|
HC EPSTEIN BARR ANTIBODY
|
Facility
|
OP
|
$36.72
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200268
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.72 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare |
$9.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.48
|
| Rate for Payer: BCBS Complete |
$14.06
|
| Rate for Payer: BCBS MAPPO |
$9.18
|
| Rate for Payer: BCBS Trust/PPO |
$28.55
|
| Rate for Payer: BCN Commercial |
$28.55
|
| Rate for Payer: BCN Medicare Advantage |
$9.18
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.18
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$13.39
|
| Rate for Payer: Meridian Medicaid |
$14.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PACE Senior Care Partners |
$8.72
|
| Rate for Payer: PACE SWMI |
$9.18
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: PHP Medicare Advantage |
$9.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.95
|
| Rate for Payer: Priority Health Medicare |
$9.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.40
|
| Rate for Payer: Railroad Medicare Medicare |
$9.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.31
|
| Rate for Payer: UHC Core |
$30.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.18
|
| Rate for Payer: UHC Medicare Advantage |
$9.46
|
| Rate for Payer: VA VA |
$9.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC EPSTEIN-BARR ANTIBODY NUCLEAR ANTIGEN
|
Facility
|
IP
|
$36.72
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200267
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: BCBS Trust/PPO |
$28.38
|
| Rate for Payer: BCN Commercial |
$28.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.31
|
| Rate for Payer: UHC Core |
$30.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC EPSTEIN-BARR ANTIBODY NUCLEAR ANTIGEN
|
Facility
|
OP
|
$36.72
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200267
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.72 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare |
$9.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.48
|
| Rate for Payer: BCBS Complete |
$11.85
|
| Rate for Payer: BCBS MAPPO |
$9.18
|
| Rate for Payer: BCBS Trust/PPO |
$28.55
|
| Rate for Payer: BCN Commercial |
$28.55
|
| Rate for Payer: BCN Medicare Advantage |
$9.18
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.18
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$11.28
|
| Rate for Payer: Meridian Medicaid |
$11.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PACE Senior Care Partners |
$8.72
|
| Rate for Payer: PACE SWMI |
$9.18
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: PHP Medicare Advantage |
$9.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.95
|
| Rate for Payer: Priority Health Medicare |
$9.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.40
|
| Rate for Payer: Railroad Medicare Medicare |
$9.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.31
|
| Rate for Payer: UHC Core |
$30.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.18
|
| Rate for Payer: UHC Medicare Advantage |
$9.46
|
| Rate for Payer: VA VA |
$9.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC EPSTEIN BARR EA AG
|
Facility
|
OP
|
$36.72
|
|
|
Service Code
|
CPT 86663
|
| Hospital Charge Code |
30200365
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.72 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare |
$9.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.48
|
| Rate for Payer: BCBS Complete |
$10.17
|
| Rate for Payer: BCBS MAPPO |
$9.18
|
| Rate for Payer: BCBS Trust/PPO |
$28.55
|
| Rate for Payer: BCN Commercial |
$28.55
|
| Rate for Payer: BCN Medicare Advantage |
$9.18
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.18
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$9.68
|
| Rate for Payer: Meridian Medicaid |
$10.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PACE Senior Care Partners |
$8.72
|
| Rate for Payer: PACE SWMI |
$9.18
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: PHP Medicare Advantage |
$9.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.95
|
| Rate for Payer: Priority Health Medicare |
$9.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.40
|
| Rate for Payer: Railroad Medicare Medicare |
$9.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.31
|
| Rate for Payer: UHC Core |
$30.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.18
|
| Rate for Payer: UHC Medicare Advantage |
$9.46
|
| Rate for Payer: VA VA |
$9.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC EPSTEIN BARR EA AG
|
Facility
|
IP
|
$36.72
|
|
|
Service Code
|
CPT 86663
|
| Hospital Charge Code |
30200365
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: BCBS Trust/PPO |
$28.38
|
| Rate for Payer: BCN Commercial |
$28.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.31
|
| Rate for Payer: UHC Core |
$30.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC EPSTEIN BARR VIRUS BY PCR FLUID
|
Facility
|
IP
|
$119.34
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600171
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$72.79 |
| Max. Negotiated Rate |
$107.41 |
| Rate for Payer: Aetna Commercial |
$101.44
|
| Rate for Payer: BCBS Trust/PPO |
$92.23
|
| Rate for Payer: BCN Commercial |
$92.23
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cofinity Commercial |
$102.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.47
|
| Rate for Payer: Healthscope Commercial |
$107.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$101.44
|
| Rate for Payer: PHP Commercial |
$101.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.02
|
| Rate for Payer: UHC Core |
$99.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.50
|
|
|
HC EPSTEIN BARR VIRUS BY PCR FLUID
|
Facility
|
OP
|
$119.34
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600171
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.90 |
| Max. Negotiated Rate |
$107.41 |
| Rate for Payer: Aetna Commercial |
$101.44
|
| Rate for Payer: Aetna Medicare |
$31.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.29
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$29.84
|
| Rate for Payer: BCBS Trust/PPO |
$92.79
|
| Rate for Payer: BCN Commercial |
$92.79
|
| Rate for Payer: BCN Medicare Advantage |
$29.84
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cofinity Commercial |
$102.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.84
|
| Rate for Payer: Healthscope Commercial |
$107.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.50
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$101.44
|
| Rate for Payer: PACE Senior Care Partners |
$28.34
|
| Rate for Payer: PACE SWMI |
$29.84
|
| Rate for Payer: PHP Commercial |
$101.44
|
| Rate for Payer: PHP Medicare Advantage |
$29.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.83
|
| Rate for Payer: Priority Health Medicare |
$29.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.79
|
| Rate for Payer: Railroad Medicare Medicare |
$29.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.02
|
| Rate for Payer: UHC Core |
$99.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.84
|
| Rate for Payer: UHC Medicare Advantage |
$30.73
|
| Rate for Payer: VA VA |
$29.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.50
|
|
|
HC EPSTEIN BARR VIRUS PCR BLOOD
|
Facility
|
IP
|
$119.34
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600172
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$72.79 |
| Max. Negotiated Rate |
$107.41 |
| Rate for Payer: Aetna Commercial |
$101.44
|
| Rate for Payer: BCBS Trust/PPO |
$92.23
|
| Rate for Payer: BCN Commercial |
$92.23
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cofinity Commercial |
$102.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.47
|
| Rate for Payer: Healthscope Commercial |
$107.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$101.44
|
| Rate for Payer: PHP Commercial |
$101.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.02
|
| Rate for Payer: UHC Core |
$99.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.50
|
|
|
HC EPSTEIN BARR VIRUS PCR BLOOD
|
Facility
|
OP
|
$119.34
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600172
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.34 |
| Max. Negotiated Rate |
$107.41 |
| Rate for Payer: Aetna Commercial |
$101.44
|
| Rate for Payer: Aetna Medicare |
$31.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.29
|
| Rate for Payer: BCBS Complete |
$33.20
|
| Rate for Payer: BCBS MAPPO |
$29.84
|
| Rate for Payer: BCBS Trust/PPO |
$92.79
|
| Rate for Payer: BCN Commercial |
$92.79
|
| Rate for Payer: BCN Medicare Advantage |
$29.84
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cofinity Commercial |
$102.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.84
|
| Rate for Payer: Healthscope Commercial |
$107.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.50
|
| Rate for Payer: Mclaren Medicaid |
$31.62
|
| Rate for Payer: Meridian Medicaid |
$33.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$101.44
|
| Rate for Payer: PACE Senior Care Partners |
$28.34
|
| Rate for Payer: PACE SWMI |
$29.84
|
| Rate for Payer: PHP Commercial |
$101.44
|
| Rate for Payer: PHP Medicare Advantage |
$29.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.83
|
| Rate for Payer: Priority Health Medicare |
$29.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.79
|
| Rate for Payer: Railroad Medicare Medicare |
$29.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.02
|
| Rate for Payer: UHC Core |
$99.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.84
|
| Rate for Payer: UHC Medicare Advantage |
$30.73
|
| Rate for Payer: VA VA |
$29.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.50
|
|
|
HC EP UPPER EXTREMITY SOMATOSENSO
|
Facility
|
IP
|
$1,098.32
|
|
|
Service Code
|
CPT 95925
|
| Hospital Charge Code |
92200014
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$669.87 |
| Max. Negotiated Rate |
$988.49 |
| Rate for Payer: Aetna Commercial |
$933.57
|
| Rate for Payer: BCBS Trust/PPO |
$848.78
|
| Rate for Payer: BCN Commercial |
$848.78
|
| Rate for Payer: Cash Price |
$878.66
|
| Rate for Payer: Cofinity Commercial |
$944.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$878.66
|
| Rate for Payer: Healthscope Commercial |
$988.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$823.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$933.57
|
| Rate for Payer: PHP Commercial |
$933.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$955.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$669.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$966.52
|
| Rate for Payer: UHC Core |
$917.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$823.74
|
|
|
HC EP UPPER EXTREMITY SOMATOSENSO
|
Facility
|
OP
|
$1,098.32
|
|
|
Service Code
|
CPT 95925
|
| Hospital Charge Code |
92200014
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$205.90 |
| Max. Negotiated Rate |
$988.49 |
| Rate for Payer: Aetna Commercial |
$933.57
|
| Rate for Payer: Aetna Medicare |
$285.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$343.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$343.22
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$274.58
|
| Rate for Payer: BCBS Trust/PPO |
$853.94
|
| Rate for Payer: BCN Commercial |
$853.94
|
| Rate for Payer: BCN Medicare Advantage |
$274.58
|
| Rate for Payer: Cash Price |
$878.66
|
| Rate for Payer: Cash Price |
$878.66
|
| Rate for Payer: Cofinity Commercial |
$944.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$878.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.58
|
| Rate for Payer: Healthscope Commercial |
$988.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$823.74
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$288.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$315.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$933.57
|
| Rate for Payer: PACE Senior Care Partners |
$260.85
|
| Rate for Payer: PACE SWMI |
$274.58
|
| Rate for Payer: PHP Commercial |
$933.57
|
| Rate for Payer: PHP Medicare Advantage |
$274.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$955.54
|
| Rate for Payer: Priority Health Medicare |
$274.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$669.87
|
| Rate for Payer: Railroad Medicare Medicare |
$274.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$966.52
|
| Rate for Payer: UHC Core |
$917.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$274.58
|
| Rate for Payer: UHC Medicare Advantage |
$282.82
|
| Rate for Payer: VA VA |
$274.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$823.74
|
|
|
HC EP UPPER/LOWER EXT. SOMATOSENSORY
|
Facility
|
IP
|
$2,457.76
|
|
|
Service Code
|
CPT 95938
|
| Hospital Charge Code |
92200025
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$1,498.99 |
| Max. Negotiated Rate |
$2,211.98 |
| Rate for Payer: Aetna Commercial |
$2,089.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,899.36
|
| Rate for Payer: BCN Commercial |
$1,899.36
|
| Rate for Payer: Cash Price |
$1,966.21
|
| Rate for Payer: Cofinity Commercial |
$2,113.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,966.21
|
| Rate for Payer: Healthscope Commercial |
$2,211.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,843.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,089.10
|
| Rate for Payer: PHP Commercial |
$2,089.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,720.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,138.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,498.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,162.83
|
| Rate for Payer: UHC Core |
$2,052.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,843.32
|
|
|
HC EP UPPER/LOWER EXT. SOMATOSENSORY
|
Facility
|
OP
|
$2,457.76
|
|
|
Service Code
|
CPT 95938
|
| Hospital Charge Code |
92200025
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$351.60 |
| Max. Negotiated Rate |
$2,211.98 |
| Rate for Payer: Aetna Commercial |
$2,089.10
|
| Rate for Payer: Aetna Medicare |
$639.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.05
|
| Rate for Payer: BCBS Complete |
$369.18
|
| Rate for Payer: BCBS MAPPO |
$614.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,910.91
|
| Rate for Payer: BCN Commercial |
$1,910.91
|
| Rate for Payer: BCN Medicare Advantage |
$614.44
|
| Rate for Payer: Cash Price |
$1,966.21
|
| Rate for Payer: Cash Price |
$1,966.21
|
| Rate for Payer: Cofinity Commercial |
$2,113.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,966.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.44
|
| Rate for Payer: Healthscope Commercial |
$2,211.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,843.32
|
| Rate for Payer: Mclaren Medicaid |
$351.60
|
| Rate for Payer: Meridian Medicaid |
$369.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,089.10
|
| Rate for Payer: PACE Senior Care Partners |
$583.72
|
| Rate for Payer: PACE SWMI |
$614.44
|
| Rate for Payer: PHP Commercial |
$2,089.10
|
| Rate for Payer: PHP Medicare Advantage |
$614.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,720.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,138.25
|
| Rate for Payer: Priority Health Medicare |
$614.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,498.99
|
| Rate for Payer: Railroad Medicare Medicare |
$614.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,162.83
|
| Rate for Payer: UHC Core |
$2,052.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.44
|
| Rate for Payer: UHC Medicare Advantage |
$632.87
|
| Rate for Payer: VA VA |
$614.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,843.32
|
|
|
HC EP VISUAL
|
Facility
|
IP
|
$770.51
|
|
|
Service Code
|
CPT 95930
|
| Hospital Charge Code |
92200018
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$469.93 |
| Max. Negotiated Rate |
$693.46 |
| Rate for Payer: Aetna Commercial |
$654.93
|
| Rate for Payer: BCBS Trust/PPO |
$595.45
|
| Rate for Payer: BCN Commercial |
$595.45
|
| Rate for Payer: Cash Price |
$616.41
|
| Rate for Payer: Cofinity Commercial |
$662.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$616.41
|
| Rate for Payer: Healthscope Commercial |
$693.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$577.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$654.93
|
| Rate for Payer: PHP Commercial |
$654.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$539.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$670.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$469.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$678.05
|
| Rate for Payer: UHC Core |
$643.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$577.88
|
|
|
HC EP VISUAL
|
Facility
|
OP
|
$770.51
|
|
|
Service Code
|
CPT 95930
|
| Hospital Charge Code |
92200018
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$183.00 |
| Max. Negotiated Rate |
$693.46 |
| Rate for Payer: Aetna Commercial |
$654.93
|
| Rate for Payer: Aetna Medicare |
$200.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$240.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$240.78
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$192.63
|
| Rate for Payer: BCBS Trust/PPO |
$599.07
|
| Rate for Payer: BCN Commercial |
$599.07
|
| Rate for Payer: BCN Medicare Advantage |
$192.63
|
| Rate for Payer: Cash Price |
$616.41
|
| Rate for Payer: Cash Price |
$616.41
|
| Rate for Payer: Cofinity Commercial |
$662.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$616.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.63
|
| Rate for Payer: Healthscope Commercial |
$693.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$577.88
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$202.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$221.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$654.93
|
| Rate for Payer: PACE Senior Care Partners |
$183.00
|
| Rate for Payer: PACE SWMI |
$192.63
|
| Rate for Payer: PHP Commercial |
$654.93
|
| Rate for Payer: PHP Medicare Advantage |
$192.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$539.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$670.34
|
| Rate for Payer: Priority Health Medicare |
$192.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$469.93
|
| Rate for Payer: Railroad Medicare Medicare |
$192.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$678.05
|
| Rate for Payer: UHC Core |
$643.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.63
|
| Rate for Payer: UHC Medicare Advantage |
$198.41
|
| Rate for Payer: VA VA |
$192.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$577.88
|
|
|
HC ERBE IRRIGATION
|
Facility
|
IP
|
$309.64
|
|
| Hospital Charge Code |
27000070
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$188.85 |
| Max. Negotiated Rate |
$278.68 |
| Rate for Payer: Aetna Commercial |
$263.19
|
| Rate for Payer: BCBS Trust/PPO |
$239.29
|
| Rate for Payer: BCN Commercial |
$239.29
|
| Rate for Payer: Cash Price |
$247.71
|
| Rate for Payer: Cofinity Commercial |
$266.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.71
|
| Rate for Payer: Healthscope Commercial |
$278.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$263.19
|
| Rate for Payer: PHP Commercial |
$263.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.48
|
| Rate for Payer: UHC Core |
$258.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.23
|
|
|
HC ERBE IRRIGATION
|
Facility
|
OP
|
$309.64
|
|
| Hospital Charge Code |
27000070
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$73.54 |
| Max. Negotiated Rate |
$278.68 |
| Rate for Payer: Aetna Commercial |
$263.19
|
| Rate for Payer: Aetna Medicare |
$80.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.76
|
| Rate for Payer: BCBS Complete |
$123.86
|
| Rate for Payer: BCBS MAPPO |
$77.41
|
| Rate for Payer: BCBS Trust/PPO |
$240.75
|
| Rate for Payer: BCN Commercial |
$240.75
|
| Rate for Payer: BCN Medicare Advantage |
$77.41
|
| Rate for Payer: Cash Price |
$247.71
|
| Rate for Payer: Cofinity Commercial |
$266.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.41
|
| Rate for Payer: Healthscope Commercial |
$278.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$81.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$263.19
|
| Rate for Payer: PACE Senior Care Partners |
$73.54
|
| Rate for Payer: PACE SWMI |
$77.41
|
| Rate for Payer: PHP Commercial |
$263.19
|
| Rate for Payer: PHP Medicare Advantage |
$77.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.39
|
| Rate for Payer: Priority Health Medicare |
$77.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.85
|
| Rate for Payer: Railroad Medicare Medicare |
$77.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.48
|
| Rate for Payer: UHC Core |
$258.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.41
|
| Rate for Payer: UHC Medicare Advantage |
$79.73
|
| Rate for Payer: VA VA |
$77.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.23
|
|
|
HC ER BURN CARE
|
Facility
|
OP
|
$396.15
|
|
| Hospital Charge Code |
45000038
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$94.09 |
| Max. Negotiated Rate |
$356.54 |
| Rate for Payer: Aetna Commercial |
$336.73
|
| Rate for Payer: Aetna Medicare |
$103.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.80
|
| Rate for Payer: BCBS Complete |
$158.46
|
| Rate for Payer: BCBS MAPPO |
$99.04
|
| Rate for Payer: BCBS Trust/PPO |
$308.01
|
| Rate for Payer: BCN Commercial |
$308.01
|
| Rate for Payer: BCN Medicare Advantage |
$99.04
|
| Rate for Payer: Cash Price |
$316.92
|
| Rate for Payer: Cofinity Commercial |
$340.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.04
|
| Rate for Payer: Healthscope Commercial |
$356.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$103.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$336.73
|
| Rate for Payer: PACE Senior Care Partners |
$94.09
|
| Rate for Payer: PACE SWMI |
$99.04
|
| Rate for Payer: PHP Commercial |
$336.73
|
| Rate for Payer: PHP Medicare Advantage |
$99.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.65
|
| Rate for Payer: Priority Health Medicare |
$99.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.61
|
| Rate for Payer: Railroad Medicare Medicare |
$99.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.61
|
| Rate for Payer: UHC Core |
$330.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.04
|
| Rate for Payer: UHC Medicare Advantage |
$102.01
|
| Rate for Payer: VA VA |
$99.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.11
|
|
|
HC ER BURN CARE
|
Facility
|
IP
|
$396.15
|
|
| Hospital Charge Code |
45000038
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$241.61 |
| Max. Negotiated Rate |
$356.54 |
| Rate for Payer: Aetna Commercial |
$336.73
|
| Rate for Payer: BCBS Trust/PPO |
$306.14
|
| Rate for Payer: BCN Commercial |
$306.14
|
| Rate for Payer: Cash Price |
$316.92
|
| Rate for Payer: Cofinity Commercial |
$340.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.92
|
| Rate for Payer: Healthscope Commercial |
$356.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$336.73
|
| Rate for Payer: PHP Commercial |
$336.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.61
|
| Rate for Payer: UHC Core |
$330.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.11
|
|
|
HC ERCP
|
Facility
|
IP
|
$3,330.35
|
|
| Hospital Charge Code |
36000039
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,031.18 |
| Max. Negotiated Rate |
$2,997.32 |
| Rate for Payer: Aetna Commercial |
$2,830.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,573.69
|
| Rate for Payer: BCN Commercial |
$2,573.69
|
| Rate for Payer: Cash Price |
$2,664.28
|
| Rate for Payer: Cofinity Commercial |
$2,864.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,664.28
|
| Rate for Payer: Healthscope Commercial |
$2,997.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,497.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,830.80
|
| Rate for Payer: PHP Commercial |
$2,830.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,331.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,897.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,031.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,930.71
|
| Rate for Payer: UHC Core |
$2,780.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,497.76
|
|
|
HC ERCP
|
Facility
|
OP
|
$3,330.35
|
|
| Hospital Charge Code |
36000039
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$790.96 |
| Max. Negotiated Rate |
$2,997.32 |
| Rate for Payer: Aetna Commercial |
$2,830.80
|
| Rate for Payer: Aetna Medicare |
$865.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,040.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,040.73
|
| Rate for Payer: BCBS Complete |
$1,332.14
|
| Rate for Payer: BCBS MAPPO |
$832.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,589.35
|
| Rate for Payer: BCN Commercial |
$2,589.35
|
| Rate for Payer: BCN Medicare Advantage |
$832.59
|
| Rate for Payer: Cash Price |
$2,664.28
|
| Rate for Payer: Cofinity Commercial |
$2,864.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,664.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$832.59
|
| Rate for Payer: Healthscope Commercial |
$2,997.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,497.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$874.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$957.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,830.80
|
| Rate for Payer: PACE Senior Care Partners |
$790.96
|
| Rate for Payer: PACE SWMI |
$832.59
|
| Rate for Payer: PHP Commercial |
$2,830.80
|
| Rate for Payer: PHP Medicare Advantage |
$832.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,331.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,897.40
|
| Rate for Payer: Priority Health Medicare |
$832.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,031.18
|
| Rate for Payer: Railroad Medicare Medicare |
$832.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,930.71
|
| Rate for Payer: UHC Core |
$2,780.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$832.59
|
| Rate for Payer: UHC Medicare Advantage |
$857.57
|
| Rate for Payer: VA VA |
$832.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,497.76
|
|
|
HC ERCP SPHINCTEROTOMY
|
Facility
|
OP
|
$3,966.57
|
|
| Hospital Charge Code |
36000040
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$942.06 |
| Max. Negotiated Rate |
$3,569.91 |
| Rate for Payer: Aetna Commercial |
$3,371.58
|
| Rate for Payer: Aetna Medicare |
$1,031.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,239.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,239.55
|
| Rate for Payer: BCBS Complete |
$1,586.63
|
| Rate for Payer: BCBS MAPPO |
$991.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,084.01
|
| Rate for Payer: BCN Commercial |
$3,084.01
|
| Rate for Payer: BCN Medicare Advantage |
$991.64
|
| Rate for Payer: Cash Price |
$3,173.26
|
| Rate for Payer: Cofinity Commercial |
$3,411.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,173.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$991.64
|
| Rate for Payer: Healthscope Commercial |
$3,569.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,974.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,041.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,140.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,371.58
|
| Rate for Payer: PACE Senior Care Partners |
$942.06
|
| Rate for Payer: PACE SWMI |
$991.64
|
| Rate for Payer: PHP Commercial |
$3,371.58
|
| Rate for Payer: PHP Medicare Advantage |
$991.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,776.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,450.92
|
| Rate for Payer: Priority Health Medicare |
$991.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,419.21
|
| Rate for Payer: Railroad Medicare Medicare |
$991.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,490.58
|
| Rate for Payer: UHC Core |
$3,312.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$991.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,021.39
|
| Rate for Payer: VA VA |
$991.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,974.93
|
|
|
HC ERCP SPHINCTEROTOMY
|
Facility
|
IP
|
$3,966.57
|
|
| Hospital Charge Code |
36000040
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,419.21 |
| Max. Negotiated Rate |
$3,569.91 |
| Rate for Payer: Aetna Commercial |
$3,371.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,065.37
|
| Rate for Payer: BCN Commercial |
$3,065.37
|
| Rate for Payer: Cash Price |
$3,173.26
|
| Rate for Payer: Cofinity Commercial |
$3,411.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,173.26
|
| Rate for Payer: Healthscope Commercial |
$3,569.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,974.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,371.58
|
| Rate for Payer: PHP Commercial |
$3,371.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,776.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,450.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,419.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,490.58
|
| Rate for Payer: UHC Core |
$3,312.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,974.93
|
|
|
HC ER CRITICAL CARE EA ADDL 30 MIN
|
Facility
|
OP
|
$746.13
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
45000081
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$177.21 |
| Max. Negotiated Rate |
$671.52 |
| Rate for Payer: Aetna Commercial |
$634.21
|
| Rate for Payer: Aetna Medicare |
$193.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$233.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$233.17
|
| Rate for Payer: BCBS Complete |
$298.45
|
| Rate for Payer: BCBS MAPPO |
$186.53
|
| Rate for Payer: BCBS Trust/PPO |
$580.12
|
| Rate for Payer: BCN Commercial |
$580.12
|
| Rate for Payer: BCN Medicare Advantage |
$186.53
|
| Rate for Payer: Cash Price |
$596.90
|
| Rate for Payer: Cofinity Commercial |
$641.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.53
|
| Rate for Payer: Healthscope Commercial |
$671.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$559.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$195.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$214.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$634.21
|
| Rate for Payer: PACE Senior Care Partners |
$177.21
|
| Rate for Payer: PACE SWMI |
$186.53
|
| Rate for Payer: PHP Commercial |
$634.21
|
| Rate for Payer: PHP Medicare Advantage |
$186.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$649.13
|
| Rate for Payer: Priority Health Medicare |
$186.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$455.06
|
| Rate for Payer: Railroad Medicare Medicare |
$186.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.59
|
| Rate for Payer: UHC Core |
$623.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.53
|
| Rate for Payer: UHC Medicare Advantage |
$192.13
|
| Rate for Payer: VA VA |
$186.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$559.60
|
|
|
HC ER CRITICAL CARE EA ADDL 30 MIN
|
Facility
|
IP
|
$746.13
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
45000081
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$455.06 |
| Max. Negotiated Rate |
$671.52 |
| Rate for Payer: Aetna Commercial |
$634.21
|
| Rate for Payer: BCBS Trust/PPO |
$576.61
|
| Rate for Payer: BCN Commercial |
$576.61
|
| Rate for Payer: Cash Price |
$596.90
|
| Rate for Payer: Cofinity Commercial |
$641.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.90
|
| Rate for Payer: Healthscope Commercial |
$671.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$559.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$634.21
|
| Rate for Payer: PHP Commercial |
$634.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$649.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$455.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.59
|
| Rate for Payer: UHC Core |
$623.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$559.60
|
|
