|
HC ADMIN TOCILIZUMAB COVID 19 2ND DOSE
|
Facility
|
IP
|
$534.77
|
|
|
Service Code
|
HCPCS M0250
|
| Hospital Charge Code |
77100045
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$347.60 |
| Max. Negotiated Rate |
$481.29 |
| Rate for Payer: Aetna Commercial |
$454.55
|
| Rate for Payer: BCBS Trust/PPO |
$436.53
|
| Rate for Payer: BCN Commercial |
$413.27
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cofinity Commercial |
$459.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.82
|
| Rate for Payer: Healthscope Commercial |
$481.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.55
|
| Rate for Payer: Nomi Health Commercial |
$438.51
|
| Rate for Payer: PHP Commercial |
$454.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.60
|
| Rate for Payer: Priority Health HMO/PPO |
$465.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$470.60
|
| Rate for Payer: UHC Core |
$446.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.08
|
|
|
HC ADMN SARSCOV2 VACC 1 DOSE
|
Facility
|
OP
|
$84.70
|
|
|
Service Code
|
CPT 90480
|
| Hospital Charge Code |
77100064
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$20.12 |
| Max. Negotiated Rate |
$76.23 |
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: Aetna Medicare |
$22.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.47
|
| Rate for Payer: BCBS Complete |
$30.88
|
| Rate for Payer: BCBS MAPPO |
$21.18
|
| Rate for Payer: BCBS Trust/PPO |
$69.63
|
| Rate for Payer: BCN Commercial |
$65.85
|
| Rate for Payer: BCN Medicare Advantage |
$21.18
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cofinity Commercial |
$72.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.18
|
| Rate for Payer: Healthscope Commercial |
$76.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.52
|
| Rate for Payer: Mclaren Medicaid |
$29.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.23
|
| Rate for Payer: Meridian Medicaid |
$30.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.00
|
| Rate for Payer: Nomi Health Commercial |
$69.45
|
| Rate for Payer: PACE Senior Care Partners |
$20.12
|
| Rate for Payer: PACE SWMI |
$21.18
|
| Rate for Payer: PHP Commercial |
$72.00
|
| Rate for Payer: PHP Medicare Advantage |
$21.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.06
|
| Rate for Payer: Priority Health HMO/PPO |
$73.69
|
| Rate for Payer: Priority Health Medicare |
$21.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.75
|
| Rate for Payer: Railroad Medicare Medicare |
$21.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.54
|
| Rate for Payer: UHC Core |
$70.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.18
|
| Rate for Payer: UHC Exchange |
$21.18
|
| Rate for Payer: UHC Medicare Advantage |
$21.18
|
| Rate for Payer: UHCCP Medicaid |
$29.41
|
| Rate for Payer: VA VA |
$21.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.52
|
|
|
HC ADMN SARSCOV2 VACC 1 DOSE
|
Facility
|
IP
|
$84.70
|
|
|
Service Code
|
CPT 90480
|
| Hospital Charge Code |
77100064
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$55.06 |
| Max. Negotiated Rate |
$76.23 |
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: BCBS Trust/PPO |
$69.14
|
| Rate for Payer: BCN Commercial |
$65.46
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cofinity Commercial |
$72.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.76
|
| Rate for Payer: Healthscope Commercial |
$76.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.00
|
| Rate for Payer: Nomi Health Commercial |
$69.45
|
| Rate for Payer: PHP Commercial |
$72.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.06
|
| Rate for Payer: Priority Health HMO/PPO |
$73.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.54
|
| Rate for Payer: UHC Core |
$70.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.52
|
|
|
HC ADMU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200020
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: BCBS Trust/PPO |
$118.43
|
| Rate for Payer: BCN Commercial |
$112.12
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO |
$126.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.67
|
| Rate for Payer: UHC Core |
$121.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC ADMU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200020
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$34.46 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna Medicare |
$37.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.34
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS MAPPO |
$36.27
|
| Rate for Payer: BCBS Trust/PPO |
$119.27
|
| Rate for Payer: BCN Commercial |
$112.80
|
| Rate for Payer: BCN Medicare Advantage |
$36.27
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.27
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: PACE Senior Care Partners |
$34.46
|
| Rate for Payer: PACE SWMI |
$36.27
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: PHP Medicare Advantage |
$36.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO |
$126.22
|
| Rate for Payer: Priority Health Medicare |
$36.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.20
|
| Rate for Payer: Railroad Medicare Medicare |
$36.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.67
|
| Rate for Payer: UHC Core |
$121.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.27
|
| Rate for Payer: UHC Exchange |
$36.27
|
| Rate for Payer: UHC Medicare Advantage |
$36.27
|
| Rate for Payer: VA VA |
$36.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC ADRENOCORTICOTROPIC HORMONE
|
Facility
|
OP
|
$63.18
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
30100071
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.01 |
| Max. Negotiated Rate |
$56.86 |
| Rate for Payer: Aetna Commercial |
$53.70
|
| Rate for Payer: Aetna Medicare |
$16.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.74
|
| Rate for Payer: BCBS Complete |
$29.32
|
| Rate for Payer: BCBS MAPPO |
$15.80
|
| Rate for Payer: BCBS Trust/PPO |
$51.94
|
| Rate for Payer: BCN Commercial |
$49.12
|
| Rate for Payer: BCN Medicare Advantage |
$15.80
|
| Rate for Payer: Cash Price |
$50.54
|
| Rate for Payer: Cash Price |
$50.54
|
| Rate for Payer: Cofinity Commercial |
$54.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.80
|
| Rate for Payer: Healthscope Commercial |
$56.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.38
|
| Rate for Payer: Mclaren Medicaid |
$27.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.58
|
| Rate for Payer: Meridian Medicaid |
$29.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.70
|
| Rate for Payer: Nomi Health Commercial |
$51.81
|
| Rate for Payer: PACE Senior Care Partners |
$15.01
|
| Rate for Payer: PACE SWMI |
$15.80
|
| Rate for Payer: PHP Commercial |
$53.70
|
| Rate for Payer: PHP Medicare Advantage |
$15.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.07
|
| Rate for Payer: Priority Health HMO/PPO |
$54.97
|
| Rate for Payer: Priority Health Medicare |
$15.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.33
|
| Rate for Payer: Railroad Medicare Medicare |
$15.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.60
|
| Rate for Payer: UHC Core |
$52.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.80
|
| Rate for Payer: UHC Exchange |
$15.80
|
| Rate for Payer: UHC Medicare Advantage |
$15.80
|
| Rate for Payer: UHCCP Medicaid |
$27.92
|
| Rate for Payer: VA VA |
$15.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.38
|
|
|
HC ADRENOCORTICOTROPIC HORMONE
|
Facility
|
IP
|
$63.18
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
30100071
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.07 |
| Max. Negotiated Rate |
$56.86 |
| Rate for Payer: Aetna Commercial |
$53.70
|
| Rate for Payer: BCBS Trust/PPO |
$51.57
|
| Rate for Payer: BCN Commercial |
$48.83
|
| Rate for Payer: Cash Price |
$50.54
|
| Rate for Payer: Cofinity Commercial |
$54.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.54
|
| Rate for Payer: Healthscope Commercial |
$56.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.70
|
| Rate for Payer: Nomi Health Commercial |
$51.81
|
| Rate for Payer: PHP Commercial |
$53.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.07
|
| Rate for Payer: Priority Health HMO/PPO |
$54.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.60
|
| Rate for Payer: UHC Core |
$52.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.38
|
|
|
HC ADULTERANT SURVEY URINE
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700010
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$12.49
|
| Rate for Payer: BCN Commercial |
$11.82
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.00
|
| Rate for Payer: Nomi Health Commercial |
$12.55
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.94
|
| Rate for Payer: Priority Health HMO/PPO |
$13.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.46
|
| Rate for Payer: UHC Core |
$12.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC ADULTERANT SURVEY URINE
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700010
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.57 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna Medicare |
$3.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.78
|
| Rate for Payer: BCBS Complete |
$1.65
|
| Rate for Payer: BCBS MAPPO |
$3.82
|
| Rate for Payer: BCBS Trust/PPO |
$12.58
|
| Rate for Payer: BCN Commercial |
$11.90
|
| Rate for Payer: BCN Medicare Advantage |
$3.82
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.82
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Mclaren Medicaid |
$1.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.02
|
| Rate for Payer: Meridian Medicaid |
$1.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.00
|
| Rate for Payer: Nomi Health Commercial |
$12.55
|
| Rate for Payer: PACE Senior Care Partners |
$3.63
|
| Rate for Payer: PACE SWMI |
$3.82
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Medicare Advantage |
$3.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.94
|
| Rate for Payer: Priority Health HMO/PPO |
$13.31
|
| Rate for Payer: Priority Health Medicare |
$3.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.25
|
| Rate for Payer: Railroad Medicare Medicare |
$3.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.46
|
| Rate for Payer: UHC Core |
$12.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.82
|
| Rate for Payer: UHC Exchange |
$3.82
|
| Rate for Payer: UHC Medicare Advantage |
$3.82
|
| Rate for Payer: UHCCP Medicaid |
$1.57
|
| Rate for Payer: VA VA |
$3.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC ADVANCE CARE PLANNING EA ADDL 30 MIN
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
CPT 99498
|
| Hospital Charge Code |
51000091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.64 |
| Max. Negotiated Rate |
$29.96 |
| Rate for Payer: Aetna Commercial |
$28.30
|
| Rate for Payer: BCBS Trust/PPO |
$27.17
|
| Rate for Payer: BCN Commercial |
$25.73
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$28.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Healthscope Commercial |
$29.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: PHP Commercial |
$28.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.64
|
| Rate for Payer: Priority Health HMO/PPO |
$28.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.30
|
| Rate for Payer: UHC Core |
$27.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.97
|
|
|
HC ADVANCE CARE PLANNING EA ADDL 30 MIN
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
CPT 99498
|
| Hospital Charge Code |
51000091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.91 |
| Max. Negotiated Rate |
$29.96 |
| Rate for Payer: Aetna Commercial |
$28.30
|
| Rate for Payer: Aetna Medicare |
$8.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.40
|
| Rate for Payer: BCBS Complete |
$13.32
|
| Rate for Payer: BCBS MAPPO |
$8.32
|
| Rate for Payer: BCBS Trust/PPO |
$27.37
|
| Rate for Payer: BCN Commercial |
$25.88
|
| Rate for Payer: BCN Medicare Advantage |
$8.32
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$28.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$29.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: PACE Senior Care Partners |
$7.91
|
| Rate for Payer: PACE SWMI |
$8.32
|
| Rate for Payer: PHP Commercial |
$28.30
|
| Rate for Payer: PHP Medicare Advantage |
$8.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.64
|
| Rate for Payer: Priority Health HMO/PPO |
$28.96
|
| Rate for Payer: Priority Health Medicare |
$8.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.30
|
| Rate for Payer: Railroad Medicare Medicare |
$8.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.30
|
| Rate for Payer: UHC Core |
$27.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.32
|
| Rate for Payer: UHC Exchange |
$8.32
|
| Rate for Payer: UHC Medicare Advantage |
$8.32
|
| Rate for Payer: VA VA |
$8.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.97
|
|
|
HC ADVANCE CARE PLANNING FIRST 30 MIN
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
CPT 99497
|
| Hospital Charge Code |
51000090
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.91 |
| Max. Negotiated Rate |
$68.81 |
| Rate for Payer: Aetna Commercial |
$28.30
|
| Rate for Payer: Aetna Medicare |
$8.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.40
|
| Rate for Payer: BCBS Complete |
$68.81
|
| Rate for Payer: BCBS MAPPO |
$8.32
|
| Rate for Payer: BCBS Trust/PPO |
$27.37
|
| Rate for Payer: BCN Commercial |
$25.88
|
| Rate for Payer: BCN Medicare Advantage |
$8.32
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$28.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$29.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.97
|
| Rate for Payer: Mclaren Medicaid |
$65.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.74
|
| Rate for Payer: Meridian Medicaid |
$68.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: PACE Senior Care Partners |
$7.91
|
| Rate for Payer: PACE SWMI |
$8.32
|
| Rate for Payer: PHP Commercial |
$28.30
|
| Rate for Payer: PHP Medicare Advantage |
$8.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.64
|
| Rate for Payer: Priority Health HMO/PPO |
$28.96
|
| Rate for Payer: Priority Health Medicare |
$8.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.30
|
| Rate for Payer: Railroad Medicare Medicare |
$8.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.30
|
| Rate for Payer: UHC Core |
$27.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.32
|
| Rate for Payer: UHC Exchange |
$8.32
|
| Rate for Payer: UHC Medicare Advantage |
$8.32
|
| Rate for Payer: UHCCP Medicaid |
$65.53
|
| Rate for Payer: VA VA |
$8.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.97
|
|
|
HC ADVANCE CARE PLANNING FIRST 30 MIN
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
CPT 99497
|
| Hospital Charge Code |
51000090
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.64 |
| Max. Negotiated Rate |
$29.96 |
| Rate for Payer: Aetna Commercial |
$28.30
|
| Rate for Payer: BCBS Trust/PPO |
$27.17
|
| Rate for Payer: BCN Commercial |
$25.73
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$28.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Healthscope Commercial |
$29.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: Nomi Health Commercial |
$27.30
|
| Rate for Payer: PHP Commercial |
$28.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.64
|
| Rate for Payer: Priority Health HMO/PPO |
$28.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.30
|
| Rate for Payer: UHC Core |
$27.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.97
|
|
|
HC AEP HEARING STATUS DETER BROADBAND STIMULI I&R
|
Facility
|
IP
|
$161.16
|
|
|
Service Code
|
CPT 92651
|
| Hospital Charge Code |
76100497
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$104.75 |
| Max. Negotiated Rate |
$145.04 |
| Rate for Payer: Aetna Commercial |
$136.99
|
| Rate for Payer: BCBS Trust/PPO |
$131.55
|
| Rate for Payer: BCN Commercial |
$124.54
|
| Rate for Payer: Cash Price |
$128.93
|
| Rate for Payer: Cofinity Commercial |
$138.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.93
|
| Rate for Payer: Healthscope Commercial |
$145.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.99
|
| Rate for Payer: Nomi Health Commercial |
$132.15
|
| Rate for Payer: PHP Commercial |
$136.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.75
|
| Rate for Payer: Priority Health HMO/PPO |
$140.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.82
|
| Rate for Payer: UHC Core |
$134.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.87
|
|
|
HC AEP HEARING STATUS DETER BROADBAND STIMULI I&R
|
Facility
|
OP
|
$161.16
|
|
|
Service Code
|
CPT 92651
|
| Hospital Charge Code |
76100497
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$38.28 |
| Max. Negotiated Rate |
$231.63 |
| Rate for Payer: Aetna Commercial |
$136.99
|
| Rate for Payer: Aetna Medicare |
$41.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.36
|
| Rate for Payer: BCBS Complete |
$231.63
|
| Rate for Payer: BCBS MAPPO |
$40.29
|
| Rate for Payer: BCBS Trust/PPO |
$132.49
|
| Rate for Payer: BCN Commercial |
$125.30
|
| Rate for Payer: BCN Medicare Advantage |
$40.29
|
| Rate for Payer: Cash Price |
$128.93
|
| Rate for Payer: Cash Price |
$128.93
|
| Rate for Payer: Cofinity Commercial |
$138.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.29
|
| Rate for Payer: Healthscope Commercial |
$145.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.87
|
| Rate for Payer: Mclaren Medicaid |
$220.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.30
|
| Rate for Payer: Meridian Medicaid |
$231.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.99
|
| Rate for Payer: Nomi Health Commercial |
$132.15
|
| Rate for Payer: PACE Senior Care Partners |
$38.28
|
| Rate for Payer: PACE SWMI |
$40.29
|
| Rate for Payer: PHP Commercial |
$136.99
|
| Rate for Payer: PHP Medicare Advantage |
$40.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.75
|
| Rate for Payer: Priority Health HMO/PPO |
$140.21
|
| Rate for Payer: Priority Health Medicare |
$40.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.98
|
| Rate for Payer: Railroad Medicare Medicare |
$40.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.82
|
| Rate for Payer: UHC Core |
$134.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.29
|
| Rate for Payer: UHC Exchange |
$40.29
|
| Rate for Payer: UHC Medicare Advantage |
$40.29
|
| Rate for Payer: UHCCP Medicaid |
$220.59
|
| Rate for Payer: VA VA |
$40.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.87
|
|
|
HC AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R
|
Facility
|
IP
|
$286.62
|
|
|
Service Code
|
CPT 92652
|
| Hospital Charge Code |
47100401
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$186.30 |
| Max. Negotiated Rate |
$257.96 |
| Rate for Payer: Aetna Commercial |
$243.63
|
| Rate for Payer: BCBS Trust/PPO |
$233.97
|
| Rate for Payer: BCN Commercial |
$221.50
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cofinity Commercial |
$246.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.30
|
| Rate for Payer: Healthscope Commercial |
$257.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.63
|
| Rate for Payer: Nomi Health Commercial |
$235.03
|
| Rate for Payer: PHP Commercial |
$243.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.30
|
| Rate for Payer: Priority Health HMO/PPO |
$249.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$192.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.23
|
| Rate for Payer: UHC Core |
$239.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.96
|
|
|
HC AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R
|
Facility
|
OP
|
$286.62
|
|
|
Service Code
|
CPT 92652
|
| Hospital Charge Code |
47100401
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$68.07 |
| Max. Negotiated Rate |
$257.96 |
| Rate for Payer: Aetna Commercial |
$243.63
|
| Rate for Payer: Aetna Medicare |
$74.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.57
|
| Rate for Payer: BCBS Complete |
$231.63
|
| Rate for Payer: BCBS MAPPO |
$71.66
|
| Rate for Payer: BCBS Trust/PPO |
$235.63
|
| Rate for Payer: BCN Commercial |
$222.85
|
| Rate for Payer: BCN Medicare Advantage |
$71.66
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cofinity Commercial |
$246.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.66
|
| Rate for Payer: Healthscope Commercial |
$257.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.96
|
| Rate for Payer: Mclaren Medicaid |
$220.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.24
|
| Rate for Payer: Meridian Medicaid |
$231.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.63
|
| Rate for Payer: Nomi Health Commercial |
$235.03
|
| Rate for Payer: PACE Senior Care Partners |
$68.07
|
| Rate for Payer: PACE SWMI |
$71.66
|
| Rate for Payer: PHP Commercial |
$243.63
|
| Rate for Payer: PHP Medicare Advantage |
$71.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.30
|
| Rate for Payer: Priority Health HMO/PPO |
$249.36
|
| Rate for Payer: Priority Health Medicare |
$72.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$192.04
|
| Rate for Payer: Railroad Medicare Medicare |
$71.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.23
|
| Rate for Payer: UHC Core |
$239.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.66
|
| Rate for Payer: UHC Exchange |
$71.66
|
| Rate for Payer: UHC Medicare Advantage |
$71.66
|
| Rate for Payer: UHCCP Medicaid |
$220.59
|
| Rate for Payer: VA VA |
$71.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.96
|
|
|
HC AEROBIKA
|
Facility
|
OP
|
$150.27
|
|
| Hospital Charge Code |
27000612
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$35.69 |
| Max. Negotiated Rate |
$135.24 |
| Rate for Payer: Aetna Commercial |
$127.73
|
| Rate for Payer: Aetna Medicare |
$39.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.96
|
| Rate for Payer: BCBS Complete |
$60.11
|
| Rate for Payer: BCBS MAPPO |
$37.57
|
| Rate for Payer: BCBS Trust/PPO |
$123.54
|
| Rate for Payer: BCN Commercial |
$116.83
|
| Rate for Payer: BCN Medicare Advantage |
$37.57
|
| Rate for Payer: Cash Price |
$120.22
|
| Rate for Payer: Cofinity Commercial |
$129.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.57
|
| Rate for Payer: Healthscope Commercial |
$135.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.73
|
| Rate for Payer: Nomi Health Commercial |
$123.22
|
| Rate for Payer: PACE Senior Care Partners |
$35.69
|
| Rate for Payer: PACE SWMI |
$37.57
|
| Rate for Payer: PHP Commercial |
$127.73
|
| Rate for Payer: PHP Medicare Advantage |
$37.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.68
|
| Rate for Payer: Priority Health HMO/PPO |
$130.73
|
| Rate for Payer: Priority Health Medicare |
$37.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.68
|
| Rate for Payer: Railroad Medicare Medicare |
$37.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.24
|
| Rate for Payer: UHC Core |
$125.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.57
|
| Rate for Payer: UHC Exchange |
$37.57
|
| Rate for Payer: UHC Medicare Advantage |
$37.57
|
| Rate for Payer: VA VA |
$37.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.70
|
|
|
HC AEROBIKA
|
Facility
|
IP
|
$150.27
|
|
| Hospital Charge Code |
27000612
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$97.68 |
| Max. Negotiated Rate |
$135.24 |
| Rate for Payer: Aetna Commercial |
$127.73
|
| Rate for Payer: BCBS Trust/PPO |
$122.67
|
| Rate for Payer: BCN Commercial |
$116.13
|
| Rate for Payer: Cash Price |
$120.22
|
| Rate for Payer: Cofinity Commercial |
$129.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.22
|
| Rate for Payer: Healthscope Commercial |
$135.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.73
|
| Rate for Payer: Nomi Health Commercial |
$123.22
|
| Rate for Payer: PHP Commercial |
$127.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.68
|
| Rate for Payer: Priority Health HMO/PPO |
$130.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.24
|
| Rate for Payer: UHC Core |
$125.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.70
|
|
|
HC AERONEB SUPPLY
|
Facility
|
OP
|
$167.21
|
|
| Hospital Charge Code |
27000465
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.71 |
| Max. Negotiated Rate |
$150.49 |
| Rate for Payer: Aetna Commercial |
$142.13
|
| Rate for Payer: Aetna Medicare |
$43.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.25
|
| Rate for Payer: BCBS Complete |
$66.88
|
| Rate for Payer: BCBS MAPPO |
$41.80
|
| Rate for Payer: BCBS Trust/PPO |
$137.46
|
| Rate for Payer: BCN Commercial |
$130.01
|
| Rate for Payer: BCN Medicare Advantage |
$41.80
|
| Rate for Payer: Cash Price |
$133.77
|
| Rate for Payer: Cofinity Commercial |
$143.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.80
|
| Rate for Payer: Healthscope Commercial |
$150.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.13
|
| Rate for Payer: Nomi Health Commercial |
$137.11
|
| Rate for Payer: PACE Senior Care Partners |
$39.71
|
| Rate for Payer: PACE SWMI |
$41.80
|
| Rate for Payer: PHP Commercial |
$142.13
|
| Rate for Payer: PHP Medicare Advantage |
$41.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.69
|
| Rate for Payer: Priority Health HMO/PPO |
$145.47
|
| Rate for Payer: Priority Health Medicare |
$42.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.03
|
| Rate for Payer: Railroad Medicare Medicare |
$41.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.14
|
| Rate for Payer: UHC Core |
$139.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.80
|
| Rate for Payer: UHC Exchange |
$41.80
|
| Rate for Payer: UHC Medicare Advantage |
$41.80
|
| Rate for Payer: VA VA |
$41.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.41
|
|
|
HC AERONEB SUPPLY
|
Facility
|
IP
|
$167.21
|
|
| Hospital Charge Code |
27000465
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$108.69 |
| Max. Negotiated Rate |
$150.49 |
| Rate for Payer: Aetna Commercial |
$142.13
|
| Rate for Payer: BCBS Trust/PPO |
$136.49
|
| Rate for Payer: BCN Commercial |
$129.22
|
| Rate for Payer: Cash Price |
$133.77
|
| Rate for Payer: Cofinity Commercial |
$143.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.77
|
| Rate for Payer: Healthscope Commercial |
$150.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.13
|
| Rate for Payer: Nomi Health Commercial |
$137.11
|
| Rate for Payer: PHP Commercial |
$142.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.69
|
| Rate for Payer: Priority Health HMO/PPO |
$145.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.14
|
| Rate for Payer: UHC Core |
$139.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.41
|
|
|
HC AEROSOLIZED MEDICATION
|
Facility
|
IP
|
$149.67
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000012
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$97.29 |
| Max. Negotiated Rate |
$134.70 |
| Rate for Payer: Aetna Commercial |
$127.22
|
| Rate for Payer: BCBS Trust/PPO |
$122.18
|
| Rate for Payer: BCN Commercial |
$115.66
|
| Rate for Payer: Cash Price |
$119.74
|
| Rate for Payer: Cofinity Commercial |
$128.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.74
|
| Rate for Payer: Healthscope Commercial |
$134.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.22
|
| Rate for Payer: Nomi Health Commercial |
$122.73
|
| Rate for Payer: PHP Commercial |
$127.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.29
|
| Rate for Payer: Priority Health HMO/PPO |
$130.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.71
|
| Rate for Payer: UHC Core |
$124.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.25
|
|
|
HC AEROSOLIZED MEDICATION
|
Facility
|
OP
|
$149.67
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000012
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$35.55 |
| Max. Negotiated Rate |
$151.29 |
| Rate for Payer: Aetna Commercial |
$127.22
|
| Rate for Payer: Aetna Medicare |
$38.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.77
|
| Rate for Payer: BCBS Complete |
$151.29
|
| Rate for Payer: BCBS MAPPO |
$37.42
|
| Rate for Payer: BCBS Trust/PPO |
$123.04
|
| Rate for Payer: BCN Commercial |
$116.37
|
| Rate for Payer: BCN Medicare Advantage |
$37.42
|
| Rate for Payer: Cash Price |
$119.74
|
| Rate for Payer: Cash Price |
$119.74
|
| Rate for Payer: Cofinity Commercial |
$128.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.42
|
| Rate for Payer: Healthscope Commercial |
$134.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.25
|
| Rate for Payer: Mclaren Medicaid |
$144.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.29
|
| Rate for Payer: Meridian Medicaid |
$151.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.22
|
| Rate for Payer: Nomi Health Commercial |
$122.73
|
| Rate for Payer: PACE Senior Care Partners |
$35.55
|
| Rate for Payer: PACE SWMI |
$37.42
|
| Rate for Payer: PHP Commercial |
$127.22
|
| Rate for Payer: PHP Medicare Advantage |
$37.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.29
|
| Rate for Payer: Priority Health HMO/PPO |
$130.21
|
| Rate for Payer: Priority Health Medicare |
$37.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.28
|
| Rate for Payer: Railroad Medicare Medicare |
$37.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.71
|
| Rate for Payer: UHC Core |
$124.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.42
|
| Rate for Payer: UHC Exchange |
$37.42
|
| Rate for Payer: UHC Medicare Advantage |
$37.42
|
| Rate for Payer: UHCCP Medicaid |
$144.08
|
| Rate for Payer: VA VA |
$37.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.25
|
|
|
HC AFB CULTURE
|
Facility
|
IP
|
$91.19
|
|
|
Service Code
|
CPT 87116
|
| Hospital Charge Code |
30600089
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$59.27 |
| Max. Negotiated Rate |
$82.07 |
| Rate for Payer: Aetna Commercial |
$77.51
|
| Rate for Payer: BCBS Trust/PPO |
$74.44
|
| Rate for Payer: BCN Commercial |
$70.47
|
| Rate for Payer: Cash Price |
$72.95
|
| Rate for Payer: Cofinity Commercial |
$78.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.95
|
| Rate for Payer: Healthscope Commercial |
$82.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.51
|
| Rate for Payer: Nomi Health Commercial |
$74.78
|
| Rate for Payer: PHP Commercial |
$77.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.27
|
| Rate for Payer: Priority Health HMO/PPO |
$79.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.25
|
| Rate for Payer: UHC Core |
$76.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.39
|
|
|
HC AFB CULTURE
|
Facility
|
OP
|
$91.19
|
|
|
Service Code
|
CPT 87116
|
| Hospital Charge Code |
30600089
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.81 |
| Max. Negotiated Rate |
$82.07 |
| Rate for Payer: Aetna Commercial |
$77.51
|
| Rate for Payer: Aetna Medicare |
$23.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.50
|
| Rate for Payer: BCBS Complete |
$8.20
|
| Rate for Payer: BCBS MAPPO |
$22.80
|
| Rate for Payer: BCBS Trust/PPO |
$74.97
|
| Rate for Payer: BCN Commercial |
$70.90
|
| Rate for Payer: BCN Medicare Advantage |
$22.80
|
| Rate for Payer: Cash Price |
$72.95
|
| Rate for Payer: Cash Price |
$72.95
|
| Rate for Payer: Cofinity Commercial |
$78.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.80
|
| Rate for Payer: Healthscope Commercial |
$82.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.39
|
| Rate for Payer: Mclaren Medicaid |
$7.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.94
|
| Rate for Payer: Meridian Medicaid |
$8.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.51
|
| Rate for Payer: Nomi Health Commercial |
$74.78
|
| Rate for Payer: PACE Senior Care Partners |
$21.66
|
| Rate for Payer: PACE SWMI |
$22.80
|
| Rate for Payer: PHP Commercial |
$77.51
|
| Rate for Payer: PHP Medicare Advantage |
$22.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.27
|
| Rate for Payer: Priority Health HMO/PPO |
$79.34
|
| Rate for Payer: Priority Health Medicare |
$23.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.10
|
| Rate for Payer: Railroad Medicare Medicare |
$22.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.25
|
| Rate for Payer: UHC Core |
$76.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.80
|
| Rate for Payer: UHC Exchange |
$22.80
|
| Rate for Payer: UHC Medicare Advantage |
$22.80
|
| Rate for Payer: UHCCP Medicaid |
$7.81
|
| Rate for Payer: VA VA |
$22.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.39
|
|
