|
HC FECAL REDUCING SUBSTANCE
|
Facility
|
OP
|
$50.30
|
|
|
Service Code
|
CPT 84376
|
| Hospital Charge Code |
30100427
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.06 |
| Max. Negotiated Rate |
$45.27 |
| Rate for Payer: Aetna Commercial |
$42.76
|
| Rate for Payer: Aetna Medicare |
$13.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.72
|
| Rate for Payer: BCBS Complete |
$4.26
|
| Rate for Payer: BCBS MAPPO |
$12.58
|
| Rate for Payer: BCBS Trust/PPO |
$39.11
|
| Rate for Payer: BCN Commercial |
$39.11
|
| Rate for Payer: BCN Medicare Advantage |
$12.58
|
| Rate for Payer: Cash Price |
$40.24
|
| Rate for Payer: Cash Price |
$40.24
|
| Rate for Payer: Cofinity Commercial |
$43.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.58
|
| Rate for Payer: Healthscope Commercial |
$45.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.72
|
| Rate for Payer: Mclaren Medicaid |
$4.06
|
| Rate for Payer: Meridian Medicaid |
$4.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.76
|
| Rate for Payer: PACE Senior Care Partners |
$11.95
|
| Rate for Payer: PACE SWMI |
$12.58
|
| Rate for Payer: PHP Commercial |
$42.76
|
| Rate for Payer: PHP Medicare Advantage |
$12.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.76
|
| Rate for Payer: Priority Health Medicare |
$12.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.68
|
| Rate for Payer: Railroad Medicare Medicare |
$12.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.26
|
| Rate for Payer: UHC Core |
$42.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.58
|
| Rate for Payer: UHC Medicare Advantage |
$12.95
|
| Rate for Payer: VA VA |
$12.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.72
|
|
|
HC FECAL WBC LACTOFERRIN
|
Facility
|
OP
|
$73.85
|
|
|
Service Code
|
CPT 83630
|
| Hospital Charge Code |
30100273
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.54 |
| Max. Negotiated Rate |
$66.46 |
| Rate for Payer: Aetna Commercial |
$62.77
|
| Rate for Payer: Aetna Medicare |
$19.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.08
|
| Rate for Payer: BCBS Complete |
$15.27
|
| Rate for Payer: BCBS MAPPO |
$18.46
|
| Rate for Payer: BCBS Trust/PPO |
$57.42
|
| Rate for Payer: BCN Commercial |
$57.42
|
| Rate for Payer: BCN Medicare Advantage |
$18.46
|
| Rate for Payer: Cash Price |
$59.08
|
| Rate for Payer: Cash Price |
$59.08
|
| Rate for Payer: Cofinity Commercial |
$63.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.46
|
| Rate for Payer: Healthscope Commercial |
$66.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.39
|
| Rate for Payer: Mclaren Medicaid |
$14.54
|
| Rate for Payer: Meridian Medicaid |
$15.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.77
|
| Rate for Payer: PACE Senior Care Partners |
$17.54
|
| Rate for Payer: PACE SWMI |
$18.46
|
| Rate for Payer: PHP Commercial |
$62.77
|
| Rate for Payer: PHP Medicare Advantage |
$18.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.25
|
| Rate for Payer: Priority Health Medicare |
$18.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.04
|
| Rate for Payer: Railroad Medicare Medicare |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.99
|
| Rate for Payer: UHC Core |
$61.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.46
|
| Rate for Payer: UHC Medicare Advantage |
$19.02
|
| Rate for Payer: VA VA |
$18.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.39
|
|
|
HC FECAL WBC LACTOFERRIN
|
Facility
|
IP
|
$73.85
|
|
|
Service Code
|
CPT 83630
|
| Hospital Charge Code |
30100273
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.04 |
| Max. Negotiated Rate |
$66.46 |
| Rate for Payer: Aetna Commercial |
$62.77
|
| Rate for Payer: BCBS Trust/PPO |
$57.07
|
| Rate for Payer: BCN Commercial |
$57.07
|
| Rate for Payer: Cash Price |
$59.08
|
| Rate for Payer: Cofinity Commercial |
$63.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.08
|
| Rate for Payer: Healthscope Commercial |
$66.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.77
|
| Rate for Payer: PHP Commercial |
$62.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.99
|
| Rate for Payer: UHC Core |
$61.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.39
|
|
|
HC FELBAMATE (FELBATOL)
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100470
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.33 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$47.30
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC FELBAMATE (FELBATOL)
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100470
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.76 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$14.44
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.58
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$14.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.76
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC FEMOSTOP
|
Facility
|
OP
|
$470.40
|
|
| Hospital Charge Code |
62200003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$111.72 |
| Max. Negotiated Rate |
$423.36 |
| Rate for Payer: Aetna Commercial |
$399.84
|
| Rate for Payer: Aetna Medicare |
$122.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$147.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$147.00
|
| Rate for Payer: BCBS Complete |
$188.16
|
| Rate for Payer: BCBS MAPPO |
$117.60
|
| Rate for Payer: BCBS Trust/PPO |
$365.74
|
| Rate for Payer: BCN Commercial |
$365.74
|
| Rate for Payer: BCN Medicare Advantage |
$117.60
|
| Rate for Payer: Cash Price |
$376.32
|
| Rate for Payer: Cofinity Commercial |
$404.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.60
|
| Rate for Payer: Healthscope Commercial |
$423.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$352.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$123.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$399.84
|
| Rate for Payer: PACE Senior Care Partners |
$111.72
|
| Rate for Payer: PACE SWMI |
$117.60
|
| Rate for Payer: PHP Commercial |
$399.84
|
| Rate for Payer: PHP Medicare Advantage |
$117.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$409.25
|
| Rate for Payer: Priority Health Medicare |
$117.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$286.90
|
| Rate for Payer: Railroad Medicare Medicare |
$117.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$413.95
|
| Rate for Payer: UHC Core |
$392.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.60
|
| Rate for Payer: UHC Medicare Advantage |
$121.13
|
| Rate for Payer: VA VA |
$117.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$352.80
|
|
|
HC FEMOSTOP
|
Facility
|
IP
|
$470.40
|
|
| Hospital Charge Code |
62200003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$286.90 |
| Max. Negotiated Rate |
$423.36 |
| Rate for Payer: Aetna Commercial |
$399.84
|
| Rate for Payer: BCBS Trust/PPO |
$363.53
|
| Rate for Payer: BCN Commercial |
$363.53
|
| Rate for Payer: Cash Price |
$376.32
|
| Rate for Payer: Cofinity Commercial |
$404.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.32
|
| Rate for Payer: Healthscope Commercial |
$423.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$352.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$399.84
|
| Rate for Payer: PHP Commercial |
$399.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$409.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$286.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$413.95
|
| Rate for Payer: UHC Core |
$392.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$352.80
|
|
|
HC FEMUR 1 VIEW
|
Facility
|
IP
|
$349.51
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000315
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$213.17 |
| Max. Negotiated Rate |
$314.56 |
| Rate for Payer: Aetna Commercial |
$297.08
|
| Rate for Payer: BCBS Trust/PPO |
$270.10
|
| Rate for Payer: BCN Commercial |
$270.10
|
| Rate for Payer: Cash Price |
$279.61
|
| Rate for Payer: Cofinity Commercial |
$300.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.61
|
| Rate for Payer: Healthscope Commercial |
$314.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.08
|
| Rate for Payer: PHP Commercial |
$297.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.57
|
| Rate for Payer: UHC Core |
$291.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.13
|
|
|
HC FEMUR 1 VIEW
|
Facility
|
OP
|
$349.51
|
|
|
Service Code
|
CPT 73551
|
| Hospital Charge Code |
32000315
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$314.56 |
| Rate for Payer: Aetna Commercial |
$297.08
|
| Rate for Payer: Aetna Medicare |
$90.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.22
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$87.38
|
| Rate for Payer: BCBS Trust/PPO |
$271.74
|
| Rate for Payer: BCN Commercial |
$271.74
|
| Rate for Payer: BCN Medicare Advantage |
$87.38
|
| Rate for Payer: Cash Price |
$279.61
|
| Rate for Payer: Cash Price |
$279.61
|
| Rate for Payer: Cofinity Commercial |
$300.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.38
|
| Rate for Payer: Healthscope Commercial |
$314.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.13
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.08
|
| Rate for Payer: PACE Senior Care Partners |
$83.01
|
| Rate for Payer: PACE SWMI |
$87.38
|
| Rate for Payer: PHP Commercial |
$297.08
|
| Rate for Payer: PHP Medicare Advantage |
$87.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.07
|
| Rate for Payer: Priority Health Medicare |
$87.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.17
|
| Rate for Payer: Railroad Medicare Medicare |
$87.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.57
|
| Rate for Payer: UHC Core |
$291.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.38
|
| Rate for Payer: UHC Medicare Advantage |
$90.00
|
| Rate for Payer: VA VA |
$87.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.13
|
|
|
HC FEMUR 2 VIEWS
|
Facility
|
OP
|
$349.51
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
32000316
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$314.56 |
| Rate for Payer: Aetna Commercial |
$297.08
|
| Rate for Payer: Aetna Medicare |
$90.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.22
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$87.38
|
| Rate for Payer: BCBS Trust/PPO |
$271.74
|
| Rate for Payer: BCN Commercial |
$271.74
|
| Rate for Payer: BCN Medicare Advantage |
$87.38
|
| Rate for Payer: Cash Price |
$279.61
|
| Rate for Payer: Cash Price |
$279.61
|
| Rate for Payer: Cofinity Commercial |
$300.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.38
|
| Rate for Payer: Healthscope Commercial |
$314.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.13
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.08
|
| Rate for Payer: PACE Senior Care Partners |
$83.01
|
| Rate for Payer: PACE SWMI |
$87.38
|
| Rate for Payer: PHP Commercial |
$297.08
|
| Rate for Payer: PHP Medicare Advantage |
$87.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.07
|
| Rate for Payer: Priority Health Medicare |
$87.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.17
|
| Rate for Payer: Railroad Medicare Medicare |
$87.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.57
|
| Rate for Payer: UHC Core |
$291.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.38
|
| Rate for Payer: UHC Medicare Advantage |
$90.00
|
| Rate for Payer: VA VA |
$87.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.13
|
|
|
HC FEMUR 2 VIEWS
|
Facility
|
IP
|
$349.51
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
32000316
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$213.17 |
| Max. Negotiated Rate |
$314.56 |
| Rate for Payer: Aetna Commercial |
$297.08
|
| Rate for Payer: BCBS Trust/PPO |
$270.10
|
| Rate for Payer: BCN Commercial |
$270.10
|
| Rate for Payer: Cash Price |
$279.61
|
| Rate for Payer: Cofinity Commercial |
$300.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.61
|
| Rate for Payer: Healthscope Commercial |
$314.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.08
|
| Rate for Payer: PHP Commercial |
$297.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.57
|
| Rate for Payer: UHC Core |
$291.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.13
|
|
|
HC FENTANYL SERUM LVL
|
Facility
|
IP
|
$199.00
|
|
|
Service Code
|
CPT 80354
|
| Hospital Charge Code |
30100564
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$121.37 |
| Max. Negotiated Rate |
$179.10 |
| Rate for Payer: Aetna Commercial |
$169.15
|
| Rate for Payer: BCBS Trust/PPO |
$153.79
|
| Rate for Payer: BCN Commercial |
$153.79
|
| Rate for Payer: Cash Price |
$159.20
|
| Rate for Payer: Cofinity Commercial |
$171.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.20
|
| Rate for Payer: Healthscope Commercial |
$179.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$169.15
|
| Rate for Payer: PHP Commercial |
$169.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.12
|
| Rate for Payer: UHC Core |
$166.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.25
|
|
|
HC FENTANYL SERUM LVL
|
Facility
|
OP
|
$199.00
|
|
|
Service Code
|
CPT 80354
|
| Hospital Charge Code |
30100564
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.26 |
| Max. Negotiated Rate |
$179.10 |
| Rate for Payer: Aetna Commercial |
$169.15
|
| Rate for Payer: Aetna Medicare |
$51.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.19
|
| Rate for Payer: BCBS Complete |
$79.60
|
| Rate for Payer: BCBS MAPPO |
$49.75
|
| Rate for Payer: BCBS Trust/PPO |
$154.72
|
| Rate for Payer: BCN Commercial |
$154.72
|
| Rate for Payer: BCN Medicare Advantage |
$49.75
|
| Rate for Payer: Cash Price |
$159.20
|
| Rate for Payer: Cofinity Commercial |
$171.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.75
|
| Rate for Payer: Healthscope Commercial |
$179.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$169.15
|
| Rate for Payer: PACE Senior Care Partners |
$47.26
|
| Rate for Payer: PACE SWMI |
$49.75
|
| Rate for Payer: PHP Commercial |
$169.15
|
| Rate for Payer: PHP Medicare Advantage |
$49.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.13
|
| Rate for Payer: Priority Health Medicare |
$49.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.37
|
| Rate for Payer: Railroad Medicare Medicare |
$49.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.12
|
| Rate for Payer: UHC Core |
$166.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.75
|
| Rate for Payer: UHC Medicare Advantage |
$51.24
|
| Rate for Payer: VA VA |
$49.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.25
|
|
|
HC FENTANYL UR
|
Facility
|
IP
|
$230.00
|
|
|
Service Code
|
CPT 80354
|
| Hospital Charge Code |
30100609
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$140.28 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna Commercial |
$195.50
|
| Rate for Payer: BCBS Trust/PPO |
$177.74
|
| Rate for Payer: BCN Commercial |
$177.74
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cofinity Commercial |
$197.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.00
|
| Rate for Payer: Healthscope Commercial |
$207.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.50
|
| Rate for Payer: PHP Commercial |
$195.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.40
|
| Rate for Payer: UHC Core |
$192.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.50
|
|
|
HC FENTANYL UR
|
Facility
|
OP
|
$230.00
|
|
|
Service Code
|
CPT 80354
|
| Hospital Charge Code |
30100609
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.62 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna Commercial |
$195.50
|
| Rate for Payer: Aetna Medicare |
$59.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.88
|
| Rate for Payer: BCBS Complete |
$92.00
|
| Rate for Payer: BCBS MAPPO |
$57.50
|
| Rate for Payer: BCBS Trust/PPO |
$178.82
|
| Rate for Payer: BCN Commercial |
$178.82
|
| Rate for Payer: BCN Medicare Advantage |
$57.50
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cofinity Commercial |
$197.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.50
|
| Rate for Payer: Healthscope Commercial |
$207.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$60.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.50
|
| Rate for Payer: PACE Senior Care Partners |
$54.62
|
| Rate for Payer: PACE SWMI |
$57.50
|
| Rate for Payer: PHP Commercial |
$195.50
|
| Rate for Payer: PHP Medicare Advantage |
$57.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.10
|
| Rate for Payer: Priority Health Medicare |
$57.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.28
|
| Rate for Payer: Railroad Medicare Medicare |
$57.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.40
|
| Rate for Payer: UHC Core |
$192.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.50
|
| Rate for Payer: UHC Medicare Advantage |
$59.22
|
| Rate for Payer: VA VA |
$57.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.50
|
|
|
HC FENTANYL URINE.
|
Facility
|
IP
|
$95.40
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000152
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.18 |
| Max. Negotiated Rate |
$85.86 |
| Rate for Payer: Aetna Commercial |
$81.09
|
| Rate for Payer: BCBS Trust/PPO |
$73.73
|
| Rate for Payer: BCN Commercial |
$73.73
|
| Rate for Payer: Cash Price |
$76.32
|
| Rate for Payer: Cofinity Commercial |
$82.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.32
|
| Rate for Payer: Healthscope Commercial |
$85.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.09
|
| Rate for Payer: PHP Commercial |
$81.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.95
|
| Rate for Payer: UHC Core |
$79.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.55
|
|
|
HC FENTANYL URINE.
|
Facility
|
OP
|
$95.40
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000152
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.66 |
| Max. Negotiated Rate |
$85.86 |
| Rate for Payer: Aetna Commercial |
$81.09
|
| Rate for Payer: Aetna Medicare |
$24.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.81
|
| Rate for Payer: BCBS Complete |
$48.15
|
| Rate for Payer: BCBS MAPPO |
$23.85
|
| Rate for Payer: BCBS Trust/PPO |
$74.17
|
| Rate for Payer: BCN Commercial |
$74.17
|
| Rate for Payer: BCN Medicare Advantage |
$23.85
|
| Rate for Payer: Cash Price |
$76.32
|
| Rate for Payer: Cash Price |
$76.32
|
| Rate for Payer: Cofinity Commercial |
$82.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.85
|
| Rate for Payer: Healthscope Commercial |
$85.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.55
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$48.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.09
|
| Rate for Payer: PACE Senior Care Partners |
$22.66
|
| Rate for Payer: PACE SWMI |
$23.85
|
| Rate for Payer: PHP Commercial |
$81.09
|
| Rate for Payer: PHP Medicare Advantage |
$23.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.00
|
| Rate for Payer: Priority Health Medicare |
$23.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.18
|
| Rate for Payer: Railroad Medicare Medicare |
$23.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.95
|
| Rate for Payer: UHC Core |
$79.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.85
|
| Rate for Payer: UHC Medicare Advantage |
$24.57
|
| Rate for Payer: VA VA |
$23.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.55
|
|
|
HC FERRITIN LEVEL
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 82728
|
| Hospital Charge Code |
30100202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.06 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$10.56
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.58
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$10.06
|
| Rate for Payer: Meridian Medicaid |
$10.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.76
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC FERRITIN LEVEL
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 82728
|
| Hospital Charge Code |
30100202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.33 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$47.30
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC FETAL BIOPHYSICAL PROFILE
|
Facility
|
IP
|
$334.56
|
|
|
Service Code
|
CPT 76818
|
| Hospital Charge Code |
40200080
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$204.05 |
| Max. Negotiated Rate |
$301.10 |
| Rate for Payer: Aetna Commercial |
$284.38
|
| Rate for Payer: BCBS Trust/PPO |
$258.55
|
| Rate for Payer: BCN Commercial |
$258.55
|
| Rate for Payer: Cash Price |
$267.65
|
| Rate for Payer: Cofinity Commercial |
$287.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.65
|
| Rate for Payer: Healthscope Commercial |
$301.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$284.38
|
| Rate for Payer: PHP Commercial |
$284.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.41
|
| Rate for Payer: UHC Core |
$279.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.92
|
|
|
HC FETAL BIOPHYSICAL PROFILE
|
Facility
|
OP
|
$334.56
|
|
|
Service Code
|
CPT 76818
|
| Hospital Charge Code |
40200080
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$301.10 |
| Rate for Payer: Aetna Commercial |
$284.38
|
| Rate for Payer: Aetna Medicare |
$86.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.55
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$83.64
|
| Rate for Payer: BCBS Trust/PPO |
$260.12
|
| Rate for Payer: BCN Commercial |
$260.12
|
| Rate for Payer: BCN Medicare Advantage |
$83.64
|
| Rate for Payer: Cash Price |
$267.65
|
| Rate for Payer: Cash Price |
$267.65
|
| Rate for Payer: Cofinity Commercial |
$287.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.64
|
| Rate for Payer: Healthscope Commercial |
$301.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.92
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$284.38
|
| Rate for Payer: PACE Senior Care Partners |
$79.46
|
| Rate for Payer: PACE SWMI |
$83.64
|
| Rate for Payer: PHP Commercial |
$284.38
|
| Rate for Payer: PHP Medicare Advantage |
$83.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.07
|
| Rate for Payer: Priority Health Medicare |
$83.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.05
|
| Rate for Payer: Railroad Medicare Medicare |
$83.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.41
|
| Rate for Payer: UHC Core |
$279.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.64
|
| Rate for Payer: UHC Medicare Advantage |
$86.15
|
| Rate for Payer: VA VA |
$83.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.92
|
|
|
HC FETAL FIBRONECTIN
|
Facility
|
IP
|
$426.70
|
|
|
Service Code
|
CPT 82731
|
| Hospital Charge Code |
30100203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$260.24 |
| Max. Negotiated Rate |
$384.03 |
| Rate for Payer: Aetna Commercial |
$362.70
|
| Rate for Payer: BCBS Trust/PPO |
$329.75
|
| Rate for Payer: BCN Commercial |
$329.75
|
| Rate for Payer: Cash Price |
$341.36
|
| Rate for Payer: Cofinity Commercial |
$366.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$341.36
|
| Rate for Payer: Healthscope Commercial |
$384.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$320.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$362.70
|
| Rate for Payer: PHP Commercial |
$362.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$371.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.50
|
| Rate for Payer: UHC Core |
$356.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$320.02
|
|
|
HC FETAL FIBRONECTIN
|
Facility
|
OP
|
$426.70
|
|
|
Service Code
|
CPT 82731
|
| Hospital Charge Code |
30100203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.53 |
| Max. Negotiated Rate |
$384.03 |
| Rate for Payer: Aetna Commercial |
$362.70
|
| Rate for Payer: Aetna Medicare |
$110.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$133.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$133.34
|
| Rate for Payer: BCBS Complete |
$49.91
|
| Rate for Payer: BCBS MAPPO |
$106.68
|
| Rate for Payer: BCBS Trust/PPO |
$331.76
|
| Rate for Payer: BCN Commercial |
$331.76
|
| Rate for Payer: BCN Medicare Advantage |
$106.68
|
| Rate for Payer: Cash Price |
$341.36
|
| Rate for Payer: Cash Price |
$341.36
|
| Rate for Payer: Cofinity Commercial |
$366.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$341.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.68
|
| Rate for Payer: Healthscope Commercial |
$384.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$320.02
|
| Rate for Payer: Mclaren Medicaid |
$47.53
|
| Rate for Payer: Meridian Medicaid |
$49.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$122.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$362.70
|
| Rate for Payer: PACE Senior Care Partners |
$101.34
|
| Rate for Payer: PACE SWMI |
$106.68
|
| Rate for Payer: PHP Commercial |
$362.70
|
| Rate for Payer: PHP Medicare Advantage |
$106.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$371.23
|
| Rate for Payer: Priority Health Medicare |
$106.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.24
|
| Rate for Payer: Railroad Medicare Medicare |
$106.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.50
|
| Rate for Payer: UHC Core |
$356.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.68
|
| Rate for Payer: UHC Medicare Advantage |
$109.88
|
| Rate for Payer: VA VA |
$106.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$320.02
|
|
|
HC FETAL PULSE OXIMETRY
|
Facility
|
IP
|
$299.27
|
|
| Hospital Charge Code |
27200122
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$182.52 |
| Max. Negotiated Rate |
$269.34 |
| Rate for Payer: Aetna Commercial |
$254.38
|
| Rate for Payer: BCBS Trust/PPO |
$231.28
|
| Rate for Payer: BCN Commercial |
$231.28
|
| Rate for Payer: Cash Price |
$239.42
|
| Rate for Payer: Cofinity Commercial |
$257.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.42
|
| Rate for Payer: Healthscope Commercial |
$269.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.38
|
| Rate for Payer: PHP Commercial |
$254.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.36
|
| Rate for Payer: UHC Core |
$249.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.45
|
|
|
HC FETAL PULSE OXIMETRY
|
Facility
|
OP
|
$299.27
|
|
| Hospital Charge Code |
27200122
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$71.08 |
| Max. Negotiated Rate |
$269.34 |
| Rate for Payer: Aetna Commercial |
$254.38
|
| Rate for Payer: Aetna Medicare |
$77.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.52
|
| Rate for Payer: BCBS Complete |
$119.71
|
| Rate for Payer: BCBS MAPPO |
$74.82
|
| Rate for Payer: BCBS Trust/PPO |
$232.68
|
| Rate for Payer: BCN Commercial |
$232.68
|
| Rate for Payer: BCN Medicare Advantage |
$74.82
|
| Rate for Payer: Cash Price |
$239.42
|
| Rate for Payer: Cofinity Commercial |
$257.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.82
|
| Rate for Payer: Healthscope Commercial |
$269.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.38
|
| Rate for Payer: PACE Senior Care Partners |
$71.08
|
| Rate for Payer: PACE SWMI |
$74.82
|
| Rate for Payer: PHP Commercial |
$254.38
|
| Rate for Payer: PHP Medicare Advantage |
$74.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.36
|
| Rate for Payer: Priority Health Medicare |
$74.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.52
|
| Rate for Payer: Railroad Medicare Medicare |
$74.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.36
|
| Rate for Payer: UHC Core |
$249.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.82
|
| Rate for Payer: UHC Medicare Advantage |
$77.06
|
| Rate for Payer: VA VA |
$74.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.45
|
|
