|
HC ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS
|
Facility
|
OP
|
$2,938.00
|
|
|
Service Code
|
CPT 36479
|
| Hospital Charge Code |
76100407
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$697.78 |
| Max. Negotiated Rate |
$2,644.20 |
| Rate for Payer: Aetna Commercial |
$2,497.30
|
| Rate for Payer: Aetna Medicare |
$763.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$918.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$918.12
|
| Rate for Payer: BCBS Complete |
$1,175.20
|
| Rate for Payer: BCBS MAPPO |
$734.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,284.30
|
| Rate for Payer: BCN Commercial |
$2,284.30
|
| Rate for Payer: BCN Medicare Advantage |
$734.50
|
| Rate for Payer: Cash Price |
$2,350.40
|
| Rate for Payer: Cofinity Commercial |
$2,526.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,350.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$734.50
|
| Rate for Payer: Healthscope Commercial |
$2,644.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,203.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$771.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$844.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,497.30
|
| Rate for Payer: PACE Senior Care Partners |
$697.78
|
| Rate for Payer: PACE SWMI |
$734.50
|
| Rate for Payer: PHP Commercial |
$2,497.30
|
| Rate for Payer: PHP Medicare Advantage |
$734.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,556.06
|
| Rate for Payer: Priority Health Medicare |
$734.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,791.89
|
| Rate for Payer: Railroad Medicare Medicare |
$734.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,585.44
|
| Rate for Payer: UHC Core |
$2,453.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$734.50
|
| Rate for Payer: UHC Medicare Advantage |
$756.54
|
| Rate for Payer: VA VA |
$734.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,203.50
|
|
|
HC ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS
|
Facility
|
IP
|
$2,938.00
|
|
|
Service Code
|
CPT 36479
|
| Hospital Charge Code |
76100407
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,791.89 |
| Max. Negotiated Rate |
$2,644.20 |
| Rate for Payer: Aetna Commercial |
$2,497.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,270.49
|
| Rate for Payer: BCN Commercial |
$2,270.49
|
| Rate for Payer: Cash Price |
$2,350.40
|
| Rate for Payer: Cofinity Commercial |
$2,526.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,350.40
|
| Rate for Payer: Healthscope Commercial |
$2,644.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,203.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,497.30
|
| Rate for Payer: PHP Commercial |
$2,497.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,556.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,791.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,585.44
|
| Rate for Payer: UHC Core |
$2,453.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,203.50
|
|
|
HC ENDOVENOUS ABLAT EXTR W IMAGING PERC FIRST VEIN
|
Facility
|
OP
|
$3,998.90
|
|
|
Service Code
|
CPT 36473
|
| Hospital Charge Code |
36100523
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$949.74 |
| Max. Negotiated Rate |
$3,599.01 |
| Rate for Payer: Aetna Commercial |
$3,399.06
|
| Rate for Payer: Aetna Medicare |
$1,039.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,249.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,249.66
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$999.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,109.14
|
| Rate for Payer: BCN Commercial |
$3,109.14
|
| Rate for Payer: BCN Medicare Advantage |
$999.72
|
| Rate for Payer: Cash Price |
$3,199.12
|
| Rate for Payer: Cash Price |
$3,199.12
|
| Rate for Payer: Cofinity Commercial |
$3,439.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,199.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$999.72
|
| Rate for Payer: Healthscope Commercial |
$3,599.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,999.18
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,049.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,149.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,399.06
|
| Rate for Payer: PACE Senior Care Partners |
$949.74
|
| Rate for Payer: PACE SWMI |
$999.72
|
| Rate for Payer: PHP Commercial |
$3,399.06
|
| Rate for Payer: PHP Medicare Advantage |
$999.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,799.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,479.04
|
| Rate for Payer: Priority Health Medicare |
$999.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,438.93
|
| Rate for Payer: Railroad Medicare Medicare |
$999.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,519.03
|
| Rate for Payer: UHC Core |
$3,339.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$999.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,029.72
|
| Rate for Payer: VA VA |
$999.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,999.18
|
|
|
HC ENDOVENOUS ABLAT EXTR W IMAGING PERC FIRST VEIN
|
Facility
|
IP
|
$3,998.90
|
|
|
Service Code
|
CPT 36473
|
| Hospital Charge Code |
36100523
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,438.93 |
| Max. Negotiated Rate |
$3,599.01 |
| Rate for Payer: Aetna Commercial |
$3,399.06
|
| Rate for Payer: BCBS Trust/PPO |
$3,090.35
|
| Rate for Payer: BCN Commercial |
$3,090.35
|
| Rate for Payer: Cash Price |
$3,199.12
|
| Rate for Payer: Cofinity Commercial |
$3,439.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,199.12
|
| Rate for Payer: Healthscope Commercial |
$3,599.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,999.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,399.06
|
| Rate for Payer: PHP Commercial |
$3,399.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,799.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,479.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,438.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,519.03
|
| Rate for Payer: UHC Core |
$3,339.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,999.18
|
|
|
HC ENDOVENOUS ABLAT SUBS VEIN SEP ACCESS SITE EXTR
|
Facility
|
IP
|
$256.40
|
|
|
Service Code
|
CPT 36474
|
| Hospital Charge Code |
36100524
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$156.38 |
| Max. Negotiated Rate |
$230.76 |
| Rate for Payer: Aetna Commercial |
$217.94
|
| Rate for Payer: BCBS Trust/PPO |
$198.15
|
| Rate for Payer: BCN Commercial |
$198.15
|
| Rate for Payer: Cash Price |
$205.12
|
| Rate for Payer: Cofinity Commercial |
$220.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.12
|
| Rate for Payer: Healthscope Commercial |
$230.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$217.94
|
| Rate for Payer: PHP Commercial |
$217.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.63
|
| Rate for Payer: UHC Core |
$214.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.30
|
|
|
HC ENDOVENOUS ABLAT SUBS VEIN SEP ACCESS SITE EXTR
|
Facility
|
OP
|
$256.40
|
|
|
Service Code
|
CPT 36474
|
| Hospital Charge Code |
36100524
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$60.90 |
| Max. Negotiated Rate |
$230.76 |
| Rate for Payer: Aetna Commercial |
$217.94
|
| Rate for Payer: Aetna Medicare |
$66.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.12
|
| Rate for Payer: BCBS Complete |
$102.56
|
| Rate for Payer: BCBS MAPPO |
$64.10
|
| Rate for Payer: BCBS Trust/PPO |
$199.35
|
| Rate for Payer: BCN Commercial |
$199.35
|
| Rate for Payer: BCN Medicare Advantage |
$64.10
|
| Rate for Payer: Cash Price |
$205.12
|
| Rate for Payer: Cofinity Commercial |
$220.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.10
|
| Rate for Payer: Healthscope Commercial |
$230.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$217.94
|
| Rate for Payer: PACE Senior Care Partners |
$60.90
|
| Rate for Payer: PACE SWMI |
$64.10
|
| Rate for Payer: PHP Commercial |
$217.94
|
| Rate for Payer: PHP Medicare Advantage |
$64.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.07
|
| Rate for Payer: Priority Health Medicare |
$64.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.38
|
| Rate for Payer: Railroad Medicare Medicare |
$64.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.63
|
| Rate for Payer: UHC Core |
$214.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.10
|
| Rate for Payer: UHC Medicare Advantage |
$66.02
|
| Rate for Payer: VA VA |
$64.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.30
|
|
|
HC ENDOVENOUS LASER 1ST VEIN
|
Facility
|
IP
|
$4,041.53
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
76100184
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,464.93 |
| Max. Negotiated Rate |
$3,637.38 |
| Rate for Payer: Aetna Commercial |
$3,435.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,123.29
|
| Rate for Payer: BCN Commercial |
$3,123.29
|
| Rate for Payer: Cash Price |
$3,233.22
|
| Rate for Payer: Cofinity Commercial |
$3,475.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,233.22
|
| Rate for Payer: Healthscope Commercial |
$3,637.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,031.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,435.30
|
| Rate for Payer: PHP Commercial |
$3,435.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,829.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,516.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,464.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,556.55
|
| Rate for Payer: UHC Core |
$3,374.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,031.15
|
|
|
HC ENDOVENOUS LASER 1ST VEIN
|
Facility
|
OP
|
$4,041.53
|
|
|
Service Code
|
CPT 36478
|
| Hospital Charge Code |
76100184
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$959.86 |
| Max. Negotiated Rate |
$3,637.38 |
| Rate for Payer: Aetna Commercial |
$3,435.30
|
| Rate for Payer: Aetna Medicare |
$1,050.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,262.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,262.98
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$1,010.38
|
| Rate for Payer: BCBS Trust/PPO |
$3,142.29
|
| Rate for Payer: BCN Commercial |
$3,142.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,010.38
|
| Rate for Payer: Cash Price |
$3,233.22
|
| Rate for Payer: Cash Price |
$3,233.22
|
| Rate for Payer: Cofinity Commercial |
$3,475.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,233.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,010.38
|
| Rate for Payer: Healthscope Commercial |
$3,637.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,031.15
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,060.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,161.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,435.30
|
| Rate for Payer: PACE Senior Care Partners |
$959.86
|
| Rate for Payer: PACE SWMI |
$1,010.38
|
| Rate for Payer: PHP Commercial |
$3,435.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,010.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,829.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,516.13
|
| Rate for Payer: Priority Health Medicare |
$1,010.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,464.93
|
| Rate for Payer: Railroad Medicare Medicare |
$1,010.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,556.55
|
| Rate for Payer: UHC Core |
$3,374.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,010.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,040.69
|
| Rate for Payer: VA VA |
$1,010.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,031.15
|
|
|
HC ENDOVENT
|
Facility
|
OP
|
$4,711.31
|
|
| Hospital Charge Code |
27000099
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,118.94 |
| Max. Negotiated Rate |
$4,240.18 |
| Rate for Payer: Aetna Commercial |
$4,004.61
|
| Rate for Payer: Aetna Medicare |
$1,224.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,472.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,472.28
|
| Rate for Payer: BCBS Complete |
$1,884.52
|
| Rate for Payer: BCBS MAPPO |
$1,177.83
|
| Rate for Payer: BCBS Trust/PPO |
$3,663.04
|
| Rate for Payer: BCN Commercial |
$3,663.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,177.83
|
| Rate for Payer: Cash Price |
$3,769.05
|
| Rate for Payer: Cofinity Commercial |
$4,051.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,769.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,177.83
|
| Rate for Payer: Healthscope Commercial |
$4,240.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,533.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,236.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,354.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,004.61
|
| Rate for Payer: PACE Senior Care Partners |
$1,118.94
|
| Rate for Payer: PACE SWMI |
$1,177.83
|
| Rate for Payer: PHP Commercial |
$4,004.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,177.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,297.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,098.84
|
| Rate for Payer: Priority Health Medicare |
$1,177.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,873.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,177.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,145.95
|
| Rate for Payer: UHC Core |
$3,933.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,177.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,213.16
|
| Rate for Payer: VA VA |
$1,177.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,533.48
|
|
|
HC ENDOVENT
|
Facility
|
IP
|
$4,711.31
|
|
| Hospital Charge Code |
27000099
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,873.43 |
| Max. Negotiated Rate |
$4,240.18 |
| Rate for Payer: Aetna Commercial |
$4,004.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,640.90
|
| Rate for Payer: BCN Commercial |
$3,640.90
|
| Rate for Payer: Cash Price |
$3,769.05
|
| Rate for Payer: Cofinity Commercial |
$4,051.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,769.05
|
| Rate for Payer: Healthscope Commercial |
$4,240.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,533.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,004.61
|
| Rate for Payer: PHP Commercial |
$4,004.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,297.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,098.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,873.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,145.95
|
| Rate for Payer: UHC Core |
$3,933.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,533.48
|
|
|
HC ENGLISH PLANTAIN IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200084
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ENGLISH PLANTAIN IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200084
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ENSITE NAVX KIT
|
Facility
|
IP
|
$4,707.00
|
|
| Hospital Charge Code |
27200121
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,870.80 |
| Max. Negotiated Rate |
$4,236.30 |
| Rate for Payer: Aetna Commercial |
$4,000.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,637.57
|
| Rate for Payer: BCN Commercial |
$3,637.57
|
| Rate for Payer: Cash Price |
$3,765.60
|
| Rate for Payer: Cofinity Commercial |
$4,048.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,765.60
|
| Rate for Payer: Healthscope Commercial |
$4,236.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,530.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,000.95
|
| Rate for Payer: PHP Commercial |
$4,000.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,294.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,095.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,870.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,142.16
|
| Rate for Payer: UHC Core |
$3,930.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,530.25
|
|
|
HC ENSITE NAVX KIT
|
Facility
|
OP
|
$4,707.00
|
|
| Hospital Charge Code |
27200121
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,117.91 |
| Max. Negotiated Rate |
$4,236.30 |
| Rate for Payer: Aetna Commercial |
$4,000.95
|
| Rate for Payer: Aetna Medicare |
$1,223.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,470.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,470.94
|
| Rate for Payer: BCBS Complete |
$1,882.80
|
| Rate for Payer: BCBS MAPPO |
$1,176.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,659.69
|
| Rate for Payer: BCN Commercial |
$3,659.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,176.75
|
| Rate for Payer: Cash Price |
$3,765.60
|
| Rate for Payer: Cofinity Commercial |
$4,048.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,765.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,176.75
|
| Rate for Payer: Healthscope Commercial |
$4,236.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,530.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,235.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,353.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,000.95
|
| Rate for Payer: PACE Senior Care Partners |
$1,117.91
|
| Rate for Payer: PACE SWMI |
$1,176.75
|
| Rate for Payer: PHP Commercial |
$4,000.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,176.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,294.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,095.09
|
| Rate for Payer: Priority Health Medicare |
$1,176.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,870.80
|
| Rate for Payer: Railroad Medicare Medicare |
$1,176.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,142.16
|
| Rate for Payer: UHC Core |
$3,930.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,176.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,212.05
|
| Rate for Payer: VA VA |
$1,176.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,530.25
|
|
|
HC ENTEROVIRUS
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600267
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC ENTEROVIRUS
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600267
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC ENTEROVIRUS BY PCR
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600168
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.90 |
| Max. Negotiated Rate |
$216.00 |
| Rate for Payer: Aetna Commercial |
$204.00
|
| Rate for Payer: Aetna Medicare |
$62.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75.00
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$60.00
|
| Rate for Payer: BCBS Trust/PPO |
$186.60
|
| Rate for Payer: BCN Commercial |
$186.60
|
| Rate for Payer: BCN Medicare Advantage |
$60.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$206.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$216.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.00
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$63.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$204.00
|
| Rate for Payer: PACE Senior Care Partners |
$57.00
|
| Rate for Payer: PACE SWMI |
$60.00
|
| Rate for Payer: PHP Commercial |
$204.00
|
| Rate for Payer: PHP Medicare Advantage |
$60.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.80
|
| Rate for Payer: Priority Health Medicare |
$60.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.38
|
| Rate for Payer: Railroad Medicare Medicare |
$60.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.20
|
| Rate for Payer: UHC Core |
$200.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.00
|
| Rate for Payer: UHC Medicare Advantage |
$61.80
|
| Rate for Payer: VA VA |
$60.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.00
|
|
|
HC ENTEROVIRUS BY PCR
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600168
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$146.38 |
| Max. Negotiated Rate |
$216.00 |
| Rate for Payer: Aetna Commercial |
$204.00
|
| Rate for Payer: BCBS Trust/PPO |
$185.47
|
| Rate for Payer: BCN Commercial |
$185.47
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$206.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.00
|
| Rate for Payer: Healthscope Commercial |
$216.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$204.00
|
| Rate for Payer: PHP Commercial |
$204.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.20
|
| Rate for Payer: UHC Core |
$200.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.00
|
|
|
HC ENTEROVIRUS BY PCR CSF
|
Facility
|
OP
|
$201.70
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600153
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.90 |
| Max. Negotiated Rate |
$181.53 |
| Rate for Payer: Aetna Commercial |
$171.44
|
| Rate for Payer: Aetna Medicare |
$52.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.03
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$50.42
|
| Rate for Payer: BCBS Trust/PPO |
$156.82
|
| Rate for Payer: BCN Commercial |
$156.82
|
| Rate for Payer: BCN Medicare Advantage |
$50.42
|
| Rate for Payer: Cash Price |
$161.36
|
| Rate for Payer: Cash Price |
$161.36
|
| Rate for Payer: Cofinity Commercial |
$173.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.42
|
| Rate for Payer: Healthscope Commercial |
$181.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.28
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$171.44
|
| Rate for Payer: PACE Senior Care Partners |
$47.90
|
| Rate for Payer: PACE SWMI |
$50.42
|
| Rate for Payer: PHP Commercial |
$171.44
|
| Rate for Payer: PHP Medicare Advantage |
$50.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.48
|
| Rate for Payer: Priority Health Medicare |
$50.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.02
|
| Rate for Payer: Railroad Medicare Medicare |
$50.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.50
|
| Rate for Payer: UHC Core |
$168.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.42
|
| Rate for Payer: UHC Medicare Advantage |
$51.94
|
| Rate for Payer: VA VA |
$50.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.28
|
|
|
HC ENTEROVIRUS BY PCR CSF
|
Facility
|
IP
|
$201.70
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600153
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$123.02 |
| Max. Negotiated Rate |
$181.53 |
| Rate for Payer: Aetna Commercial |
$171.44
|
| Rate for Payer: BCBS Trust/PPO |
$155.87
|
| Rate for Payer: BCN Commercial |
$155.87
|
| Rate for Payer: Cash Price |
$161.36
|
| Rate for Payer: Cofinity Commercial |
$173.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.36
|
| Rate for Payer: Healthscope Commercial |
$181.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$171.44
|
| Rate for Payer: PHP Commercial |
$171.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.50
|
| Rate for Payer: UHC Core |
$168.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.28
|
|
|
HC ENTEROVIRUS PCR
|
Facility
|
OP
|
$96.90
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600292
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.01 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: Aetna Medicare |
$25.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.28
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$24.22
|
| Rate for Payer: BCBS Trust/PPO |
$75.34
|
| Rate for Payer: BCN Commercial |
$75.34
|
| Rate for Payer: BCN Medicare Advantage |
$24.22
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.22
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.68
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.36
|
| Rate for Payer: PACE Senior Care Partners |
$23.01
|
| Rate for Payer: PACE SWMI |
$24.22
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: PHP Medicare Advantage |
$24.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.30
|
| Rate for Payer: Priority Health Medicare |
$24.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.10
|
| Rate for Payer: Railroad Medicare Medicare |
$24.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.27
|
| Rate for Payer: UHC Core |
$80.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.22
|
| Rate for Payer: UHC Medicare Advantage |
$24.95
|
| Rate for Payer: VA VA |
$24.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.68
|
|
|
HC ENTEROVIRUS PCR
|
Facility
|
IP
|
$96.90
|
|
|
Service Code
|
CPT 87498
|
| Hospital Charge Code |
30600292
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$59.10 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: BCBS Trust/PPO |
$74.88
|
| Rate for Payer: BCN Commercial |
$74.88
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.36
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.27
|
| Rate for Payer: UHC Core |
$80.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.68
|
|
|
HC ENVIRONMENTAL CULTURE
|
Facility
|
OP
|
$36.82
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.36 |
| Max. Negotiated Rate |
$33.14 |
| Rate for Payer: Aetna Commercial |
$31.30
|
| Rate for Payer: Aetna Medicare |
$9.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.51
|
| Rate for Payer: BCBS Complete |
$6.68
|
| Rate for Payer: BCBS MAPPO |
$9.20
|
| Rate for Payer: BCBS Trust/PPO |
$28.63
|
| Rate for Payer: BCN Commercial |
$28.63
|
| Rate for Payer: BCN Medicare Advantage |
$9.20
|
| Rate for Payer: Cash Price |
$29.46
|
| Rate for Payer: Cash Price |
$29.46
|
| Rate for Payer: Cofinity Commercial |
$31.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.20
|
| Rate for Payer: Healthscope Commercial |
$33.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.62
|
| Rate for Payer: Mclaren Medicaid |
$6.36
|
| Rate for Payer: Meridian Medicaid |
$6.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.30
|
| Rate for Payer: PACE Senior Care Partners |
$8.74
|
| Rate for Payer: PACE SWMI |
$9.20
|
| Rate for Payer: PHP Commercial |
$31.30
|
| Rate for Payer: PHP Medicare Advantage |
$9.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.03
|
| Rate for Payer: Priority Health Medicare |
$9.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.46
|
| Rate for Payer: Railroad Medicare Medicare |
$9.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.40
|
| Rate for Payer: UHC Core |
$30.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.20
|
| Rate for Payer: UHC Medicare Advantage |
$9.48
|
| Rate for Payer: VA VA |
$9.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.62
|
|
|
HC ENVIRONMENTAL CULTURE
|
Facility
|
IP
|
$36.82
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
30600076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.46 |
| Max. Negotiated Rate |
$33.14 |
| Rate for Payer: Aetna Commercial |
$31.30
|
| Rate for Payer: BCBS Trust/PPO |
$28.45
|
| Rate for Payer: BCN Commercial |
$28.45
|
| Rate for Payer: Cash Price |
$29.46
|
| Rate for Payer: Cofinity Commercial |
$31.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.46
|
| Rate for Payer: Healthscope Commercial |
$33.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.30
|
| Rate for Payer: PHP Commercial |
$31.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.40
|
| Rate for Payer: UHC Core |
$30.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.62
|
|
|
HC ENZYME DETECTION
|
Facility
|
IP
|
$28.70
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.50 |
| Max. Negotiated Rate |
$25.83 |
| Rate for Payer: Aetna Commercial |
$24.40
|
| Rate for Payer: BCBS Trust/PPO |
$22.18
|
| Rate for Payer: BCN Commercial |
$22.18
|
| Rate for Payer: Cash Price |
$22.96
|
| Rate for Payer: Cofinity Commercial |
$24.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.96
|
| Rate for Payer: Healthscope Commercial |
$25.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.40
|
| Rate for Payer: PHP Commercial |
$24.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.26
|
| Rate for Payer: UHC Core |
$23.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.52
|
|
