|
HC BILIARY BRUSH BIOPSY
|
Facility
|
IP
|
$4,149.40
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,887.98 |
| Max. Negotiated Rate |
$3,734.46 |
| Rate for Payer: Aetna Commercial |
$3,526.99
|
| Rate for Payer: BCBS Trust/PPO |
$3,426.99
|
| Rate for Payer: BCN Commercial |
$3,426.99
|
| Rate for Payer: Cash Price |
$3,319.52
|
| Rate for Payer: Cofinity Commercial |
$3,568.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,319.52
|
| Rate for Payer: Healthscope Commercial |
$3,734.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,112.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,526.99
|
| Rate for Payer: Nomi Health Commercial |
$3,402.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,112.05
|
| Rate for Payer: PHP Commercial |
$3,526.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,609.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,887.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,651.47
|
| Rate for Payer: UHC Core |
$3,464.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,112.05
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
OP
|
$4,149.40
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$731.54 |
| Max. Negotiated Rate |
$3,734.46 |
| Rate for Payer: Aetna Commercial |
$3,526.99
|
| Rate for Payer: Aetna Medicare |
$1,078.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,296.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,296.69
|
| Rate for Payer: BCBS Complete |
$768.05
|
| Rate for Payer: BCBS MAPPO |
$1,037.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,411.22
|
| Rate for Payer: BCN Commercial |
$3,411.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,037.35
|
| Rate for Payer: Cash Price |
$3,319.52
|
| Rate for Payer: Cofinity Commercial |
$3,568.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,319.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,037.35
|
| Rate for Payer: Healthscope Commercial |
$3,734.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,112.05
|
| Rate for Payer: Mclaren Medicaid |
$731.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,089.22
|
| Rate for Payer: Meridian Medicaid |
$768.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,192.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,141.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,526.99
|
| Rate for Payer: Nomi Health Commercial |
$3,402.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,112.05
|
| Rate for Payer: PACE Senior Care Partners |
$985.48
|
| Rate for Payer: PACE SWMI |
$1,037.35
|
| Rate for Payer: PHP Commercial |
$3,526.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,037.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$731.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,609.98
|
| Rate for Payer: Priority Health Medicare |
$1,047.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,887.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,037.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,651.47
|
| Rate for Payer: UHC Core |
$3,464.75
|
| Rate for Payer: UHC Exchange |
$1,037.35
|
| Rate for Payer: UHC Medicaid |
$731.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,037.35
|
| Rate for Payer: UHCCP Medicaid |
$731.54
|
| Rate for Payer: VA VA |
$1,037.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,112.05
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
OP
|
$478.47
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$84.35 |
| Max. Negotiated Rate |
$430.62 |
| Rate for Payer: Aetna Commercial |
$406.70
|
| Rate for Payer: Aetna Medicare |
$124.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$149.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$149.52
|
| Rate for Payer: BCBS Complete |
$88.56
|
| Rate for Payer: BCBS MAPPO |
$119.62
|
| Rate for Payer: BCBS Trust/PPO |
$393.35
|
| Rate for Payer: BCN Commercial |
$393.35
|
| Rate for Payer: BCN Medicare Advantage |
$119.62
|
| Rate for Payer: Cash Price |
$382.78
|
| Rate for Payer: Cofinity Commercial |
$411.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$382.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.62
|
| Rate for Payer: Healthscope Commercial |
$430.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$358.85
|
| Rate for Payer: Mclaren Medicaid |
$84.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.60
|
| Rate for Payer: Meridian Medicaid |
$88.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$137.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$131.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$406.70
|
| Rate for Payer: Nomi Health Commercial |
$392.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$358.85
|
| Rate for Payer: PACE Senior Care Partners |
$113.64
|
| Rate for Payer: PACE SWMI |
$119.62
|
| Rate for Payer: PHP Commercial |
$406.70
|
| Rate for Payer: PHP Medicare Advantage |
$119.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$416.27
|
| Rate for Payer: Priority Health Medicare |
$120.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$333.02
|
| Rate for Payer: Railroad Medicare Medicare |
$119.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.05
|
| Rate for Payer: UHC Core |
$399.52
|
| Rate for Payer: UHC Exchange |
$119.62
|
| Rate for Payer: UHC Medicaid |
$84.35
|
| Rate for Payer: UHC Medicare Advantage |
$119.62
|
| Rate for Payer: UHCCP Medicaid |
$84.35
|
| Rate for Payer: VA VA |
$119.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$358.85
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
IP
|
$478.47
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$333.02 |
| Max. Negotiated Rate |
$430.62 |
| Rate for Payer: Aetna Commercial |
$406.70
|
| Rate for Payer: BCBS Trust/PPO |
$395.17
|
| Rate for Payer: BCN Commercial |
$395.17
|
| Rate for Payer: Cash Price |
$382.78
|
| Rate for Payer: Cofinity Commercial |
$411.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$382.78
|
| Rate for Payer: Healthscope Commercial |
$430.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$358.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$406.70
|
| Rate for Payer: Nomi Health Commercial |
$392.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$358.85
|
| Rate for Payer: PHP Commercial |
$406.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$416.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$333.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.05
|
| Rate for Payer: UHC Core |
$399.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$358.85
|
|
|
HC BILIARY DUCT BALLOON DILATATIO
|
Facility
|
IP
|
$1,892.73
|
|
| Hospital Charge Code |
36000011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,317.34 |
| Max. Negotiated Rate |
$1,703.46 |
| Rate for Payer: Aetna Commercial |
$1,608.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,563.21
|
| Rate for Payer: BCN Commercial |
$1,563.21
|
| Rate for Payer: Cash Price |
$1,514.18
|
| Rate for Payer: Cofinity Commercial |
$1,627.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,514.18
|
| Rate for Payer: Healthscope Commercial |
$1,703.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,419.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,608.82
|
| Rate for Payer: Nomi Health Commercial |
$1,552.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,419.55
|
| Rate for Payer: PHP Commercial |
$1,608.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,646.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,317.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,665.60
|
| Rate for Payer: UHC Core |
$1,580.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,419.55
|
|
|
HC BILIARY DUCT BALLOON DILATATIO
|
Facility
|
OP
|
$1,892.73
|
|
| Hospital Charge Code |
36000011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$333.69 |
| Max. Negotiated Rate |
$1,703.46 |
| Rate for Payer: Aetna Commercial |
$1,608.82
|
| Rate for Payer: Aetna Medicare |
$492.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$591.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$591.48
|
| Rate for Payer: BCBS Complete |
$350.34
|
| Rate for Payer: BCBS MAPPO |
$473.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,556.01
|
| Rate for Payer: BCN Commercial |
$1,556.01
|
| Rate for Payer: BCN Medicare Advantage |
$473.18
|
| Rate for Payer: Cash Price |
$1,514.18
|
| Rate for Payer: Cofinity Commercial |
$1,627.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,514.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.18
|
| Rate for Payer: Healthscope Commercial |
$1,703.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,419.55
|
| Rate for Payer: Mclaren Medicaid |
$333.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$496.84
|
| Rate for Payer: Meridian Medicaid |
$350.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$544.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$520.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,608.82
|
| Rate for Payer: Nomi Health Commercial |
$1,552.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,419.55
|
| Rate for Payer: PACE Senior Care Partners |
$449.52
|
| Rate for Payer: PACE SWMI |
$473.18
|
| Rate for Payer: PHP Commercial |
$1,608.82
|
| Rate for Payer: PHP Medicare Advantage |
$473.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,646.68
|
| Rate for Payer: Priority Health Medicare |
$477.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,317.34
|
| Rate for Payer: Railroad Medicare Medicare |
$473.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,665.60
|
| Rate for Payer: UHC Core |
$1,580.43
|
| Rate for Payer: UHC Exchange |
$473.18
|
| Rate for Payer: UHC Medicaid |
$333.69
|
| Rate for Payer: UHC Medicare Advantage |
$473.18
|
| Rate for Payer: UHCCP Medicaid |
$333.69
|
| Rate for Payer: VA VA |
$473.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,419.55
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX REMV CALCULI
|
Facility
|
OP
|
$29,386.20
|
|
|
Service Code
|
CPT 47554
|
| Hospital Charge Code |
36100633
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,180.79 |
| Max. Negotiated Rate |
$26,447.58 |
| Rate for Payer: Aetna Commercial |
$24,978.27
|
| Rate for Payer: Aetna Medicare |
$7,640.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,183.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,183.19
|
| Rate for Payer: BCBS Complete |
$5,439.39
|
| Rate for Payer: BCBS MAPPO |
$7,346.55
|
| Rate for Payer: BCBS Trust/PPO |
$24,158.40
|
| Rate for Payer: BCN Commercial |
$24,158.40
|
| Rate for Payer: BCN Medicare Advantage |
$7,346.55
|
| Rate for Payer: Cash Price |
$23,508.96
|
| Rate for Payer: Cofinity Commercial |
$25,272.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,508.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,346.55
|
| Rate for Payer: Healthscope Commercial |
$26,447.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,039.65
|
| Rate for Payer: Mclaren Medicaid |
$5,180.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,713.88
|
| Rate for Payer: Meridian Medicaid |
$5,439.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,448.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,081.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,978.27
|
| Rate for Payer: Nomi Health Commercial |
$24,096.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,039.65
|
| Rate for Payer: PACE Senior Care Partners |
$6,979.22
|
| Rate for Payer: PACE SWMI |
$7,346.55
|
| Rate for Payer: PHP Commercial |
$24,978.27
|
| Rate for Payer: PHP Medicare Advantage |
$7,346.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,180.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25,565.99
|
| Rate for Payer: Priority Health Medicare |
$7,420.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20,452.80
|
| Rate for Payer: Railroad Medicare Medicare |
$7,346.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,859.86
|
| Rate for Payer: UHC Core |
$24,537.48
|
| Rate for Payer: UHC Exchange |
$7,346.55
|
| Rate for Payer: UHC Medicaid |
$5,180.79
|
| Rate for Payer: UHC Medicare Advantage |
$7,346.55
|
| Rate for Payer: UHCCP Medicaid |
$5,180.79
|
| Rate for Payer: VA VA |
$7,346.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,039.65
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX REMV CALCULI
|
Facility
|
IP
|
$29,386.20
|
|
|
Service Code
|
CPT 47554
|
| Hospital Charge Code |
36100633
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$20,452.80 |
| Max. Negotiated Rate |
$26,447.58 |
| Rate for Payer: Aetna Commercial |
$24,978.27
|
| Rate for Payer: BCBS Trust/PPO |
$24,270.06
|
| Rate for Payer: BCN Commercial |
$24,270.06
|
| Rate for Payer: Cash Price |
$23,508.96
|
| Rate for Payer: Cofinity Commercial |
$25,272.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,508.96
|
| Rate for Payer: Healthscope Commercial |
$26,447.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,039.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,978.27
|
| Rate for Payer: Nomi Health Commercial |
$24,096.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,039.65
|
| Rate for Payer: PHP Commercial |
$24,978.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25,565.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20,452.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,859.86
|
| Rate for Payer: UHC Core |
$24,537.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,039.65
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX SING OR MULTI
|
Facility
|
IP
|
$21,624.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
36100632
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,050.30 |
| Max. Negotiated Rate |
$19,461.60 |
| Rate for Payer: Aetna Commercial |
$18,380.40
|
| Rate for Payer: BCBS Trust/PPO |
$17,859.26
|
| Rate for Payer: BCN Commercial |
$17,859.26
|
| Rate for Payer: Cash Price |
$17,299.20
|
| Rate for Payer: Cofinity Commercial |
$18,596.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,299.20
|
| Rate for Payer: Healthscope Commercial |
$19,461.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,218.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,380.40
|
| Rate for Payer: Nomi Health Commercial |
$17,731.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,218.00
|
| Rate for Payer: PHP Commercial |
$18,380.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18,812.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15,050.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,029.12
|
| Rate for Payer: UHC Core |
$18,056.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,218.00
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX SING OR MULTI
|
Facility
|
OP
|
$21,624.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
36100632
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,812.31 |
| Max. Negotiated Rate |
$19,461.60 |
| Rate for Payer: Aetna Commercial |
$18,380.40
|
| Rate for Payer: Aetna Medicare |
$5,622.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,757.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,757.50
|
| Rate for Payer: BCBS Complete |
$4,002.60
|
| Rate for Payer: BCBS MAPPO |
$5,406.00
|
| Rate for Payer: BCBS Trust/PPO |
$17,777.09
|
| Rate for Payer: BCN Commercial |
$17,777.09
|
| Rate for Payer: BCN Medicare Advantage |
$5,406.00
|
| Rate for Payer: Cash Price |
$17,299.20
|
| Rate for Payer: Cofinity Commercial |
$18,596.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,299.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,406.00
|
| Rate for Payer: Healthscope Commercial |
$19,461.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,218.00
|
| Rate for Payer: Mclaren Medicaid |
$3,812.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,676.30
|
| Rate for Payer: Meridian Medicaid |
$4,002.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,216.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,946.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,380.40
|
| Rate for Payer: Nomi Health Commercial |
$17,731.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,218.00
|
| Rate for Payer: PACE Senior Care Partners |
$5,135.70
|
| Rate for Payer: PACE SWMI |
$5,406.00
|
| Rate for Payer: PHP Commercial |
$18,380.40
|
| Rate for Payer: PHP Medicare Advantage |
$5,406.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,812.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18,812.88
|
| Rate for Payer: Priority Health Medicare |
$5,460.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15,050.30
|
| Rate for Payer: Railroad Medicare Medicare |
$5,406.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,029.12
|
| Rate for Payer: UHC Core |
$18,056.04
|
| Rate for Payer: UHC Exchange |
$5,406.00
|
| Rate for Payer: UHC Medicaid |
$3,812.31
|
| Rate for Payer: UHC Medicare Advantage |
$5,406.00
|
| Rate for Payer: UHCCP Medicaid |
$3,812.31
|
| Rate for Payer: VA VA |
$5,406.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,218.00
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W DIL OF BIL STRICT WO STENT
|
Facility
|
IP
|
$9,894.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
36100634
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,886.22 |
| Max. Negotiated Rate |
$8,904.60 |
| Rate for Payer: Aetna Commercial |
$8,409.90
|
| Rate for Payer: BCBS Trust/PPO |
$8,171.45
|
| Rate for Payer: BCN Commercial |
$8,171.45
|
| Rate for Payer: Cash Price |
$7,915.20
|
| Rate for Payer: Cofinity Commercial |
$8,508.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,915.20
|
| Rate for Payer: Healthscope Commercial |
$8,904.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,420.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,409.90
|
| Rate for Payer: Nomi Health Commercial |
$8,113.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,420.50
|
| Rate for Payer: PHP Commercial |
$8,409.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,607.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,886.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,706.72
|
| Rate for Payer: UHC Core |
$8,261.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,420.50
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W DIL OF BIL STRICT WO STENT
|
Facility
|
OP
|
$9,894.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
36100634
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,744.31 |
| Max. Negotiated Rate |
$8,904.60 |
| Rate for Payer: Aetna Commercial |
$8,409.90
|
| Rate for Payer: Aetna Medicare |
$2,572.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,091.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,091.88
|
| Rate for Payer: BCBS Complete |
$1,831.38
|
| Rate for Payer: BCBS MAPPO |
$2,473.50
|
| Rate for Payer: BCBS Trust/PPO |
$8,133.86
|
| Rate for Payer: BCN Commercial |
$8,133.86
|
| Rate for Payer: BCN Medicare Advantage |
$2,473.50
|
| Rate for Payer: Cash Price |
$7,915.20
|
| Rate for Payer: Cofinity Commercial |
$8,508.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,915.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,473.50
|
| Rate for Payer: Healthscope Commercial |
$8,904.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,420.50
|
| Rate for Payer: Mclaren Medicaid |
$1,744.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,597.18
|
| Rate for Payer: Meridian Medicaid |
$1,831.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,844.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,720.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,409.90
|
| Rate for Payer: Nomi Health Commercial |
$8,113.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,420.50
|
| Rate for Payer: PACE Senior Care Partners |
$2,349.82
|
| Rate for Payer: PACE SWMI |
$2,473.50
|
| Rate for Payer: PHP Commercial |
$8,409.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,473.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,744.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,607.78
|
| Rate for Payer: Priority Health Medicare |
$2,498.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,886.22
|
| Rate for Payer: Railroad Medicare Medicare |
$2,473.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,706.72
|
| Rate for Payer: UHC Core |
$8,261.49
|
| Rate for Payer: UHC Exchange |
$2,473.50
|
| Rate for Payer: UHC Medicaid |
$1,744.31
|
| Rate for Payer: UHC Medicare Advantage |
$2,473.50
|
| Rate for Payer: UHCCP Medicaid |
$1,744.31
|
| Rate for Payer: VA VA |
$2,473.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,420.50
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
30100118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
30100118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$17.53
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC BILIRUBIN TOTAL
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
30100117
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$17.53
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC BILIRUBIN TOTAL
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
30100117
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC BILIRUBIN TOTAL TRANSCUTANEOUS
|
Facility
|
IP
|
$48.43
|
|
|
Service Code
|
CPT 88720
|
| Hospital Charge Code |
30100694
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.71 |
| Max. Negotiated Rate |
$43.59 |
| Rate for Payer: Aetna Commercial |
$41.17
|
| Rate for Payer: BCBS Trust/PPO |
$40.00
|
| Rate for Payer: BCN Commercial |
$40.00
|
| Rate for Payer: Cash Price |
$38.74
|
| Rate for Payer: Cofinity Commercial |
$41.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.74
|
| Rate for Payer: Healthscope Commercial |
$43.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.17
|
| Rate for Payer: Nomi Health Commercial |
$39.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.32
|
| Rate for Payer: PHP Commercial |
$41.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.62
|
| Rate for Payer: UHC Core |
$40.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.32
|
|
|
HC BILIRUBIN TOTAL TRANSCUTANEOUS
|
Facility
|
OP
|
$48.43
|
|
|
Service Code
|
CPT 88720
|
| Hospital Charge Code |
30100694
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$43.59 |
| Rate for Payer: Aetna Commercial |
$41.17
|
| Rate for Payer: Aetna Medicare |
$12.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.13
|
| Rate for Payer: BCBS Complete |
$8.96
|
| Rate for Payer: BCBS MAPPO |
$12.11
|
| Rate for Payer: BCBS Trust/PPO |
$39.81
|
| Rate for Payer: BCN Commercial |
$39.81
|
| Rate for Payer: BCN Medicare Advantage |
$12.11
|
| Rate for Payer: Cash Price |
$38.74
|
| Rate for Payer: Cofinity Commercial |
$41.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.11
|
| Rate for Payer: Healthscope Commercial |
$43.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.32
|
| Rate for Payer: Mclaren Medicaid |
$8.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.71
|
| Rate for Payer: Meridian Medicaid |
$8.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.17
|
| Rate for Payer: Nomi Health Commercial |
$39.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.32
|
| Rate for Payer: PACE Senior Care Partners |
$11.50
|
| Rate for Payer: PACE SWMI |
$12.11
|
| Rate for Payer: PHP Commercial |
$41.17
|
| Rate for Payer: PHP Medicare Advantage |
$12.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.13
|
| Rate for Payer: Priority Health Medicare |
$12.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.71
|
| Rate for Payer: Railroad Medicare Medicare |
$12.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.62
|
| Rate for Payer: UHC Core |
$40.44
|
| Rate for Payer: UHC Exchange |
$12.11
|
| Rate for Payer: UHC Medicaid |
$8.54
|
| Rate for Payer: UHC Medicare Advantage |
$12.11
|
| Rate for Payer: UHCCP Medicaid |
$8.54
|
| Rate for Payer: VA VA |
$12.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.32
|
|
|
HC BILL ONLY URINE DRUG SCR8 AUTO
|
Facility
|
IP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000141
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$77.43 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: BCBS Trust/PPO |
$91.88
|
| Rate for Payer: BCN Commercial |
$91.88
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.90
|
| Rate for Payer: UHC Core |
$92.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC BILL ONLY URINE DRUG SCR8 AUTO
|
Facility
|
OP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000141
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.61 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: Aetna Medicare |
$28.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.77
|
| Rate for Payer: BCBS Complete |
$20.59
|
| Rate for Payer: BCBS MAPPO |
$27.81
|
| Rate for Payer: BCBS Trust/PPO |
$91.46
|
| Rate for Payer: BCN Commercial |
$91.46
|
| Rate for Payer: BCN Medicare Advantage |
$27.81
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.81
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Mclaren Medicaid |
$19.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.20
|
| Rate for Payer: Meridian Medicaid |
$20.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PACE Senior Care Partners |
$26.42
|
| Rate for Payer: PACE SWMI |
$27.81
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: PHP Medicare Advantage |
$27.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.79
|
| Rate for Payer: Priority Health Medicare |
$28.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.43
|
| Rate for Payer: Railroad Medicare Medicare |
$27.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.90
|
| Rate for Payer: UHC Core |
$92.89
|
| Rate for Payer: UHC Exchange |
$27.81
|
| Rate for Payer: UHC Medicaid |
$19.61
|
| Rate for Payer: UHC Medicare Advantage |
$27.81
|
| Rate for Payer: UHCCP Medicaid |
$19.61
|
| Rate for Payer: VA VA |
$27.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC BILL ONLY URINE DRUG SCR8 MAN
|
Facility
|
IP
|
$46.70
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000135
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: BCBS Trust/PPO |
$38.57
|
| Rate for Payer: BCN Commercial |
$38.57
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.10
|
| Rate for Payer: UHC Core |
$38.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
|
HC BILL ONLY URINE DRUG SCR8 MAN
|
Facility
|
OP
|
$46.70
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000135
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: Aetna Medicare |
$12.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.59
|
| Rate for Payer: BCBS Complete |
$8.64
|
| Rate for Payer: BCBS MAPPO |
$11.68
|
| Rate for Payer: BCBS Trust/PPO |
$38.39
|
| Rate for Payer: BCN Commercial |
$38.39
|
| Rate for Payer: BCN Medicare Advantage |
$11.68
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.68
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: Mclaren Medicaid |
$8.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.26
|
| Rate for Payer: Meridian Medicaid |
$8.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PACE Senior Care Partners |
$11.09
|
| Rate for Payer: PACE SWMI |
$11.68
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: PHP Medicare Advantage |
$11.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.63
|
| Rate for Payer: Priority Health Medicare |
$11.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.50
|
| Rate for Payer: Railroad Medicare Medicare |
$11.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.10
|
| Rate for Payer: UHC Core |
$38.99
|
| Rate for Payer: UHC Exchange |
$11.68
|
| Rate for Payer: UHC Medicaid |
$8.23
|
| Rate for Payer: UHC Medicare Advantage |
$11.68
|
| Rate for Payer: UHCCP Medicaid |
$8.23
|
| Rate for Payer: VA VA |
$11.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
|
HC BILL ONLY URINE DRUG SCR AUTO
|
Facility
|
OP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000142
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.61 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: Aetna Medicare |
$28.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.77
|
| Rate for Payer: BCBS Complete |
$20.59
|
| Rate for Payer: BCBS MAPPO |
$27.81
|
| Rate for Payer: BCBS Trust/PPO |
$91.46
|
| Rate for Payer: BCN Commercial |
$91.46
|
| Rate for Payer: BCN Medicare Advantage |
$27.81
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.81
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Mclaren Medicaid |
$19.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.20
|
| Rate for Payer: Meridian Medicaid |
$20.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PACE Senior Care Partners |
$26.42
|
| Rate for Payer: PACE SWMI |
$27.81
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: PHP Medicare Advantage |
$27.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.79
|
| Rate for Payer: Priority Health Medicare |
$28.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.43
|
| Rate for Payer: Railroad Medicare Medicare |
$27.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.90
|
| Rate for Payer: UHC Core |
$92.89
|
| Rate for Payer: UHC Exchange |
$27.81
|
| Rate for Payer: UHC Medicaid |
$19.61
|
| Rate for Payer: UHC Medicare Advantage |
$27.81
|
| Rate for Payer: UHCCP Medicaid |
$19.61
|
| Rate for Payer: VA VA |
$27.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC BILL ONLY URINE DRUG SCR AUTO
|
Facility
|
IP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000142
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$77.43 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: BCBS Trust/PPO |
$91.88
|
| Rate for Payer: BCN Commercial |
$91.88
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$91.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.90
|
| Rate for Payer: UHC Core |
$92.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC BILL ONLY URINE DRUG SCR MAN
|
Facility
|
OP
|
$46.70
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000143
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: Aetna Medicare |
$12.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.59
|
| Rate for Payer: BCBS Complete |
$8.64
|
| Rate for Payer: BCBS MAPPO |
$11.68
|
| Rate for Payer: BCBS Trust/PPO |
$38.39
|
| Rate for Payer: BCN Commercial |
$38.39
|
| Rate for Payer: BCN Medicare Advantage |
$11.68
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.68
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: Mclaren Medicaid |
$8.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.26
|
| Rate for Payer: Meridian Medicaid |
$8.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PACE Senior Care Partners |
$11.09
|
| Rate for Payer: PACE SWMI |
$11.68
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: PHP Medicare Advantage |
$11.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.63
|
| Rate for Payer: Priority Health Medicare |
$11.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.50
|
| Rate for Payer: Railroad Medicare Medicare |
$11.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.10
|
| Rate for Payer: UHC Core |
$38.99
|
| Rate for Payer: UHC Exchange |
$11.68
|
| Rate for Payer: UHC Medicaid |
$8.23
|
| Rate for Payer: UHC Medicare Advantage |
$11.68
|
| Rate for Payer: UHCCP Medicaid |
$8.23
|
| Rate for Payer: VA VA |
$11.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
