payer: UHCCP Medicaid |
$7.89
|
| Rate for Payer: VA VA |
$11.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.55
|
|
|
HC AMITRIPTYLINE
|
Facility
|
IP
|
$44.74
|
|
|
Service Code
|
CPT 80335
|
| Hospital Charge Code |
30100563
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.14 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: BCBS Trust/PPO |
$36.95
|
| Rate for Payer: BCN Commercial |
$36.95
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.55
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.37
|
| Rate for Payer: UHC Core |
$37.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.55
|
|
|
HC AMMONIA LEVEL
|
Facility
|
OP
|
$50.94
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
30100094
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.92
|
| Rate for Payer: BCBS Complete |
$9.43
|
| Rate for Payer: BCBS MAPPO |
$12.73
|
| Rate for Payer: BCBS Trust/PPO |
$41.88
|
| Rate for Payer: BCN Commercial |
$41.88
|
| Rate for Payer: BCN Medicare Advantage |
$12.73
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.73
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$8.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.37
|
| Rate for Payer: Meridian Medicaid |
$9.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$41.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PACE Senior Care Partners |
$12.10
|
| Rate for Payer: PACE SWMI |
$12.73
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: PHP Medicare Advantage |
$12.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.32
|
| Rate for Payer: Priority Health Medicare |
$12.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.45
|
| Rate for Payer: Railroad Medicare Medicare |
$12.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.83
|
| Rate for Payer: UHC Core |
$42.53
|
| Rate for Payer: UHC Exchange |
$12.73
|
| Rate for Payer: UHC Medicaid |
$8.98
|
| Rate for Payer: UHC Medicare Advantage |
$12.73
|
| Rate for Payer: UHCCP Medicaid |
$8.98
|
| Rate for Payer: VA VA |
$12.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.20
|
|
|
HC AMMONIA LEVEL
|
Facility
|
IP
|
$50.94
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
30100094
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.45 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: BCBS Trust/PPO |
$42.07
|
| Rate for Payer: BCN Commercial |
$42.07
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$41.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.83
|
| Rate for Payer: UHC Core |
$42.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.20
|
|
|
HC AMNIOCENTESIS
|
Facility
|
IP
|
$832.87
|
|
|
Service Code
|
CPT 59001
|
| Hospital Charge Code |
76100006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$579.68 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: BCBS Trust/PPO |
$687.87
|
| Rate for Payer: BCN Commercial |
$687.87
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$624.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$682.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$724.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$732.93
|
| Rate for Payer: UHC Core |
$695.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$624.65
|
|
|
HC AMNIOCENTESIS
|
Facility
|
OP
|
$832.87
|
|
|
Service Code
|
CPT 59001
|
| Hospital Charge Code |
76100006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$146.83 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna Medicare |
$216.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$260.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$260.27
|
| Rate for Payer: BCBS Complete |
$154.16
|
| Rate for Payer: BCBS MAPPO |
$208.22
|
| Rate for Payer: BCBS Trust/PPO |
$684.70
|
| Rate for Payer: BCN Commercial |
$684.70
|
| Rate for Payer: BCN Medicare Advantage |
$208.22
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.22
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$624.65
|
| Rate for Payer: Mclaren Medicaid |
$146.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$218.63
|
| Rate for Payer: Meridian Medicaid |
$154.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$239.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$229.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$682.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PACE Senior Care Partners |
$197.81
|
| Rate for Payer: PACE SWMI |
$208.22
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: PHP Medicare Advantage |
$208.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$724.60
|
| Rate for Payer: Priority Health Medicare |
$210.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.68
|
| Rate for Payer: Railroad Medicare Medicare |
$208.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$732.93
|
| Rate for Payer: UHC Core |
$695.45
|
| Rate for Payer: UHC Exchange |
$208.22
|
| Rate for Payer: UHC Medicaid |
$146.83
|
| Rate for Payer: UHC Medicare Advantage |
$208.22
|
| Rate for Payer: UHCCP Medicaid |
$146.83
|
| Rate for Payer: VA VA |
$208.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$624.65
|
|
|
HC AMNIOCENTESIS DIAGNOSTIC
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 59000
|
| Hospital Charge Code |
36100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$78.70 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna Medicare |
$116.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.49
|
| Rate for Payer: BCBS Complete |
$82.62
|
| Rate for Payer: BCBS MAPPO |
$111.59
|
| Rate for Payer: BCBS Trust/PPO |
$366.97
|
| Rate for Payer: BCN Commercial |
$366.97
|
| Rate for Payer: BCN Medicare Advantage |
$111.59
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.59
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Mclaren Medicaid |
$78.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.17
|
| Rate for Payer: Meridian Medicaid |
$82.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$122.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PACE Senior Care Partners |
$106.02
|
| Rate for Payer: PACE SWMI |
$111.59
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: PHP Medicare Advantage |
$111.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.35
|
| Rate for Payer: Priority Health Medicare |
$112.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.68
|
| Rate for Payer: Railroad Medicare Medicare |
$111.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.81
|
| Rate for Payer: UHC Core |
$372.73
|
| Rate for Payer: UHC Exchange |
$111.59
|
| Rate for Payer: UHC Medicaid |
$78.70
|
| Rate for Payer: UHC Medicare Advantage |
$111.59
|
| Rate for Payer: UHCCP Medicaid |
$78.70
|
| Rate for Payer: VA VA |
$111.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC AMNIOCENTESIS DIAGNOSTIC
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 59000
|
| Hospital Charge Code |
36100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$310.68 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: BCBS Trust/PPO |
$368.67
|
| Rate for Payer: BCN Commercial |
$368.67
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$366.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$388.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.81
|
| Rate for Payer: UHC Core |
$372.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC AMNIOINFUSION
|
Facility
|
IP
|
$586.12
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
76100007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$407.94 |
| Max. Negotiated Rate |
$527.51 |
| Rate for Payer: Aetna Commercial |
$498.20
|
| Rate for Payer: BCBS Trust/PPO |
$484.08
|
| Rate for Payer: BCN Commercial |
$484.08
|
| Rate for Payer: Cash Price |
$468.90
|
| Rate for Payer: Cofinity Commercial |
$504.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.90
|
| Rate for Payer: Healthscope Commercial |
$527.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$439.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$498.20
|
| Rate for Payer: Nomi Health Commercial |
$480.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$439.59
|
| Rate for Payer: PHP Commercial |
$498.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$509.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$407.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$515.79
|
| Rate for Payer: UHC Core |
$489.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$439.59
|
|
|
HC AMNIOINFUSION
|
Facility
|
OP
|
$586.12
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
76100007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.33 |
| Max. Negotiated Rate |
$527.51 |
| Rate for Payer: Aetna Commercial |
$498.20
|
| Rate for Payer: Aetna Medicare |
$152.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$183.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$183.16
|
| Rate for Payer: BCBS Complete |
$108.49
|
| Rate for Payer: BCBS MAPPO |
$146.53
|
| Rate for Payer: BCBS Trust/PPO |
$481.85
|
| Rate for Payer: BCN Commercial |
$481.85
|
| Rate for Payer: BCN Medicare Advantage |
$146.53
|
| Rate for Payer: Cash Price |
$468.90
|
| Rate for Payer: Cofinity Commercial |
$504.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.53
|
| Rate for Payer: Healthscope Commercial |
$527.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$439.59
|
| Rate for Payer: Mclaren Medicaid |
$103.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.86
|
| Rate for Payer: Meridian Medicaid |
$108.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$168.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$498.20
|
| Rate for Payer: Nomi Health Commercial |
$480.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$439.59
|
| Rate for Payer: PACE Senior Care Partners |
$139.20
|
| Rate for Payer: PACE SWMI |
$146.53
|
| Rate for Payer: PHP Commercial |
$498.20
|
| Rate for Payer: PHP Medicare Advantage |
$146.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$509.92
|
| Rate for Payer: Priority Health Medicare |
$148.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$407.94
|
| Rate for Payer: Railroad Medicare Medicare |
$146.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$515.79
|
| Rate for Payer: UHC Core |
$489.41
|
| Rate for Payer: UHC Exchange |
$146.53
|
| Rate for Payer: UHC Medicaid |
$103.33
|
| Rate for Payer: UHC Medicare Advantage |
$146.53
|
| Rate for Payer: UHCCP Medicaid |
$103.33
|
| Rate for Payer: VA VA |
$146.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$439.59
|
|
|
HC AMNIOTIC FLUID DELTA OD
|
Facility
|
OP
|
$71.89
|
|
|
Service Code
|
CPT 82143
|
| Hospital Charge Code |
30100095
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.67 |
| Max. Negotiated Rate |
$64.70 |
| Rate for Payer: Aetna Commercial |
$61.11
|
| Rate for Payer: Aetna Medicare |
$18.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.47
|
| Rate for Payer: BCBS Complete |
$13.31
|
| Rate for Payer: BCBS MAPPO |
$17.97
|
| Rate for Payer: BCBS Trust/PPO |
$59.10
|
| Rate for Payer: BCN Commercial |
$59.10
|
| Rate for Payer: BCN Medicare Advantage |
$17.97
|
| Rate for Payer: Cash Price |
$57.51
|
| Rate for Payer: Cofinity Commercial |
$61.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.97
|
| Rate for Payer: Healthscope Commercial |
$64.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.92
|
| Rate for Payer: Mclaren Medicaid |
$12.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.87
|
| Rate for Payer: Meridian Medicaid |
$13.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.11
|
| Rate for Payer: Nomi Health Commercial |
$58.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.92
|
| Rate for Payer: PACE Senior Care Partners |
$17.07
|
| Rate for Payer: PACE SWMI |
$17.97
|
| Rate for Payer: PHP Commercial |
$61.11
|
| Rate for Payer: PHP Medicare Advantage |
$17.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.54
|
| Rate for Payer: Priority Health Medicare |
$18.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.04
|
| Rate for Payer: Railroad Medicare Medicare |
$17.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.26
|
| Rate for Payer: UHC Core |
$60.03
|
| Rate for Payer: UHC Exchange |
$17.97
|
| Rate for Payer: UHC Medicaid |
$12.67
|
| Rate for Payer: UHC Medicare Advantage |
$17.97
|
| Rate for Payer: UHCCP Medicaid |
$12.67
|
| Rate for Payer: VA VA |
$17.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.92
|
|
|
HC AMNIOTIC FLUID DELTA OD
|
Facility
|
IP
|
$71.89
|
|
|
Service Code
|
CPT 82143
|
| Hospital Charge Code |
30100095
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.04 |
| Max. Negotiated Rate |
$64.70 |
| Rate for Payer: Aetna Commercial |
$61.11
|
| Rate for Payer: BCBS Trust/PPO |
$59.37
|
| Rate for Payer: BCN Commercial |
$59.37
|
| Rate for Payer: Cash Price |
$57.51
|
| Rate for Payer: Cofinity Commercial |
$61.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.51
|
| Rate for Payer: Healthscope Commercial |
$64.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.11
|
| Rate for Payer: Nomi Health Commercial |
$58.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.92
|
| Rate for Payer: PHP Commercial |
$61.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.26
|
| Rate for Payer: UHC Core |
$60.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.92
|
|
