|
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
|
|
|
HC CARDIOVERSION
|
Facility
|
OP
|
$1,232.88
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
48000002
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$217.36 |
| Max. Negotiated Rate |
$1,109.59 |
| Rate for Payer: Aetna Commercial |
$1,047.95
|
| Rate for Payer: Aetna Medicare |
$320.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$385.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$385.27
|
| Rate for Payer: BCBS Complete |
$228.21
|
| Rate for Payer: BCBS MAPPO |
$308.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,013.55
|
| Rate for Payer: BCN Commercial |
$1,013.55
|
| Rate for Payer: BCN Medicare Advantage |
$308.22
|
| Rate for Payer: Cash Price |
$986.30
|
| Rate for Payer: Cofinity Commercial |
$1,060.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.22
|
| Rate for Payer: Healthscope Commercial |
$1,109.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.66
|
| Rate for Payer: Mclaren Medicaid |
$217.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.63
|
| Rate for Payer: Meridian Medicaid |
$228.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$354.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$339.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.95
|
| Rate for Payer: Nomi Health Commercial |
$1,010.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$924.66
|
| Rate for Payer: PACE Senior Care Partners |
$292.81
|
| Rate for Payer: PACE SWMI |
$308.22
|
| Rate for Payer: PHP Commercial |
$1,047.95
|
| Rate for Payer: PHP Medicare Advantage |
$308.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,072.61
|
| Rate for Payer: Priority Health Medicare |
$311.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$858.08
|
| Rate for Payer: Railroad Medicare Medicare |
$308.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,084.93
|
| Rate for Payer: UHC Core |
$1,029.45
|
| Rate for Payer: UHC Exchange |
$308.22
|
| Rate for Payer: UHC Medicaid |
$217.36
|
| Rate for Payer: UHC Medicare Advantage |
$308.22
|
| Rate for Payer: UHCCP Medicaid |
$217.36
|
| Rate for Payer: VA VA |
$308.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.66
|
|
|
HC CARDIOVERSION
|
Facility
|
IP
|
$1,232.88
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
48000002
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$858.08 |
| Max. Negotiated Rate |
$1,109.59 |
| Rate for Payer: Aetna Commercial |
$1,047.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,018.24
|
| Rate for Payer: BCN Commercial |
$1,018.24
|
| Rate for Payer: Cash Price |
$986.30
|
| Rate for Payer: Cofinity Commercial |
$1,060.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.30
|
| Rate for Payer: Healthscope Commercial |
$1,109.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.95
|
| Rate for Payer: Nomi Health Commercial |
$1,010.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$924.66
|
| Rate for Payer: PHP Commercial |
$1,047.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,072.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$858.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,084.93
|
| Rate for Payer: UHC Core |
$1,029.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.66
|
|
|
HC CARDIOVERSION EXT
|
Facility
|
OP
|
$1,018.16
|
|
| Hospital Charge Code |
45000034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$916.34 |
| Rate for Payer: Aetna Commercial |
$865.44
|
| Rate for Payer: Aetna Medicare |
$264.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$318.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$318.18
|
| Rate for Payer: BCBS Complete |
$188.46
|
| Rate for Payer: BCBS MAPPO |
$254.54
|
| Rate for Payer: BCBS Trust/PPO |
$837.03
|
| Rate for Payer: BCN Commercial |
$837.03
|
| Rate for Payer: BCN Medicare Advantage |
$254.54
|
| Rate for Payer: Cash Price |
$814.53
|
| Rate for Payer: Cash Price |
$814.53
|
| Rate for Payer: Cofinity Commercial |
$875.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$814.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.54
|
| Rate for Payer: Healthscope Commercial |
$916.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$763.62
|
| Rate for Payer: Mclaren Medicaid |
$179.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$267.27
|
| Rate for Payer: Meridian Medicaid |
$188.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$292.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$279.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$865.44
|
| Rate for Payer: Nomi Health Commercial |
$834.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$763.62
|
| Rate for Payer: PACE Senior Care Partners |
$241.81
|
| Rate for Payer: PACE SWMI |
$254.54
|
| Rate for Payer: PHP Commercial |
$865.44
|
| Rate for Payer: PHP Medicare Advantage |
$254.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$885.80
|
| Rate for Payer: Priority Health Medicare |
$257.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$708.64
|
| Rate for Payer: Railroad Medicare Medicare |
$254.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$895.98
|
| Rate for Payer: UHC Core |
$850.16
|
| Rate for Payer: UHC Exchange |
$254.54
|
| Rate for Payer: UHC Medicaid |
$179.50
|
| Rate for Payer: UHC Medicare Advantage |
$254.54
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$254.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$763.62
|
|
|
HC CARDIOVERSION EXT
|
Facility
|
IP
|
$1,018.16
|
|
| Hospital Charge Code |
45000034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$708.64 |
| Max. Negotiated Rate |
$916.34 |
| Rate for Payer: Aetna Commercial |
$865.44
|
| Rate for Payer: BCBS Trust/PPO |
$840.90
|
| Rate for Payer: BCN Commercial |
$840.90
|
| Rate for Payer: Cash Price |
$814.53
|
| Rate for Payer: Cofinity Commercial |
$875.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$814.53
|
| Rate for Payer: Healthscope Commercial |
$916.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$763.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$865.44
|
| Rate for Payer: Nomi Health Commercial |
$834.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$763.62
|
| Rate for Payer: PHP Commercial |
$865.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$885.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$708.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$895.98
|
| Rate for Payer: UHC Core |
$850.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$763.62
|
|
|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
IP
|
$54.12
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$37.67 |
| Max. Negotiated Rate |
$48.71 |
| Rate for Payer: Aetna Commercial |
$46.00
|
| Rate for Payer: BCBS Trust/PPO |
$44.70
|
| Rate for Payer: BCN Commercial |
$44.70
|
| Rate for Payer: Cash Price |
$43.30
|
| Rate for Payer: Cofinity Commercial |
$46.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.30
|
| Rate for Payer: Healthscope Commercial |
$48.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.00
|
| Rate for Payer: Nomi Health Commercial |
$44.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.59
|
| Rate for Payer: PHP Commercial |
$46.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.63
|
| Rate for Payer: UHC Core |
$45.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.59
|
|
|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
OP
|
$54.12
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$9.54 |
| Max. Negotiated Rate |
$48.71 |
| Rate for Payer: Aetna Commercial |
$46.00
|
| Rate for Payer: Aetna Medicare |
$14.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.91
|
| Rate for Payer: BCBS Complete |
$10.02
|
| Rate for Payer: BCBS MAPPO |
$13.53
|
| Rate for Payer: BCBS Trust/PPO |
$44.49
|
| Rate for Payer: BCN Commercial |
$44.49
|
| Rate for Payer: BCN Medicare Advantage |
$13.53
|
| Rate for Payer: Cash Price |
$43.30
|
| Rate for Payer: Cofinity Commercial |
$46.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.53
|
| Rate for Payer: Healthscope Commercial |
$48.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.59
|
| Rate for Payer: Mclaren Medicaid |
$9.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.21
|
| Rate for Payer: Meridian Medicaid |
$10.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.00
|
| Rate for Payer: Nomi Health Commercial |
$44.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.59
|
| Rate for Payer: PACE Senior Care Partners |
$12.85
|
| Rate for Payer: PACE SWMI |
$13.53
|
| Rate for Payer: PHP Commercial |
$46.00
|
| Rate for Payer: PHP Medicare Advantage |
$13.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.08
|
| Rate for Payer: Priority Health Medicare |
$13.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.67
|
| Rate for Payer: Railroad Medicare Medicare |
$13.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.63
|
| Rate for Payer: UHC Core |
$45.19
|
| Rate for Payer: UHC Exchange |
$13.53
|
| Rate for Payer: UHC Medicaid |
$9.54
|
| Rate for Payer: UHC Medicare Advantage |
$13.53
|
| Rate for Payer: UHCCP Medicaid |
$9.54
|
| Rate for Payer: VA VA |
$13.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.59
|
|
|
HC CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Facility
|
IP
|
$83.83
|
|
|
Service Code
|
CPT 99484
|
| Hospital Charge Code |
51000107
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$58.35 |
| Max. Negotiated Rate |
$75.45 |
| Rate for Payer: Aetna Commercial |
$71.26
|
| Rate for Payer: BCBS Trust/PPO |
$69.24
|
| Rate for Payer: BCN Commercial |
$69.24
|
| Rate for Payer: Cash Price |
$67.06
|
| Rate for Payer: Cofinity Commercial |
$72.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.06
|
| Rate for Payer: Healthscope Commercial |
$75.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.26
|
| Rate for Payer: Nomi Health Commercial |
$68.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.87
|
| Rate for Payer: PHP Commercial |
$71.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$72.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.77
|
| Rate for Payer: UHC Core |
$70.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.87
|
|
|
HC CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Facility
|
OP
|
$83.83
|
|
|
Service Code
|
CPT 99484
|
| Hospital Charge Code |
51000107
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$75.45 |
| Rate for Payer: Aetna Commercial |
$71.26
|
| Rate for Payer: Aetna Medicare |
$21.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.20
|
| Rate for Payer: BCBS Complete |
$15.52
|
| Rate for Payer: BCBS MAPPO |
$20.96
|
| Rate for Payer: BCBS Trust/PPO |
$68.92
|
| Rate for Payer: BCN Commercial |
$68.92
|
| Rate for Payer: BCN Medicare Advantage |
$20.96
|
| Rate for Payer: Cash Price |
$67.06
|
| Rate for Payer: Cofinity Commercial |
$72.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.96
|
| Rate for Payer: Healthscope Commercial |
$75.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.87
|
| Rate for Payer: Mclaren Medicaid |
$14.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.01
|
| Rate for Payer: Meridian Medicaid |
$15.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.26
|
| Rate for Payer: Nomi Health Commercial |
$68.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.87
|
| Rate for Payer: PACE Senior Care Partners |
$19.91
|
| Rate for Payer: PACE SWMI |
$20.96
|
| Rate for Payer: PHP Commercial |
$71.26
|
| Rate for Payer: PHP Medicare Advantage |
$20.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$72.93
|
| Rate for Payer: Priority Health Medicare |
$21.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.35
|
| Rate for Payer: Railroad Medicare Medicare |
$20.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.77
|
| Rate for Payer: UHC Core |
$70.00
|
| Rate for Payer: UHC Exchange |
$20.96
|
| Rate for Payer: UHC Medicaid |
$14.78
|
| Rate for Payer: UHC Medicare Advantage |
$20.96
|
| Rate for Payer: UHCCP Medicaid |
$14.78
|
| Rate for Payer: VA VA |
$20.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.87
|
|
|
HC CARNITINE
|
Facility
|
OP
|
$60.34
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.64 |
| Max. Negotiated Rate |
$54.31 |
| Rate for Payer: Aetna Commercial |
$51.29
|
| Rate for Payer: Aetna Medicare |
$15.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.86
|
| Rate for Payer: BCBS Complete |
$11.17
|
| Rate for Payer: BCBS MAPPO |
$15.09
|
| Rate for Payer: BCBS Trust/PPO |
$49.61
|
| Rate for Payer: BCN Commercial |
$49.61
|
| Rate for Payer: BCN Medicare Advantage |
$15.09
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cofinity Commercial |
$51.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.09
|
| Rate for Payer: Healthscope Commercial |
$54.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.26
|
| Rate for Payer: Mclaren Medicaid |
$10.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.84
|
| Rate for Payer: Meridian Medicaid |
$11.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.29
|
| Rate for Payer: Nomi Health Commercial |
$49.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.26
|
| Rate for Payer: PACE Senior Care Partners |
$14.33
|
| Rate for Payer: PACE SWMI |
$15.09
|
| Rate for Payer: PHP Commercial |
$51.29
|
| Rate for Payer: PHP Medicare Advantage |
$15.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.50
|
| Rate for Payer: Priority Health Medicare |
$15.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.00
|
| Rate for Payer: Railroad Medicare Medicare |
$15.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.10
|
| Rate for Payer: UHC Core |
$50.38
|
| Rate for Payer: UHC Exchange |
$15.09
|
| Rate for Payer: UHC Medicaid |
$10.64
|
| Rate for Payer: UHC Medicare Advantage |
$15.09
|
| Rate for Payer: UHCCP Medicaid |
$10.64
|
| Rate for Payer: VA VA |
$15.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.26
|
|
|
HC CARNITINE
|
Facility
|
IP
|
$60.34
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$54.31 |
| Rate for Payer: Aetna Commercial |
$51.29
|
| Rate for Payer: BCBS Trust/PPO |
$49.83
|
| Rate for Payer: BCN Commercial |
$49.83
|
| Rate for Payer: Cash Price |
$48.27
|
| Rate for Payer: Cofinity Commercial |
$51.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.27
|
| Rate for Payer: Healthscope Commercial |
$54.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.29
|
| Rate for Payer: Nomi Health Commercial |
$49.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.26
|
| Rate for Payer: PHP Commercial |
$51.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.10
|
| Rate for Payer: UHC Core |
$50.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.26
|
|
|
HC CAR OBSERVATION PER HOUR
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna Medicare |
$41.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.00
|
| Rate for Payer: BCBS Complete |
$29.62
|
| Rate for Payer: BCBS MAPPO |
$40.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.54
|
| Rate for Payer: BCN Commercial |
$131.54
|
| Rate for Payer: BCN Medicare Advantage |
$40.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Mclaren Medicaid |
$28.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.00
|
| Rate for Payer: Meridian Medicaid |
$29.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PACE Senior Care Partners |
$38.00
|
| Rate for Payer: PACE SWMI |
$40.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: PHP Medicare Advantage |
$40.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: Railroad Medicare Medicare |
$40.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: UHC Exchange |
$40.00
|
| Rate for Payer: UHC Medicaid |
$28.21
|
| Rate for Payer: UHC Medicare Advantage |
$40.00
|
| Rate for Payer: UHCCP Medicaid |
$850.00
|
| Rate for Payer: VA VA |
$40.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC CAR OBSERVATION PER HOUR
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$111.36 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: BCBS Trust/PPO |
$132.14
|
| Rate for Payer: BCN Commercial |
$132.14
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC CAROTENE
|
Facility
|
IP
|
$153.98
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
30100137
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$107.17 |
| Max. Negotiated Rate |
$138.58 |
| Rate for Payer: Aetna Commercial |
$130.88
|
| Rate for Payer: BCBS Trust/PPO |
$127.17
|
| Rate for Payer: BCN Commercial |
$127.17
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$132.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Healthscope Commercial |
$138.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.88
|
| Rate for Payer: Nomi Health Commercial |
$126.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.48
|
| Rate for Payer: PHP Commercial |
$130.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$133.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.50
|
| Rate for Payer: UHC Core |
$128.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.48
|
|
|
HC CAROTENE
|
Facility
|
OP
|
$153.98
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
30100137
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$138.58 |
| Rate for Payer: Aetna Commercial |
$130.88
|
| Rate for Payer: Aetna Medicare |
$40.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.12
|
| Rate for Payer: BCBS Complete |
$28.50
|
| Rate for Payer: BCBS MAPPO |
$38.49
|
| Rate for Payer: BCBS Trust/PPO |
$126.59
|
| Rate for Payer: BCN Commercial |
$126.59
|
| Rate for Payer: BCN Medicare Advantage |
$38.49
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$132.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.49
|
| Rate for Payer: Healthscope Commercial |
$138.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.48
|
| Rate for Payer: Mclaren Medicaid |
$27.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.42
|
| Rate for Payer: Meridian Medicaid |
$28.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.88
|
| Rate for Payer: Nomi Health Commercial |
$126.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$115.48
|
| Rate for Payer: PACE Senior Care Partners |
$36.57
|
| Rate for Payer: PACE SWMI |
$38.49
|
| Rate for Payer: PHP Commercial |
$130.88
|
| Rate for Payer: PHP Medicare Advantage |
$38.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$133.96
|
| Rate for Payer: Priority Health Medicare |
$38.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.17
|
| Rate for Payer: Railroad Medicare Medicare |
$38.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.50
|
| Rate for Payer: UHC Core |
$128.57
|
| Rate for Payer: UHC Exchange |
$38.49
|
| Rate for Payer: UHC Medicaid |
$27.15
|
| Rate for Payer: UHC Medicare Advantage |
$38.49
|
| Rate for Payer: UHCCP Medicaid |
$27.15
|
| Rate for Payer: VA VA |
$38.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.48
|
|
|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
OP
|
$741.06
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$130.65 |
| Max. Negotiated Rate |
$666.95 |
| Rate for Payer: Aetna Commercial |
$629.90
|
| Rate for Payer: Aetna Medicare |
$192.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$231.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$231.58
|
| Rate for Payer: BCBS Complete |
$137.17
|
| Rate for Payer: BCBS MAPPO |
$185.26
|
| Rate for Payer: BCBS Trust/PPO |
$609.23
|
| Rate for Payer: BCN Commercial |
$609.23
|
| Rate for Payer: BCN Medicare Advantage |
$185.26
|
| Rate for Payer: Cash Price |
$592.85
|
| Rate for Payer: Cofinity Commercial |
$637.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$592.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.26
|
| Rate for Payer: Healthscope Commercial |
$666.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$555.79
|
| Rate for Payer: Mclaren Medicaid |
$130.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.53
|
| Rate for Payer: Meridian Medicaid |
$137.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$213.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$203.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$629.90
|
| Rate for Payer: Nomi Health Commercial |
$607.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$555.79
|
| Rate for Payer: PACE Senior Care Partners |
$176.00
|
| Rate for Payer: PACE SWMI |
$185.26
|
| Rate for Payer: PHP Commercial |
$629.90
|
| Rate for Payer: PHP Medicare Advantage |
$185.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$644.72
|
| Rate for Payer: Priority Health Medicare |
$187.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$515.78
|
| Rate for Payer: Railroad Medicare Medicare |
$185.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$652.13
|
| Rate for Payer: UHC Core |
$618.79
|
| Rate for Payer: UHC Exchange |
$185.26
|
| Rate for Payer: UHC Medicaid |
$130.65
|
| Rate for Payer: UHC Medicare Advantage |
$185.26
|
| Rate for Payer: UHCCP Medicaid |
$130.65
|
| Rate for Payer: VA VA |
$185.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$555.79
|
|
|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
IP
|
$741.06
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$515.78 |
| Max. Negotiated Rate |
$666.95 |
| Rate for Payer: Aetna Commercial |
$629.90
|
| Rate for Payer: BCBS Trust/PPO |
$612.04
|
| Rate for Payer: BCN Commercial |
$612.04
|
| Rate for Payer: Cash Price |
$592.85
|
| Rate for Payer: Cofinity Commercial |
$637.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$592.85
|
| Rate for Payer: Healthscope Commercial |
$666.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$555.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$629.90
|
| Rate for Payer: Nomi Health Commercial |
$607.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$555.79
|
| Rate for Payer: PHP Commercial |
$629.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$644.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$515.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$652.13
|
| Rate for Payer: UHC Core |
$618.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$555.79
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
IP
|
$1,409.73
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$981.17 |
| Max. Negotiated Rate |
$1,268.76 |
| Rate for Payer: Aetna Commercial |
$1,198.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,164.30
|
| Rate for Payer: BCN Commercial |
$1,164.30
|
| Rate for Payer: Cash Price |
$1,127.78
|
| Rate for Payer: Cofinity Commercial |
$1,212.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,127.78
|
| Rate for Payer: Healthscope Commercial |
$1,268.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,057.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,198.27
|
| Rate for Payer: Nomi Health Commercial |
$1,155.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,057.30
|
| Rate for Payer: PHP Commercial |
$1,198.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,226.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$981.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,240.56
|
| Rate for Payer: UHC Core |
$1,177.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,057.30
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
OP
|
$1,409.73
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$248.54 |
| Max. Negotiated Rate |
$1,268.76 |
| Rate for Payer: Aetna Commercial |
$1,198.27
|
| Rate for Payer: Aetna Medicare |
$366.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$440.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$440.54
|
| Rate for Payer: BCBS Complete |
$260.94
|
| Rate for Payer: BCBS MAPPO |
$352.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,158.94
|
| Rate for Payer: BCN Commercial |
$1,158.94
|
| Rate for Payer: BCN Medicare Advantage |
$352.43
|
| Rate for Payer: Cash Price |
$1,127.78
|
| Rate for Payer: Cofinity Commercial |
$1,212.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,127.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.43
|
| Rate for Payer: Healthscope Commercial |
$1,268.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,057.30
|
| Rate for Payer: Mclaren Medicaid |
$248.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.05
|
| Rate for Payer: Meridian Medicaid |
$260.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$405.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$387.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,198.27
|
| Rate for Payer: Nomi Health Commercial |
$1,155.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,057.30
|
| Rate for Payer: PACE Senior Care Partners |
$334.81
|
| Rate for Payer: PACE SWMI |
$352.43
|
| Rate for Payer: PHP Commercial |
$1,198.27
|
| Rate for Payer: PHP Medicare Advantage |
$352.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,226.47
|
| Rate for Payer: Priority Health Medicare |
$355.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$981.17
|
| Rate for Payer: Railroad Medicare Medicare |
$352.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,240.56
|
| Rate for Payer: UHC Core |
$1,177.12
|
| Rate for Payer: UHC Exchange |
$352.43
|
| Rate for Payer: UHC Medicaid |
$248.54
|
| Rate for Payer: UHC Medicare Advantage |
$352.43
|
| Rate for Payer: UHCCP Medicaid |
$248.54
|
| Rate for Payer: VA VA |
$352.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,057.30
|
|
|
HC CART TRACE 24 IN
|
Facility
|
IP
|
$114.00
|
|
| Hospital Charge Code |
27000714
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$79.34 |
| Max. Negotiated Rate |
$102.60 |
| Rate for Payer: Aetna Commercial |
$96.90
|
| Rate for Payer: BCBS Trust/PPO |
$94.15
|
| Rate for Payer: BCN Commercial |
$94.15
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$98.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.20
|
| Rate for Payer: Healthscope Commercial |
$102.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.90
|
| Rate for Payer: Nomi Health Commercial |
$93.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.50
|
| Rate for Payer: PHP Commercial |
$96.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.32
|
| Rate for Payer: UHC Core |
$95.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.50
|
|
|
HC CART TRACE 24 IN
|
Facility
|
OP
|
$114.00
|
|
| Hospital Charge Code |
27000714
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.10 |
| Max. Negotiated Rate |
$102.60 |
| Rate for Payer: Aetna Commercial |
$96.90
|
| Rate for Payer: Aetna Medicare |
$29.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.62
|
| Rate for Payer: BCBS Complete |
$21.10
|
| Rate for Payer: BCBS MAPPO |
$28.50
|
| Rate for Payer: BCBS Trust/PPO |
$93.72
|
| Rate for Payer: BCN Commercial |
$93.72
|
| Rate for Payer: BCN Medicare Advantage |
$28.50
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$98.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.50
|
| Rate for Payer: Healthscope Commercial |
$102.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.50
|
| Rate for Payer: Mclaren Medicaid |
$20.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.93
|
| Rate for Payer: Meridian Medicaid |
$21.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.90
|
| Rate for Payer: Nomi Health Commercial |
$93.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.50
|
| Rate for Payer: PACE Senior Care Partners |
$27.07
|
| Rate for Payer: PACE SWMI |
$28.50
|
| Rate for Payer: PHP Commercial |
$96.90
|
| Rate for Payer: PHP Medicare Advantage |
$28.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.18
|
| Rate for Payer: Priority Health Medicare |
$28.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.34
|
| Rate for Payer: Railroad Medicare Medicare |
$28.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.32
|
| Rate for Payer: UHC Core |
$95.19
|
| Rate for Payer: UHC Exchange |
$28.50
|
| Rate for Payer: UHC Medicaid |
$20.10
|
| Rate for Payer: UHC Medicare Advantage |
$28.50
|
| Rate for Payer: UHCCP Medicaid |
$20.10
|
| Rate for Payer: VA VA |
$28.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.50
|
|
|
HC CASHEW IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC CASHEW IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC CASSETTE ADDITIVE
|
Facility
|
IP
|
$109.50
|
|
| Hospital Charge Code |
27000719
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$76.21 |
| Max. Negotiated Rate |
$98.55 |
| Rate for Payer: Aetna Commercial |
$93.08
|
| Rate for Payer: BCBS Trust/PPO |
$90.44
|
| Rate for Payer: BCN Commercial |
$90.44
|
| Rate for Payer: Cash Price |
$87.60
|
| Rate for Payer: Cofinity Commercial |
$94.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.60
|
| Rate for Payer: Healthscope Commercial |
$98.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.08
|
| Rate for Payer: Nomi Health Commercial |
$89.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.12
|
| Rate for Payer: PHP Commercial |
$93.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.36
|
| Rate for Payer: UHC Core |
$91.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.12
|
|
|
HC CASSETTE ADDITIVE
|
Facility
|
OP
|
$109.50
|
|
| Hospital Charge Code |
27000719
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.30 |
| Max. Negotiated Rate |
$98.55 |
| Rate for Payer: Aetna Commercial |
$93.08
|
| Rate for Payer: Aetna Medicare |
$28.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.22
|
| Rate for Payer: BCBS Complete |
$20.27
|
| Rate for Payer: BCBS MAPPO |
$27.38
|
| Rate for Payer: BCBS Trust/PPO |
$90.02
|
| Rate for Payer: BCN Commercial |
$90.02
|
| Rate for Payer: BCN Medicare Advantage |
$27.38
|
| Rate for Payer: Cash Price |
$87.60
|
| Rate for Payer: Cofinity Commercial |
$94.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.38
|
| Rate for Payer: Healthscope Commercial |
$98.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.12
|
| Rate for Payer: Mclaren Medicaid |
$19.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.74
|
| Rate for Payer: Meridian Medicaid |
$20.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.08
|
| Rate for Payer: Nomi Health Commercial |
$89.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.12
|
| Rate for Payer: PACE Senior Care Partners |
$26.01
|
| Rate for Payer: PACE SWMI |
$27.38
|
| Rate for Payer: PHP Commercial |
$93.08
|
| Rate for Payer: PHP Medicare Advantage |
$27.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.27
|
| Rate for Payer: Priority Health Medicare |
$27.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.21
|
| Rate for Payer: Railroad Medicare Medicare |
$27.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.36
|
| Rate for Payer: UHC Core |
$91.43
|
| Rate for Payer: UHC Exchange |
$27.38
|
| Rate for Payer: UHC Medicaid |
$19.30
|
| Rate for Payer: UHC Medicare Advantage |
$27.38
|
| Rate for Payer: UHCCP Medicaid |
$19.30
|
| Rate for Payer: VA VA |
$27.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.12
|
|
