|
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 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 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 |
$70.23 |
| 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 |
$70.23
|
| 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 |
$66.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.74
|
| Rate for Payer: Meridian Medicaid |
$70.23
|
| 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 |
$66.88
|
| 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 |
$66.88
|
| 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 |
$236.41 |
| 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 |
$236.41
|
| 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 |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.30
|
| Rate for Payer: Meridian Medicaid |
$236.41
|
| 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 |
$225.14
|
| 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 |
$225.14
|
| 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
|
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 |
$236.41
|
| 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 |
$214.97
|
| Rate for Payer: Mclaren Medicaid |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.24
|
| Rate for Payer: Meridian Medicaid |
$236.41
|
| 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 |
$225.14
|
| 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 |
$225.14
|
| Rate for Payer: VA VA |
$71.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.97
|
|
|
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 |
$214.97
|
| 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 |
$214.97
|
|
|
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
|
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 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 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 |
$154.41 |
| 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 |
$154.41
|
| 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 |
$147.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.29
|
| Rate for Payer: Meridian Medicaid |
$154.41
|
| 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 |
$147.05
|
| 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 |
$147.05
|
| Rate for Payer: VA VA |
$37.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.25
|
|
|
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 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
|
|
|
HC AFB SMEAR
|
Facility
|
IP
|
$58.65
|
|
|
Service Code
|
CPT 87206
|
| Hospital Charge Code |
30600105
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$38.12 |
| Max. Negotiated Rate |
$52.78 |
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: BCBS Trust/PPO |
$47.88
|
| Rate for Payer: BCN Commercial |
$45.32
|
| Rate for Payer: Cash Price |
$46.92
|
| Rate for Payer: Cofinity Commercial |
$50.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.92
|
| Rate for Payer: Healthscope Commercial |
$52.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.85
|
| Rate for Payer: Nomi Health Commercial |
$48.09
|
| Rate for Payer: PHP Commercial |
$49.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.12
|
| Rate for Payer: Priority Health HMO/PPO |
$51.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.61
|
| Rate for Payer: UHC Core |
$48.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.99
|
|
|
HC AFB SMEAR
|
Facility
|
OP
|
$58.65
|
|
|
Service Code
|
CPT 87206
|
| Hospital Charge Code |
30600105
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$52.78 |
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: Aetna Medicare |
$15.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.33
|
| Rate for Payer: BCBS Complete |
$4.09
|
| Rate for Payer: BCBS MAPPO |
$14.66
|
| Rate for Payer: BCBS Trust/PPO |
$48.22
|
| Rate for Payer: BCN Commercial |
$45.60
|
| Rate for Payer: BCN Medicare Advantage |
$14.66
|
| Rate for Payer: Cash Price |
$46.92
|
| Rate for Payer: Cash Price |
$46.92
|
| Rate for Payer: Cofinity Commercial |
$50.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.66
|
| Rate for Payer: Healthscope Commercial |
$52.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.99
|
| Rate for Payer: Mclaren Medicaid |
$3.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.40
|
| Rate for Payer: Meridian Medicaid |
$4.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.85
|
| Rate for Payer: Nomi Health Commercial |
$48.09
|
| Rate for Payer: PACE Senior Care Partners |
$13.93
|
| Rate for Payer: PACE SWMI |
$14.66
|
| Rate for Payer: PHP Commercial |
$49.85
|
| Rate for Payer: PHP Medicare Advantage |
$14.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.12
|
| Rate for Payer: Priority Health HMO/PPO |
$51.03
|
| Rate for Payer: Priority Health Medicare |
$14.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.30
|
| Rate for Payer: Railroad Medicare Medicare |
$14.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.61
|
| Rate for Payer: UHC Core |
$48.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.66
|
| Rate for Payer: UHC Exchange |
$14.66
|
| Rate for Payer: UHC Medicare Advantage |
$14.66
|
| Rate for Payer: UHCCP Medicaid |
$3.90
|
| Rate for Payer: VA VA |
$14.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.99
|
|
|
HC AFFINITY 1.5 X 1.5 PER SQ CM
|
Facility
|
IP
|
$721.00
|
|
|
Service Code
|
HCPCS Q4159
|
| Hospital Charge Code |
63600124
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$468.65 |
| Max. Negotiated Rate |
$648.90 |
| Rate for Payer: Aetna Commercial |
$612.85
|
| Rate for Payer: BCBS Trust/PPO |
$588.55
|
| Rate for Payer: BCN Commercial |
$557.19
|
| Rate for Payer: Cash Price |
$576.80
|
| Rate for Payer: Cofinity Commercial |
$620.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.80
|
| Rate for Payer: Healthscope Commercial |
$648.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$612.85
|
| Rate for Payer: Nomi Health Commercial |
$591.22
|
| Rate for Payer: PHP Commercial |
$612.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$468.65
|
| Rate for Payer: Priority Health HMO/PPO |
$627.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$483.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$634.48
|
| Rate for Payer: UHC Core |
$602.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.75
|
|
|
HC AFFINITY 1.5 X 1.5 PER SQ CM
|
Facility
|
OP
|
$721.00
|
|
|
Service Code
|
HCPCS Q4159
|
| Hospital Charge Code |
63600124
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$171.24 |
| Max. Negotiated Rate |
$648.90 |
| Rate for Payer: Aetna Commercial |
$612.85
|
| Rate for Payer: Aetna Medicare |
$187.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$225.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$225.31
|
| Rate for Payer: BCBS Complete |
$288.40
|
| Rate for Payer: BCBS MAPPO |
$180.25
|
| Rate for Payer: BCBS Trust/PPO |
$592.73
|
| Rate for Payer: BCN Commercial |
$560.58
|
| Rate for Payer: BCN Medicare Advantage |
$180.25
|
| Rate for Payer: Cash Price |
$576.80
|
| Rate for Payer: Cofinity Commercial |
$620.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.25
|
| Rate for Payer: Healthscope Commercial |
$648.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$612.85
|
| Rate for Payer: Nomi Health Commercial |
$591.22
|
| Rate for Payer: PACE Senior Care Partners |
$171.24
|
| Rate for Payer: PACE SWMI |
$180.25
|
| Rate for Payer: PHP Commercial |
$612.85
|
| Rate for Payer: PHP Medicare Advantage |
$180.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$468.65
|
| Rate for Payer: Priority Health HMO/PPO |
$627.27
|
| Rate for Payer: Priority Health Medicare |
$182.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$483.07
|
| Rate for Payer: Railroad Medicare Medicare |
$180.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$634.48
|
| Rate for Payer: UHC Core |
$602.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.25
|
| Rate for Payer: UHC Exchange |
$180.25
|
| Rate for Payer: UHC Medicare Advantage |
$180.25
|
| Rate for Payer: VA VA |
$180.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.75
|
|
|
HC AFFINITY 2.5 X 2.5 PER SQ CM
|
Facility
|
OP
|
$434.79
|
|
|
Service Code
|
HCPCS Q4159
|
| Hospital Charge Code |
63600125
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$103.26 |
| Max. Negotiated Rate |
$391.31 |
| Rate for Payer: Aetna Commercial |
$369.57
|
| Rate for Payer: Aetna Medicare |
$113.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$135.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$135.87
|
| Rate for Payer: BCBS Complete |
$173.92
|
| Rate for Payer: BCBS MAPPO |
$108.70
|
| Rate for Payer: BCBS Trust/PPO |
$357.44
|
| Rate for Payer: BCN Commercial |
$338.05
|
| Rate for Payer: BCN Medicare Advantage |
$108.70
|
| Rate for Payer: Cash Price |
$347.83
|
| Rate for Payer: Cofinity Commercial |
$373.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$347.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.70
|
| Rate for Payer: Healthscope Commercial |
$391.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$326.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$369.57
|
| Rate for Payer: Nomi Health Commercial |
$356.53
|
| Rate for Payer: PACE Senior Care Partners |
$103.26
|
| Rate for Payer: PACE SWMI |
$108.70
|
| Rate for Payer: PHP Commercial |
$369.57
|
| Rate for Payer: PHP Medicare Advantage |
$108.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.61
|
| Rate for Payer: Priority Health HMO/PPO |
$378.27
|
| Rate for Payer: Priority Health Medicare |
$109.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$291.31
|
| Rate for Payer: Railroad Medicare Medicare |
$108.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.62
|
| Rate for Payer: UHC Core |
$363.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.70
|
| Rate for Payer: UHC Exchange |
$108.70
|
| Rate for Payer: UHC Medicare Advantage |
$108.70
|
| Rate for Payer: VA VA |
$108.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$326.09
|
|
|
HC AFFINITY 2.5 X 2.5 PER SQ CM
|
Facility
|
IP
|
$434.79
|
|
|
Service Code
|
HCPCS Q4159
|
| Hospital Charge Code |
63600125
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$282.61 |
| Max. Negotiated Rate |
$391.31 |
| Rate for Payer: Aetna Commercial |
$369.57
|
| Rate for Payer: BCBS Trust/PPO |
$354.92
|
| Rate for Payer: BCN Commercial |
$336.01
|
| Rate for Payer: Cash Price |
$347.83
|
| Rate for Payer: Cofinity Commercial |
$373.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$347.83
|
| Rate for Payer: Healthscope Commercial |
$391.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$326.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$369.57
|
| Rate for Payer: Nomi Health Commercial |
$356.53
|
| Rate for Payer: PHP Commercial |
$369.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.61
|
| Rate for Payer: Priority Health HMO/PPO |
$378.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$291.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.62
|
| Rate for Payer: UHC Core |
$363.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$326.09
|
|
|
HC AFP SINGLE MARKER SCRN,MS
|
Facility
|
OP
|
$48.90
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100622
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.61 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: Aetna Medicare |
$12.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.28
|
| Rate for Payer: BCBS Complete |
$12.73
|
| Rate for Payer: BCBS MAPPO |
$12.22
|
| Rate for Payer: BCBS Trust/PPO |
$40.20
|
| Rate for Payer: BCN Commercial |
$38.02
|
| Rate for Payer: BCN Medicare Advantage |
$12.22
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.22
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.67
|
| Rate for Payer: Mclaren Medicaid |
$12.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.84
|
| Rate for Payer: Meridian Medicaid |
$12.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: PACE Senior Care Partners |
$11.61
|
| Rate for Payer: PACE SWMI |
$12.22
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: PHP Medicare Advantage |
$12.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.79
|
| Rate for Payer: Priority Health HMO/PPO |
$42.54
|
| Rate for Payer: Priority Health Medicare |
$12.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.76
|
| Rate for Payer: Railroad Medicare Medicare |
$12.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.03
|
| Rate for Payer: UHC Core |
$40.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.22
|
| Rate for Payer: UHC Exchange |
$12.22
|
| Rate for Payer: UHC Medicare Advantage |
$12.22
|
| Rate for Payer: UHCCP Medicaid |
$12.12
|
| Rate for Payer: VA VA |
$12.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.67
|
|
|
HC AFP SINGLE MARKER SCRN,MS
|
Facility
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100622
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.79 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: BCBS Trust/PPO |
$39.92
|
| Rate for Payer: BCN Commercial |
$37.79
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.79
|
| Rate for Payer: Priority Health HMO/PPO |
$42.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.03
|
| Rate for Payer: UHC Core |
$40.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.67
|
|
|
HC AFTER HOURS ACCESS
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 99050
|
| Hospital Charge Code |
98300006
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$13.26 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$16.65
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.34
|
| Rate for Payer: Nomi Health Commercial |
$16.73
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.26
|
| Rate for Payer: Priority Health HMO/PPO |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
