|
HC CONVERT NEPHROSTOMY TO NEPHROURETERAL CATH
|
Facility
|
OP
|
$1,180.78
|
|
|
Service Code
|
CPT 50434
|
| Hospital Charge Code |
36100506
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$280.44 |
| Max. Negotiated Rate |
$1,402.94 |
| Rate for Payer: Aetna Commercial |
$1,003.66
|
| Rate for Payer: Aetna Medicare |
$307.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$368.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$368.99
|
| Rate for Payer: BCBS Complete |
$1,402.94
|
| Rate for Payer: BCBS MAPPO |
$295.20
|
| Rate for Payer: BCBS Trust/PPO |
$918.06
|
| Rate for Payer: BCN Commercial |
$918.06
|
| Rate for Payer: BCN Medicare Advantage |
$295.20
|
| Rate for Payer: Cash Price |
$944.62
|
| 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: Health Alliance Plan Medicare Advantage |
$295.20
|
| Rate for Payer: Healthscope Commercial |
$1,062.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$885.58
|
| Rate for Payer: Mclaren Medicaid |
$1,336.13
|
| Rate for Payer: Meridian Medicaid |
$1,402.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$309.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$339.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,003.66
|
| Rate for Payer: PACE Senior Care Partners |
$280.44
|
| Rate for Payer: PACE SWMI |
$295.20
|
| Rate for Payer: PHP Commercial |
$1,003.66
|
| Rate for Payer: PHP Medicare Advantage |
$295.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,336.13
|
| 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 Medicare |
$295.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$720.16
|
| Rate for Payer: Railroad Medicare Medicare |
$295.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,039.09
|
| Rate for Payer: UHC Core |
$985.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$295.20
|
| Rate for Payer: UHC Medicare Advantage |
$304.05
|
| Rate for Payer: VA VA |
$295.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$885.58
|
|
|
HC CONVEX WAFER
|
Facility
|
IP
|
$55.92
|
|
| Hospital Charge Code |
27000049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$34.11 |
| Max. Negotiated Rate |
$50.33 |
| Rate for Payer: Aetna Commercial |
$47.53
|
| Rate for Payer: BCBS Trust/PPO |
$43.21
|
| Rate for Payer: BCN Commercial |
$43.21
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$48.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Healthscope Commercial |
$50.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.53
|
| Rate for Payer: PHP Commercial |
$47.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.21
|
| Rate for Payer: UHC Core |
$46.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.94
|
|
|
HC CONVEX WAFER
|
Facility
|
OP
|
$55.92
|
|
| Hospital Charge Code |
27000049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$50.33 |
| Rate for Payer: Aetna Commercial |
$47.53
|
| Rate for Payer: Aetna Medicare |
$14.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.48
|
| Rate for Payer: BCBS Complete |
$22.37
|
| Rate for Payer: BCBS MAPPO |
$13.98
|
| Rate for Payer: BCBS Trust/PPO |
$43.48
|
| Rate for Payer: BCN Commercial |
$43.48
|
| Rate for Payer: BCN Medicare Advantage |
$13.98
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$48.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.98
|
| Rate for Payer: Healthscope Commercial |
$50.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.53
|
| Rate for Payer: PACE Senior Care Partners |
$13.28
|
| Rate for Payer: PACE SWMI |
$13.98
|
| Rate for Payer: PHP Commercial |
$47.53
|
| Rate for Payer: PHP Medicare Advantage |
$13.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.65
|
| Rate for Payer: Priority Health Medicare |
$13.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.11
|
| Rate for Payer: Railroad Medicare Medicare |
$13.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.21
|
| Rate for Payer: UHC Core |
$46.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.98
|
| Rate for Payer: UHC Medicare Advantage |
$14.40
|
| Rate for Payer: VA VA |
$13.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.94
|
|
|
HC COOK GUIDEWIRE
|
Facility
|
OP
|
$46.93
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$42.24 |
| Rate for Payer: Aetna Commercial |
$39.89
|
| Rate for Payer: Aetna Medicare |
$12.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.67
|
| Rate for Payer: BCBS Complete |
$18.77
|
| Rate for Payer: BCBS MAPPO |
$11.73
|
| Rate for Payer: BCBS Trust/PPO |
$36.49
|
| Rate for Payer: BCN Commercial |
$36.49
|
| Rate for Payer: BCN Medicare Advantage |
$11.73
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$40.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.73
|
| Rate for Payer: Healthscope Commercial |
$42.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.89
|
| Rate for Payer: PACE Senior Care Partners |
$11.15
|
| Rate for Payer: PACE SWMI |
$11.73
|
| Rate for Payer: PHP Commercial |
$39.89
|
| Rate for Payer: PHP Medicare Advantage |
$11.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.83
|
| Rate for Payer: Priority Health Medicare |
$11.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.62
|
| Rate for Payer: Railroad Medicare Medicare |
$11.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.30
|
| Rate for Payer: UHC Core |
$39.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.73
|
| Rate for Payer: UHC Medicare Advantage |
$12.08
|
| Rate for Payer: VA VA |
$11.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.20
|
|
|
HC COOK GUIDEWIRE
|
Facility
|
IP
|
$46.93
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.62 |
| Max. Negotiated Rate |
$42.24 |
| Rate for Payer: Aetna Commercial |
$39.89
|
| Rate for Payer: BCBS Trust/PPO |
$36.27
|
| Rate for Payer: BCN Commercial |
$36.27
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$40.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.54
|
| Rate for Payer: Healthscope Commercial |
$42.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.89
|
| Rate for Payer: PHP Commercial |
$39.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.30
|
| Rate for Payer: UHC Core |
$39.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.20
|
|
|
HC COOK PIGTAIL
|
Facility
|
IP
|
$459.14
|
|
| Hospital Charge Code |
27200233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$280.03 |
| Max. Negotiated Rate |
$413.23 |
| Rate for Payer: Aetna Commercial |
$390.27
|
| Rate for Payer: BCBS Trust/PPO |
$354.82
|
| Rate for Payer: BCN Commercial |
$354.82
|
| Rate for Payer: Cash Price |
$367.31
|
| Rate for Payer: Cofinity Commercial |
$394.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.31
|
| Rate for Payer: Healthscope Commercial |
$413.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$390.27
|
| Rate for Payer: PHP Commercial |
$390.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$399.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$280.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.04
|
| Rate for Payer: UHC Core |
$383.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.36
|
|
|
HC COOK PIGTAIL
|
Facility
|
OP
|
$459.14
|
|
| Hospital Charge Code |
27200233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$109.05 |
| Max. Negotiated Rate |
$413.23 |
| Rate for Payer: Aetna Commercial |
$390.27
|
| Rate for Payer: Aetna Medicare |
$119.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$143.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$143.48
|
| Rate for Payer: BCBS Complete |
$183.66
|
| Rate for Payer: BCBS MAPPO |
$114.78
|
| Rate for Payer: BCBS Trust/PPO |
$356.98
|
| Rate for Payer: BCN Commercial |
$356.98
|
| Rate for Payer: BCN Medicare Advantage |
$114.78
|
| Rate for Payer: Cash Price |
$367.31
|
| Rate for Payer: Cofinity Commercial |
$394.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.78
|
| Rate for Payer: Healthscope Commercial |
$413.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$120.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$390.27
|
| Rate for Payer: PACE Senior Care Partners |
$109.05
|
| Rate for Payer: PACE SWMI |
$114.78
|
| Rate for Payer: PHP Commercial |
$390.27
|
| Rate for Payer: PHP Medicare Advantage |
$114.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$399.45
|
| Rate for Payer: Priority Health Medicare |
$114.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$280.03
|
| Rate for Payer: Railroad Medicare Medicare |
$114.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.04
|
| Rate for Payer: UHC Core |
$383.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.78
|
| Rate for Payer: UHC Medicare Advantage |
$118.23
|
| Rate for Payer: VA VA |
$114.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.36
|
|
|
HC COOLIEF RF PROBE
|
Facility
|
OP
|
$1,875.00
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$445.31 |
| Max. Negotiated Rate |
$1,687.50 |
| Rate for Payer: Aetna Commercial |
$1,593.75
|
| Rate for Payer: Aetna Medicare |
$487.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$585.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$585.94
|
| Rate for Payer: BCBS Complete |
$750.00
|
| Rate for Payer: BCBS MAPPO |
$468.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,457.81
|
| Rate for Payer: BCN Commercial |
$1,457.81
|
| Rate for Payer: BCN Medicare Advantage |
$468.75
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cofinity Commercial |
$1,612.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,500.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$468.75
|
| Rate for Payer: Healthscope Commercial |
$1,687.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,406.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$492.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$539.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,593.75
|
| Rate for Payer: PACE Senior Care Partners |
$445.31
|
| Rate for Payer: PACE SWMI |
$468.75
|
| Rate for Payer: PHP Commercial |
$1,593.75
|
| Rate for Payer: PHP Medicare Advantage |
$468.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,312.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,631.25
|
| Rate for Payer: Priority Health Medicare |
$468.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,143.56
|
| Rate for Payer: Railroad Medicare Medicare |
$468.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,650.00
|
| Rate for Payer: UHC Core |
$1,565.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$468.75
|
| Rate for Payer: UHC Medicare Advantage |
$482.81
|
| Rate for Payer: VA VA |
$468.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,406.25
|
|
|
HC COOLIEF RF PROBE
|
Facility
|
IP
|
$1,875.00
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,143.56 |
| Max. Negotiated Rate |
$1,687.50 |
| Rate for Payer: Aetna Commercial |
$1,593.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,449.00
|
| Rate for Payer: BCN Commercial |
$1,449.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cofinity Commercial |
$1,612.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,500.00
|
| Rate for Payer: Healthscope Commercial |
$1,687.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,406.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,593.75
|
| Rate for Payer: PHP Commercial |
$1,593.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,312.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,631.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,143.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,650.00
|
| Rate for Payer: UHC Core |
$1,565.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,406.25
|
|
|
HC COPPER SERUM
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.16 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Aetna Commercial |
$37.40
|
| Rate for Payer: Aetna Medicare |
$11.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.75
|
| Rate for Payer: BCBS Complete |
$9.62
|
| Rate for Payer: BCBS MAPPO |
$11.00
|
| Rate for Payer: BCBS Trust/PPO |
$34.21
|
| Rate for Payer: BCN Commercial |
$34.21
|
| Rate for Payer: BCN Medicare Advantage |
$11.00
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.00
|
| Rate for Payer: Healthscope Commercial |
$39.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.00
|
| Rate for Payer: Mclaren Medicaid |
$9.16
|
| Rate for Payer: Meridian Medicaid |
$9.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.40
|
| Rate for Payer: PACE Senior Care Partners |
$10.45
|
| Rate for Payer: PACE SWMI |
$11.00
|
| Rate for Payer: PHP Commercial |
$37.40
|
| Rate for Payer: PHP Medicare Advantage |
$11.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.28
|
| Rate for Payer: Priority Health Medicare |
$11.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.84
|
| Rate for Payer: Railroad Medicare Medicare |
$11.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.72
|
| Rate for Payer: UHC Core |
$36.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.00
|
| Rate for Payer: UHC Medicare Advantage |
$11.33
|
| Rate for Payer: VA VA |
$11.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.00
|
|
|
HC COPPER SERUM
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Aetna Commercial |
$37.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.00
|
| Rate for Payer: BCN Commercial |
$34.00
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.20
|
| Rate for Payer: Healthscope Commercial |
$39.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.40
|
| Rate for Payer: PHP Commercial |
$37.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.72
|
| Rate for Payer: UHC Core |
$36.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.00
|
|
|
HC COPPER URINE
|
Facility
|
IP
|
$62.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.81 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Aetna Commercial |
$52.70
|
| Rate for Payer: BCBS Trust/PPO |
$47.91
|
| Rate for Payer: BCN Commercial |
$47.91
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$53.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.60
|
| Rate for Payer: Healthscope Commercial |
$55.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.70
|
| Rate for Payer: PHP Commercial |
$52.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.56
|
| Rate for Payer: UHC Core |
$51.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.50
|
|
|
HC COPPER URINE
|
Facility
|
OP
|
$62.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.16 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Aetna Commercial |
$52.70
|
| Rate for Payer: Aetna Medicare |
$16.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.38
|
| Rate for Payer: BCBS Complete |
$9.62
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$48.20
|
| Rate for Payer: BCN Commercial |
$48.20
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$53.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$55.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.50
|
| Rate for Payer: Mclaren Medicaid |
$9.16
|
| Rate for Payer: Meridian Medicaid |
$9.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.70
|
| Rate for Payer: PACE Senior Care Partners |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Commercial |
$52.70
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.94
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.81
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.56
|
| Rate for Payer: UHC Core |
$51.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.50
|
| Rate for Payer: UHC Medicare Advantage |
$15.96
|
| Rate for Payer: VA VA |
$15.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.50
|
|
|
HC CORDIS CATHETER
|
Facility
|
IP
|
$192.76
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$117.56 |
| Max. Negotiated Rate |
$173.48 |
| Rate for Payer: Aetna Commercial |
$163.85
|
| Rate for Payer: BCBS Trust/PPO |
$148.96
|
| Rate for Payer: BCN Commercial |
$148.96
|
| Rate for Payer: Cash Price |
$154.21
|
| Rate for Payer: Cofinity Commercial |
$165.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.21
|
| Rate for Payer: Healthscope Commercial |
$173.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.85
|
| Rate for Payer: PHP Commercial |
$163.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.63
|
| Rate for Payer: UHC Core |
$160.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.57
|
|
|
HC CORDIS CATHETER
|
Facility
|
OP
|
$192.76
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.78 |
| Max. Negotiated Rate |
$173.48 |
| Rate for Payer: Aetna Commercial |
$163.85
|
| Rate for Payer: Aetna Medicare |
$50.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.24
|
| Rate for Payer: BCBS Complete |
$77.10
|
| Rate for Payer: BCBS MAPPO |
$48.19
|
| Rate for Payer: BCBS Trust/PPO |
$149.87
|
| Rate for Payer: BCN Commercial |
$149.87
|
| Rate for Payer: BCN Medicare Advantage |
$48.19
|
| Rate for Payer: Cash Price |
$154.21
|
| Rate for Payer: Cofinity Commercial |
$165.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.19
|
| Rate for Payer: Healthscope Commercial |
$173.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.85
|
| Rate for Payer: PACE Senior Care Partners |
$45.78
|
| Rate for Payer: PACE SWMI |
$48.19
|
| Rate for Payer: PHP Commercial |
$163.85
|
| Rate for Payer: PHP Medicare Advantage |
$48.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.70
|
| Rate for Payer: Priority Health Medicare |
$48.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.56
|
| Rate for Payer: Railroad Medicare Medicare |
$48.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.63
|
| Rate for Payer: UHC Core |
$160.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.19
|
| Rate for Payer: UHC Medicare Advantage |
$49.64
|
| Rate for Payer: VA VA |
$48.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.57
|
|
|
HC CORDIS PERIPHERAL STENT
|
Facility
|
OP
|
$3,739.66
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800006
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$888.17 |
| Max. Negotiated Rate |
$3,365.69 |
| Rate for Payer: Aetna Commercial |
$3,178.71
|
| Rate for Payer: Aetna Medicare |
$972.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,168.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,168.64
|
| Rate for Payer: BCBS Complete |
$1,495.86
|
| Rate for Payer: BCBS MAPPO |
$934.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,907.59
|
| Rate for Payer: BCN Commercial |
$2,907.59
|
| Rate for Payer: BCN Medicare Advantage |
$934.92
|
| Rate for Payer: Cash Price |
$2,991.73
|
| Rate for Payer: Cofinity Commercial |
$3,216.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,991.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$934.92
|
| Rate for Payer: Healthscope Commercial |
$3,365.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,804.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$981.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,075.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,178.71
|
| Rate for Payer: PACE Senior Care Partners |
$888.17
|
| Rate for Payer: PACE SWMI |
$934.92
|
| Rate for Payer: PHP Commercial |
$3,178.71
|
| Rate for Payer: PHP Medicare Advantage |
$934.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,617.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,253.50
|
| Rate for Payer: Priority Health Medicare |
$934.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,280.82
|
| Rate for Payer: Railroad Medicare Medicare |
$934.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,290.90
|
| Rate for Payer: UHC Core |
$3,122.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$934.92
|
| Rate for Payer: UHC Medicare Advantage |
$962.96
|
| Rate for Payer: VA VA |
$934.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,804.74
|
|
|
HC CORDIS PERIPHERAL STENT
|
Facility
|
IP
|
$3,739.66
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800006
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,280.82 |
| Max. Negotiated Rate |
$3,365.69 |
| Rate for Payer: Aetna Commercial |
$3,178.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,890.01
|
| Rate for Payer: BCN Commercial |
$2,890.01
|
| Rate for Payer: Cash Price |
$2,991.73
|
| Rate for Payer: Cofinity Commercial |
$3,216.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,991.73
|
| Rate for Payer: Healthscope Commercial |
$3,365.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,804.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,178.71
|
| Rate for Payer: PHP Commercial |
$3,178.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,617.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,253.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,280.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,290.90
|
| Rate for Payer: UHC Core |
$3,122.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,804.74
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
IP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.53 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: BCBS Trust/PPO |
$71.62
|
| Rate for Payer: BCN Commercial |
$71.62
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
OP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.01 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: Aetna Medicare |
$24.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.96
|
| Rate for Payer: BCBS Complete |
$48.15
|
| Rate for Payer: BCBS MAPPO |
$23.17
|
| Rate for Payer: BCBS Trust/PPO |
$72.06
|
| Rate for Payer: BCN Commercial |
$72.06
|
| Rate for Payer: BCN Medicare Advantage |
$23.17
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.17
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$48.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PACE Senior Care Partners |
$22.01
|
| Rate for Payer: PACE SWMI |
$23.17
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: PHP Medicare Advantage |
$23.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Medicare |
$23.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: Railroad Medicare Medicare |
$23.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.17
|
| Rate for Payer: UHC Medicare Advantage |
$23.87
|
| Rate for Payer: VA VA |
$23.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
IP
|
$45.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.45 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna Commercial |
$38.25
|
| Rate for Payer: BCBS Trust/PPO |
$34.78
|
| Rate for Payer: BCN Commercial |
$34.78
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$38.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.00
|
| Rate for Payer: Healthscope Commercial |
$40.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.25
|
| Rate for Payer: PHP Commercial |
$38.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.60
|
| Rate for Payer: UHC Core |
$37.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.75
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
OP
|
$45.00
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.69 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Aetna Commercial |
$38.25
|
| Rate for Payer: Aetna Medicare |
$11.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.06
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS MAPPO |
$11.25
|
| Rate for Payer: BCBS Trust/PPO |
$34.99
|
| Rate for Payer: BCN Commercial |
$34.99
|
| Rate for Payer: BCN Medicare Advantage |
$11.25
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$38.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.25
|
| Rate for Payer: Healthscope Commercial |
$40.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.25
|
| Rate for Payer: PACE Senior Care Partners |
$10.69
|
| Rate for Payer: PACE SWMI |
$11.25
|
| Rate for Payer: PHP Commercial |
$38.25
|
| Rate for Payer: PHP Medicare Advantage |
$11.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.15
|
| Rate for Payer: Priority Health Medicare |
$11.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.45
|
| Rate for Payer: Railroad Medicare Medicare |
$11.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.60
|
| Rate for Payer: UHC Core |
$37.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.25
|
| Rate for Payer: UHC Medicare Advantage |
$11.59
|
| Rate for Payer: VA VA |
$11.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.75
|
|
|
HC CORN IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC CORN IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC CORN POLLEN IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC CORN POLLEN IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
