|
HC EEG W/O VID 12-26 HRS CONT MNTR
|
Facility
|
IP
|
$2,754.67
|
|
|
Service Code
|
CPT 95710
|
| Hospital Charge Code |
74000031
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,680.07 |
| Max. Negotiated Rate |
$2,479.20 |
| Rate for Payer: Aetna Commercial |
$2,341.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,128.81
|
| Rate for Payer: BCN Commercial |
$2,128.81
|
| Rate for Payer: Cash Price |
$2,203.74
|
| Rate for Payer: Cofinity Commercial |
$2,369.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,203.74
|
| Rate for Payer: Healthscope Commercial |
$2,479.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,066.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,341.47
|
| Rate for Payer: PHP Commercial |
$2,341.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,928.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,396.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,680.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,424.11
|
| Rate for Payer: UHC Core |
$2,300.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,066.00
|
|
|
HC EEG W/O VID 12-26 HRS INTMT MNTR
|
Facility
|
OP
|
$2,754.67
|
|
|
Service Code
|
CPT 95709
|
| Hospital Charge Code |
74000030
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$351.60 |
| Max. Negotiated Rate |
$2,479.20 |
| Rate for Payer: Aetna Commercial |
$2,341.47
|
| Rate for Payer: Aetna Medicare |
$716.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$860.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$860.83
|
| Rate for Payer: BCBS Complete |
$369.18
|
| Rate for Payer: BCBS MAPPO |
$688.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,141.76
|
| Rate for Payer: BCN Commercial |
$2,141.76
|
| Rate for Payer: BCN Medicare Advantage |
$688.67
|
| Rate for Payer: Cash Price |
$2,203.74
|
| Rate for Payer: Cash Price |
$2,203.74
|
| Rate for Payer: Cofinity Commercial |
$2,369.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,203.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.67
|
| Rate for Payer: Healthscope Commercial |
$2,479.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,066.00
|
| Rate for Payer: Mclaren Medicaid |
$351.60
|
| Rate for Payer: Meridian Medicaid |
$369.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$723.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$791.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,341.47
|
| Rate for Payer: PACE Senior Care Partners |
$654.23
|
| Rate for Payer: PACE SWMI |
$688.67
|
| Rate for Payer: PHP Commercial |
$2,341.47
|
| Rate for Payer: PHP Medicare Advantage |
$688.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,928.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,396.56
|
| Rate for Payer: Priority Health Medicare |
$688.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,680.07
|
| Rate for Payer: Railroad Medicare Medicare |
$688.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,424.11
|
| Rate for Payer: UHC Core |
$2,300.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$688.67
|
| Rate for Payer: UHC Medicare Advantage |
$709.33
|
| Rate for Payer: VA VA |
$688.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,066.00
|
|
|
HC EEG W/O VID 12-26 HRS INTMT MNTR
|
Facility
|
IP
|
$2,754.67
|
|
|
Service Code
|
CPT 95709
|
| Hospital Charge Code |
74000030
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,680.07 |
| Max. Negotiated Rate |
$2,479.20 |
| Rate for Payer: Aetna Commercial |
$2,341.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,128.81
|
| Rate for Payer: BCN Commercial |
$2,128.81
|
| Rate for Payer: Cash Price |
$2,203.74
|
| Rate for Payer: Cofinity Commercial |
$2,369.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,203.74
|
| Rate for Payer: Healthscope Commercial |
$2,479.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,066.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,341.47
|
| Rate for Payer: PHP Commercial |
$2,341.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,928.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,396.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,680.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,424.11
|
| Rate for Payer: UHC Core |
$2,300.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,066.00
|
|
|
HC EEG W/O VID 2-12 HRS CONT MNTR
|
Facility
|
OP
|
$1,614.20
|
|
|
Service Code
|
CPT 95707
|
| Hospital Charge Code |
74000029
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$205.90 |
| Max. Negotiated Rate |
$1,452.78 |
| Rate for Payer: Aetna Commercial |
$1,372.07
|
| Rate for Payer: Aetna Medicare |
$419.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$504.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$504.44
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$403.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,255.04
|
| Rate for Payer: BCN Commercial |
$1,255.04
|
| Rate for Payer: BCN Medicare Advantage |
$403.55
|
| Rate for Payer: Cash Price |
$1,291.36
|
| Rate for Payer: Cash Price |
$1,291.36
|
| Rate for Payer: Cofinity Commercial |
$1,388.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.55
|
| Rate for Payer: Healthscope Commercial |
$1,452.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,210.65
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$423.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$464.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,372.07
|
| Rate for Payer: PACE Senior Care Partners |
$383.37
|
| Rate for Payer: PACE SWMI |
$403.55
|
| Rate for Payer: PHP Commercial |
$1,372.07
|
| Rate for Payer: PHP Medicare Advantage |
$403.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,404.35
|
| Rate for Payer: Priority Health Medicare |
$403.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$984.50
|
| Rate for Payer: Railroad Medicare Medicare |
$403.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.50
|
| Rate for Payer: UHC Core |
$1,347.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.55
|
| Rate for Payer: UHC Medicare Advantage |
$415.66
|
| Rate for Payer: VA VA |
$403.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,210.65
|
|
|
HC EEG W/O VID 2-12 HRS CONT MNTR
|
Facility
|
IP
|
$1,614.20
|
|
|
Service Code
|
CPT 95707
|
| Hospital Charge Code |
74000029
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$984.50 |
| Max. Negotiated Rate |
$1,452.78 |
| Rate for Payer: Aetna Commercial |
$1,372.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,247.45
|
| Rate for Payer: BCN Commercial |
$1,247.45
|
| Rate for Payer: Cash Price |
$1,291.36
|
| Rate for Payer: Cofinity Commercial |
$1,388.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.36
|
| Rate for Payer: Healthscope Commercial |
$1,452.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,210.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,372.07
|
| Rate for Payer: PHP Commercial |
$1,372.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,404.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$984.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.50
|
| Rate for Payer: UHC Core |
$1,347.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,210.65
|
|
|
HC EEG W/O VID 2-12 HRS INTMT MNTR
|
Facility
|
OP
|
$1,614.01
|
|
|
Service Code
|
CPT 95706
|
| Hospital Charge Code |
74000028
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$205.90 |
| Max. Negotiated Rate |
$1,452.61 |
| Rate for Payer: Aetna Commercial |
$1,371.91
|
| Rate for Payer: Aetna Medicare |
$419.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$504.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$504.38
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$403.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.89
|
| Rate for Payer: BCN Commercial |
$1,254.89
|
| Rate for Payer: BCN Medicare Advantage |
$403.50
|
| Rate for Payer: Cash Price |
$1,291.21
|
| Rate for Payer: Cash Price |
$1,291.21
|
| Rate for Payer: Cofinity Commercial |
$1,388.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.50
|
| Rate for Payer: Healthscope Commercial |
$1,452.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,210.51
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$423.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$464.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,371.91
|
| Rate for Payer: PACE Senior Care Partners |
$383.33
|
| Rate for Payer: PACE SWMI |
$403.50
|
| Rate for Payer: PHP Commercial |
$1,371.91
|
| Rate for Payer: PHP Medicare Advantage |
$403.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,404.19
|
| Rate for Payer: Priority Health Medicare |
$403.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$984.38
|
| Rate for Payer: Railroad Medicare Medicare |
$403.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.33
|
| Rate for Payer: UHC Core |
$1,347.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.50
|
| Rate for Payer: UHC Medicare Advantage |
$415.61
|
| Rate for Payer: VA VA |
$403.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,210.51
|
|
|
HC EEG W/O VID 2-12 HRS INTMT MNTR
|
Facility
|
IP
|
$1,614.01
|
|
|
Service Code
|
CPT 95706
|
| Hospital Charge Code |
74000028
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$984.38 |
| Max. Negotiated Rate |
$1,452.61 |
| Rate for Payer: Aetna Commercial |
$1,371.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,247.31
|
| Rate for Payer: BCN Commercial |
$1,247.31
|
| Rate for Payer: Cash Price |
$1,291.21
|
| Rate for Payer: Cofinity Commercial |
$1,388.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.21
|
| Rate for Payer: Healthscope Commercial |
$1,452.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,210.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,371.91
|
| Rate for Payer: PHP Commercial |
$1,371.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,404.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$984.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.33
|
| Rate for Payer: UHC Core |
$1,347.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,210.51
|
|
|
HC EEG W/O VID 2-12 HR UNMNTR
|
Facility
|
OP
|
$1,001.24
|
|
|
Service Code
|
CPT 95705
|
| Hospital Charge Code |
74000020
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$205.90 |
| Max. Negotiated Rate |
$901.12 |
| Rate for Payer: Aetna Commercial |
$851.05
|
| Rate for Payer: Aetna Medicare |
$260.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$312.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$312.89
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$250.31
|
| Rate for Payer: BCBS Trust/PPO |
$778.46
|
| Rate for Payer: BCN Commercial |
$778.46
|
| Rate for Payer: BCN Medicare Advantage |
$250.31
|
| Rate for Payer: Cash Price |
$800.99
|
| Rate for Payer: Cash Price |
$800.99
|
| Rate for Payer: Cofinity Commercial |
$861.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.31
|
| Rate for Payer: Healthscope Commercial |
$901.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.93
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$262.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$287.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$851.05
|
| Rate for Payer: PACE Senior Care Partners |
$237.79
|
| Rate for Payer: PACE SWMI |
$250.31
|
| Rate for Payer: PHP Commercial |
$851.05
|
| Rate for Payer: PHP Medicare Advantage |
$250.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$871.08
|
| Rate for Payer: Priority Health Medicare |
$250.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$610.66
|
| Rate for Payer: Railroad Medicare Medicare |
$250.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$881.09
|
| Rate for Payer: UHC Core |
$836.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$250.31
|
| Rate for Payer: UHC Medicare Advantage |
$257.82
|
| Rate for Payer: VA VA |
$250.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.93
|
|
|
HC EEG W/O VID 2-12 HR UNMNTR
|
Facility
|
IP
|
$1,001.24
|
|
|
Service Code
|
CPT 95705
|
| Hospital Charge Code |
74000020
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$610.66 |
| Max. Negotiated Rate |
$901.12 |
| Rate for Payer: Aetna Commercial |
$851.05
|
| Rate for Payer: BCBS Trust/PPO |
$773.76
|
| Rate for Payer: BCN Commercial |
$773.76
|
| Rate for Payer: Cash Price |
$800.99
|
| Rate for Payer: Cofinity Commercial |
$861.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.99
|
| Rate for Payer: Healthscope Commercial |
$901.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$851.05
|
| Rate for Payer: PHP Commercial |
$851.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$871.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$610.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$881.09
|
| Rate for Payer: UHC Core |
$836.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.93
|
|
|
HC EEG W/O VID EA 12-26 HR UNMNTR
|
Facility
|
OP
|
$1,921.04
|
|
|
Service Code
|
CPT 95708
|
| Hospital Charge Code |
74000021
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$351.60 |
| Max. Negotiated Rate |
$1,728.94 |
| Rate for Payer: Aetna Commercial |
$1,632.88
|
| Rate for Payer: Aetna Medicare |
$499.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$600.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$600.32
|
| Rate for Payer: BCBS Complete |
$369.18
|
| Rate for Payer: BCBS MAPPO |
$480.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,493.61
|
| Rate for Payer: BCN Commercial |
$1,493.61
|
| Rate for Payer: BCN Medicare Advantage |
$480.26
|
| Rate for Payer: Cash Price |
$1,536.83
|
| Rate for Payer: Cash Price |
$1,536.83
|
| Rate for Payer: Cofinity Commercial |
$1,652.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,536.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.26
|
| Rate for Payer: Healthscope Commercial |
$1,728.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,440.78
|
| Rate for Payer: Mclaren Medicaid |
$351.60
|
| Rate for Payer: Meridian Medicaid |
$369.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$504.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$552.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,632.88
|
| Rate for Payer: PACE Senior Care Partners |
$456.25
|
| Rate for Payer: PACE SWMI |
$480.26
|
| Rate for Payer: PHP Commercial |
$1,632.88
|
| Rate for Payer: PHP Medicare Advantage |
$480.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,671.30
|
| Rate for Payer: Priority Health Medicare |
$480.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,171.64
|
| Rate for Payer: Railroad Medicare Medicare |
$480.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,690.52
|
| Rate for Payer: UHC Core |
$1,604.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$480.26
|
| Rate for Payer: UHC Medicare Advantage |
$494.67
|
| Rate for Payer: VA VA |
$480.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,440.78
|
|
|
HC EEG W/O VID EA 12-26 HR UNMNTR
|
Facility
|
IP
|
$1,921.04
|
|
|
Service Code
|
CPT 95708
|
| Hospital Charge Code |
74000021
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,171.64 |
| Max. Negotiated Rate |
$1,728.94 |
| Rate for Payer: Aetna Commercial |
$1,632.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,484.58
|
| Rate for Payer: BCN Commercial |
$1,484.58
|
| Rate for Payer: Cash Price |
$1,536.83
|
| Rate for Payer: Cofinity Commercial |
$1,652.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,536.83
|
| Rate for Payer: Healthscope Commercial |
$1,728.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,440.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,632.88
|
| Rate for Payer: PHP Commercial |
$1,632.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,671.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,171.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,690.52
|
| Rate for Payer: UHC Core |
$1,604.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,440.78
|
|
|
HC EGD W EUS EXAM ESOPH ONLY
|
Facility
|
OP
|
$2,796.13
|
|
| Hospital Charge Code |
36000035
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$664.08 |
| Max. Negotiated Rate |
$2,516.52 |
| Rate for Payer: Aetna Commercial |
$2,376.71
|
| Rate for Payer: Aetna Medicare |
$726.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$873.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$873.79
|
| Rate for Payer: BCBS Complete |
$1,118.45
|
| Rate for Payer: BCBS MAPPO |
$699.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,173.99
|
| Rate for Payer: BCN Commercial |
$2,173.99
|
| Rate for Payer: BCN Medicare Advantage |
$699.03
|
| Rate for Payer: Cash Price |
$2,236.90
|
| Rate for Payer: Cofinity Commercial |
$2,404.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,236.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$699.03
|
| Rate for Payer: Healthscope Commercial |
$2,516.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,097.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$733.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$803.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,376.71
|
| Rate for Payer: PACE Senior Care Partners |
$664.08
|
| Rate for Payer: PACE SWMI |
$699.03
|
| Rate for Payer: PHP Commercial |
$2,376.71
|
| Rate for Payer: PHP Medicare Advantage |
$699.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,957.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,432.63
|
| Rate for Payer: Priority Health Medicare |
$699.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,705.36
|
| Rate for Payer: Railroad Medicare Medicare |
$699.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,460.59
|
| Rate for Payer: UHC Core |
$2,334.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$699.03
|
| Rate for Payer: UHC Medicare Advantage |
$720.00
|
| Rate for Payer: VA VA |
$699.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,097.10
|
|
|
HC EGD W EUS EXAM ESOPH ONLY
|
Facility
|
IP
|
$2,796.13
|
|
| Hospital Charge Code |
36000035
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,705.36 |
| Max. Negotiated Rate |
$2,516.52 |
| Rate for Payer: Aetna Commercial |
$2,376.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,160.85
|
| Rate for Payer: BCN Commercial |
$2,160.85
|
| Rate for Payer: Cash Price |
$2,236.90
|
| Rate for Payer: Cofinity Commercial |
$2,404.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,236.90
|
| Rate for Payer: Healthscope Commercial |
$2,516.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,097.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,376.71
|
| Rate for Payer: PHP Commercial |
$2,376.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,957.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,432.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,705.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,460.59
|
| Rate for Payer: UHC Core |
$2,334.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,097.10
|
|
|
HC EGD W EUS EXAM ESOPH,STOM,DUO,
|
Facility
|
IP
|
$2,920.68
|
|
| Hospital Charge Code |
36000036
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,781.32 |
| Max. Negotiated Rate |
$2,628.61 |
| Rate for Payer: Aetna Commercial |
$2,482.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,257.10
|
| Rate for Payer: BCN Commercial |
$2,257.10
|
| Rate for Payer: Cash Price |
$2,336.54
|
| Rate for Payer: Cofinity Commercial |
$2,511.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,336.54
|
| Rate for Payer: Healthscope Commercial |
$2,628.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,190.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,482.58
|
| Rate for Payer: PHP Commercial |
$2,482.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,044.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,540.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,781.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,570.20
|
| Rate for Payer: UHC Core |
$2,438.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,190.51
|
|
|
HC EGD W EUS EXAM ESOPH,STOM,DUO,
|
Facility
|
OP
|
$2,920.68
|
|
| Hospital Charge Code |
36000036
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$693.66 |
| Max. Negotiated Rate |
$2,628.61 |
| Rate for Payer: Aetna Commercial |
$2,482.58
|
| Rate for Payer: Aetna Medicare |
$759.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$912.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$912.71
|
| Rate for Payer: BCBS Complete |
$1,168.27
|
| Rate for Payer: BCBS MAPPO |
$730.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,270.83
|
| Rate for Payer: BCN Commercial |
$2,270.83
|
| Rate for Payer: BCN Medicare Advantage |
$730.17
|
| Rate for Payer: Cash Price |
$2,336.54
|
| Rate for Payer: Cofinity Commercial |
$2,511.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,336.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$730.17
|
| Rate for Payer: Healthscope Commercial |
$2,628.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,190.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$766.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$839.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,482.58
|
| Rate for Payer: PACE Senior Care Partners |
$693.66
|
| Rate for Payer: PACE SWMI |
$730.17
|
| Rate for Payer: PHP Commercial |
$2,482.58
|
| Rate for Payer: PHP Medicare Advantage |
$730.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,044.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,540.99
|
| Rate for Payer: Priority Health Medicare |
$730.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,781.32
|
| Rate for Payer: Railroad Medicare Medicare |
$730.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,570.20
|
| Rate for Payer: UHC Core |
$2,438.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$730.17
|
| Rate for Payer: UHC Medicare Advantage |
$752.08
|
| Rate for Payer: VA VA |
$730.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,190.51
|
|
|
HC EGG WHITE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200041
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC EGG WHITE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200041
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC EGG YOLK, IGE
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200482
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.66 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$23.65
|
| Rate for Payer: BCN Commercial |
$23.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC EGG YOLK, IGE
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200482
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.56
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$23.79
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.65
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PACE Senior Care Partners |
$7.27
|
| Rate for Payer: PACE SWMI |
$7.65
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.62
|
| Rate for Payer: Priority Health Medicare |
$7.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.66
|
| Rate for Payer: Railroad Medicare Medicare |
$7.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.65
|
| Rate for Payer: UHC Medicare Advantage |
$7.88
|
| Rate for Payer: VA VA |
$7.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC EKG RHYTHM STRIP
|
Facility
|
OP
|
$72.41
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000002
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$65.17 |
| Rate for Payer: Aetna Commercial |
$61.55
|
| Rate for Payer: Aetna Medicare |
$18.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.63
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$18.10
|
| Rate for Payer: BCBS Trust/PPO |
$56.30
|
| Rate for Payer: BCN Commercial |
$56.30
|
| Rate for Payer: BCN Medicare Advantage |
$18.10
|
| Rate for Payer: Cash Price |
$57.93
|
| Rate for Payer: Cash Price |
$57.93
|
| Rate for Payer: Cofinity Commercial |
$62.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.10
|
| Rate for Payer: Healthscope Commercial |
$65.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.31
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.55
|
| Rate for Payer: PACE Senior Care Partners |
$17.20
|
| Rate for Payer: PACE SWMI |
$18.10
|
| Rate for Payer: PHP Commercial |
$61.55
|
| Rate for Payer: PHP Medicare Advantage |
$18.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.00
|
| Rate for Payer: Priority Health Medicare |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.16
|
| Rate for Payer: Railroad Medicare Medicare |
$18.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.72
|
| Rate for Payer: UHC Core |
$60.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.10
|
| Rate for Payer: UHC Medicare Advantage |
$18.65
|
| Rate for Payer: VA VA |
$18.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.31
|
|
|
HC EKG RHYTHM STRIP
|
Facility
|
IP
|
$72.41
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000002
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$44.16 |
| Max. Negotiated Rate |
$65.17 |
| Rate for Payer: Aetna Commercial |
$61.55
|
| Rate for Payer: BCBS Trust/PPO |
$55.96
|
| Rate for Payer: BCN Commercial |
$55.96
|
| Rate for Payer: Cash Price |
$57.93
|
| Rate for Payer: Cofinity Commercial |
$62.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$65.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.55
|
| Rate for Payer: PHP Commercial |
$61.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.72
|
| Rate for Payer: UHC Core |
$60.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.31
|
|
|
HC EKG TRACING FOR INITIAL PREV
|
Facility
|
IP
|
$35.68
|
|
|
Service Code
|
HCPCS G0404
|
| Hospital Charge Code |
73000004
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$21.76 |
| Max. Negotiated Rate |
$32.11 |
| Rate for Payer: Aetna Commercial |
$30.33
|
| Rate for Payer: BCBS Trust/PPO |
$27.57
|
| Rate for Payer: BCN Commercial |
$27.57
|
| Rate for Payer: Cash Price |
$28.54
|
| Rate for Payer: Cofinity Commercial |
$30.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.54
|
| Rate for Payer: Healthscope Commercial |
$32.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.33
|
| Rate for Payer: PHP Commercial |
$30.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.40
|
| Rate for Payer: UHC Core |
$29.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.76
|
|
|
HC EKG TRACING FOR INITIAL PREV
|
Facility
|
OP
|
$35.68
|
|
|
Service Code
|
HCPCS G0404
|
| Hospital Charge Code |
73000004
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$8.47 |
| Max. Negotiated Rate |
$32.11 |
| Rate for Payer: Aetna Commercial |
$30.33
|
| Rate for Payer: Aetna Medicare |
$9.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.15
|
| Rate for Payer: BCBS Complete |
$20.51
|
| Rate for Payer: BCBS MAPPO |
$8.92
|
| Rate for Payer: BCBS Trust/PPO |
$27.74
|
| Rate for Payer: BCN Commercial |
$27.74
|
| Rate for Payer: BCN Medicare Advantage |
$8.92
|
| Rate for Payer: Cash Price |
$28.54
|
| Rate for Payer: Cash Price |
$28.54
|
| Rate for Payer: Cofinity Commercial |
$30.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.92
|
| Rate for Payer: Healthscope Commercial |
$32.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.76
|
| Rate for Payer: Mclaren Medicaid |
$19.53
|
| Rate for Payer: Meridian Medicaid |
$20.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.33
|
| Rate for Payer: PACE Senior Care Partners |
$8.47
|
| Rate for Payer: PACE SWMI |
$8.92
|
| Rate for Payer: PHP Commercial |
$30.33
|
| Rate for Payer: PHP Medicare Advantage |
$8.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.04
|
| Rate for Payer: Priority Health Medicare |
$8.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.76
|
| Rate for Payer: Railroad Medicare Medicare |
$8.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.40
|
| Rate for Payer: UHC Core |
$29.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.92
|
| Rate for Payer: UHC Medicare Advantage |
$9.19
|
| Rate for Payer: VA VA |
$8.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.76
|
|
|
HC EKO INFUSION SYSTEM
|
Facility
|
OP
|
$7,545.17
|
|
| Hospital Charge Code |
27200279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,791.98 |
| Max. Negotiated Rate |
$6,790.65 |
| Rate for Payer: Aetna Commercial |
$6,413.39
|
| Rate for Payer: Aetna Medicare |
$1,961.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,357.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,357.87
|
| Rate for Payer: BCBS Complete |
$3,018.07
|
| Rate for Payer: BCBS MAPPO |
$1,886.29
|
| Rate for Payer: BCBS Trust/PPO |
$5,866.37
|
| Rate for Payer: BCN Commercial |
$5,866.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,886.29
|
| Rate for Payer: Cash Price |
$6,036.14
|
| Rate for Payer: Cofinity Commercial |
$6,488.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,036.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,886.29
|
| Rate for Payer: Healthscope Commercial |
$6,790.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,658.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,980.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,169.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,413.39
|
| Rate for Payer: PACE Senior Care Partners |
$1,791.98
|
| Rate for Payer: PACE SWMI |
$1,886.29
|
| Rate for Payer: PHP Commercial |
$6,413.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,886.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,281.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,564.30
|
| Rate for Payer: Priority Health Medicare |
$1,886.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,601.80
|
| Rate for Payer: Railroad Medicare Medicare |
$1,886.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,639.75
|
| Rate for Payer: UHC Core |
$6,300.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,886.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,942.88
|
| Rate for Payer: VA VA |
$1,886.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,658.88
|
|
|
HC EKO INFUSION SYSTEM
|
Facility
|
IP
|
$7,545.17
|
|
| Hospital Charge Code |
27200279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,601.80 |
| Max. Negotiated Rate |
$6,790.65 |
| Rate for Payer: Aetna Commercial |
$6,413.39
|
| Rate for Payer: BCBS Trust/PPO |
$5,830.91
|
| Rate for Payer: BCN Commercial |
$5,830.91
|
| Rate for Payer: Cash Price |
$6,036.14
|
| Rate for Payer: Cofinity Commercial |
$6,488.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,036.14
|
| Rate for Payer: Healthscope Commercial |
$6,790.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,658.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,413.39
|
| Rate for Payer: PHP Commercial |
$6,413.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,281.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,564.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,601.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,639.75
|
| Rate for Payer: UHC Core |
$6,300.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,658.88
|
|
