|
HC BDIAL TT
|
Facility
|
OP
|
$25.60
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
30500087
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$23.04 |
| Rate for Payer: Aetna Commercial |
$21.76
|
| Rate for Payer: Aetna Medicare |
$6.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.00
|
| Rate for Payer: BCBS Complete |
$4.74
|
| Rate for Payer: BCBS MAPPO |
$6.40
|
| Rate for Payer: BCBS Trust/PPO |
$21.05
|
| Rate for Payer: BCN Commercial |
$21.05
|
| Rate for Payer: BCN Medicare Advantage |
$6.40
|
| Rate for Payer: Cash Price |
$20.48
|
| Rate for Payer: Cofinity Commercial |
$22.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.40
|
| Rate for Payer: Healthscope Commercial |
$23.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.20
|
| Rate for Payer: Mclaren Medicaid |
$4.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.72
|
| Rate for Payer: Meridian Medicaid |
$4.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.76
|
| Rate for Payer: Nomi Health Commercial |
$20.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.20
|
| Rate for Payer: PACE Senior Care Partners |
$6.08
|
| Rate for Payer: PACE SWMI |
$6.40
|
| Rate for Payer: PHP Commercial |
$21.76
|
| Rate for Payer: PHP Medicare Advantage |
$6.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.27
|
| Rate for Payer: Priority Health Medicare |
$6.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.82
|
| Rate for Payer: Railroad Medicare Medicare |
$6.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.53
|
| Rate for Payer: UHC Core |
$21.38
|
| Rate for Payer: UHC Exchange |
$6.40
|
| Rate for Payer: UHC Medicaid |
$4.51
|
| Rate for Payer: UHC Medicare Advantage |
$6.40
|
| Rate for Payer: UHCCP Medicaid |
$4.51
|
| Rate for Payer: VA VA |
$6.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.20
|
|
|
HC BDIAL VWAG
|
Facility
|
OP
|
$86.02
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500092
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.17 |
| Max. Negotiated Rate |
$77.42 |
| Rate for Payer: Aetna Commercial |
$73.12
|
| Rate for Payer: Aetna Medicare |
$22.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.88
|
| Rate for Payer: BCBS Complete |
$15.92
|
| Rate for Payer: BCBS MAPPO |
$21.50
|
| Rate for Payer: BCBS Trust/PPO |
$70.72
|
| Rate for Payer: BCN Commercial |
$70.72
|
| Rate for Payer: BCN Medicare Advantage |
$21.50
|
| Rate for Payer: Cash Price |
$68.82
|
| Rate for Payer: Cofinity Commercial |
$73.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.50
|
| Rate for Payer: Healthscope Commercial |
$77.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.52
|
| Rate for Payer: Mclaren Medicaid |
$15.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.58
|
| Rate for Payer: Meridian Medicaid |
$15.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.12
|
| Rate for Payer: Nomi Health Commercial |
$70.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.52
|
| Rate for Payer: PACE Senior Care Partners |
$20.43
|
| Rate for Payer: PACE SWMI |
$21.50
|
| Rate for Payer: PHP Commercial |
$73.12
|
| Rate for Payer: PHP Medicare Advantage |
$21.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.84
|
| Rate for Payer: Priority Health Medicare |
$21.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.87
|
| Rate for Payer: Railroad Medicare Medicare |
$21.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.70
|
| Rate for Payer: UHC Core |
$71.83
|
| Rate for Payer: UHC Exchange |
$21.50
|
| Rate for Payer: UHC Medicaid |
$15.17
|
| Rate for Payer: UHC Medicare Advantage |
$21.50
|
| Rate for Payer: UHCCP Medicaid |
$15.17
|
| Rate for Payer: VA VA |
$21.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.52
|
|
|
HC BDIAL VWAG
|
Facility
|
IP
|
$86.02
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500092
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$59.87 |
| Max. Negotiated Rate |
$77.42 |
| Rate for Payer: Aetna Commercial |
$73.12
|
| Rate for Payer: BCBS Trust/PPO |
$71.04
|
| Rate for Payer: BCN Commercial |
$71.04
|
| Rate for Payer: Cash Price |
$68.82
|
| Rate for Payer: Cofinity Commercial |
$73.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.82
|
| Rate for Payer: Healthscope Commercial |
$77.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.12
|
| Rate for Payer: Nomi Health Commercial |
$70.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.52
|
| Rate for Payer: PHP Commercial |
$73.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.70
|
| Rate for Payer: UHC Core |
$71.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.52
|
|
|
HC BDIAL VWFX
|
Facility
|
IP
|
$103.02
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500093
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$71.70 |
| Max. Negotiated Rate |
$92.72 |
| Rate for Payer: Aetna Commercial |
$87.57
|
| Rate for Payer: BCBS Trust/PPO |
$85.08
|
| Rate for Payer: BCN Commercial |
$85.08
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$88.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Healthscope Commercial |
$92.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.57
|
| Rate for Payer: Nomi Health Commercial |
$84.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.27
|
| Rate for Payer: PHP Commercial |
$87.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$89.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.66
|
| Rate for Payer: UHC Core |
$86.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.27
|
|
|
HC BDIAL VWFX
|
Facility
|
OP
|
$103.02
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500093
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.16 |
| Max. Negotiated Rate |
$92.72 |
| Rate for Payer: Aetna Commercial |
$87.57
|
| Rate for Payer: Aetna Medicare |
$26.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.19
|
| Rate for Payer: BCBS Complete |
$19.07
|
| Rate for Payer: BCBS MAPPO |
$25.75
|
| Rate for Payer: BCBS Trust/PPO |
$84.69
|
| Rate for Payer: BCN Commercial |
$84.69
|
| Rate for Payer: BCN Medicare Advantage |
$25.75
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$88.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.75
|
| Rate for Payer: Healthscope Commercial |
$92.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.27
|
| Rate for Payer: Mclaren Medicaid |
$18.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.04
|
| Rate for Payer: Meridian Medicaid |
$19.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.57
|
| Rate for Payer: Nomi Health Commercial |
$84.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.27
|
| Rate for Payer: PACE Senior Care Partners |
$24.47
|
| Rate for Payer: PACE SWMI |
$25.75
|
| Rate for Payer: PHP Commercial |
$87.57
|
| Rate for Payer: PHP Medicare Advantage |
$25.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$89.63
|
| Rate for Payer: Priority Health Medicare |
$26.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.70
|
| Rate for Payer: Railroad Medicare Medicare |
$25.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.66
|
| Rate for Payer: UHC Core |
$86.02
|
| Rate for Payer: UHC Exchange |
$25.75
|
| Rate for Payer: UHC Medicaid |
$18.16
|
| Rate for Payer: UHC Medicare Advantage |
$25.75
|
| Rate for Payer: UHCCP Medicaid |
$18.16
|
| Rate for Payer: VA VA |
$25.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.27
|
|
|
HC BEDSIDE/SIMPLE SPIROMETRY
|
Facility
|
OP
|
$244.04
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000001
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$43.02 |
| Max. Negotiated Rate |
$219.64 |
| Rate for Payer: Aetna Commercial |
$207.43
|
| Rate for Payer: Aetna Medicare |
$63.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.26
|
| Rate for Payer: BCBS Complete |
$45.17
|
| Rate for Payer: BCBS MAPPO |
$61.01
|
| Rate for Payer: BCBS Trust/PPO |
$200.63
|
| Rate for Payer: BCN Commercial |
$200.63
|
| Rate for Payer: BCN Medicare Advantage |
$61.01
|
| Rate for Payer: Cash Price |
$195.23
|
| Rate for Payer: Cofinity Commercial |
$209.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.01
|
| Rate for Payer: Healthscope Commercial |
$219.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.03
|
| Rate for Payer: Mclaren Medicaid |
$43.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.06
|
| Rate for Payer: Meridian Medicaid |
$45.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.43
|
| Rate for Payer: Nomi Health Commercial |
$200.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.03
|
| Rate for Payer: PACE Senior Care Partners |
$57.96
|
| Rate for Payer: PACE SWMI |
$61.01
|
| Rate for Payer: PHP Commercial |
$207.43
|
| Rate for Payer: PHP Medicare Advantage |
$61.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$212.31
|
| Rate for Payer: Priority Health Medicare |
$61.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.85
|
| Rate for Payer: Railroad Medicare Medicare |
$61.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.76
|
| Rate for Payer: UHC Core |
$203.77
|
| Rate for Payer: UHC Exchange |
$61.01
|
| Rate for Payer: UHC Medicaid |
$43.02
|
| Rate for Payer: UHC Medicare Advantage |
$61.01
|
| Rate for Payer: UHCCP Medicaid |
$43.02
|
| Rate for Payer: VA VA |
$61.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.03
|
|
|
HC BEDSIDE/SIMPLE SPIROMETRY
|
Facility
|
IP
|
$244.04
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000001
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$169.85 |
| Max. Negotiated Rate |
$219.64 |
| Rate for Payer: Aetna Commercial |
$207.43
|
| Rate for Payer: BCBS Trust/PPO |
$201.55
|
| Rate for Payer: BCN Commercial |
$201.55
|
| Rate for Payer: Cash Price |
$195.23
|
| Rate for Payer: Cofinity Commercial |
$209.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.23
|
| Rate for Payer: Healthscope Commercial |
$219.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.43
|
| Rate for Payer: Nomi Health Commercial |
$200.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.03
|
| Rate for Payer: PHP Commercial |
$207.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$212.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.76
|
| Rate for Payer: UHC Core |
$203.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.03
|
|
|
HC BEDSIDE URINE PREG TEST
|
Facility
|
OP
|
$29.71
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30000000
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$26.74 |
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: Aetna Medicare |
$7.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.28
|
| Rate for Payer: BCBS Complete |
$5.50
|
| Rate for Payer: BCBS MAPPO |
$7.43
|
| Rate for Payer: BCBS Trust/PPO |
$24.42
|
| Rate for Payer: BCCCP Commercial |
$8.61
|
| Rate for Payer: BCN Commercial |
$24.42
|
| Rate for Payer: BCN Medicare Advantage |
$7.43
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.43
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.28
|
| Rate for Payer: Mclaren Medicaid |
$5.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.80
|
| Rate for Payer: Meridian Medicaid |
$5.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Nomi Health Commercial |
$24.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PACE Senior Care Partners |
$7.06
|
| Rate for Payer: PACE SWMI |
$7.43
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: PHP Medicare Advantage |
$7.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.85
|
| Rate for Payer: Priority Health Medicare |
$7.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.68
|
| Rate for Payer: Railroad Medicare Medicare |
$7.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.14
|
| Rate for Payer: UHC Core |
$24.81
|
| Rate for Payer: UHC Exchange |
$7.43
|
| Rate for Payer: UHC Medicaid |
$5.24
|
| Rate for Payer: UHC Medicare Advantage |
$7.43
|
| Rate for Payer: UHCCP Medicaid |
$5.24
|
| Rate for Payer: VA VA |
$7.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.28
|
|
|
HC BEDSIDE URINE PREG TEST
|
Facility
|
IP
|
$29.71
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30000000
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.68 |
| Max. Negotiated Rate |
$26.74 |
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: BCBS Trust/PPO |
$24.54
|
| Rate for Payer: BCN Commercial |
$24.54
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Nomi Health Commercial |
$24.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.14
|
| Rate for Payer: UHC Core |
$24.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.28
|
|
|
HC BEECH IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200074
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC BEECH IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200074
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC BEHAVIOR COUNSEL OBESITY 15M
|
Facility
|
OP
|
$285.00
|
|
|
Service Code
|
HCPCS G0447
|
| Hospital Charge Code |
51000133
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$50.25 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Aetna Commercial |
$242.25
|
| Rate for Payer: Aetna Medicare |
$74.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.06
|
| Rate for Payer: BCBS Complete |
$52.75
|
| Rate for Payer: BCBS MAPPO |
$71.25
|
| Rate for Payer: BCBS Trust/PPO |
$234.30
|
| Rate for Payer: BCN Commercial |
$234.30
|
| Rate for Payer: BCN Medicare Advantage |
$71.25
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$245.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.25
|
| Rate for Payer: Healthscope Commercial |
$256.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.75
|
| Rate for Payer: Mclaren Medicaid |
$50.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.81
|
| Rate for Payer: Meridian Medicaid |
$52.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.25
|
| Rate for Payer: Nomi Health Commercial |
$233.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.75
|
| Rate for Payer: PACE Senior Care Partners |
$67.69
|
| Rate for Payer: PACE SWMI |
$71.25
|
| Rate for Payer: PHP Commercial |
$242.25
|
| Rate for Payer: PHP Medicare Advantage |
$71.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$247.95
|
| Rate for Payer: Priority Health Medicare |
$71.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.36
|
| Rate for Payer: Railroad Medicare Medicare |
$71.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.80
|
| Rate for Payer: UHC Core |
$237.97
|
| Rate for Payer: UHC Exchange |
$71.25
|
| Rate for Payer: UHC Medicaid |
$50.25
|
| Rate for Payer: UHC Medicare Advantage |
$71.25
|
| Rate for Payer: UHCCP Medicaid |
$50.25
|
| Rate for Payer: VA VA |
$71.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.75
|
|
|
HC BEHAVIOR COUNSEL OBESITY 15M
|
Facility
|
IP
|
$285.00
|
|
|
Service Code
|
HCPCS G0447
|
| Hospital Charge Code |
51000133
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$198.36 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Aetna Commercial |
$242.25
|
| Rate for Payer: BCBS Trust/PPO |
$235.38
|
| Rate for Payer: BCN Commercial |
$235.38
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$245.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.00
|
| Rate for Payer: Healthscope Commercial |
$256.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.25
|
| Rate for Payer: Nomi Health Commercial |
$233.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.75
|
| Rate for Payer: PHP Commercial |
$242.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$247.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.80
|
| Rate for Payer: UHC Core |
$237.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.75
|
|
|
HC BENCE JONES PROTEIN
|
Facility
|
OP
|
$172.50
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200197
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.41 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Aetna Commercial |
$146.62
|
| Rate for Payer: Aetna Medicare |
$44.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.91
|
| Rate for Payer: BCBS Complete |
$31.93
|
| Rate for Payer: BCBS MAPPO |
$43.12
|
| Rate for Payer: BCBS Trust/PPO |
$141.81
|
| Rate for Payer: BCN Commercial |
$141.81
|
| Rate for Payer: BCN Medicare Advantage |
$43.12
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cofinity Commercial |
$148.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.12
|
| Rate for Payer: Healthscope Commercial |
$155.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.38
|
| Rate for Payer: Mclaren Medicaid |
$30.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.28
|
| Rate for Payer: Meridian Medicaid |
$31.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.62
|
| Rate for Payer: Nomi Health Commercial |
$141.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.38
|
| Rate for Payer: PACE Senior Care Partners |
$40.97
|
| Rate for Payer: PACE SWMI |
$43.12
|
| Rate for Payer: PHP Commercial |
$146.62
|
| Rate for Payer: PHP Medicare Advantage |
$43.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$150.07
|
| Rate for Payer: Priority Health Medicare |
$43.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$120.06
|
| Rate for Payer: Railroad Medicare Medicare |
$43.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.80
|
| Rate for Payer: UHC Core |
$144.04
|
| Rate for Payer: UHC Exchange |
$43.12
|
| Rate for Payer: UHC Medicaid |
$30.41
|
| Rate for Payer: UHC Medicare Advantage |
$43.12
|
| Rate for Payer: UHCCP Medicaid |
$30.41
|
| Rate for Payer: VA VA |
$43.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.38
|
|
|
HC BENCE JONES PROTEIN
|
Facility
|
IP
|
$172.50
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200197
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$120.06 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Aetna Commercial |
$146.62
|
| Rate for Payer: BCBS Trust/PPO |
$142.47
|
| Rate for Payer: BCN Commercial |
$142.47
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cofinity Commercial |
$148.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.00
|
| Rate for Payer: Healthscope Commercial |
$155.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.62
|
| Rate for Payer: Nomi Health Commercial |
$141.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.38
|
| Rate for Payer: PHP Commercial |
$146.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$150.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$120.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.80
|
| Rate for Payer: UHC Core |
$144.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.38
|
|
|
HC BENIGN HYPERKERATOTIC 2-4 LESIONS
|
Facility
|
OP
|
$283.50
|
|
|
Service Code
|
CPT 11056
|
| Hospital Charge Code |
76100039
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.98 |
| Max. Negotiated Rate |
$255.15 |
| Rate for Payer: Aetna Commercial |
$240.97
|
| Rate for Payer: Aetna Medicare |
$73.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.59
|
| Rate for Payer: BCBS Complete |
$52.48
|
| Rate for Payer: BCBS MAPPO |
$70.88
|
| Rate for Payer: BCBS Trust/PPO |
$233.07
|
| Rate for Payer: BCN Commercial |
$233.07
|
| Rate for Payer: BCN Medicare Advantage |
$70.88
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cofinity Commercial |
$243.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.88
|
| Rate for Payer: Healthscope Commercial |
$255.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.62
|
| Rate for Payer: Mclaren Medicaid |
$49.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.42
|
| Rate for Payer: Meridian Medicaid |
$52.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.97
|
| Rate for Payer: Nomi Health Commercial |
$232.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.62
|
| Rate for Payer: PACE Senior Care Partners |
$67.33
|
| Rate for Payer: PACE SWMI |
$70.88
|
| Rate for Payer: PHP Commercial |
$240.97
|
| Rate for Payer: PHP Medicare Advantage |
$70.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$246.65
|
| Rate for Payer: Priority Health Medicare |
$71.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.32
|
| Rate for Payer: Railroad Medicare Medicare |
$70.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.48
|
| Rate for Payer: UHC Core |
$236.72
|
| Rate for Payer: UHC Exchange |
$70.88
|
| Rate for Payer: UHC Medicaid |
$49.98
|
| Rate for Payer: UHC Medicare Advantage |
$70.88
|
| Rate for Payer: UHCCP Medicaid |
$49.98
|
| Rate for Payer: VA VA |
$70.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.62
|
|
|
HC BENIGN HYPERKERATOTIC 2-4 LESIONS
|
Facility
|
IP
|
$283.50
|
|
|
Service Code
|
CPT 11056
|
| Hospital Charge Code |
76100039
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$197.32 |
| Max. Negotiated Rate |
$255.15 |
| Rate for Payer: Aetna Commercial |
$240.97
|
| Rate for Payer: BCBS Trust/PPO |
$234.14
|
| Rate for Payer: BCN Commercial |
$234.14
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cofinity Commercial |
$243.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.80
|
| Rate for Payer: Healthscope Commercial |
$255.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.97
|
| Rate for Payer: Nomi Health Commercial |
$232.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.62
|
| Rate for Payer: PHP Commercial |
$240.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$246.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.48
|
| Rate for Payer: UHC Core |
$236.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.62
|
|
|
HC BENIGN HYPERKERATOTIC >4 LESIONS
|
Facility
|
OP
|
$283.50
|
|
|
Service Code
|
CPT 11057
|
| Hospital Charge Code |
76100040
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.98 |
| Max. Negotiated Rate |
$255.15 |
| Rate for Payer: Aetna Commercial |
$240.97
|
| Rate for Payer: Aetna Medicare |
$73.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.59
|
| Rate for Payer: BCBS Complete |
$52.48
|
| Rate for Payer: BCBS MAPPO |
$70.88
|
| Rate for Payer: BCBS Trust/PPO |
$233.07
|
| Rate for Payer: BCN Commercial |
$233.07
|
| Rate for Payer: BCN Medicare Advantage |
$70.88
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cofinity Commercial |
$243.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.88
|
| Rate for Payer: Healthscope Commercial |
$255.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.62
|
| Rate for Payer: Mclaren Medicaid |
$49.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.42
|
| Rate for Payer: Meridian Medicaid |
$52.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.97
|
| Rate for Payer: Nomi Health Commercial |
$232.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.62
|
| Rate for Payer: PACE Senior Care Partners |
$67.33
|
| Rate for Payer: PACE SWMI |
$70.88
|
| Rate for Payer: PHP Commercial |
$240.97
|
| Rate for Payer: PHP Medicare Advantage |
$70.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$246.65
|
| Rate for Payer: Priority Health Medicare |
$71.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.32
|
| Rate for Payer: Railroad Medicare Medicare |
$70.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.48
|
| Rate for Payer: UHC Core |
$236.72
|
| Rate for Payer: UHC Exchange |
$70.88
|
| Rate for Payer: UHC Medicaid |
$49.98
|
| Rate for Payer: UHC Medicare Advantage |
$70.88
|
| Rate for Payer: UHCCP Medicaid |
$49.98
|
| Rate for Payer: VA VA |
$70.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.62
|
|
|
HC BENIGN HYPERKERATOTIC >4 LESIONS
|
Facility
|
IP
|
$283.50
|
|
|
Service Code
|
CPT 11057
|
| Hospital Charge Code |
76100040
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$197.32 |
| Max. Negotiated Rate |
$255.15 |
| Rate for Payer: Aetna Commercial |
$240.97
|
| Rate for Payer: BCBS Trust/PPO |
$234.14
|
| Rate for Payer: BCN Commercial |
$234.14
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cofinity Commercial |
$243.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.80
|
| Rate for Payer: Healthscope Commercial |
$255.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.97
|
| Rate for Payer: Nomi Health Commercial |
$232.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.62
|
| Rate for Payer: PHP Commercial |
$240.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$246.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.48
|
| Rate for Payer: UHC Core |
$236.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.62
|
|
|
HC BENIGN HYPERKERATOTIC LESION
|
Facility
|
IP
|
$283.50
|
|
|
Service Code
|
CPT 11055
|
| Hospital Charge Code |
76100041
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$197.32 |
| Max. Negotiated Rate |
$255.15 |
| Rate for Payer: Aetna Commercial |
$240.97
|
| Rate for Payer: BCBS Trust/PPO |
$234.14
|
| Rate for Payer: BCN Commercial |
$234.14
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cofinity Commercial |
$243.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.80
|
| Rate for Payer: Healthscope Commercial |
$255.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.97
|
| Rate for Payer: Nomi Health Commercial |
$232.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.62
|
| Rate for Payer: PHP Commercial |
$240.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$246.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.48
|
| Rate for Payer: UHC Core |
$236.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.62
|
|
|
HC BENIGN HYPERKERATOTIC LESION
|
Facility
|
OP
|
$283.50
|
|
|
Service Code
|
CPT 11055
|
| Hospital Charge Code |
76100041
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.98 |
| Max. Negotiated Rate |
$255.15 |
| Rate for Payer: Aetna Commercial |
$240.97
|
| Rate for Payer: Aetna Medicare |
$73.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.59
|
| Rate for Payer: BCBS Complete |
$52.48
|
| Rate for Payer: BCBS MAPPO |
$70.88
|
| Rate for Payer: BCBS Trust/PPO |
$233.07
|
| Rate for Payer: BCN Commercial |
$233.07
|
| Rate for Payer: BCN Medicare Advantage |
$70.88
|
| Rate for Payer: Cash Price |
$226.80
|
| Rate for Payer: Cofinity Commercial |
$243.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.88
|
| Rate for Payer: Healthscope Commercial |
$255.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.62
|
| Rate for Payer: Mclaren Medicaid |
$49.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.42
|
| Rate for Payer: Meridian Medicaid |
$52.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$240.97
|
| Rate for Payer: Nomi Health Commercial |
$232.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$212.62
|
| Rate for Payer: PACE Senior Care Partners |
$67.33
|
| Rate for Payer: PACE SWMI |
$70.88
|
| Rate for Payer: PHP Commercial |
$240.97
|
| Rate for Payer: PHP Medicare Advantage |
$70.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$246.65
|
| Rate for Payer: Priority Health Medicare |
$71.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.32
|
| Rate for Payer: Railroad Medicare Medicare |
$70.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.48
|
| Rate for Payer: UHC Core |
$236.72
|
| Rate for Payer: UHC Exchange |
$70.88
|
| Rate for Payer: UHC Medicaid |
$49.98
|
| Rate for Payer: UHC Medicare Advantage |
$70.88
|
| Rate for Payer: UHCCP Medicaid |
$49.98
|
| Rate for Payer: VA VA |
$70.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.62
|
|
|
HC BENZO CONFIRMATION CMPT 1
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 80347
|
| Hospital Charge Code |
30000164
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna Medicare |
$9.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.38
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$9.10
|
| Rate for Payer: BCBS Trust/PPO |
$29.93
|
| Rate for Payer: BCN Commercial |
$29.93
|
| Rate for Payer: BCN Medicare Advantage |
$9.10
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.10
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.56
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.31
|
| Rate for Payer: PACE Senior Care Partners |
$8.65
|
| Rate for Payer: PACE SWMI |
$9.10
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: PHP Medicare Advantage |
$9.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.68
|
| Rate for Payer: Priority Health Medicare |
$9.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.34
|
| Rate for Payer: Railroad Medicare Medicare |
$9.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.04
|
| Rate for Payer: UHC Core |
$30.40
|
| Rate for Payer: UHC Exchange |
$9.10
|
| Rate for Payer: UHC Medicaid |
$6.42
|
| Rate for Payer: UHC Medicare Advantage |
$9.10
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: VA VA |
$9.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC BENZO CONFIRMATION CMPT 1
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 80347
|
| Hospital Charge Code |
30000164
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.34 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: BCBS Trust/PPO |
$30.07
|
| Rate for Payer: BCN Commercial |
$30.07
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.31
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.04
|
| Rate for Payer: UHC Core |
$30.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC BENZO CONFIRMATION CMPT 2
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
CPT 80368
|
| Hospital Charge Code |
30000165
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.87 |
| Max. Negotiated Rate |
$29.96 |
| Rate for Payer: Aetna Commercial |
$28.30
|
| Rate for Payer: Aetna Medicare |
$8.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.40
|
| Rate for Payer: BCBS Complete |
$6.16
|
| Rate for Payer: BCBS MAPPO |
$8.32
|
| Rate for Payer: BCBS Trust/PPO |
$27.37
|
| Rate for Payer: BCN Commercial |
$27.37
|
| Rate for Payer: BCN Medicare Advantage |
$8.32
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$28.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$29.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.97
|
| Rate for Payer: Mclaren Medicaid |
$5.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.74
|
| Rate for Payer: Meridian Medicaid |
$6.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.97
|
| Rate for Payer: PACE Senior Care Partners |
$7.91
|
| Rate for Payer: PACE SWMI |
$8.32
|
| Rate for Payer: PHP Commercial |
$28.30
|
| Rate for Payer: PHP Medicare Advantage |
$8.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.96
|
| Rate for Payer: Priority Health Medicare |
$8.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.17
|
| Rate for Payer: Railroad Medicare Medicare |
$8.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.30
|
| Rate for Payer: UHC Core |
$27.80
|
| Rate for Payer: UHC Exchange |
$8.32
|
| Rate for Payer: UHC Medicaid |
$5.87
|
| Rate for Payer: UHC Medicare Advantage |
$8.32
|
| Rate for Payer: UHCCP Medicaid |
$5.87
|
| Rate for Payer: VA VA |
$8.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.97
|
|
|
HC BENZO CONFIRMATION CMPT 2
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
CPT 80368
|
| Hospital Charge Code |
30000165
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.17 |
| Max. Negotiated Rate |
$29.96 |
| Rate for Payer: Aetna Commercial |
$28.30
|
| Rate for Payer: BCBS Trust/PPO |
$27.49
|
| Rate for Payer: BCN Commercial |
$27.49
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$28.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Healthscope Commercial |
$29.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.97
|
| Rate for Payer: PHP Commercial |
$28.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.30
|
| Rate for Payer: UHC Core |
$27.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.97
|
|
