|
HC CONNECTOR V
|
Facility
|
IP
|
$7.80
|
|
| Hospital Charge Code |
27000678
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$7.02 |
| Rate for Payer: Aetna Commercial |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$6.44
|
| Rate for Payer: BCN Commercial |
$6.44
|
| Rate for Payer: Cash Price |
$6.24
|
| Rate for Payer: Cofinity Commercial |
$6.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.24
|
| Rate for Payer: Healthscope Commercial |
$7.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.63
|
| Rate for Payer: Nomi Health Commercial |
$6.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.85
|
| Rate for Payer: PHP Commercial |
$6.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.86
|
| Rate for Payer: UHC Core |
$6.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.85
|
|
|
HC CONNECTOR V
|
Facility
|
OP
|
$7.80
|
|
| Hospital Charge Code |
27000678
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.38 |
| Max. Negotiated Rate |
$7.02 |
| Rate for Payer: Aetna Commercial |
$6.63
|
| Rate for Payer: Aetna Medicare |
$2.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.44
|
| Rate for Payer: BCBS Complete |
$1.44
|
| Rate for Payer: BCBS MAPPO |
$1.95
|
| Rate for Payer: BCBS Trust/PPO |
$6.41
|
| Rate for Payer: BCN Commercial |
$6.41
|
| Rate for Payer: BCN Medicare Advantage |
$1.95
|
| Rate for Payer: Cash Price |
$6.24
|
| Rate for Payer: Cofinity Commercial |
$6.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.95
|
| Rate for Payer: Healthscope Commercial |
$7.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.85
|
| Rate for Payer: Mclaren Medicaid |
$1.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.05
|
| Rate for Payer: Meridian Medicaid |
$1.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.63
|
| Rate for Payer: Nomi Health Commercial |
$6.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.85
|
| Rate for Payer: PACE Senior Care Partners |
$1.85
|
| Rate for Payer: PACE SWMI |
$1.95
|
| Rate for Payer: PHP Commercial |
$6.63
|
| Rate for Payer: PHP Medicare Advantage |
$1.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6.79
|
| Rate for Payer: Priority Health Medicare |
$1.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.86
|
| Rate for Payer: UHC Core |
$6.51
|
| Rate for Payer: UHC Exchange |
$1.95
|
| Rate for Payer: UHC Medicaid |
$1.38
|
| Rate for Payer: UHC Medicare Advantage |
$1.95
|
| Rate for Payer: UHCCP Medicaid |
$1.38
|
| Rate for Payer: VA VA |
$1.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.85
|
|
|
HC CONNECTOR Y
|
Facility
|
IP
|
$5.47
|
|
| Hospital Charge Code |
27000048
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$4.92 |
| Rate for Payer: Aetna Commercial |
$4.65
|
| Rate for Payer: BCBS Trust/PPO |
$4.52
|
| Rate for Payer: BCN Commercial |
$4.52
|
| Rate for Payer: Cash Price |
$4.38
|
| Rate for Payer: Cofinity Commercial |
$4.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.38
|
| Rate for Payer: Healthscope Commercial |
$4.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.65
|
| Rate for Payer: Nomi Health Commercial |
$4.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.10
|
| Rate for Payer: PHP Commercial |
$4.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.81
|
| Rate for Payer: UHC Core |
$4.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.10
|
|
|
HC CONNECTOR Y
|
Facility
|
OP
|
$5.47
|
|
| Hospital Charge Code |
27000048
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.96 |
| Max. Negotiated Rate |
$4.92 |
| Rate for Payer: Aetna Commercial |
$4.65
|
| Rate for Payer: Aetna Medicare |
$1.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.71
|
| Rate for Payer: BCBS Complete |
$1.01
|
| Rate for Payer: BCBS MAPPO |
$1.37
|
| Rate for Payer: BCBS Trust/PPO |
$4.50
|
| Rate for Payer: BCN Commercial |
$4.50
|
| Rate for Payer: BCN Medicare Advantage |
$1.37
|
| Rate for Payer: Cash Price |
$4.38
|
| Rate for Payer: Cofinity Commercial |
$4.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.37
|
| Rate for Payer: Healthscope Commercial |
$4.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.10
|
| Rate for Payer: Mclaren Medicaid |
$0.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.44
|
| Rate for Payer: Meridian Medicaid |
$1.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.65
|
| Rate for Payer: Nomi Health Commercial |
$4.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.10
|
| Rate for Payer: PACE Senior Care Partners |
$1.30
|
| Rate for Payer: PACE SWMI |
$1.37
|
| Rate for Payer: PHP Commercial |
$4.65
|
| Rate for Payer: PHP Medicare Advantage |
$1.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4.76
|
| Rate for Payer: Priority Health Medicare |
$1.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.81
|
| Rate for Payer: UHC Core |
$4.57
|
| Rate for Payer: UHC Exchange |
$1.37
|
| Rate for Payer: UHC Medicaid |
$0.96
|
| Rate for Payer: UHC Medicare Advantage |
$1.37
|
| Rate for Payer: UHCCP Medicaid |
$0.96
|
| Rate for Payer: VA VA |
$1.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.10
|
|
|
HC CONSULT NUTRITIONAL
|
Facility
|
OP
|
$35.66
|
|
| Hospital Charge Code |
94200010
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$6.29 |
| Max. Negotiated Rate |
$32.09 |
| Rate for Payer: Aetna Commercial |
$30.31
|
| Rate for Payer: Aetna Medicare |
$9.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.14
|
| Rate for Payer: BCBS Complete |
$6.60
|
| Rate for Payer: BCBS MAPPO |
$8.91
|
| Rate for Payer: BCBS Trust/PPO |
$29.32
|
| Rate for Payer: BCN Commercial |
$29.32
|
| Rate for Payer: BCN Medicare Advantage |
$8.91
|
| Rate for Payer: Cash Price |
$28.53
|
| Rate for Payer: Cofinity Commercial |
$30.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.91
|
| Rate for Payer: Healthscope Commercial |
$32.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.75
|
| Rate for Payer: Mclaren Medicaid |
$6.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.36
|
| Rate for Payer: Meridian Medicaid |
$6.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.31
|
| Rate for Payer: Nomi Health Commercial |
$29.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.75
|
| Rate for Payer: PACE Senior Care Partners |
$8.47
|
| Rate for Payer: PACE SWMI |
$8.91
|
| Rate for Payer: PHP Commercial |
$30.31
|
| Rate for Payer: PHP Medicare Advantage |
$8.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.02
|
| Rate for Payer: Priority Health Medicare |
$9.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.82
|
| Rate for Payer: Railroad Medicare Medicare |
$8.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.38
|
| Rate for Payer: UHC Core |
$29.78
|
| Rate for Payer: UHC Exchange |
$8.91
|
| Rate for Payer: UHC Medicaid |
$6.29
|
| Rate for Payer: UHC Medicare Advantage |
$8.91
|
| Rate for Payer: UHCCP Medicaid |
$6.29
|
| Rate for Payer: VA VA |
$8.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.75
|
|
|
HC CONSULT NUTRITIONAL
|
Facility
|
IP
|
$35.66
|
|
| Hospital Charge Code |
94200010
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$24.82 |
| Max. Negotiated Rate |
$32.09 |
| Rate for Payer: Aetna Commercial |
$30.31
|
| Rate for Payer: BCBS Trust/PPO |
$29.45
|
| Rate for Payer: BCN Commercial |
$29.45
|
| Rate for Payer: Cash Price |
$28.53
|
| Rate for Payer: Cofinity Commercial |
$30.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.53
|
| Rate for Payer: Healthscope Commercial |
$32.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.31
|
| Rate for Payer: Nomi Health Commercial |
$29.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.75
|
| Rate for Payer: PHP Commercial |
$30.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.38
|
| Rate for Payer: UHC Core |
$29.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.75
|
|
|
HC CONT GLUCOSE MONITOR OFFICE EQUIP
|
Facility
|
OP
|
$1,004.28
|
|
|
Service Code
|
CPT 95250
|
| Hospital Charge Code |
94200001
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$177.05 |
| Max. Negotiated Rate |
$903.85 |
| Rate for Payer: Aetna Commercial |
$853.64
|
| Rate for Payer: Aetna Medicare |
$261.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$313.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$313.84
|
| Rate for Payer: BCBS Complete |
$185.89
|
| Rate for Payer: BCBS MAPPO |
$251.07
|
| Rate for Payer: BCBS Trust/PPO |
$825.62
|
| Rate for Payer: BCN Commercial |
$825.62
|
| Rate for Payer: BCN Medicare Advantage |
$251.07
|
| Rate for Payer: Cash Price |
$803.42
|
| Rate for Payer: Cofinity Commercial |
$863.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$803.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.07
|
| Rate for Payer: Healthscope Commercial |
$903.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$753.21
|
| Rate for Payer: Mclaren Medicaid |
$177.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.62
|
| Rate for Payer: Meridian Medicaid |
$185.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$288.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$276.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.64
|
| Rate for Payer: Nomi Health Commercial |
$823.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$753.21
|
| Rate for Payer: PACE Senior Care Partners |
$238.52
|
| Rate for Payer: PACE SWMI |
$251.07
|
| Rate for Payer: PHP Commercial |
$853.64
|
| Rate for Payer: PHP Medicare Advantage |
$251.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$177.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$873.72
|
| Rate for Payer: Priority Health Medicare |
$253.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$698.98
|
| Rate for Payer: Railroad Medicare Medicare |
$251.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$883.77
|
| Rate for Payer: UHC Core |
$838.57
|
| Rate for Payer: UHC Exchange |
$251.07
|
| Rate for Payer: UHC Medicaid |
$177.05
|
| Rate for Payer: UHC Medicare Advantage |
$251.07
|
| Rate for Payer: UHCCP Medicaid |
$177.05
|
| Rate for Payer: VA VA |
$251.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$753.21
|
|
|
HC CONT GLUCOSE MONITOR OFFICE EQUIP
|
Facility
|
IP
|
$1,004.28
|
|
|
Service Code
|
CPT 95250
|
| Hospital Charge Code |
94200001
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$698.98 |
| Max. Negotiated Rate |
$903.85 |
| Rate for Payer: Aetna Commercial |
$853.64
|
| Rate for Payer: BCBS Trust/PPO |
$829.43
|
| Rate for Payer: BCN Commercial |
$829.43
|
| Rate for Payer: Cash Price |
$803.42
|
| Rate for Payer: Cofinity Commercial |
$863.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$803.42
|
| Rate for Payer: Healthscope Commercial |
$903.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$753.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.64
|
| Rate for Payer: Nomi Health Commercial |
$823.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$753.21
|
| Rate for Payer: PHP Commercial |
$853.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$873.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$698.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$883.77
|
| Rate for Payer: UHC Core |
$838.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$753.21
|
|
|
HC CONT GLUCOSE MONITOR PATIENT EQUIP
|
Facility
|
OP
|
$387.71
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
94200038
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$68.35 |
| Max. Negotiated Rate |
$348.94 |
| Rate for Payer: Aetna Commercial |
$329.55
|
| Rate for Payer: Aetna Medicare |
$100.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.16
|
| Rate for Payer: BCBS Complete |
$71.77
|
| Rate for Payer: BCBS MAPPO |
$96.93
|
| Rate for Payer: BCBS Trust/PPO |
$318.74
|
| Rate for Payer: BCN Commercial |
$318.74
|
| Rate for Payer: BCN Medicare Advantage |
$96.93
|
| Rate for Payer: Cash Price |
$310.17
|
| Rate for Payer: Cofinity Commercial |
$333.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.93
|
| Rate for Payer: Healthscope Commercial |
$348.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.78
|
| Rate for Payer: Mclaren Medicaid |
$68.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.77
|
| Rate for Payer: Meridian Medicaid |
$71.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.55
|
| Rate for Payer: Nomi Health Commercial |
$317.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.78
|
| Rate for Payer: PACE Senior Care Partners |
$92.08
|
| Rate for Payer: PACE SWMI |
$96.93
|
| Rate for Payer: PHP Commercial |
$329.55
|
| Rate for Payer: PHP Medicare Advantage |
$96.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$337.31
|
| Rate for Payer: Priority Health Medicare |
$97.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$269.85
|
| Rate for Payer: Railroad Medicare Medicare |
$96.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.18
|
| Rate for Payer: UHC Core |
$323.74
|
| Rate for Payer: UHC Exchange |
$96.93
|
| Rate for Payer: UHC Medicaid |
$68.35
|
| Rate for Payer: UHC Medicare Advantage |
$96.93
|
| Rate for Payer: UHCCP Medicaid |
$68.35
|
| Rate for Payer: VA VA |
$96.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.78
|
|
|
HC CONT GLUCOSE MONITOR PATIENT EQUIP
|
Facility
|
IP
|
$387.71
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
94200038
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$269.85 |
| Max. Negotiated Rate |
$348.94 |
| Rate for Payer: Aetna Commercial |
$329.55
|
| Rate for Payer: BCBS Trust/PPO |
$320.21
|
| Rate for Payer: BCN Commercial |
$320.21
|
| Rate for Payer: Cash Price |
$310.17
|
| Rate for Payer: Cofinity Commercial |
$333.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.17
|
| Rate for Payer: Healthscope Commercial |
$348.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.55
|
| Rate for Payer: Nomi Health Commercial |
$317.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.78
|
| Rate for Payer: PHP Commercial |
$329.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$337.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$269.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.18
|
| Rate for Payer: UHC Core |
$323.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.78
|
|
|
HC CONTINUOUS NEB SUBSEQUENT HR
|
Facility
|
OP
|
$106.62
|
|
|
Service Code
|
CPT 94645
|
| Hospital Charge Code |
41000007
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$95.96 |
| Rate for Payer: Aetna Commercial |
$90.63
|
| Rate for Payer: Aetna Medicare |
$27.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.32
|
| Rate for Payer: BCBS Complete |
$19.74
|
| Rate for Payer: BCBS MAPPO |
$26.66
|
| Rate for Payer: BCBS Trust/PPO |
$87.65
|
| Rate for Payer: BCN Commercial |
$87.65
|
| Rate for Payer: BCN Medicare Advantage |
$26.66
|
| Rate for Payer: Cash Price |
$85.30
|
| Rate for Payer: Cofinity Commercial |
$91.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.66
|
| Rate for Payer: Healthscope Commercial |
$95.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.97
|
| Rate for Payer: Mclaren Medicaid |
$18.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.99
|
| Rate for Payer: Meridian Medicaid |
$19.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.63
|
| Rate for Payer: Nomi Health Commercial |
$87.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.97
|
| Rate for Payer: PACE Senior Care Partners |
$25.32
|
| Rate for Payer: PACE SWMI |
$26.66
|
| Rate for Payer: PHP Commercial |
$90.63
|
| Rate for Payer: PHP Medicare Advantage |
$26.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$92.76
|
| Rate for Payer: Priority Health Medicare |
$26.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.21
|
| Rate for Payer: Railroad Medicare Medicare |
$26.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.83
|
| Rate for Payer: UHC Core |
$89.03
|
| Rate for Payer: UHC Exchange |
$26.66
|
| Rate for Payer: UHC Medicaid |
$18.80
|
| Rate for Payer: UHC Medicare Advantage |
$26.66
|
| Rate for Payer: UHCCP Medicaid |
$18.80
|
| Rate for Payer: VA VA |
$26.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.97
|
|
|
HC CONTINUOUS NEB SUBSEQUENT HR
|
Facility
|
IP
|
$106.62
|
|
|
Service Code
|
CPT 94645
|
| Hospital Charge Code |
41000007
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$74.21 |
| Max. Negotiated Rate |
$95.96 |
| Rate for Payer: Aetna Commercial |
$90.63
|
| Rate for Payer: BCBS Trust/PPO |
$88.06
|
| Rate for Payer: BCN Commercial |
$88.06
|
| Rate for Payer: Cash Price |
$85.30
|
| Rate for Payer: Cofinity Commercial |
$91.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.30
|
| Rate for Payer: Healthscope Commercial |
$95.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.63
|
| Rate for Payer: Nomi Health Commercial |
$87.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.97
|
| Rate for Payer: PHP Commercial |
$90.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$92.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.83
|
| Rate for Payer: UHC Core |
$89.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.97
|
|
|
HC CONTINUOUS NEB TX INITIAL HOUR
|
Facility
|
IP
|
$382.93
|
|
|
Service Code
|
CPT 94644
|
| Hospital Charge Code |
41000006
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$266.52 |
| Max. Negotiated Rate |
$344.64 |
| Rate for Payer: Aetna Commercial |
$325.49
|
| Rate for Payer: BCBS Trust/PPO |
$316.26
|
| Rate for Payer: BCN Commercial |
$316.26
|
| Rate for Payer: Cash Price |
$306.34
|
| Rate for Payer: Cofinity Commercial |
$329.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.34
|
| Rate for Payer: Healthscope Commercial |
$344.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.49
|
| Rate for Payer: Nomi Health Commercial |
$314.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.20
|
| Rate for Payer: PHP Commercial |
$325.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$333.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.98
|
| Rate for Payer: UHC Core |
$319.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.20
|
|
|
HC CONTINUOUS NEB TX INITIAL HOUR
|
Facility
|
OP
|
$382.93
|
|
|
Service Code
|
CPT 94644
|
| Hospital Charge Code |
41000006
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$67.51 |
| Max. Negotiated Rate |
$344.64 |
| Rate for Payer: Aetna Commercial |
$325.49
|
| Rate for Payer: Aetna Medicare |
$99.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.67
|
| Rate for Payer: BCBS Complete |
$70.88
|
| Rate for Payer: BCBS MAPPO |
$95.73
|
| Rate for Payer: BCBS Trust/PPO |
$314.81
|
| Rate for Payer: BCN Commercial |
$314.81
|
| Rate for Payer: BCN Medicare Advantage |
$95.73
|
| Rate for Payer: Cash Price |
$306.34
|
| Rate for Payer: Cofinity Commercial |
$329.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.73
|
| Rate for Payer: Healthscope Commercial |
$344.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.20
|
| Rate for Payer: Mclaren Medicaid |
$67.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.52
|
| Rate for Payer: Meridian Medicaid |
$70.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.49
|
| Rate for Payer: Nomi Health Commercial |
$314.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.20
|
| Rate for Payer: PACE Senior Care Partners |
$90.95
|
| Rate for Payer: PACE SWMI |
$95.73
|
| Rate for Payer: PHP Commercial |
$325.49
|
| Rate for Payer: PHP Medicare Advantage |
$95.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$333.15
|
| Rate for Payer: Priority Health Medicare |
$96.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.52
|
| Rate for Payer: Railroad Medicare Medicare |
$95.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.98
|
| Rate for Payer: UHC Core |
$319.75
|
| Rate for Payer: UHC Exchange |
$95.73
|
| Rate for Payer: UHC Medicaid |
$67.51
|
| Rate for Payer: UHC Medicare Advantage |
$95.73
|
| Rate for Payer: UHCCP Medicaid |
$67.51
|
| Rate for Payer: VA VA |
$95.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.20
|
|
|
HC CONT PHYSICS CONSULT
|
Facility
|
OP
|
$596.39
|
|
|
Service Code
|
CPT 77336
|
| Hospital Charge Code |
33300015
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$105.14 |
| Max. Negotiated Rate |
$536.75 |
| Rate for Payer: Aetna Commercial |
$506.93
|
| Rate for Payer: Aetna Medicare |
$155.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$186.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$186.37
|
| Rate for Payer: BCBS Complete |
$110.39
|
| Rate for Payer: BCBS MAPPO |
$149.10
|
| Rate for Payer: BCBS Trust/PPO |
$490.29
|
| Rate for Payer: BCN Commercial |
$490.29
|
| Rate for Payer: BCN Medicare Advantage |
$149.10
|
| Rate for Payer: Cash Price |
$477.11
|
| Rate for Payer: Cofinity Commercial |
$512.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.10
|
| Rate for Payer: Healthscope Commercial |
$536.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.29
|
| Rate for Payer: Mclaren Medicaid |
$105.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.55
|
| Rate for Payer: Meridian Medicaid |
$110.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$171.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$164.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.93
|
| Rate for Payer: Nomi Health Commercial |
$489.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$447.29
|
| Rate for Payer: PACE Senior Care Partners |
$141.64
|
| Rate for Payer: PACE SWMI |
$149.10
|
| Rate for Payer: PHP Commercial |
$506.93
|
| Rate for Payer: PHP Medicare Advantage |
$149.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$518.86
|
| Rate for Payer: Priority Health Medicare |
$150.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$415.09
|
| Rate for Payer: Railroad Medicare Medicare |
$149.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$524.82
|
| Rate for Payer: UHC Core |
$497.99
|
| Rate for Payer: UHC Exchange |
$149.10
|
| Rate for Payer: UHC Medicaid |
$105.14
|
| Rate for Payer: UHC Medicare Advantage |
$149.10
|
| Rate for Payer: UHCCP Medicaid |
$105.14
|
| Rate for Payer: VA VA |
$149.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.29
|
|
|
HC CONT PHYSICS CONSULT
|
Facility
|
IP
|
$596.39
|
|
|
Service Code
|
CPT 77336
|
| Hospital Charge Code |
33300015
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$415.09 |
| Max. Negotiated Rate |
$536.75 |
| Rate for Payer: Aetna Commercial |
$506.93
|
| Rate for Payer: BCBS Trust/PPO |
$492.56
|
| Rate for Payer: BCN Commercial |
$492.56
|
| Rate for Payer: Cash Price |
$477.11
|
| Rate for Payer: Cofinity Commercial |
$512.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.11
|
| Rate for Payer: Healthscope Commercial |
$536.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.93
|
| Rate for Payer: Nomi Health Commercial |
$489.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$447.29
|
| Rate for Payer: PHP Commercial |
$506.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$518.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$415.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$524.82
|
| Rate for Payer: UHC Core |
$497.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.29
|
|
|
HC CONTRAST BATHS EACH 15 MIN
|
Facility
|
OP
|
$107.89
|
|
|
Service Code
|
CPT 97034
|
| Hospital Charge Code |
42000017
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.02 |
| Max. Negotiated Rate |
$97.10 |
| Rate for Payer: Aetna Commercial |
$91.71
|
| Rate for Payer: Aetna Medicare |
$28.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.72
|
| Rate for Payer: BCBS Complete |
$19.97
|
| Rate for Payer: BCBS MAPPO |
$26.97
|
| Rate for Payer: BCBS Trust/PPO |
$88.70
|
| Rate for Payer: BCN Commercial |
$88.70
|
| Rate for Payer: BCN Medicare Advantage |
$26.97
|
| Rate for Payer: Cash Price |
$86.31
|
| Rate for Payer: Cofinity Commercial |
$92.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.97
|
| Rate for Payer: Healthscope Commercial |
$97.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.92
|
| Rate for Payer: Mclaren Medicaid |
$19.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.32
|
| Rate for Payer: Meridian Medicaid |
$19.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.71
|
| Rate for Payer: Nomi Health Commercial |
$88.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.92
|
| Rate for Payer: PACE Senior Care Partners |
$25.62
|
| Rate for Payer: PACE SWMI |
$26.97
|
| Rate for Payer: PHP Commercial |
$91.71
|
| Rate for Payer: PHP Medicare Advantage |
$26.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.86
|
| Rate for Payer: Priority Health Medicare |
$27.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.09
|
| Rate for Payer: Railroad Medicare Medicare |
$26.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.94
|
| Rate for Payer: UHC Core |
$90.09
|
| Rate for Payer: UHC Exchange |
$26.97
|
| Rate for Payer: UHC Medicaid |
$19.02
|
| Rate for Payer: UHC Medicare Advantage |
$26.97
|
| Rate for Payer: UHCCP Medicaid |
$19.02
|
| Rate for Payer: VA VA |
$26.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.92
|
|
|
HC CONTRAST BATHS EACH 15 MIN
|
Facility
|
IP
|
$107.89
|
|
|
Service Code
|
CPT 97034
|
| Hospital Charge Code |
42000017
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$75.09 |
| Max. Negotiated Rate |
$97.10 |
| Rate for Payer: Aetna Commercial |
$91.71
|
| Rate for Payer: BCBS Trust/PPO |
$89.11
|
| Rate for Payer: BCN Commercial |
$89.11
|
| Rate for Payer: Cash Price |
$86.31
|
| Rate for Payer: Cofinity Commercial |
$92.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.31
|
| Rate for Payer: Healthscope Commercial |
$97.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.71
|
| Rate for Payer: Nomi Health Commercial |
$88.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.92
|
| Rate for Payer: PHP Commercial |
$91.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.94
|
| Rate for Payer: UHC Core |
$90.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.92
|
|
|
HC CONTROL NASAL HEMORR POST PACK/CAUTERY INIT
|
Facility
|
IP
|
$461.04
|
|
|
Service Code
|
CPT 30905
|
| Hospital Charge Code |
76100530
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$320.88 |
| Max. Negotiated Rate |
$414.94 |
| Rate for Payer: Aetna Commercial |
$391.88
|
| Rate for Payer: BCBS Trust/PPO |
$380.77
|
| Rate for Payer: BCN Commercial |
$380.77
|
| Rate for Payer: Cash Price |
$368.83
|
| Rate for Payer: Cofinity Commercial |
$396.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.83
|
| Rate for Payer: Healthscope Commercial |
$414.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.88
|
| Rate for Payer: Nomi Health Commercial |
$378.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.78
|
| Rate for Payer: PHP Commercial |
$391.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$401.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$320.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.72
|
| Rate for Payer: UHC Core |
$384.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.78
|
|
|
HC CONTROL NASAL HEMORR POST PACK/CAUTERY INIT
|
Facility
|
OP
|
$461.04
|
|
|
Service Code
|
CPT 30905
|
| Hospital Charge Code |
76100530
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.28 |
| Max. Negotiated Rate |
$414.94 |
| Rate for Payer: Aetna Commercial |
$391.88
|
| Rate for Payer: Aetna Medicare |
$119.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$144.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$144.07
|
| Rate for Payer: BCBS Complete |
$85.34
|
| Rate for Payer: BCBS MAPPO |
$115.26
|
| Rate for Payer: BCBS Trust/PPO |
$379.02
|
| Rate for Payer: BCN Commercial |
$379.02
|
| Rate for Payer: BCN Medicare Advantage |
$115.26
|
| Rate for Payer: Cash Price |
$368.83
|
| Rate for Payer: Cofinity Commercial |
$396.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.26
|
| Rate for Payer: Healthscope Commercial |
$414.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.78
|
| Rate for Payer: Mclaren Medicaid |
$81.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.02
|
| Rate for Payer: Meridian Medicaid |
$85.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$126.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.88
|
| Rate for Payer: Nomi Health Commercial |
$378.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.78
|
| Rate for Payer: PACE Senior Care Partners |
$109.50
|
| Rate for Payer: PACE SWMI |
$115.26
|
| Rate for Payer: PHP Commercial |
$391.88
|
| Rate for Payer: PHP Medicare Advantage |
$115.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$401.10
|
| Rate for Payer: Priority Health Medicare |
$116.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$320.88
|
| Rate for Payer: Railroad Medicare Medicare |
$115.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.72
|
| Rate for Payer: UHC Core |
$384.97
|
| Rate for Payer: UHC Exchange |
$115.26
|
| Rate for Payer: UHC Medicaid |
$81.28
|
| Rate for Payer: UHC Medicare Advantage |
$115.26
|
| Rate for Payer: UHCCP Medicaid |
$81.28
|
| Rate for Payer: VA VA |
$115.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.78
|
|
|
HC CONTROL NOSEBLEED ANTERIOR SIMPLE
|
Facility
|
OP
|
$422.93
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
45000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.56 |
| Max. Negotiated Rate |
$380.64 |
| Rate for Payer: Aetna Commercial |
$359.49
|
| Rate for Payer: Aetna Medicare |
$109.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$132.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$132.17
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCBS MAPPO |
$105.73
|
| Rate for Payer: BCBS Trust/PPO |
$347.69
|
| Rate for Payer: BCN Commercial |
$347.69
|
| Rate for Payer: BCN Medicare Advantage |
$105.73
|
| Rate for Payer: Cash Price |
$338.34
|
| Rate for Payer: Cofinity Commercial |
$363.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.73
|
| Rate for Payer: Healthscope Commercial |
$380.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.20
|
| Rate for Payer: Mclaren Medicaid |
$74.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.02
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$116.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.49
|
| Rate for Payer: Nomi Health Commercial |
$346.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$317.20
|
| Rate for Payer: PACE Senior Care Partners |
$100.45
|
| Rate for Payer: PACE SWMI |
$105.73
|
| Rate for Payer: PHP Commercial |
$359.49
|
| Rate for Payer: PHP Medicare Advantage |
$105.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$367.95
|
| Rate for Payer: Priority Health Medicare |
$106.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.36
|
| Rate for Payer: Railroad Medicare Medicare |
$105.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.18
|
| Rate for Payer: UHC Core |
$353.15
|
| Rate for Payer: UHC Exchange |
$105.73
|
| Rate for Payer: UHC Medicaid |
$74.56
|
| Rate for Payer: UHC Medicare Advantage |
$105.73
|
| Rate for Payer: UHCCP Medicaid |
$74.56
|
| Rate for Payer: VA VA |
$105.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.20
|
|
|
HC CONTROL NOSEBLEED ANTERIOR SIMPLE
|
Facility
|
IP
|
$422.93
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
45000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$294.36 |
| Max. Negotiated Rate |
$380.64 |
| Rate for Payer: Aetna Commercial |
$359.49
|
| Rate for Payer: BCBS Trust/PPO |
$349.30
|
| Rate for Payer: BCN Commercial |
$349.30
|
| Rate for Payer: Cash Price |
$338.34
|
| Rate for Payer: Cofinity Commercial |
$363.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.34
|
| Rate for Payer: Healthscope Commercial |
$380.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.49
|
| Rate for Payer: Nomi Health Commercial |
$346.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$317.20
|
| Rate for Payer: PHP Commercial |
$359.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$367.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.18
|
| Rate for Payer: UHC Core |
$353.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.20
|
|
|
HC CONTROL OROPHARYNGEAL HEM SIMPLE
|
Facility
|
IP
|
$768.85
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
45000100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$535.12 |
| Max. Negotiated Rate |
$691.97 |
| Rate for Payer: Aetna Commercial |
$653.52
|
| Rate for Payer: BCBS Trust/PPO |
$634.99
|
| Rate for Payer: BCN Commercial |
$634.99
|
| Rate for Payer: Cash Price |
$615.08
|
| Rate for Payer: Cofinity Commercial |
$661.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$615.08
|
| Rate for Payer: Healthscope Commercial |
$691.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$576.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$653.52
|
| Rate for Payer: Nomi Health Commercial |
$630.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$576.64
|
| Rate for Payer: PHP Commercial |
$653.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$668.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$535.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$676.59
|
| Rate for Payer: UHC Core |
$641.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$576.64
|
|
|
HC CONTROL OROPHARYNGEAL HEM SIMPLE
|
Facility
|
OP
|
$768.85
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
45000100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$691.97 |
| Rate for Payer: Aetna Commercial |
$653.52
|
| Rate for Payer: Aetna Medicare |
$199.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$240.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$240.27
|
| Rate for Payer: BCBS Complete |
$142.31
|
| Rate for Payer: BCBS MAPPO |
$192.21
|
| Rate for Payer: BCBS Trust/PPO |
$632.07
|
| Rate for Payer: BCN Commercial |
$632.07
|
| Rate for Payer: BCN Medicare Advantage |
$192.21
|
| Rate for Payer: Cash Price |
$615.08
|
| Rate for Payer: Cash Price |
$615.08
|
| Rate for Payer: Cofinity Commercial |
$661.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$615.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.21
|
| Rate for Payer: Healthscope Commercial |
$691.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$576.64
|
| Rate for Payer: Mclaren Medicaid |
$135.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.82
|
| Rate for Payer: Meridian Medicaid |
$142.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$221.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$211.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$653.52
|
| Rate for Payer: Nomi Health Commercial |
$630.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$576.64
|
| Rate for Payer: PACE Senior Care Partners |
$182.60
|
| Rate for Payer: PACE SWMI |
$192.21
|
| Rate for Payer: PHP Commercial |
$653.52
|
| Rate for Payer: PHP Medicare Advantage |
$192.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$135.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$668.90
|
| Rate for Payer: Priority Health Medicare |
$194.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$535.12
|
| Rate for Payer: Railroad Medicare Medicare |
$192.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$676.59
|
| Rate for Payer: UHC Core |
$641.99
|
| Rate for Payer: UHC Exchange |
$192.21
|
| Rate for Payer: UHC Medicaid |
$135.55
|
| Rate for Payer: UHC Medicare Advantage |
$192.21
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$192.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$576.64
|
|
|
HC CONTROL OROPHARYNG HEMORRHAGE SIMPLE
|
Facility
|
IP
|
$1,369.17
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
76100478
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$952.94 |
| Max. Negotiated Rate |
$1,232.25 |
| Rate for Payer: Aetna Commercial |
$1,163.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,130.80
|
| Rate for Payer: BCN Commercial |
$1,130.80
|
| Rate for Payer: Cash Price |
$1,095.34
|
| Rate for Payer: Cofinity Commercial |
$1,177.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,095.34
|
| Rate for Payer: Healthscope Commercial |
$1,232.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,026.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,163.79
|
| Rate for Payer: Nomi Health Commercial |
$1,122.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,026.88
|
| Rate for Payer: PHP Commercial |
$1,163.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,191.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$952.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,204.87
|
| Rate for Payer: UHC Core |
$1,143.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,026.88
|
|
