|
HC ACB NEW PT LEVEL 3
|
Facility
|
OP
|
$688.85
|
|
|
Service Code
|
CPT 99203
|
| Hospital Charge Code |
51000102
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$108.06 |
| Max. Negotiated Rate |
$619.96 |
| Rate for Payer: Aetna Commercial |
$585.52
|
| Rate for Payer: Aetna Medicare |
$179.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$215.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$215.27
|
| Rate for Payer: BCBS Complete |
$275.54
|
| Rate for Payer: BCBS MAPPO |
$172.21
|
| Rate for Payer: BCBS Trust/PPO |
$566.30
|
| Rate for Payer: BCCCP Commercial |
$108.06
|
| Rate for Payer: BCN Commercial |
$535.58
|
| Rate for Payer: BCN Medicare Advantage |
$172.21
|
| Rate for Payer: Cash Price |
$551.08
|
| Rate for Payer: Cash Price |
$551.08
|
| Rate for Payer: Cofinity Commercial |
$592.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$551.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.21
|
| Rate for Payer: Healthscope Commercial |
$619.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$516.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.52
|
| Rate for Payer: Nomi Health Commercial |
$564.86
|
| Rate for Payer: PACE Senior Care Partners |
$163.60
|
| Rate for Payer: PACE SWMI |
$172.21
|
| Rate for Payer: PHP Commercial |
$585.52
|
| Rate for Payer: PHP Medicare Advantage |
$172.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.75
|
| Rate for Payer: Priority Health HMO/PPO |
$599.30
|
| Rate for Payer: Priority Health Medicare |
$173.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$461.53
|
| Rate for Payer: Railroad Medicare Medicare |
$172.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$606.19
|
| Rate for Payer: UHC Core |
$575.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.21
|
| Rate for Payer: UHC Exchange |
$172.21
|
| Rate for Payer: UHC Medicare Advantage |
$172.21
|
| Rate for Payer: VA VA |
$172.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$516.64
|
|
|
HC ACB NEW PT LEVEL 4
|
Facility
|
OP
|
$874.52
|
|
|
Service Code
|
CPT 99204
|
| Hospital Charge Code |
51000103
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$115.00 |
| Max. Negotiated Rate |
$787.07 |
| Rate for Payer: Aetna Commercial |
$743.34
|
| Rate for Payer: Aetna Medicare |
$227.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$273.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$273.29
|
| Rate for Payer: BCBS Complete |
$349.81
|
| Rate for Payer: BCBS MAPPO |
$218.63
|
| Rate for Payer: BCBS Trust/PPO |
$718.94
|
| Rate for Payer: BCCCP Commercial |
$115.00
|
| Rate for Payer: BCN Commercial |
$679.94
|
| Rate for Payer: BCN Medicare Advantage |
$218.63
|
| Rate for Payer: Cash Price |
$699.62
|
| Rate for Payer: Cash Price |
$699.62
|
| Rate for Payer: Cofinity Commercial |
$752.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.63
|
| Rate for Payer: Healthscope Commercial |
$787.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$655.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$251.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.34
|
| Rate for Payer: Nomi Health Commercial |
$717.11
|
| Rate for Payer: PACE Senior Care Partners |
$207.70
|
| Rate for Payer: PACE SWMI |
$218.63
|
| Rate for Payer: PHP Commercial |
$743.34
|
| Rate for Payer: PHP Medicare Advantage |
$218.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.44
|
| Rate for Payer: Priority Health HMO/PPO |
$760.83
|
| Rate for Payer: Priority Health Medicare |
$220.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$585.93
|
| Rate for Payer: Railroad Medicare Medicare |
$218.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.58
|
| Rate for Payer: UHC Core |
$730.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.63
|
| Rate for Payer: UHC Exchange |
$218.63
|
| Rate for Payer: UHC Medicare Advantage |
$218.63
|
| Rate for Payer: VA VA |
$218.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$655.89
|
|
|
HC ACB NEW PT LEVEL 4
|
Facility
|
IP
|
$874.52
|
|
|
Service Code
|
CPT 99204
|
| Hospital Charge Code |
51000103
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$568.44 |
| Max. Negotiated Rate |
$787.07 |
| Rate for Payer: Aetna Commercial |
$743.34
|
| Rate for Payer: BCBS Trust/PPO |
$713.87
|
| Rate for Payer: BCN Commercial |
$675.83
|
| Rate for Payer: Cash Price |
$699.62
|
| Rate for Payer: Cofinity Commercial |
$752.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.62
|
| Rate for Payer: Healthscope Commercial |
$787.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$655.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.34
|
| Rate for Payer: Nomi Health Commercial |
$717.11
|
| Rate for Payer: PHP Commercial |
$743.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.44
|
| Rate for Payer: Priority Health HMO/PPO |
$760.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$585.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.58
|
| Rate for Payer: UHC Core |
$730.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$655.89
|
|
|
HC ACB NEW PT LEVEL 5
|
Facility
|
OP
|
$1,042.88
|
|
|
Service Code
|
CPT 99205
|
| Hospital Charge Code |
51000104
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$115.00 |
| Max. Negotiated Rate |
$938.59 |
| Rate for Payer: Aetna Commercial |
$886.45
|
| Rate for Payer: Aetna Medicare |
$271.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.90
|
| Rate for Payer: BCBS Complete |
$417.15
|
| Rate for Payer: BCBS MAPPO |
$260.72
|
| Rate for Payer: BCBS Trust/PPO |
$857.35
|
| Rate for Payer: BCCCP Commercial |
$115.00
|
| Rate for Payer: BCN Commercial |
$810.84
|
| Rate for Payer: BCN Medicare Advantage |
$260.72
|
| Rate for Payer: Cash Price |
$834.30
|
| Rate for Payer: Cash Price |
$834.30
|
| Rate for Payer: Cofinity Commercial |
$896.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$834.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.72
|
| Rate for Payer: Healthscope Commercial |
$938.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$782.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$886.45
|
| Rate for Payer: Nomi Health Commercial |
$855.16
|
| Rate for Payer: PACE Senior Care Partners |
$247.68
|
| Rate for Payer: PACE SWMI |
$260.72
|
| Rate for Payer: PHP Commercial |
$886.45
|
| Rate for Payer: PHP Medicare Advantage |
$260.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$677.87
|
| Rate for Payer: Priority Health HMO/PPO |
$907.31
|
| Rate for Payer: Priority Health Medicare |
$263.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$698.73
|
| Rate for Payer: Railroad Medicare Medicare |
$260.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$917.73
|
| Rate for Payer: UHC Core |
$870.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.72
|
| Rate for Payer: UHC Exchange |
$260.72
|
| Rate for Payer: UHC Medicare Advantage |
$260.72
|
| Rate for Payer: VA VA |
$260.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$782.16
|
|
|
HC ACB NEW PT LEVEL 5
|
Facility
|
IP
|
$1,042.88
|
|
|
Service Code
|
CPT 99205
|
| Hospital Charge Code |
51000104
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$677.87 |
| Max. Negotiated Rate |
$938.59 |
| Rate for Payer: Aetna Commercial |
$886.45
|
| Rate for Payer: BCBS Trust/PPO |
$851.30
|
| Rate for Payer: BCN Commercial |
$805.94
|
| Rate for Payer: Cash Price |
$834.30
|
| Rate for Payer: Cofinity Commercial |
$896.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$834.30
|
| Rate for Payer: Healthscope Commercial |
$938.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$782.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$886.45
|
| Rate for Payer: Nomi Health Commercial |
$855.16
|
| Rate for Payer: PHP Commercial |
$886.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$677.87
|
| Rate for Payer: Priority Health HMO/PPO |
$907.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$698.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$917.73
|
| Rate for Payer: UHC Core |
$870.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$782.16
|
|
|
HC ACCESS AORTA
|
Facility
|
IP
|
$3,920.31
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
36100105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,548.20 |
| Max. Negotiated Rate |
$3,528.28 |
| Rate for Payer: Aetna Commercial |
$3,332.26
|
| Rate for Payer: BCBS Trust/PPO |
$3,200.15
|
| Rate for Payer: BCN Commercial |
$3,029.62
|
| Rate for Payer: Cash Price |
$3,136.25
|
| Rate for Payer: Cofinity Commercial |
$3,371.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,136.25
|
| Rate for Payer: Healthscope Commercial |
$3,528.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,940.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,332.26
|
| Rate for Payer: Nomi Health Commercial |
$3,214.65
|
| Rate for Payer: PHP Commercial |
$3,332.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,548.20
|
| Rate for Payer: Priority Health HMO/PPO |
$3,410.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,626.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,449.87
|
| Rate for Payer: UHC Core |
$3,273.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,940.23
|
|
|
HC ACCESS AORTA
|
Facility
|
OP
|
$3,920.31
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
36100105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$931.07 |
| Max. Negotiated Rate |
$3,528.28 |
| Rate for Payer: Aetna Commercial |
$3,332.26
|
| Rate for Payer: Aetna Medicare |
$1,019.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,225.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,225.10
|
| Rate for Payer: BCBS Complete |
$1,568.12
|
| Rate for Payer: BCBS MAPPO |
$980.08
|
| Rate for Payer: BCBS Trust/PPO |
$3,222.89
|
| Rate for Payer: BCN Commercial |
$3,048.04
|
| Rate for Payer: BCN Medicare Advantage |
$980.08
|
| Rate for Payer: Cash Price |
$3,136.25
|
| Rate for Payer: Cofinity Commercial |
$3,371.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,136.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$980.08
|
| Rate for Payer: Healthscope Commercial |
$3,528.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,940.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,029.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,127.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,332.26
|
| Rate for Payer: Nomi Health Commercial |
$3,214.65
|
| Rate for Payer: PACE Senior Care Partners |
$931.07
|
| Rate for Payer: PACE SWMI |
$980.08
|
| Rate for Payer: PHP Commercial |
$3,332.26
|
| Rate for Payer: PHP Medicare Advantage |
$980.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,548.20
|
| Rate for Payer: Priority Health HMO/PPO |
$3,410.67
|
| Rate for Payer: Priority Health Medicare |
$989.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,626.61
|
| Rate for Payer: Railroad Medicare Medicare |
$980.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,449.87
|
| Rate for Payer: UHC Core |
$3,273.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$980.08
|
| Rate for Payer: UHC Exchange |
$980.08
|
| Rate for Payer: UHC Medicare Advantage |
$980.08
|
| Rate for Payer: VA VA |
$980.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,940.23
|
|
|
HC ACCESS EXTREMITY ARTERY
|
Facility
|
OP
|
$500.92
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
36100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.97 |
| Max. Negotiated Rate |
$450.83 |
| Rate for Payer: Aetna Commercial |
$425.78
|
| Rate for Payer: Aetna Medicare |
$130.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.54
|
| Rate for Payer: BCBS Complete |
$200.37
|
| Rate for Payer: BCBS MAPPO |
$125.23
|
| Rate for Payer: BCBS Trust/PPO |
$411.81
|
| Rate for Payer: BCN Commercial |
$389.47
|
| Rate for Payer: BCN Medicare Advantage |
$125.23
|
| Rate for Payer: Cash Price |
$400.74
|
| Rate for Payer: Cofinity Commercial |
$430.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.23
|
| Rate for Payer: Healthscope Commercial |
$450.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.78
|
| Rate for Payer: Nomi Health Commercial |
$410.75
|
| Rate for Payer: PACE Senior Care Partners |
$118.97
|
| Rate for Payer: PACE SWMI |
$125.23
|
| Rate for Payer: PHP Commercial |
$425.78
|
| Rate for Payer: PHP Medicare Advantage |
$125.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.60
|
| Rate for Payer: Priority Health HMO/PPO |
$435.80
|
| Rate for Payer: Priority Health Medicare |
$126.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.62
|
| Rate for Payer: Railroad Medicare Medicare |
$125.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.81
|
| Rate for Payer: UHC Core |
$418.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.23
|
| Rate for Payer: UHC Exchange |
$125.23
|
| Rate for Payer: UHC Medicare Advantage |
$125.23
|
| Rate for Payer: VA VA |
$125.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.69
|
|
|
HC ACCESS EXTREMITY ARTERY
|
Facility
|
IP
|
$500.92
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
36100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$325.60 |
| Max. Negotiated Rate |
$450.83 |
| Rate for Payer: Aetna Commercial |
$425.78
|
| Rate for Payer: BCBS Trust/PPO |
$408.90
|
| Rate for Payer: BCN Commercial |
$387.11
|
| Rate for Payer: Cash Price |
$400.74
|
| Rate for Payer: Cofinity Commercial |
$430.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.74
|
| Rate for Payer: Healthscope Commercial |
$450.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.78
|
| Rate for Payer: Nomi Health Commercial |
$410.75
|
| Rate for Payer: PHP Commercial |
$425.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.60
|
| Rate for Payer: Priority Health HMO/PPO |
$435.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$335.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.81
|
| Rate for Payer: UHC Core |
$418.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.69
|
|
|
HC ACCESS MAIN PULMONARY
|
Facility
|
OP
|
$427.58
|
|
|
Service Code
|
CPT 36013
|
| Hospital Charge Code |
36100099
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$101.55 |
| Max. Negotiated Rate |
$384.82 |
| Rate for Payer: Aetna Commercial |
$363.44
|
| Rate for Payer: Aetna Medicare |
$111.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$133.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$133.62
|
| Rate for Payer: BCBS Complete |
$171.03
|
| Rate for Payer: BCBS MAPPO |
$106.90
|
| Rate for Payer: BCBS Trust/PPO |
$351.51
|
| Rate for Payer: BCN Commercial |
$332.44
|
| Rate for Payer: BCN Medicare Advantage |
$106.90
|
| Rate for Payer: Cash Price |
$342.06
|
| Rate for Payer: Cofinity Commercial |
$367.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.90
|
| Rate for Payer: Healthscope Commercial |
$384.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$320.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$122.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$363.44
|
| Rate for Payer: Nomi Health Commercial |
$350.62
|
| Rate for Payer: PACE Senior Care Partners |
$101.55
|
| Rate for Payer: PACE SWMI |
$106.90
|
| Rate for Payer: PHP Commercial |
$363.44
|
| Rate for Payer: PHP Medicare Advantage |
$106.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.93
|
| Rate for Payer: Priority Health HMO/PPO |
$371.99
|
| Rate for Payer: Priority Health Medicare |
$107.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$286.48
|
| Rate for Payer: Railroad Medicare Medicare |
$106.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.27
|
| Rate for Payer: UHC Core |
$357.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.90
|
| Rate for Payer: UHC Exchange |
$106.90
|
| Rate for Payer: UHC Medicare Advantage |
$106.90
|
| Rate for Payer: VA VA |
$106.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$320.68
|
|
|
HC ACCESS MAIN PULMONARY
|
Facility
|
IP
|
$427.58
|
|
|
Service Code
|
CPT 36013
|
| Hospital Charge Code |
36100099
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$277.93 |
| Max. Negotiated Rate |
$384.82 |
| Rate for Payer: Aetna Commercial |
$363.44
|
| Rate for Payer: BCBS Trust/PPO |
$349.03
|
| Rate for Payer: BCN Commercial |
$330.43
|
| Rate for Payer: Cash Price |
$342.06
|
| Rate for Payer: Cofinity Commercial |
$367.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.06
|
| Rate for Payer: Healthscope Commercial |
$384.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$320.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$363.44
|
| Rate for Payer: Nomi Health Commercial |
$350.62
|
| Rate for Payer: PHP Commercial |
$363.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.93
|
| Rate for Payer: Priority Health HMO/PPO |
$371.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$286.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.27
|
| Rate for Payer: UHC Core |
$357.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$320.68
|
|
|
HC ACCESS VEIN
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
36100093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$92.32 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna Medicare |
$101.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.47
|
| Rate for Payer: BCBS Complete |
$155.48
|
| Rate for Payer: BCBS MAPPO |
$97.18
|
| Rate for Payer: BCBS Trust/PPO |
$319.56
|
| Rate for Payer: BCN Commercial |
$302.22
|
| Rate for Payer: BCN Medicare Advantage |
$97.18
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.18
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PACE Senior Care Partners |
$92.32
|
| Rate for Payer: PACE SWMI |
$97.18
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: PHP Medicare Advantage |
$97.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Medicare |
$98.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: Railroad Medicare Medicare |
$97.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.18
|
| Rate for Payer: UHC Exchange |
$97.18
|
| Rate for Payer: UHC Medicare Advantage |
$97.18
|
| Rate for Payer: VA VA |
$97.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC ACCESS VEIN
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
36100093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$252.66 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: BCBS Trust/PPO |
$317.30
|
| Rate for Payer: BCN Commercial |
$300.40
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC ACCESS VEIN ORGAN BLOOD SAMPLING
|
Facility
|
OP
|
$1,069.35
|
|
|
Service Code
|
CPT 36500
|
| Hospital Charge Code |
36100118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$253.97 |
| Max. Negotiated Rate |
$962.42 |
| Rate for Payer: Aetna Commercial |
$908.95
|
| Rate for Payer: Aetna Medicare |
$278.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$334.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$334.17
|
| Rate for Payer: BCBS Complete |
$427.74
|
| Rate for Payer: BCBS MAPPO |
$267.34
|
| Rate for Payer: BCBS Trust/PPO |
$879.11
|
| Rate for Payer: BCN Commercial |
$831.42
|
| Rate for Payer: BCN Medicare Advantage |
$267.34
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cofinity Commercial |
$919.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.34
|
| Rate for Payer: Healthscope Commercial |
$962.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$802.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$307.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.95
|
| Rate for Payer: Nomi Health Commercial |
$876.87
|
| Rate for Payer: PACE Senior Care Partners |
$253.97
|
| Rate for Payer: PACE SWMI |
$267.34
|
| Rate for Payer: PHP Commercial |
$908.95
|
| Rate for Payer: PHP Medicare Advantage |
$267.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.08
|
| Rate for Payer: Priority Health HMO/PPO |
$930.33
|
| Rate for Payer: Priority Health Medicare |
$270.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$716.46
|
| Rate for Payer: Railroad Medicare Medicare |
$267.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$941.03
|
| Rate for Payer: UHC Core |
$892.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$267.34
|
| Rate for Payer: UHC Exchange |
$267.34
|
| Rate for Payer: UHC Medicare Advantage |
$267.34
|
| Rate for Payer: VA VA |
$267.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$802.01
|
|
|
HC ACCESS VEIN ORGAN BLOOD SAMPLING
|
Facility
|
IP
|
$1,069.35
|
|
|
Service Code
|
CPT 36500
|
| Hospital Charge Code |
36100118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$695.08 |
| Max. Negotiated Rate |
$962.42 |
| Rate for Payer: Aetna Commercial |
$908.95
|
| Rate for Payer: BCBS Trust/PPO |
$872.91
|
| Rate for Payer: BCN Commercial |
$826.39
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cofinity Commercial |
$919.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.48
|
| Rate for Payer: Healthscope Commercial |
$962.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$802.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.95
|
| Rate for Payer: Nomi Health Commercial |
$876.87
|
| Rate for Payer: PHP Commercial |
$908.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.08
|
| Rate for Payer: Priority Health HMO/PPO |
$930.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$716.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$941.03
|
| Rate for Payer: UHC Core |
$892.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$802.01
|
|
|
HC ACCESS VENA CAVA
|
Facility
|
OP
|
$3,128.58
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
36100096
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$743.04 |
| Max. Negotiated Rate |
$2,815.72 |
| Rate for Payer: Aetna Commercial |
$2,659.29
|
| Rate for Payer: Aetna Medicare |
$813.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$977.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$977.68
|
| Rate for Payer: BCBS Complete |
$1,251.43
|
| Rate for Payer: BCBS MAPPO |
$782.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,572.01
|
| Rate for Payer: BCN Commercial |
$2,432.47
|
| Rate for Payer: BCN Medicare Advantage |
$782.14
|
| Rate for Payer: Cash Price |
$2,502.86
|
| Rate for Payer: Cofinity Commercial |
$2,690.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$782.14
|
| Rate for Payer: Healthscope Commercial |
$2,815.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,346.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$821.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$899.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.29
|
| Rate for Payer: Nomi Health Commercial |
$2,565.44
|
| Rate for Payer: PACE Senior Care Partners |
$743.04
|
| Rate for Payer: PACE SWMI |
$782.14
|
| Rate for Payer: PHP Commercial |
$2,659.29
|
| Rate for Payer: PHP Medicare Advantage |
$782.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.58
|
| Rate for Payer: Priority Health HMO/PPO |
$2,721.86
|
| Rate for Payer: Priority Health Medicare |
$789.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,096.15
|
| Rate for Payer: Railroad Medicare Medicare |
$782.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,753.15
|
| Rate for Payer: UHC Core |
$2,612.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$782.14
|
| Rate for Payer: UHC Exchange |
$782.14
|
| Rate for Payer: UHC Medicare Advantage |
$782.14
|
| Rate for Payer: VA VA |
$782.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,346.44
|
|
|
HC ACCESS VENA CAVA
|
Facility
|
IP
|
$3,128.58
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
36100096
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,033.58 |
| Max. Negotiated Rate |
$2,815.72 |
| Rate for Payer: Aetna Commercial |
$2,659.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,553.86
|
| Rate for Payer: BCN Commercial |
$2,417.77
|
| Rate for Payer: Cash Price |
$2,502.86
|
| Rate for Payer: Cofinity Commercial |
$2,690.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.86
|
| Rate for Payer: Healthscope Commercial |
$2,815.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,346.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.29
|
| Rate for Payer: Nomi Health Commercial |
$2,565.44
|
| Rate for Payer: PHP Commercial |
$2,659.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.58
|
| Rate for Payer: Priority Health HMO/PPO |
$2,721.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,096.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,753.15
|
| Rate for Payer: UHC Core |
$2,612.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,346.44
|
|
|
HC ACCESS WINDOW
|
Facility
|
OP
|
$38.93
|
|
| Hospital Charge Code |
27000624
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.25 |
| Max. Negotiated Rate |
$35.04 |
| Rate for Payer: Aetna Commercial |
$33.09
|
| Rate for Payer: Aetna Medicare |
$10.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.17
|
| Rate for Payer: BCBS Complete |
$15.57
|
| Rate for Payer: BCBS MAPPO |
$9.73
|
| Rate for Payer: BCBS Trust/PPO |
$32.00
|
| Rate for Payer: BCN Commercial |
$30.27
|
| Rate for Payer: BCN Medicare Advantage |
$9.73
|
| Rate for Payer: Cash Price |
$31.14
|
| Rate for Payer: Cofinity Commercial |
$33.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.73
|
| Rate for Payer: Healthscope Commercial |
$35.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.09
|
| Rate for Payer: Nomi Health Commercial |
$31.92
|
| Rate for Payer: PACE Senior Care Partners |
$9.25
|
| Rate for Payer: PACE SWMI |
$9.73
|
| Rate for Payer: PHP Commercial |
$33.09
|
| Rate for Payer: PHP Medicare Advantage |
$9.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.30
|
| Rate for Payer: Priority Health HMO/PPO |
$33.87
|
| Rate for Payer: Priority Health Medicare |
$9.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.08
|
| Rate for Payer: Railroad Medicare Medicare |
$9.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.26
|
| Rate for Payer: UHC Core |
$32.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.73
|
| Rate for Payer: UHC Exchange |
$9.73
|
| Rate for Payer: UHC Medicare Advantage |
$9.73
|
| Rate for Payer: VA VA |
$9.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.20
|
|
|
HC ACCESS WINDOW
|
Facility
|
IP
|
$38.93
|
|
| Hospital Charge Code |
27000624
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$35.04 |
| Rate for Payer: Aetna Commercial |
$33.09
|
| Rate for Payer: BCBS Trust/PPO |
$31.78
|
| Rate for Payer: BCN Commercial |
$30.09
|
| Rate for Payer: Cash Price |
$31.14
|
| Rate for Payer: Cofinity Commercial |
$33.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.14
|
| Rate for Payer: Healthscope Commercial |
$35.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.09
|
| Rate for Payer: Nomi Health Commercial |
$31.92
|
| Rate for Payer: PHP Commercial |
$33.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.30
|
| Rate for Payer: Priority Health HMO/PPO |
$33.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.26
|
| Rate for Payer: UHC Core |
$32.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.20
|
|
|
HC ACCUNET EMBOLIC PROTECTION
|
Facility
|
OP
|
$4,011.59
|
|
| Hospital Charge Code |
27200110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$952.75 |
| Max. Negotiated Rate |
$3,610.43 |
| Rate for Payer: Aetna Commercial |
$3,409.85
|
| Rate for Payer: Aetna Medicare |
$1,043.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,253.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,253.62
|
| Rate for Payer: BCBS Complete |
$1,604.64
|
| Rate for Payer: BCBS MAPPO |
$1,002.90
|
| Rate for Payer: BCBS Trust/PPO |
$3,297.93
|
| Rate for Payer: BCN Commercial |
$3,119.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,002.90
|
| Rate for Payer: Cash Price |
$3,209.27
|
| Rate for Payer: Cofinity Commercial |
$3,449.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,209.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,002.90
|
| Rate for Payer: Healthscope Commercial |
$3,610.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,008.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,053.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,153.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,409.85
|
| Rate for Payer: Nomi Health Commercial |
$3,289.50
|
| Rate for Payer: PACE Senior Care Partners |
$952.75
|
| Rate for Payer: PACE SWMI |
$1,002.90
|
| Rate for Payer: PHP Commercial |
$3,409.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,002.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,607.53
|
| Rate for Payer: Priority Health HMO/PPO |
$3,490.08
|
| Rate for Payer: Priority Health Medicare |
$1,012.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,687.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,002.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,530.20
|
| Rate for Payer: UHC Core |
$3,349.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,002.90
|
| Rate for Payer: UHC Exchange |
$1,002.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,002.90
|
| Rate for Payer: VA VA |
$1,002.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,008.69
|
|
|
HC ACCUNET EMBOLIC PROTECTION
|
Facility
|
IP
|
$4,011.59
|
|
| Hospital Charge Code |
27200110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,607.53 |
| Max. Negotiated Rate |
$3,610.43 |
| Rate for Payer: Aetna Commercial |
$3,409.85
|
| Rate for Payer: BCBS Trust/PPO |
$3,274.66
|
| Rate for Payer: BCN Commercial |
$3,100.16
|
| Rate for Payer: Cash Price |
$3,209.27
|
| Rate for Payer: Cofinity Commercial |
$3,449.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,209.27
|
| Rate for Payer: Healthscope Commercial |
$3,610.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,008.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,409.85
|
| Rate for Payer: Nomi Health Commercial |
$3,289.50
|
| Rate for Payer: PHP Commercial |
$3,409.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,607.53
|
| Rate for Payer: Priority Health HMO/PPO |
$3,490.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,687.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,530.20
|
| Rate for Payer: UHC Core |
$3,349.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,008.69
|
|
|
HC ACETAMINOPHEN LVL.
|
Facility
|
IP
|
$129.11
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100648
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$83.92 |
| Max. Negotiated Rate |
$116.20 |
| Rate for Payer: Aetna Commercial |
$109.74
|
| Rate for Payer: BCBS Trust/PPO |
$105.39
|
| Rate for Payer: BCN Commercial |
$99.78
|
| Rate for Payer: Cash Price |
$103.29
|
| Rate for Payer: Cofinity Commercial |
$111.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.29
|
| Rate for Payer: Healthscope Commercial |
$116.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.74
|
| Rate for Payer: Nomi Health Commercial |
$105.87
|
| Rate for Payer: PHP Commercial |
$109.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.92
|
| Rate for Payer: Priority Health HMO/PPO |
$112.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.62
|
| Rate for Payer: UHC Core |
$107.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.83
|
|
|
HC ACETAMINOPHEN LVL.
|
Facility
|
OP
|
$129.11
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100648
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.66 |
| Max. Negotiated Rate |
$116.20 |
| Rate for Payer: Aetna Commercial |
$109.74
|
| Rate for Payer: Aetna Medicare |
$33.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.35
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$32.28
|
| Rate for Payer: BCBS Trust/PPO |
$106.14
|
| Rate for Payer: BCN Commercial |
$100.38
|
| Rate for Payer: BCN Medicare Advantage |
$32.28
|
| Rate for Payer: Cash Price |
$103.29
|
| Rate for Payer: Cash Price |
$103.29
|
| Rate for Payer: Cofinity Commercial |
$111.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.28
|
| Rate for Payer: Healthscope Commercial |
$116.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.83
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.89
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.74
|
| Rate for Payer: Nomi Health Commercial |
$105.87
|
| Rate for Payer: PACE Senior Care Partners |
$30.66
|
| Rate for Payer: PACE SWMI |
$32.28
|
| Rate for Payer: PHP Commercial |
$109.74
|
| Rate for Payer: PHP Medicare Advantage |
$32.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.92
|
| Rate for Payer: Priority Health HMO/PPO |
$112.33
|
| Rate for Payer: Priority Health Medicare |
$32.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.50
|
| Rate for Payer: Railroad Medicare Medicare |
$32.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.62
|
| Rate for Payer: UHC Core |
$107.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.28
|
| Rate for Payer: UHC Exchange |
$32.28
|
| Rate for Payer: UHC Medicare Advantage |
$32.28
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$32.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.83
|
|
|
HC ACETOMINOPHEN THERAPEUTIC DRUG ASSAY
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 80143
|
| Hospital Charge Code |
30100729
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC ACETOMINOPHEN THERAPEUTIC DRUG ASSAY
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 80143
|
| Hospital Charge Code |
30100729
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.88 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$14.15
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Mclaren Medicaid |
$13.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$14.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$13.48
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
