|
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 |
$602.04
|
| 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 |
$602.04
|
| 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
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100622
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.78 |
| 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 |
$36.68
|
| 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 |
$31.78
|
| 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 |
$36.68
|
|
|
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 |
$36.68
|
| 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 |
$31.78
|
| 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 |
$36.68
|
|
|
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
|
|
|
HC AFTER HOURS ACCESS
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 99050
|
| Hospital Charge Code |
98300006
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$8.16
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$16.77
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| 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: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.34
|
| Rate for Payer: Nomi Health Commercial |
$16.73
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.26
|
| Rate for Payer: Priority Health HMO/PPO |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.67
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Exchange |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.10
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC ALBUMIN SERUM
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
30100072
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna Medicare |
$10.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.08
|
| Rate for Payer: BCBS Complete |
$3.76
|
| Rate for Payer: BCBS MAPPO |
$9.66
|
| Rate for Payer: BCBS Trust/PPO |
$31.78
|
| Rate for Payer: BCN Commercial |
$30.06
|
| Rate for Payer: BCN Medicare Advantage |
$9.66
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.66
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Mclaren Medicaid |
$3.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.15
|
| Rate for Payer: Meridian Medicaid |
$3.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PACE Senior Care Partners |
$9.18
|
| Rate for Payer: PACE SWMI |
$9.66
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: PHP Medicare Advantage |
$9.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Medicare |
$9.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: Railroad Medicare Medicare |
$9.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.66
|
| Rate for Payer: UHC Exchange |
$9.66
|
| Rate for Payer: UHC Medicare Advantage |
$9.66
|
| Rate for Payer: UHCCP Medicaid |
$3.58
|
| Rate for Payer: VA VA |
$9.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC ALBUMIN SERUM
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
30100072
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Commercial |
$29.88
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC ALBUMIN URINE OR OTHER SOURCE
|
Facility
|
OP
|
$41.30
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
30100663
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.62 |
| Max. Negotiated Rate |
$37.17 |
| Rate for Payer: Aetna Commercial |
$35.10
|
| Rate for Payer: Aetna Medicare |
$10.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.91
|
| Rate for Payer: BCBS Complete |
$5.91
|
| Rate for Payer: BCBS MAPPO |
$10.32
|
| Rate for Payer: BCBS Trust/PPO |
$33.95
|
| Rate for Payer: BCN Commercial |
$32.11
|
| Rate for Payer: BCN Medicare Advantage |
$10.32
|
| Rate for Payer: Cash Price |
$33.04
|
| Rate for Payer: Cash Price |
$33.04
|
| Rate for Payer: Cofinity Commercial |
$35.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.32
|
| Rate for Payer: Healthscope Commercial |
$37.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.98
|
| Rate for Payer: Mclaren Medicaid |
$5.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.84
|
| Rate for Payer: Meridian Medicaid |
$5.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.10
|
| Rate for Payer: Nomi Health Commercial |
$33.87
|
| Rate for Payer: PACE Senior Care Partners |
$9.81
|
| Rate for Payer: PACE SWMI |
$10.32
|
| Rate for Payer: PHP Commercial |
$35.10
|
| Rate for Payer: PHP Medicare Advantage |
$10.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.84
|
| Rate for Payer: Priority Health HMO/PPO |
$35.93
|
| Rate for Payer: Priority Health Medicare |
$10.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.67
|
| Rate for Payer: Railroad Medicare Medicare |
$10.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.34
|
| Rate for Payer: UHC Core |
$34.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.32
|
| Rate for Payer: UHC Exchange |
$10.32
|
| Rate for Payer: UHC Medicare Advantage |
$10.32
|
| Rate for Payer: UHCCP Medicaid |
$5.62
|
| Rate for Payer: VA VA |
$10.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.98
|
|
|
HC ALBUMIN URINE OR OTHER SOURCE
|
Facility
|
IP
|
$41.30
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
30100663
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$37.17 |
| Rate for Payer: Aetna Commercial |
$35.10
|
| Rate for Payer: BCBS Trust/PPO |
$33.71
|
| Rate for Payer: BCN Commercial |
$31.92
|
| Rate for Payer: Cash Price |
$33.04
|
| Rate for Payer: Cofinity Commercial |
$35.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.04
|
| Rate for Payer: Healthscope Commercial |
$37.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.10
|
| Rate for Payer: Nomi Health Commercial |
$33.87
|
| Rate for Payer: PHP Commercial |
$35.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.84
|
| Rate for Payer: Priority Health HMO/PPO |
$35.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.34
|
| Rate for Payer: UHC Core |
$34.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.98
|
|
|
HC ALBUTEROL, INHALATION SOLUTION, UNIT DOSE 1MG
|
Facility
|
OP
|
$6.24
|
|
|
Service Code
|
CPT J7613
|
| Hospital Charge Code |
63600110
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.48 |
| Max. Negotiated Rate |
$5.62 |
| Rate for Payer: Aetna Commercial |
$5.30
|
| Rate for Payer: Aetna Medicare |
$1.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.95
|
| Rate for Payer: BCBS Complete |
$2.50
|
| Rate for Payer: BCBS MAPPO |
$1.56
|
| Rate for Payer: BCBS Trust/PPO |
$5.13
|
| Rate for Payer: BCN Commercial |
$4.85
|
| Rate for Payer: BCN Medicare Advantage |
$1.56
|
| Rate for Payer: Cash Price |
$4.99
|
| Rate for Payer: Cofinity Commercial |
$5.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.56
|
| Rate for Payer: Healthscope Commercial |
$5.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.30
|
| Rate for Payer: Nomi Health Commercial |
$5.12
|
| Rate for Payer: PACE Senior Care Partners |
$1.48
|
| Rate for Payer: PACE SWMI |
$1.56
|
| Rate for Payer: PHP Commercial |
$5.30
|
| Rate for Payer: PHP Medicare Advantage |
$1.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.06
|
| Rate for Payer: Priority Health HMO/PPO |
$5.43
|
| Rate for Payer: Priority Health Medicare |
$1.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.49
|
| Rate for Payer: UHC Core |
$5.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.56
|
| Rate for Payer: UHC Exchange |
$1.56
|
| Rate for Payer: UHC Medicare Advantage |
$1.56
|
| Rate for Payer: VA VA |
$1.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.68
|
|
|
HC ALBUTEROL, INHALATION SOLUTION, UNIT DOSE 1MG
|
Facility
|
IP
|
$6.24
|
|
|
Service Code
|
CPT J7613
|
| Hospital Charge Code |
63600110
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.06 |
| Max. Negotiated Rate |
$5.62 |
| Rate for Payer: Aetna Commercial |
$5.30
|
| Rate for Payer: BCBS Trust/PPO |
$5.09
|
| Rate for Payer: BCN Commercial |
$4.82
|
| Rate for Payer: Cash Price |
$4.99
|
| Rate for Payer: Cofinity Commercial |
$5.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.99
|
| Rate for Payer: Healthscope Commercial |
$5.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.30
|
| Rate for Payer: Nomi Health Commercial |
$5.12
|
| Rate for Payer: PHP Commercial |
$5.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.06
|
| Rate for Payer: Priority Health HMO/PPO |
$5.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.49
|
| Rate for Payer: UHC Core |
$5.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.68
|
|
|
HC ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG
|
Facility
|
IP
|
$4.16
|
|
|
Service Code
|
CPT J7620
|
| Hospital Charge Code |
63600111
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.70 |
| Max. Negotiated Rate |
$3.74 |
| Rate for Payer: Aetna Commercial |
$3.54
|
| Rate for Payer: BCBS Trust/PPO |
$3.40
|
| Rate for Payer: BCN Commercial |
$3.21
|
| Rate for Payer: Cash Price |
$3.33
|
| Rate for Payer: Cofinity Commercial |
$3.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.33
|
| Rate for Payer: Healthscope Commercial |
$3.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.54
|
| Rate for Payer: Nomi Health Commercial |
$3.41
|
| Rate for Payer: PHP Commercial |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.70
|
| Rate for Payer: Priority Health HMO/PPO |
$3.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.66
|
| Rate for Payer: UHC Core |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.12
|
|
|
HC ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG
|
Facility
|
OP
|
$4.16
|
|
|
Service Code
|
CPT J7620
|
| Hospital Charge Code |
63600111
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.99 |
| Max. Negotiated Rate |
$3.74 |
| Rate for Payer: Aetna Commercial |
$3.54
|
| Rate for Payer: Aetna Medicare |
$1.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.30
|
| Rate for Payer: BCBS Complete |
$1.66
|
| Rate for Payer: BCBS MAPPO |
$1.04
|
| Rate for Payer: BCBS Trust/PPO |
$3.42
|
| Rate for Payer: BCN Commercial |
$3.23
|
| Rate for Payer: BCN Medicare Advantage |
$1.04
|
| Rate for Payer: Cash Price |
$3.33
|
| Rate for Payer: Cofinity Commercial |
$3.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.04
|
| Rate for Payer: Healthscope Commercial |
$3.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.54
|
| Rate for Payer: Nomi Health Commercial |
$3.41
|
| Rate for Payer: PACE Senior Care Partners |
$0.99
|
| Rate for Payer: PACE SWMI |
$1.04
|
| Rate for Payer: PHP Commercial |
$3.54
|
| Rate for Payer: PHP Medicare Advantage |
$1.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.70
|
| Rate for Payer: Priority Health HMO/PPO |
$3.62
|
| Rate for Payer: Priority Health Medicare |
$1.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.66
|
| Rate for Payer: UHC Core |
$3.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.04
|
| Rate for Payer: UHC Exchange |
$1.04
|
| Rate for Payer: UHC Medicare Advantage |
$1.04
|
| Rate for Payer: VA VA |
$1.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.12
|
|
|
HC ALCOHOL ETHANOL LVL.
|
Facility
|
IP
|
$125.88
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100651
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$81.82 |
| Max. Negotiated Rate |
$113.29 |
| Rate for Payer: Aetna Commercial |
$107.00
|
| Rate for Payer: BCBS Trust/PPO |
$102.76
|
| Rate for Payer: BCN Commercial |
$97.28
|
| Rate for Payer: Cash Price |
$100.70
|
| Rate for Payer: Cofinity Commercial |
$108.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.70
|
| Rate for Payer: Healthscope Commercial |
$113.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.00
|
| Rate for Payer: Nomi Health Commercial |
$103.22
|
| Rate for Payer: PHP Commercial |
$107.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.82
|
| Rate for Payer: Priority Health HMO/PPO |
$109.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.77
|
| Rate for Payer: UHC Core |
$105.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.41
|
|
|
HC ALCOHOL ETHANOL LVL.
|
Facility
|
OP
|
$125.88
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100651
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.90 |
| Max. Negotiated Rate |
$113.29 |
| Rate for Payer: Aetna Commercial |
$107.00
|
| Rate for Payer: Aetna Medicare |
$32.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.34
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$31.47
|
| Rate for Payer: BCBS Trust/PPO |
$103.49
|
| Rate for Payer: BCN Commercial |
$97.87
|
| Rate for Payer: BCN Medicare Advantage |
$31.47
|
| Rate for Payer: Cash Price |
$100.70
|
| Rate for Payer: Cash Price |
$100.70
|
| Rate for Payer: Cofinity Commercial |
$108.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.47
|
| Rate for Payer: Healthscope Commercial |
$113.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.41
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.04
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.00
|
| Rate for Payer: Nomi Health Commercial |
$103.22
|
| Rate for Payer: PACE Senior Care Partners |
$29.90
|
| Rate for Payer: PACE SWMI |
$31.47
|
| Rate for Payer: PHP Commercial |
$107.00
|
| Rate for Payer: PHP Medicare Advantage |
$31.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.82
|
| Rate for Payer: Priority Health HMO/PPO |
$109.52
|
| Rate for Payer: Priority Health Medicare |
$31.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.34
|
| Rate for Payer: Railroad Medicare Medicare |
$31.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.77
|
| Rate for Payer: UHC Core |
$105.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.47
|
| Rate for Payer: UHC Exchange |
$31.47
|
| Rate for Payer: UHC Medicare Advantage |
$31.47
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$31.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.41
|
|
|
HC ALCOHOL ETHANOL LVL REFLEX
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100617
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.75 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.72
|
| Rate for Payer: BCBS Complete |
$26.52
|
| Rate for Payer: BCBS MAPPO |
$16.58
|
| Rate for Payer: BCBS Trust/PPO |
$54.51
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: BCN Medicare Advantage |
$16.58
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PACE Senior Care Partners |
$15.75
|
| Rate for Payer: PACE SWMI |
$16.58
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$16.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO |
$57.68
|
| Rate for Payer: Priority Health Medicare |
$16.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.42
|
| Rate for Payer: Railroad Medicare Medicare |
$16.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.58
|
| Rate for Payer: UHC Exchange |
$16.58
|
| Rate for Payer: UHC Medicare Advantage |
$16.58
|
| Rate for Payer: VA VA |
$16.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC ALCOHOL ETHANOL LVL REFLEX
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100617
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.10 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: BCBS Trust/PPO |
$54.12
|
| Rate for Payer: BCN Commercial |
$51.24
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO |
$57.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC ALDER IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200071
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC ALDER IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200071
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC ALDOLASE
|
Facility
|
OP
|
$43.86
|
|
|
Service Code
|
CPT 82085
|
| Hospital Charge Code |
30100079
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$39.47 |
| Rate for Payer: Aetna Commercial |
$37.28
|
| Rate for Payer: Aetna Medicare |
$11.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.71
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS MAPPO |
$10.96
|
| Rate for Payer: BCBS Trust/PPO |
$36.06
|
| Rate for Payer: BCN Commercial |
$34.10
|
| Rate for Payer: BCN Medicare Advantage |
$10.96
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$37.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.96
|
| Rate for Payer: Healthscope Commercial |
$39.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.90
|
| Rate for Payer: Mclaren Medicaid |
$7.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.51
|
| Rate for Payer: Meridian Medicaid |
$7.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.28
|
| Rate for Payer: Nomi Health Commercial |
$35.97
|
| Rate for Payer: PACE Senior Care Partners |
$10.42
|
| Rate for Payer: PACE SWMI |
$10.96
|
| Rate for Payer: PHP Commercial |
$37.28
|
| Rate for Payer: PHP Medicare Advantage |
$10.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.51
|
| Rate for Payer: Priority Health HMO/PPO |
$38.16
|
| Rate for Payer: Priority Health Medicare |
$11.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.39
|
| Rate for Payer: Railroad Medicare Medicare |
$10.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.60
|
| Rate for Payer: UHC Core |
$36.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.96
|
| Rate for Payer: UHC Exchange |
$10.96
|
| Rate for Payer: UHC Medicare Advantage |
$10.96
|
| Rate for Payer: UHCCP Medicaid |
$7.02
|
| Rate for Payer: VA VA |
$10.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.90
|
|
