HC DRSG MEPILEX BORDER LITE 4X5 EA
|
Facility
|
OP
|
$5.53
|
|
Service Code
|
HCPCS A6213
|
Hospital Charge Code |
62300221
|
Hospital Revenue Code
|
623
|
Min. Negotiated Rate |
$1.31 |
Max. Negotiated Rate |
$4.98 |
Rate for Payer: Aetna Commercial |
$4.70
|
Rate for Payer: Aetna Medicare |
$1.44
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.73
|
Rate for Payer: Amish Plain Church Group Commercial |
$1.73
|
Rate for Payer: BCBS Complete |
$2.21
|
Rate for Payer: BCBS MAPPO |
$1.38
|
Rate for Payer: BCBS Trust/PPO |
$4.30
|
Rate for Payer: BCN Commercial |
$4.30
|
Rate for Payer: BCN Medicare Advantage |
$1.38
|
Rate for Payer: Cash Price |
$4.42
|
Rate for Payer: Cofinity Commercial |
$4.76
|
Rate for Payer: Encore Health Key Benefits Commercial |
$4.42
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.38
|
Rate for Payer: Healthscope Commercial |
$4.98
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.15
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1.45
|
Rate for Payer: MI Amish Medical Board Commercial |
$1.59
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.70
|
Rate for Payer: PACE Senior Care Partners |
$1.31
|
Rate for Payer: PACE SWMI |
$1.38
|
Rate for Payer: PHP Commercial |
$4.70
|
Rate for Payer: PHP Medicare Advantage |
$1.38
|
Rate for Payer: Priority Health Cigna Priority Health |
$3.87
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.81
|
Rate for Payer: Priority Health Medicare |
$1.38
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$3.37
|
Rate for Payer: Railroad Medicare Medicare |
$1.38
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$4.87
|
Rate for Payer: UHC Core |
$4.62
|
Rate for Payer: UHC Dual Complete DSNP |
$1.38
|
Rate for Payer: UHC Medicare Advantage |
$1.42
|
Rate for Payer: VA VA |
$1.38
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.15
|
|
HC DRSG MEPILEX BORDER SACRUM 9X9 EA
|
Facility
|
OP
|
$26.81
|
|
Service Code
|
HCPCS A6214
|
Hospital Charge Code |
62300222
|
Hospital Revenue Code
|
623
|
Min. Negotiated Rate |
$6.37 |
Max. Negotiated Rate |
$24.13 |
Rate for Payer: Aetna Commercial |
$22.79
|
Rate for Payer: Aetna Medicare |
$6.97
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.38
|
Rate for Payer: Amish Plain Church Group Commercial |
$8.38
|
Rate for Payer: BCBS Complete |
$10.72
|
Rate for Payer: BCBS MAPPO |
$6.70
|
Rate for Payer: BCBS Trust/PPO |
$20.84
|
Rate for Payer: BCN Commercial |
$20.84
|
Rate for Payer: BCN Medicare Advantage |
$6.70
|
Rate for Payer: Cash Price |
$21.45
|
Rate for Payer: Cofinity Commercial |
$23.06
|
Rate for Payer: Encore Health Key Benefits Commercial |
$21.45
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.70
|
Rate for Payer: Healthscope Commercial |
$24.13
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.11
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.04
|
Rate for Payer: MI Amish Medical Board Commercial |
$7.71
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.79
|
Rate for Payer: PACE Senior Care Partners |
$6.37
|
Rate for Payer: PACE SWMI |
$6.70
|
Rate for Payer: PHP Commercial |
$22.79
|
Rate for Payer: PHP Medicare Advantage |
$6.70
|
Rate for Payer: Priority Health Cigna Priority Health |
$18.77
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.32
|
Rate for Payer: Priority Health Medicare |
$6.70
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$16.35
|
Rate for Payer: Railroad Medicare Medicare |
$6.70
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$23.59
|
Rate for Payer: UHC Core |
$22.39
|
Rate for Payer: UHC Dual Complete DSNP |
$6.70
|
Rate for Payer: UHC Medicare Advantage |
$6.90
|
Rate for Payer: VA VA |
$6.70
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.11
|
|
HC DRSG MEPILEX BORDER SACRUM 9X9 EA
|
Facility
|
IP
|
$26.81
|
|
Service Code
|
HCPCS A6214
|
Hospital Charge Code |
62300222
|
Hospital Revenue Code
|
623
|
Min. Negotiated Rate |
$16.35 |
Max. Negotiated Rate |
$24.13 |
Rate for Payer: Aetna Commercial |
$22.79
|
Rate for Payer: BCBS Trust/PPO |
$20.72
|
Rate for Payer: BCN Commercial |
$20.72
|
Rate for Payer: Cash Price |
$21.45
|
Rate for Payer: Cofinity Commercial |
$23.06
|
Rate for Payer: Encore Health Key Benefits Commercial |
$21.45
|
Rate for Payer: Healthscope Commercial |
$24.13
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.11
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.79
|
Rate for Payer: PHP Commercial |
$22.79
|
Rate for Payer: Priority Health Cigna Priority Health |
$18.77
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.32
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$16.35
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$23.59
|
Rate for Payer: UHC Core |
$22.39
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.11
|
|
HC DRUG SCREEN 10 URINE
|
Facility
|
IP
|
$102.00
|
|
Service Code
|
CPT 80307
|
Hospital Charge Code |
30000134
|
Hospital Revenue Code
|
300
|
Min. Negotiated Rate |
$62.21 |
Max. Negotiated Rate |
$91.80 |
Rate for Payer: Aetna Commercial |
$86.70
|
Rate for Payer: BCBS Trust/PPO |
$78.83
|
Rate for Payer: BCN Commercial |
$78.83
|
Rate for Payer: Cash Price |
$81.60
|
Rate for Payer: Cofinity Commercial |
$87.72
|
Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
Rate for Payer: Healthscope Commercial |
$91.80
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
Rate for Payer: PHP Commercial |
$86.70
|
Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.74
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$62.21
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$89.76
|
Rate for Payer: UHC Core |
$85.17
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
HC DRUG SCREEN 10 URINE
|
Facility
|
OP
|
$102.00
|
|
Service Code
|
CPT 80307
|
Hospital Charge Code |
30000134
|
Hospital Revenue Code
|
300
|
Min. Negotiated Rate |
$24.22 |
Max. Negotiated Rate |
$91.80 |
Rate for Payer: Aetna Commercial |
$86.70
|
Rate for Payer: Aetna Medicare |
$26.52
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.88
|
Rate for Payer: Amish Plain Church Group Commercial |
$31.88
|
Rate for Payer: BCBS Complete |
$48.15
|
Rate for Payer: BCBS MAPPO |
$25.50
|
Rate for Payer: BCBS Trust/PPO |
$79.30
|
Rate for Payer: BCN Commercial |
$79.30
|
Rate for Payer: BCN Medicare Advantage |
$25.50
|
Rate for Payer: Cash Price |
$81.60
|
Rate for Payer: Cash Price |
$81.60
|
Rate for Payer: Cofinity Commercial |
$87.72
|
Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.50
|
Rate for Payer: Healthscope Commercial |
$91.80
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
Rate for Payer: Mclaren Medicaid |
$45.86
|
Rate for Payer: Meridian Medicaid |
$48.15
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.78
|
Rate for Payer: MI Amish Medical Board Commercial |
$29.32
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
Rate for Payer: PACE Senior Care Partners |
$24.22
|
Rate for Payer: PACE SWMI |
$25.50
|
Rate for Payer: PHP Commercial |
$86.70
|
Rate for Payer: PHP Medicare Advantage |
$25.50
|
Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.74
|
Rate for Payer: Priority Health Medicare |
$25.50
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$62.21
|
Rate for Payer: Railroad Medicare Medicare |
$25.50
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$89.76
|
Rate for Payer: UHC Core |
$85.17
|
Rate for Payer: UHC Dual Complete DSNP |
$25.50
|
Rate for Payer: UHC Medicare Advantage |
$26.26
|
Rate for Payer: VA VA |
$25.50
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
HC DRUG SCREEN COLLECT-OUTSIDE SVC
|
Facility
|
IP
|
$24.00
|
|
Service Code
|
CPT 99000
|
Hospital Charge Code |
98300005
|
Hospital Revenue Code
|
983
|
Min. Negotiated Rate |
$14.64 |
Max. Negotiated Rate |
$21.60 |
Rate for Payer: Aetna Commercial |
$20.40
|
Rate for Payer: BCBS Trust/PPO |
$18.55
|
Rate for Payer: BCN Commercial |
$18.55
|
Rate for Payer: Cash Price |
$19.20
|
Rate for Payer: Cofinity Commercial |
$20.64
|
Rate for Payer: Encore Health Key Benefits Commercial |
$19.20
|
Rate for Payer: Healthscope Commercial |
$21.60
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.00
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.40
|
Rate for Payer: PHP Commercial |
$20.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.88
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$14.64
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$21.12
|
Rate for Payer: UHC Core |
$20.04
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.00
|
|
HC DRUG SCREEN COLLECT-OUTSIDE SVC
|
Facility
|
OP
|
$24.00
|
|
Service Code
|
CPT 99000
|
Hospital Charge Code |
98300005
|
Hospital Revenue Code
|
983
|
Min. Negotiated Rate |
$5.70 |
Max. Negotiated Rate |
$21.60 |
Rate for Payer: Aetna Commercial |
$20.40
|
Rate for Payer: Aetna Medicare |
$6.24
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.50
|
Rate for Payer: Amish Plain Church Group Commercial |
$7.50
|
Rate for Payer: BCBS Complete |
$9.60
|
Rate for Payer: BCBS MAPPO |
$6.00
|
Rate for Payer: BCBS Trust/PPO |
$18.66
|
Rate for Payer: BCN Commercial |
$18.66
|
Rate for Payer: BCN Medicare Advantage |
$6.00
|
Rate for Payer: Cash Price |
$19.20
|
Rate for Payer: Cofinity Commercial |
$20.64
|
Rate for Payer: Encore Health Key Benefits Commercial |
$19.20
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.00
|
Rate for Payer: Healthscope Commercial |
$21.60
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.00
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.30
|
Rate for Payer: MI Amish Medical Board Commercial |
$6.90
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.40
|
Rate for Payer: PACE Senior Care Partners |
$5.70
|
Rate for Payer: PACE SWMI |
$6.00
|
Rate for Payer: PHP Commercial |
$20.40
|
Rate for Payer: PHP Medicare Advantage |
$6.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.88
|
Rate for Payer: Priority Health Medicare |
$6.00
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$14.64
|
Rate for Payer: Railroad Medicare Medicare |
$6.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$21.12
|
Rate for Payer: UHC Core |
$20.04
|
Rate for Payer: UHC Dual Complete DSNP |
$6.00
|
Rate for Payer: UHC Medicare Advantage |
$6.18
|
Rate for Payer: VA VA |
$6.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.00
|
|
HC DRUG SCREEN QUAL EA PROC
|
Facility
|
OP
|
$47.28
|
|
Service Code
|
CPT 80305
|
Hospital Charge Code |
30100652
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$9.30 |
Max. Negotiated Rate |
$42.55 |
Rate for Payer: Aetna Commercial |
$40.19
|
Rate for Payer: Aetna Medicare |
$12.29
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.78
|
Rate for Payer: Amish Plain Church Group Commercial |
$14.78
|
Rate for Payer: BCBS Complete |
$9.76
|
Rate for Payer: BCBS MAPPO |
$11.82
|
Rate for Payer: BCBS Trust/PPO |
$36.76
|
Rate for Payer: BCN Commercial |
$36.76
|
Rate for Payer: BCN Medicare Advantage |
$11.82
|
Rate for Payer: Cash Price |
$37.82
|
Rate for Payer: Cash Price |
$37.82
|
Rate for Payer: Cofinity Commercial |
$40.66
|
Rate for Payer: Encore Health Key Benefits Commercial |
$37.82
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.82
|
Rate for Payer: Healthscope Commercial |
$42.55
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.46
|
Rate for Payer: Mclaren Medicaid |
$9.30
|
Rate for Payer: Meridian Medicaid |
$9.76
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.41
|
Rate for Payer: MI Amish Medical Board Commercial |
$13.59
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.19
|
Rate for Payer: PACE Senior Care Partners |
$11.23
|
Rate for Payer: PACE SWMI |
$11.82
|
Rate for Payer: PHP Commercial |
$40.19
|
Rate for Payer: PHP Medicare Advantage |
$11.82
|
Rate for Payer: Priority Health Choice Medicaid |
$9.30
|
Rate for Payer: Priority Health Cigna Priority Health |
$33.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.13
|
Rate for Payer: Priority Health Medicare |
$11.82
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$28.84
|
Rate for Payer: Railroad Medicare Medicare |
$11.82
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$41.61
|
Rate for Payer: UHC Core |
$39.48
|
Rate for Payer: UHC Dual Complete DSNP |
$11.82
|
Rate for Payer: UHC Medicare Advantage |
$12.17
|
Rate for Payer: VA VA |
$11.82
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.46
|
|
HC DRUG SCREEN QUAL EA PROC
|
Facility
|
IP
|
$47.28
|
|
Service Code
|
CPT 80305
|
Hospital Charge Code |
30100652
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$28.84 |
Max. Negotiated Rate |
$42.55 |
Rate for Payer: Aetna Commercial |
$40.19
|
Rate for Payer: BCBS Trust/PPO |
$36.54
|
Rate for Payer: BCN Commercial |
$36.54
|
Rate for Payer: Cash Price |
$37.82
|
Rate for Payer: Cofinity Commercial |
$40.66
|
Rate for Payer: Encore Health Key Benefits Commercial |
$37.82
|
Rate for Payer: Healthscope Commercial |
$42.55
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.46
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.19
|
Rate for Payer: PHP Commercial |
$40.19
|
Rate for Payer: Priority Health Cigna Priority Health |
$33.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.13
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$28.84
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$41.61
|
Rate for Payer: UHC Core |
$39.48
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.46
|
|
HC DRUG SCREEN QUANTALCOHOLS
|
Facility
|
IP
|
$75.00
|
|
Service Code
|
CPT 80320
|
Hospital Charge Code |
30100732
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$45.74 |
Max. Negotiated Rate |
$67.50 |
Rate for Payer: Aetna Commercial |
$63.75
|
Rate for Payer: BCBS Trust/PPO |
$57.96
|
Rate for Payer: BCN Commercial |
$57.96
|
Rate for Payer: Cash Price |
$60.00
|
Rate for Payer: Cofinity Commercial |
$64.50
|
Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
Rate for Payer: Healthscope Commercial |
$67.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
Rate for Payer: PHP Commercial |
$63.75
|
Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
Rate for Payer: UHC Core |
$62.62
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
HC DRUG SCREEN QUANTALCOHOLS
|
Facility
|
OP
|
$75.00
|
|
Service Code
|
CPT 80320
|
Hospital Charge Code |
30100732
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$17.81 |
Max. Negotiated Rate |
$67.50 |
Rate for Payer: Aetna Commercial |
$63.75
|
Rate for Payer: Aetna Medicare |
$19.50
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.44
|
Rate for Payer: Amish Plain Church Group Commercial |
$23.44
|
Rate for Payer: BCBS Complete |
$30.00
|
Rate for Payer: BCBS MAPPO |
$18.75
|
Rate for Payer: BCBS Trust/PPO |
$58.31
|
Rate for Payer: BCN Commercial |
$58.31
|
Rate for Payer: BCN Medicare Advantage |
$18.75
|
Rate for Payer: Cash Price |
$60.00
|
Rate for Payer: Cofinity Commercial |
$64.50
|
Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.75
|
Rate for Payer: Healthscope Commercial |
$67.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.69
|
Rate for Payer: MI Amish Medical Board Commercial |
$21.56
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
Rate for Payer: PACE Senior Care Partners |
$17.81
|
Rate for Payer: PACE SWMI |
$18.75
|
Rate for Payer: PHP Commercial |
$63.75
|
Rate for Payer: PHP Medicare Advantage |
$18.75
|
Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
Rate for Payer: Priority Health Medicare |
$18.75
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
Rate for Payer: Railroad Medicare Medicare |
$18.75
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
Rate for Payer: UHC Core |
$62.62
|
Rate for Payer: UHC Dual Complete DSNP |
$18.75
|
Rate for Payer: UHC Medicare Advantage |
$19.31
|
Rate for Payer: VA VA |
$18.75
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
HC DSDNA AB WITH REFLEX, IGG, S
|
Facility
|
OP
|
$38.74
|
|
Service Code
|
CPT 86225
|
Hospital Charge Code |
30200505
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$9.20 |
Max. Negotiated Rate |
$34.87 |
Rate for Payer: Aetna Commercial |
$32.93
|
Rate for Payer: Aetna Medicare |
$10.07
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.11
|
Rate for Payer: Amish Plain Church Group Commercial |
$12.11
|
Rate for Payer: BCBS Complete |
$10.65
|
Rate for Payer: BCBS MAPPO |
$9.68
|
Rate for Payer: BCBS Trust/PPO |
$30.12
|
Rate for Payer: BCN Commercial |
$30.12
|
Rate for Payer: BCN Medicare Advantage |
$9.68
|
Rate for Payer: Cash Price |
$30.99
|
Rate for Payer: Cash Price |
$30.99
|
Rate for Payer: Cofinity Commercial |
$33.32
|
Rate for Payer: Encore Health Key Benefits Commercial |
$30.99
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.68
|
Rate for Payer: Healthscope Commercial |
$34.87
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.06
|
Rate for Payer: Mclaren Medicaid |
$10.14
|
Rate for Payer: Meridian Medicaid |
$10.65
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.17
|
Rate for Payer: MI Amish Medical Board Commercial |
$11.14
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.93
|
Rate for Payer: PACE Senior Care Partners |
$9.20
|
Rate for Payer: PACE SWMI |
$9.68
|
Rate for Payer: PHP Commercial |
$32.93
|
Rate for Payer: PHP Medicare Advantage |
$9.68
|
Rate for Payer: Priority Health Choice Medicaid |
$10.14
|
Rate for Payer: Priority Health Cigna Priority Health |
$27.12
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.70
|
Rate for Payer: Priority Health Medicare |
$9.68
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$23.63
|
Rate for Payer: Railroad Medicare Medicare |
$9.68
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$34.09
|
Rate for Payer: UHC Core |
$32.35
|
Rate for Payer: UHC Dual Complete DSNP |
$9.68
|
Rate for Payer: UHC Medicare Advantage |
$9.98
|
Rate for Payer: VA VA |
$9.68
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.06
|
|
HC DSDNA AB WITH REFLEX, IGG, S
|
Facility
|
IP
|
$38.74
|
|
Service Code
|
CPT 86225
|
Hospital Charge Code |
30200505
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$23.63 |
Max. Negotiated Rate |
$34.87 |
Rate for Payer: Aetna Commercial |
$32.93
|
Rate for Payer: BCBS Trust/PPO |
$29.94
|
Rate for Payer: BCN Commercial |
$29.94
|
Rate for Payer: Cash Price |
$30.99
|
Rate for Payer: Cofinity Commercial |
$33.32
|
Rate for Payer: Encore Health Key Benefits Commercial |
$30.99
|
Rate for Payer: Healthscope Commercial |
$34.87
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.06
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.93
|
Rate for Payer: PHP Commercial |
$32.93
|
Rate for Payer: Priority Health Cigna Priority Health |
$27.12
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.70
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$23.63
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$34.09
|
Rate for Payer: UHC Core |
$32.35
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.06
|
|
HC DSMA TC 99M PER STUDY
|
Facility
|
IP
|
$381.09
|
|
Service Code
|
HCPCS A9551
|
Hospital Charge Code |
34300004
|
Hospital Revenue Code
|
343
|
Min. Negotiated Rate |
$232.43 |
Max. Negotiated Rate |
$342.98 |
Rate for Payer: Aetna Commercial |
$323.93
|
Rate for Payer: BCBS Trust/PPO |
$294.51
|
Rate for Payer: BCN Commercial |
$294.51
|
Rate for Payer: Cash Price |
$304.87
|
Rate for Payer: Cofinity Commercial |
$327.74
|
Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
Rate for Payer: Healthscope Commercial |
$342.98
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
Rate for Payer: PHP Commercial |
$323.93
|
Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.55
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$232.43
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$335.36
|
Rate for Payer: UHC Core |
$318.21
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
HC DSMA TC 99M PER STUDY
|
Facility
|
OP
|
$381.09
|
|
Service Code
|
HCPCS A9551
|
Hospital Charge Code |
34300004
|
Hospital Revenue Code
|
343
|
Min. Negotiated Rate |
$90.51 |
Max. Negotiated Rate |
$342.98 |
Rate for Payer: Aetna Commercial |
$323.93
|
Rate for Payer: Aetna Medicare |
$99.08
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.09
|
Rate for Payer: Amish Plain Church Group Commercial |
$119.09
|
Rate for Payer: BCBS Complete |
$152.44
|
Rate for Payer: BCBS MAPPO |
$95.27
|
Rate for Payer: BCBS Trust/PPO |
$296.30
|
Rate for Payer: BCN Commercial |
$296.30
|
Rate for Payer: BCN Medicare Advantage |
$95.27
|
Rate for Payer: Cash Price |
$304.87
|
Rate for Payer: Cofinity Commercial |
$327.74
|
Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.27
|
Rate for Payer: Healthscope Commercial |
$342.98
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.04
|
Rate for Payer: MI Amish Medical Board Commercial |
$109.56
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
Rate for Payer: PACE Senior Care Partners |
$90.51
|
Rate for Payer: PACE SWMI |
$95.27
|
Rate for Payer: PHP Commercial |
$323.93
|
Rate for Payer: PHP Medicare Advantage |
$95.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.55
|
Rate for Payer: Priority Health Medicare |
$95.27
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$232.43
|
Rate for Payer: Railroad Medicare Medicare |
$95.27
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$335.36
|
Rate for Payer: UHC Core |
$318.21
|
Rate for Payer: UHC Dual Complete DSNP |
$95.27
|
Rate for Payer: UHC Medicare Advantage |
$98.13
|
Rate for Payer: VA VA |
$95.27
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
HC DTAP HEPB IPV VACCINE INTRAMUSCULAR
|
Facility
|
IP
|
$172.74
|
|
Service Code
|
CPT 90723
|
Hospital Charge Code |
63600137
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$105.35 |
Max. Negotiated Rate |
$155.47 |
Rate for Payer: Aetna Commercial |
$146.83
|
Rate for Payer: BCBS Trust/PPO |
$133.49
|
Rate for Payer: BCN Commercial |
$133.49
|
Rate for Payer: Cash Price |
$138.19
|
Rate for Payer: Cofinity Commercial |
$148.56
|
Rate for Payer: Encore Health Key Benefits Commercial |
$138.19
|
Rate for Payer: Healthscope Commercial |
$155.47
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.56
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$146.83
|
Rate for Payer: PHP Commercial |
$146.83
|
Rate for Payer: Priority Health Cigna Priority Health |
$120.92
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.28
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$105.35
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$152.01
|
Rate for Payer: UHC Core |
$144.24
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.56
|
|
HC DTAP HEPB IPV VACCINE INTRAMUSCULAR
|
Facility
|
OP
|
$172.74
|
|
Service Code
|
CPT 90723
|
Hospital Charge Code |
63600137
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$41.03 |
Max. Negotiated Rate |
$155.47 |
Rate for Payer: Aetna Commercial |
$146.83
|
Rate for Payer: Aetna Medicare |
$44.91
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.98
|
Rate for Payer: Amish Plain Church Group Commercial |
$53.98
|
Rate for Payer: BCBS Complete |
$69.10
|
Rate for Payer: BCBS MAPPO |
$43.18
|
Rate for Payer: BCBS Trust/PPO |
$134.31
|
Rate for Payer: BCN Commercial |
$134.31
|
Rate for Payer: BCN Medicare Advantage |
$43.18
|
Rate for Payer: Cash Price |
$138.19
|
Rate for Payer: Cofinity Commercial |
$148.56
|
Rate for Payer: Encore Health Key Benefits Commercial |
$138.19
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.18
|
Rate for Payer: Healthscope Commercial |
$155.47
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.56
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.34
|
Rate for Payer: MI Amish Medical Board Commercial |
$49.66
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$146.83
|
Rate for Payer: PACE Senior Care Partners |
$41.03
|
Rate for Payer: PACE SWMI |
$43.18
|
Rate for Payer: PHP Commercial |
$146.83
|
Rate for Payer: PHP Medicare Advantage |
$43.18
|
Rate for Payer: Priority Health Cigna Priority Health |
$120.92
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.28
|
Rate for Payer: Priority Health Medicare |
$43.18
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$105.35
|
Rate for Payer: Railroad Medicare Medicare |
$43.18
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$152.01
|
Rate for Payer: UHC Core |
$144.24
|
Rate for Payer: UHC Dual Complete DSNP |
$43.18
|
Rate for Payer: UHC Medicare Advantage |
$44.48
|
Rate for Payer: VA VA |
$43.18
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.56
|
|
HC DTAP-IPV VACCINE 4-6 YEARS IM
|
Facility
|
IP
|
$75.17
|
|
Service Code
|
CPT 90696
|
Hospital Charge Code |
63600120
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$45.85 |
Max. Negotiated Rate |
$67.65 |
Rate for Payer: Aetna Commercial |
$63.89
|
Rate for Payer: BCBS Trust/PPO |
$58.09
|
Rate for Payer: BCN Commercial |
$58.09
|
Rate for Payer: Cash Price |
$60.14
|
Rate for Payer: Cofinity Commercial |
$64.65
|
Rate for Payer: Encore Health Key Benefits Commercial |
$60.14
|
Rate for Payer: Healthscope Commercial |
$67.65
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.38
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.89
|
Rate for Payer: PHP Commercial |
$63.89
|
Rate for Payer: Priority Health Cigna Priority Health |
$52.62
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.40
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$45.85
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$66.15
|
Rate for Payer: UHC Core |
$62.77
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.38
|
|
HC DTAP-IPV VACCINE 4-6 YEARS IM
|
Facility
|
OP
|
$75.17
|
|
Service Code
|
CPT 90696
|
Hospital Charge Code |
63600120
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$17.85 |
Max. Negotiated Rate |
$67.65 |
Rate for Payer: Aetna Commercial |
$63.89
|
Rate for Payer: Aetna Medicare |
$19.54
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.49
|
Rate for Payer: Amish Plain Church Group Commercial |
$23.49
|
Rate for Payer: BCBS Complete |
$30.07
|
Rate for Payer: BCBS MAPPO |
$18.79
|
Rate for Payer: BCBS Trust/PPO |
$58.44
|
Rate for Payer: BCN Commercial |
$58.44
|
Rate for Payer: BCN Medicare Advantage |
$18.79
|
Rate for Payer: Cash Price |
$60.14
|
Rate for Payer: Cofinity Commercial |
$64.65
|
Rate for Payer: Encore Health Key Benefits Commercial |
$60.14
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.79
|
Rate for Payer: Healthscope Commercial |
$67.65
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.38
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.73
|
Rate for Payer: MI Amish Medical Board Commercial |
$21.61
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.89
|
Rate for Payer: PACE Senior Care Partners |
$17.85
|
Rate for Payer: PACE SWMI |
$18.79
|
Rate for Payer: PHP Commercial |
$63.89
|
Rate for Payer: PHP Medicare Advantage |
$18.79
|
Rate for Payer: Priority Health Cigna Priority Health |
$52.62
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.40
|
Rate for Payer: Priority Health Medicare |
$18.79
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$45.85
|
Rate for Payer: Railroad Medicare Medicare |
$18.79
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$66.15
|
Rate for Payer: UHC Core |
$62.77
|
Rate for Payer: UHC Dual Complete DSNP |
$18.79
|
Rate for Payer: UHC Medicare Advantage |
$19.36
|
Rate for Payer: VA VA |
$18.79
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.38
|
|
HC DTAP-IVP-HIB-HEPB INTRAMUSCULAR
|
Facility
|
IP
|
$163.20
|
|
Service Code
|
CPT 90697
|
Hospital Charge Code |
63600207
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$99.54 |
Max. Negotiated Rate |
$146.88 |
Rate for Payer: Aetna Commercial |
$138.72
|
Rate for Payer: BCBS Trust/PPO |
$126.12
|
Rate for Payer: BCN Commercial |
$126.12
|
Rate for Payer: Cash Price |
$130.56
|
Rate for Payer: Cofinity Commercial |
$140.35
|
Rate for Payer: Encore Health Key Benefits Commercial |
$130.56
|
Rate for Payer: Healthscope Commercial |
$146.88
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.40
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.72
|
Rate for Payer: PHP Commercial |
$138.72
|
Rate for Payer: Priority Health Cigna Priority Health |
$114.24
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.98
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$99.54
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$143.62
|
Rate for Payer: UHC Core |
$136.27
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.40
|
|
HC DTAP-IVP-HIB-HEPB INTRAMUSCULAR
|
Facility
|
OP
|
$163.20
|
|
Service Code
|
CPT 90697
|
Hospital Charge Code |
63600207
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$38.76 |
Max. Negotiated Rate |
$146.88 |
Rate for Payer: Aetna Commercial |
$138.72
|
Rate for Payer: Aetna Medicare |
$42.43
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.00
|
Rate for Payer: Amish Plain Church Group Commercial |
$51.00
|
Rate for Payer: BCBS Complete |
$65.28
|
Rate for Payer: BCBS MAPPO |
$40.80
|
Rate for Payer: BCBS Trust/PPO |
$126.89
|
Rate for Payer: BCN Commercial |
$126.89
|
Rate for Payer: BCN Medicare Advantage |
$40.80
|
Rate for Payer: Cash Price |
$130.56
|
Rate for Payer: Cofinity Commercial |
$140.35
|
Rate for Payer: Encore Health Key Benefits Commercial |
$130.56
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.80
|
Rate for Payer: Healthscope Commercial |
$146.88
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.40
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42.84
|
Rate for Payer: MI Amish Medical Board Commercial |
$46.92
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.72
|
Rate for Payer: PACE Senior Care Partners |
$38.76
|
Rate for Payer: PACE SWMI |
$40.80
|
Rate for Payer: PHP Commercial |
$138.72
|
Rate for Payer: PHP Medicare Advantage |
$40.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$114.24
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.98
|
Rate for Payer: Priority Health Medicare |
$40.80
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$99.54
|
Rate for Payer: Railroad Medicare Medicare |
$40.80
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$143.62
|
Rate for Payer: UHC Core |
$136.27
|
Rate for Payer: UHC Dual Complete DSNP |
$40.80
|
Rate for Payer: UHC Medicare Advantage |
$42.02
|
Rate for Payer: VA VA |
$40.80
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.40
|
|
HC DTPA PER STUDY
|
Facility
|
IP
|
$166.83
|
|
Service Code
|
HCPCS A9539
|
Hospital Charge Code |
34300005
|
Hospital Revenue Code
|
343
|
Min. Negotiated Rate |
$101.75 |
Max. Negotiated Rate |
$150.15 |
Rate for Payer: Aetna Commercial |
$141.81
|
Rate for Payer: BCBS Trust/PPO |
$128.93
|
Rate for Payer: BCN Commercial |
$128.93
|
Rate for Payer: Cash Price |
$133.46
|
Rate for Payer: Cofinity Commercial |
$143.47
|
Rate for Payer: Encore Health Key Benefits Commercial |
$133.46
|
Rate for Payer: Healthscope Commercial |
$150.15
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.12
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$141.81
|
Rate for Payer: PHP Commercial |
$141.81
|
Rate for Payer: Priority Health Cigna Priority Health |
$116.78
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.14
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$101.75
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$146.81
|
Rate for Payer: UHC Core |
$139.30
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.12
|
|
HC DTPA PER STUDY
|
Facility
|
OP
|
$166.83
|
|
Service Code
|
HCPCS A9539
|
Hospital Charge Code |
34300005
|
Hospital Revenue Code
|
343
|
Min. Negotiated Rate |
$39.62 |
Max. Negotiated Rate |
$150.15 |
Rate for Payer: Aetna Commercial |
$141.81
|
Rate for Payer: Aetna Medicare |
$43.38
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.13
|
Rate for Payer: Amish Plain Church Group Commercial |
$52.13
|
Rate for Payer: BCBS Complete |
$66.73
|
Rate for Payer: BCBS MAPPO |
$41.71
|
Rate for Payer: BCBS Trust/PPO |
$129.71
|
Rate for Payer: BCN Commercial |
$129.71
|
Rate for Payer: BCN Medicare Advantage |
$41.71
|
Rate for Payer: Cash Price |
$133.46
|
Rate for Payer: Cofinity Commercial |
$143.47
|
Rate for Payer: Encore Health Key Benefits Commercial |
$133.46
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.71
|
Rate for Payer: Healthscope Commercial |
$150.15
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.12
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.79
|
Rate for Payer: MI Amish Medical Board Commercial |
$47.96
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$141.81
|
Rate for Payer: PACE Senior Care Partners |
$39.62
|
Rate for Payer: PACE SWMI |
$41.71
|
Rate for Payer: PHP Commercial |
$141.81
|
Rate for Payer: PHP Medicare Advantage |
$41.71
|
Rate for Payer: Priority Health Cigna Priority Health |
$116.78
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.14
|
Rate for Payer: Priority Health Medicare |
$41.71
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$101.75
|
Rate for Payer: Railroad Medicare Medicare |
$41.71
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$146.81
|
Rate for Payer: UHC Core |
$139.30
|
Rate for Payer: UHC Dual Complete DSNP |
$41.71
|
Rate for Payer: UHC Medicare Advantage |
$42.96
|
Rate for Payer: VA VA |
$41.71
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.12
|
|
HC DUAL LEAD INSERTION
|
Facility
|
IP
|
$12,461.13
|
|
Service Code
|
CPT 33217
|
Hospital Charge Code |
36100066
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$7,600.04 |
Max. Negotiated Rate |
$11,215.02 |
Rate for Payer: Aetna Commercial |
$10,591.96
|
Rate for Payer: BCBS Trust/PPO |
$9,629.96
|
Rate for Payer: BCN Commercial |
$9,629.96
|
Rate for Payer: Cash Price |
$9,968.90
|
Rate for Payer: Cofinity Commercial |
$10,716.57
|
Rate for Payer: Encore Health Key Benefits Commercial |
$9,968.90
|
Rate for Payer: Healthscope Commercial |
$11,215.02
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,345.85
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,591.96
|
Rate for Payer: PHP Commercial |
$10,591.96
|
Rate for Payer: Priority Health Cigna Priority Health |
$8,722.79
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,841.18
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$7,600.04
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$10,965.79
|
Rate for Payer: UHC Core |
$10,405.04
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,345.85
|
|
HC DUAL LEAD INSERTION
|
Facility
|
OP
|
$12,461.13
|
|
Service Code
|
CPT 33217
|
Hospital Charge Code |
36100066
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$2,959.52 |
Max. Negotiated Rate |
$11,215.02 |
Rate for Payer: Aetna Commercial |
$10,591.96
|
Rate for Payer: Aetna Medicare |
$3,239.89
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.10
|
Rate for Payer: Amish Plain Church Group Commercial |
$3,894.10
|
Rate for Payer: BCBS Complete |
$5,851.75
|
Rate for Payer: BCBS MAPPO |
$3,115.28
|
Rate for Payer: BCBS Trust/PPO |
$9,688.53
|
Rate for Payer: BCN Commercial |
$9,688.53
|
Rate for Payer: BCN Medicare Advantage |
$3,115.28
|
Rate for Payer: Cash Price |
$9,968.90
|
Rate for Payer: Cash Price |
$9,968.90
|
Rate for Payer: Cofinity Commercial |
$10,716.57
|
Rate for Payer: Encore Health Key Benefits Commercial |
$9,968.90
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.28
|
Rate for Payer: Healthscope Commercial |
$11,215.02
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,345.85
|
Rate for Payer: Mclaren Medicaid |
$5,573.10
|
Rate for Payer: Meridian Medicaid |
$5,851.75
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,271.05
|
Rate for Payer: MI Amish Medical Board Commercial |
$3,582.57
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,591.96
|
Rate for Payer: PACE Senior Care Partners |
$2,959.52
|
Rate for Payer: PACE SWMI |
$3,115.28
|
Rate for Payer: PHP Commercial |
$10,591.96
|
Rate for Payer: PHP Medicare Advantage |
$3,115.28
|
Rate for Payer: Priority Health Choice Medicaid |
$5,573.10
|
Rate for Payer: Priority Health Cigna Priority Health |
$8,722.79
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,841.18
|
Rate for Payer: Priority Health Medicare |
$3,115.28
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$7,600.04
|
Rate for Payer: Railroad Medicare Medicare |
$3,115.28
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$10,965.79
|
Rate for Payer: UHC Core |
$10,405.04
|
Rate for Payer: UHC Dual Complete DSNP |
$3,115.28
|
Rate for Payer: UHC Medicare Advantage |
$3,208.74
|
Rate for Payer: VA VA |
$3,115.28
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,345.85
|
|