|
HC AUTONOMIC FUNC CARDIO INNERVAT
|
Facility
|
IP
|
$370.31
|
|
|
Service Code
|
CPT 95921
|
| Hospital Charge Code |
92000006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$257.74 |
| Max. Negotiated Rate |
$333.28 |
| Rate for Payer: Aetna Commercial |
$314.76
|
| Rate for Payer: BCBS Trust/PPO |
$305.84
|
| Rate for Payer: BCN Commercial |
$305.84
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cofinity Commercial |
$318.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.25
|
| Rate for Payer: Healthscope Commercial |
$333.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.76
|
| Rate for Payer: Nomi Health Commercial |
$303.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.73
|
| Rate for Payer: PHP Commercial |
$314.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$322.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$257.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$325.87
|
| Rate for Payer: UHC Core |
$309.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.73
|
|
|
HC AUTONOMIC FUNC CARDIO INNERVAT
|
Facility
|
OP
|
$370.31
|
|
|
Service Code
|
CPT 95921
|
| Hospital Charge Code |
92000006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$65.29 |
| Max. Negotiated Rate |
$333.28 |
| Rate for Payer: Aetna Commercial |
$314.76
|
| Rate for Payer: Aetna Medicare |
$96.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.72
|
| Rate for Payer: BCBS Complete |
$68.54
|
| Rate for Payer: BCBS MAPPO |
$92.58
|
| Rate for Payer: BCBS Trust/PPO |
$304.43
|
| Rate for Payer: BCN Commercial |
$304.43
|
| Rate for Payer: BCN Medicare Advantage |
$92.58
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cofinity Commercial |
$318.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.58
|
| Rate for Payer: Healthscope Commercial |
$333.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.73
|
| Rate for Payer: Mclaren Medicaid |
$65.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.21
|
| Rate for Payer: Meridian Medicaid |
$68.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$101.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.76
|
| Rate for Payer: Nomi Health Commercial |
$303.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.73
|
| Rate for Payer: PACE Senior Care Partners |
$87.95
|
| Rate for Payer: PACE SWMI |
$92.58
|
| Rate for Payer: PHP Commercial |
$314.76
|
| Rate for Payer: PHP Medicare Advantage |
$92.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$322.17
|
| Rate for Payer: Priority Health Medicare |
$93.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$257.74
|
| Rate for Payer: Railroad Medicare Medicare |
$92.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$325.87
|
| Rate for Payer: UHC Core |
$309.21
|
| Rate for Payer: UHC Exchange |
$92.58
|
| Rate for Payer: UHC Medicaid |
$65.29
|
| Rate for Payer: UHC Medicare Advantage |
$92.58
|
| Rate for Payer: UHCCP Medicaid |
$65.29
|
| Rate for Payer: VA VA |
$92.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.73
|
|
|
HC AUTONOMIC FUNC QSART
|
Facility
|
OP
|
$370.31
|
|
|
Service Code
|
CPT 95923
|
| Hospital Charge Code |
92000008
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$65.29 |
| Max. Negotiated Rate |
$333.28 |
| Rate for Payer: Aetna Commercial |
$314.76
|
| Rate for Payer: Aetna Medicare |
$96.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.72
|
| Rate for Payer: BCBS Complete |
$68.54
|
| Rate for Payer: BCBS MAPPO |
$92.58
|
| Rate for Payer: BCBS Trust/PPO |
$304.43
|
| Rate for Payer: BCN Commercial |
$304.43
|
| Rate for Payer: BCN Medicare Advantage |
$92.58
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cofinity Commercial |
$318.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.58
|
| Rate for Payer: Healthscope Commercial |
$333.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.73
|
| Rate for Payer: Mclaren Medicaid |
$65.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.21
|
| Rate for Payer: Meridian Medicaid |
$68.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$101.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.76
|
| Rate for Payer: Nomi Health Commercial |
$303.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.73
|
| Rate for Payer: PACE Senior Care Partners |
$87.95
|
| Rate for Payer: PACE SWMI |
$92.58
|
| Rate for Payer: PHP Commercial |
$314.76
|
| Rate for Payer: PHP Medicare Advantage |
$92.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$322.17
|
| Rate for Payer: Priority Health Medicare |
$93.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$257.74
|
| Rate for Payer: Railroad Medicare Medicare |
$92.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$325.87
|
| Rate for Payer: UHC Core |
$309.21
|
| Rate for Payer: UHC Exchange |
$92.58
|
| Rate for Payer: UHC Medicaid |
$65.29
|
| Rate for Payer: UHC Medicare Advantage |
$92.58
|
| Rate for Payer: UHCCP Medicaid |
$65.29
|
| Rate for Payer: VA VA |
$92.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.73
|
|
|
HC AUTONOMIC FUNC QSART
|
Facility
|
IP
|
$370.31
|
|
|
Service Code
|
CPT 95923
|
| Hospital Charge Code |
92000008
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$257.74 |
| Max. Negotiated Rate |
$333.28 |
| Rate for Payer: Aetna Commercial |
$314.76
|
| Rate for Payer: BCBS Trust/PPO |
$305.84
|
| Rate for Payer: BCN Commercial |
$305.84
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cofinity Commercial |
$318.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.25
|
| Rate for Payer: Healthscope Commercial |
$333.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.76
|
| Rate for Payer: Nomi Health Commercial |
$303.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.73
|
| Rate for Payer: PHP Commercial |
$314.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$322.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$257.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$325.87
|
| Rate for Payer: UHC Core |
$309.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.73
|
|
|
HC AUTONOMIC W/O QSART
|
Facility
|
OP
|
$529.01
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
92000012
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$93.26 |
| Max. Negotiated Rate |
$476.11 |
| Rate for Payer: Aetna Commercial |
$449.66
|
| Rate for Payer: Aetna Medicare |
$137.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.32
|
| Rate for Payer: BCBS Complete |
$97.92
|
| Rate for Payer: BCBS MAPPO |
$132.25
|
| Rate for Payer: BCBS Trust/PPO |
$434.90
|
| Rate for Payer: BCN Commercial |
$434.90
|
| Rate for Payer: BCN Medicare Advantage |
$132.25
|
| Rate for Payer: Cash Price |
$423.21
|
| Rate for Payer: Cofinity Commercial |
$454.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.25
|
| Rate for Payer: Healthscope Commercial |
$476.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$396.76
|
| Rate for Payer: Mclaren Medicaid |
$93.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.87
|
| Rate for Payer: Meridian Medicaid |
$97.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$449.66
|
| Rate for Payer: Nomi Health Commercial |
$433.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.76
|
| Rate for Payer: PACE Senior Care Partners |
$125.64
|
| Rate for Payer: PACE SWMI |
$132.25
|
| Rate for Payer: PHP Commercial |
$449.66
|
| Rate for Payer: PHP Medicare Advantage |
$132.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$460.24
|
| Rate for Payer: Priority Health Medicare |
$133.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$368.19
|
| Rate for Payer: Railroad Medicare Medicare |
$132.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$465.53
|
| Rate for Payer: UHC Core |
$441.72
|
| Rate for Payer: UHC Exchange |
$132.25
|
| Rate for Payer: UHC Medicaid |
$93.26
|
| Rate for Payer: UHC Medicare Advantage |
$132.25
|
| Rate for Payer: UHCCP Medicaid |
$93.26
|
| Rate for Payer: VA VA |
$132.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$396.76
|
|
|
HC AUTONOMIC W/O QSART
|
Facility
|
IP
|
$529.01
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
92000012
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$368.19 |
| Max. Negotiated Rate |
$476.11 |
| Rate for Payer: Aetna Commercial |
$449.66
|
| Rate for Payer: BCBS Trust/PPO |
$436.91
|
| Rate for Payer: BCN Commercial |
$436.91
|
| Rate for Payer: Cash Price |
$423.21
|
| Rate for Payer: Cofinity Commercial |
$454.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.21
|
| Rate for Payer: Healthscope Commercial |
$476.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$396.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$449.66
|
| Rate for Payer: Nomi Health Commercial |
$433.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.76
|
| Rate for Payer: PHP Commercial |
$449.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$460.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$368.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$465.53
|
| Rate for Payer: UHC Core |
$441.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$396.76
|
|
|
HC AVULSION OF NAIL PLATE
|
Facility
|
IP
|
$326.34
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
76100045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$227.13 |
| Max. Negotiated Rate |
$293.71 |
| Rate for Payer: Aetna Commercial |
$277.39
|
| Rate for Payer: BCBS Trust/PPO |
$269.52
|
| Rate for Payer: BCN Commercial |
$269.52
|
| Rate for Payer: Cash Price |
$261.07
|
| Rate for Payer: Cofinity Commercial |
$280.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.07
|
| Rate for Payer: Healthscope Commercial |
$293.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.39
|
| Rate for Payer: Nomi Health Commercial |
$267.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$244.75
|
| Rate for Payer: PHP Commercial |
$277.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$283.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.18
|
| Rate for Payer: UHC Core |
$272.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.75
|
|
|
HC AVULSION OF NAIL PLATE
|
Facility
|
OP
|
$326.34
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
76100045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$57.53 |
| Max. Negotiated Rate |
$293.71 |
| Rate for Payer: Aetna Commercial |
$277.39
|
| Rate for Payer: Aetna Medicare |
$84.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$101.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$101.98
|
| Rate for Payer: BCBS Complete |
$60.41
|
| Rate for Payer: BCBS MAPPO |
$81.58
|
| Rate for Payer: BCBS Trust/PPO |
$268.28
|
| Rate for Payer: BCN Commercial |
$268.28
|
| Rate for Payer: BCN Medicare Advantage |
$81.58
|
| Rate for Payer: Cash Price |
$261.07
|
| Rate for Payer: Cofinity Commercial |
$280.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.58
|
| Rate for Payer: Healthscope Commercial |
$293.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.75
|
| Rate for Payer: Mclaren Medicaid |
$57.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.66
|
| Rate for Payer: Meridian Medicaid |
$60.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.39
|
| Rate for Payer: Nomi Health Commercial |
$267.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$244.75
|
| Rate for Payer: PACE Senior Care Partners |
$77.51
|
| Rate for Payer: PACE SWMI |
$81.58
|
| Rate for Payer: PHP Commercial |
$277.39
|
| Rate for Payer: PHP Medicare Advantage |
$81.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$283.92
|
| Rate for Payer: Priority Health Medicare |
$82.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.13
|
| Rate for Payer: Railroad Medicare Medicare |
$81.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.18
|
| Rate for Payer: UHC Core |
$272.49
|
| Rate for Payer: UHC Exchange |
$81.58
|
| Rate for Payer: UHC Medicaid |
$57.53
|
| Rate for Payer: UHC Medicare Advantage |
$81.58
|
| Rate for Payer: UHCCP Medicaid |
$57.53
|
| Rate for Payer: VA VA |
$81.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.75
|
|
|
HC BACITRACIN 1 OZ
|
Facility
|
OP
|
$8.29
|
|
| Hospital Charge Code |
27100006
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.46 |
| Max. Negotiated Rate |
$7.46 |
| Rate for Payer: Aetna Commercial |
$7.05
|
| Rate for Payer: Aetna Medicare |
$2.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.59
|
| Rate for Payer: BCBS Complete |
$1.53
|
| Rate for Payer: BCBS MAPPO |
$2.07
|
| Rate for Payer: BCBS Trust/PPO |
$6.82
|
| Rate for Payer: BCN Commercial |
$6.82
|
| Rate for Payer: BCN Medicare Advantage |
$2.07
|
| Rate for Payer: Cash Price |
$6.63
|
| Rate for Payer: Cofinity Commercial |
$7.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.07
|
| Rate for Payer: Healthscope Commercial |
$7.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.22
|
| Rate for Payer: Mclaren Medicaid |
$1.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.18
|
| Rate for Payer: Meridian Medicaid |
$1.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.05
|
| Rate for Payer: Nomi Health Commercial |
$6.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.22
|
| Rate for Payer: PACE Senior Care Partners |
$1.97
|
| Rate for Payer: PACE SWMI |
$2.07
|
| Rate for Payer: PHP Commercial |
$7.05
|
| Rate for Payer: PHP Medicare Advantage |
$2.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.21
|
| Rate for Payer: Priority Health Medicare |
$2.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.30
|
| Rate for Payer: UHC Core |
$6.92
|
| Rate for Payer: UHC Exchange |
$2.07
|
| Rate for Payer: UHC Medicaid |
$1.46
|
| Rate for Payer: UHC Medicare Advantage |
$2.07
|
| Rate for Payer: UHCCP Medicaid |
$1.46
|
| Rate for Payer: VA VA |
$2.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.22
|
|
|
HC BACITRACIN 1 OZ
|
Facility
|
IP
|
$8.29
|
|
| Hospital Charge Code |
27100006
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.77 |
| Max. Negotiated Rate |
$7.46 |
| Rate for Payer: Aetna Commercial |
$7.05
|
| Rate for Payer: BCBS Trust/PPO |
$6.85
|
| Rate for Payer: BCN Commercial |
$6.85
|
| Rate for Payer: Cash Price |
$6.63
|
| Rate for Payer: Cofinity Commercial |
$7.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$7.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.05
|
| Rate for Payer: Nomi Health Commercial |
$6.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.22
|
| Rate for Payer: PHP Commercial |
$7.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.30
|
| Rate for Payer: UHC Core |
$6.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.22
|
|
|
HC BACITRACIN 4 OZ
|
Facility
|
IP
|
$31.60
|
|
| Hospital Charge Code |
27100007
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$21.99 |
| Max. Negotiated Rate |
$28.44 |
| Rate for Payer: Aetna Commercial |
$26.86
|
| Rate for Payer: BCBS Trust/PPO |
$26.10
|
| Rate for Payer: BCN Commercial |
$26.10
|
| Rate for Payer: Cash Price |
$25.28
|
| Rate for Payer: Cofinity Commercial |
$27.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.28
|
| Rate for Payer: Healthscope Commercial |
$28.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.86
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.70
|
| Rate for Payer: PHP Commercial |
$26.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.81
|
| Rate for Payer: UHC Core |
$26.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.70
|
|
|
HC BACITRACIN 4 OZ
|
Facility
|
OP
|
$31.60
|
|
| Hospital Charge Code |
27100007
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.57 |
| Max. Negotiated Rate |
$28.44 |
| Rate for Payer: Aetna Commercial |
$26.86
|
| Rate for Payer: Aetna Medicare |
$8.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.88
|
| Rate for Payer: BCBS Complete |
$5.85
|
| Rate for Payer: BCBS MAPPO |
$7.90
|
| Rate for Payer: BCBS Trust/PPO |
$25.98
|
| Rate for Payer: BCN Commercial |
$25.98
|
| Rate for Payer: BCN Medicare Advantage |
$7.90
|
| Rate for Payer: Cash Price |
$25.28
|
| Rate for Payer: Cofinity Commercial |
$27.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.90
|
| Rate for Payer: Healthscope Commercial |
$28.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.70
|
| Rate for Payer: Mclaren Medicaid |
$5.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.29
|
| Rate for Payer: Meridian Medicaid |
$5.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.86
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.70
|
| Rate for Payer: PACE Senior Care Partners |
$7.50
|
| Rate for Payer: PACE SWMI |
$7.90
|
| Rate for Payer: PHP Commercial |
$26.86
|
| Rate for Payer: PHP Medicare Advantage |
$7.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.49
|
| Rate for Payer: Priority Health Medicare |
$7.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.99
|
| Rate for Payer: Railroad Medicare Medicare |
$7.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.81
|
| Rate for Payer: UHC Core |
$26.39
|
| Rate for Payer: UHC Exchange |
$7.90
|
| Rate for Payer: UHC Medicaid |
$5.57
|
| Rate for Payer: UHC Medicare Advantage |
$7.90
|
| Rate for Payer: UHCCP Medicaid |
$5.57
|
| Rate for Payer: VA VA |
$7.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.70
|
|
|
HC BACK SCREEN
|
Facility
|
IP
|
$53.06
|
|
| Hospital Charge Code |
42000047
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC BACK SCREEN
|
Facility
|
OP
|
$53.06
|
|
| Hospital Charge Code |
42000047
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC BACK SCREEN, VBISD
|
Facility
|
OP
|
$69.71
|
|
| Hospital Charge Code |
43000014
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$12.29 |
| Max. Negotiated Rate |
$62.74 |
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: Aetna Medicare |
$18.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.78
|
| Rate for Payer: BCBS Complete |
$12.90
|
| Rate for Payer: BCBS MAPPO |
$17.43
|
| Rate for Payer: BCBS Trust/PPO |
$57.31
|
| Rate for Payer: BCN Commercial |
$57.31
|
| Rate for Payer: BCN Medicare Advantage |
$17.43
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.43
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: Mclaren Medicaid |
$12.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.30
|
| Rate for Payer: Meridian Medicaid |
$12.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$57.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.28
|
| Rate for Payer: PACE Senior Care Partners |
$16.56
|
| Rate for Payer: PACE SWMI |
$17.43
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: PHP Medicare Advantage |
$17.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.65
|
| Rate for Payer: Priority Health Medicare |
$17.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.52
|
| Rate for Payer: Railroad Medicare Medicare |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.34
|
| Rate for Payer: UHC Core |
$58.21
|
| Rate for Payer: UHC Exchange |
$17.43
|
| Rate for Payer: UHC Medicaid |
$12.29
|
| Rate for Payer: UHC Medicare Advantage |
$17.43
|
| Rate for Payer: UHCCP Medicaid |
$12.29
|
| Rate for Payer: VA VA |
$17.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC BACK SCREEN, VBISD
|
Facility
|
IP
|
$69.71
|
|
| Hospital Charge Code |
43000014
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$48.52 |
| Max. Negotiated Rate |
$62.74 |
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: BCBS Trust/PPO |
$57.57
|
| Rate for Payer: BCN Commercial |
$57.57
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$57.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.28
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.34
|
| Rate for Payer: UHC Core |
$58.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC BACTERIAL VAGINOSIS PANEL
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
CPT 0352U
|
| Hospital Charge Code |
30600337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$108.62 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: BCBS Trust/PPO |
$128.89
|
| Rate for Payer: BCN Commercial |
$128.89
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC BACTERIAL VAGINOSIS PANEL
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
CPT 0352U
|
| Hospital Charge Code |
30600337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.51 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$40.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.77
|
| Rate for Payer: BCBS Complete |
$28.89
|
| Rate for Payer: BCBS MAPPO |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$128.30
|
| Rate for Payer: BCN Commercial |
$128.30
|
| Rate for Payer: BCN Medicare Advantage |
$39.02
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.02
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Mclaren Medicaid |
$27.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.97
|
| Rate for Payer: Meridian Medicaid |
$28.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PACE Senior Care Partners |
$37.06
|
| Rate for Payer: PACE SWMI |
$39.02
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: PHP Medicare Advantage |
$39.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Medicare |
$39.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.62
|
| Rate for Payer: Railroad Medicare Medicare |
$39.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: UHC Exchange |
$39.02
|
| Rate for Payer: UHC Medicaid |
$27.51
|
| Rate for Payer: UHC Medicare Advantage |
$39.02
|
| Rate for Payer: UHCCP Medicaid |
$27.51
|
| Rate for Payer: VA VA |
$39.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC BAG BLOOD TRANSFER
|
Facility
|
IP
|
$9.05
|
|
| Hospital Charge Code |
27000161
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$8.14 |
| Rate for Payer: Aetna Commercial |
$7.69
|
| Rate for Payer: BCBS Trust/PPO |
$7.47
|
| Rate for Payer: BCN Commercial |
$7.47
|
| Rate for Payer: Cash Price |
$7.24
|
| Rate for Payer: Cofinity Commercial |
$7.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.24
|
| Rate for Payer: Healthscope Commercial |
$8.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.69
|
| Rate for Payer: Nomi Health Commercial |
$7.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.79
|
| Rate for Payer: PHP Commercial |
$7.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.96
|
| Rate for Payer: UHC Core |
$7.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.79
|
|
|
HC BAG BLOOD TRANSFER
|
Facility
|
OP
|
$9.05
|
|
| Hospital Charge Code |
27000161
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$8.14 |
| Rate for Payer: Aetna Commercial |
$7.69
|
| Rate for Payer: Aetna Medicare |
$2.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.83
|
| Rate for Payer: BCBS Complete |
$1.68
|
| Rate for Payer: BCBS MAPPO |
$2.26
|
| Rate for Payer: BCBS Trust/PPO |
$7.44
|
| Rate for Payer: BCN Commercial |
$7.44
|
| Rate for Payer: BCN Medicare Advantage |
$2.26
|
| Rate for Payer: Cash Price |
$7.24
|
| Rate for Payer: Cofinity Commercial |
$7.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.26
|
| Rate for Payer: Healthscope Commercial |
$8.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.79
|
| Rate for Payer: Mclaren Medicaid |
$1.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.38
|
| Rate for Payer: Meridian Medicaid |
$1.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.69
|
| Rate for Payer: Nomi Health Commercial |
$7.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.79
|
| Rate for Payer: PACE Senior Care Partners |
$2.15
|
| Rate for Payer: PACE SWMI |
$2.26
|
| Rate for Payer: PHP Commercial |
$7.69
|
| Rate for Payer: PHP Medicare Advantage |
$2.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.87
|
| Rate for Payer: Priority Health Medicare |
$2.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.30
|
| Rate for Payer: Railroad Medicare Medicare |
$2.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.96
|
| Rate for Payer: UHC Core |
$7.56
|
| Rate for Payer: UHC Exchange |
$2.26
|
| Rate for Payer: UHC Medicaid |
$1.60
|
| Rate for Payer: UHC Medicare Advantage |
$2.26
|
| Rate for Payer: UHCCP Medicaid |
$1.60
|
| Rate for Payer: VA VA |
$2.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.79
|
|
|
HC BAG WASTE
|
Facility
|
OP
|
$65.55
|
|
| Hospital Charge Code |
27000670
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.56 |
| Max. Negotiated Rate |
$58.99 |
| Rate for Payer: Aetna Commercial |
$55.72
|
| Rate for Payer: Aetna Medicare |
$17.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.48
|
| Rate for Payer: BCBS Complete |
$12.13
|
| Rate for Payer: BCBS MAPPO |
$16.39
|
| Rate for Payer: BCBS Trust/PPO |
$53.89
|
| Rate for Payer: BCN Commercial |
$53.89
|
| Rate for Payer: BCN Medicare Advantage |
$16.39
|
| Rate for Payer: Cash Price |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$56.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.39
|
| Rate for Payer: Healthscope Commercial |
$58.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.16
|
| Rate for Payer: Mclaren Medicaid |
$11.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.21
|
| Rate for Payer: Meridian Medicaid |
$12.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.72
|
| Rate for Payer: Nomi Health Commercial |
$53.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.16
|
| Rate for Payer: PACE Senior Care Partners |
$15.57
|
| Rate for Payer: PACE SWMI |
$16.39
|
| Rate for Payer: PHP Commercial |
$55.72
|
| Rate for Payer: PHP Medicare Advantage |
$16.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.03
|
| Rate for Payer: Priority Health Medicare |
$16.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.62
|
| Rate for Payer: Railroad Medicare Medicare |
$16.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.68
|
| Rate for Payer: UHC Core |
$54.73
|
| Rate for Payer: UHC Exchange |
$16.39
|
| Rate for Payer: UHC Medicaid |
$11.56
|
| Rate for Payer: UHC Medicare Advantage |
$16.39
|
| Rate for Payer: UHCCP Medicaid |
$11.56
|
| Rate for Payer: VA VA |
$16.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.16
|
|
|
HC BAG WASTE
|
Facility
|
IP
|
$65.55
|
|
| Hospital Charge Code |
27000670
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.62 |
| Max. Negotiated Rate |
$58.99 |
| Rate for Payer: Aetna Commercial |
$55.72
|
| Rate for Payer: BCBS Trust/PPO |
$54.14
|
| Rate for Payer: BCN Commercial |
$54.14
|
| Rate for Payer: Cash Price |
$52.44
|
| Rate for Payer: Cofinity Commercial |
$56.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.44
|
| Rate for Payer: Healthscope Commercial |
$58.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.72
|
| Rate for Payer: Nomi Health Commercial |
$53.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.16
|
| Rate for Payer: PHP Commercial |
$55.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.68
|
| Rate for Payer: UHC Core |
$54.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.16
|
|
|
HC BAKRI BALLOON CATHETER
|
Facility
|
OP
|
$1,209.83
|
|
| Hospital Charge Code |
27200112
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$213.29 |
| Max. Negotiated Rate |
$1,088.85 |
| Rate for Payer: Aetna Commercial |
$1,028.36
|
| Rate for Payer: Aetna Medicare |
$314.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$378.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$378.07
|
| Rate for Payer: BCBS Complete |
$223.94
|
| Rate for Payer: BCBS MAPPO |
$302.46
|
| Rate for Payer: BCBS Trust/PPO |
$994.60
|
| Rate for Payer: BCN Commercial |
$994.60
|
| Rate for Payer: BCN Medicare Advantage |
$302.46
|
| Rate for Payer: Cash Price |
$967.86
|
| Rate for Payer: Cofinity Commercial |
$1,040.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$967.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.46
|
| Rate for Payer: Healthscope Commercial |
$1,088.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$907.37
|
| Rate for Payer: Mclaren Medicaid |
$213.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.58
|
| Rate for Payer: Meridian Medicaid |
$223.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$347.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$332.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,028.36
|
| Rate for Payer: Nomi Health Commercial |
$992.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$907.37
|
| Rate for Payer: PACE Senior Care Partners |
$287.33
|
| Rate for Payer: PACE SWMI |
$302.46
|
| Rate for Payer: PHP Commercial |
$1,028.36
|
| Rate for Payer: PHP Medicare Advantage |
$302.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,052.55
|
| Rate for Payer: Priority Health Medicare |
$305.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$842.04
|
| Rate for Payer: Railroad Medicare Medicare |
$302.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,064.65
|
| Rate for Payer: UHC Core |
$1,010.21
|
| Rate for Payer: UHC Exchange |
$302.46
|
| Rate for Payer: UHC Medicaid |
$213.29
|
| Rate for Payer: UHC Medicare Advantage |
$302.46
|
| Rate for Payer: UHCCP Medicaid |
$213.29
|
| Rate for Payer: VA VA |
$302.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$907.37
|
|
|
HC BAKRI BALLOON CATHETER
|
Facility
|
IP
|
$1,209.83
|
|
| Hospital Charge Code |
27200112
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$842.04 |
| Max. Negotiated Rate |
$1,088.85 |
| Rate for Payer: Aetna Commercial |
$1,028.36
|
| Rate for Payer: BCBS Trust/PPO |
$999.20
|
| Rate for Payer: BCN Commercial |
$999.20
|
| Rate for Payer: Cash Price |
$967.86
|
| Rate for Payer: Cofinity Commercial |
$1,040.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$967.86
|
| Rate for Payer: Healthscope Commercial |
$1,088.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$907.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,028.36
|
| Rate for Payer: Nomi Health Commercial |
$992.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$907.37
|
| Rate for Payer: PHP Commercial |
$1,028.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,052.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$842.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,064.65
|
| Rate for Payer: UHC Core |
$1,010.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$907.37
|
|
|
HC BALLOON CATH TRANSLUMINAL LVL 10
|
Facility
|
IP
|
$1,041.42
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200066
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$724.83 |
| Max. Negotiated Rate |
$937.28 |
| Rate for Payer: Aetna Commercial |
$885.21
|
| Rate for Payer: BCBS Trust/PPO |
$860.11
|
| Rate for Payer: BCN Commercial |
$860.11
|
| Rate for Payer: Cash Price |
$833.14
|
| Rate for Payer: Cofinity Commercial |
$895.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$833.14
|
| Rate for Payer: Healthscope Commercial |
$937.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$781.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.21
|
| Rate for Payer: Nomi Health Commercial |
$853.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$781.07
|
| Rate for Payer: PHP Commercial |
$885.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$906.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$724.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$916.45
|
| Rate for Payer: UHC Core |
$869.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$781.07
|
|
