|
HC ENZYME DETECTION
|
Facility
|
OP
|
$28.70
|
|
|
Service Code
|
CPT 87185
|
| Hospital Charge Code |
30600099
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.51 |
| Max. Negotiated Rate |
$25.83 |
| Rate for Payer: Aetna Commercial |
$24.40
|
| Rate for Payer: Aetna Medicare |
$7.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.97
|
| Rate for Payer: BCBS Complete |
$3.68
|
| Rate for Payer: BCBS MAPPO |
$7.18
|
| Rate for Payer: BCBS Trust/PPO |
$22.31
|
| Rate for Payer: BCN Commercial |
$22.31
|
| Rate for Payer: BCN Medicare Advantage |
$7.18
|
| Rate for Payer: Cash Price |
$22.96
|
| 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: Health Alliance Plan Medicare Advantage |
$7.18
|
| Rate for Payer: Healthscope Commercial |
$25.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.52
|
| Rate for Payer: Mclaren Medicaid |
$3.51
|
| Rate for Payer: Meridian Medicaid |
$3.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.40
|
| Rate for Payer: PACE Senior Care Partners |
$6.82
|
| Rate for Payer: PACE SWMI |
$7.18
|
| Rate for Payer: PHP Commercial |
$24.40
|
| Rate for Payer: PHP Medicare Advantage |
$7.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.51
|
| 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 Medicare |
$7.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.50
|
| Rate for Payer: Railroad Medicare Medicare |
$7.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.26
|
| Rate for Payer: UHC Core |
$23.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.18
|
| Rate for Payer: UHC Medicare Advantage |
$7.39
|
| Rate for Payer: VA VA |
$7.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.52
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
OP
|
$162.00
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$38.48 |
| Max. Negotiated Rate |
$592.28 |
| Rate for Payer: Aetna Commercial |
$137.70
|
| Rate for Payer: Aetna Medicare |
$42.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.62
|
| Rate for Payer: BCBS Complete |
$592.28
|
| Rate for Payer: BCBS MAPPO |
$40.50
|
| Rate for Payer: BCBS Trust/PPO |
$125.96
|
| Rate for Payer: BCN Commercial |
$125.96
|
| Rate for Payer: BCN Medicare Advantage |
$40.50
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cofinity Commercial |
$139.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.50
|
| Rate for Payer: Healthscope Commercial |
$145.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.50
|
| Rate for Payer: Mclaren Medicaid |
$564.08
|
| Rate for Payer: Meridian Medicaid |
$592.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$137.70
|
| Rate for Payer: PACE Senior Care Partners |
$38.48
|
| Rate for Payer: PACE SWMI |
$40.50
|
| Rate for Payer: PHP Commercial |
$137.70
|
| Rate for Payer: PHP Medicare Advantage |
$40.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$564.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$140.94
|
| Rate for Payer: Priority Health Medicare |
$40.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.80
|
| Rate for Payer: Railroad Medicare Medicare |
$40.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.56
|
| Rate for Payer: UHC Core |
$135.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.50
|
| Rate for Payer: UHC Medicare Advantage |
$41.72
|
| Rate for Payer: VA VA |
$40.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.50
|
|
|
HC ENZYME HISTOCHEMISTRY
|
Facility
|
IP
|
$162.00
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
31200006
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$98.80 |
| Max. Negotiated Rate |
$145.80 |
| Rate for Payer: Aetna Commercial |
$137.70
|
| Rate for Payer: BCBS Trust/PPO |
$125.19
|
| Rate for Payer: BCN Commercial |
$125.19
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cofinity Commercial |
$139.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.60
|
| Rate for Payer: Healthscope Commercial |
$145.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$137.70
|
| Rate for Payer: PHP Commercial |
$137.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$140.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.56
|
| Rate for Payer: UHC Core |
$135.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.50
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
IP
|
$45.40
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.69 |
| Max. Negotiated Rate |
$40.86 |
| Rate for Payer: Aetna Commercial |
$38.59
|
| Rate for Payer: BCBS Trust/PPO |
$35.09
|
| Rate for Payer: BCN Commercial |
$35.09
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cofinity Commercial |
$39.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.32
|
| Rate for Payer: Healthscope Commercial |
$40.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.59
|
| Rate for Payer: PHP Commercial |
$38.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.95
|
| Rate for Payer: UHC Core |
$37.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.05
|
|
|
HC EOSINOPHIL NASAL SMEAR
|
Facility
|
OP
|
$45.40
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
30000003
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.27 |
| Max. Negotiated Rate |
$40.86 |
| Rate for Payer: Aetna Commercial |
$38.59
|
| Rate for Payer: Aetna Medicare |
$11.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.19
|
| Rate for Payer: BCBS Complete |
$4.49
|
| Rate for Payer: BCBS MAPPO |
$11.35
|
| Rate for Payer: BCBS Trust/PPO |
$35.30
|
| Rate for Payer: BCN Commercial |
$35.30
|
| Rate for Payer: BCN Medicare Advantage |
$11.35
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cofinity Commercial |
$39.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.35
|
| Rate for Payer: Healthscope Commercial |
$40.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.05
|
| Rate for Payer: Mclaren Medicaid |
$4.27
|
| Rate for Payer: Meridian Medicaid |
$4.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.59
|
| Rate for Payer: PACE Senior Care Partners |
$10.78
|
| Rate for Payer: PACE SWMI |
$11.35
|
| Rate for Payer: PHP Commercial |
$38.59
|
| Rate for Payer: PHP Medicare Advantage |
$11.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.50
|
| Rate for Payer: Priority Health Medicare |
$11.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.69
|
| Rate for Payer: Railroad Medicare Medicare |
$11.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.95
|
| Rate for Payer: UHC Core |
$37.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.35
|
| Rate for Payer: UHC Medicare Advantage |
$11.69
|
| Rate for Payer: VA VA |
$11.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.05
|
|
|
HC EOVIST PER ML
|
Facility
|
IP
|
$30.70
|
|
|
Service Code
|
HCPCS A9581
|
| Hospital Charge Code |
63600009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.72 |
| Max. Negotiated Rate |
$27.63 |
| Rate for Payer: Aetna Commercial |
$26.10
|
| Rate for Payer: BCBS Trust/PPO |
$23.72
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.56
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.56
|
| Rate for Payer: Healthscope Commercial |
$27.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.10
|
| Rate for Payer: PHP Commercial |
$26.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.02
|
| Rate for Payer: UHC Core |
$25.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.02
|
|
|
HC EOVIST PER ML
|
Facility
|
OP
|
$30.70
|
|
|
Service Code
|
HCPCS A9581
|
| Hospital Charge Code |
63600009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.29 |
| Max. Negotiated Rate |
$27.63 |
| Rate for Payer: Aetna Commercial |
$26.10
|
| Rate for Payer: Aetna Medicare |
$7.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.59
|
| Rate for Payer: BCBS Complete |
$12.28
|
| Rate for Payer: BCBS MAPPO |
$7.68
|
| Rate for Payer: BCBS Trust/PPO |
$23.87
|
| Rate for Payer: BCN Commercial |
$23.87
|
| Rate for Payer: BCN Medicare Advantage |
$7.68
|
| Rate for Payer: Cash Price |
$24.56
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.68
|
| Rate for Payer: Healthscope Commercial |
$27.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.10
|
| Rate for Payer: PACE Senior Care Partners |
$7.29
|
| Rate for Payer: PACE SWMI |
$7.68
|
| Rate for Payer: PHP Commercial |
$26.10
|
| Rate for Payer: PHP Medicare Advantage |
$7.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.71
|
| Rate for Payer: Priority Health Medicare |
$7.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.72
|
| Rate for Payer: Railroad Medicare Medicare |
$7.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.02
|
| Rate for Payer: UHC Core |
$25.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.68
|
| Rate for Payer: UHC Medicare Advantage |
$7.91
|
| Rate for Payer: VA VA |
$7.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.02
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
OP
|
$270.30
|
|
|
Service Code
|
HCPCS L3702
|
| Hospital Charge Code |
27400050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$64.20 |
| Max. Negotiated Rate |
$243.27 |
| Rate for Payer: Aetna Commercial |
$229.76
|
| Rate for Payer: Aetna Medicare |
$70.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.47
|
| Rate for Payer: BCBS Complete |
$108.12
|
| Rate for Payer: BCBS MAPPO |
$67.58
|
| Rate for Payer: BCBS Trust/PPO |
$210.16
|
| Rate for Payer: BCN Commercial |
$210.16
|
| Rate for Payer: BCN Medicare Advantage |
$67.58
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cofinity Commercial |
$232.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.58
|
| Rate for Payer: Healthscope Commercial |
$243.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$70.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.76
|
| Rate for Payer: PACE Senior Care Partners |
$64.20
|
| Rate for Payer: PACE SWMI |
$67.58
|
| Rate for Payer: PHP Commercial |
$229.76
|
| Rate for Payer: PHP Medicare Advantage |
$67.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.16
|
| Rate for Payer: Priority Health Medicare |
$67.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.86
|
| Rate for Payer: Railroad Medicare Medicare |
$67.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.86
|
| Rate for Payer: UHC Core |
$225.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.58
|
| Rate for Payer: UHC Medicare Advantage |
$69.60
|
| Rate for Payer: VA VA |
$67.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.72
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
IP
|
$270.30
|
|
|
Service Code
|
HCPCS L3702
|
| Hospital Charge Code |
27400050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$164.86 |
| Max. Negotiated Rate |
$243.27 |
| Rate for Payer: Aetna Commercial |
$229.76
|
| Rate for Payer: BCBS Trust/PPO |
$208.89
|
| Rate for Payer: BCN Commercial |
$208.89
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cofinity Commercial |
$232.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.24
|
| Rate for Payer: Healthscope Commercial |
$243.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.76
|
| Rate for Payer: PHP Commercial |
$229.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.86
|
| Rate for Payer: UHC Core |
$225.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.72
|
|
|
HC EP+ABL ARRHYTHMIA
|
Facility
|
OP
|
$17,391.67
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
48100091
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,130.52 |
| Max. Negotiated Rate |
$16,359.08 |
| Rate for Payer: Aetna Commercial |
$14,782.92
|
| Rate for Payer: Aetna Medicare |
$4,521.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,434.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,434.90
|
| Rate for Payer: BCBS Complete |
$16,359.08
|
| Rate for Payer: BCBS MAPPO |
$4,347.92
|
| Rate for Payer: BCBS Trust/PPO |
$13,522.02
|
| Rate for Payer: BCN Commercial |
$13,522.02
|
| Rate for Payer: BCN Medicare Advantage |
$4,347.92
|
| Rate for Payer: Cash Price |
$13,913.34
|
| Rate for Payer: Cash Price |
$13,913.34
|
| Rate for Payer: Cofinity Commercial |
$14,956.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,913.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,347.92
|
| Rate for Payer: Healthscope Commercial |
$15,652.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,043.75
|
| Rate for Payer: Mclaren Medicaid |
$15,580.08
|
| Rate for Payer: Meridian Medicaid |
$16,359.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,565.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,000.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,782.92
|
| Rate for Payer: PACE Senior Care Partners |
$4,130.52
|
| Rate for Payer: PACE SWMI |
$4,347.92
|
| Rate for Payer: PHP Commercial |
$14,782.92
|
| Rate for Payer: PHP Medicare Advantage |
$4,347.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,580.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,174.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,130.75
|
| Rate for Payer: Priority Health Medicare |
$4,347.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,607.18
|
| Rate for Payer: Railroad Medicare Medicare |
$4,347.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,304.67
|
| Rate for Payer: UHC Core |
$14,522.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,347.92
|
| Rate for Payer: UHC Medicare Advantage |
$4,478.36
|
| Rate for Payer: VA VA |
$4,347.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,043.75
|
|
|
HC EP+ABL ARRHYTHMIA
|
Facility
|
IP
|
$17,391.67
|
|
|
Service Code
|
CPT 93653
|
| Hospital Charge Code |
48100091
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,607.18 |
| Max. Negotiated Rate |
$15,652.50 |
| Rate for Payer: Aetna Commercial |
$14,782.92
|
| Rate for Payer: BCBS Trust/PPO |
$13,440.28
|
| Rate for Payer: BCN Commercial |
$13,440.28
|
| Rate for Payer: Cash Price |
$13,913.34
|
| Rate for Payer: Cofinity Commercial |
$14,956.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,913.34
|
| Rate for Payer: Healthscope Commercial |
$15,652.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,043.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,782.92
|
| Rate for Payer: PHP Commercial |
$14,782.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,174.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,130.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,607.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,304.67
|
| Rate for Payer: UHC Core |
$14,522.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,043.75
|
|
|
HC EP+ABL VT
|
Facility
|
OP
|
$17,391.67
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
48100092
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,130.52 |
| Max. Negotiated Rate |
$16,359.08 |
| Rate for Payer: Aetna Commercial |
$14,782.92
|
| Rate for Payer: Aetna Medicare |
$4,521.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,434.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,434.90
|
| Rate for Payer: BCBS Complete |
$16,359.08
|
| Rate for Payer: BCBS MAPPO |
$4,347.92
|
| Rate for Payer: BCBS Trust/PPO |
$13,522.02
|
| Rate for Payer: BCN Commercial |
$13,522.02
|
| Rate for Payer: BCN Medicare Advantage |
$4,347.92
|
| Rate for Payer: Cash Price |
$13,913.34
|
| Rate for Payer: Cash Price |
$13,913.34
|
| Rate for Payer: Cofinity Commercial |
$14,956.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,913.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,347.92
|
| Rate for Payer: Healthscope Commercial |
$15,652.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,043.75
|
| Rate for Payer: Mclaren Medicaid |
$15,580.08
|
| Rate for Payer: Meridian Medicaid |
$16,359.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,565.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,000.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,782.92
|
| Rate for Payer: PACE Senior Care Partners |
$4,130.52
|
| Rate for Payer: PACE SWMI |
$4,347.92
|
| Rate for Payer: PHP Commercial |
$14,782.92
|
| Rate for Payer: PHP Medicare Advantage |
$4,347.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,580.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,174.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,130.75
|
| Rate for Payer: Priority Health Medicare |
$4,347.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,607.18
|
| Rate for Payer: Railroad Medicare Medicare |
$4,347.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,304.67
|
| Rate for Payer: UHC Core |
$14,522.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,347.92
|
| Rate for Payer: UHC Medicare Advantage |
$4,478.36
|
| Rate for Payer: VA VA |
$4,347.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,043.75
|
|
|
HC EP+ABL VT
|
Facility
|
IP
|
$17,391.67
|
|
|
Service Code
|
CPT 93654
|
| Hospital Charge Code |
48100092
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,607.18 |
| Max. Negotiated Rate |
$15,652.50 |
| Rate for Payer: Aetna Commercial |
$14,782.92
|
| Rate for Payer: BCBS Trust/PPO |
$13,440.28
|
| Rate for Payer: BCN Commercial |
$13,440.28
|
| Rate for Payer: Cash Price |
$13,913.34
|
| Rate for Payer: Cofinity Commercial |
$14,956.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,913.34
|
| Rate for Payer: Healthscope Commercial |
$15,652.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,043.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,782.92
|
| Rate for Payer: PHP Commercial |
$14,782.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,174.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,130.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,607.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,304.67
|
| Rate for Payer: UHC Core |
$14,522.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,043.75
|
|
|
HC EP AFTER DRUGS
|
Facility
|
OP
|
$7,278.36
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
48100039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,728.61 |
| Max. Negotiated Rate |
$6,550.52 |
| Rate for Payer: Aetna Commercial |
$6,186.61
|
| Rate for Payer: Aetna Medicare |
$1,892.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,274.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,274.49
|
| Rate for Payer: BCBS Complete |
$2,911.34
|
| Rate for Payer: BCBS MAPPO |
$1,819.59
|
| Rate for Payer: BCBS Trust/PPO |
$5,658.92
|
| Rate for Payer: BCN Commercial |
$5,658.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,819.59
|
| Rate for Payer: Cash Price |
$5,822.69
|
| Rate for Payer: Cofinity Commercial |
$6,259.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,822.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,819.59
|
| Rate for Payer: Healthscope Commercial |
$6,550.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,458.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,910.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,092.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,186.61
|
| Rate for Payer: PACE Senior Care Partners |
$1,728.61
|
| Rate for Payer: PACE SWMI |
$1,819.59
|
| Rate for Payer: PHP Commercial |
$6,186.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,819.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,094.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,332.17
|
| Rate for Payer: Priority Health Medicare |
$1,819.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,439.07
|
| Rate for Payer: Railroad Medicare Medicare |
$1,819.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,404.96
|
| Rate for Payer: UHC Core |
$6,077.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,819.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,874.18
|
| Rate for Payer: VA VA |
$1,819.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,458.77
|
|
|
HC EP AFTER DRUGS
|
Facility
|
IP
|
$7,278.36
|
|
|
Service Code
|
CPT 93623
|
| Hospital Charge Code |
48100039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,439.07 |
| Max. Negotiated Rate |
$6,550.52 |
| Rate for Payer: Aetna Commercial |
$6,186.61
|
| Rate for Payer: BCBS Trust/PPO |
$5,624.72
|
| Rate for Payer: BCN Commercial |
$5,624.72
|
| Rate for Payer: Cash Price |
$5,822.69
|
| Rate for Payer: Cofinity Commercial |
$6,259.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,822.69
|
| Rate for Payer: Healthscope Commercial |
$6,550.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,458.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,186.61
|
| Rate for Payer: PHP Commercial |
$6,186.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,094.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,332.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,439.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,404.96
|
| Rate for Payer: UHC Core |
$6,077.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,458.77
|
|
|
HC EP EVAL OF SQ ICD
|
Facility
|
OP
|
$3,277.26
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
48000027
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$778.35 |
| Max. Negotiated Rate |
$2,949.53 |
| Rate for Payer: Aetna Commercial |
$2,785.67
|
| Rate for Payer: Aetna Medicare |
$852.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,024.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,024.14
|
| Rate for Payer: BCBS Complete |
$1,310.90
|
| Rate for Payer: BCBS MAPPO |
$819.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,548.07
|
| Rate for Payer: BCN Commercial |
$2,548.07
|
| Rate for Payer: BCN Medicare Advantage |
$819.32
|
| Rate for Payer: Cash Price |
$2,621.81
|
| Rate for Payer: Cofinity Commercial |
$2,818.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,621.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$819.32
|
| Rate for Payer: Healthscope Commercial |
$2,949.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,457.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$860.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$942.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,785.67
|
| Rate for Payer: PACE Senior Care Partners |
$778.35
|
| Rate for Payer: PACE SWMI |
$819.32
|
| Rate for Payer: PHP Commercial |
$2,785.67
|
| Rate for Payer: PHP Medicare Advantage |
$819.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,294.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,851.22
|
| Rate for Payer: Priority Health Medicare |
$819.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,998.80
|
| Rate for Payer: Railroad Medicare Medicare |
$819.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,883.99
|
| Rate for Payer: UHC Core |
$2,736.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$819.32
|
| Rate for Payer: UHC Medicare Advantage |
$843.89
|
| Rate for Payer: VA VA |
$819.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,457.94
|
|
|
HC EP EVAL OF SQ ICD
|
Facility
|
IP
|
$3,277.26
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
48000027
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,998.80 |
| Max. Negotiated Rate |
$2,949.53 |
| Rate for Payer: Aetna Commercial |
$2,785.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,532.67
|
| Rate for Payer: BCN Commercial |
$2,532.67
|
| Rate for Payer: Cash Price |
$2,621.81
|
| Rate for Payer: Cofinity Commercial |
$2,818.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,621.81
|
| Rate for Payer: Healthscope Commercial |
$2,949.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,457.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,785.67
|
| Rate for Payer: PHP Commercial |
$2,785.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,294.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,851.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,998.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,883.99
|
| Rate for Payer: UHC Core |
$2,736.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,457.94
|
|
|
HC EP EVALUATION OF GEN/LEADS
|
Facility
|
OP
|
$2,341.80
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
48100042
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$556.18 |
| Max. Negotiated Rate |
$2,107.62 |
| Rate for Payer: Aetna Commercial |
$1,990.53
|
| Rate for Payer: Aetna Medicare |
$608.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$731.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$731.81
|
| Rate for Payer: BCBS Complete |
$936.72
|
| Rate for Payer: BCBS MAPPO |
$585.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,820.75
|
| Rate for Payer: BCN Commercial |
$1,820.75
|
| Rate for Payer: BCN Medicare Advantage |
$585.45
|
| Rate for Payer: Cash Price |
$1,873.44
|
| Rate for Payer: Cofinity Commercial |
$2,013.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,873.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$585.45
|
| Rate for Payer: Healthscope Commercial |
$2,107.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,756.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$614.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$673.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,990.53
|
| Rate for Payer: PACE Senior Care Partners |
$556.18
|
| Rate for Payer: PACE SWMI |
$585.45
|
| Rate for Payer: PHP Commercial |
$1,990.53
|
| Rate for Payer: PHP Medicare Advantage |
$585.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,639.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,037.37
|
| Rate for Payer: Priority Health Medicare |
$585.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,428.26
|
| Rate for Payer: Railroad Medicare Medicare |
$585.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,060.78
|
| Rate for Payer: UHC Core |
$1,955.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$585.45
|
| Rate for Payer: UHC Medicare Advantage |
$603.01
|
| Rate for Payer: VA VA |
$585.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,756.35
|
|
|
HC EP EVALUATION OF GEN/LEADS
|
Facility
|
IP
|
$2,341.80
|
|
|
Service Code
|
CPT 93641
|
| Hospital Charge Code |
48100042
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,428.26 |
| Max. Negotiated Rate |
$2,107.62 |
| Rate for Payer: Aetna Commercial |
$1,990.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,809.74
|
| Rate for Payer: BCN Commercial |
$1,809.74
|
| Rate for Payer: Cash Price |
$1,873.44
|
| Rate for Payer: Cofinity Commercial |
$2,013.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,873.44
|
| Rate for Payer: Healthscope Commercial |
$2,107.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,756.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,990.53
|
| Rate for Payer: PHP Commercial |
$1,990.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,639.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,037.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,428.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,060.78
|
| Rate for Payer: UHC Core |
$1,955.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,756.35
|
|
|
HC EP EVALUATION OF LEADS
|
Facility
|
OP
|
$2,146.53
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
48100041
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$509.80 |
| Max. Negotiated Rate |
$1,931.88 |
| Rate for Payer: Aetna Commercial |
$1,824.55
|
| Rate for Payer: Aetna Medicare |
$558.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$670.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$670.79
|
| Rate for Payer: BCBS Complete |
$858.61
|
| Rate for Payer: BCBS MAPPO |
$536.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,668.93
|
| Rate for Payer: BCN Commercial |
$1,668.93
|
| Rate for Payer: BCN Medicare Advantage |
$536.63
|
| Rate for Payer: Cash Price |
$1,717.22
|
| Rate for Payer: Cofinity Commercial |
$1,846.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$536.63
|
| Rate for Payer: Healthscope Commercial |
$1,931.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$563.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$617.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,824.55
|
| Rate for Payer: PACE Senior Care Partners |
$509.80
|
| Rate for Payer: PACE SWMI |
$536.63
|
| Rate for Payer: PHP Commercial |
$1,824.55
|
| Rate for Payer: PHP Medicare Advantage |
$536.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,502.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,867.48
|
| Rate for Payer: Priority Health Medicare |
$536.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,309.17
|
| Rate for Payer: Railroad Medicare Medicare |
$536.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,888.95
|
| Rate for Payer: UHC Core |
$1,792.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$536.63
|
| Rate for Payer: UHC Medicare Advantage |
$552.73
|
| Rate for Payer: VA VA |
$536.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.90
|
|
|
HC EP EVALUATION OF LEADS
|
Facility
|
IP
|
$2,146.53
|
|
|
Service Code
|
CPT 93640
|
| Hospital Charge Code |
48100041
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,309.17 |
| Max. Negotiated Rate |
$1,931.88 |
| Rate for Payer: Aetna Commercial |
$1,824.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,658.84
|
| Rate for Payer: BCN Commercial |
$1,658.84
|
| Rate for Payer: Cash Price |
$1,717.22
|
| Rate for Payer: Cofinity Commercial |
$1,846.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,717.22
|
| Rate for Payer: Healthscope Commercial |
$1,931.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,609.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,824.55
|
| Rate for Payer: PHP Commercial |
$1,824.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,502.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,867.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,309.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,888.95
|
| Rate for Payer: UHC Core |
$1,792.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,609.90
|
|
|
HC EPIDURAL PREP (OB)
|
Facility
|
IP
|
$633.42
|
|
| Hospital Charge Code |
37000003
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$386.32 |
| Max. Negotiated Rate |
$570.08 |
| Rate for Payer: Aetna Commercial |
$538.41
|
| Rate for Payer: BCBS Trust/PPO |
$489.51
|
| Rate for Payer: BCN Commercial |
$489.51
|
| Rate for Payer: Cash Price |
$506.74
|
| Rate for Payer: Cofinity Commercial |
$544.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$506.74
|
| Rate for Payer: Healthscope Commercial |
$570.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$475.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$538.41
|
| Rate for Payer: PHP Commercial |
$538.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$443.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$551.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$386.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$557.41
|
| Rate for Payer: UHC Core |
$528.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$475.06
|
|
|
HC EPIDURAL PREP (OB)
|
Facility
|
OP
|
$633.42
|
|
| Hospital Charge Code |
37000003
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$150.44 |
| Max. Negotiated Rate |
$570.08 |
| Rate for Payer: Aetna Commercial |
$538.41
|
| Rate for Payer: Aetna Medicare |
$164.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$197.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$197.94
|
| Rate for Payer: BCBS Complete |
$253.37
|
| Rate for Payer: BCBS MAPPO |
$158.36
|
| Rate for Payer: BCBS Trust/PPO |
$492.48
|
| Rate for Payer: BCN Commercial |
$492.48
|
| Rate for Payer: BCN Medicare Advantage |
$158.36
|
| Rate for Payer: Cash Price |
$506.74
|
| Rate for Payer: Cofinity Commercial |
$544.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$506.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.36
|
| Rate for Payer: Healthscope Commercial |
$570.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$475.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$166.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$182.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$538.41
|
| Rate for Payer: PACE Senior Care Partners |
$150.44
|
| Rate for Payer: PACE SWMI |
$158.36
|
| Rate for Payer: PHP Commercial |
$538.41
|
| Rate for Payer: PHP Medicare Advantage |
$158.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$443.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$551.08
|
| Rate for Payer: Priority Health Medicare |
$158.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$386.32
|
| Rate for Payer: Railroad Medicare Medicare |
$158.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$557.41
|
| Rate for Payer: UHC Core |
$528.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$158.36
|
| Rate for Payer: UHC Medicare Advantage |
$163.11
|
| Rate for Payer: VA VA |
$158.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$475.06
|
|
|
HC EPIFIX (14 MM DISC) PER SQ CM
|
Facility
|
OP
|
$478.89
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600135
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$113.74 |
| Max. Negotiated Rate |
$431.00 |
| Rate for Payer: Aetna Commercial |
$407.06
|
| Rate for Payer: Aetna Medicare |
$124.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$149.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$149.65
|
| Rate for Payer: BCBS Complete |
$191.56
|
| Rate for Payer: BCBS MAPPO |
$119.72
|
| Rate for Payer: BCBS Trust/PPO |
$372.34
|
| Rate for Payer: BCN Commercial |
$372.34
|
| Rate for Payer: BCN Medicare Advantage |
$119.72
|
| Rate for Payer: Cash Price |
$383.11
|
| Rate for Payer: Cofinity Commercial |
$411.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.72
|
| Rate for Payer: Healthscope Commercial |
$431.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$125.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$137.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$407.06
|
| Rate for Payer: PACE Senior Care Partners |
$113.74
|
| Rate for Payer: PACE SWMI |
$119.72
|
| Rate for Payer: PHP Commercial |
$407.06
|
| Rate for Payer: PHP Medicare Advantage |
$119.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$335.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$416.63
|
| Rate for Payer: Priority Health Medicare |
$119.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$292.08
|
| Rate for Payer: Railroad Medicare Medicare |
$119.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.42
|
| Rate for Payer: UHC Core |
$399.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.72
|
| Rate for Payer: UHC Medicare Advantage |
$123.31
|
| Rate for Payer: VA VA |
$119.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.17
|
|
|
HC EPIFIX (14 MM DISC) PER SQ CM
|
Facility
|
IP
|
$478.89
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600135
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$292.08 |
| Max. Negotiated Rate |
$431.00 |
| Rate for Payer: Aetna Commercial |
$407.06
|
| Rate for Payer: BCBS Trust/PPO |
$370.09
|
| Rate for Payer: BCN Commercial |
$370.09
|
| Rate for Payer: Cash Price |
$383.11
|
| Rate for Payer: Cofinity Commercial |
$411.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$383.11
|
| Rate for Payer: Healthscope Commercial |
$431.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$359.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$407.06
|
| Rate for Payer: PHP Commercial |
$407.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$335.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$416.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$292.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$421.42
|
| Rate for Payer: UHC Core |
$399.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$359.17
|
|
