|
HC BK VIRUS PCR, QUANT
|
Facility
|
OP
|
$113.40
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.93 |
| Max. Negotiated Rate |
$102.06 |
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: Aetna Medicare |
$29.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.44
|
| Rate for Payer: BCBS Complete |
$32.52
|
| Rate for Payer: BCBS MAPPO |
$28.35
|
| Rate for Payer: BCBS Trust/PPO |
$93.23
|
| Rate for Payer: BCN Commercial |
$88.17
|
| Rate for Payer: BCN Medicare Advantage |
$28.35
|
| Rate for Payer: Cash Price |
$90.72
|
| Rate for Payer: Cash Price |
$90.72
|
| Rate for Payer: Cofinity Commercial |
$97.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.35
|
| Rate for Payer: Healthscope Commercial |
$102.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.05
|
| Rate for Payer: Mclaren Medicaid |
$30.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.77
|
| Rate for Payer: Meridian Medicaid |
$32.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.39
|
| Rate for Payer: Nomi Health Commercial |
$92.99
|
| Rate for Payer: PACE Senior Care Partners |
$26.93
|
| Rate for Payer: PACE SWMI |
$28.35
|
| Rate for Payer: PHP Commercial |
$96.39
|
| Rate for Payer: PHP Medicare Advantage |
$28.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.71
|
| Rate for Payer: Priority Health HMO/PPO |
$98.66
|
| Rate for Payer: Priority Health Medicare |
$28.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.98
|
| Rate for Payer: Railroad Medicare Medicare |
$28.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.79
|
| Rate for Payer: UHC Core |
$94.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.35
|
| Rate for Payer: UHC Exchange |
$28.35
|
| Rate for Payer: UHC Medicare Advantage |
$28.35
|
| Rate for Payer: UHCCP Medicaid |
$30.97
|
| Rate for Payer: VA VA |
$28.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.05
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
IP
|
$279.85
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$181.90 |
| Max. Negotiated Rate |
$251.86 |
| Rate for Payer: Aetna Commercial |
$237.87
|
| Rate for Payer: BCBS Trust/PPO |
$228.44
|
| Rate for Payer: BCN Commercial |
$216.27
|
| Rate for Payer: Cash Price |
$223.88
|
| Rate for Payer: Cofinity Commercial |
$240.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.88
|
| Rate for Payer: Healthscope Commercial |
$251.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.87
|
| Rate for Payer: Nomi Health Commercial |
$229.48
|
| Rate for Payer: PHP Commercial |
$237.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.90
|
| Rate for Payer: Priority Health HMO/PPO |
$243.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.27
|
| Rate for Payer: UHC Core |
$233.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.89
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
OP
|
$279.85
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$66.46 |
| Max. Negotiated Rate |
$251.86 |
| Rate for Payer: Aetna Commercial |
$237.87
|
| Rate for Payer: Aetna Medicare |
$72.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.45
|
| Rate for Payer: BCBS Complete |
$111.94
|
| Rate for Payer: BCBS MAPPO |
$69.96
|
| Rate for Payer: BCBS Trust/PPO |
$230.06
|
| Rate for Payer: BCN Commercial |
$217.58
|
| Rate for Payer: BCN Medicare Advantage |
$69.96
|
| Rate for Payer: Cash Price |
$223.88
|
| Rate for Payer: Cofinity Commercial |
$240.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.96
|
| Rate for Payer: Healthscope Commercial |
$251.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.87
|
| Rate for Payer: Nomi Health Commercial |
$229.48
|
| Rate for Payer: PACE Senior Care Partners |
$66.46
|
| Rate for Payer: PACE SWMI |
$69.96
|
| Rate for Payer: PHP Commercial |
$237.87
|
| Rate for Payer: PHP Medicare Advantage |
$69.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.90
|
| Rate for Payer: Priority Health HMO/PPO |
$243.47
|
| Rate for Payer: Priority Health Medicare |
$70.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.50
|
| Rate for Payer: Railroad Medicare Medicare |
$69.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.27
|
| Rate for Payer: UHC Core |
$233.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.96
|
| Rate for Payer: UHC Exchange |
$69.96
|
| Rate for Payer: UHC Medicare Advantage |
$69.96
|
| Rate for Payer: VA VA |
$69.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.89
|
|
|
HC BLADDER SCAN
|
Facility
|
OP
|
$153.14
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$36.37 |
| Max. Negotiated Rate |
$137.83 |
| Rate for Payer: Aetna Commercial |
$130.17
|
| Rate for Payer: Aetna Medicare |
$39.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.86
|
| Rate for Payer: BCBS Complete |
$44.19
|
| Rate for Payer: BCBS MAPPO |
$38.28
|
| Rate for Payer: BCBS Trust/PPO |
$125.90
|
| Rate for Payer: BCN Commercial |
$119.07
|
| Rate for Payer: BCN Medicare Advantage |
$38.28
|
| Rate for Payer: Cash Price |
$122.51
|
| Rate for Payer: Cash Price |
$122.51
|
| Rate for Payer: Cofinity Commercial |
$131.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$137.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.86
|
| Rate for Payer: Mclaren Medicaid |
$42.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.20
|
| Rate for Payer: Meridian Medicaid |
$44.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.17
|
| Rate for Payer: Nomi Health Commercial |
$125.57
|
| Rate for Payer: PACE Senior Care Partners |
$36.37
|
| Rate for Payer: PACE SWMI |
$38.28
|
| Rate for Payer: PHP Commercial |
$130.17
|
| Rate for Payer: PHP Medicare Advantage |
$38.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.54
|
| Rate for Payer: Priority Health HMO/PPO |
$133.23
|
| Rate for Payer: Priority Health Medicare |
$38.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.60
|
| Rate for Payer: Railroad Medicare Medicare |
$38.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.76
|
| Rate for Payer: UHC Core |
$127.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.28
|
| Rate for Payer: UHC Exchange |
$38.28
|
| Rate for Payer: UHC Medicare Advantage |
$38.28
|
| Rate for Payer: UHCCP Medicaid |
$42.08
|
| Rate for Payer: VA VA |
$38.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.86
|
|
|
HC BLADDER SCAN
|
Facility
|
IP
|
$153.14
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$99.54 |
| Max. Negotiated Rate |
$137.83 |
| Rate for Payer: Aetna Commercial |
$130.17
|
| Rate for Payer: BCBS Trust/PPO |
$125.01
|
| Rate for Payer: BCN Commercial |
$118.35
|
| Rate for Payer: Cash Price |
$122.51
|
| Rate for Payer: Cofinity Commercial |
$131.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.51
|
| Rate for Payer: Healthscope Commercial |
$137.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.17
|
| Rate for Payer: Nomi Health Commercial |
$125.57
|
| Rate for Payer: PHP Commercial |
$130.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.54
|
| Rate for Payer: Priority Health HMO/PPO |
$133.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.76
|
| Rate for Payer: UHC Core |
$127.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.86
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.33 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$9.79
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$62.89
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$9.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: Meridian Medicaid |
$9.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Exchange |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.12
|
| Rate for Payer: UHCCP Medicaid |
$9.33
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.72 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: BCBS Trust/PPO |
$62.45
|
| Rate for Payer: BCN Commercial |
$59.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
IP
|
$124.52
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$80.94 |
| Max. Negotiated Rate |
$112.07 |
| Rate for Payer: Aetna Commercial |
$105.84
|
| Rate for Payer: BCBS Trust/PPO |
$101.65
|
| Rate for Payer: BCN Commercial |
$96.23
|
| Rate for Payer: Cash Price |
$99.62
|
| Rate for Payer: Cofinity Commercial |
$107.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.62
|
| Rate for Payer: Healthscope Commercial |
$112.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.84
|
| Rate for Payer: Nomi Health Commercial |
$102.11
|
| Rate for Payer: PHP Commercial |
$105.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.94
|
| Rate for Payer: Priority Health HMO/PPO |
$108.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.58
|
| Rate for Payer: UHC Core |
$103.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.39
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
OP
|
$124.52
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.57 |
| Max. Negotiated Rate |
$112.07 |
| Rate for Payer: Aetna Commercial |
$105.84
|
| Rate for Payer: Aetna Medicare |
$32.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.91
|
| Rate for Payer: BCBS Complete |
$95.88
|
| Rate for Payer: BCBS MAPPO |
$31.13
|
| Rate for Payer: BCBS Trust/PPO |
$102.37
|
| Rate for Payer: BCN Commercial |
$96.81
|
| Rate for Payer: BCN Medicare Advantage |
$31.13
|
| Rate for Payer: Cash Price |
$99.62
|
| Rate for Payer: Cash Price |
$99.62
|
| Rate for Payer: Cofinity Commercial |
$107.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.13
|
| Rate for Payer: Healthscope Commercial |
$112.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.39
|
| Rate for Payer: Mclaren Medicaid |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.69
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.84
|
| Rate for Payer: Nomi Health Commercial |
$102.11
|
| Rate for Payer: PACE Senior Care Partners |
$29.57
|
| Rate for Payer: PACE SWMI |
$31.13
|
| Rate for Payer: PHP Commercial |
$105.84
|
| Rate for Payer: PHP Medicare Advantage |
$31.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.94
|
| Rate for Payer: Priority Health HMO/PPO |
$108.33
|
| Rate for Payer: Priority Health Medicare |
$31.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.43
|
| Rate for Payer: Railroad Medicare Medicare |
$31.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.58
|
| Rate for Payer: UHC Core |
$103.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.13
|
| Rate for Payer: UHC Exchange |
$31.13
|
| Rate for Payer: UHC Medicare Advantage |
$31.13
|
| Rate for Payer: UHCCP Medicaid |
$91.31
|
| Rate for Payer: VA VA |
$31.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.39
|
|
|
HC BLEEDING TIME
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: BCBS Trust/PPO |
$62.78
|
| Rate for Payer: BCN Commercial |
$59.44
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC BLEEDING TIME
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.48 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.03
|
| Rate for Payer: BCBS Complete |
$3.66
|
| Rate for Payer: BCBS MAPPO |
$19.23
|
| Rate for Payer: BCBS Trust/PPO |
$63.23
|
| Rate for Payer: BCN Commercial |
$59.80
|
| Rate for Payer: BCN Medicare Advantage |
$19.23
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.23
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$3.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.19
|
| Rate for Payer: Meridian Medicaid |
$3.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PACE Senior Care Partners |
$18.27
|
| Rate for Payer: PACE SWMI |
$19.23
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Medicare |
$19.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: Railroad Medicare Medicare |
$19.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.23
|
| Rate for Payer: UHC Exchange |
$19.23
|
| Rate for Payer: UHC Medicare Advantage |
$19.23
|
| Rate for Payer: UHCCP Medicaid |
$3.48
|
| Rate for Payer: VA VA |
$19.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC BLOOD CULTURE
|
Facility
|
OP
|
$97.70
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
30600072
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$87.93 |
| Rate for Payer: Aetna Commercial |
$83.04
|
| Rate for Payer: Aetna Medicare |
$25.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.53
|
| Rate for Payer: BCBS Complete |
$7.83
|
| Rate for Payer: BCBS MAPPO |
$24.42
|
| Rate for Payer: BCBS Trust/PPO |
$80.32
|
| Rate for Payer: BCN Commercial |
$75.96
|
| Rate for Payer: BCN Medicare Advantage |
$24.42
|
| Rate for Payer: Cash Price |
$78.16
|
| Rate for Payer: Cash Price |
$78.16
|
| Rate for Payer: Cofinity Commercial |
$84.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.42
|
| Rate for Payer: Healthscope Commercial |
$87.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.28
|
| Rate for Payer: Mclaren Medicaid |
$7.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.65
|
| Rate for Payer: Meridian Medicaid |
$7.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.04
|
| Rate for Payer: Nomi Health Commercial |
$80.11
|
| Rate for Payer: PACE Senior Care Partners |
$23.20
|
| Rate for Payer: PACE SWMI |
$24.42
|
| Rate for Payer: PHP Commercial |
$83.04
|
| Rate for Payer: PHP Medicare Advantage |
$24.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.50
|
| Rate for Payer: Priority Health HMO/PPO |
$85.00
|
| Rate for Payer: Priority Health Medicare |
$24.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.46
|
| Rate for Payer: Railroad Medicare Medicare |
$24.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.98
|
| Rate for Payer: UHC Core |
$81.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.42
|
| Rate for Payer: UHC Exchange |
$24.42
|
| Rate for Payer: UHC Medicare Advantage |
$24.42
|
| Rate for Payer: UHCCP Medicaid |
$7.46
|
| Rate for Payer: VA VA |
$24.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.28
|
|
|
HC BLOOD CULTURE
|
Facility
|
IP
|
$97.70
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
30600072
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$63.50 |
| Max. Negotiated Rate |
$87.93 |
| Rate for Payer: Aetna Commercial |
$83.04
|
| Rate for Payer: BCBS Trust/PPO |
$79.75
|
| Rate for Payer: BCN Commercial |
$75.50
|
| Rate for Payer: Cash Price |
$78.16
|
| Rate for Payer: Cofinity Commercial |
$84.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.16
|
| Rate for Payer: Healthscope Commercial |
$87.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.04
|
| Rate for Payer: Nomi Health Commercial |
$80.11
|
| Rate for Payer: PHP Commercial |
$83.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.50
|
| Rate for Payer: Priority Health HMO/PPO |
$85.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.98
|
| Rate for Payer: UHC Core |
$81.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.28
|
|
|
HC BLOOD DRAW IMPLANTED DEVICE
|
Facility
|
OP
|
$167.77
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
76100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.85 |
| Max. Negotiated Rate |
$150.99 |
| Rate for Payer: Aetna Commercial |
$142.60
|
| Rate for Payer: Aetna Medicare |
$43.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.43
|
| Rate for Payer: BCBS Complete |
$95.88
|
| Rate for Payer: BCBS MAPPO |
$41.94
|
| Rate for Payer: BCBS Trust/PPO |
$137.92
|
| Rate for Payer: BCN Commercial |
$130.44
|
| Rate for Payer: BCN Medicare Advantage |
$41.94
|
| Rate for Payer: Cash Price |
$134.22
|
| Rate for Payer: Cash Price |
$134.22
|
| Rate for Payer: Cofinity Commercial |
$144.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.94
|
| Rate for Payer: Healthscope Commercial |
$150.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.83
|
| Rate for Payer: Mclaren Medicaid |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.04
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.60
|
| Rate for Payer: Nomi Health Commercial |
$137.57
|
| Rate for Payer: PACE Senior Care Partners |
$39.85
|
| Rate for Payer: PACE SWMI |
$41.94
|
| Rate for Payer: PHP Commercial |
$142.60
|
| Rate for Payer: PHP Medicare Advantage |
$41.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.05
|
| Rate for Payer: Priority Health HMO/PPO |
$145.96
|
| Rate for Payer: Priority Health Medicare |
$42.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.41
|
| Rate for Payer: Railroad Medicare Medicare |
$41.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.64
|
| Rate for Payer: UHC Core |
$140.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.94
|
| Rate for Payer: UHC Exchange |
$41.94
|
| Rate for Payer: UHC Medicare Advantage |
$41.94
|
| Rate for Payer: UHCCP Medicaid |
$91.31
|
| Rate for Payer: VA VA |
$41.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.83
|
|
|
HC BLOOD DRAW IMPLANTED DEVICE
|
Facility
|
IP
|
$167.77
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
76100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$109.05 |
| Max. Negotiated Rate |
$150.99 |
| Rate for Payer: Aetna Commercial |
$142.60
|
| Rate for Payer: BCBS Trust/PPO |
$136.95
|
| Rate for Payer: BCN Commercial |
$129.65
|
| Rate for Payer: Cash Price |
$134.22
|
| Rate for Payer: Cofinity Commercial |
$144.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.22
|
| Rate for Payer: Healthscope Commercial |
$150.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.60
|
| Rate for Payer: Nomi Health Commercial |
$137.57
|
| Rate for Payer: PHP Commercial |
$142.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.05
|
| Rate for Payer: Priority Health HMO/PPO |
$145.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.64
|
| Rate for Payer: UHC Core |
$140.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.83
|
|
|
HC BLOOD GAS PKG, CALC O2 SAT
|
Facility
|
OP
|
$176.97
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.85 |
| Max. Negotiated Rate |
$159.27 |
| Rate for Payer: Aetna Commercial |
$150.42
|
| Rate for Payer: Aetna Medicare |
$46.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.30
|
| Rate for Payer: BCBS Complete |
$19.79
|
| Rate for Payer: BCBS MAPPO |
$44.24
|
| Rate for Payer: BCBS Trust/PPO |
$145.49
|
| Rate for Payer: BCN Commercial |
$137.59
|
| Rate for Payer: BCN Medicare Advantage |
$44.24
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cofinity Commercial |
$152.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.24
|
| Rate for Payer: Healthscope Commercial |
$159.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.73
|
| Rate for Payer: Mclaren Medicaid |
$18.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.45
|
| Rate for Payer: Meridian Medicaid |
$19.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.42
|
| Rate for Payer: Nomi Health Commercial |
$145.12
|
| Rate for Payer: PACE Senior Care Partners |
$42.03
|
| Rate for Payer: PACE SWMI |
$44.24
|
| Rate for Payer: PHP Commercial |
$150.42
|
| Rate for Payer: PHP Medicare Advantage |
$44.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.03
|
| Rate for Payer: Priority Health HMO/PPO |
$153.96
|
| Rate for Payer: Priority Health Medicare |
$44.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.57
|
| Rate for Payer: Railroad Medicare Medicare |
$44.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.73
|
| Rate for Payer: UHC Core |
$147.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.24
|
| Rate for Payer: UHC Exchange |
$44.24
|
| Rate for Payer: UHC Medicare Advantage |
$44.24
|
| Rate for Payer: UHCCP Medicaid |
$18.85
|
| Rate for Payer: VA VA |
$44.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.73
|
|
|
HC BLOOD GAS PKG, CALC O2 SAT
|
Facility
|
IP
|
$176.97
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$115.03 |
| Max. Negotiated Rate |
$159.27 |
| Rate for Payer: Aetna Commercial |
$150.42
|
| Rate for Payer: BCBS Trust/PPO |
$144.46
|
| Rate for Payer: BCN Commercial |
$136.76
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cofinity Commercial |
$152.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.58
|
| Rate for Payer: Healthscope Commercial |
$159.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.42
|
| Rate for Payer: Nomi Health Commercial |
$145.12
|
| Rate for Payer: PHP Commercial |
$150.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.03
|
| Rate for Payer: Priority Health HMO/PPO |
$153.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.73
|
| Rate for Payer: UHC Core |
$147.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.73
|
|
|
HC BLOOD GAS PKG & DIRECT O2 SAT
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.65 |
| Max. Negotiated Rate |
$169.20 |
| Rate for Payer: Aetna Commercial |
$159.80
|
| Rate for Payer: Aetna Medicare |
$48.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.75
|
| Rate for Payer: BCBS Complete |
$59.80
|
| Rate for Payer: BCBS MAPPO |
$47.00
|
| Rate for Payer: BCBS Trust/PPO |
$154.55
|
| Rate for Payer: BCN Commercial |
$146.17
|
| Rate for Payer: BCN Medicare Advantage |
$47.00
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$161.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.00
|
| Rate for Payer: Healthscope Commercial |
$169.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.00
|
| Rate for Payer: Mclaren Medicaid |
$56.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.35
|
| Rate for Payer: Meridian Medicaid |
$59.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.80
|
| Rate for Payer: Nomi Health Commercial |
$154.16
|
| Rate for Payer: PACE Senior Care Partners |
$44.65
|
| Rate for Payer: PACE SWMI |
$47.00
|
| Rate for Payer: PHP Commercial |
$159.80
|
| Rate for Payer: PHP Medicare Advantage |
$47.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health HMO/PPO |
$163.56
|
| Rate for Payer: Priority Health Medicare |
$47.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.96
|
| Rate for Payer: Railroad Medicare Medicare |
$47.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.44
|
| Rate for Payer: UHC Core |
$156.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.00
|
| Rate for Payer: UHC Exchange |
$47.00
|
| Rate for Payer: UHC Medicare Advantage |
$47.00
|
| Rate for Payer: UHCCP Medicaid |
$56.95
|
| Rate for Payer: VA VA |
$47.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.00
|
|
|
HC BLOOD GAS PKG & DIRECT O2 SAT
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$122.20 |
| Max. Negotiated Rate |
$169.20 |
| Rate for Payer: Aetna Commercial |
$159.80
|
| Rate for Payer: BCBS Trust/PPO |
$153.46
|
| Rate for Payer: BCN Commercial |
$145.29
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$161.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.40
|
| Rate for Payer: Healthscope Commercial |
$169.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.80
|
| Rate for Payer: Nomi Health Commercial |
$154.16
|
| Rate for Payer: PHP Commercial |
$159.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health HMO/PPO |
$163.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.44
|
| Rate for Payer: UHC Core |
$156.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.00
|
|
|
HC BLOOD,OCLT,FECES IMMUNO SCREEN
|
Facility
|
IP
|
$31.29
|
|
|
Service Code
|
HCPCS G0328
|
| Hospital Charge Code |
30100000
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.34 |
| Max. Negotiated Rate |
$28.16 |
| Rate for Payer: Aetna Commercial |
$26.60
|
| Rate for Payer: BCBS Trust/PPO |
$25.54
|
| Rate for Payer: BCN Commercial |
$24.18
|
| Rate for Payer: Cash Price |
$25.03
|
| Rate for Payer: Cofinity Commercial |
$26.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.03
|
| Rate for Payer: Healthscope Commercial |
$28.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.60
|
| Rate for Payer: Nomi Health Commercial |
$25.66
|
| Rate for Payer: PHP Commercial |
$26.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.34
|
| Rate for Payer: Priority Health HMO/PPO |
$27.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.54
|
| Rate for Payer: UHC Core |
$26.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.47
|
|
|
HC BLOOD,OCLT,FECES IMMUNO SCREEN
|
Facility
|
OP
|
$31.29
|
|
|
Service Code
|
HCPCS G0328
|
| Hospital Charge Code |
30100000
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.43 |
| Max. Negotiated Rate |
$28.16 |
| Rate for Payer: Aetna Commercial |
$26.60
|
| Rate for Payer: Aetna Medicare |
$8.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.78
|
| Rate for Payer: BCBS Complete |
$13.70
|
| Rate for Payer: BCBS MAPPO |
$7.82
|
| Rate for Payer: BCBS Trust/PPO |
$25.72
|
| Rate for Payer: BCN Commercial |
$24.33
|
| Rate for Payer: BCN Medicare Advantage |
$7.82
|
| Rate for Payer: Cash Price |
$25.03
|
| Rate for Payer: Cash Price |
$25.03
|
| Rate for Payer: Cofinity Commercial |
$26.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.82
|
| Rate for Payer: Healthscope Commercial |
$28.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.47
|
| Rate for Payer: Mclaren Medicaid |
$13.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.21
|
| Rate for Payer: Meridian Medicaid |
$13.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.60
|
| Rate for Payer: Nomi Health Commercial |
$25.66
|
| Rate for Payer: PACE Senior Care Partners |
$7.43
|
| Rate for Payer: PACE SWMI |
$7.82
|
| Rate for Payer: PHP Commercial |
$26.60
|
| Rate for Payer: PHP Medicare Advantage |
$7.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.34
|
| Rate for Payer: Priority Health HMO/PPO |
$27.22
|
| Rate for Payer: Priority Health Medicare |
$7.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.96
|
| Rate for Payer: Railroad Medicare Medicare |
$7.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.54
|
| Rate for Payer: UHC Core |
$26.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.82
|
| Rate for Payer: UHC Exchange |
$7.82
|
| Rate for Payer: UHC Medicare Advantage |
$7.82
|
| Rate for Payer: UHCCP Medicaid |
$13.05
|
| Rate for Payer: VA VA |
$7.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.47
|
|
|
HC BLOOD PATCH
|
Facility
|
OP
|
$1,212.51
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
45000033
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$287.97 |
| Max. Negotiated Rate |
$1,091.26 |
| Rate for Payer: Aetna Commercial |
$1,030.63
|
| Rate for Payer: Aetna Medicare |
$315.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$378.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$378.91
|
| Rate for Payer: BCBS Complete |
$515.13
|
| Rate for Payer: BCBS MAPPO |
$303.13
|
| Rate for Payer: BCBS Trust/PPO |
$996.80
|
| Rate for Payer: BCN Commercial |
$942.73
|
| Rate for Payer: BCN Medicare Advantage |
$303.13
|
| Rate for Payer: Cash Price |
$970.01
|
| Rate for Payer: Cash Price |
$970.01
|
| Rate for Payer: Cofinity Commercial |
$1,042.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$970.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.13
|
| Rate for Payer: Healthscope Commercial |
$1,091.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$909.38
|
| Rate for Payer: Mclaren Medicaid |
$490.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.28
|
| Rate for Payer: Meridian Medicaid |
$515.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$348.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.63
|
| Rate for Payer: Nomi Health Commercial |
$994.26
|
| Rate for Payer: PACE Senior Care Partners |
$287.97
|
| Rate for Payer: PACE SWMI |
$303.13
|
| Rate for Payer: PHP Commercial |
$1,030.63
|
| Rate for Payer: PHP Medicare Advantage |
$303.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.13
|
| Rate for Payer: Priority Health HMO/PPO |
$1,054.88
|
| Rate for Payer: Priority Health Medicare |
$306.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$812.38
|
| Rate for Payer: Railroad Medicare Medicare |
$303.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,067.01
|
| Rate for Payer: UHC Core |
$1,012.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.13
|
| Rate for Payer: UHC Exchange |
$303.13
|
| Rate for Payer: UHC Medicare Advantage |
$303.13
|
| Rate for Payer: UHCCP Medicaid |
$490.57
|
| Rate for Payer: VA VA |
$303.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$909.38
|
|
|
HC BLOOD PATCH
|
Facility
|
IP
|
$1,212.51
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
45000033
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$788.13 |
| Max. Negotiated Rate |
$1,091.26 |
| Rate for Payer: Aetna Commercial |
$1,030.63
|
| Rate for Payer: BCBS Trust/PPO |
$989.77
|
| Rate for Payer: BCN Commercial |
$937.03
|
| Rate for Payer: Cash Price |
$970.01
|
| Rate for Payer: Cofinity Commercial |
$1,042.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$970.01
|
| Rate for Payer: Healthscope Commercial |
$1,091.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$909.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.63
|
| Rate for Payer: Nomi Health Commercial |
$994.26
|
| Rate for Payer: PHP Commercial |
$1,030.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.13
|
| Rate for Payer: Priority Health HMO/PPO |
$1,054.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$812.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,067.01
|
| Rate for Payer: UHC Core |
$1,012.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$909.38
|
|
|
HC BLOOD PATCH PROCEDURE
|
Facility
|
OP
|
$1,212.51
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
36100280
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$287.97 |
| Max. Negotiated Rate |
$1,091.26 |
| Rate for Payer: Aetna Commercial |
$1,030.63
|
| Rate for Payer: Aetna Medicare |
$315.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$378.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$378.91
|
| Rate for Payer: BCBS Complete |
$515.13
|
| Rate for Payer: BCBS MAPPO |
$303.13
|
| Rate for Payer: BCBS Trust/PPO |
$996.80
|
| Rate for Payer: BCN Commercial |
$942.73
|
| Rate for Payer: BCN Medicare Advantage |
$303.13
|
| Rate for Payer: Cash Price |
$970.01
|
| Rate for Payer: Cash Price |
$970.01
|
| Rate for Payer: Cofinity Commercial |
$1,042.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$970.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.13
|
| Rate for Payer: Healthscope Commercial |
$1,091.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$909.38
|
| Rate for Payer: Mclaren Medicaid |
$490.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.28
|
| Rate for Payer: Meridian Medicaid |
$515.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$348.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.63
|
| Rate for Payer: Nomi Health Commercial |
$994.26
|
| Rate for Payer: PACE Senior Care Partners |
$287.97
|
| Rate for Payer: PACE SWMI |
$303.13
|
| Rate for Payer: PHP Commercial |
$1,030.63
|
| Rate for Payer: PHP Medicare Advantage |
$303.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.13
|
| Rate for Payer: Priority Health HMO/PPO |
$1,054.88
|
| Rate for Payer: Priority Health Medicare |
$306.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$812.38
|
| Rate for Payer: Railroad Medicare Medicare |
$303.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,067.01
|
| Rate for Payer: UHC Core |
$1,012.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.13
|
| Rate for Payer: UHC Exchange |
$303.13
|
| Rate for Payer: UHC Medicare Advantage |
$303.13
|
| Rate for Payer: UHCCP Medicaid |
$490.57
|
| Rate for Payer: VA VA |
$303.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$909.38
|
|
|
HC BLOOD PATCH PROCEDURE
|
Facility
|
IP
|
$1,212.51
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
36100280
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$788.13 |
| Max. Negotiated Rate |
$1,091.26 |
| Rate for Payer: Aetna Commercial |
$1,030.63
|
| Rate for Payer: BCBS Trust/PPO |
$989.77
|
| Rate for Payer: BCN Commercial |
$937.03
|
| Rate for Payer: Cash Price |
$970.01
|
| Rate for Payer: Cofinity Commercial |
$1,042.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$970.01
|
| Rate for Payer: Healthscope Commercial |
$1,091.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$909.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,030.63
|
| Rate for Payer: Nomi Health Commercial |
$994.26
|
| Rate for Payer: PHP Commercial |
$1,030.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$788.13
|
| Rate for Payer: Priority Health HMO/PPO |
$1,054.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$812.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,067.01
|
| Rate for Payer: UHC Core |
$1,012.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$909.38
|
|
