|
HC BOSTON SCI ICD DUAL
|
Facility
|
OP
|
$18,889.50
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,330.22 |
| Max. Negotiated Rate |
$17,000.55 |
| Rate for Payer: Aetna Commercial |
$16,056.08
|
| Rate for Payer: Aetna Medicare |
$4,911.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,902.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,902.97
|
| Rate for Payer: BCBS Complete |
$3,496.45
|
| Rate for Payer: BCBS MAPPO |
$4,722.38
|
| Rate for Payer: BCBS Trust/PPO |
$15,529.06
|
| Rate for Payer: BCN Commercial |
$15,529.06
|
| Rate for Payer: BCN Medicare Advantage |
$4,722.38
|
| Rate for Payer: Cash Price |
$15,111.60
|
| Rate for Payer: Cofinity Commercial |
$16,244.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,111.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,722.38
|
| Rate for Payer: Healthscope Commercial |
$17,000.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,167.12
|
| Rate for Payer: Mclaren Medicaid |
$3,330.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,958.49
|
| Rate for Payer: Meridian Medicaid |
$3,496.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,430.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,194.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,056.08
|
| Rate for Payer: Nomi Health Commercial |
$15,489.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,167.12
|
| Rate for Payer: PACE Senior Care Partners |
$4,486.26
|
| Rate for Payer: PACE SWMI |
$4,722.38
|
| Rate for Payer: PHP Commercial |
$16,056.08
|
| Rate for Payer: PHP Medicare Advantage |
$4,722.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,330.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16,433.87
|
| Rate for Payer: Priority Health Medicare |
$4,769.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,147.09
|
| Rate for Payer: Railroad Medicare Medicare |
$4,722.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,622.76
|
| Rate for Payer: UHC Core |
$15,772.73
|
| Rate for Payer: UHC Exchange |
$4,722.38
|
| Rate for Payer: UHC Medicaid |
$3,330.22
|
| Rate for Payer: UHC Medicare Advantage |
$4,722.38
|
| Rate for Payer: UHCCP Medicaid |
$3,330.22
|
| Rate for Payer: VA VA |
$4,722.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,167.12
|
|
|
HC BOSTON SCI ICD DUAL
|
Facility
|
IP
|
$18,889.50
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,147.09 |
| Max. Negotiated Rate |
$17,000.55 |
| Rate for Payer: Aetna Commercial |
$16,056.08
|
| Rate for Payer: BCBS Trust/PPO |
$15,600.84
|
| Rate for Payer: BCN Commercial |
$15,600.84
|
| Rate for Payer: Cash Price |
$15,111.60
|
| Rate for Payer: Cofinity Commercial |
$16,244.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,111.60
|
| Rate for Payer: Healthscope Commercial |
$17,000.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,167.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,056.08
|
| Rate for Payer: Nomi Health Commercial |
$15,489.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,167.12
|
| Rate for Payer: PHP Commercial |
$16,056.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$16,433.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,147.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,622.76
|
| Rate for Payer: UHC Core |
$15,772.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,167.12
|
|
|
HC BOSTON SCI ICD SINGLE
|
Facility
|
OP
|
$22,497.61
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,966.33 |
| Max. Negotiated Rate |
$20,247.85 |
| Rate for Payer: Aetna Commercial |
$19,122.97
|
| Rate for Payer: Aetna Medicare |
$5,849.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,030.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,030.50
|
| Rate for Payer: BCBS Complete |
$4,164.31
|
| Rate for Payer: BCBS MAPPO |
$5,624.40
|
| Rate for Payer: BCBS Trust/PPO |
$18,495.29
|
| Rate for Payer: BCN Commercial |
$18,495.29
|
| Rate for Payer: BCN Medicare Advantage |
$5,624.40
|
| Rate for Payer: Cash Price |
$17,998.09
|
| Rate for Payer: Cofinity Commercial |
$19,347.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,998.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,624.40
|
| Rate for Payer: Healthscope Commercial |
$20,247.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,873.21
|
| Rate for Payer: Mclaren Medicaid |
$3,966.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,905.62
|
| Rate for Payer: Meridian Medicaid |
$4,164.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,468.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,186.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,122.97
|
| Rate for Payer: Nomi Health Commercial |
$18,448.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,873.21
|
| Rate for Payer: PACE Senior Care Partners |
$5,343.18
|
| Rate for Payer: PACE SWMI |
$5,624.40
|
| Rate for Payer: PHP Commercial |
$19,122.97
|
| Rate for Payer: PHP Medicare Advantage |
$5,624.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,966.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19,572.92
|
| Rate for Payer: Priority Health Medicare |
$5,680.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15,658.34
|
| Rate for Payer: Railroad Medicare Medicare |
$5,624.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,797.90
|
| Rate for Payer: UHC Core |
$18,785.50
|
| Rate for Payer: UHC Exchange |
$5,624.40
|
| Rate for Payer: UHC Medicaid |
$3,966.33
|
| Rate for Payer: UHC Medicare Advantage |
$5,624.40
|
| Rate for Payer: UHCCP Medicaid |
$3,966.33
|
| Rate for Payer: VA VA |
$5,624.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,873.21
|
|
|
HC BOSTON SCI ICD SINGLE
|
Facility
|
IP
|
$22,497.61
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15,658.34 |
| Max. Negotiated Rate |
$20,247.85 |
| Rate for Payer: Aetna Commercial |
$19,122.97
|
| Rate for Payer: BCBS Trust/PPO |
$18,580.78
|
| Rate for Payer: BCN Commercial |
$18,580.78
|
| Rate for Payer: Cash Price |
$17,998.09
|
| Rate for Payer: Cofinity Commercial |
$19,347.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,998.09
|
| Rate for Payer: Healthscope Commercial |
$20,247.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,873.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,122.97
|
| Rate for Payer: Nomi Health Commercial |
$18,448.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,873.21
|
| Rate for Payer: PHP Commercial |
$19,122.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19,572.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15,658.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,797.90
|
| Rate for Payer: UHC Core |
$18,785.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,873.21
|
|
|
HC BOSTON SCI PACEMAKER LEAD
|
Facility
|
OP
|
$2,302.92
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$406.00 |
| Max. Negotiated Rate |
$2,072.63 |
| Rate for Payer: Aetna Commercial |
$1,957.48
|
| Rate for Payer: Aetna Medicare |
$598.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$719.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$719.66
|
| Rate for Payer: BCBS Complete |
$426.27
|
| Rate for Payer: BCBS MAPPO |
$575.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,893.23
|
| Rate for Payer: BCN Commercial |
$1,893.23
|
| Rate for Payer: BCN Medicare Advantage |
$575.73
|
| Rate for Payer: Cash Price |
$1,842.34
|
| Rate for Payer: Cofinity Commercial |
$1,980.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,842.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$575.73
|
| Rate for Payer: Healthscope Commercial |
$2,072.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,727.19
|
| Rate for Payer: Mclaren Medicaid |
$406.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$604.52
|
| Rate for Payer: Meridian Medicaid |
$426.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$662.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$633.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,957.48
|
| Rate for Payer: Nomi Health Commercial |
$1,888.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,727.19
|
| Rate for Payer: PACE Senior Care Partners |
$546.94
|
| Rate for Payer: PACE SWMI |
$575.73
|
| Rate for Payer: PHP Commercial |
$1,957.48
|
| Rate for Payer: PHP Medicare Advantage |
$575.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$406.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,003.54
|
| Rate for Payer: Priority Health Medicare |
$581.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,602.83
|
| Rate for Payer: Railroad Medicare Medicare |
$575.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,026.57
|
| Rate for Payer: UHC Core |
$1,922.94
|
| Rate for Payer: UHC Exchange |
$575.73
|
| Rate for Payer: UHC Medicaid |
$406.00
|
| Rate for Payer: UHC Medicare Advantage |
$575.73
|
| Rate for Payer: UHCCP Medicaid |
$406.00
|
| Rate for Payer: VA VA |
$575.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,727.19
|
|
|
HC BOSTON SCI PACEMAKER LEAD
|
Facility
|
IP
|
$2,302.92
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,602.83 |
| Max. Negotiated Rate |
$2,072.63 |
| Rate for Payer: Aetna Commercial |
$1,957.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,901.98
|
| Rate for Payer: BCN Commercial |
$1,901.98
|
| Rate for Payer: Cash Price |
$1,842.34
|
| Rate for Payer: Cofinity Commercial |
$1,980.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,842.34
|
| Rate for Payer: Healthscope Commercial |
$2,072.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,727.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,957.48
|
| Rate for Payer: Nomi Health Commercial |
$1,888.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,727.19
|
| Rate for Payer: PHP Commercial |
$1,957.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,003.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,602.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,026.57
|
| Rate for Payer: UHC Core |
$1,922.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,727.19
|
|
|
HC BOSTON SCI SINGLE PACEMAKER
|
Facility
|
OP
|
$14,510.97
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500005
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,558.28 |
| Max. Negotiated Rate |
$13,059.87 |
| Rate for Payer: Aetna Commercial |
$12,334.32
|
| Rate for Payer: Aetna Medicare |
$3,772.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,534.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,534.68
|
| Rate for Payer: BCBS Complete |
$2,685.98
|
| Rate for Payer: BCBS MAPPO |
$3,627.74
|
| Rate for Payer: BCBS Trust/PPO |
$11,929.47
|
| Rate for Payer: BCN Commercial |
$11,929.47
|
| Rate for Payer: BCN Medicare Advantage |
$3,627.74
|
| Rate for Payer: Cash Price |
$11,608.78
|
| Rate for Payer: Cofinity Commercial |
$12,479.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,608.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,627.74
|
| Rate for Payer: Healthscope Commercial |
$13,059.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,883.23
|
| Rate for Payer: Mclaren Medicaid |
$2,558.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,809.13
|
| Rate for Payer: Meridian Medicaid |
$2,685.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,171.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,990.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,334.32
|
| Rate for Payer: Nomi Health Commercial |
$11,899.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,883.23
|
| Rate for Payer: PACE Senior Care Partners |
$3,446.36
|
| Rate for Payer: PACE SWMI |
$3,627.74
|
| Rate for Payer: PHP Commercial |
$12,334.32
|
| Rate for Payer: PHP Medicare Advantage |
$3,627.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,558.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12,624.54
|
| Rate for Payer: Priority Health Medicare |
$3,664.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,099.64
|
| Rate for Payer: Railroad Medicare Medicare |
$3,627.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,769.65
|
| Rate for Payer: UHC Core |
$12,116.66
|
| Rate for Payer: UHC Exchange |
$3,627.74
|
| Rate for Payer: UHC Medicaid |
$2,558.28
|
| Rate for Payer: UHC Medicare Advantage |
$3,627.74
|
| Rate for Payer: UHCCP Medicaid |
$2,558.28
|
| Rate for Payer: VA VA |
$3,627.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,883.23
|
|
|
HC BOSTON SCI SINGLE PACEMAKER
|
Facility
|
IP
|
$14,510.97
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500005
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$10,099.64 |
| Max. Negotiated Rate |
$13,059.87 |
| Rate for Payer: Aetna Commercial |
$12,334.32
|
| Rate for Payer: BCBS Trust/PPO |
$11,984.61
|
| Rate for Payer: BCN Commercial |
$11,984.61
|
| Rate for Payer: Cash Price |
$11,608.78
|
| Rate for Payer: Cofinity Commercial |
$12,479.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,608.78
|
| Rate for Payer: Healthscope Commercial |
$13,059.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,883.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,334.32
|
| Rate for Payer: Nomi Health Commercial |
$11,899.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,883.23
|
| Rate for Payer: PHP Commercial |
$12,334.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12,624.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,099.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,769.65
|
| Rate for Payer: UHC Core |
$12,116.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,883.23
|
|
|
HC BOSTON SCI TACHY (ICD) LEAD
|
Facility
|
IP
|
$8,948.46
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,228.13 |
| Max. Negotiated Rate |
$8,053.61 |
| Rate for Payer: Aetna Commercial |
$7,606.19
|
| Rate for Payer: BCBS Trust/PPO |
$7,390.53
|
| Rate for Payer: BCN Commercial |
$7,390.53
|
| Rate for Payer: Cash Price |
$7,158.77
|
| Rate for Payer: Cofinity Commercial |
$7,695.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,158.77
|
| Rate for Payer: Healthscope Commercial |
$8,053.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,711.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,606.19
|
| Rate for Payer: Nomi Health Commercial |
$7,337.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,711.35
|
| Rate for Payer: PHP Commercial |
$7,606.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,785.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,228.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,874.64
|
| Rate for Payer: UHC Core |
$7,471.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,711.35
|
|
|
HC BOSTON SCI TACHY (ICD) LEAD
|
Facility
|
OP
|
$8,948.46
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,577.61 |
| Max. Negotiated Rate |
$8,053.61 |
| Rate for Payer: Aetna Commercial |
$7,606.19
|
| Rate for Payer: Aetna Medicare |
$2,326.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,796.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,796.39
|
| Rate for Payer: BCBS Complete |
$1,656.36
|
| Rate for Payer: BCBS MAPPO |
$2,237.11
|
| Rate for Payer: BCBS Trust/PPO |
$7,356.53
|
| Rate for Payer: BCN Commercial |
$7,356.53
|
| Rate for Payer: BCN Medicare Advantage |
$2,237.11
|
| Rate for Payer: Cash Price |
$7,158.77
|
| Rate for Payer: Cofinity Commercial |
$7,695.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,158.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,237.11
|
| Rate for Payer: Healthscope Commercial |
$8,053.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,711.35
|
| Rate for Payer: Mclaren Medicaid |
$1,577.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,348.97
|
| Rate for Payer: Meridian Medicaid |
$1,656.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,572.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,460.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,606.19
|
| Rate for Payer: Nomi Health Commercial |
$7,337.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,711.35
|
| Rate for Payer: PACE Senior Care Partners |
$2,125.26
|
| Rate for Payer: PACE SWMI |
$2,237.11
|
| Rate for Payer: PHP Commercial |
$7,606.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,237.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,577.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,785.16
|
| Rate for Payer: Priority Health Medicare |
$2,259.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,228.13
|
| Rate for Payer: Railroad Medicare Medicare |
$2,237.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,874.64
|
| Rate for Payer: UHC Core |
$7,471.96
|
| Rate for Payer: UHC Exchange |
$2,237.11
|
| Rate for Payer: UHC Medicaid |
$1,577.61
|
| Rate for Payer: UHC Medicare Advantage |
$2,237.11
|
| Rate for Payer: UHCCP Medicaid |
$1,577.61
|
| Rate for Payer: VA VA |
$2,237.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,711.35
|
|
|
HC BOTRYTIS CINEREA IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200075
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC BOTRYTIS CINEREA IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200075
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC BOTTLE A/B CDI 500
|
Facility
|
OP
|
$206.00
|
|
| Hospital Charge Code |
27000684
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.32 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: Aetna Medicare |
$53.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.38
|
| Rate for Payer: BCBS Complete |
$38.13
|
| Rate for Payer: BCBS MAPPO |
$51.50
|
| Rate for Payer: BCBS Trust/PPO |
$169.35
|
| Rate for Payer: BCN Commercial |
$169.35
|
| Rate for Payer: BCN Medicare Advantage |
$51.50
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.50
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: Mclaren Medicaid |
$36.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.08
|
| Rate for Payer: Meridian Medicaid |
$38.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.10
|
| Rate for Payer: Nomi Health Commercial |
$168.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$154.50
|
| Rate for Payer: PACE Senior Care Partners |
$48.92
|
| Rate for Payer: PACE SWMI |
$51.50
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: PHP Medicare Advantage |
$51.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$179.22
|
| Rate for Payer: Priority Health Medicare |
$52.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$143.38
|
| Rate for Payer: Railroad Medicare Medicare |
$51.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.28
|
| Rate for Payer: UHC Core |
$172.01
|
| Rate for Payer: UHC Exchange |
$51.50
|
| Rate for Payer: UHC Medicaid |
$36.32
|
| Rate for Payer: UHC Medicare Advantage |
$51.50
|
| Rate for Payer: UHCCP Medicaid |
$36.32
|
| Rate for Payer: VA VA |
$51.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC BOTTLE A/B CDI 500
|
Facility
|
IP
|
$206.00
|
|
| Hospital Charge Code |
27000684
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$143.38 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: BCBS Trust/PPO |
$170.14
|
| Rate for Payer: BCN Commercial |
$170.14
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.10
|
| Rate for Payer: Nomi Health Commercial |
$168.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$154.50
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$179.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$143.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.28
|
| Rate for Payer: UHC Core |
$172.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC BOWL
|
Facility
|
OP
|
$234.09
|
|
| Hospital Charge Code |
27000091
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$41.27 |
| Max. Negotiated Rate |
$210.68 |
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: Aetna Medicare |
$60.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.15
|
| Rate for Payer: BCBS Complete |
$43.33
|
| Rate for Payer: BCBS MAPPO |
$58.52
|
| Rate for Payer: BCBS Trust/PPO |
$192.45
|
| Rate for Payer: BCN Commercial |
$192.45
|
| Rate for Payer: BCN Medicare Advantage |
$58.52
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.52
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| Rate for Payer: Mclaren Medicaid |
$41.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.45
|
| Rate for Payer: Meridian Medicaid |
$43.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$191.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$175.57
|
| Rate for Payer: PACE Senior Care Partners |
$55.60
|
| Rate for Payer: PACE SWMI |
$58.52
|
| Rate for Payer: PHP Commercial |
$198.98
|
| Rate for Payer: PHP Medicare Advantage |
$58.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$203.66
|
| Rate for Payer: Priority Health Medicare |
$59.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.93
|
| Rate for Payer: Railroad Medicare Medicare |
$58.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.00
|
| Rate for Payer: UHC Core |
$195.47
|
| Rate for Payer: UHC Exchange |
$58.52
|
| Rate for Payer: UHC Medicaid |
$41.27
|
| Rate for Payer: UHC Medicare Advantage |
$58.52
|
| Rate for Payer: UHCCP Medicaid |
$41.27
|
| Rate for Payer: VA VA |
$58.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC BOWL
|
Facility
|
IP
|
$234.09
|
|
| Hospital Charge Code |
27000091
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$162.93 |
| Max. Negotiated Rate |
$210.68 |
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: BCBS Trust/PPO |
$193.33
|
| Rate for Payer: BCN Commercial |
$193.33
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$191.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$175.57
|
| Rate for Payer: PHP Commercial |
$198.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$203.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.00
|
| Rate for Payer: UHC Core |
$195.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC BOWL ATS 55 ML
|
Facility
|
IP
|
$258.54
|
|
| Hospital Charge Code |
27000283
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$179.94 |
| Max. Negotiated Rate |
$232.69 |
| Rate for Payer: Aetna Commercial |
$219.76
|
| Rate for Payer: BCBS Trust/PPO |
$213.53
|
| Rate for Payer: BCN Commercial |
$213.53
|
| Rate for Payer: Cash Price |
$206.83
|
| Rate for Payer: Cofinity Commercial |
$222.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.83
|
| Rate for Payer: Healthscope Commercial |
$232.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.76
|
| Rate for Payer: Nomi Health Commercial |
$212.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.91
|
| Rate for Payer: PHP Commercial |
$219.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$224.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.52
|
| Rate for Payer: UHC Core |
$215.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.91
|
|
|
HC BOWL ATS 55 ML
|
Facility
|
OP
|
$258.54
|
|
| Hospital Charge Code |
27000283
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$232.69 |
| Rate for Payer: Aetna Commercial |
$219.76
|
| Rate for Payer: Aetna Medicare |
$67.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.79
|
| Rate for Payer: BCBS Complete |
$47.86
|
| Rate for Payer: BCBS MAPPO |
$64.64
|
| Rate for Payer: BCBS Trust/PPO |
$212.55
|
| Rate for Payer: BCN Commercial |
$212.55
|
| Rate for Payer: BCN Medicare Advantage |
$64.64
|
| Rate for Payer: Cash Price |
$206.83
|
| Rate for Payer: Cofinity Commercial |
$222.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.64
|
| Rate for Payer: Healthscope Commercial |
$232.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.91
|
| Rate for Payer: Mclaren Medicaid |
$45.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.87
|
| Rate for Payer: Meridian Medicaid |
$47.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.76
|
| Rate for Payer: Nomi Health Commercial |
$212.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.91
|
| Rate for Payer: PACE Senior Care Partners |
$61.40
|
| Rate for Payer: PACE SWMI |
$64.64
|
| Rate for Payer: PHP Commercial |
$219.76
|
| Rate for Payer: PHP Medicare Advantage |
$64.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$224.93
|
| Rate for Payer: Priority Health Medicare |
$65.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.94
|
| Rate for Payer: Railroad Medicare Medicare |
$64.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.52
|
| Rate for Payer: UHC Core |
$215.88
|
| Rate for Payer: UHC Exchange |
$64.64
|
| Rate for Payer: UHC Medicaid |
$45.58
|
| Rate for Payer: UHC Medicare Advantage |
$64.64
|
| Rate for Payer: UHCCP Medicaid |
$45.58
|
| Rate for Payer: VA VA |
$64.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.91
|
|
|
HC B. PARAPERTUSSIS BY PCR CMPT
|
Facility
|
OP
|
$53.49
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600219
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.43 |
| Max. Negotiated Rate |
$48.14 |
| Rate for Payer: Aetna Commercial |
$45.47
|
| Rate for Payer: Aetna Medicare |
$13.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.72
|
| Rate for Payer: BCBS Complete |
$9.90
|
| Rate for Payer: BCBS MAPPO |
$13.37
|
| Rate for Payer: BCBS Trust/PPO |
$43.97
|
| Rate for Payer: BCN Commercial |
$43.97
|
| Rate for Payer: BCN Medicare Advantage |
$13.37
|
| Rate for Payer: Cash Price |
$42.79
|
| Rate for Payer: Cofinity Commercial |
$46.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.37
|
| Rate for Payer: Healthscope Commercial |
$48.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.12
|
| Rate for Payer: Mclaren Medicaid |
$9.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.04
|
| Rate for Payer: Meridian Medicaid |
$9.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.47
|
| Rate for Payer: Nomi Health Commercial |
$43.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.12
|
| Rate for Payer: PACE Senior Care Partners |
$12.70
|
| Rate for Payer: PACE SWMI |
$13.37
|
| Rate for Payer: PHP Commercial |
$45.47
|
| Rate for Payer: PHP Medicare Advantage |
$13.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.54
|
| Rate for Payer: Priority Health Medicare |
$13.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.23
|
| Rate for Payer: Railroad Medicare Medicare |
$13.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.07
|
| Rate for Payer: UHC Core |
$44.66
|
| Rate for Payer: UHC Exchange |
$13.37
|
| Rate for Payer: UHC Medicaid |
$9.43
|
| Rate for Payer: UHC Medicare Advantage |
$13.37
|
| Rate for Payer: UHCCP Medicaid |
$9.43
|
| Rate for Payer: VA VA |
$13.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.12
|
|
|
HC B. PARAPERTUSSIS BY PCR CMPT
|
Facility
|
IP
|
$53.49
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600219
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.23 |
| Max. Negotiated Rate |
$48.14 |
| Rate for Payer: Aetna Commercial |
$45.47
|
| Rate for Payer: BCBS Trust/PPO |
$44.18
|
| Rate for Payer: BCN Commercial |
$44.18
|
| Rate for Payer: Cash Price |
$42.79
|
| Rate for Payer: Cofinity Commercial |
$46.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.79
|
| Rate for Payer: Healthscope Commercial |
$48.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.47
|
| Rate for Payer: Nomi Health Commercial |
$43.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.12
|
| Rate for Payer: PHP Commercial |
$45.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.07
|
| Rate for Payer: UHC Core |
$44.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.12
|
|
|
HC B.PERTUSSIS BY PCR
|
Facility
|
IP
|
$62.82
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600218
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.72 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: BCBS Trust/PPO |
$51.88
|
| Rate for Payer: BCN Commercial |
$51.88
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.28
|
| Rate for Payer: UHC Core |
$52.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC B.PERTUSSIS BY PCR
|
Facility
|
OP
|
$62.82
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600218
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: Aetna Medicare |
$16.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.63
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$15.71
|
| Rate for Payer: BCBS Trust/PPO |
$51.64
|
| Rate for Payer: BCN Commercial |
$51.64
|
| Rate for Payer: BCN Medicare Advantage |
$15.71
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.49
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PACE Senior Care Partners |
$14.92
|
| Rate for Payer: PACE SWMI |
$15.71
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: PHP Medicare Advantage |
$15.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.65
|
| Rate for Payer: Priority Health Medicare |
$15.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.72
|
| Rate for Payer: Railroad Medicare Medicare |
$15.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.28
|
| Rate for Payer: UHC Core |
$52.45
|
| Rate for Payer: UHC Exchange |
$15.71
|
| Rate for Payer: UHC Medicaid |
$11.08
|
| Rate for Payer: UHC Medicare Advantage |
$15.71
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: VA VA |
$15.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC BRACE ADD TO LE PELVIC CONTROL HIP JOINT
|
Facility
|
OP
|
$991.54
|
|
|
Service Code
|
HCPCS L2624
|
| Hospital Charge Code |
27400039
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$174.81 |
| Max. Negotiated Rate |
$892.39 |
| Rate for Payer: Aetna Commercial |
$842.81
|
| Rate for Payer: Aetna Medicare |
$257.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$309.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$309.86
|
| Rate for Payer: BCBS Complete |
$183.53
|
| Rate for Payer: BCBS MAPPO |
$247.88
|
| Rate for Payer: BCBS Trust/PPO |
$815.15
|
| Rate for Payer: BCN Commercial |
$815.15
|
| Rate for Payer: BCN Medicare Advantage |
$247.88
|
| Rate for Payer: Cash Price |
$793.23
|
| Rate for Payer: Cofinity Commercial |
$852.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.88
|
| Rate for Payer: Healthscope Commercial |
$892.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.65
|
| Rate for Payer: Mclaren Medicaid |
$174.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$260.28
|
| Rate for Payer: Meridian Medicaid |
$183.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$285.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$272.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.81
|
| Rate for Payer: Nomi Health Commercial |
$813.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$743.65
|
| Rate for Payer: PACE Senior Care Partners |
$235.49
|
| Rate for Payer: PACE SWMI |
$247.88
|
| Rate for Payer: PHP Commercial |
$842.81
|
| Rate for Payer: PHP Medicare Advantage |
$247.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$862.64
|
| Rate for Payer: Priority Health Medicare |
$250.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$690.11
|
| Rate for Payer: Railroad Medicare Medicare |
$247.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.56
|
| Rate for Payer: UHC Core |
$827.94
|
| Rate for Payer: UHC Exchange |
$247.88
|
| Rate for Payer: UHC Medicaid |
$174.81
|
| Rate for Payer: UHC Medicare Advantage |
$247.88
|
| Rate for Payer: UHCCP Medicaid |
$174.81
|
| Rate for Payer: VA VA |
$247.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.65
|
|
|
HC BRACE ADD TO LE PELVIC CONTROL HIP JOINT
|
Facility
|
IP
|
$991.54
|
|
|
Service Code
|
HCPCS L2624
|
| Hospital Charge Code |
27400039
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$690.11 |
| Max. Negotiated Rate |
$892.39 |
| Rate for Payer: Aetna Commercial |
$842.81
|
| Rate for Payer: BCBS Trust/PPO |
$818.91
|
| Rate for Payer: BCN Commercial |
$818.91
|
| Rate for Payer: Cash Price |
$793.23
|
| Rate for Payer: Cofinity Commercial |
$852.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.23
|
| Rate for Payer: Healthscope Commercial |
$892.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.81
|
| Rate for Payer: Nomi Health Commercial |
$813.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$743.65
|
| Rate for Payer: PHP Commercial |
$842.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$862.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$690.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$872.56
|
| Rate for Payer: UHC Core |
$827.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.65
|
|
|
HC BRACE AFO
|
Facility
|
IP
|
$608.06
|
|
|
Service Code
|
HCPCS L1930
|
| Hospital Charge Code |
27000002
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$423.21 |
| Max. Negotiated Rate |
$547.25 |
| Rate for Payer: Aetna Commercial |
$516.85
|
| Rate for Payer: BCBS Trust/PPO |
$502.20
|
| Rate for Payer: BCN Commercial |
$502.20
|
| Rate for Payer: Cash Price |
$486.45
|
| Rate for Payer: Cofinity Commercial |
$522.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$486.45
|
| Rate for Payer: Healthscope Commercial |
$547.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$456.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$516.85
|
| Rate for Payer: Nomi Health Commercial |
$498.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.05
|
| Rate for Payer: PHP Commercial |
$516.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$529.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$423.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$535.09
|
| Rate for Payer: UHC Core |
$507.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$456.05
|
|
