|
HC BRONCHO HYGIENE SUBS
|
Facility
|
IP
|
$268.38
|
|
|
Service Code
|
CPT 94668
|
| Hospital Charge Code |
41000011
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$186.79 |
| Max. Negotiated Rate |
$241.54 |
| Rate for Payer: Aetna Commercial |
$228.12
|
| Rate for Payer: BCBS Trust/PPO |
$221.66
|
| Rate for Payer: BCN Commercial |
$221.66
|
| Rate for Payer: Cash Price |
$214.70
|
| Rate for Payer: Cofinity Commercial |
$230.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.70
|
| Rate for Payer: Healthscope Commercial |
$241.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.12
|
| Rate for Payer: Nomi Health Commercial |
$220.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.28
|
| Rate for Payer: PHP Commercial |
$228.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$233.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.17
|
| Rate for Payer: UHC Core |
$224.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.28
|
|
|
HC BRONCHOSCOPY
|
Facility
|
OP
|
$2,616.10
|
|
| Hospital Charge Code |
36000014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$461.22 |
| Max. Negotiated Rate |
$2,354.49 |
| Rate for Payer: Aetna Commercial |
$2,223.68
|
| Rate for Payer: Aetna Medicare |
$680.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$817.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$817.53
|
| Rate for Payer: BCBS Complete |
$484.24
|
| Rate for Payer: BCBS MAPPO |
$654.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,150.70
|
| Rate for Payer: BCN Commercial |
$2,150.70
|
| Rate for Payer: BCN Medicare Advantage |
$654.02
|
| Rate for Payer: Cash Price |
$2,092.88
|
| Rate for Payer: Cofinity Commercial |
$2,249.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,092.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$654.02
|
| Rate for Payer: Healthscope Commercial |
$2,354.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,962.08
|
| Rate for Payer: Mclaren Medicaid |
$461.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$686.73
|
| Rate for Payer: Meridian Medicaid |
$484.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$752.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$719.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,223.68
|
| Rate for Payer: Nomi Health Commercial |
$2,145.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,962.08
|
| Rate for Payer: PACE Senior Care Partners |
$621.32
|
| Rate for Payer: PACE SWMI |
$654.02
|
| Rate for Payer: PHP Commercial |
$2,223.68
|
| Rate for Payer: PHP Medicare Advantage |
$654.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,276.01
|
| Rate for Payer: Priority Health Medicare |
$660.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,820.81
|
| Rate for Payer: Railroad Medicare Medicare |
$654.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,302.17
|
| Rate for Payer: UHC Core |
$2,184.44
|
| Rate for Payer: UHC Exchange |
$654.02
|
| Rate for Payer: UHC Medicaid |
$461.22
|
| Rate for Payer: UHC Medicare Advantage |
$654.02
|
| Rate for Payer: UHCCP Medicaid |
$461.22
|
| Rate for Payer: VA VA |
$654.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,962.08
|
|
|
HC BRONCHOSCOPY
|
Facility
|
IP
|
$2,616.10
|
|
| Hospital Charge Code |
36000014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,820.81 |
| Max. Negotiated Rate |
$2,354.49 |
| Rate for Payer: Aetna Commercial |
$2,223.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,160.64
|
| Rate for Payer: BCN Commercial |
$2,160.64
|
| Rate for Payer: Cash Price |
$2,092.88
|
| Rate for Payer: Cofinity Commercial |
$2,249.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,092.88
|
| Rate for Payer: Healthscope Commercial |
$2,354.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,962.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,223.68
|
| Rate for Payer: Nomi Health Commercial |
$2,145.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,962.08
|
| Rate for Payer: PHP Commercial |
$2,223.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,276.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,820.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,302.17
|
| Rate for Payer: UHC Core |
$2,184.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,962.08
|
|
|
HC BRONCHOSCOPY W EBUS EXAM
|
Facility
|
OP
|
$3,241.58
|
|
| Hospital Charge Code |
36000015
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$571.49 |
| Max. Negotiated Rate |
$2,917.42 |
| Rate for Payer: Aetna Commercial |
$2,755.34
|
| Rate for Payer: Aetna Medicare |
$842.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.99
|
| Rate for Payer: BCBS Complete |
$600.02
|
| Rate for Payer: BCBS MAPPO |
$810.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,664.90
|
| Rate for Payer: BCN Commercial |
$2,664.90
|
| Rate for Payer: BCN Medicare Advantage |
$810.39
|
| Rate for Payer: Cash Price |
$2,593.26
|
| Rate for Payer: Cofinity Commercial |
$2,787.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,593.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.39
|
| Rate for Payer: Healthscope Commercial |
$2,917.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,431.18
|
| Rate for Payer: Mclaren Medicaid |
$571.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$850.91
|
| Rate for Payer: Meridian Medicaid |
$600.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$891.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,755.34
|
| Rate for Payer: Nomi Health Commercial |
$2,658.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,431.18
|
| Rate for Payer: PACE Senior Care Partners |
$769.88
|
| Rate for Payer: PACE SWMI |
$810.39
|
| Rate for Payer: PHP Commercial |
$2,755.34
|
| Rate for Payer: PHP Medicare Advantage |
$810.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,820.17
|
| Rate for Payer: Priority Health Medicare |
$818.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,256.14
|
| Rate for Payer: Railroad Medicare Medicare |
$810.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,852.59
|
| Rate for Payer: UHC Core |
$2,706.72
|
| Rate for Payer: UHC Exchange |
$810.39
|
| Rate for Payer: UHC Medicaid |
$571.49
|
| Rate for Payer: UHC Medicare Advantage |
$810.39
|
| Rate for Payer: UHCCP Medicaid |
$571.49
|
| Rate for Payer: VA VA |
$810.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,431.18
|
|
|
HC BRONCHOSCOPY W EBUS EXAM
|
Facility
|
IP
|
$3,241.58
|
|
| Hospital Charge Code |
36000015
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,256.14 |
| Max. Negotiated Rate |
$2,917.42 |
| Rate for Payer: Aetna Commercial |
$2,755.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,677.22
|
| Rate for Payer: BCN Commercial |
$2,677.22
|
| Rate for Payer: Cash Price |
$2,593.26
|
| Rate for Payer: Cofinity Commercial |
$2,787.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,593.26
|
| Rate for Payer: Healthscope Commercial |
$2,917.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,431.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,755.34
|
| Rate for Payer: Nomi Health Commercial |
$2,658.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,431.18
|
| Rate for Payer: PHP Commercial |
$2,755.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,820.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,256.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,852.59
|
| Rate for Payer: UHC Core |
$2,706.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,431.18
|
|
|
HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)
|
Facility
|
OP
|
$722.85
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
46000003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$127.44 |
| Max. Negotiated Rate |
$650.57 |
| Rate for Payer: Aetna Commercial |
$614.42
|
| Rate for Payer: Aetna Medicare |
$187.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$225.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$225.89
|
| Rate for Payer: BCBS Complete |
$133.80
|
| Rate for Payer: BCBS MAPPO |
$180.71
|
| Rate for Payer: BCBS Trust/PPO |
$594.25
|
| Rate for Payer: BCN Commercial |
$594.25
|
| Rate for Payer: BCN Medicare Advantage |
$180.71
|
| Rate for Payer: Cash Price |
$578.28
|
| Rate for Payer: Cofinity Commercial |
$621.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.71
|
| Rate for Payer: Healthscope Commercial |
$650.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$542.14
|
| Rate for Payer: Mclaren Medicaid |
$127.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.75
|
| Rate for Payer: Meridian Medicaid |
$133.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$198.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.42
|
| Rate for Payer: Nomi Health Commercial |
$592.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$542.14
|
| Rate for Payer: PACE Senior Care Partners |
$171.68
|
| Rate for Payer: PACE SWMI |
$180.71
|
| Rate for Payer: PHP Commercial |
$614.42
|
| Rate for Payer: PHP Medicare Advantage |
$180.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$628.88
|
| Rate for Payer: Priority Health Medicare |
$182.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$503.10
|
| Rate for Payer: Railroad Medicare Medicare |
$180.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$636.11
|
| Rate for Payer: UHC Core |
$603.58
|
| Rate for Payer: UHC Exchange |
$180.71
|
| Rate for Payer: UHC Medicaid |
$127.44
|
| Rate for Payer: UHC Medicare Advantage |
$180.71
|
| Rate for Payer: UHCCP Medicaid |
$127.44
|
| Rate for Payer: VA VA |
$180.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$542.14
|
|
|
HC BRONCHOSPASM PROVOCATION (METHACHOLINE CHALLENGE)
|
Facility
|
IP
|
$722.85
|
|
|
Service Code
|
CPT 94070
|
| Hospital Charge Code |
46000003
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$503.10 |
| Max. Negotiated Rate |
$650.57 |
| Rate for Payer: Aetna Commercial |
$614.42
|
| Rate for Payer: BCBS Trust/PPO |
$597.00
|
| Rate for Payer: BCN Commercial |
$597.00
|
| Rate for Payer: Cash Price |
$578.28
|
| Rate for Payer: Cofinity Commercial |
$621.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$578.28
|
| Rate for Payer: Healthscope Commercial |
$650.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$542.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$614.42
|
| Rate for Payer: Nomi Health Commercial |
$592.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$542.14
|
| Rate for Payer: PHP Commercial |
$614.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$628.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$503.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$636.11
|
| Rate for Payer: UHC Core |
$603.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$542.14
|
|
|
HC BRUCELLA ANTIBODY
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200236
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$52.14 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: BCBS Trust/PPO |
$61.87
|
| Rate for Payer: BCN Commercial |
$61.87
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.92
|
| Rate for Payer: UHC Core |
$62.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.18
|
|
|
HC BRUCELLA ANTIBODY
|
Facility
|
OP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200236
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna Medicare |
$19.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.41
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCBS MAPPO |
$18.73
|
| Rate for Payer: BCBS Trust/PPO |
$61.58
|
| Rate for Payer: BCN Commercial |
$61.58
|
| Rate for Payer: BCN Medicare Advantage |
$18.73
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.73
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.18
|
| Rate for Payer: Mclaren Medicaid |
$13.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.66
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PACE Senior Care Partners |
$17.79
|
| Rate for Payer: PACE SWMI |
$18.73
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: PHP Medicare Advantage |
$18.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.17
|
| Rate for Payer: Priority Health Medicare |
$18.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.14
|
| Rate for Payer: Railroad Medicare Medicare |
$18.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.92
|
| Rate for Payer: UHC Core |
$62.55
|
| Rate for Payer: UHC Exchange |
$18.73
|
| Rate for Payer: UHC Medicaid |
$13.21
|
| Rate for Payer: UHC Medicare Advantage |
$18.73
|
| Rate for Payer: UHCCP Medicaid |
$13.21
|
| Rate for Payer: VA VA |
$18.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.18
|
|
|
HC BRUCELLA ANTIBODY CMPT
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200238
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$52.14 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: BCBS Trust/PPO |
$61.87
|
| Rate for Payer: BCN Commercial |
$61.87
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.92
|
| Rate for Payer: UHC Core |
$62.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.18
|
|
|
HC BRUCELLA ANTIBODY CMPT
|
Facility
|
OP
|
$74.91
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200238
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna Medicare |
$19.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.41
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCBS MAPPO |
$18.73
|
| Rate for Payer: BCBS Trust/PPO |
$61.58
|
| Rate for Payer: BCN Commercial |
$61.58
|
| Rate for Payer: BCN Medicare Advantage |
$18.73
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.73
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.18
|
| Rate for Payer: Mclaren Medicaid |
$13.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.66
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PACE Senior Care Partners |
$17.79
|
| Rate for Payer: PACE SWMI |
$18.73
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: PHP Medicare Advantage |
$18.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.17
|
| Rate for Payer: Priority Health Medicare |
$18.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.14
|
| Rate for Payer: Railroad Medicare Medicare |
$18.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.92
|
| Rate for Payer: UHC Core |
$62.55
|
| Rate for Payer: UHC Exchange |
$18.73
|
| Rate for Payer: UHC Medicaid |
$13.21
|
| Rate for Payer: UHC Medicare Advantage |
$18.73
|
| Rate for Payer: UHCCP Medicaid |
$13.21
|
| Rate for Payer: VA VA |
$18.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.18
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
OP
|
$54.10
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.54 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna Medicare |
$14.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.91
|
| Rate for Payer: BCBS Complete |
$10.01
|
| Rate for Payer: BCBS MAPPO |
$13.53
|
| Rate for Payer: BCBS Trust/PPO |
$44.48
|
| Rate for Payer: BCN Commercial |
$44.48
|
| Rate for Payer: BCN Medicare Advantage |
$13.53
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.53
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Mclaren Medicaid |
$9.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.20
|
| Rate for Payer: Meridian Medicaid |
$10.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.58
|
| Rate for Payer: PACE Senior Care Partners |
$12.85
|
| Rate for Payer: PACE SWMI |
$13.53
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: PHP Medicare Advantage |
$13.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.07
|
| Rate for Payer: Priority Health Medicare |
$13.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.65
|
| Rate for Payer: Railroad Medicare Medicare |
$13.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.61
|
| Rate for Payer: UHC Core |
$45.17
|
| Rate for Payer: UHC Exchange |
$13.53
|
| Rate for Payer: UHC Medicaid |
$9.54
|
| Rate for Payer: UHC Medicare Advantage |
$13.53
|
| Rate for Payer: UHCCP Medicaid |
$9.54
|
| Rate for Payer: VA VA |
$13.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
IP
|
$54.10
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.65 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: BCBS Trust/PPO |
$44.68
|
| Rate for Payer: BCN Commercial |
$44.68
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.58
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.61
|
| Rate for Payer: UHC Core |
$45.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC BUDESONIDE INHALATION SOLUTION
|
Facility
|
OP
|
$29.94
|
|
| Hospital Charge Code |
63700005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$26.95 |
| Rate for Payer: Aetna Commercial |
$25.45
|
| Rate for Payer: Aetna Medicare |
$7.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.36
|
| Rate for Payer: BCBS Complete |
$5.54
|
| Rate for Payer: BCBS MAPPO |
$7.49
|
| Rate for Payer: BCBS Trust/PPO |
$24.61
|
| Rate for Payer: BCN Commercial |
$24.61
|
| Rate for Payer: BCN Medicare Advantage |
$7.49
|
| Rate for Payer: Cash Price |
$23.95
|
| Rate for Payer: Cofinity Commercial |
$25.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.49
|
| Rate for Payer: Healthscope Commercial |
$26.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.45
|
| Rate for Payer: Mclaren Medicaid |
$5.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.86
|
| Rate for Payer: Meridian Medicaid |
$5.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.45
|
| Rate for Payer: Nomi Health Commercial |
$24.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.45
|
| Rate for Payer: PACE Senior Care Partners |
$7.11
|
| Rate for Payer: PACE SWMI |
$7.49
|
| Rate for Payer: PHP Commercial |
$25.45
|
| Rate for Payer: PHP Medicare Advantage |
$7.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.05
|
| Rate for Payer: Priority Health Medicare |
$7.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.84
|
| Rate for Payer: Railroad Medicare Medicare |
$7.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.35
|
| Rate for Payer: UHC Core |
$25.00
|
| Rate for Payer: UHC Exchange |
$7.49
|
| Rate for Payer: UHC Medicaid |
$5.28
|
| Rate for Payer: UHC Medicare Advantage |
$7.49
|
| Rate for Payer: UHCCP Medicaid |
$5.28
|
| Rate for Payer: VA VA |
$7.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.45
|
|
|
HC BUDESONIDE INHALATION SOLUTION
|
Facility
|
IP
|
$29.94
|
|
| Hospital Charge Code |
63700005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$20.84 |
| Max. Negotiated Rate |
$26.95 |
| Rate for Payer: Aetna Commercial |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$24.73
|
| Rate for Payer: BCN Commercial |
$24.73
|
| Rate for Payer: Cash Price |
$23.95
|
| Rate for Payer: Cofinity Commercial |
$25.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.95
|
| Rate for Payer: Healthscope Commercial |
$26.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.45
|
| Rate for Payer: Nomi Health Commercial |
$24.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.45
|
| Rate for Payer: PHP Commercial |
$25.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.35
|
| Rate for Payer: UHC Core |
$25.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.45
|
|
|
HC BUNDLE OF HIS RECORDING
|
Facility
|
OP
|
$4,101.81
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
48100029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$723.15 |
| Max. Negotiated Rate |
$3,691.63 |
| Rate for Payer: Aetna Commercial |
$3,486.54
|
| Rate for Payer: Aetna Medicare |
$1,066.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,281.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,281.82
|
| Rate for Payer: BCBS Complete |
$759.25
|
| Rate for Payer: BCBS MAPPO |
$1,025.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,372.10
|
| Rate for Payer: BCN Commercial |
$3,372.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,025.45
|
| Rate for Payer: Cash Price |
$3,281.45
|
| Rate for Payer: Cofinity Commercial |
$3,527.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,281.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,025.45
|
| Rate for Payer: Healthscope Commercial |
$3,691.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,076.36
|
| Rate for Payer: Mclaren Medicaid |
$723.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,076.73
|
| Rate for Payer: Meridian Medicaid |
$759.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,179.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,128.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,486.54
|
| Rate for Payer: Nomi Health Commercial |
$3,363.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,076.36
|
| Rate for Payer: PACE Senior Care Partners |
$974.18
|
| Rate for Payer: PACE SWMI |
$1,025.45
|
| Rate for Payer: PHP Commercial |
$3,486.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,025.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$723.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,568.57
|
| Rate for Payer: Priority Health Medicare |
$1,035.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,854.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,025.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,609.59
|
| Rate for Payer: UHC Core |
$3,425.01
|
| Rate for Payer: UHC Exchange |
$1,025.45
|
| Rate for Payer: UHC Medicaid |
$723.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,025.45
|
| Rate for Payer: UHCCP Medicaid |
$723.15
|
| Rate for Payer: VA VA |
$1,025.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,076.36
|
|
|
HC BUNDLE OF HIS RECORDING
|
Facility
|
IP
|
$4,101.81
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
48100029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,854.86 |
| Max. Negotiated Rate |
$3,691.63 |
| Rate for Payer: Aetna Commercial |
$3,486.54
|
| Rate for Payer: BCBS Trust/PPO |
$3,387.68
|
| Rate for Payer: BCN Commercial |
$3,387.68
|
| Rate for Payer: Cash Price |
$3,281.45
|
| Rate for Payer: Cofinity Commercial |
$3,527.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,281.45
|
| Rate for Payer: Healthscope Commercial |
$3,691.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,076.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,486.54
|
| Rate for Payer: Nomi Health Commercial |
$3,363.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,076.36
|
| Rate for Payer: PHP Commercial |
$3,486.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,568.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,854.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,609.59
|
| Rate for Payer: UHC Core |
$3,425.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,076.36
|
|
|
HC BUPIVACAINE 0.5 MG
|
Facility
|
IP
|
$1.54
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
25000016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$1.39 |
| Rate for Payer: Aetna Commercial |
$1.31
|
| Rate for Payer: BCBS Trust/PPO |
$1.27
|
| Rate for Payer: BCN Commercial |
$1.27
|
| Rate for Payer: Cash Price |
$1.23
|
| Rate for Payer: Cofinity Commercial |
$1.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.23
|
| Rate for Payer: Healthscope Commercial |
$1.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.31
|
| Rate for Payer: Nomi Health Commercial |
$1.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.16
|
| Rate for Payer: PHP Commercial |
$1.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.36
|
| Rate for Payer: UHC Core |
$1.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.16
|
|
|
HC BUPIVACAINE 0.5 MG
|
Facility
|
OP
|
$1.54
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
25000016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.27 |
| Max. Negotiated Rate |
$1.39 |
| Rate for Payer: Aetna Commercial |
$1.31
|
| Rate for Payer: Aetna Medicare |
$0.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.48
|
| Rate for Payer: BCBS Complete |
$0.29
|
| Rate for Payer: BCBS MAPPO |
$0.39
|
| Rate for Payer: BCBS Trust/PPO |
$1.27
|
| Rate for Payer: BCN Commercial |
$1.27
|
| Rate for Payer: BCN Medicare Advantage |
$0.39
|
| Rate for Payer: Cash Price |
$1.23
|
| Rate for Payer: Cofinity Commercial |
$1.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.39
|
| Rate for Payer: Healthscope Commercial |
$1.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.16
|
| Rate for Payer: Mclaren Medicaid |
$0.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.40
|
| Rate for Payer: Meridian Medicaid |
$0.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.31
|
| Rate for Payer: Nomi Health Commercial |
$1.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.16
|
| Rate for Payer: PACE Senior Care Partners |
$0.37
|
| Rate for Payer: PACE SWMI |
$0.39
|
| Rate for Payer: PHP Commercial |
$1.31
|
| Rate for Payer: PHP Medicare Advantage |
$0.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.34
|
| Rate for Payer: Priority Health Medicare |
$0.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.07
|
| Rate for Payer: Railroad Medicare Medicare |
$0.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.36
|
| Rate for Payer: UHC Core |
$1.29
|
| Rate for Payer: UHC Exchange |
$0.39
|
| Rate for Payer: UHC Medicaid |
$0.27
|
| Rate for Payer: UHC Medicare Advantage |
$0.39
|
| Rate for Payer: UHCCP Medicaid |
$0.27
|
| Rate for Payer: VA VA |
$0.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.16
|
|
|
HC BUPRENORPHINE & MET QUANT, UR
|
Facility
|
OP
|
$181.03
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30100598
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.92 |
| Max. Negotiated Rate |
$162.93 |
| Rate for Payer: Aetna Commercial |
$153.88
|
| Rate for Payer: Aetna Medicare |
$47.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.57
|
| Rate for Payer: BCBS Complete |
$33.51
|
| Rate for Payer: BCBS MAPPO |
$45.26
|
| Rate for Payer: BCBS Trust/PPO |
$148.82
|
| Rate for Payer: BCN Commercial |
$148.82
|
| Rate for Payer: BCN Medicare Advantage |
$45.26
|
| Rate for Payer: Cash Price |
$144.82
|
| Rate for Payer: Cofinity Commercial |
$155.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.26
|
| Rate for Payer: Healthscope Commercial |
$162.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.77
|
| Rate for Payer: Mclaren Medicaid |
$31.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.52
|
| Rate for Payer: Meridian Medicaid |
$33.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.88
|
| Rate for Payer: Nomi Health Commercial |
$148.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.77
|
| Rate for Payer: PACE Senior Care Partners |
$42.99
|
| Rate for Payer: PACE SWMI |
$45.26
|
| Rate for Payer: PHP Commercial |
$153.88
|
| Rate for Payer: PHP Medicare Advantage |
$45.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$157.50
|
| Rate for Payer: Priority Health Medicare |
$45.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.00
|
| Rate for Payer: Railroad Medicare Medicare |
$45.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.31
|
| Rate for Payer: UHC Core |
$151.16
|
| Rate for Payer: UHC Exchange |
$45.26
|
| Rate for Payer: UHC Medicaid |
$31.92
|
| Rate for Payer: UHC Medicare Advantage |
$45.26
|
| Rate for Payer: UHCCP Medicaid |
$31.92
|
| Rate for Payer: VA VA |
$45.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.77
|
|
|
HC BUPRENORPHINE & MET QUANT, UR
|
Facility
|
IP
|
$181.03
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30100598
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$162.93 |
| Rate for Payer: Aetna Commercial |
$153.88
|
| Rate for Payer: BCBS Trust/PPO |
$149.51
|
| Rate for Payer: BCN Commercial |
$149.51
|
| Rate for Payer: Cash Price |
$144.82
|
| Rate for Payer: Cofinity Commercial |
$155.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.82
|
| Rate for Payer: Healthscope Commercial |
$162.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.88
|
| Rate for Payer: Nomi Health Commercial |
$148.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.77
|
| Rate for Payer: PHP Commercial |
$153.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$157.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.31
|
| Rate for Payer: UHC Core |
$151.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.77
|
|
|
HC BUPRENORPHINE SCRN URN
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000116
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC BUPRENORPHINE SCRN URN
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000116
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC BURN CARE LARGE
|
Facility
|
IP
|
$705.48
|
|
|
Service Code
|
CPT 16030
|
| Hospital Charge Code |
36100007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$491.01 |
| Max. Negotiated Rate |
$634.93 |
| Rate for Payer: Aetna Commercial |
$599.66
|
| Rate for Payer: BCBS Trust/PPO |
$582.66
|
| Rate for Payer: BCN Commercial |
$582.66
|
| Rate for Payer: Cash Price |
$564.38
|
| Rate for Payer: Cofinity Commercial |
$606.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.38
|
| Rate for Payer: Healthscope Commercial |
$634.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.66
|
| Rate for Payer: Nomi Health Commercial |
$578.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.11
|
| Rate for Payer: PHP Commercial |
$599.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$613.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$491.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.82
|
| Rate for Payer: UHC Core |
$589.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.11
|
|
|
HC BURN CARE LARGE
|
Facility
|
OP
|
$705.48
|
|
|
Service Code
|
CPT 16030
|
| Hospital Charge Code |
36100007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$124.38 |
| Max. Negotiated Rate |
$634.93 |
| Rate for Payer: Aetna Commercial |
$599.66
|
| Rate for Payer: Aetna Medicare |
$183.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.46
|
| Rate for Payer: BCBS Complete |
$130.58
|
| Rate for Payer: BCBS MAPPO |
$176.37
|
| Rate for Payer: BCBS Trust/PPO |
$579.98
|
| Rate for Payer: BCN Commercial |
$579.98
|
| Rate for Payer: BCN Medicare Advantage |
$176.37
|
| Rate for Payer: Cash Price |
$564.38
|
| Rate for Payer: Cofinity Commercial |
$606.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$564.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.37
|
| Rate for Payer: Healthscope Commercial |
$634.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$529.11
|
| Rate for Payer: Mclaren Medicaid |
$124.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.19
|
| Rate for Payer: Meridian Medicaid |
$130.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.66
|
| Rate for Payer: Nomi Health Commercial |
$578.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$529.11
|
| Rate for Payer: PACE Senior Care Partners |
$167.55
|
| Rate for Payer: PACE SWMI |
$176.37
|
| Rate for Payer: PHP Commercial |
$599.66
|
| Rate for Payer: PHP Medicare Advantage |
$176.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$613.77
|
| Rate for Payer: Priority Health Medicare |
$178.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$491.01
|
| Rate for Payer: Railroad Medicare Medicare |
$176.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.82
|
| Rate for Payer: UHC Core |
$589.08
|
| Rate for Payer: UHC Exchange |
$176.37
|
| Rate for Payer: UHC Medicaid |
$124.38
|
| Rate for Payer: UHC Medicare Advantage |
$176.37
|
| Rate for Payer: UHCCP Medicaid |
$124.38
|
| Rate for Payer: VA VA |
$176.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$529.11
|
|
