|
HC CULTURE ENTERIC PATH STOOL CMPT
|
Facility
|
OP
|
$15.34
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
30600324
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$13.81 |
| Rate for Payer: Aetna Commercial |
$13.04
|
| Rate for Payer: Aetna Medicare |
$3.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.79
|
| Rate for Payer: BCBS Complete |
$7.32
|
| Rate for Payer: BCBS MAPPO |
$3.84
|
| Rate for Payer: BCBS Trust/PPO |
$11.93
|
| Rate for Payer: BCN Commercial |
$11.93
|
| Rate for Payer: BCN Medicare Advantage |
$3.84
|
| Rate for Payer: Cash Price |
$12.27
|
| Rate for Payer: Cash Price |
$12.27
|
| Rate for Payer: Cofinity Commercial |
$13.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.84
|
| Rate for Payer: Healthscope Commercial |
$13.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.50
|
| Rate for Payer: Mclaren Medicaid |
$6.97
|
| Rate for Payer: Meridian Medicaid |
$7.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.04
|
| Rate for Payer: PACE Senior Care Partners |
$3.64
|
| Rate for Payer: PACE SWMI |
$3.84
|
| Rate for Payer: PHP Commercial |
$13.04
|
| Rate for Payer: PHP Medicare Advantage |
$3.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.35
|
| Rate for Payer: Priority Health Medicare |
$3.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.50
|
| Rate for Payer: UHC Core |
$12.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.84
|
| Rate for Payer: UHC Medicare Advantage |
$3.95
|
| Rate for Payer: VA VA |
$3.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.50
|
|
|
HC CULTURE ENTERIC PATH STOOL CMPT
|
Facility
|
IP
|
$15.34
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
30600324
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$13.81 |
| Rate for Payer: Aetna Commercial |
$13.04
|
| Rate for Payer: BCBS Trust/PPO |
$11.85
|
| Rate for Payer: BCN Commercial |
$11.85
|
| Rate for Payer: Cash Price |
$12.27
|
| Rate for Payer: Cofinity Commercial |
$13.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.27
|
| Rate for Payer: Healthscope Commercial |
$13.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.04
|
| Rate for Payer: PHP Commercial |
$13.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.50
|
| Rate for Payer: UHC Core |
$12.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.50
|
|
|
HC CULTURE FUNGAL OTHER SOURCE
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
30600083
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.21 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$67.15
|
| Rate for Payer: Aetna Medicare |
$20.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.69
|
| Rate for Payer: BCBS Complete |
$6.52
|
| Rate for Payer: BCBS MAPPO |
$19.75
|
| Rate for Payer: BCBS Trust/PPO |
$61.42
|
| Rate for Payer: BCN Commercial |
$61.42
|
| Rate for Payer: BCN Medicare Advantage |
$19.75
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$67.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.75
|
| Rate for Payer: Healthscope Commercial |
$71.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.25
|
| Rate for Payer: Mclaren Medicaid |
$6.21
|
| Rate for Payer: Meridian Medicaid |
$6.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PACE Senior Care Partners |
$18.76
|
| Rate for Payer: PACE SWMI |
$19.75
|
| Rate for Payer: PHP Commercial |
$67.15
|
| Rate for Payer: PHP Medicare Advantage |
$19.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.73
|
| Rate for Payer: Priority Health Medicare |
$19.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.18
|
| Rate for Payer: Railroad Medicare Medicare |
$19.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.52
|
| Rate for Payer: UHC Core |
$65.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.75
|
| Rate for Payer: UHC Medicare Advantage |
$20.34
|
| Rate for Payer: VA VA |
$19.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.25
|
|
|
HC CULTURE FUNGAL OTHER SOURCE
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
30600083
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$48.18 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$67.15
|
| Rate for Payer: BCBS Trust/PPO |
$61.05
|
| Rate for Payer: BCN Commercial |
$61.05
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$67.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Healthscope Commercial |
$71.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PHP Commercial |
$67.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.52
|
| Rate for Payer: UHC Core |
$65.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.25
|
|
|
HC CULTURE FUNGAL SKIN, HAIR, NAIL
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
30600082
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.69 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$67.15
|
| Rate for Payer: Aetna Medicare |
$20.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.69
|
| Rate for Payer: BCBS Complete |
$5.97
|
| Rate for Payer: BCBS MAPPO |
$19.75
|
| Rate for Payer: BCBS Trust/PPO |
$61.42
|
| Rate for Payer: BCN Commercial |
$61.42
|
| Rate for Payer: BCN Medicare Advantage |
$19.75
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$67.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.75
|
| Rate for Payer: Healthscope Commercial |
$71.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.25
|
| Rate for Payer: Mclaren Medicaid |
$5.69
|
| Rate for Payer: Meridian Medicaid |
$5.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PACE Senior Care Partners |
$18.76
|
| Rate for Payer: PACE SWMI |
$19.75
|
| Rate for Payer: PHP Commercial |
$67.15
|
| Rate for Payer: PHP Medicare Advantage |
$19.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.73
|
| Rate for Payer: Priority Health Medicare |
$19.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.18
|
| Rate for Payer: Railroad Medicare Medicare |
$19.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.52
|
| Rate for Payer: UHC Core |
$65.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.75
|
| Rate for Payer: UHC Medicare Advantage |
$20.34
|
| Rate for Payer: VA VA |
$19.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.25
|
|
|
HC CULTURE FUNGAL SKIN, HAIR, NAIL
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
30600082
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$48.18 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$67.15
|
| Rate for Payer: BCBS Trust/PPO |
$61.05
|
| Rate for Payer: BCN Commercial |
$61.05
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$67.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Healthscope Commercial |
$71.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PHP Commercial |
$67.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.52
|
| Rate for Payer: UHC Core |
$65.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.25
|
|
|
HC CULTURE ID BLOOD PATHOGEN BY NUCLEIC ACID
|
Facility
|
OP
|
$612.00
|
|
|
Service Code
|
CPT 87154
|
| Hospital Charge Code |
30600329
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$145.35 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna Medicare |
$159.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.25
|
| Rate for Payer: BCBS Complete |
$168.97
|
| Rate for Payer: BCBS MAPPO |
$153.00
|
| Rate for Payer: BCBS Trust/PPO |
$475.83
|
| Rate for Payer: BCN Commercial |
$475.83
|
| Rate for Payer: BCN Medicare Advantage |
$153.00
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.00
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| Rate for Payer: Mclaren Medicaid |
$160.93
|
| Rate for Payer: Meridian Medicaid |
$168.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$160.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$520.20
|
| Rate for Payer: PACE Senior Care Partners |
$145.35
|
| Rate for Payer: PACE SWMI |
$153.00
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: PHP Medicare Advantage |
$153.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$532.44
|
| Rate for Payer: Priority Health Medicare |
$153.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$373.26
|
| Rate for Payer: Railroad Medicare Medicare |
$153.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.56
|
| Rate for Payer: UHC Core |
$511.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.00
|
| Rate for Payer: UHC Medicare Advantage |
$157.59
|
| Rate for Payer: VA VA |
$153.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
HC CULTURE ID BLOOD PATHOGEN BY NUCLEIC ACID
|
Facility
|
IP
|
$612.00
|
|
|
Service Code
|
CPT 87154
|
| Hospital Charge Code |
30600329
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$373.26 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: BCBS Trust/PPO |
$472.95
|
| Rate for Payer: BCN Commercial |
$472.95
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$520.20
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$532.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$373.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$538.56
|
| Rate for Payer: UHC Core |
$511.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
HC CULTURE OTHER SOURCE
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600075
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.99 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$35.47
|
| Rate for Payer: BCN Commercial |
$35.47
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC CULTURE OTHER SOURCE
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600075
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.36 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$11.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.34
|
| Rate for Payer: BCBS Complete |
$6.68
|
| Rate for Payer: BCBS MAPPO |
$11.48
|
| Rate for Payer: BCBS Trust/PPO |
$35.69
|
| Rate for Payer: BCN Commercial |
$35.69
|
| Rate for Payer: BCN Medicare Advantage |
$11.48
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.48
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$6.36
|
| Rate for Payer: Meridian Medicaid |
$6.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Senior Care Partners |
$10.90
|
| Rate for Payer: PACE SWMI |
$11.48
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$11.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.93
|
| Rate for Payer: Priority Health Medicare |
$11.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.99
|
| Rate for Payer: Railroad Medicare Medicare |
$11.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.48
|
| Rate for Payer: UHC Medicare Advantage |
$11.82
|
| Rate for Payer: VA VA |
$11.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC CULTURE SCREENING
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
30600079
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.89 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$4.89
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC CULTURE SCREENING
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
30600079
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC CUVETTE HEMOCHRON JR ACT+
|
Facility
|
IP
|
$12.75
|
|
| Hospital Charge Code |
27000657
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.78 |
| Max. Negotiated Rate |
$11.48 |
| Rate for Payer: Aetna Commercial |
$10.84
|
| Rate for Payer: BCBS Trust/PPO |
$9.85
|
| Rate for Payer: BCN Commercial |
$9.85
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cofinity Commercial |
$10.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$11.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.84
|
| Rate for Payer: PHP Commercial |
$10.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.22
|
| Rate for Payer: UHC Core |
$10.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.56
|
|
|
HC CUVETTE HEMOCHRON JR ACT+
|
Facility
|
OP
|
$12.75
|
|
| Hospital Charge Code |
27000657
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$11.48 |
| Rate for Payer: Aetna Commercial |
$10.84
|
| Rate for Payer: Aetna Medicare |
$3.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.98
|
| Rate for Payer: BCBS Complete |
$5.10
|
| Rate for Payer: BCBS MAPPO |
$3.19
|
| Rate for Payer: BCBS Trust/PPO |
$9.91
|
| Rate for Payer: BCN Commercial |
$9.91
|
| Rate for Payer: BCN Medicare Advantage |
$3.19
|
| Rate for Payer: Cash Price |
$10.20
|
| Rate for Payer: Cofinity Commercial |
$10.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.19
|
| Rate for Payer: Healthscope Commercial |
$11.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.84
|
| Rate for Payer: PACE Senior Care Partners |
$3.03
|
| Rate for Payer: PACE SWMI |
$3.19
|
| Rate for Payer: PHP Commercial |
$10.84
|
| Rate for Payer: PHP Medicare Advantage |
$3.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.09
|
| Rate for Payer: Priority Health Medicare |
$3.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.22
|
| Rate for Payer: UHC Core |
$10.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.19
|
| Rate for Payer: UHC Medicare Advantage |
$3.28
|
| Rate for Payer: VA VA |
$3.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.56
|
|
|
HC CVC ACCESS TRAY
|
Facility
|
IP
|
$131.94
|
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$80.47 |
| Max. Negotiated Rate |
$118.75 |
| Rate for Payer: Aetna Commercial |
$112.15
|
| Rate for Payer: BCBS Trust/PPO |
$101.96
|
| Rate for Payer: BCN Commercial |
$101.96
|
| Rate for Payer: Cash Price |
$105.55
|
| Rate for Payer: Cofinity Commercial |
$113.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.55
|
| Rate for Payer: Healthscope Commercial |
$118.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.15
|
| Rate for Payer: PHP Commercial |
$112.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.11
|
| Rate for Payer: UHC Core |
$110.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.96
|
|
|
HC CVC ACCESS TRAY
|
Facility
|
OP
|
$131.94
|
|
| Hospital Charge Code |
27000052
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.34 |
| Max. Negotiated Rate |
$118.75 |
| Rate for Payer: Aetna Commercial |
$112.15
|
| Rate for Payer: Aetna Medicare |
$34.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.23
|
| Rate for Payer: BCBS Complete |
$52.78
|
| Rate for Payer: BCBS MAPPO |
$32.98
|
| Rate for Payer: BCBS Trust/PPO |
$102.58
|
| Rate for Payer: BCN Commercial |
$102.58
|
| Rate for Payer: BCN Medicare Advantage |
$32.98
|
| Rate for Payer: Cash Price |
$105.55
|
| Rate for Payer: Cofinity Commercial |
$113.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.98
|
| Rate for Payer: Healthscope Commercial |
$118.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.15
|
| Rate for Payer: PACE Senior Care Partners |
$31.34
|
| Rate for Payer: PACE SWMI |
$32.98
|
| Rate for Payer: PHP Commercial |
$112.15
|
| Rate for Payer: PHP Medicare Advantage |
$32.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.79
|
| Rate for Payer: Priority Health Medicare |
$32.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.47
|
| Rate for Payer: Railroad Medicare Medicare |
$32.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.11
|
| Rate for Payer: UHC Core |
$110.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.98
|
| Rate for Payer: UHC Medicare Advantage |
$33.97
|
| Rate for Payer: VA VA |
$32.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.96
|
|
|
HC CVC INSERT
|
Facility
|
OP
|
$2,495.63
|
|
| Hospital Charge Code |
45000036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$592.71 |
| Max. Negotiated Rate |
$2,246.07 |
| Rate for Payer: Aetna Commercial |
$2,121.29
|
| Rate for Payer: Aetna Medicare |
$648.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$779.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$779.88
|
| Rate for Payer: BCBS Complete |
$998.25
|
| Rate for Payer: BCBS MAPPO |
$623.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,940.35
|
| Rate for Payer: BCN Commercial |
$1,940.35
|
| Rate for Payer: BCN Medicare Advantage |
$623.91
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$2,146.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$623.91
|
| Rate for Payer: Healthscope Commercial |
$2,246.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,871.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$655.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$717.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PACE Senior Care Partners |
$592.71
|
| Rate for Payer: PACE SWMI |
$623.91
|
| Rate for Payer: PHP Commercial |
$2,121.29
|
| Rate for Payer: PHP Medicare Advantage |
$623.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,171.20
|
| Rate for Payer: Priority Health Medicare |
$623.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,522.08
|
| Rate for Payer: Railroad Medicare Medicare |
$623.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,196.15
|
| Rate for Payer: UHC Core |
$2,083.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$623.91
|
| Rate for Payer: UHC Medicare Advantage |
$642.62
|
| Rate for Payer: VA VA |
$623.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,871.72
|
|
|
HC CVC INSERT
|
Facility
|
IP
|
$2,495.63
|
|
| Hospital Charge Code |
45000036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,522.08 |
| Max. Negotiated Rate |
$2,246.07 |
| Rate for Payer: Aetna Commercial |
$2,121.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,928.62
|
| Rate for Payer: BCN Commercial |
$1,928.62
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$2,146.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Healthscope Commercial |
$2,246.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,871.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PHP Commercial |
$2,121.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,171.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,522.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,196.15
|
| Rate for Payer: UHC Core |
$2,083.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,871.72
|
|
|
HC CVS PSEUDOANEURYSM COMPRESSION
|
Facility
|
OP
|
$800.53
|
|
|
Service Code
|
CPT 76936
|
| Hospital Charge Code |
40200042
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$190.13 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: Aetna Medicare |
$208.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$250.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$250.17
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$200.13
|
| Rate for Payer: BCBS Trust/PPO |
$622.41
|
| Rate for Payer: BCN Commercial |
$622.41
|
| Rate for Payer: BCN Medicare Advantage |
$200.13
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.13
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$210.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$230.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PACE Senior Care Partners |
$190.13
|
| Rate for Payer: PACE SWMI |
$200.13
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: PHP Medicare Advantage |
$200.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.46
|
| Rate for Payer: Priority Health Medicare |
$200.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.24
|
| Rate for Payer: Railroad Medicare Medicare |
$200.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.47
|
| Rate for Payer: UHC Core |
$668.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.13
|
| Rate for Payer: UHC Medicare Advantage |
$206.14
|
| Rate for Payer: VA VA |
$200.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
|
HC CVS PSEUDOANEURYSM COMPRESSION
|
Facility
|
IP
|
$800.53
|
|
|
Service Code
|
CPT 76936
|
| Hospital Charge Code |
40200042
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$488.24 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: BCBS Trust/PPO |
$618.65
|
| Rate for Payer: BCN Commercial |
$618.65
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.47
|
| Rate for Payer: UHC Core |
$668.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
|
HC CVVHD INSERTION
|
Facility
|
OP
|
$408.67
|
|
| Hospital Charge Code |
27000053
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$97.06 |
| Max. Negotiated Rate |
$367.80 |
| Rate for Payer: Aetna Commercial |
$347.37
|
| Rate for Payer: Aetna Medicare |
$106.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$127.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$127.71
|
| Rate for Payer: BCBS Complete |
$163.47
|
| Rate for Payer: BCBS MAPPO |
$102.17
|
| Rate for Payer: BCBS Trust/PPO |
$317.74
|
| Rate for Payer: BCN Commercial |
$317.74
|
| Rate for Payer: BCN Medicare Advantage |
$102.17
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$351.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.17
|
| Rate for Payer: Healthscope Commercial |
$367.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$107.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$347.37
|
| Rate for Payer: PACE Senior Care Partners |
$97.06
|
| Rate for Payer: PACE SWMI |
$102.17
|
| Rate for Payer: PHP Commercial |
$347.37
|
| Rate for Payer: PHP Medicare Advantage |
$102.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$355.54
|
| Rate for Payer: Priority Health Medicare |
$102.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.25
|
| Rate for Payer: Railroad Medicare Medicare |
$102.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.63
|
| Rate for Payer: UHC Core |
$341.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.17
|
| Rate for Payer: UHC Medicare Advantage |
$105.23
|
| Rate for Payer: VA VA |
$102.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.50
|
|
|
HC CVVHD INSERTION
|
Facility
|
IP
|
$408.67
|
|
| Hospital Charge Code |
27000053
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$249.25 |
| Max. Negotiated Rate |
$367.80 |
| Rate for Payer: Aetna Commercial |
$347.37
|
| Rate for Payer: BCBS Trust/PPO |
$315.82
|
| Rate for Payer: BCN Commercial |
$315.82
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$351.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Healthscope Commercial |
$367.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$347.37
|
| Rate for Payer: PHP Commercial |
$347.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$355.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.63
|
| Rate for Payer: UHC Core |
$341.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.50
|
|
|
HC CVVH SUBSEQUENT CARTRIDGE
|
Facility
|
IP
|
$619.07
|
|
| Hospital Charge Code |
27000611
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$377.57 |
| Max. Negotiated Rate |
$557.16 |
| Rate for Payer: Aetna Commercial |
$526.21
|
| Rate for Payer: BCBS Trust/PPO |
$478.42
|
| Rate for Payer: BCN Commercial |
$478.42
|
| Rate for Payer: Cash Price |
$495.26
|
| Rate for Payer: Cofinity Commercial |
$532.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$495.26
|
| Rate for Payer: Healthscope Commercial |
$557.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$464.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$526.21
|
| Rate for Payer: PHP Commercial |
$526.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$538.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$544.78
|
| Rate for Payer: UHC Core |
$516.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$464.30
|
|
|
HC CVVH SUBSEQUENT CARTRIDGE
|
Facility
|
OP
|
$619.07
|
|
| Hospital Charge Code |
27000611
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$147.03 |
| Max. Negotiated Rate |
$557.16 |
| Rate for Payer: Aetna Commercial |
$526.21
|
| Rate for Payer: Aetna Medicare |
$160.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.46
|
| Rate for Payer: BCBS Complete |
$247.63
|
| Rate for Payer: BCBS MAPPO |
$154.77
|
| Rate for Payer: BCBS Trust/PPO |
$481.33
|
| Rate for Payer: BCN Commercial |
$481.33
|
| Rate for Payer: BCN Medicare Advantage |
$154.77
|
| Rate for Payer: Cash Price |
$495.26
|
| Rate for Payer: Cofinity Commercial |
$532.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$495.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.77
|
| Rate for Payer: Healthscope Commercial |
$557.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$464.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$162.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$526.21
|
| Rate for Payer: PACE Senior Care Partners |
$147.03
|
| Rate for Payer: PACE SWMI |
$154.77
|
| Rate for Payer: PHP Commercial |
$526.21
|
| Rate for Payer: PHP Medicare Advantage |
$154.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$538.59
|
| Rate for Payer: Priority Health Medicare |
$154.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.57
|
| Rate for Payer: Railroad Medicare Medicare |
$154.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$544.78
|
| Rate for Payer: UHC Core |
$516.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.77
|
| Rate for Payer: UHC Medicare Advantage |
$159.41
|
| Rate for Payer: VA VA |
$154.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$464.30
|
|
|
HC CX ID BY PCR AMP, ENTEROBACTERIACEA
|
Facility
|
OP
|
$56.35
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600240
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.38 |
| Max. Negotiated Rate |
$50.72 |
| Rate for Payer: Aetna Commercial |
$47.90
|
| Rate for Payer: Aetna Medicare |
$14.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.61
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$14.09
|
| Rate for Payer: BCBS Trust/PPO |
$43.81
|
| Rate for Payer: BCN Commercial |
$43.81
|
| Rate for Payer: BCN Medicare Advantage |
$14.09
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Cofinity Commercial |
$48.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.09
|
| Rate for Payer: Healthscope Commercial |
$50.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.26
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.90
|
| Rate for Payer: PACE Senior Care Partners |
$13.38
|
| Rate for Payer: PACE SWMI |
$14.09
|
| Rate for Payer: PHP Commercial |
$47.90
|
| Rate for Payer: PHP Medicare Advantage |
$14.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.02
|
| Rate for Payer: Priority Health Medicare |
$14.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.37
|
| Rate for Payer: Railroad Medicare Medicare |
$14.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.59
|
| Rate for Payer: UHC Core |
$47.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.09
|
| Rate for Payer: UHC Medicare Advantage |
$14.51
|
| Rate for Payer: VA VA |
$14.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.26
|
|
