|
HC ARCTIC SUN TORSO/LEG PADS
|
Facility
|
OP
|
$2,580.84
|
|
| Hospital Charge Code |
27000610
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$612.95 |
| Max. Negotiated Rate |
$2,322.76 |
| Rate for Payer: Aetna Commercial |
$2,193.71
|
| Rate for Payer: Aetna Medicare |
$671.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$806.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$806.51
|
| Rate for Payer: BCBS Complete |
$1,032.34
|
| Rate for Payer: BCBS MAPPO |
$645.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,121.71
|
| Rate for Payer: BCN Commercial |
$2,006.60
|
| Rate for Payer: BCN Medicare Advantage |
$645.21
|
| Rate for Payer: Cash Price |
$2,064.67
|
| Rate for Payer: Cofinity Commercial |
$2,219.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,064.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$645.21
|
| Rate for Payer: Healthscope Commercial |
$2,322.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,935.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$677.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$741.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,193.71
|
| Rate for Payer: Nomi Health Commercial |
$2,116.29
|
| Rate for Payer: PACE Senior Care Partners |
$612.95
|
| Rate for Payer: PACE SWMI |
$645.21
|
| Rate for Payer: PHP Commercial |
$2,193.71
|
| Rate for Payer: PHP Medicare Advantage |
$645.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,677.55
|
| Rate for Payer: Priority Health HMO/PPO |
$2,245.33
|
| Rate for Payer: Priority Health Medicare |
$651.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,729.16
|
| Rate for Payer: Railroad Medicare Medicare |
$645.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,271.14
|
| Rate for Payer: UHC Core |
$2,155.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$645.21
|
| Rate for Payer: UHC Exchange |
$645.21
|
| Rate for Payer: UHC Medicare Advantage |
$645.21
|
| Rate for Payer: VA VA |
$645.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,935.63
|
|
|
HC ARCTIC SUN UNIVERSAL PAD
|
Facility
|
OP
|
$1,118.37
|
|
| Hospital Charge Code |
27000617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$265.61 |
| Max. Negotiated Rate |
$1,006.53 |
| Rate for Payer: Aetna Commercial |
$950.61
|
| Rate for Payer: Aetna Medicare |
$290.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$349.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$349.49
|
| Rate for Payer: BCBS Complete |
$447.35
|
| Rate for Payer: BCBS MAPPO |
$279.59
|
| Rate for Payer: BCBS Trust/PPO |
$919.41
|
| Rate for Payer: BCN Commercial |
$869.53
|
| Rate for Payer: BCN Medicare Advantage |
$279.59
|
| Rate for Payer: Cash Price |
$894.70
|
| Rate for Payer: Cofinity Commercial |
$961.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.59
|
| Rate for Payer: Healthscope Commercial |
$1,006.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$838.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$321.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$950.61
|
| Rate for Payer: Nomi Health Commercial |
$917.06
|
| Rate for Payer: PACE Senior Care Partners |
$265.61
|
| Rate for Payer: PACE SWMI |
$279.59
|
| Rate for Payer: PHP Commercial |
$950.61
|
| Rate for Payer: PHP Medicare Advantage |
$279.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$726.94
|
| Rate for Payer: Priority Health HMO/PPO |
$972.98
|
| Rate for Payer: Priority Health Medicare |
$282.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$749.31
|
| Rate for Payer: Railroad Medicare Medicare |
$279.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.17
|
| Rate for Payer: UHC Core |
$933.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.59
|
| Rate for Payer: UHC Exchange |
$279.59
|
| Rate for Payer: UHC Medicare Advantage |
$279.59
|
| Rate for Payer: VA VA |
$279.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$838.78
|
|
|
HC ARCTIC SUN UNIVERSAL PAD
|
Facility
|
IP
|
$1,118.37
|
|
| Hospital Charge Code |
27000617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$726.94 |
| Max. Negotiated Rate |
$1,006.53 |
| Rate for Payer: Aetna Commercial |
$950.61
|
| Rate for Payer: BCBS Trust/PPO |
$912.93
|
| Rate for Payer: BCN Commercial |
$864.28
|
| Rate for Payer: Cash Price |
$894.70
|
| Rate for Payer: Cofinity Commercial |
$961.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$894.70
|
| Rate for Payer: Healthscope Commercial |
$1,006.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$838.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$950.61
|
| Rate for Payer: Nomi Health Commercial |
$917.06
|
| Rate for Payer: PHP Commercial |
$950.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$726.94
|
| Rate for Payer: Priority Health HMO/PPO |
$972.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$749.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.17
|
| Rate for Payer: UHC Core |
$933.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$838.78
|
|
|
HC ARGON PLASMA COAGULATION
|
Facility
|
IP
|
$1,860.09
|
|
| Hospital Charge Code |
36000007
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,209.06 |
| Max. Negotiated Rate |
$1,674.08 |
| Rate for Payer: Aetna Commercial |
$1,581.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,518.39
|
| Rate for Payer: BCN Commercial |
$1,437.48
|
| Rate for Payer: Cash Price |
$1,488.07
|
| Rate for Payer: Cofinity Commercial |
$1,599.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,488.07
|
| Rate for Payer: Healthscope Commercial |
$1,674.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,395.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,581.08
|
| Rate for Payer: Nomi Health Commercial |
$1,525.27
|
| Rate for Payer: PHP Commercial |
$1,581.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,209.06
|
| Rate for Payer: Priority Health HMO/PPO |
$1,618.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,246.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,636.88
|
| Rate for Payer: UHC Core |
$1,553.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,395.07
|
|
|
HC ARGON PLASMA COAGULATION
|
Facility
|
OP
|
$1,860.09
|
|
| Hospital Charge Code |
36000007
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$441.77 |
| Max. Negotiated Rate |
$1,674.08 |
| Rate for Payer: Aetna Commercial |
$1,581.08
|
| Rate for Payer: Aetna Medicare |
$483.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$581.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$581.28
|
| Rate for Payer: BCBS Complete |
$744.04
|
| Rate for Payer: BCBS MAPPO |
$465.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,529.18
|
| Rate for Payer: BCN Commercial |
$1,446.22
|
| Rate for Payer: BCN Medicare Advantage |
$465.02
|
| Rate for Payer: Cash Price |
$1,488.07
|
| Rate for Payer: Cofinity Commercial |
$1,599.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,488.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$465.02
|
| Rate for Payer: Healthscope Commercial |
$1,674.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,395.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$488.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$534.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,581.08
|
| Rate for Payer: Nomi Health Commercial |
$1,525.27
|
| Rate for Payer: PACE Senior Care Partners |
$441.77
|
| Rate for Payer: PACE SWMI |
$465.02
|
| Rate for Payer: PHP Commercial |
$1,581.08
|
| Rate for Payer: PHP Medicare Advantage |
$465.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,209.06
|
| Rate for Payer: Priority Health HMO/PPO |
$1,618.28
|
| Rate for Payer: Priority Health Medicare |
$469.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,246.26
|
| Rate for Payer: Railroad Medicare Medicare |
$465.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,636.88
|
| Rate for Payer: UHC Core |
$1,553.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$465.02
|
| Rate for Payer: UHC Exchange |
$465.02
|
| Rate for Payer: UHC Medicare Advantage |
$465.02
|
| Rate for Payer: VA VA |
$465.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,395.07
|
|
|
HC ARISTA HEMOSTAT
|
Facility
|
OP
|
$1,141.67
|
|
| Hospital Charge Code |
27200111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$271.15 |
| Max. Negotiated Rate |
$1,027.50 |
| Rate for Payer: Aetna Commercial |
$970.42
|
| Rate for Payer: Aetna Medicare |
$296.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.77
|
| Rate for Payer: BCBS Complete |
$456.67
|
| Rate for Payer: BCBS MAPPO |
$285.42
|
| Rate for Payer: BCBS Trust/PPO |
$938.57
|
| Rate for Payer: BCN Commercial |
$887.65
|
| Rate for Payer: BCN Medicare Advantage |
$285.42
|
| Rate for Payer: Cash Price |
$913.34
|
| Rate for Payer: Cofinity Commercial |
$981.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$913.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.42
|
| Rate for Payer: Healthscope Commercial |
$1,027.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$856.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$328.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$970.42
|
| Rate for Payer: Nomi Health Commercial |
$936.17
|
| Rate for Payer: PACE Senior Care Partners |
$271.15
|
| Rate for Payer: PACE SWMI |
$285.42
|
| Rate for Payer: PHP Commercial |
$970.42
|
| Rate for Payer: PHP Medicare Advantage |
$285.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$742.09
|
| Rate for Payer: Priority Health HMO/PPO |
$993.25
|
| Rate for Payer: Priority Health Medicare |
$288.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$764.92
|
| Rate for Payer: Railroad Medicare Medicare |
$285.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,004.67
|
| Rate for Payer: UHC Core |
$953.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.42
|
| Rate for Payer: UHC Exchange |
$285.42
|
| Rate for Payer: UHC Medicare Advantage |
$285.42
|
| Rate for Payer: VA VA |
$285.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$856.25
|
|
|
HC ARISTA HEMOSTAT
|
Facility
|
IP
|
$1,141.67
|
|
| Hospital Charge Code |
27200111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$742.09 |
| Max. Negotiated Rate |
$1,027.50 |
| Rate for Payer: Aetna Commercial |
$970.42
|
| Rate for Payer: BCBS Trust/PPO |
$931.95
|
| Rate for Payer: BCN Commercial |
$882.28
|
| Rate for Payer: Cash Price |
$913.34
|
| Rate for Payer: Cofinity Commercial |
$981.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$913.34
|
| Rate for Payer: Healthscope Commercial |
$1,027.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$856.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$970.42
|
| Rate for Payer: Nomi Health Commercial |
$936.17
|
| Rate for Payer: PHP Commercial |
$970.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$742.09
|
| Rate for Payer: Priority Health HMO/PPO |
$993.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$764.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,004.67
|
| Rate for Payer: UHC Core |
$953.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$856.25
|
|
|
HC ARRAY COMPARATIVE GENOMIC ACGH
|
Facility
|
IP
|
$1,597.01
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
31000094
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,038.06 |
| Max. Negotiated Rate |
$1,437.31 |
| Rate for Payer: Aetna Commercial |
$1,357.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,303.64
|
| Rate for Payer: BCN Commercial |
$1,234.17
|
| Rate for Payer: Cash Price |
$1,277.61
|
| Rate for Payer: Cofinity Commercial |
$1,373.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,277.61
|
| Rate for Payer: Healthscope Commercial |
$1,437.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,197.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,357.46
|
| Rate for Payer: Nomi Health Commercial |
$1,309.55
|
| Rate for Payer: PHP Commercial |
$1,357.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.06
|
| Rate for Payer: Priority Health HMO/PPO |
$1,389.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,070.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,405.37
|
| Rate for Payer: UHC Core |
$1,333.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,197.76
|
|
|
HC ARRAY COMPARATIVE GENOMIC ACGH
|
Facility
|
OP
|
$1,597.01
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
31000094
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$379.29 |
| Max. Negotiated Rate |
$1,437.31 |
| Rate for Payer: Aetna Commercial |
$1,357.46
|
| Rate for Payer: Aetna Medicare |
$415.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$499.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$499.07
|
| Rate for Payer: BCBS Complete |
$683.28
|
| Rate for Payer: BCBS MAPPO |
$399.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,312.90
|
| Rate for Payer: BCN Commercial |
$1,241.68
|
| Rate for Payer: BCN Medicare Advantage |
$399.25
|
| Rate for Payer: Cash Price |
$1,277.61
|
| Rate for Payer: Cash Price |
$1,277.61
|
| Rate for Payer: Cofinity Commercial |
$1,373.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,277.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.25
|
| Rate for Payer: Healthscope Commercial |
$1,437.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,197.76
|
| Rate for Payer: Mclaren Medicaid |
$650.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$419.22
|
| Rate for Payer: Meridian Medicaid |
$683.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$459.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,357.46
|
| Rate for Payer: Nomi Health Commercial |
$1,309.55
|
| Rate for Payer: PACE Senior Care Partners |
$379.29
|
| Rate for Payer: PACE SWMI |
$399.25
|
| Rate for Payer: PHP Commercial |
$1,357.46
|
| Rate for Payer: PHP Medicare Advantage |
$399.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.06
|
| Rate for Payer: Priority Health HMO/PPO |
$1,389.40
|
| Rate for Payer: Priority Health Medicare |
$403.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,070.00
|
| Rate for Payer: Railroad Medicare Medicare |
$399.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,405.37
|
| Rate for Payer: UHC Core |
$1,333.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$399.25
|
| Rate for Payer: UHC Exchange |
$399.25
|
| Rate for Payer: UHC Medicare Advantage |
$399.25
|
| Rate for Payer: UHCCP Medicaid |
$650.70
|
| Rate for Payer: VA VA |
$399.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,197.76
|
|
|
HC ARRAY COMPARATIVE GENOMIC CMPT
|
Facility
|
OP
|
$1,412.70
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
31000061
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$38.63 |
| Max. Negotiated Rate |
$1,271.43 |
| Rate for Payer: Aetna Commercial |
$1,200.80
|
| Rate for Payer: Aetna Medicare |
$367.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$441.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$441.47
|
| Rate for Payer: BCBS Complete |
$40.56
|
| Rate for Payer: BCBS MAPPO |
$353.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,161.38
|
| Rate for Payer: BCN Commercial |
$1,098.37
|
| Rate for Payer: BCN Medicare Advantage |
$353.18
|
| Rate for Payer: Cash Price |
$1,130.16
|
| Rate for Payer: Cash Price |
$1,130.16
|
| Rate for Payer: Cofinity Commercial |
$1,214.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$353.18
|
| Rate for Payer: Healthscope Commercial |
$1,271.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,059.53
|
| Rate for Payer: Mclaren Medicaid |
$38.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.83
|
| Rate for Payer: Meridian Medicaid |
$40.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$406.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.80
|
| Rate for Payer: Nomi Health Commercial |
$1,158.41
|
| Rate for Payer: PACE Senior Care Partners |
$335.52
|
| Rate for Payer: PACE SWMI |
$353.18
|
| Rate for Payer: PHP Commercial |
$1,200.80
|
| Rate for Payer: PHP Medicare Advantage |
$353.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,229.05
|
| Rate for Payer: Priority Health Medicare |
$356.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$946.51
|
| Rate for Payer: Railroad Medicare Medicare |
$353.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,243.18
|
| Rate for Payer: UHC Core |
$1,179.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$353.18
|
| Rate for Payer: UHC Exchange |
$353.18
|
| Rate for Payer: UHC Medicare Advantage |
$353.18
|
| Rate for Payer: UHCCP Medicaid |
$38.63
|
| Rate for Payer: VA VA |
$353.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,059.53
|
|
|
HC ARRAY COMPARATIVE GENOMIC CMPT
|
Facility
|
IP
|
$1,412.70
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
31000061
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$918.25 |
| Max. Negotiated Rate |
$1,271.43 |
| Rate for Payer: Aetna Commercial |
$1,200.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,153.19
|
| Rate for Payer: BCN Commercial |
$1,091.73
|
| Rate for Payer: Cash Price |
$1,130.16
|
| Rate for Payer: Cofinity Commercial |
$1,214.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.16
|
| Rate for Payer: Healthscope Commercial |
$1,271.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,059.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.80
|
| Rate for Payer: Nomi Health Commercial |
$1,158.41
|
| Rate for Payer: PHP Commercial |
$1,200.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.25
|
| Rate for Payer: Priority Health HMO/PPO |
$1,229.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$946.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,243.18
|
| Rate for Payer: UHC Core |
$1,179.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,059.53
|
|
|
HC ARSENIC
|
Facility
|
IP
|
$196.04
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$127.43 |
| Max. Negotiated Rate |
$176.44 |
| Rate for Payer: Aetna Commercial |
$166.63
|
| Rate for Payer: BCBS Trust/PPO |
$160.03
|
| Rate for Payer: BCN Commercial |
$151.50
|
| Rate for Payer: Cash Price |
$156.83
|
| Rate for Payer: Cofinity Commercial |
$168.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.83
|
| Rate for Payer: Healthscope Commercial |
$176.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.63
|
| Rate for Payer: Nomi Health Commercial |
$160.75
|
| Rate for Payer: PHP Commercial |
$166.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.43
|
| Rate for Payer: Priority Health HMO/PPO |
$170.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.52
|
| Rate for Payer: UHC Core |
$163.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.03
|
|
|
HC ARSENIC
|
Facility
|
OP
|
$196.04
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.72 |
| Max. Negotiated Rate |
$176.44 |
| Rate for Payer: Aetna Commercial |
$166.63
|
| Rate for Payer: Aetna Medicare |
$50.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.26
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS MAPPO |
$49.01
|
| Rate for Payer: BCBS Trust/PPO |
$161.16
|
| Rate for Payer: BCN Commercial |
$152.42
|
| Rate for Payer: BCN Medicare Advantage |
$49.01
|
| Rate for Payer: Cash Price |
$156.83
|
| Rate for Payer: Cash Price |
$156.83
|
| Rate for Payer: Cofinity Commercial |
$168.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.01
|
| Rate for Payer: Healthscope Commercial |
$176.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.03
|
| Rate for Payer: Mclaren Medicaid |
$13.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.46
|
| Rate for Payer: Meridian Medicaid |
$14.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.63
|
| Rate for Payer: Nomi Health Commercial |
$160.75
|
| Rate for Payer: PACE Senior Care Partners |
$46.56
|
| Rate for Payer: PACE SWMI |
$49.01
|
| Rate for Payer: PHP Commercial |
$166.63
|
| Rate for Payer: PHP Medicare Advantage |
$49.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.43
|
| Rate for Payer: Priority Health HMO/PPO |
$170.55
|
| Rate for Payer: Priority Health Medicare |
$49.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.35
|
| Rate for Payer: Railroad Medicare Medicare |
$49.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.52
|
| Rate for Payer: UHC Core |
$163.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.01
|
| Rate for Payer: UHC Exchange |
$49.01
|
| Rate for Payer: UHC Medicare Advantage |
$49.01
|
| Rate for Payer: UHCCP Medicaid |
$13.72
|
| Rate for Payer: VA VA |
$49.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.03
|
|
|
HC ARSENIC 24HR U
|
Facility
|
OP
|
$114.24
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100679
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.72 |
| Max. Negotiated Rate |
$102.82 |
| Rate for Payer: Aetna Commercial |
$97.10
|
| Rate for Payer: Aetna Medicare |
$29.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.70
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS MAPPO |
$28.56
|
| Rate for Payer: BCBS Trust/PPO |
$93.92
|
| Rate for Payer: BCN Commercial |
$88.82
|
| Rate for Payer: BCN Medicare Advantage |
$28.56
|
| Rate for Payer: Cash Price |
$91.39
|
| Rate for Payer: Cash Price |
$91.39
|
| Rate for Payer: Cofinity Commercial |
$98.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.56
|
| Rate for Payer: Healthscope Commercial |
$102.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.68
|
| Rate for Payer: Mclaren Medicaid |
$13.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.99
|
| Rate for Payer: Meridian Medicaid |
$14.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.10
|
| Rate for Payer: Nomi Health Commercial |
$93.68
|
| Rate for Payer: PACE Senior Care Partners |
$27.13
|
| Rate for Payer: PACE SWMI |
$28.56
|
| Rate for Payer: PHP Commercial |
$97.10
|
| Rate for Payer: PHP Medicare Advantage |
$28.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.26
|
| Rate for Payer: Priority Health HMO/PPO |
$99.39
|
| Rate for Payer: Priority Health Medicare |
$28.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.54
|
| Rate for Payer: Railroad Medicare Medicare |
$28.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.53
|
| Rate for Payer: UHC Core |
$95.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.56
|
| Rate for Payer: UHC Exchange |
$28.56
|
| Rate for Payer: UHC Medicare Advantage |
$28.56
|
| Rate for Payer: UHCCP Medicaid |
$13.72
|
| Rate for Payer: VA VA |
$28.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.68
|
|
|
HC ARSENIC 24HR U
|
Facility
|
IP
|
$114.24
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100679
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$74.26 |
| Max. Negotiated Rate |
$102.82 |
| Rate for Payer: Aetna Commercial |
$97.10
|
| Rate for Payer: BCBS Trust/PPO |
$93.25
|
| Rate for Payer: BCN Commercial |
$88.28
|
| Rate for Payer: Cash Price |
$91.39
|
| Rate for Payer: Cofinity Commercial |
$98.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.39
|
| Rate for Payer: Healthscope Commercial |
$102.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.10
|
| Rate for Payer: Nomi Health Commercial |
$93.68
|
| Rate for Payer: PHP Commercial |
$97.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.26
|
| Rate for Payer: Priority Health HMO/PPO |
$99.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.53
|
| Rate for Payer: UHC Core |
$95.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.68
|
|
|
HC ARSENIC URINE
|
Facility
|
OP
|
$65.28
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.72 |
| Max. Negotiated Rate |
$58.75 |
| Rate for Payer: Aetna Commercial |
$55.49
|
| Rate for Payer: Aetna Medicare |
$16.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.40
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS MAPPO |
$16.32
|
| Rate for Payer: BCBS Trust/PPO |
$53.67
|
| Rate for Payer: BCN Commercial |
$50.76
|
| Rate for Payer: BCN Medicare Advantage |
$16.32
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cofinity Commercial |
$56.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$58.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.96
|
| Rate for Payer: Mclaren Medicaid |
$13.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.14
|
| Rate for Payer: Meridian Medicaid |
$14.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.49
|
| Rate for Payer: Nomi Health Commercial |
$53.53
|
| Rate for Payer: PACE Senior Care Partners |
$15.50
|
| Rate for Payer: PACE SWMI |
$16.32
|
| Rate for Payer: PHP Commercial |
$55.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.43
|
| Rate for Payer: Priority Health HMO/PPO |
$56.79
|
| Rate for Payer: Priority Health Medicare |
$16.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.74
|
| Rate for Payer: Railroad Medicare Medicare |
$16.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.45
|
| Rate for Payer: UHC Core |
$54.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.32
|
| Rate for Payer: UHC Exchange |
$16.32
|
| Rate for Payer: UHC Medicare Advantage |
$16.32
|
| Rate for Payer: UHCCP Medicaid |
$13.72
|
| Rate for Payer: VA VA |
$16.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.96
|
|
|
HC ARSENIC URINE
|
Facility
|
IP
|
$65.28
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.43 |
| Max. Negotiated Rate |
$58.75 |
| Rate for Payer: Aetna Commercial |
$55.49
|
| Rate for Payer: BCBS Trust/PPO |
$53.29
|
| Rate for Payer: BCN Commercial |
$50.45
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cofinity Commercial |
$56.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.22
|
| Rate for Payer: Healthscope Commercial |
$58.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.49
|
| Rate for Payer: Nomi Health Commercial |
$53.53
|
| Rate for Payer: PHP Commercial |
$55.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.43
|
| Rate for Payer: Priority Health HMO/PPO |
$56.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.45
|
| Rate for Payer: UHC Core |
$54.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.96
|
|
|
HC ART CATH INSERT
|
Facility
|
OP
|
$452.71
|
|
| Hospital Charge Code |
45000029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$107.52 |
| Max. Negotiated Rate |
$407.44 |
| Rate for Payer: Aetna Commercial |
$384.80
|
| Rate for Payer: Aetna Medicare |
$117.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.47
|
| Rate for Payer: BCBS Complete |
$181.08
|
| Rate for Payer: BCBS MAPPO |
$113.18
|
| Rate for Payer: BCBS Trust/PPO |
$372.17
|
| Rate for Payer: BCN Commercial |
$351.98
|
| Rate for Payer: BCN Medicare Advantage |
$113.18
|
| Rate for Payer: Cash Price |
$362.17
|
| Rate for Payer: Cofinity Commercial |
$389.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.18
|
| Rate for Payer: Healthscope Commercial |
$407.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$339.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$384.80
|
| Rate for Payer: Nomi Health Commercial |
$371.22
|
| Rate for Payer: PACE Senior Care Partners |
$107.52
|
| Rate for Payer: PACE SWMI |
$113.18
|
| Rate for Payer: PHP Commercial |
$384.80
|
| Rate for Payer: PHP Medicare Advantage |
$113.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.26
|
| Rate for Payer: Priority Health HMO/PPO |
$393.86
|
| Rate for Payer: Priority Health Medicare |
$114.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$303.32
|
| Rate for Payer: Railroad Medicare Medicare |
$113.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$398.38
|
| Rate for Payer: UHC Core |
$378.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.18
|
| Rate for Payer: UHC Exchange |
$113.18
|
| Rate for Payer: UHC Medicare Advantage |
$113.18
|
| Rate for Payer: VA VA |
$113.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$339.53
|
|
|
HC ART CATH INSERT
|
Facility
|
IP
|
$452.71
|
|
| Hospital Charge Code |
45000029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$294.26 |
| Max. Negotiated Rate |
$407.44 |
| Rate for Payer: Aetna Commercial |
$384.80
|
| Rate for Payer: BCBS Trust/PPO |
$369.55
|
| Rate for Payer: BCN Commercial |
$349.85
|
| Rate for Payer: Cash Price |
$362.17
|
| Rate for Payer: Cofinity Commercial |
$389.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.17
|
| Rate for Payer: Healthscope Commercial |
$407.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$339.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$384.80
|
| Rate for Payer: Nomi Health Commercial |
$371.22
|
| Rate for Payer: PHP Commercial |
$384.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.26
|
| Rate for Payer: Priority Health HMO/PPO |
$393.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$303.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$398.38
|
| Rate for Payer: UHC Core |
$378.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$339.53
|
|
|
HC ARTERIAL DUPLEX IMAG BIL LOWER EXTREMITY
|
Facility
|
IP
|
$1,588.11
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100007
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,032.27 |
| Max. Negotiated Rate |
$1,429.30 |
| Rate for Payer: Aetna Commercial |
$1,349.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,296.37
|
| Rate for Payer: BCN Commercial |
$1,227.29
|
| Rate for Payer: Cash Price |
$1,270.49
|
| Rate for Payer: Cofinity Commercial |
$1,365.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,270.49
|
| Rate for Payer: Healthscope Commercial |
$1,429.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,191.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,349.89
|
| Rate for Payer: Nomi Health Commercial |
$1,302.25
|
| Rate for Payer: PHP Commercial |
$1,349.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.27
|
| Rate for Payer: Priority Health HMO/PPO |
$1,381.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,064.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,397.54
|
| Rate for Payer: UHC Core |
$1,326.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,191.08
|
|
|
HC ARTERIAL DUPLEX IMAG BIL LOWER EXTREMITY
|
Facility
|
OP
|
$1,588.11
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100007
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$174.76 |
| Max. Negotiated Rate |
$1,429.30 |
| Rate for Payer: Aetna Commercial |
$1,349.89
|
| Rate for Payer: Aetna Medicare |
$412.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$496.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$496.28
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$397.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,305.59
|
| Rate for Payer: BCN Commercial |
$1,234.76
|
| Rate for Payer: BCN Medicare Advantage |
$397.03
|
| Rate for Payer: Cash Price |
$1,270.49
|
| Rate for Payer: Cash Price |
$1,270.49
|
| Rate for Payer: Cofinity Commercial |
$1,365.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,270.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.03
|
| Rate for Payer: Healthscope Commercial |
$1,429.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,191.08
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$416.88
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$456.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,349.89
|
| Rate for Payer: Nomi Health Commercial |
$1,302.25
|
| Rate for Payer: PACE Senior Care Partners |
$377.18
|
| Rate for Payer: PACE SWMI |
$397.03
|
| Rate for Payer: PHP Commercial |
$1,349.89
|
| Rate for Payer: PHP Medicare Advantage |
$397.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,032.27
|
| Rate for Payer: Priority Health HMO/PPO |
$1,381.66
|
| Rate for Payer: Priority Health Medicare |
$401.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,064.03
|
| Rate for Payer: Railroad Medicare Medicare |
$397.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,397.54
|
| Rate for Payer: UHC Core |
$1,326.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$397.03
|
| Rate for Payer: UHC Exchange |
$397.03
|
| Rate for Payer: UHC Medicare Advantage |
$397.03
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$397.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,191.08
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
OP
|
$1,308.89
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$174.76 |
| Max. Negotiated Rate |
$1,178.00 |
| Rate for Payer: Aetna Commercial |
$1,112.56
|
| Rate for Payer: Aetna Medicare |
$340.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$409.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$409.03
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$327.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,076.04
|
| Rate for Payer: BCN Commercial |
$1,017.66
|
| Rate for Payer: BCN Medicare Advantage |
$327.22
|
| Rate for Payer: Cash Price |
$1,047.11
|
| Rate for Payer: Cash Price |
$1,047.11
|
| Rate for Payer: Cofinity Commercial |
$1,125.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,047.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$327.22
|
| Rate for Payer: Healthscope Commercial |
$1,178.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$981.67
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$343.58
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$376.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,112.56
|
| Rate for Payer: Nomi Health Commercial |
$1,073.29
|
| Rate for Payer: PACE Senior Care Partners |
$310.86
|
| Rate for Payer: PACE SWMI |
$327.22
|
| Rate for Payer: PHP Commercial |
$1,112.56
|
| Rate for Payer: PHP Medicare Advantage |
$327.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.78
|
| Rate for Payer: Priority Health HMO/PPO |
$1,138.73
|
| Rate for Payer: Priority Health Medicare |
$330.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$876.96
|
| Rate for Payer: Railroad Medicare Medicare |
$327.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,151.82
|
| Rate for Payer: UHC Core |
$1,092.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$327.22
|
| Rate for Payer: UHC Exchange |
$327.22
|
| Rate for Payer: UHC Medicare Advantage |
$327.22
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$327.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$981.67
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
IP
|
$1,308.89
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$850.78 |
| Max. Negotiated Rate |
$1,178.00 |
| Rate for Payer: Aetna Commercial |
$1,112.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,068.45
|
| Rate for Payer: BCN Commercial |
$1,011.51
|
| Rate for Payer: Cash Price |
$1,047.11
|
| Rate for Payer: Cofinity Commercial |
$1,125.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,047.11
|
| Rate for Payer: Healthscope Commercial |
$1,178.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$981.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,112.56
|
| Rate for Payer: Nomi Health Commercial |
$1,073.29
|
| Rate for Payer: PHP Commercial |
$1,112.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$850.78
|
| Rate for Payer: Priority Health HMO/PPO |
$1,138.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$876.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,151.82
|
| Rate for Payer: UHC Core |
$1,092.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$981.67
|
|
|
HC ARTERIAL PUNCTURE
|
Facility
|
OP
|
$132.01
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$31.35 |
| Max. Negotiated Rate |
$118.81 |
| Rate for Payer: Aetna Commercial |
$112.21
|
| Rate for Payer: Aetna Medicare |
$34.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.25
|
| Rate for Payer: BCBS Complete |
$97.86
|
| Rate for Payer: BCBS MAPPO |
$33.00
|
| Rate for Payer: BCBS Trust/PPO |
$108.53
|
| Rate for Payer: BCN Commercial |
$102.64
|
| Rate for Payer: BCN Medicare Advantage |
$33.00
|
| Rate for Payer: Cash Price |
$105.61
|
| Rate for Payer: Cash Price |
$105.61
|
| Rate for Payer: Cofinity Commercial |
$113.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.00
|
| Rate for Payer: Healthscope Commercial |
$118.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.01
|
| Rate for Payer: Mclaren Medicaid |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.65
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.21
|
| Rate for Payer: Nomi Health Commercial |
$108.25
|
| Rate for Payer: PACE Senior Care Partners |
$31.35
|
| Rate for Payer: PACE SWMI |
$33.00
|
| Rate for Payer: PHP Commercial |
$112.21
|
| Rate for Payer: PHP Medicare Advantage |
$33.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.81
|
| Rate for Payer: Priority Health HMO/PPO |
$114.85
|
| Rate for Payer: Priority Health Medicare |
$33.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.45
|
| Rate for Payer: Railroad Medicare Medicare |
$33.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.17
|
| Rate for Payer: UHC Core |
$110.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.00
|
| Rate for Payer: UHC Exchange |
$33.00
|
| Rate for Payer: UHC Medicare Advantage |
$33.00
|
| Rate for Payer: UHCCP Medicaid |
$93.19
|
| Rate for Payer: VA VA |
$33.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.01
|
|
|
HC ARTERIAL PUNCTURE
|
Facility
|
IP
|
$132.01
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$85.81 |
| Max. Negotiated Rate |
$118.81 |
| Rate for Payer: Aetna Commercial |
$112.21
|
| Rate for Payer: BCBS Trust/PPO |
$107.76
|
| Rate for Payer: BCN Commercial |
$102.02
|
| Rate for Payer: Cash Price |
$105.61
|
| Rate for Payer: Cofinity Commercial |
$113.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.61
|
| Rate for Payer: Healthscope Commercial |
$118.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.21
|
| Rate for Payer: Nomi Health Commercial |
$108.25
|
| Rate for Payer: PHP Commercial |
$112.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.81
|
| Rate for Payer: Priority Health HMO/PPO |
$114.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.17
|
| Rate for Payer: UHC Core |
$110.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.01
|
|
