|
HC ARTHRT EXPL DRAIN RMV FOREIGN BODY FINGER JT
|
Facility
|
OP
|
$4,096.99
|
|
|
Service Code
|
CPT 26080
|
| Hospital Charge Code |
76100373
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$973.04 |
| Max. Negotiated Rate |
$3,687.29 |
| Rate for Payer: Aetna Commercial |
$3,482.44
|
| Rate for Payer: Aetna Medicare |
$1,065.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,280.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,280.31
|
| Rate for Payer: BCBS Complete |
$1,190.46
|
| Rate for Payer: BCBS MAPPO |
$1,024.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,368.14
|
| Rate for Payer: BCN Commercial |
$3,185.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,024.25
|
| Rate for Payer: Cash Price |
$3,277.59
|
| Rate for Payer: Cash Price |
$3,277.59
|
| Rate for Payer: Cofinity Commercial |
$3,523.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,277.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,024.25
|
| Rate for Payer: Healthscope Commercial |
$3,687.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,072.74
|
| Rate for Payer: Mclaren Medicaid |
$1,133.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,075.46
|
| Rate for Payer: Meridian Medicaid |
$1,190.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,177.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,482.44
|
| Rate for Payer: Nomi Health Commercial |
$3,359.53
|
| Rate for Payer: PACE Senior Care Partners |
$973.04
|
| Rate for Payer: PACE SWMI |
$1,024.25
|
| Rate for Payer: PHP Commercial |
$3,482.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,024.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,133.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,663.04
|
| Rate for Payer: Priority Health HMO/PPO |
$3,564.38
|
| Rate for Payer: Priority Health Medicare |
$1,034.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,744.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,024.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,605.35
|
| Rate for Payer: UHC Core |
$3,420.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,024.25
|
| Rate for Payer: UHC Exchange |
$1,024.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,024.25
|
| Rate for Payer: UHCCP Medicaid |
$1,133.70
|
| Rate for Payer: VA VA |
$1,024.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,072.74
|
|
|
HC ART IMG UNILAT LOWER EXTREMITY
|
Facility
|
OP
|
$922.21
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100012
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$829.99 |
| Rate for Payer: Aetna Commercial |
$783.88
|
| Rate for Payer: Aetna Medicare |
$239.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$288.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$288.19
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$230.55
|
| Rate for Payer: BCBS Trust/PPO |
$758.15
|
| Rate for Payer: BCN Commercial |
$717.02
|
| Rate for Payer: BCN Medicare Advantage |
$230.55
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cofinity Commercial |
$793.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.55
|
| Rate for Payer: Healthscope Commercial |
$829.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.66
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.08
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.88
|
| Rate for Payer: Nomi Health Commercial |
$756.21
|
| Rate for Payer: PACE Senior Care Partners |
$219.02
|
| Rate for Payer: PACE SWMI |
$230.55
|
| Rate for Payer: PHP Commercial |
$783.88
|
| Rate for Payer: PHP Medicare Advantage |
$230.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.44
|
| Rate for Payer: Priority Health HMO/PPO |
$802.32
|
| Rate for Payer: Priority Health Medicare |
$232.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.88
|
| Rate for Payer: Railroad Medicare Medicare |
$230.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$811.54
|
| Rate for Payer: UHC Core |
$770.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.55
|
| Rate for Payer: UHC Exchange |
$230.55
|
| Rate for Payer: UHC Medicare Advantage |
$230.55
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$230.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.66
|
|
|
HC ART IMG UNILAT LOWER EXTREMITY
|
Facility
|
IP
|
$922.21
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100012
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$599.44 |
| Max. Negotiated Rate |
$829.99 |
| Rate for Payer: Aetna Commercial |
$783.88
|
| Rate for Payer: BCBS Trust/PPO |
$752.80
|
| Rate for Payer: BCN Commercial |
$712.68
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cofinity Commercial |
$793.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.77
|
| Rate for Payer: Healthscope Commercial |
$829.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.88
|
| Rate for Payer: Nomi Health Commercial |
$756.21
|
| Rate for Payer: PHP Commercial |
$783.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.44
|
| Rate for Payer: Priority Health HMO/PPO |
$802.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$811.54
|
| Rate for Payer: UHC Core |
$770.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.66
|
|
|
HC ART IMG UNILAT UPPER EXTREM
|
Facility
|
IP
|
$756.35
|
|
|
Service Code
|
CPT 93931
|
| Hospital Charge Code |
92100009
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$491.63 |
| Max. Negotiated Rate |
$680.72 |
| Rate for Payer: Aetna Commercial |
$642.90
|
| Rate for Payer: BCBS Trust/PPO |
$617.41
|
| Rate for Payer: BCN Commercial |
$584.51
|
| Rate for Payer: Cash Price |
$605.08
|
| Rate for Payer: Cofinity Commercial |
$650.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$605.08
|
| Rate for Payer: Healthscope Commercial |
$680.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$567.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$642.90
|
| Rate for Payer: Nomi Health Commercial |
$620.21
|
| Rate for Payer: PHP Commercial |
$642.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.63
|
| Rate for Payer: Priority Health HMO/PPO |
$658.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$506.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.59
|
| Rate for Payer: UHC Core |
$631.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$567.26
|
|
|
HC ART IMG UNILAT UPPER EXTREM
|
Facility
|
OP
|
$756.35
|
|
|
Service Code
|
CPT 93931
|
| Hospital Charge Code |
92100009
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$680.72 |
| Rate for Payer: Aetna Commercial |
$642.90
|
| Rate for Payer: Aetna Medicare |
$196.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.36
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$189.09
|
| Rate for Payer: BCBS Trust/PPO |
$621.80
|
| Rate for Payer: BCN Commercial |
$588.06
|
| Rate for Payer: BCN Medicare Advantage |
$189.09
|
| Rate for Payer: Cash Price |
$605.08
|
| Rate for Payer: Cash Price |
$605.08
|
| Rate for Payer: Cofinity Commercial |
$650.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$605.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.09
|
| Rate for Payer: Healthscope Commercial |
$680.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$567.26
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.54
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$217.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$642.90
|
| Rate for Payer: Nomi Health Commercial |
$620.21
|
| Rate for Payer: PACE Senior Care Partners |
$179.63
|
| Rate for Payer: PACE SWMI |
$189.09
|
| Rate for Payer: PHP Commercial |
$642.90
|
| Rate for Payer: PHP Medicare Advantage |
$189.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.63
|
| Rate for Payer: Priority Health HMO/PPO |
$658.02
|
| Rate for Payer: Priority Health Medicare |
$190.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$506.75
|
| Rate for Payer: Railroad Medicare Medicare |
$189.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.59
|
| Rate for Payer: UHC Core |
$631.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.09
|
| Rate for Payer: UHC Exchange |
$189.09
|
| Rate for Payer: UHC Medicare Advantage |
$189.09
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$189.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$567.26
|
|
|
HC ART&VEN TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$4,644.53
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
36100373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,018.94 |
| Max. Negotiated Rate |
$4,180.08 |
| Rate for Payer: Aetna Commercial |
$3,947.85
|
| Rate for Payer: BCBS Trust/PPO |
$3,791.33
|
| Rate for Payer: BCN Commercial |
$3,589.29
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cofinity Commercial |
$3,994.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,715.62
|
| Rate for Payer: Healthscope Commercial |
$4,180.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,483.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,947.85
|
| Rate for Payer: Nomi Health Commercial |
$3,808.51
|
| Rate for Payer: PHP Commercial |
$3,947.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.94
|
| Rate for Payer: Priority Health HMO/PPO |
$4,040.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,111.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,087.19
|
| Rate for Payer: UHC Core |
$3,878.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,483.40
|
|
|
HC ART&VEN TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$4,644.53
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
36100373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,103.08 |
| Max. Negotiated Rate |
$4,180.08 |
| Rate for Payer: Aetna Commercial |
$3,947.85
|
| Rate for Payer: Aetna Medicare |
$1,207.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,451.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,451.42
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$1,161.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,818.27
|
| Rate for Payer: BCN Commercial |
$3,611.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,161.13
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cofinity Commercial |
$3,994.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,715.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,161.13
|
| Rate for Payer: Healthscope Commercial |
$4,180.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,483.40
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,219.19
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,335.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,947.85
|
| Rate for Payer: Nomi Health Commercial |
$3,808.51
|
| Rate for Payer: PACE Senior Care Partners |
$1,103.08
|
| Rate for Payer: PACE SWMI |
$1,161.13
|
| Rate for Payer: PHP Commercial |
$3,947.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,161.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.94
|
| Rate for Payer: Priority Health HMO/PPO |
$4,040.74
|
| Rate for Payer: Priority Health Medicare |
$1,172.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,111.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,161.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,087.19
|
| Rate for Payer: UHC Core |
$3,878.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,161.13
|
| Rate for Payer: UHC Exchange |
$1,161.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,161.13
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$1,161.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,483.40
|
|
|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
IP
|
$195.66
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$127.18 |
| Max. Negotiated Rate |
$176.09 |
| Rate for Payer: Aetna Commercial |
$166.31
|
| Rate for Payer: BCBS Trust/PPO |
$159.72
|
| Rate for Payer: BCN Commercial |
$151.21
|
| Rate for Payer: Cash Price |
$156.53
|
| Rate for Payer: Cofinity Commercial |
$168.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.53
|
| Rate for Payer: Healthscope Commercial |
$176.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.31
|
| Rate for Payer: Nomi Health Commercial |
$160.44
|
| Rate for Payer: PHP Commercial |
$166.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.18
|
| Rate for Payer: Priority Health HMO/PPO |
$170.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.18
|
| Rate for Payer: UHC Core |
$163.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.74
|
|
|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
OP
|
$195.66
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.47 |
| Max. Negotiated Rate |
$176.09 |
| Rate for Payer: Aetna Commercial |
$166.31
|
| Rate for Payer: Aetna Medicare |
$50.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.14
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$48.92
|
| Rate for Payer: BCBS Trust/PPO |
$160.85
|
| Rate for Payer: BCN Commercial |
$152.13
|
| Rate for Payer: BCN Medicare Advantage |
$48.92
|
| Rate for Payer: Cash Price |
$156.53
|
| Rate for Payer: Cash Price |
$156.53
|
| Rate for Payer: Cofinity Commercial |
$168.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.92
|
| Rate for Payer: Healthscope Commercial |
$176.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.74
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.36
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.31
|
| Rate for Payer: Nomi Health Commercial |
$160.44
|
| Rate for Payer: PACE Senior Care Partners |
$46.47
|
| Rate for Payer: PACE SWMI |
$48.92
|
| Rate for Payer: PHP Commercial |
$166.31
|
| Rate for Payer: PHP Medicare Advantage |
$48.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.18
|
| Rate for Payer: Priority Health HMO/PPO |
$170.22
|
| Rate for Payer: Priority Health Medicare |
$49.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.09
|
| Rate for Payer: Railroad Medicare Medicare |
$48.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.18
|
| Rate for Payer: UHC Core |
$163.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.92
|
| Rate for Payer: UHC Exchange |
$48.92
|
| Rate for Payer: UHC Medicare Advantage |
$48.92
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$48.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.74
|
|
|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
IP
|
$1,234.97
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$802.73 |
| Max. Negotiated Rate |
$1,111.47 |
| Rate for Payer: Aetna Commercial |
$1,049.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,008.11
|
| Rate for Payer: BCN Commercial |
$954.38
|
| Rate for Payer: Cash Price |
$987.98
|
| Rate for Payer: Cofinity Commercial |
$1,062.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.98
|
| Rate for Payer: Healthscope Commercial |
$1,111.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$926.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,049.72
|
| Rate for Payer: Nomi Health Commercial |
$1,012.68
|
| Rate for Payer: PHP Commercial |
$1,049.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.73
|
| Rate for Payer: Priority Health HMO/PPO |
$1,074.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$827.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,086.77
|
| Rate for Payer: UHC Core |
$1,031.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$926.23
|
|
|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
OP
|
$1,234.97
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$293.31 |
| Max. Negotiated Rate |
$1,111.47 |
| Rate for Payer: Aetna Commercial |
$1,049.72
|
| Rate for Payer: Aetna Medicare |
$321.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$385.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$385.93
|
| Rate for Payer: BCBS Complete |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$308.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,015.27
|
| Rate for Payer: BCN Commercial |
$960.19
|
| Rate for Payer: BCN Medicare Advantage |
$308.74
|
| Rate for Payer: Cash Price |
$987.98
|
| Rate for Payer: Cash Price |
$987.98
|
| Rate for Payer: Cofinity Commercial |
$1,062.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.74
|
| Rate for Payer: Healthscope Commercial |
$1,111.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$926.23
|
| Rate for Payer: Mclaren Medicaid |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.18
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$355.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,049.72
|
| Rate for Payer: Nomi Health Commercial |
$1,012.68
|
| Rate for Payer: PACE Senior Care Partners |
$293.31
|
| Rate for Payer: PACE SWMI |
$308.74
|
| Rate for Payer: PHP Commercial |
$1,049.72
|
| Rate for Payer: PHP Medicare Advantage |
$308.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.73
|
| Rate for Payer: Priority Health HMO/PPO |
$1,074.42
|
| Rate for Payer: Priority Health Medicare |
$311.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$827.43
|
| Rate for Payer: Railroad Medicare Medicare |
$308.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,086.77
|
| Rate for Payer: UHC Core |
$1,031.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.74
|
| Rate for Payer: UHC Exchange |
$308.74
|
| Rate for Payer: UHC Medicare Advantage |
$308.74
|
| Rate for Payer: UHCCP Medicaid |
$498.41
|
| Rate for Payer: VA VA |
$308.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$926.23
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: BCBS Trust/PPO |
$38.22
|
| Rate for Payer: BCN Commercial |
$36.18
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.88 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.63
|
| Rate for Payer: BCBS Complete |
$11.43
|
| Rate for Payer: BCBS MAPPO |
$11.70
|
| Rate for Payer: BCBS Trust/PPO |
$38.49
|
| Rate for Payer: BCN Commercial |
$36.40
|
| Rate for Payer: BCN Medicare Advantage |
$11.70
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.70
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$10.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.29
|
| Rate for Payer: Meridian Medicaid |
$11.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PACE Senior Care Partners |
$11.12
|
| Rate for Payer: PACE SWMI |
$11.70
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.37
|
| Rate for Payer: Railroad Medicare Medicare |
$11.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.70
|
| Rate for Payer: UHC Exchange |
$11.70
|
| Rate for Payer: UHC Medicare Advantage |
$11.70
|
| Rate for Payer: UHCCP Medicaid |
$10.88
|
| Rate for Payer: VA VA |
$11.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC ASPERGILLUS ANTIBODIES CMPT
|
Facility
|
OP
|
$40.58
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.64 |
| Max. Negotiated Rate |
$36.52 |
| Rate for Payer: Aetna Commercial |
$34.49
|
| Rate for Payer: Aetna Medicare |
$10.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.68
|
| Rate for Payer: BCBS Complete |
$11.43
|
| Rate for Payer: BCBS MAPPO |
$10.14
|
| Rate for Payer: BCBS Trust/PPO |
$33.36
|
| Rate for Payer: BCN Commercial |
$31.55
|
| Rate for Payer: BCN Medicare Advantage |
$10.14
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cofinity Commercial |
$34.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.14
|
| Rate for Payer: Healthscope Commercial |
$36.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.44
|
| Rate for Payer: Mclaren Medicaid |
$10.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.65
|
| Rate for Payer: Meridian Medicaid |
$11.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.49
|
| Rate for Payer: Nomi Health Commercial |
$33.28
|
| Rate for Payer: PACE Senior Care Partners |
$9.64
|
| Rate for Payer: PACE SWMI |
$10.14
|
| Rate for Payer: PHP Commercial |
$34.49
|
| Rate for Payer: PHP Medicare Advantage |
$10.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.38
|
| Rate for Payer: Priority Health HMO/PPO |
$35.30
|
| Rate for Payer: Priority Health Medicare |
$10.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.19
|
| Rate for Payer: Railroad Medicare Medicare |
$10.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.71
|
| Rate for Payer: UHC Core |
$33.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.14
|
| Rate for Payer: UHC Exchange |
$10.14
|
| Rate for Payer: UHC Medicare Advantage |
$10.14
|
| Rate for Payer: UHCCP Medicaid |
$10.88
|
| Rate for Payer: VA VA |
$10.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.44
|
|
|
HC ASPERGILLUS ANTIBODIES CMPT
|
Facility
|
IP
|
$40.58
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.38 |
| Max. Negotiated Rate |
$36.52 |
| Rate for Payer: Aetna Commercial |
$34.49
|
| Rate for Payer: BCBS Trust/PPO |
$33.13
|
| Rate for Payer: BCN Commercial |
$31.36
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cofinity Commercial |
$34.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.46
|
| Rate for Payer: Healthscope Commercial |
$36.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.49
|
| Rate for Payer: Nomi Health Commercial |
$33.28
|
| Rate for Payer: PHP Commercial |
$34.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.38
|
| Rate for Payer: Priority Health HMO/PPO |
$35.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.71
|
| Rate for Payer: UHC Core |
$33.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.44
|
|
|
HC ASPERGILLUS ANTIGEN
|
Facility
|
OP
|
$83.64
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600135
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.66 |
| Max. Negotiated Rate |
$75.28 |
| Rate for Payer: Aetna Commercial |
$71.09
|
| Rate for Payer: Aetna Medicare |
$21.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.14
|
| Rate for Payer: BCBS Complete |
$9.10
|
| Rate for Payer: BCBS MAPPO |
$20.91
|
| Rate for Payer: BCBS Trust/PPO |
$68.76
|
| Rate for Payer: BCN Commercial |
$65.03
|
| Rate for Payer: BCN Medicare Advantage |
$20.91
|
| Rate for Payer: Cash Price |
$66.91
|
| Rate for Payer: Cash Price |
$66.91
|
| Rate for Payer: Cofinity Commercial |
$71.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.91
|
| Rate for Payer: Healthscope Commercial |
$75.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.73
|
| Rate for Payer: Mclaren Medicaid |
$8.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.96
|
| Rate for Payer: Meridian Medicaid |
$9.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.09
|
| Rate for Payer: Nomi Health Commercial |
$68.58
|
| Rate for Payer: PACE Senior Care Partners |
$19.86
|
| Rate for Payer: PACE SWMI |
$20.91
|
| Rate for Payer: PHP Commercial |
$71.09
|
| Rate for Payer: PHP Medicare Advantage |
$20.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.37
|
| Rate for Payer: Priority Health HMO/PPO |
$72.77
|
| Rate for Payer: Priority Health Medicare |
$21.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.04
|
| Rate for Payer: Railroad Medicare Medicare |
$20.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.60
|
| Rate for Payer: UHC Core |
$69.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.91
|
| Rate for Payer: UHC Exchange |
$20.91
|
| Rate for Payer: UHC Medicare Advantage |
$20.91
|
| Rate for Payer: UHCCP Medicaid |
$8.66
|
| Rate for Payer: VA VA |
$20.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.73
|
|
|
HC ASPERGILLUS ANTIGEN
|
Facility
|
IP
|
$83.64
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600135
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$54.37 |
| Max. Negotiated Rate |
$75.28 |
| Rate for Payer: Aetna Commercial |
$71.09
|
| Rate for Payer: BCBS Trust/PPO |
$68.28
|
| Rate for Payer: BCN Commercial |
$64.64
|
| Rate for Payer: Cash Price |
$66.91
|
| Rate for Payer: Cofinity Commercial |
$71.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.91
|
| Rate for Payer: Healthscope Commercial |
$75.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.09
|
| Rate for Payer: Nomi Health Commercial |
$68.58
|
| Rate for Payer: PHP Commercial |
$71.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.37
|
| Rate for Payer: Priority Health HMO/PPO |
$72.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.60
|
| Rate for Payer: UHC Core |
$69.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.73
|
|
|
HC ASPERGILLUS ANTIGEN, BAL
|
Facility
|
IP
|
$90.78
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$59.01 |
| Max. Negotiated Rate |
$81.70 |
| Rate for Payer: Aetna Commercial |
$77.16
|
| Rate for Payer: BCBS Trust/PPO |
$74.10
|
| 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 Commercial |
$77.16
|
| Rate for Payer: Nomi Health Commercial |
$74.44
|
| Rate for Payer: PHP Commercial |
$77.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.01
|
| Rate for Payer: Priority Health HMO/PPO |
$78.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.82
|
| 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 ASPERGILLUS ANTIGEN, BAL
|
Facility
|
OP
|
$90.78
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.66 |
| 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 |
$9.10
|
| Rate for Payer: BCBS MAPPO |
$22.70
|
| Rate for Payer: BCBS Trust/PPO |
$74.63
|
| 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: 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: Mclaren Medicaid |
$8.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.83
|
| Rate for Payer: Meridian Medicaid |
$9.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.16
|
| Rate for Payer: Nomi Health Commercial |
$74.44
|
| 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 Choice Medicaid |
$8.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.01
|
| Rate for Payer: Priority Health HMO/PPO |
$78.98
|
| Rate for Payer: Priority Health Medicare |
$22.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.82
|
| 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 Exchange |
$22.70
|
| Rate for Payer: UHC Medicare Advantage |
$22.70
|
| Rate for Payer: UHCCP Medicaid |
$8.66
|
| Rate for Payer: VA VA |
$22.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.08
|
|
|
HC ASPERGILLUS FUMIGATUS IGG AB
|
Facility
|
IP
|
$58.14
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: BCBS Trust/PPO |
$47.46
|
| Rate for Payer: BCN Commercial |
$44.93
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO |
$50.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.16
|
| Rate for Payer: UHC Core |
$48.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
|
HC ASPERGILLUS FUMIGATUS IGG AB
|
Facility
|
OP
|
$58.14
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.88 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: Aetna Medicare |
$15.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.17
|
| Rate for Payer: BCBS Complete |
$11.43
|
| Rate for Payer: BCBS MAPPO |
$14.54
|
| Rate for Payer: BCBS Trust/PPO |
$47.80
|
| Rate for Payer: BCN Commercial |
$45.20
|
| Rate for Payer: BCN Medicare Advantage |
$14.54
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.54
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
| Rate for Payer: Mclaren Medicaid |
$10.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.26
|
| Rate for Payer: Meridian Medicaid |
$11.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: PACE Senior Care Partners |
$13.81
|
| Rate for Payer: PACE SWMI |
$14.54
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: PHP Medicare Advantage |
$14.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO |
$50.58
|
| Rate for Payer: Priority Health Medicare |
$14.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.95
|
| Rate for Payer: Railroad Medicare Medicare |
$14.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.16
|
| Rate for Payer: UHC Core |
$48.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.54
|
| Rate for Payer: UHC Exchange |
$14.54
|
| Rate for Payer: UHC Medicare Advantage |
$14.54
|
| Rate for Payer: UHCCP Medicaid |
$10.88
|
| Rate for Payer: VA VA |
$14.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
OP
|
$843.49
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$200.33 |
| Max. Negotiated Rate |
$759.14 |
| Rate for Payer: Aetna Commercial |
$716.97
|
| Rate for Payer: Aetna Medicare |
$219.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$263.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$263.59
|
| Rate for Payer: BCBS Complete |
$523.36
|
| Rate for Payer: BCBS MAPPO |
$210.87
|
| Rate for Payer: BCBS Trust/PPO |
$693.43
|
| Rate for Payer: BCN Commercial |
$655.81
|
| Rate for Payer: BCN Medicare Advantage |
$210.87
|
| Rate for Payer: Cash Price |
$674.79
|
| Rate for Payer: Cash Price |
$674.79
|
| Rate for Payer: Cofinity Commercial |
$725.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.87
|
| Rate for Payer: Healthscope Commercial |
$759.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$632.62
|
| Rate for Payer: Mclaren Medicaid |
$498.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$221.42
|
| Rate for Payer: Meridian Medicaid |
$523.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$242.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.97
|
| Rate for Payer: Nomi Health Commercial |
$691.66
|
| Rate for Payer: PACE Senior Care Partners |
$200.33
|
| Rate for Payer: PACE SWMI |
$210.87
|
| Rate for Payer: PHP Commercial |
$716.97
|
| Rate for Payer: PHP Medicare Advantage |
$210.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$498.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.27
|
| Rate for Payer: Priority Health HMO/PPO |
$733.84
|
| Rate for Payer: Priority Health Medicare |
$212.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$565.14
|
| Rate for Payer: Railroad Medicare Medicare |
$210.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$742.27
|
| Rate for Payer: UHC Core |
$704.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.87
|
| Rate for Payer: UHC Exchange |
$210.87
|
| Rate for Payer: UHC Medicare Advantage |
$210.87
|
| Rate for Payer: UHCCP Medicaid |
$498.41
|
| Rate for Payer: VA VA |
$210.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$632.62
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
IP
|
$843.49
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$548.27 |
| Max. Negotiated Rate |
$759.14 |
| Rate for Payer: Aetna Commercial |
$716.97
|
| Rate for Payer: BCBS Trust/PPO |
$688.54
|
| Rate for Payer: BCN Commercial |
$651.85
|
| Rate for Payer: Cash Price |
$674.79
|
| Rate for Payer: Cofinity Commercial |
$725.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.79
|
| Rate for Payer: Healthscope Commercial |
$759.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$632.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.97
|
| Rate for Payer: Nomi Health Commercial |
$691.66
|
| Rate for Payer: PHP Commercial |
$716.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.27
|
| Rate for Payer: Priority Health HMO/PPO |
$733.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$565.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$742.27
|
| Rate for Payer: UHC Core |
$704.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$632.62
|
|
