|
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
|
|
|
HC CONVERT EXTERNAL BILIARY DRAIN TO INTERNAL EXTERNAL
|
Facility
|
OP
|
$3,867.19
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
36100492
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$681.79 |
| Max. Negotiated Rate |
$3,480.47 |
| Rate for Payer: Aetna Commercial |
$3,287.11
|
| Rate for Payer: Aetna Medicare |
$1,005.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,208.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,208.50
|
| Rate for Payer: BCBS Complete |
$715.82
|
| Rate for Payer: BCBS MAPPO |
$966.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,179.22
|
| Rate for Payer: BCN Commercial |
$3,179.22
|
| Rate for Payer: BCN Medicare Advantage |
$966.80
|
| Rate for Payer: Cash Price |
$3,093.75
|
| Rate for Payer: Cofinity Commercial |
$3,325.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,093.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$966.80
|
| Rate for Payer: Healthscope Commercial |
$3,480.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,900.39
|
| Rate for Payer: Mclaren Medicaid |
$681.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,015.14
|
| Rate for Payer: Meridian Medicaid |
$715.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,111.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,063.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,287.11
|
| Rate for Payer: Nomi Health Commercial |
$3,171.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,900.39
|
| Rate for Payer: PACE Senior Care Partners |
$918.46
|
| Rate for Payer: PACE SWMI |
$966.80
|
| Rate for Payer: PHP Commercial |
$3,287.11
|
| Rate for Payer: PHP Medicare Advantage |
$966.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$681.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,364.46
|
| Rate for Payer: Priority Health Medicare |
$976.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,691.56
|
| Rate for Payer: Railroad Medicare Medicare |
$966.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,403.13
|
| Rate for Payer: UHC Core |
$3,229.10
|
| Rate for Payer: UHC Exchange |
$966.80
|
| Rate for Payer: UHC Medicaid |
$681.79
|
| Rate for Payer: UHC Medicare Advantage |
$966.80
|
| Rate for Payer: UHCCP Medicaid |
$681.79
|
| Rate for Payer: VA VA |
$966.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,900.39
|
|
|
HC CONVERT EXTERNAL BILIARY DRAIN TO INTERNAL EXTERNAL
|
Facility
|
IP
|
$3,867.19
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
36100492
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,691.56 |
| Max. Negotiated Rate |
$3,480.47 |
| Rate for Payer: Aetna Commercial |
$3,287.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,193.91
|
| Rate for Payer: BCN Commercial |
$3,193.91
|
| Rate for Payer: Cash Price |
$3,093.75
|
| Rate for Payer: Cofinity Commercial |
$3,325.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,093.75
|
| Rate for Payer: Healthscope Commercial |
$3,480.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,900.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,287.11
|
| Rate for Payer: Nomi Health Commercial |
$3,171.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,900.39
|
| Rate for Payer: PHP Commercial |
$3,287.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,364.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,691.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,403.13
|
| Rate for Payer: UHC Core |
$3,229.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,900.39
|
|
|
HC CONVERT NEPHROSTOMY TO NEPHROURETERAL CATH
|
Facility
|
OP
|
$1,228.49
|
|
|
Service Code
|
CPT 50434
|
| Hospital Charge Code |
36100506
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$216.58 |
| Max. Negotiated Rate |
$1,105.64 |
| Rate for Payer: Aetna Commercial |
$1,044.22
|
| Rate for Payer: Aetna Medicare |
$319.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$383.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$383.90
|
| Rate for Payer: BCBS Complete |
$227.39
|
| Rate for Payer: BCBS MAPPO |
$307.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.94
|
| Rate for Payer: BCN Commercial |
$1,009.94
|
| Rate for Payer: BCN Medicare Advantage |
$307.12
|
| Rate for Payer: Cash Price |
$982.79
|
| Rate for Payer: Cofinity Commercial |
$1,056.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$982.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.12
|
| Rate for Payer: Healthscope Commercial |
$1,105.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$921.37
|
| Rate for Payer: Mclaren Medicaid |
$216.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.48
|
| Rate for Payer: Meridian Medicaid |
$227.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$353.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$337.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.22
|
| Rate for Payer: Nomi Health Commercial |
$1,007.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$921.37
|
| Rate for Payer: PACE Senior Care Partners |
$291.77
|
| Rate for Payer: PACE SWMI |
$307.12
|
| Rate for Payer: PHP Commercial |
$1,044.22
|
| Rate for Payer: PHP Medicare Advantage |
$307.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,068.79
|
| Rate for Payer: Priority Health Medicare |
$310.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$855.03
|
| Rate for Payer: Railroad Medicare Medicare |
$307.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,081.07
|
| Rate for Payer: UHC Core |
$1,025.79
|
| Rate for Payer: UHC Exchange |
$307.12
|
| Rate for Payer: UHC Medicaid |
$216.58
|
| Rate for Payer: UHC Medicare Advantage |
$307.12
|
| Rate for Payer: UHCCP Medicaid |
$216.58
|
| Rate for Payer: VA VA |
$307.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$921.37
|
|
|
HC CONVERT NEPHROSTOMY TO NEPHROURETERAL CATH
|
Facility
|
IP
|
$1,228.49
|
|
|
Service Code
|
CPT 50434
|
| Hospital Charge Code |
36100506
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$855.03 |
| Max. Negotiated Rate |
$1,105.64 |
| Rate for Payer: Aetna Commercial |
$1,044.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,014.61
|
| Rate for Payer: BCN Commercial |
$1,014.61
|
| Rate for Payer: Cash Price |
$982.79
|
| Rate for Payer: Cofinity Commercial |
$1,056.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$982.79
|
| Rate for Payer: Healthscope Commercial |
$1,105.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$921.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.22
|
| Rate for Payer: Nomi Health Commercial |
$1,007.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$921.37
|
| Rate for Payer: PHP Commercial |
$1,044.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,068.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$855.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,081.07
|
| Rate for Payer: UHC Core |
$1,025.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$921.37
|
|
|
HC CONVEX WAFER
|
Facility
|
OP
|
$58.18
|
|
| Hospital Charge Code |
27000049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.26 |
| Max. Negotiated Rate |
$52.36 |
| Rate for Payer: Aetna Commercial |
$49.45
|
| Rate for Payer: Aetna Medicare |
$15.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.18
|
| Rate for Payer: BCBS Complete |
$10.77
|
| Rate for Payer: BCBS MAPPO |
$14.54
|
| Rate for Payer: BCBS Trust/PPO |
$47.83
|
| Rate for Payer: BCN Commercial |
$47.83
|
| Rate for Payer: BCN Medicare Advantage |
$14.54
|
| Rate for Payer: Cash Price |
$46.54
|
| Rate for Payer: Cofinity Commercial |
$50.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.54
|
| Rate for Payer: Healthscope Commercial |
$52.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.63
|
| Rate for Payer: Mclaren Medicaid |
$10.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.27
|
| Rate for Payer: Meridian Medicaid |
$10.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.45
|
| Rate for Payer: Nomi Health Commercial |
$47.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.63
|
| Rate for Payer: PACE Senior Care Partners |
$13.82
|
| Rate for Payer: PACE SWMI |
$14.54
|
| Rate for Payer: PHP Commercial |
$49.45
|
| Rate for Payer: PHP Medicare Advantage |
$14.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.62
|
| Rate for Payer: Priority Health Medicare |
$14.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.49
|
| Rate for Payer: Railroad Medicare Medicare |
$14.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.20
|
| Rate for Payer: UHC Core |
$48.58
|
| Rate for Payer: UHC Exchange |
$14.54
|
| Rate for Payer: UHC Medicaid |
$10.26
|
| Rate for Payer: UHC Medicare Advantage |
$14.54
|
| Rate for Payer: UHCCP Medicaid |
$10.26
|
| Rate for Payer: VA VA |
$14.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.63
|
|
|
HC CONVEX WAFER
|
Facility
|
IP
|
$58.18
|
|
| Hospital Charge Code |
27000049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.49 |
| Max. Negotiated Rate |
$52.36 |
| Rate for Payer: Aetna Commercial |
$49.45
|
| Rate for Payer: BCBS Trust/PPO |
$48.05
|
| Rate for Payer: BCN Commercial |
$48.05
|
| Rate for Payer: Cash Price |
$46.54
|
| Rate for Payer: Cofinity Commercial |
$50.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.54
|
| Rate for Payer: Healthscope Commercial |
$52.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.45
|
| Rate for Payer: Nomi Health Commercial |
$47.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.63
|
| Rate for Payer: PHP Commercial |
$49.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.20
|
| Rate for Payer: UHC Core |
$48.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.63
|
|
|
HC COOK GUIDEWIRE
|
Facility
|
OP
|
$48.83
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$43.95 |
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna Medicare |
$12.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.26
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$12.21
|
| Rate for Payer: BCBS Trust/PPO |
$40.14
|
| Rate for Payer: BCN Commercial |
$40.14
|
| Rate for Payer: BCN Medicare Advantage |
$12.21
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.21
|
| Rate for Payer: Healthscope Commercial |
$43.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.82
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Nomi Health Commercial |
$40.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PACE Senior Care Partners |
$11.60
|
| Rate for Payer: PACE SWMI |
$12.21
|
| Rate for Payer: PHP Commercial |
$41.51
|
| Rate for Payer: PHP Medicare Advantage |
$12.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.48
|
| Rate for Payer: Priority Health Medicare |
$12.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.99
|
| Rate for Payer: Railroad Medicare Medicare |
$12.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.97
|
| Rate for Payer: UHC Core |
$40.77
|
| Rate for Payer: UHC Exchange |
$12.21
|
| Rate for Payer: UHC Medicaid |
$8.61
|
| Rate for Payer: UHC Medicare Advantage |
$12.21
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$12.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
HC COOK GUIDEWIRE
|
Facility
|
IP
|
$48.83
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.99 |
| Max. Negotiated Rate |
$43.95 |
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: BCBS Trust/PPO |
$40.33
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$43.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Nomi Health Commercial |
$40.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PHP Commercial |
$41.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.97
|
| Rate for Payer: UHC Core |
$40.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
HC COOK PIGTAIL
|
Facility
|
OP
|
$477.69
|
|
| Hospital Charge Code |
27200233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.22 |
| Max. Negotiated Rate |
$429.92 |
| Rate for Payer: Aetna Commercial |
$406.04
|
| Rate for Payer: Aetna Medicare |
$124.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$149.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$149.28
|
| Rate for Payer: BCBS Complete |
$88.42
|
| Rate for Payer: BCBS MAPPO |
$119.42
|
| Rate for Payer: BCBS Trust/PPO |
$392.71
|
| Rate for Payer: BCN Commercial |
$392.71
|
| Rate for Payer: BCN Medicare Advantage |
$119.42
|
| Rate for Payer: Cash Price |
$382.15
|
| Rate for Payer: Cofinity Commercial |
$410.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$382.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.42
|
| Rate for Payer: Healthscope Commercial |
$429.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$358.27
|
| Rate for Payer: Mclaren Medicaid |
$84.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.39
|
| Rate for Payer: Meridian Medicaid |
$88.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$137.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$131.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$406.04
|
| Rate for Payer: Nomi Health Commercial |
$391.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$358.27
|
| Rate for Payer: PACE Senior Care Partners |
$113.45
|
| Rate for Payer: PACE SWMI |
$119.42
|
| Rate for Payer: PHP Commercial |
$406.04
|
| Rate for Payer: PHP Medicare Advantage |
$119.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$415.59
|
| Rate for Payer: Priority Health Medicare |
$120.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$332.47
|
| Rate for Payer: Railroad Medicare Medicare |
$119.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$420.37
|
| Rate for Payer: UHC Core |
$398.87
|
| Rate for Payer: UHC Exchange |
$119.42
|
| Rate for Payer: UHC Medicaid |
$84.22
|
| Rate for Payer: UHC Medicare Advantage |
$119.42
|
| Rate for Payer: UHCCP Medicaid |
$84.22
|
| Rate for Payer: VA VA |
$119.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$358.27
|
|
|
HC COOK PIGTAIL
|
Facility
|
IP
|
$477.69
|
|
| Hospital Charge Code |
27200233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$332.47 |
| Max. Negotiated Rate |
$429.92 |
| Rate for Payer: Aetna Commercial |
$406.04
|
| Rate for Payer: BCBS Trust/PPO |
$394.52
|
| Rate for Payer: BCN Commercial |
$394.52
|
| Rate for Payer: Cash Price |
$382.15
|
| Rate for Payer: Cofinity Commercial |
$410.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$382.15
|
| Rate for Payer: Healthscope Commercial |
$429.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$358.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$406.04
|
| Rate for Payer: Nomi Health Commercial |
$391.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$358.27
|
| Rate for Payer: PHP Commercial |
$406.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$415.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$332.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$420.37
|
| Rate for Payer: UHC Core |
$398.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$358.27
|
|
|
HC COOLIEF RF PROBE
|
Facility
|
IP
|
$1,950.75
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,357.72 |
| Max. Negotiated Rate |
$1,755.67 |
| Rate for Payer: Aetna Commercial |
$1,658.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,611.12
|
| Rate for Payer: BCN Commercial |
$1,611.12
|
| Rate for Payer: Cash Price |
$1,560.60
|
| Rate for Payer: Cofinity Commercial |
$1,677.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,560.60
|
| Rate for Payer: Healthscope Commercial |
$1,755.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,463.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,658.14
|
| Rate for Payer: Nomi Health Commercial |
$1,599.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,463.06
|
| Rate for Payer: PHP Commercial |
$1,658.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,697.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,357.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,716.66
|
| Rate for Payer: UHC Core |
$1,628.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,463.06
|
|
|
HC COOLIEF RF PROBE
|
Facility
|
OP
|
$1,950.75
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$343.92 |
| Max. Negotiated Rate |
$1,755.67 |
| Rate for Payer: Aetna Commercial |
$1,658.14
|
| Rate for Payer: Aetna Medicare |
$507.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$609.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$609.61
|
| Rate for Payer: BCBS Complete |
$361.08
|
| Rate for Payer: BCBS MAPPO |
$487.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,603.71
|
| Rate for Payer: BCN Commercial |
$1,603.71
|
| Rate for Payer: BCN Medicare Advantage |
$487.69
|
| Rate for Payer: Cash Price |
$1,560.60
|
| Rate for Payer: Cofinity Commercial |
$1,677.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,560.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.69
|
| Rate for Payer: Healthscope Commercial |
$1,755.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,463.06
|
| Rate for Payer: Mclaren Medicaid |
$343.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$512.07
|
| Rate for Payer: Meridian Medicaid |
$361.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$560.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$536.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,658.14
|
| Rate for Payer: Nomi Health Commercial |
$1,599.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,463.06
|
| Rate for Payer: PACE Senior Care Partners |
$463.30
|
| Rate for Payer: PACE SWMI |
$487.69
|
| Rate for Payer: PHP Commercial |
$1,658.14
|
| Rate for Payer: PHP Medicare Advantage |
$487.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,697.15
|
| Rate for Payer: Priority Health Medicare |
$492.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,357.72
|
| Rate for Payer: Railroad Medicare Medicare |
$487.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,716.66
|
| Rate for Payer: UHC Core |
$1,628.88
|
| Rate for Payer: UHC Exchange |
$487.69
|
| Rate for Payer: UHC Medicaid |
$343.92
|
| Rate for Payer: UHC Medicare Advantage |
$487.69
|
| Rate for Payer: UHCCP Medicaid |
$343.92
|
| Rate for Payer: VA VA |
$487.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,463.06
|
|
|
HC COPPER SERUM
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.86 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: BCBS Trust/PPO |
$37.81
|
| Rate for Payer: BCN Commercial |
$37.81
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.34
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.29
|
| Rate for Payer: UHC Core |
$38.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC COPPER SERUM
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna Medicare |
$11.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.31
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: BCBS MAPPO |
$11.45
|
| Rate for Payer: BCBS Trust/PPO |
$37.64
|
| Rate for Payer: BCN Commercial |
$37.64
|
| Rate for Payer: BCN Medicare Advantage |
$11.45
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.45
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Mclaren Medicaid |
$8.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.02
|
| Rate for Payer: Meridian Medicaid |
$8.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.34
|
| Rate for Payer: PACE Senior Care Partners |
$10.87
|
| Rate for Payer: PACE SWMI |
$11.45
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: PHP Medicare Advantage |
$11.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.83
|
| Rate for Payer: Priority Health Medicare |
$11.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.86
|
| Rate for Payer: Railroad Medicare Medicare |
$11.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.29
|
| Rate for Payer: UHC Core |
$38.23
|
| Rate for Payer: UHC Exchange |
$11.45
|
| Rate for Payer: UHC Medicaid |
$8.07
|
| Rate for Payer: UHC Medicare Advantage |
$11.45
|
| Rate for Payer: UHCCP Medicaid |
$8.07
|
| Rate for Payer: VA VA |
$11.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC COPPER URINE
|
Facility
|
IP
|
$64.50
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.89 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: BCBS Trust/PPO |
$53.27
|
| Rate for Payer: BCN Commercial |
$53.27
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.76
|
| Rate for Payer: UHC Core |
$53.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
|
HC COPPER URINE
|
Facility
|
OP
|
$64.50
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.37 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: Aetna Medicare |
$16.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.16
|
| Rate for Payer: BCBS Complete |
$11.94
|
| Rate for Payer: BCBS MAPPO |
$16.12
|
| Rate for Payer: BCBS Trust/PPO |
$53.03
|
| Rate for Payer: BCN Commercial |
$53.03
|
| Rate for Payer: BCN Medicare Advantage |
$16.12
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.12
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: Mclaren Medicaid |
$11.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.93
|
| Rate for Payer: Meridian Medicaid |
$11.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: PACE Senior Care Partners |
$15.32
|
| Rate for Payer: PACE SWMI |
$16.12
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: PHP Medicare Advantage |
$16.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.12
|
| Rate for Payer: Priority Health Medicare |
$16.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.89
|
| Rate for Payer: Railroad Medicare Medicare |
$16.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.76
|
| Rate for Payer: UHC Core |
$53.86
|
| Rate for Payer: UHC Exchange |
$16.12
|
| Rate for Payer: UHC Medicaid |
$11.37
|
| Rate for Payer: UHC Medicare Advantage |
$16.12
|
| Rate for Payer: UHCCP Medicaid |
$11.37
|
| Rate for Payer: VA VA |
$16.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
|
HC CORDIS CATHETER
|
Facility
|
OP
|
$200.55
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$180.50 |
| Rate for Payer: Aetna Commercial |
$170.47
|
| Rate for Payer: Aetna Medicare |
$52.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.67
|
| Rate for Payer: BCBS Complete |
$37.12
|
| Rate for Payer: BCBS MAPPO |
$50.14
|
| Rate for Payer: BCBS Trust/PPO |
$164.87
|
| Rate for Payer: BCN Commercial |
$164.87
|
| Rate for Payer: BCN Medicare Advantage |
$50.14
|
| Rate for Payer: Cash Price |
$160.44
|
| Rate for Payer: Cofinity Commercial |
$172.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.14
|
| Rate for Payer: Healthscope Commercial |
$180.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.41
|
| Rate for Payer: Mclaren Medicaid |
$35.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.64
|
| Rate for Payer: Meridian Medicaid |
$37.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.47
|
| Rate for Payer: Nomi Health Commercial |
$164.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.41
|
| Rate for Payer: PACE Senior Care Partners |
$47.63
|
| Rate for Payer: PACE SWMI |
$50.14
|
| Rate for Payer: PHP Commercial |
$170.47
|
| Rate for Payer: PHP Medicare Advantage |
$50.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$174.48
|
| Rate for Payer: Priority Health Medicare |
$50.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.58
|
| Rate for Payer: Railroad Medicare Medicare |
$50.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.48
|
| Rate for Payer: UHC Core |
$167.46
|
| Rate for Payer: UHC Exchange |
$50.14
|
| Rate for Payer: UHC Medicaid |
$35.36
|
| Rate for Payer: UHC Medicare Advantage |
$50.14
|
| Rate for Payer: UHCCP Medicaid |
$35.36
|
| Rate for Payer: VA VA |
$50.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.41
|
|
|
HC CORDIS CATHETER
|
Facility
|
IP
|
$200.55
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.58 |
| Max. Negotiated Rate |
$180.50 |
| Rate for Payer: Aetna Commercial |
$170.47
|
| Rate for Payer: BCBS Trust/PPO |
$165.63
|
| Rate for Payer: BCN Commercial |
$165.63
|
| Rate for Payer: Cash Price |
$160.44
|
| Rate for Payer: Cofinity Commercial |
$172.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.44
|
| Rate for Payer: Healthscope Commercial |
$180.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.47
|
| Rate for Payer: Nomi Health Commercial |
$164.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.41
|
| Rate for Payer: PHP Commercial |
$170.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$174.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.48
|
| Rate for Payer: UHC Core |
$167.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.41
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
OP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$86.78 |
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: Aetna Medicare |
$25.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.13
|
| Rate for Payer: BCBS Complete |
$17.85
|
| Rate for Payer: BCBS MAPPO |
$24.11
|
| Rate for Payer: BCBS Trust/PPO |
$79.27
|
| Rate for Payer: BCN Commercial |
$79.27
|
| Rate for Payer: BCN Medicare Advantage |
$24.11
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.11
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Mclaren Medicaid |
$17.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.31
|
| Rate for Payer: Meridian Medicaid |
$17.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$79.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PACE Senior Care Partners |
$22.90
|
| Rate for Payer: PACE SWMI |
$24.11
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: PHP Medicare Advantage |
$24.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.89
|
| Rate for Payer: Priority Health Medicare |
$24.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.11
|
| Rate for Payer: Railroad Medicare Medicare |
$24.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.85
|
| Rate for Payer: UHC Core |
$80.51
|
| Rate for Payer: UHC Exchange |
$24.11
|
| Rate for Payer: UHC Medicaid |
$17.00
|
| Rate for Payer: UHC Medicare Advantage |
$24.11
|
| Rate for Payer: UHCCP Medicaid |
$17.00
|
| Rate for Payer: VA VA |
$24.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
IP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.11 |
| Max. Negotiated Rate |
$86.78 |
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: BCBS Trust/PPO |
$79.63
|
| Rate for Payer: BCN Commercial |
$79.63
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$79.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.85
|
| Rate for Payer: UHC Core |
$80.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.63
|
| Rate for Payer: BCBS Complete |
$8.67
|
| Rate for Payer: BCBS MAPPO |
$11.71
|
| Rate for Payer: BCBS Trust/PPO |
$38.49
|
| Rate for Payer: BCN Commercial |
$38.49
|
| Rate for Payer: BCN Medicare Advantage |
$11.71
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.71
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$8.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.29
|
| Rate for Payer: Meridian Medicaid |
$8.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PACE Senior Care Partners |
$11.12
|
| Rate for Payer: PACE SWMI |
$11.71
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: Railroad Medicare Medicare |
$11.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: UHC Exchange |
$11.71
|
| Rate for Payer: UHC Medicaid |
$8.25
|
| Rate for Payer: UHC Medicare Advantage |
$11.71
|
| Rate for Payer: UHCCP Medicaid |
$8.25
|
| Rate for Payer: VA VA |
$11.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.59 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: BCBS Trust/PPO |
$38.67
|
| Rate for Payer: BCN Commercial |
$38.67
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC CORN IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC CORN IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
