|
HC CANNULA VEN TRIPLE STAGE
|
Facility
|
IP
|
$74.91
|
|
| Hospital Charge Code |
27000035
|
|
Hospital Revenue Code
|
270
|
| 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 CANNULA VEN TRIPLE STAGE
|
Facility
|
OP
|
$74.91
|
|
| Hospital Charge Code |
27000035
|
|
Hospital Revenue Code
|
270
|
| 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 CARB 10,11 EPXID
|
Facility
|
IP
|
$45.66
|
|
|
Service Code
|
CPT 80161
|
| Hospital Charge Code |
30100742
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.78 |
| Max. Negotiated Rate |
$41.09 |
| Rate for Payer: Aetna Commercial |
$38.81
|
| Rate for Payer: BCBS Trust/PPO |
$37.71
|
| Rate for Payer: BCN Commercial |
$37.71
|
| Rate for Payer: Cash Price |
$36.53
|
| Rate for Payer: Cofinity Commercial |
$39.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.53
|
| Rate for Payer: Healthscope Commercial |
$41.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.81
|
| Rate for Payer: Nomi Health Commercial |
$37.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.24
|
| Rate for Payer: PHP Commercial |
$38.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.18
|
| Rate for Payer: UHC Core |
$38.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.24
|
|
|
HC CARB 10,11 EPXID
|
Facility
|
OP
|
$45.66
|
|
|
Service Code
|
CPT 80161
|
| Hospital Charge Code |
30100742
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.05 |
| Max. Negotiated Rate |
$41.09 |
| Rate for Payer: Aetna Commercial |
$38.81
|
| Rate for Payer: Aetna Medicare |
$11.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.27
|
| Rate for Payer: BCBS Complete |
$8.45
|
| Rate for Payer: BCBS MAPPO |
$11.41
|
| Rate for Payer: BCBS Trust/PPO |
$37.54
|
| Rate for Payer: BCN Commercial |
$37.54
|
| Rate for Payer: BCN Medicare Advantage |
$11.41
|
| Rate for Payer: Cash Price |
$36.53
|
| Rate for Payer: Cofinity Commercial |
$39.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.41
|
| Rate for Payer: Healthscope Commercial |
$41.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.24
|
| Rate for Payer: Mclaren Medicaid |
$8.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.99
|
| Rate for Payer: Meridian Medicaid |
$8.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.81
|
| Rate for Payer: Nomi Health Commercial |
$37.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.24
|
| Rate for Payer: PACE Senior Care Partners |
$10.84
|
| Rate for Payer: PACE SWMI |
$11.41
|
| Rate for Payer: PHP Commercial |
$38.81
|
| Rate for Payer: PHP Medicare Advantage |
$11.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.72
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.78
|
| Rate for Payer: Railroad Medicare Medicare |
$11.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.18
|
| Rate for Payer: UHC Core |
$38.13
|
| Rate for Payer: UHC Exchange |
$11.41
|
| Rate for Payer: UHC Medicaid |
$8.05
|
| Rate for Payer: UHC Medicare Advantage |
$11.41
|
| Rate for Payer: UHCCP Medicaid |
$8.05
|
| Rate for Payer: VA VA |
$11.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.24
|
|
|
HC CARBAMAZEPINE 10 11 EPOXIDE
|
Facility
|
OP
|
$46.70
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100022
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: Aetna Medicare |
$12.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.59
|
| Rate for Payer: BCBS Complete |
$8.64
|
| Rate for Payer: BCBS MAPPO |
$11.68
|
| Rate for Payer: BCBS Trust/PPO |
$38.39
|
| Rate for Payer: BCN Commercial |
$38.39
|
| Rate for Payer: BCN Medicare Advantage |
$11.68
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.68
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: Mclaren Medicaid |
$8.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.26
|
| Rate for Payer: Meridian Medicaid |
$8.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PACE Senior Care Partners |
$11.09
|
| Rate for Payer: PACE SWMI |
$11.68
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: PHP Medicare Advantage |
$11.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.63
|
| Rate for Payer: Priority Health Medicare |
$11.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.50
|
| Rate for Payer: Railroad Medicare Medicare |
$11.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.10
|
| Rate for Payer: UHC Core |
$38.99
|
| Rate for Payer: UHC Exchange |
$11.68
|
| Rate for Payer: UHC Medicaid |
$8.23
|
| Rate for Payer: UHC Medicare Advantage |
$11.68
|
| Rate for Payer: UHCCP Medicaid |
$8.23
|
| Rate for Payer: VA VA |
$11.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
|
HC CARBAMAZEPINE 10 11 EPOXIDE
|
Facility
|
IP
|
$46.70
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100022
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: BCBS Trust/PPO |
$38.57
|
| Rate for Payer: BCN Commercial |
$38.57
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.10
|
| Rate for Payer: UHC Core |
$38.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
|
HC CARBAMAZEPINE 10 11 EPOXIDE CMPT
|
Facility
|
OP
|
$45.63
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100060
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.04 |
| Max. Negotiated Rate |
$41.07 |
| Rate for Payer: Aetna Commercial |
$38.79
|
| Rate for Payer: Aetna Medicare |
$11.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.26
|
| Rate for Payer: BCBS Complete |
$8.45
|
| Rate for Payer: BCBS MAPPO |
$11.41
|
| Rate for Payer: BCBS Trust/PPO |
$37.51
|
| Rate for Payer: BCN Commercial |
$37.51
|
| Rate for Payer: BCN Medicare Advantage |
$11.41
|
| Rate for Payer: Cash Price |
$36.50
|
| Rate for Payer: Cofinity Commercial |
$39.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.41
|
| Rate for Payer: Healthscope Commercial |
$41.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.22
|
| Rate for Payer: Mclaren Medicaid |
$8.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.98
|
| Rate for Payer: Meridian Medicaid |
$8.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.79
|
| Rate for Payer: Nomi Health Commercial |
$37.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.22
|
| Rate for Payer: PACE Senior Care Partners |
$10.84
|
| Rate for Payer: PACE SWMI |
$11.41
|
| Rate for Payer: PHP Commercial |
$38.79
|
| Rate for Payer: PHP Medicare Advantage |
$11.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.70
|
| Rate for Payer: Priority Health Medicare |
$11.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.76
|
| Rate for Payer: Railroad Medicare Medicare |
$11.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.15
|
| Rate for Payer: UHC Core |
$38.10
|
| Rate for Payer: UHC Exchange |
$11.41
|
| Rate for Payer: UHC Medicaid |
$8.04
|
| Rate for Payer: UHC Medicare Advantage |
$11.41
|
| Rate for Payer: UHCCP Medicaid |
$8.04
|
| Rate for Payer: VA VA |
$11.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.22
|
|
|
HC CARBAMAZEPINE 10 11 EPOXIDE CMPT
|
Facility
|
IP
|
$45.63
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100060
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.76 |
| Max. Negotiated Rate |
$41.07 |
| Rate for Payer: Aetna Commercial |
$38.79
|
| Rate for Payer: BCBS Trust/PPO |
$37.69
|
| Rate for Payer: BCN Commercial |
$37.69
|
| Rate for Payer: Cash Price |
$36.50
|
| Rate for Payer: Cofinity Commercial |
$39.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.50
|
| Rate for Payer: Healthscope Commercial |
$41.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.79
|
| Rate for Payer: Nomi Health Commercial |
$37.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.22
|
| Rate for Payer: PHP Commercial |
$38.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.15
|
| Rate for Payer: UHC Core |
$38.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.22
|
|
|
HC CARBON DIOXIDE (BICARB)
|
Facility
|
IP
|
$22.07
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100133
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$19.86 |
| Rate for Payer: Aetna Commercial |
$18.76
|
| Rate for Payer: BCBS Trust/PPO |
$18.23
|
| Rate for Payer: BCN Commercial |
$18.23
|
| Rate for Payer: Cash Price |
$17.66
|
| Rate for Payer: Cofinity Commercial |
$18.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.66
|
| Rate for Payer: Healthscope Commercial |
$19.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.76
|
| Rate for Payer: Nomi Health Commercial |
$18.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.55
|
| Rate for Payer: PHP Commercial |
$18.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.42
|
| Rate for Payer: UHC Core |
$18.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.55
|
|
|
HC CARBON DIOXIDE (BICARB)
|
Facility
|
OP
|
$22.07
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100133
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.89 |
| Max. Negotiated Rate |
$19.86 |
| Rate for Payer: Aetna Commercial |
$18.76
|
| Rate for Payer: Aetna Medicare |
$5.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.90
|
| Rate for Payer: BCBS Complete |
$4.09
|
| Rate for Payer: BCBS MAPPO |
$5.52
|
| Rate for Payer: BCBS Trust/PPO |
$18.14
|
| Rate for Payer: BCN Commercial |
$18.14
|
| Rate for Payer: BCN Medicare Advantage |
$5.52
|
| Rate for Payer: Cash Price |
$17.66
|
| Rate for Payer: Cofinity Commercial |
$18.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.52
|
| Rate for Payer: Healthscope Commercial |
$19.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.55
|
| Rate for Payer: Mclaren Medicaid |
$3.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.79
|
| Rate for Payer: Meridian Medicaid |
$4.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.76
|
| Rate for Payer: Nomi Health Commercial |
$18.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.55
|
| Rate for Payer: PACE Senior Care Partners |
$5.24
|
| Rate for Payer: PACE SWMI |
$5.52
|
| Rate for Payer: PHP Commercial |
$18.76
|
| Rate for Payer: PHP Medicare Advantage |
$5.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.20
|
| Rate for Payer: Priority Health Medicare |
$5.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.36
|
| Rate for Payer: Railroad Medicare Medicare |
$5.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.42
|
| Rate for Payer: UHC Core |
$18.43
|
| Rate for Payer: UHC Exchange |
$5.52
|
| Rate for Payer: UHC Medicaid |
$3.89
|
| Rate for Payer: UHC Medicare Advantage |
$5.52
|
| Rate for Payer: UHCCP Medicaid |
$3.89
|
| Rate for Payer: VA VA |
$5.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.55
|
|
|
HC CARBOXYHEMOGLOBIN
|
Facility
|
IP
|
$80.02
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
30100134
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.69 |
| Max. Negotiated Rate |
$72.02 |
| Rate for Payer: Aetna Commercial |
$68.02
|
| Rate for Payer: BCBS Trust/PPO |
$66.09
|
| Rate for Payer: BCN Commercial |
$66.09
|
| Rate for Payer: Cash Price |
$64.02
|
| Rate for Payer: Cofinity Commercial |
$68.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.02
|
| Rate for Payer: Healthscope Commercial |
$72.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.02
|
| Rate for Payer: Nomi Health Commercial |
$65.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.02
|
| Rate for Payer: PHP Commercial |
$68.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.42
|
| Rate for Payer: UHC Core |
$66.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.02
|
|
|
HC CARBOXYHEMOGLOBIN
|
Facility
|
OP
|
$80.02
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
30100134
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.11 |
| Max. Negotiated Rate |
$72.02 |
| Rate for Payer: Aetna Commercial |
$68.02
|
| Rate for Payer: Aetna Medicare |
$20.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.01
|
| Rate for Payer: BCBS Complete |
$14.81
|
| Rate for Payer: BCBS MAPPO |
$20.00
|
| Rate for Payer: BCBS Trust/PPO |
$65.78
|
| Rate for Payer: BCN Commercial |
$65.78
|
| Rate for Payer: BCN Medicare Advantage |
$20.00
|
| Rate for Payer: Cash Price |
$64.02
|
| Rate for Payer: Cofinity Commercial |
$68.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$72.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.02
|
| Rate for Payer: Mclaren Medicaid |
$14.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.01
|
| Rate for Payer: Meridian Medicaid |
$14.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.02
|
| Rate for Payer: Nomi Health Commercial |
$65.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.02
|
| Rate for Payer: PACE Senior Care Partners |
$19.00
|
| Rate for Payer: PACE SWMI |
$20.00
|
| Rate for Payer: PHP Commercial |
$68.02
|
| Rate for Payer: PHP Medicare Advantage |
$20.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.62
|
| Rate for Payer: Priority Health Medicare |
$20.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.69
|
| Rate for Payer: Railroad Medicare Medicare |
$20.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.42
|
| Rate for Payer: UHC Core |
$66.82
|
| Rate for Payer: UHC Exchange |
$20.00
|
| Rate for Payer: UHC Medicaid |
$14.11
|
| Rate for Payer: UHC Medicare Advantage |
$20.00
|
| Rate for Payer: UHCCP Medicaid |
$14.11
|
| Rate for Payer: VA VA |
$20.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.02
|
|
|
HC CARDIAC PET CT STRESS TEST
|
Facility
|
OP
|
$967.23
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200006
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$170.52 |
| Max. Negotiated Rate |
$870.51 |
| Rate for Payer: Aetna Commercial |
$822.15
|
| Rate for Payer: Aetna Medicare |
$251.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$302.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$302.26
|
| Rate for Payer: BCBS Complete |
$179.03
|
| Rate for Payer: BCBS MAPPO |
$241.81
|
| Rate for Payer: BCBS Trust/PPO |
$795.16
|
| Rate for Payer: BCN Commercial |
$795.16
|
| Rate for Payer: BCN Medicare Advantage |
$241.81
|
| Rate for Payer: Cash Price |
$773.78
|
| Rate for Payer: Cofinity Commercial |
$831.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.81
|
| Rate for Payer: Healthscope Commercial |
$870.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.42
|
| Rate for Payer: Mclaren Medicaid |
$170.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$253.90
|
| Rate for Payer: Meridian Medicaid |
$179.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$278.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$265.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$822.15
|
| Rate for Payer: Nomi Health Commercial |
$793.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$725.42
|
| Rate for Payer: PACE Senior Care Partners |
$229.72
|
| Rate for Payer: PACE SWMI |
$241.81
|
| Rate for Payer: PHP Commercial |
$822.15
|
| Rate for Payer: PHP Medicare Advantage |
$241.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$170.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$841.49
|
| Rate for Payer: Priority Health Medicare |
$244.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$673.19
|
| Rate for Payer: Railroad Medicare Medicare |
$241.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$851.16
|
| Rate for Payer: UHC Core |
$807.64
|
| Rate for Payer: UHC Exchange |
$241.81
|
| Rate for Payer: UHC Medicaid |
$170.52
|
| Rate for Payer: UHC Medicare Advantage |
$241.81
|
| Rate for Payer: UHCCP Medicaid |
$170.52
|
| Rate for Payer: VA VA |
$241.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.42
|
|
|
HC CARDIAC PET CT STRESS TEST
|
Facility
|
IP
|
$967.23
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200006
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$673.19 |
| Max. Negotiated Rate |
$870.51 |
| Rate for Payer: Aetna Commercial |
$822.15
|
| Rate for Payer: BCBS Trust/PPO |
$798.84
|
| Rate for Payer: BCN Commercial |
$798.84
|
| Rate for Payer: Cash Price |
$773.78
|
| Rate for Payer: Cofinity Commercial |
$831.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.78
|
| Rate for Payer: Healthscope Commercial |
$870.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$822.15
|
| Rate for Payer: Nomi Health Commercial |
$793.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$725.42
|
| Rate for Payer: PHP Commercial |
$822.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$841.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$673.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$851.16
|
| Rate for Payer: UHC Core |
$807.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.42
|
|
|
HC CARDIAC REH OP PH 2 WO MONITOR
|
Facility
|
IP
|
$201.87
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
94300007
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$140.50 |
| Max. Negotiated Rate |
$181.68 |
| Rate for Payer: Aetna Commercial |
$171.59
|
| Rate for Payer: BCBS Trust/PPO |
$166.72
|
| Rate for Payer: BCN Commercial |
$166.72
|
| Rate for Payer: Cash Price |
$161.50
|
| Rate for Payer: Cofinity Commercial |
$173.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.50
|
| Rate for Payer: Healthscope Commercial |
$181.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.59
|
| Rate for Payer: Nomi Health Commercial |
$165.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.40
|
| Rate for Payer: PHP Commercial |
$171.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$175.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.65
|
| Rate for Payer: UHC Core |
$168.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.40
|
|
|
HC CARDIAC REH OP PH 2 WO MONITOR
|
Facility
|
OP
|
$201.87
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
94300007
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$35.59 |
| Max. Negotiated Rate |
$181.68 |
| Rate for Payer: Aetna Commercial |
$171.59
|
| Rate for Payer: Aetna Medicare |
$52.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.08
|
| Rate for Payer: BCBS Complete |
$37.37
|
| Rate for Payer: BCBS MAPPO |
$50.47
|
| Rate for Payer: BCBS Trust/PPO |
$165.96
|
| Rate for Payer: BCN Commercial |
$165.96
|
| Rate for Payer: BCN Medicare Advantage |
$50.47
|
| Rate for Payer: Cash Price |
$161.50
|
| Rate for Payer: Cofinity Commercial |
$173.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.47
|
| Rate for Payer: Healthscope Commercial |
$181.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.40
|
| Rate for Payer: Mclaren Medicaid |
$35.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.99
|
| Rate for Payer: Meridian Medicaid |
$37.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.59
|
| Rate for Payer: Nomi Health Commercial |
$165.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.40
|
| Rate for Payer: PACE Senior Care Partners |
$47.94
|
| Rate for Payer: PACE SWMI |
$50.47
|
| Rate for Payer: PHP Commercial |
$171.59
|
| Rate for Payer: PHP Medicare Advantage |
$50.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$175.63
|
| Rate for Payer: Priority Health Medicare |
$50.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.50
|
| Rate for Payer: Railroad Medicare Medicare |
$50.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.65
|
| Rate for Payer: UHC Core |
$168.56
|
| Rate for Payer: UHC Exchange |
$50.47
|
| Rate for Payer: UHC Medicaid |
$35.59
|
| Rate for Payer: UHC Medicare Advantage |
$50.47
|
| Rate for Payer: UHCCP Medicaid |
$35.59
|
| Rate for Payer: VA VA |
$50.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.40
|
|
|
HC CARDIOLIPIN AB IGA
|
Facility
|
OP
|
$52.19
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200146
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$46.97 |
| Rate for Payer: Aetna Commercial |
$44.36
|
| Rate for Payer: Aetna Medicare |
$13.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.31
|
| Rate for Payer: BCBS Complete |
$9.66
|
| Rate for Payer: BCBS MAPPO |
$13.05
|
| Rate for Payer: BCBS Trust/PPO |
$42.91
|
| Rate for Payer: BCN Commercial |
$42.91
|
| Rate for Payer: BCN Medicare Advantage |
$13.05
|
| Rate for Payer: Cash Price |
$41.75
|
| Rate for Payer: Cofinity Commercial |
$44.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.05
|
| Rate for Payer: Healthscope Commercial |
$46.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.14
|
| Rate for Payer: Mclaren Medicaid |
$9.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.70
|
| Rate for Payer: Meridian Medicaid |
$9.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.36
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.14
|
| Rate for Payer: PACE Senior Care Partners |
$12.40
|
| Rate for Payer: PACE SWMI |
$13.05
|
| Rate for Payer: PHP Commercial |
$44.36
|
| Rate for Payer: PHP Medicare Advantage |
$13.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.41
|
| Rate for Payer: Priority Health Medicare |
$13.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.32
|
| Rate for Payer: Railroad Medicare Medicare |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.93
|
| Rate for Payer: UHC Core |
$43.58
|
| Rate for Payer: UHC Exchange |
$13.05
|
| Rate for Payer: UHC Medicaid |
$9.20
|
| Rate for Payer: UHC Medicare Advantage |
$13.05
|
| Rate for Payer: UHCCP Medicaid |
$9.20
|
| Rate for Payer: VA VA |
$13.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.14
|
|
|
HC CARDIOLIPIN AB IGA
|
Facility
|
IP
|
$52.19
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200146
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.32 |
| Max. Negotiated Rate |
$46.97 |
| Rate for Payer: Aetna Commercial |
$44.36
|
| Rate for Payer: BCBS Trust/PPO |
$43.10
|
| Rate for Payer: BCN Commercial |
$43.10
|
| Rate for Payer: Cash Price |
$41.75
|
| Rate for Payer: Cofinity Commercial |
$44.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.75
|
| Rate for Payer: Healthscope Commercial |
$46.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.36
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.14
|
| Rate for Payer: PHP Commercial |
$44.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.93
|
| Rate for Payer: UHC Core |
$43.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.14
|
|
|
HC CARDIOLIPIN AB IGG
|
Facility
|
OP
|
$52.19
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200144
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$46.97 |
| Rate for Payer: Aetna Commercial |
$44.36
|
| Rate for Payer: Aetna Medicare |
$13.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.31
|
| Rate for Payer: BCBS Complete |
$9.66
|
| Rate for Payer: BCBS MAPPO |
$13.05
|
| Rate for Payer: BCBS Trust/PPO |
$42.91
|
| Rate for Payer: BCN Commercial |
$42.91
|
| Rate for Payer: BCN Medicare Advantage |
$13.05
|
| Rate for Payer: Cash Price |
$41.75
|
| Rate for Payer: Cofinity Commercial |
$44.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.05
|
| Rate for Payer: Healthscope Commercial |
$46.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.14
|
| Rate for Payer: Mclaren Medicaid |
$9.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.70
|
| Rate for Payer: Meridian Medicaid |
$9.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.36
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.14
|
| Rate for Payer: PACE Senior Care Partners |
$12.40
|
| Rate for Payer: PACE SWMI |
$13.05
|
| Rate for Payer: PHP Commercial |
$44.36
|
| Rate for Payer: PHP Medicare Advantage |
$13.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.41
|
| Rate for Payer: Priority Health Medicare |
$13.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.32
|
| Rate for Payer: Railroad Medicare Medicare |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.93
|
| Rate for Payer: UHC Core |
$43.58
|
| Rate for Payer: UHC Exchange |
$13.05
|
| Rate for Payer: UHC Medicaid |
$9.20
|
| Rate for Payer: UHC Medicare Advantage |
$13.05
|
| Rate for Payer: UHCCP Medicaid |
$9.20
|
| Rate for Payer: VA VA |
$13.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.14
|
|
|
HC CARDIOLIPIN AB IGG
|
Facility
|
IP
|
$52.19
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200144
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.32 |
| Max. Negotiated Rate |
$46.97 |
| Rate for Payer: Aetna Commercial |
$44.36
|
| Rate for Payer: BCBS Trust/PPO |
$43.10
|
| Rate for Payer: BCN Commercial |
$43.10
|
| Rate for Payer: Cash Price |
$41.75
|
| Rate for Payer: Cofinity Commercial |
$44.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.75
|
| Rate for Payer: Healthscope Commercial |
$46.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.36
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.14
|
| Rate for Payer: PHP Commercial |
$44.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.93
|
| Rate for Payer: UHC Core |
$43.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.14
|
|
|
HC CARDIOLIPIN AB IGM
|
Facility
|
IP
|
$52.19
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.32 |
| Max. Negotiated Rate |
$46.97 |
| Rate for Payer: Aetna Commercial |
$44.36
|
| Rate for Payer: BCBS Trust/PPO |
$43.10
|
| Rate for Payer: BCN Commercial |
$43.10
|
| Rate for Payer: Cash Price |
$41.75
|
| Rate for Payer: Cofinity Commercial |
$44.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.75
|
| Rate for Payer: Healthscope Commercial |
$46.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.36
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.14
|
| Rate for Payer: PHP Commercial |
$44.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.93
|
| Rate for Payer: UHC Core |
$43.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.14
|
|
|
HC CARDIOLIPIN AB IGM
|
Facility
|
OP
|
$52.19
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$46.97 |
| Rate for Payer: Aetna Commercial |
$44.36
|
| Rate for Payer: Aetna Medicare |
$13.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.31
|
| Rate for Payer: BCBS Complete |
$9.66
|
| Rate for Payer: BCBS MAPPO |
$13.05
|
| Rate for Payer: BCBS Trust/PPO |
$42.91
|
| Rate for Payer: BCN Commercial |
$42.91
|
| Rate for Payer: BCN Medicare Advantage |
$13.05
|
| Rate for Payer: Cash Price |
$41.75
|
| Rate for Payer: Cofinity Commercial |
$44.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.05
|
| Rate for Payer: Healthscope Commercial |
$46.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.14
|
| Rate for Payer: Mclaren Medicaid |
$9.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.70
|
| Rate for Payer: Meridian Medicaid |
$9.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.36
|
| Rate for Payer: Nomi Health Commercial |
$42.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.14
|
| Rate for Payer: PACE Senior Care Partners |
$12.40
|
| Rate for Payer: PACE SWMI |
$13.05
|
| Rate for Payer: PHP Commercial |
$44.36
|
| Rate for Payer: PHP Medicare Advantage |
$13.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.41
|
| Rate for Payer: Priority Health Medicare |
$13.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.32
|
| Rate for Payer: Railroad Medicare Medicare |
$13.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.93
|
| Rate for Payer: UHC Core |
$43.58
|
| Rate for Payer: UHC Exchange |
$13.05
|
| Rate for Payer: UHC Medicaid |
$9.20
|
| Rate for Payer: UHC Medicare Advantage |
$13.05
|
| Rate for Payer: UHCCP Medicaid |
$9.20
|
| Rate for Payer: VA VA |
$13.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.14
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
OP
|
$525.85
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$92.71 |
| Max. Negotiated Rate |
$473.26 |
| Rate for Payer: Aetna Commercial |
$446.97
|
| Rate for Payer: Aetna Medicare |
$136.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$164.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$164.33
|
| Rate for Payer: BCBS Complete |
$97.33
|
| Rate for Payer: BCBS MAPPO |
$131.46
|
| Rate for Payer: BCBS Trust/PPO |
$432.30
|
| Rate for Payer: BCN Commercial |
$432.30
|
| Rate for Payer: BCN Medicare Advantage |
$131.46
|
| Rate for Payer: Cash Price |
$420.68
|
| Rate for Payer: Cofinity Commercial |
$452.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.46
|
| Rate for Payer: Healthscope Commercial |
$473.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$394.39
|
| Rate for Payer: Mclaren Medicaid |
$92.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.04
|
| Rate for Payer: Meridian Medicaid |
$97.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$151.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$144.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.97
|
| Rate for Payer: Nomi Health Commercial |
$431.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$394.39
|
| Rate for Payer: PACE Senior Care Partners |
$124.89
|
| Rate for Payer: PACE SWMI |
$131.46
|
| Rate for Payer: PHP Commercial |
$446.97
|
| Rate for Payer: PHP Medicare Advantage |
$131.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$457.49
|
| Rate for Payer: Priority Health Medicare |
$132.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$365.99
|
| Rate for Payer: Railroad Medicare Medicare |
$131.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.75
|
| Rate for Payer: UHC Core |
$439.08
|
| Rate for Payer: UHC Exchange |
$131.46
|
| Rate for Payer: UHC Medicaid |
$92.71
|
| Rate for Payer: UHC Medicare Advantage |
$131.46
|
| Rate for Payer: UHCCP Medicaid |
$92.71
|
| Rate for Payer: VA VA |
$131.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$394.39
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
IP
|
$525.85
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$365.99 |
| Max. Negotiated Rate |
$473.26 |
| Rate for Payer: Aetna Commercial |
$446.97
|
| Rate for Payer: BCBS Trust/PPO |
$434.30
|
| Rate for Payer: BCN Commercial |
$434.30
|
| Rate for Payer: Cash Price |
$420.68
|
| Rate for Payer: Cofinity Commercial |
$452.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.68
|
| Rate for Payer: Healthscope Commercial |
$473.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$394.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.97
|
| Rate for Payer: Nomi Health Commercial |
$431.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$394.39
|
| Rate for Payer: PHP Commercial |
$446.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$457.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$365.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.75
|
| Rate for Payer: UHC Core |
$439.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$394.39
|
|
|
HC CARDIOPULMONARY EX TEST
|
Facility
|
OP
|
$1,145.14
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
46000007
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$201.89 |
| Max. Negotiated Rate |
$1,030.63 |
| Rate for Payer: Aetna Commercial |
$973.37
|
| Rate for Payer: Aetna Medicare |
$297.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$357.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$357.86
|
| Rate for Payer: BCBS Complete |
$211.97
|
| Rate for Payer: BCBS MAPPO |
$286.29
|
| Rate for Payer: BCBS Trust/PPO |
$941.42
|
| Rate for Payer: BCN Commercial |
$941.42
|
| Rate for Payer: BCN Medicare Advantage |
$286.29
|
| Rate for Payer: Cash Price |
$916.11
|
| Rate for Payer: Cofinity Commercial |
$984.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.29
|
| Rate for Payer: Healthscope Commercial |
$1,030.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.86
|
| Rate for Payer: Mclaren Medicaid |
$201.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.60
|
| Rate for Payer: Meridian Medicaid |
$211.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$329.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$314.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.37
|
| Rate for Payer: Nomi Health Commercial |
$939.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.86
|
| Rate for Payer: PACE Senior Care Partners |
$271.97
|
| Rate for Payer: PACE SWMI |
$286.29
|
| Rate for Payer: PHP Commercial |
$973.37
|
| Rate for Payer: PHP Medicare Advantage |
$286.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$996.27
|
| Rate for Payer: Priority Health Medicare |
$289.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$797.02
|
| Rate for Payer: Railroad Medicare Medicare |
$286.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.72
|
| Rate for Payer: UHC Core |
$956.19
|
| Rate for Payer: UHC Exchange |
$286.29
|
| Rate for Payer: UHC Medicaid |
$201.89
|
| Rate for Payer: UHC Medicare Advantage |
$286.29
|
| Rate for Payer: UHCCP Medicaid |
$201.89
|
| Rate for Payer: VA VA |
$286.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.86
|
|
