|
HC ELEC ALYS IMPLT NPGT CPLX SP/PN PRGM
|
Facility
|
IP
|
$190.74
|
|
|
Service Code
|
CPT 95972
|
| Hospital Charge Code |
92000029
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$116.33 |
| Max. Negotiated Rate |
$171.67 |
| Rate for Payer: Aetna Commercial |
$162.13
|
| Rate for Payer: BCBS Trust/PPO |
$147.40
|
| Rate for Payer: BCN Commercial |
$147.40
|
| Rate for Payer: Cash Price |
$152.59
|
| Rate for Payer: Cofinity Commercial |
$164.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$171.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$162.13
|
| Rate for Payer: PHP Commercial |
$162.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.85
|
| Rate for Payer: UHC Core |
$159.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.06
|
|
|
HC ELEC ALYS IMPLT NPGT CPLX SP/PN PRGM
|
Facility
|
OP
|
$190.74
|
|
|
Service Code
|
CPT 95972
|
| Hospital Charge Code |
92000029
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$45.30 |
| Max. Negotiated Rate |
$171.67 |
| Rate for Payer: Aetna Commercial |
$162.13
|
| Rate for Payer: Aetna Medicare |
$49.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.61
|
| Rate for Payer: BCBS Complete |
$66.67
|
| Rate for Payer: BCBS MAPPO |
$47.68
|
| Rate for Payer: BCBS Trust/PPO |
$148.30
|
| Rate for Payer: BCN Commercial |
$148.30
|
| Rate for Payer: BCN Medicare Advantage |
$47.68
|
| Rate for Payer: Cash Price |
$152.59
|
| Rate for Payer: Cash Price |
$152.59
|
| Rate for Payer: Cofinity Commercial |
$164.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.68
|
| Rate for Payer: Healthscope Commercial |
$171.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.06
|
| Rate for Payer: Mclaren Medicaid |
$63.50
|
| Rate for Payer: Meridian Medicaid |
$66.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$162.13
|
| Rate for Payer: PACE Senior Care Partners |
$45.30
|
| Rate for Payer: PACE SWMI |
$47.68
|
| Rate for Payer: PHP Commercial |
$162.13
|
| Rate for Payer: PHP Medicare Advantage |
$47.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.94
|
| Rate for Payer: Priority Health Medicare |
$47.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.33
|
| Rate for Payer: Railroad Medicare Medicare |
$47.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.85
|
| Rate for Payer: UHC Core |
$159.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.68
|
| Rate for Payer: UHC Medicare Advantage |
$49.12
|
| Rate for Payer: VA VA |
$47.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.06
|
|
|
HC ELEC ALYS IMPLT NPGT PHYS/QHP W/O PRGM
|
Facility
|
OP
|
$166.80
|
|
|
Service Code
|
CPT 95970
|
| Hospital Charge Code |
92000030
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$39.62 |
| Max. Negotiated Rate |
$150.12 |
| Rate for Payer: Aetna Commercial |
$141.78
|
| Rate for Payer: Aetna Medicare |
$43.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.12
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$41.70
|
| Rate for Payer: BCBS Trust/PPO |
$129.69
|
| Rate for Payer: BCN Commercial |
$129.69
|
| Rate for Payer: BCN Medicare Advantage |
$41.70
|
| Rate for Payer: Cash Price |
$133.44
|
| Rate for Payer: Cash Price |
$133.44
|
| Rate for Payer: Cofinity Commercial |
$143.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.70
|
| Rate for Payer: Healthscope Commercial |
$150.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.10
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$141.78
|
| Rate for Payer: PACE Senior Care Partners |
$39.62
|
| Rate for Payer: PACE SWMI |
$41.70
|
| Rate for Payer: PHP Commercial |
$141.78
|
| Rate for Payer: PHP Medicare Advantage |
$41.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.12
|
| Rate for Payer: Priority Health Medicare |
$41.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.73
|
| Rate for Payer: Railroad Medicare Medicare |
$41.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.78
|
| Rate for Payer: UHC Core |
$139.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.70
|
| Rate for Payer: UHC Medicare Advantage |
$42.95
|
| Rate for Payer: VA VA |
$41.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.10
|
|
|
HC ELEC ALYS IMPLT NPGT PHYS/QHP W/O PRGM
|
Facility
|
IP
|
$166.80
|
|
|
Service Code
|
CPT 95970
|
| Hospital Charge Code |
92000030
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$101.73 |
| Max. Negotiated Rate |
$150.12 |
| Rate for Payer: Aetna Commercial |
$141.78
|
| Rate for Payer: BCBS Trust/PPO |
$128.90
|
| Rate for Payer: BCN Commercial |
$128.90
|
| Rate for Payer: Cash Price |
$133.44
|
| Rate for Payer: Cofinity Commercial |
$143.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.44
|
| Rate for Payer: Healthscope Commercial |
$150.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$141.78
|
| Rate for Payer: PHP Commercial |
$141.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.78
|
| Rate for Payer: UHC Core |
$139.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.10
|
|
|
HC ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGM
|
Facility
|
IP
|
$173.52
|
|
|
Service Code
|
CPT 95971
|
| Hospital Charge Code |
92000031
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$105.83 |
| Max. Negotiated Rate |
$156.17 |
| Rate for Payer: Aetna Commercial |
$147.49
|
| Rate for Payer: BCBS Trust/PPO |
$134.10
|
| Rate for Payer: BCN Commercial |
$134.10
|
| Rate for Payer: Cash Price |
$138.82
|
| Rate for Payer: Cofinity Commercial |
$149.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.82
|
| Rate for Payer: Healthscope Commercial |
$156.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.49
|
| Rate for Payer: PHP Commercial |
$147.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.70
|
| Rate for Payer: UHC Core |
$144.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.14
|
|
|
HC ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGM
|
Facility
|
OP
|
$173.52
|
|
|
Service Code
|
CPT 95971
|
| Hospital Charge Code |
92000031
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$156.17 |
| Rate for Payer: Aetna Commercial |
$147.49
|
| Rate for Payer: Aetna Medicare |
$45.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.22
|
| Rate for Payer: BCBS Complete |
$66.67
|
| Rate for Payer: BCBS MAPPO |
$43.38
|
| Rate for Payer: BCBS Trust/PPO |
$134.91
|
| Rate for Payer: BCN Commercial |
$134.91
|
| Rate for Payer: BCN Medicare Advantage |
$43.38
|
| Rate for Payer: Cash Price |
$138.82
|
| Rate for Payer: Cash Price |
$138.82
|
| Rate for Payer: Cofinity Commercial |
$149.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.38
|
| Rate for Payer: Healthscope Commercial |
$156.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.14
|
| Rate for Payer: Mclaren Medicaid |
$63.50
|
| Rate for Payer: Meridian Medicaid |
$66.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.49
|
| Rate for Payer: PACE Senior Care Partners |
$41.21
|
| Rate for Payer: PACE SWMI |
$43.38
|
| Rate for Payer: PHP Commercial |
$147.49
|
| Rate for Payer: PHP Medicare Advantage |
$43.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.96
|
| Rate for Payer: Priority Health Medicare |
$43.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.83
|
| Rate for Payer: Railroad Medicare Medicare |
$43.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.70
|
| Rate for Payer: UHC Core |
$144.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.38
|
| Rate for Payer: UHC Medicare Advantage |
$44.68
|
| Rate for Payer: VA VA |
$43.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.14
|
|
|
HC ELEC BREAST PUMP KI (OB)
|
Facility
|
OP
|
$202.50
|
|
| Hospital Charge Code |
27000069
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.09 |
| Max. Negotiated Rate |
$182.25 |
| Rate for Payer: Aetna Commercial |
$172.12
|
| Rate for Payer: Aetna Medicare |
$52.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.28
|
| Rate for Payer: BCBS Complete |
$81.00
|
| Rate for Payer: BCBS MAPPO |
$50.62
|
| Rate for Payer: BCBS Trust/PPO |
$157.44
|
| Rate for Payer: BCN Commercial |
$157.44
|
| Rate for Payer: BCN Medicare Advantage |
$50.62
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cofinity Commercial |
$174.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.62
|
| Rate for Payer: Healthscope Commercial |
$182.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$172.12
|
| Rate for Payer: PACE Senior Care Partners |
$48.09
|
| Rate for Payer: PACE SWMI |
$50.62
|
| Rate for Payer: PHP Commercial |
$172.12
|
| Rate for Payer: PHP Medicare Advantage |
$50.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.18
|
| Rate for Payer: Priority Health Medicare |
$50.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.50
|
| Rate for Payer: Railroad Medicare Medicare |
$50.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.20
|
| Rate for Payer: UHC Core |
$169.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.62
|
| Rate for Payer: UHC Medicare Advantage |
$52.14
|
| Rate for Payer: VA VA |
$50.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.88
|
|
|
HC ELEC BREAST PUMP KI (OB)
|
Facility
|
IP
|
$202.50
|
|
| Hospital Charge Code |
27000069
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.50 |
| Max. Negotiated Rate |
$182.25 |
| Rate for Payer: Aetna Commercial |
$172.12
|
| Rate for Payer: BCBS Trust/PPO |
$156.49
|
| Rate for Payer: BCN Commercial |
$156.49
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cofinity Commercial |
$174.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.00
|
| Rate for Payer: Healthscope Commercial |
$182.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$172.12
|
| Rate for Payer: PHP Commercial |
$172.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.20
|
| Rate for Payer: UHC Core |
$169.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.88
|
|
|
HC ELECTRICAL STIM UNATTENDED
|
Facility
|
IP
|
$90.78
|
|
|
Service Code
|
CPT 97014
|
| Hospital Charge Code |
42000010
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$55.37 |
| Max. Negotiated Rate |
$81.70 |
| Rate for Payer: Aetna Commercial |
$77.16
|
| Rate for Payer: BCBS Trust/PPO |
$70.15
|
| Rate for Payer: BCN Commercial |
$70.15
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$78.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Healthscope Commercial |
$81.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$77.16
|
| Rate for Payer: PHP Commercial |
$77.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.89
|
| Rate for Payer: UHC Core |
$75.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.08
|
|
|
HC ELECTRICAL STIM UNATTENDED
|
Facility
|
OP
|
$90.78
|
|
|
Service Code
|
CPT 97014
|
| Hospital Charge Code |
42000010
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.56 |
| Max. Negotiated Rate |
$81.70 |
| Rate for Payer: Aetna Commercial |
$77.16
|
| Rate for Payer: Aetna Medicare |
$23.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.37
|
| Rate for Payer: BCBS Complete |
$36.31
|
| Rate for Payer: BCBS MAPPO |
$22.70
|
| Rate for Payer: BCBS Trust/PPO |
$70.58
|
| Rate for Payer: BCN Commercial |
$70.58
|
| Rate for Payer: BCN Medicare Advantage |
$22.70
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$78.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.70
|
| Rate for Payer: Healthscope Commercial |
$81.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$77.16
|
| Rate for Payer: PACE Senior Care Partners |
$21.56
|
| Rate for Payer: PACE SWMI |
$22.70
|
| Rate for Payer: PHP Commercial |
$77.16
|
| Rate for Payer: PHP Medicare Advantage |
$22.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.98
|
| Rate for Payer: Priority Health Medicare |
$22.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.37
|
| Rate for Payer: Railroad Medicare Medicare |
$22.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.89
|
| Rate for Payer: UHC Core |
$75.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.70
|
| Rate for Payer: UHC Medicare Advantage |
$23.38
|
| Rate for Payer: VA VA |
$22.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.08
|
|
|
HC ELECTRICAL STIM UNATTENDED FOR PRESSURE
|
Facility
|
OP
|
$100.43
|
|
|
Service Code
|
HCPCS G0281
|
| Hospital Charge Code |
42000057
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.85 |
| Max. Negotiated Rate |
$90.39 |
| Rate for Payer: Aetna Commercial |
$85.37
|
| Rate for Payer: Aetna Medicare |
$26.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.38
|
| Rate for Payer: BCBS Complete |
$40.17
|
| Rate for Payer: BCBS MAPPO |
$25.11
|
| Rate for Payer: BCBS Trust/PPO |
$78.08
|
| Rate for Payer: BCN Commercial |
$78.08
|
| Rate for Payer: BCN Medicare Advantage |
$25.11
|
| Rate for Payer: Cash Price |
$80.34
|
| Rate for Payer: Cofinity Commercial |
$86.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.11
|
| Rate for Payer: Healthscope Commercial |
$90.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.37
|
| Rate for Payer: PACE Senior Care Partners |
$23.85
|
| Rate for Payer: PACE SWMI |
$25.11
|
| Rate for Payer: PHP Commercial |
$85.37
|
| Rate for Payer: PHP Medicare Advantage |
$25.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.37
|
| Rate for Payer: Priority Health Medicare |
$25.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.25
|
| Rate for Payer: Railroad Medicare Medicare |
$25.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.38
|
| Rate for Payer: UHC Core |
$83.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.11
|
| Rate for Payer: UHC Medicare Advantage |
$25.86
|
| Rate for Payer: VA VA |
$25.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.32
|
|
|
HC ELECTRICAL STIM UNATTENDED FOR PRESSURE
|
Facility
|
IP
|
$100.43
|
|
|
Service Code
|
HCPCS G0281
|
| Hospital Charge Code |
42000057
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$61.25 |
| Max. Negotiated Rate |
$90.39 |
| Rate for Payer: Aetna Commercial |
$85.37
|
| Rate for Payer: BCBS Trust/PPO |
$77.61
|
| Rate for Payer: BCN Commercial |
$77.61
|
| Rate for Payer: Cash Price |
$80.34
|
| Rate for Payer: Cofinity Commercial |
$86.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.34
|
| Rate for Payer: Healthscope Commercial |
$90.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.37
|
| Rate for Payer: PHP Commercial |
$85.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.38
|
| Rate for Payer: UHC Core |
$83.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.32
|
|
|
HC ELECTRICAL STIM UNATTENDED NOT PRESSURE
|
Facility
|
IP
|
$130.16
|
|
|
Service Code
|
HCPCS G0283
|
| Hospital Charge Code |
42000058
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$79.38 |
| Max. Negotiated Rate |
$117.14 |
| Rate for Payer: Aetna Commercial |
$110.64
|
| Rate for Payer: BCBS Trust/PPO |
$100.59
|
| Rate for Payer: BCN Commercial |
$100.59
|
| Rate for Payer: Cash Price |
$104.13
|
| Rate for Payer: Cofinity Commercial |
$111.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.13
|
| Rate for Payer: Healthscope Commercial |
$117.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.64
|
| Rate for Payer: PHP Commercial |
$110.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.54
|
| Rate for Payer: UHC Core |
$108.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.62
|
|
|
HC ELECTRICAL STIM UNATTENDED NOT PRESSURE
|
Facility
|
OP
|
$130.16
|
|
|
Service Code
|
HCPCS G0283
|
| Hospital Charge Code |
42000058
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$30.91 |
| Max. Negotiated Rate |
$117.14 |
| Rate for Payer: Aetna Commercial |
$110.64
|
| Rate for Payer: Aetna Medicare |
$33.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.68
|
| Rate for Payer: BCBS Complete |
$52.06
|
| Rate for Payer: BCBS MAPPO |
$32.54
|
| Rate for Payer: BCBS Trust/PPO |
$101.20
|
| Rate for Payer: BCN Commercial |
$101.20
|
| Rate for Payer: BCN Medicare Advantage |
$32.54
|
| Rate for Payer: Cash Price |
$104.13
|
| Rate for Payer: Cofinity Commercial |
$111.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.54
|
| Rate for Payer: Healthscope Commercial |
$117.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.64
|
| Rate for Payer: PACE Senior Care Partners |
$30.91
|
| Rate for Payer: PACE SWMI |
$32.54
|
| Rate for Payer: PHP Commercial |
$110.64
|
| Rate for Payer: PHP Medicare Advantage |
$32.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.24
|
| Rate for Payer: Priority Health Medicare |
$32.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.38
|
| Rate for Payer: Railroad Medicare Medicare |
$32.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.54
|
| Rate for Payer: UHC Core |
$108.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.54
|
| Rate for Payer: UHC Medicare Advantage |
$33.52
|
| Rate for Payer: VA VA |
$32.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.62
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST BINAURAL
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
CPT 92595
|
| Hospital Charge Code |
76100494
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$46.96 |
| Max. Negotiated Rate |
$69.30 |
| Rate for Payer: Aetna Commercial |
$65.45
|
| Rate for Payer: BCBS Trust/PPO |
$59.51
|
| Rate for Payer: BCN Commercial |
$59.51
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$66.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.60
|
| Rate for Payer: Healthscope Commercial |
$69.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.45
|
| Rate for Payer: PHP Commercial |
$65.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.76
|
| Rate for Payer: UHC Core |
$64.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.75
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST BINAURAL
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
CPT 92595
|
| Hospital Charge Code |
76100494
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$18.29 |
| Max. Negotiated Rate |
$69.30 |
| Rate for Payer: Aetna Commercial |
$65.45
|
| Rate for Payer: Aetna Medicare |
$20.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.06
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCBS MAPPO |
$19.25
|
| Rate for Payer: BCBS Trust/PPO |
$59.87
|
| Rate for Payer: BCN Commercial |
$59.87
|
| Rate for Payer: BCN Medicare Advantage |
$19.25
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$66.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.25
|
| Rate for Payer: Healthscope Commercial |
$69.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.45
|
| Rate for Payer: PACE Senior Care Partners |
$18.29
|
| Rate for Payer: PACE SWMI |
$19.25
|
| Rate for Payer: PHP Commercial |
$65.45
|
| Rate for Payer: PHP Medicare Advantage |
$19.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.99
|
| Rate for Payer: Priority Health Medicare |
$19.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.96
|
| Rate for Payer: Railroad Medicare Medicare |
$19.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.76
|
| Rate for Payer: UHC Core |
$64.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.25
|
| Rate for Payer: UHC Medicare Advantage |
$19.83
|
| Rate for Payer: VA VA |
$19.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.75
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST MONAURAL
|
Facility
|
IP
|
$88.00
|
|
|
Service Code
|
CPT 92594
|
| Hospital Charge Code |
76100493
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$53.67 |
| Max. Negotiated Rate |
$79.20 |
| Rate for Payer: Aetna Commercial |
$74.80
|
| Rate for Payer: BCBS Trust/PPO |
$68.01
|
| Rate for Payer: BCN Commercial |
$68.01
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$75.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.40
|
| Rate for Payer: Healthscope Commercial |
$79.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.80
|
| Rate for Payer: PHP Commercial |
$74.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.44
|
| Rate for Payer: UHC Core |
$73.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.00
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST MONAURAL
|
Facility
|
OP
|
$88.00
|
|
|
Service Code
|
CPT 92594
|
| Hospital Charge Code |
76100493
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$20.90 |
| Max. Negotiated Rate |
$79.20 |
| Rate for Payer: Aetna Commercial |
$74.80
|
| Rate for Payer: Aetna Medicare |
$22.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.50
|
| Rate for Payer: BCBS Complete |
$35.20
|
| Rate for Payer: BCBS MAPPO |
$22.00
|
| Rate for Payer: BCBS Trust/PPO |
$68.42
|
| Rate for Payer: BCN Commercial |
$68.42
|
| Rate for Payer: BCN Medicare Advantage |
$22.00
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$75.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.00
|
| Rate for Payer: Healthscope Commercial |
$79.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.80
|
| Rate for Payer: PACE Senior Care Partners |
$20.90
|
| Rate for Payer: PACE SWMI |
$22.00
|
| Rate for Payer: PHP Commercial |
$74.80
|
| Rate for Payer: PHP Medicare Advantage |
$22.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.56
|
| Rate for Payer: Priority Health Medicare |
$22.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.67
|
| Rate for Payer: Railroad Medicare Medicare |
$22.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.44
|
| Rate for Payer: UHC Core |
$73.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.00
|
| Rate for Payer: UHC Medicare Advantage |
$22.66
|
| Rate for Payer: VA VA |
$22.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.00
|
|
|
HC ELECTROCARDIOGRAM
|
Facility
|
IP
|
$213.14
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
73000001
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$129.99 |
| Max. Negotiated Rate |
$191.83 |
| Rate for Payer: Aetna Commercial |
$181.17
|
| Rate for Payer: BCBS Trust/PPO |
$164.71
|
| Rate for Payer: BCN Commercial |
$164.71
|
| Rate for Payer: Cash Price |
$170.51
|
| Rate for Payer: Cofinity Commercial |
$183.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.51
|
| Rate for Payer: Healthscope Commercial |
$191.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$181.17
|
| Rate for Payer: PHP Commercial |
$181.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.56
|
| Rate for Payer: UHC Core |
$177.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.86
|
|
|
HC ELECTROCARDIOGRAM
|
Facility
|
OP
|
$213.14
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
73000001
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$40.13 |
| Max. Negotiated Rate |
$191.83 |
| Rate for Payer: Aetna Commercial |
$181.17
|
| Rate for Payer: Aetna Medicare |
$55.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.61
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$53.28
|
| Rate for Payer: BCBS Trust/PPO |
$165.72
|
| Rate for Payer: BCN Commercial |
$165.72
|
| Rate for Payer: BCN Medicare Advantage |
$53.28
|
| Rate for Payer: Cash Price |
$170.51
|
| Rate for Payer: Cash Price |
$170.51
|
| Rate for Payer: Cofinity Commercial |
$183.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.28
|
| Rate for Payer: Healthscope Commercial |
$191.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.86
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$181.17
|
| Rate for Payer: PACE Senior Care Partners |
$50.62
|
| Rate for Payer: PACE SWMI |
$53.28
|
| Rate for Payer: PHP Commercial |
$181.17
|
| Rate for Payer: PHP Medicare Advantage |
$53.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$185.43
|
| Rate for Payer: Priority Health Medicare |
$53.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.99
|
| Rate for Payer: Railroad Medicare Medicare |
$53.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.56
|
| Rate for Payer: UHC Core |
$177.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.28
|
| Rate for Payer: UHC Medicare Advantage |
$54.88
|
| Rate for Payer: VA VA |
$53.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.86
|
|
|
HC ELECTROCORTICOGRAM IMPLTD BRN NPGT <30 D
|
Facility
|
OP
|
$74.46
|
|
|
Service Code
|
CPT 95836
|
| Hospital Charge Code |
74000033
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$17.68 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: Aetna Medicare |
$19.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.27
|
| Rate for Payer: BCBS Complete |
$25.97
|
| Rate for Payer: BCBS MAPPO |
$18.62
|
| Rate for Payer: BCBS Trust/PPO |
$57.89
|
| Rate for Payer: BCN Commercial |
$57.89
|
| Rate for Payer: BCN Medicare Advantage |
$18.62
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.62
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Mclaren Medicaid |
$24.74
|
| Rate for Payer: Meridian Medicaid |
$25.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.29
|
| Rate for Payer: PACE Senior Care Partners |
$17.68
|
| Rate for Payer: PACE SWMI |
$18.62
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: PHP Medicare Advantage |
$18.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.78
|
| Rate for Payer: Priority Health Medicare |
$18.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.41
|
| Rate for Payer: Railroad Medicare Medicare |
$18.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.52
|
| Rate for Payer: UHC Core |
$62.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.62
|
| Rate for Payer: UHC Medicare Advantage |
$19.17
|
| Rate for Payer: VA VA |
$18.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
HC ELECTROCORTICOGRAM IMPLTD BRN NPGT <30 D
|
Facility
|
IP
|
$74.46
|
|
|
Service Code
|
CPT 95836
|
| Hospital Charge Code |
74000033
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$45.41 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: BCBS Trust/PPO |
$57.54
|
| Rate for Payer: BCN Commercial |
$57.54
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.29
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.52
|
| Rate for Payer: UHC Core |
$62.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
IP
|
$27.54
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$24.79 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: BCBS Trust/PPO |
$21.28
|
| Rate for Payer: BCN Commercial |
$21.28
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Cofinity Commercial |
$23.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.03
|
| Rate for Payer: Healthscope Commercial |
$24.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.41
|
| Rate for Payer: PHP Commercial |
$23.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.24
|
| Rate for Payer: UHC Core |
$23.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.66
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
OP
|
$27.54
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$24.79 |
| Rate for Payer: Aetna Commercial |
$23.41
|
| Rate for Payer: Aetna Medicare |
$7.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.61
|
| Rate for Payer: BCBS Complete |
$5.43
|
| Rate for Payer: BCBS MAPPO |
$6.88
|
| Rate for Payer: BCBS Trust/PPO |
$21.41
|
| Rate for Payer: BCN Commercial |
$21.41
|
| Rate for Payer: BCN Medicare Advantage |
$6.88
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Cofinity Commercial |
$23.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.88
|
| Rate for Payer: Healthscope Commercial |
$24.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.66
|
| Rate for Payer: Mclaren Medicaid |
$5.17
|
| Rate for Payer: Meridian Medicaid |
$5.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.41
|
| Rate for Payer: PACE Senior Care Partners |
$6.54
|
| Rate for Payer: PACE SWMI |
$6.88
|
| Rate for Payer: PHP Commercial |
$23.41
|
| Rate for Payer: PHP Medicare Advantage |
$6.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.96
|
| Rate for Payer: Priority Health Medicare |
$6.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.80
|
| Rate for Payer: Railroad Medicare Medicare |
$6.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.24
|
| Rate for Payer: UHC Core |
$23.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.88
|
| Rate for Payer: UHC Medicare Advantage |
$7.09
|
| Rate for Payer: VA VA |
$6.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.66
|
|
|
HC ELECTROLYTES WHOLE BLOOD
|
Facility
|
OP
|
$86.10
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100490
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$77.49 |
| Rate for Payer: Aetna Commercial |
$73.18
|
| Rate for Payer: Aetna Medicare |
$22.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.91
|
| Rate for Payer: BCBS Complete |
$5.43
|
| Rate for Payer: BCBS MAPPO |
$21.52
|
| Rate for Payer: BCBS Trust/PPO |
$66.94
|
| Rate for Payer: BCN Commercial |
$66.94
|
| Rate for Payer: BCN Medicare Advantage |
$21.52
|
| Rate for Payer: Cash Price |
$68.88
|
| Rate for Payer: Cash Price |
$68.88
|
| Rate for Payer: Cofinity Commercial |
$74.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.52
|
| Rate for Payer: Healthscope Commercial |
$77.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.58
|
| Rate for Payer: Mclaren Medicaid |
$5.17
|
| Rate for Payer: Meridian Medicaid |
$5.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$73.18
|
| Rate for Payer: PACE Senior Care Partners |
$20.45
|
| Rate for Payer: PACE SWMI |
$21.52
|
| Rate for Payer: PHP Commercial |
$73.18
|
| Rate for Payer: PHP Medicare Advantage |
$21.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.91
|
| Rate for Payer: Priority Health Medicare |
$21.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.51
|
| Rate for Payer: Railroad Medicare Medicare |
$21.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.77
|
| Rate for Payer: UHC Core |
$71.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.52
|
| Rate for Payer: UHC Medicare Advantage |
$22.17
|
| Rate for Payer: VA VA |
$21.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.58
|
|
