|
HC CONNECTOR Y
|
Facility
|
IP
|
$5.25
|
|
| Hospital Charge Code |
27000048
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: BCBS Trust/PPO |
$4.06
|
| Rate for Payer: BCN Commercial |
$4.06
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$4.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.46
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.62
|
| Rate for Payer: UHC Core |
$4.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
HC CONNECTOR Y
|
Facility
|
OP
|
$5.25
|
|
| Hospital Charge Code |
27000048
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna Medicare |
$1.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.64
|
| Rate for Payer: BCBS Complete |
$2.10
|
| Rate for Payer: BCBS MAPPO |
$1.31
|
| Rate for Payer: BCBS Trust/PPO |
$4.08
|
| Rate for Payer: BCN Commercial |
$4.08
|
| Rate for Payer: BCN Medicare Advantage |
$1.31
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$4.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.31
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.46
|
| Rate for Payer: PACE Senior Care Partners |
$1.25
|
| Rate for Payer: PACE SWMI |
$1.31
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: PHP Medicare Advantage |
$1.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.57
|
| Rate for Payer: Priority Health Medicare |
$1.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.62
|
| Rate for Payer: UHC Core |
$4.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.31
|
| Rate for Payer: UHC Medicare Advantage |
$1.35
|
| Rate for Payer: VA VA |
$1.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
HC CONSULT NUTRITIONAL
|
Facility
|
IP
|
$34.27
|
|
| Hospital Charge Code |
94200010
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$20.90 |
| Max. Negotiated Rate |
$30.84 |
| Rate for Payer: Aetna Commercial |
$29.13
|
| Rate for Payer: BCBS Trust/PPO |
$26.48
|
| Rate for Payer: BCN Commercial |
$26.48
|
| Rate for Payer: Cash Price |
$27.42
|
| Rate for Payer: Cofinity Commercial |
$29.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.42
|
| Rate for Payer: Healthscope Commercial |
$30.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.13
|
| Rate for Payer: PHP Commercial |
$29.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.16
|
| Rate for Payer: UHC Core |
$28.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.70
|
|
|
HC CONSULT NUTRITIONAL
|
Facility
|
OP
|
$34.27
|
|
| Hospital Charge Code |
94200010
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$8.14 |
| Max. Negotiated Rate |
$30.84 |
| Rate for Payer: Aetna Commercial |
$29.13
|
| Rate for Payer: Aetna Medicare |
$8.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.71
|
| Rate for Payer: BCBS Complete |
$13.71
|
| Rate for Payer: BCBS MAPPO |
$8.57
|
| Rate for Payer: BCBS Trust/PPO |
$26.64
|
| Rate for Payer: BCN Commercial |
$26.64
|
| Rate for Payer: BCN Medicare Advantage |
$8.57
|
| Rate for Payer: Cash Price |
$27.42
|
| Rate for Payer: Cofinity Commercial |
$29.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.57
|
| Rate for Payer: Healthscope Commercial |
$30.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.13
|
| Rate for Payer: PACE Senior Care Partners |
$8.14
|
| Rate for Payer: PACE SWMI |
$8.57
|
| Rate for Payer: PHP Commercial |
$29.13
|
| Rate for Payer: PHP Medicare Advantage |
$8.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.81
|
| Rate for Payer: Priority Health Medicare |
$8.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.90
|
| Rate for Payer: Railroad Medicare Medicare |
$8.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.16
|
| Rate for Payer: UHC Core |
$28.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.57
|
| Rate for Payer: UHC Medicare Advantage |
$8.82
|
| Rate for Payer: VA VA |
$8.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.70
|
|
|
HC CONT GLUCOSE MONITOR OFFICE EQUIP
|
Facility
|
IP
|
$965.28
|
|
|
Service Code
|
CPT 95250
|
| Hospital Charge Code |
94200001
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$588.72 |
| Max. Negotiated Rate |
$868.75 |
| Rate for Payer: Aetna Commercial |
$820.49
|
| Rate for Payer: BCBS Trust/PPO |
$745.97
|
| Rate for Payer: BCN Commercial |
$745.97
|
| Rate for Payer: Cash Price |
$772.22
|
| Rate for Payer: Cofinity Commercial |
$830.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$772.22
|
| Rate for Payer: Healthscope Commercial |
$868.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$820.49
|
| Rate for Payer: PHP Commercial |
$820.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$588.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$849.45
|
| Rate for Payer: UHC Core |
$806.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.96
|
|
|
HC CONT GLUCOSE MONITOR OFFICE EQUIP
|
Facility
|
OP
|
$965.28
|
|
|
Service Code
|
CPT 95250
|
| Hospital Charge Code |
94200001
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$86.72 |
| Max. Negotiated Rate |
$868.75 |
| Rate for Payer: Aetna Commercial |
$820.49
|
| Rate for Payer: Aetna Medicare |
$250.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$301.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$301.65
|
| Rate for Payer: BCBS Complete |
$91.05
|
| Rate for Payer: BCBS MAPPO |
$241.32
|
| Rate for Payer: BCBS Trust/PPO |
$750.51
|
| Rate for Payer: BCN Commercial |
$750.51
|
| Rate for Payer: BCN Medicare Advantage |
$241.32
|
| Rate for Payer: Cash Price |
$772.22
|
| Rate for Payer: Cash Price |
$772.22
|
| Rate for Payer: Cofinity Commercial |
$830.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$772.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.32
|
| Rate for Payer: Healthscope Commercial |
$868.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.96
|
| Rate for Payer: Mclaren Medicaid |
$86.72
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$253.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$277.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$820.49
|
| Rate for Payer: PACE Senior Care Partners |
$229.25
|
| Rate for Payer: PACE SWMI |
$241.32
|
| Rate for Payer: PHP Commercial |
$820.49
|
| Rate for Payer: PHP Medicare Advantage |
$241.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$839.79
|
| Rate for Payer: Priority Health Medicare |
$241.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$588.72
|
| Rate for Payer: Railroad Medicare Medicare |
$241.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$849.45
|
| Rate for Payer: UHC Core |
$806.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$241.32
|
| Rate for Payer: UHC Medicare Advantage |
$248.56
|
| Rate for Payer: VA VA |
$241.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.96
|
|
|
HC CONT GLUCOSE MONITOR PATIENT EQUIP
|
Facility
|
IP
|
$376.90
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
94200038
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$229.87 |
| Max. Negotiated Rate |
$339.21 |
| Rate for Payer: Aetna Commercial |
$320.36
|
| Rate for Payer: BCBS Trust/PPO |
$291.27
|
| Rate for Payer: BCN Commercial |
$291.27
|
| Rate for Payer: Cash Price |
$301.52
|
| Rate for Payer: Cofinity Commercial |
$324.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.52
|
| Rate for Payer: Healthscope Commercial |
$339.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$282.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$320.36
|
| Rate for Payer: PHP Commercial |
$320.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$229.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$331.67
|
| Rate for Payer: UHC Core |
$314.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$282.68
|
|
|
HC CONT GLUCOSE MONITOR PATIENT EQUIP
|
Facility
|
OP
|
$376.90
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
94200038
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$40.13 |
| Max. Negotiated Rate |
$339.21 |
| Rate for Payer: Aetna Commercial |
$320.36
|
| Rate for Payer: Aetna Medicare |
$97.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$117.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$117.78
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$94.22
|
| Rate for Payer: BCBS Trust/PPO |
$293.04
|
| Rate for Payer: BCN Commercial |
$293.04
|
| Rate for Payer: BCN Medicare Advantage |
$94.22
|
| Rate for Payer: Cash Price |
$301.52
|
| Rate for Payer: Cash Price |
$301.52
|
| Rate for Payer: Cofinity Commercial |
$324.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.22
|
| Rate for Payer: Healthscope Commercial |
$339.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$282.68
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$320.36
|
| Rate for Payer: PACE Senior Care Partners |
$89.51
|
| Rate for Payer: PACE SWMI |
$94.22
|
| Rate for Payer: PHP Commercial |
$320.36
|
| Rate for Payer: PHP Medicare Advantage |
$94.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.90
|
| Rate for Payer: Priority Health Medicare |
$94.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$229.87
|
| Rate for Payer: Railroad Medicare Medicare |
$94.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$331.67
|
| Rate for Payer: UHC Core |
$314.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.22
|
| Rate for Payer: UHC Medicare Advantage |
$97.05
|
| Rate for Payer: VA VA |
$94.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$282.68
|
|
|
HC CONTINUOUS NEB SUBSEQUENT HR
|
Facility
|
IP
|
$102.48
|
|
|
Service Code
|
CPT 94645
|
| Hospital Charge Code |
41000007
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$62.50 |
| Max. Negotiated Rate |
$92.23 |
| Rate for Payer: Aetna Commercial |
$87.11
|
| Rate for Payer: BCBS Trust/PPO |
$79.20
|
| Rate for Payer: BCN Commercial |
$79.20
|
| Rate for Payer: Cash Price |
$81.98
|
| Rate for Payer: Cofinity Commercial |
$88.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.98
|
| Rate for Payer: Healthscope Commercial |
$92.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.11
|
| Rate for Payer: PHP Commercial |
$87.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.18
|
| Rate for Payer: UHC Core |
$85.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.86
|
|
|
HC CONTINUOUS NEB SUBSEQUENT HR
|
Facility
|
OP
|
$102.48
|
|
|
Service Code
|
CPT 94645
|
| Hospital Charge Code |
41000007
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$24.34 |
| Max. Negotiated Rate |
$92.23 |
| Rate for Payer: Aetna Commercial |
$87.11
|
| Rate for Payer: Aetna Medicare |
$26.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.02
|
| Rate for Payer: BCBS Complete |
$40.99
|
| Rate for Payer: BCBS MAPPO |
$25.62
|
| Rate for Payer: BCBS Trust/PPO |
$79.68
|
| Rate for Payer: BCN Commercial |
$79.68
|
| Rate for Payer: BCN Medicare Advantage |
$25.62
|
| Rate for Payer: Cash Price |
$81.98
|
| Rate for Payer: Cofinity Commercial |
$88.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.62
|
| Rate for Payer: Healthscope Commercial |
$92.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.11
|
| Rate for Payer: PACE Senior Care Partners |
$24.34
|
| Rate for Payer: PACE SWMI |
$25.62
|
| Rate for Payer: PHP Commercial |
$87.11
|
| Rate for Payer: PHP Medicare Advantage |
$25.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.16
|
| Rate for Payer: Priority Health Medicare |
$25.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.50
|
| Rate for Payer: Railroad Medicare Medicare |
$25.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.18
|
| Rate for Payer: UHC Core |
$85.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.62
|
| Rate for Payer: UHC Medicare Advantage |
$26.39
|
| Rate for Payer: VA VA |
$25.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.86
|
|
|
HC CONTINUOUS NEB TX INITIAL HOUR
|
Facility
|
IP
|
$368.06
|
|
|
Service Code
|
CPT 94644
|
| Hospital Charge Code |
41000006
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$224.48 |
| Max. Negotiated Rate |
$331.25 |
| Rate for Payer: Aetna Commercial |
$312.85
|
| Rate for Payer: BCBS Trust/PPO |
$284.44
|
| Rate for Payer: BCN Commercial |
$284.44
|
| Rate for Payer: Cash Price |
$294.45
|
| Rate for Payer: Cofinity Commercial |
$316.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.45
|
| Rate for Payer: Healthscope Commercial |
$331.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.85
|
| Rate for Payer: PHP Commercial |
$312.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.89
|
| Rate for Payer: UHC Core |
$307.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.04
|
|
|
HC CONTINUOUS NEB TX INITIAL HOUR
|
Facility
|
OP
|
$368.06
|
|
|
Service Code
|
CPT 94644
|
| Hospital Charge Code |
41000006
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$83.80 |
| Max. Negotiated Rate |
$331.25 |
| Rate for Payer: Aetna Commercial |
$312.85
|
| Rate for Payer: Aetna Medicare |
$95.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.02
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$92.02
|
| Rate for Payer: BCBS Trust/PPO |
$286.17
|
| Rate for Payer: BCN Commercial |
$286.17
|
| Rate for Payer: BCN Medicare Advantage |
$92.02
|
| Rate for Payer: Cash Price |
$294.45
|
| Rate for Payer: Cash Price |
$294.45
|
| Rate for Payer: Cofinity Commercial |
$316.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.02
|
| Rate for Payer: Healthscope Commercial |
$331.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.04
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$96.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.85
|
| Rate for Payer: PACE Senior Care Partners |
$87.41
|
| Rate for Payer: PACE SWMI |
$92.02
|
| Rate for Payer: PHP Commercial |
$312.85
|
| Rate for Payer: PHP Medicare Advantage |
$92.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.21
|
| Rate for Payer: Priority Health Medicare |
$92.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.48
|
| Rate for Payer: Railroad Medicare Medicare |
$92.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.89
|
| Rate for Payer: UHC Core |
$307.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.02
|
| Rate for Payer: UHC Medicare Advantage |
$94.78
|
| Rate for Payer: VA VA |
$92.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.04
|
|
|
HC CONT PHYSICS CONSULT
|
Facility
|
IP
|
$573.24
|
|
|
Service Code
|
CPT 77336
|
| Hospital Charge Code |
33300015
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$349.62 |
| Max. Negotiated Rate |
$515.92 |
| Rate for Payer: Aetna Commercial |
$487.25
|
| Rate for Payer: Aetna Commercial |
$561.85
|
| Rate for Payer: BCBS Trust/PPO |
$510.82
|
| Rate for Payer: BCBS Trust/PPO |
$443.00
|
| Rate for Payer: BCN Commercial |
$510.82
|
| Rate for Payer: BCN Commercial |
$443.00
|
| Rate for Payer: Cash Price |
$528.80
|
| Rate for Payer: Cash Price |
$458.59
|
| Rate for Payer: Cofinity Commercial |
$568.46
|
| Rate for Payer: Cofinity Commercial |
$492.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.59
|
| Rate for Payer: Healthscope Commercial |
$515.92
|
| Rate for Payer: Healthscope Commercial |
$594.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$495.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$561.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$487.25
|
| Rate for Payer: PHP Commercial |
$487.25
|
| Rate for Payer: PHP Commercial |
$561.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$498.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$575.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$349.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$581.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.45
|
| Rate for Payer: UHC Core |
$478.66
|
| Rate for Payer: UHC Core |
$551.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$495.75
|
|
|
HC CONT PHYSICS CONSULT
|
Facility
|
OP
|
$661.00
|
|
|
Service Code
|
CPT 77336
|
| Hospital Charge Code |
33300015
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$89.01 |
| Max. Negotiated Rate |
$594.90 |
| Rate for Payer: Aetna Commercial |
$561.85
|
| Rate for Payer: Aetna Commercial |
$487.25
|
| Rate for Payer: Aetna Medicare |
$149.04
|
| Rate for Payer: Aetna Medicare |
$171.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$206.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$206.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.14
|
| Rate for Payer: BCBS Complete |
$93.46
|
| Rate for Payer: BCBS Complete |
$93.46
|
| Rate for Payer: BCBS MAPPO |
$165.25
|
| Rate for Payer: BCBS MAPPO |
$143.31
|
| Rate for Payer: BCBS Trust/PPO |
$445.69
|
| Rate for Payer: BCBS Trust/PPO |
$513.93
|
| Rate for Payer: BCN Commercial |
$513.93
|
| Rate for Payer: BCN Commercial |
$445.69
|
| Rate for Payer: BCN Medicare Advantage |
$143.31
|
| Rate for Payer: BCN Medicare Advantage |
$165.25
|
| Rate for Payer: Cash Price |
$528.80
|
| Rate for Payer: Cash Price |
$458.59
|
| Rate for Payer: Cash Price |
$528.80
|
| Rate for Payer: Cash Price |
$458.59
|
| Rate for Payer: Cofinity Commercial |
$568.46
|
| Rate for Payer: Cofinity Commercial |
$492.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.31
|
| Rate for Payer: Healthscope Commercial |
$594.90
|
| Rate for Payer: Healthscope Commercial |
$515.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$495.75
|
| Rate for Payer: Mclaren Medicaid |
$89.01
|
| Rate for Payer: Mclaren Medicaid |
$89.01
|
| Rate for Payer: Meridian Medicaid |
$93.46
|
| Rate for Payer: Meridian Medicaid |
$93.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$173.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$190.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$561.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$487.25
|
| Rate for Payer: PACE Senior Care Partners |
$136.14
|
| Rate for Payer: PACE Senior Care Partners |
$156.99
|
| Rate for Payer: PACE SWMI |
$165.25
|
| Rate for Payer: PACE SWMI |
$143.31
|
| Rate for Payer: PHP Commercial |
$487.25
|
| Rate for Payer: PHP Commercial |
$561.85
|
| Rate for Payer: PHP Medicare Advantage |
$165.25
|
| Rate for Payer: PHP Medicare Advantage |
$143.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$498.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$575.07
|
| Rate for Payer: Priority Health Medicare |
$143.31
|
| Rate for Payer: Priority Health Medicare |
$165.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$349.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$403.14
|
| Rate for Payer: Railroad Medicare Medicare |
$165.25
|
| Rate for Payer: Railroad Medicare Medicare |
$143.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$581.68
|
| Rate for Payer: UHC Core |
$478.66
|
| Rate for Payer: UHC Core |
$551.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.31
|
| Rate for Payer: UHC Medicare Advantage |
$170.21
|
| Rate for Payer: UHC Medicare Advantage |
$147.61
|
| Rate for Payer: VA VA |
$143.31
|
| Rate for Payer: VA VA |
$165.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$495.75
|
|
|
HC CONTRAST BATHS EACH 15 MIN
|
Facility
|
OP
|
$103.70
|
|
|
Service Code
|
CPT 97034
|
| Hospital Charge Code |
42000017
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$24.63 |
| Max. Negotiated Rate |
$93.33 |
| Rate for Payer: Aetna Commercial |
$88.14
|
| Rate for Payer: Aetna Medicare |
$26.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.41
|
| Rate for Payer: BCBS Complete |
$41.48
|
| Rate for Payer: BCBS MAPPO |
$25.92
|
| Rate for Payer: BCBS Trust/PPO |
$80.63
|
| Rate for Payer: BCN Commercial |
$80.63
|
| Rate for Payer: BCN Medicare Advantage |
$25.92
|
| Rate for Payer: Cash Price |
$82.96
|
| Rate for Payer: Cofinity Commercial |
$89.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.92
|
| Rate for Payer: Healthscope Commercial |
$93.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.14
|
| Rate for Payer: PACE Senior Care Partners |
$24.63
|
| Rate for Payer: PACE SWMI |
$25.92
|
| Rate for Payer: PHP Commercial |
$88.14
|
| Rate for Payer: PHP Medicare Advantage |
$25.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.22
|
| Rate for Payer: Priority Health Medicare |
$25.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.25
|
| Rate for Payer: Railroad Medicare Medicare |
$25.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.26
|
| Rate for Payer: UHC Core |
$86.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.92
|
| Rate for Payer: UHC Medicare Advantage |
$26.70
|
| Rate for Payer: VA VA |
$25.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.78
|
|
|
HC CONTRAST BATHS EACH 15 MIN
|
Facility
|
IP
|
$103.70
|
|
|
Service Code
|
CPT 97034
|
| Hospital Charge Code |
42000017
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$63.25 |
| Max. Negotiated Rate |
$93.33 |
| Rate for Payer: Aetna Commercial |
$88.14
|
| Rate for Payer: BCBS Trust/PPO |
$80.14
|
| Rate for Payer: BCN Commercial |
$80.14
|
| Rate for Payer: Cash Price |
$82.96
|
| Rate for Payer: Cofinity Commercial |
$89.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.96
|
| Rate for Payer: Healthscope Commercial |
$93.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.14
|
| Rate for Payer: PHP Commercial |
$88.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.26
|
| Rate for Payer: UHC Core |
$86.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.78
|
|
|
HC CONTROL NOSEBLEED ANTERIOR SIMPLE
|
Facility
|
OP
|
$406.51
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
45000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$83.80 |
| Max. Negotiated Rate |
$365.86 |
| Rate for Payer: Aetna Commercial |
$345.53
|
| Rate for Payer: Aetna Medicare |
$105.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$127.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$127.03
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$101.63
|
| Rate for Payer: BCBS Trust/PPO |
$316.06
|
| Rate for Payer: BCN Commercial |
$316.06
|
| Rate for Payer: BCN Medicare Advantage |
$101.63
|
| Rate for Payer: Cash Price |
$325.21
|
| Rate for Payer: Cash Price |
$325.21
|
| Rate for Payer: Cofinity Commercial |
$349.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.63
|
| Rate for Payer: Healthscope Commercial |
$365.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.88
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$106.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$345.53
|
| Rate for Payer: PACE Senior Care Partners |
$96.55
|
| Rate for Payer: PACE SWMI |
$101.63
|
| Rate for Payer: PHP Commercial |
$345.53
|
| Rate for Payer: PHP Medicare Advantage |
$101.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$353.66
|
| Rate for Payer: Priority Health Medicare |
$101.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$247.93
|
| Rate for Payer: Railroad Medicare Medicare |
$101.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$357.73
|
| Rate for Payer: UHC Core |
$339.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.63
|
| Rate for Payer: UHC Medicare Advantage |
$104.68
|
| Rate for Payer: VA VA |
$101.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.88
|
|
|
HC CONTROL NOSEBLEED ANTERIOR SIMPLE
|
Facility
|
IP
|
$406.51
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
45000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$247.93 |
| Max. Negotiated Rate |
$365.86 |
| Rate for Payer: Aetna Commercial |
$345.53
|
| Rate for Payer: BCBS Trust/PPO |
$314.15
|
| Rate for Payer: BCN Commercial |
$314.15
|
| Rate for Payer: Cash Price |
$325.21
|
| Rate for Payer: Cofinity Commercial |
$349.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.21
|
| Rate for Payer: Healthscope Commercial |
$365.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$345.53
|
| Rate for Payer: PHP Commercial |
$345.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$353.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$247.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$357.73
|
| Rate for Payer: UHC Core |
$339.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.88
|
|
|
HC CONTROL OROPHARYNGEAL HEM SIMPLE
|
Facility
|
IP
|
$738.99
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
45000100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$450.71 |
| Max. Negotiated Rate |
$665.09 |
| Rate for Payer: Aetna Commercial |
$628.14
|
| Rate for Payer: BCBS Trust/PPO |
$571.09
|
| Rate for Payer: BCN Commercial |
$571.09
|
| Rate for Payer: Cash Price |
$591.19
|
| Rate for Payer: Cofinity Commercial |
$635.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$591.19
|
| Rate for Payer: Healthscope Commercial |
$665.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$554.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$628.14
|
| Rate for Payer: PHP Commercial |
$628.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$642.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$450.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$650.31
|
| Rate for Payer: UHC Core |
$617.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$554.24
|
|
|
HC CONTROL OROPHARYNGEAL HEM SIMPLE
|
Facility
|
OP
|
$738.99
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
45000100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$175.51 |
| Max. Negotiated Rate |
$665.09 |
| Rate for Payer: Aetna Commercial |
$628.14
|
| Rate for Payer: Aetna Medicare |
$192.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$230.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$230.93
|
| Rate for Payer: BCBS Complete |
$378.97
|
| Rate for Payer: BCBS MAPPO |
$184.75
|
| Rate for Payer: BCBS Trust/PPO |
$574.56
|
| Rate for Payer: BCN Commercial |
$574.56
|
| Rate for Payer: BCN Medicare Advantage |
$184.75
|
| Rate for Payer: Cash Price |
$591.19
|
| Rate for Payer: Cash Price |
$591.19
|
| Rate for Payer: Cofinity Commercial |
$635.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$591.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.75
|
| Rate for Payer: Healthscope Commercial |
$665.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$554.24
|
| Rate for Payer: Mclaren Medicaid |
$360.93
|
| Rate for Payer: Meridian Medicaid |
$378.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$193.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$628.14
|
| Rate for Payer: PACE Senior Care Partners |
$175.51
|
| Rate for Payer: PACE SWMI |
$184.75
|
| Rate for Payer: PHP Commercial |
$628.14
|
| Rate for Payer: PHP Medicare Advantage |
$184.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$642.92
|
| Rate for Payer: Priority Health Medicare |
$184.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$450.71
|
| Rate for Payer: Railroad Medicare Medicare |
$184.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$650.31
|
| Rate for Payer: UHC Core |
$617.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$184.75
|
| Rate for Payer: UHC Medicare Advantage |
$190.29
|
| Rate for Payer: VA VA |
$184.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$554.24
|
|
|
HC CONTROL OROPHARYNG HEMORRHAGE SIMPLE
|
Facility
|
IP
|
$1,316.00
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
76100478
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$802.63 |
| Max. Negotiated Rate |
$1,184.40 |
| Rate for Payer: Aetna Commercial |
$1,118.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,017.00
|
| Rate for Payer: BCN Commercial |
$1,017.00
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,131.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,052.80
|
| Rate for Payer: Healthscope Commercial |
$1,184.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$987.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,118.60
|
| Rate for Payer: PHP Commercial |
$1,118.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,144.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$802.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,158.08
|
| Rate for Payer: UHC Core |
$1,098.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$987.00
|
|
|
HC CONTROL OROPHARYNG HEMORRHAGE SIMPLE
|
Facility
|
OP
|
$1,316.00
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
76100478
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$312.55 |
| Max. Negotiated Rate |
$1,184.40 |
| Rate for Payer: Aetna Commercial |
$1,118.60
|
| Rate for Payer: Aetna Medicare |
$342.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$411.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$411.25
|
| Rate for Payer: BCBS Complete |
$378.97
|
| Rate for Payer: BCBS MAPPO |
$329.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,023.19
|
| Rate for Payer: BCN Commercial |
$1,023.19
|
| Rate for Payer: BCN Medicare Advantage |
$329.00
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,131.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,052.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.00
|
| Rate for Payer: Healthscope Commercial |
$1,184.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$987.00
|
| Rate for Payer: Mclaren Medicaid |
$360.93
|
| Rate for Payer: Meridian Medicaid |
$378.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$345.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$378.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,118.60
|
| Rate for Payer: PACE Senior Care Partners |
$312.55
|
| Rate for Payer: PACE SWMI |
$329.00
|
| Rate for Payer: PHP Commercial |
$1,118.60
|
| Rate for Payer: PHP Medicare Advantage |
$329.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,144.92
|
| Rate for Payer: Priority Health Medicare |
$329.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$802.63
|
| Rate for Payer: Railroad Medicare Medicare |
$329.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,158.08
|
| Rate for Payer: UHC Core |
$1,098.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$329.00
|
| Rate for Payer: UHC Medicare Advantage |
$338.87
|
| Rate for Payer: VA VA |
$329.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$987.00
|
|
|
HC CONVERT EXTERNAL BILIARY DRAIN TO INTERNAL EXTERNAL
|
Facility
|
IP
|
$3,610.82
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
36100492
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,202.24 |
| Max. Negotiated Rate |
$3,249.74 |
| Rate for Payer: Aetna Commercial |
$3,069.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,790.44
|
| Rate for Payer: BCN Commercial |
$2,790.44
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cofinity Commercial |
$3,105.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,888.66
|
| Rate for Payer: Healthscope Commercial |
$3,249.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,708.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,069.20
|
| Rate for Payer: PHP Commercial |
$3,069.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,527.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,141.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,202.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,177.52
|
| Rate for Payer: UHC Core |
$3,015.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,708.12
|
|
|
HC CONVERT EXTERNAL BILIARY DRAIN TO INTERNAL EXTERNAL
|
Facility
|
OP
|
$3,610.82
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
36100492
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$857.57 |
| Max. Negotiated Rate |
$3,249.74 |
| Rate for Payer: Aetna Commercial |
$3,069.20
|
| Rate for Payer: Aetna Medicare |
$938.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,128.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,128.38
|
| Rate for Payer: BCBS Complete |
$2,382.99
|
| Rate for Payer: BCBS MAPPO |
$902.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,807.41
|
| Rate for Payer: BCN Commercial |
$2,807.41
|
| Rate for Payer: BCN Medicare Advantage |
$902.70
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cofinity Commercial |
$3,105.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,888.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$902.70
|
| Rate for Payer: Healthscope Commercial |
$3,249.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,708.12
|
| Rate for Payer: Mclaren Medicaid |
$2,269.51
|
| Rate for Payer: Meridian Medicaid |
$2,382.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$947.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,038.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,069.20
|
| Rate for Payer: PACE Senior Care Partners |
$857.57
|
| Rate for Payer: PACE SWMI |
$902.70
|
| Rate for Payer: PHP Commercial |
$3,069.20
|
| Rate for Payer: PHP Medicare Advantage |
$902.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,269.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,527.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,141.41
|
| Rate for Payer: Priority Health Medicare |
$902.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,202.24
|
| Rate for Payer: Railroad Medicare Medicare |
$902.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,177.52
|
| Rate for Payer: UHC Core |
$3,015.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$902.70
|
| Rate for Payer: UHC Medicare Advantage |
$929.79
|
| Rate for Payer: VA VA |
$902.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,708.12
|
|
|
HC CONVERT NEPHROSTOMY TO NEPHROURETERAL CATH
|
Facility
|
IP
|
$1,180.78
|
|
|
Service Code
|
CPT 50434
|
| Hospital Charge Code |
36100506
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$720.16 |
| Max. Negotiated Rate |
$1,062.70 |
| Rate for Payer: Aetna Commercial |
$1,003.66
|
| Rate for Payer: BCBS Trust/PPO |
$912.51
|
| Rate for Payer: BCN Commercial |
$912.51
|
| Rate for Payer: Cash Price |
$944.62
|
| Rate for Payer: Cofinity Commercial |
$1,015.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.62
|
| Rate for Payer: Healthscope Commercial |
$1,062.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$885.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,003.66
|
| Rate for Payer: PHP Commercial |
$1,003.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,027.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$720.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,039.09
|
| Rate for Payer: UHC Core |
$985.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$885.58
|
|
