|
HC CANNULA RETROGRD 15 FR
|
Facility
|
IP
|
$311.01
|
|
| Hospital Charge Code |
27000447
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$202.16 |
| Max. Negotiated Rate |
$279.91 |
| Rate for Payer: Aetna Commercial |
$264.36
|
| Rate for Payer: BCBS Trust/PPO |
$253.88
|
| Rate for Payer: BCN Commercial |
$240.35
|
| Rate for Payer: Cash Price |
$248.81
|
| Rate for Payer: Cofinity Commercial |
$267.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.81
|
| Rate for Payer: Healthscope Commercial |
$279.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.36
|
| Rate for Payer: Nomi Health Commercial |
$255.03
|
| Rate for Payer: PHP Commercial |
$264.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$202.16
|
| Rate for Payer: Priority Health HMO/PPO |
$270.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$208.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.69
|
| Rate for Payer: UHC Core |
$259.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.26
|
|
|
HC CANNULA VEIN GRAFT
|
Facility
|
IP
|
$35.19
|
|
| Hospital Charge Code |
27000096
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.87 |
| Max. Negotiated Rate |
$31.67 |
| Rate for Payer: Aetna Commercial |
$29.91
|
| Rate for Payer: BCBS Trust/PPO |
$28.73
|
| Rate for Payer: BCN Commercial |
$27.19
|
| Rate for Payer: Cash Price |
$28.15
|
| Rate for Payer: Cofinity Commercial |
$30.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.15
|
| Rate for Payer: Healthscope Commercial |
$31.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.91
|
| Rate for Payer: Nomi Health Commercial |
$28.86
|
| Rate for Payer: PHP Commercial |
$29.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.87
|
| Rate for Payer: Priority Health HMO/PPO |
$30.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.97
|
| Rate for Payer: UHC Core |
$29.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.39
|
|
|
HC CANNULA VEIN GRAFT
|
Facility
|
OP
|
$35.19
|
|
| Hospital Charge Code |
27000096
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.36 |
| Max. Negotiated Rate |
$31.67 |
| Rate for Payer: Aetna Commercial |
$29.91
|
| Rate for Payer: Aetna Medicare |
$9.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.00
|
| Rate for Payer: BCBS Complete |
$14.08
|
| Rate for Payer: BCBS MAPPO |
$8.80
|
| Rate for Payer: BCBS Trust/PPO |
$28.93
|
| Rate for Payer: BCN Commercial |
$27.36
|
| Rate for Payer: BCN Medicare Advantage |
$8.80
|
| Rate for Payer: Cash Price |
$28.15
|
| Rate for Payer: Cofinity Commercial |
$30.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.80
|
| Rate for Payer: Healthscope Commercial |
$31.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.91
|
| Rate for Payer: Nomi Health Commercial |
$28.86
|
| Rate for Payer: PACE Senior Care Partners |
$8.36
|
| Rate for Payer: PACE SWMI |
$8.80
|
| Rate for Payer: PHP Commercial |
$29.91
|
| Rate for Payer: PHP Medicare Advantage |
$8.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.87
|
| Rate for Payer: Priority Health HMO/PPO |
$30.62
|
| Rate for Payer: Priority Health Medicare |
$8.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.58
|
| Rate for Payer: Railroad Medicare Medicare |
$8.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.97
|
| Rate for Payer: UHC Core |
$29.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.80
|
| Rate for Payer: UHC Exchange |
$8.80
|
| Rate for Payer: UHC Medicare Advantage |
$8.80
|
| Rate for Payer: VA VA |
$8.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.39
|
|
|
HC CANNULA VENOUS RT PVC
|
Facility
|
OP
|
$85.68
|
|
| Hospital Charge Code |
27000681
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.35 |
| Max. Negotiated Rate |
$77.11 |
| Rate for Payer: Aetna Commercial |
$72.83
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: BCBS Complete |
$34.27
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$70.44
|
| Rate for Payer: BCN Commercial |
$66.62
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$68.54
|
| Rate for Payer: Cofinity Commercial |
$73.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$77.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.83
|
| Rate for Payer: Nomi Health Commercial |
$70.26
|
| Rate for Payer: PACE Senior Care Partners |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$72.83
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.69
|
| Rate for Payer: Priority Health HMO/PPO |
$74.54
|
| Rate for Payer: Priority Health Medicare |
$21.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.41
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.40
|
| Rate for Payer: UHC Core |
$71.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.26
|
|
|
HC CANNULA VENOUS RT PVC
|
Facility
|
IP
|
$85.68
|
|
| Hospital Charge Code |
27000681
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.69 |
| Max. Negotiated Rate |
$77.11 |
| Rate for Payer: Aetna Commercial |
$72.83
|
| Rate for Payer: BCBS Trust/PPO |
$69.94
|
| Rate for Payer: BCN Commercial |
$66.21
|
| Rate for Payer: Cash Price |
$68.54
|
| Rate for Payer: Cofinity Commercial |
$73.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.54
|
| Rate for Payer: Healthscope Commercial |
$77.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.83
|
| Rate for Payer: Nomi Health Commercial |
$70.26
|
| Rate for Payer: PHP Commercial |
$72.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.69
|
| Rate for Payer: Priority Health HMO/PPO |
$74.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.40
|
| Rate for Payer: UHC Core |
$71.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.26
|
|
|
HC CANNULA VEN SINGLE STAGE
|
Facility
|
OP
|
$73.44
|
|
| Hospital Charge Code |
27000263
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.44 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna Medicare |
$19.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.95
|
| Rate for Payer: BCBS Complete |
$29.38
|
| Rate for Payer: BCBS MAPPO |
$18.36
|
| Rate for Payer: BCBS Trust/PPO |
$60.38
|
| Rate for Payer: BCN Commercial |
$57.10
|
| Rate for Payer: BCN Medicare Advantage |
$18.36
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.36
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: PACE Senior Care Partners |
$17.44
|
| Rate for Payer: PACE SWMI |
$18.36
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: PHP Medicare Advantage |
$18.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.74
|
| Rate for Payer: Priority Health HMO/PPO |
$63.89
|
| Rate for Payer: Priority Health Medicare |
$18.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.20
|
| Rate for Payer: Railroad Medicare Medicare |
$18.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.63
|
| Rate for Payer: UHC Core |
$61.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.36
|
| Rate for Payer: UHC Exchange |
$18.36
|
| Rate for Payer: UHC Medicare Advantage |
$18.36
|
| Rate for Payer: VA VA |
$18.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.08
|
|
|
HC CANNULA VEN SINGLE STAGE
|
Facility
|
IP
|
$73.44
|
|
| Hospital Charge Code |
27000263
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$47.74 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: BCBS Trust/PPO |
$59.95
|
| Rate for Payer: BCN Commercial |
$56.75
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.74
|
| Rate for Payer: Priority Health HMO/PPO |
$63.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.63
|
| Rate for Payer: UHC Core |
$61.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.08
|
|
|
HC CANNULA VEN SNGL STG RT ANG
|
Facility
|
IP
|
$97.92
|
|
| Hospital Charge Code |
27000267
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$63.65 |
| Max. Negotiated Rate |
$88.13 |
| Rate for Payer: Aetna Commercial |
$83.23
|
| Rate for Payer: BCBS Trust/PPO |
$79.93
|
| Rate for Payer: BCN Commercial |
$75.67
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$84.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.34
|
| Rate for Payer: Healthscope Commercial |
$88.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.23
|
| Rate for Payer: Nomi Health Commercial |
$80.29
|
| Rate for Payer: PHP Commercial |
$83.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.65
|
| Rate for Payer: Priority Health HMO/PPO |
$85.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.17
|
| Rate for Payer: UHC Core |
$81.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.44
|
|
|
HC CANNULA VEN SNGL STG RT ANG
|
Facility
|
OP
|
$97.92
|
|
| Hospital Charge Code |
27000267
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.26 |
| Max. Negotiated Rate |
$88.13 |
| Rate for Payer: Aetna Commercial |
$83.23
|
| Rate for Payer: Aetna Medicare |
$25.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.60
|
| Rate for Payer: BCBS Complete |
$39.17
|
| Rate for Payer: BCBS MAPPO |
$24.48
|
| Rate for Payer: BCBS Trust/PPO |
$80.50
|
| Rate for Payer: BCN Commercial |
$76.13
|
| Rate for Payer: BCN Medicare Advantage |
$24.48
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$84.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$88.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.23
|
| Rate for Payer: Nomi Health Commercial |
$80.29
|
| Rate for Payer: PACE Senior Care Partners |
$23.26
|
| Rate for Payer: PACE SWMI |
$24.48
|
| Rate for Payer: PHP Commercial |
$83.23
|
| Rate for Payer: PHP Medicare Advantage |
$24.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.65
|
| Rate for Payer: Priority Health HMO/PPO |
$85.19
|
| Rate for Payer: Priority Health Medicare |
$24.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.61
|
| Rate for Payer: Railroad Medicare Medicare |
$24.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.17
|
| Rate for Payer: UHC Core |
$81.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.48
|
| Rate for Payer: UHC Exchange |
$24.48
|
| Rate for Payer: UHC Medicare Advantage |
$24.48
|
| Rate for Payer: VA VA |
$24.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.44
|
|
|
HC CANNULA VEN TRIPLE STAGE
|
Facility
|
IP
|
$73.44
|
|
| Hospital Charge Code |
27000035
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$47.74 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: BCBS Trust/PPO |
$59.95
|
| Rate for Payer: BCN Commercial |
$56.75
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.74
|
| Rate for Payer: Priority Health HMO/PPO |
$63.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.63
|
| Rate for Payer: UHC Core |
$61.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.08
|
|
|
HC CANNULA VEN TRIPLE STAGE
|
Facility
|
OP
|
$73.44
|
|
| Hospital Charge Code |
27000035
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.44 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna Medicare |
$19.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.95
|
| Rate for Payer: BCBS Complete |
$29.38
|
| Rate for Payer: BCBS MAPPO |
$18.36
|
| Rate for Payer: BCBS Trust/PPO |
$60.38
|
| Rate for Payer: BCN Commercial |
$57.10
|
| Rate for Payer: BCN Medicare Advantage |
$18.36
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.36
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: Nomi Health Commercial |
$60.22
|
| Rate for Payer: PACE Senior Care Partners |
$17.44
|
| Rate for Payer: PACE SWMI |
$18.36
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: PHP Medicare Advantage |
$18.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.74
|
| Rate for Payer: Priority Health HMO/PPO |
$63.89
|
| Rate for Payer: Priority Health Medicare |
$18.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.20
|
| Rate for Payer: Railroad Medicare Medicare |
$18.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.63
|
| Rate for Payer: UHC Core |
$61.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.36
|
| Rate for Payer: UHC Exchange |
$18.36
|
| Rate for Payer: UHC Medicare Advantage |
$18.36
|
| Rate for Payer: VA VA |
$18.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.08
|
|
|
HC CARB 10,11 EPXID
|
Facility
|
IP
|
$44.76
|
|
|
Service Code
|
CPT 80161
|
| Hospital Charge Code |
30100742
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.09 |
| Max. Negotiated Rate |
$40.28 |
| Rate for Payer: Aetna Commercial |
$38.05
|
| Rate for Payer: BCBS Trust/PPO |
$36.54
|
| Rate for Payer: BCN Commercial |
$34.59
|
| Rate for Payer: Cash Price |
$35.81
|
| Rate for Payer: Cofinity Commercial |
$38.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.81
|
| Rate for Payer: Healthscope Commercial |
$40.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.05
|
| Rate for Payer: Nomi Health Commercial |
$36.70
|
| Rate for Payer: PHP Commercial |
$38.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.09
|
| Rate for Payer: Priority Health HMO/PPO |
$38.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.39
|
| Rate for Payer: UHC Core |
$37.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.57
|
|
|
HC CARB 10,11 EPXID
|
Facility
|
OP
|
$44.76
|
|
|
Service Code
|
CPT 80161
|
| Hospital Charge Code |
30100742
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.63 |
| Max. Negotiated Rate |
$40.28 |
| Rate for Payer: Aetna Commercial |
$38.05
|
| Rate for Payer: Aetna Medicare |
$11.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.99
|
| Rate for Payer: BCBS Complete |
$14.15
|
| Rate for Payer: BCBS MAPPO |
$11.19
|
| Rate for Payer: BCBS Trust/PPO |
$36.80
|
| Rate for Payer: BCN Commercial |
$34.80
|
| Rate for Payer: BCN Medicare Advantage |
$11.19
|
| Rate for Payer: Cash Price |
$35.81
|
| Rate for Payer: Cash Price |
$35.81
|
| Rate for Payer: Cofinity Commercial |
$38.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.19
|
| Rate for Payer: Healthscope Commercial |
$40.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.57
|
| Rate for Payer: Mclaren Medicaid |
$13.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.75
|
| Rate for Payer: Meridian Medicaid |
$14.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.05
|
| Rate for Payer: Nomi Health Commercial |
$36.70
|
| Rate for Payer: PACE Senior Care Partners |
$10.63
|
| Rate for Payer: PACE SWMI |
$11.19
|
| Rate for Payer: PHP Commercial |
$38.05
|
| Rate for Payer: PHP Medicare Advantage |
$11.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.09
|
| Rate for Payer: Priority Health HMO/PPO |
$38.94
|
| Rate for Payer: Priority Health Medicare |
$11.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.99
|
| Rate for Payer: Railroad Medicare Medicare |
$11.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.39
|
| Rate for Payer: UHC Core |
$37.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.19
|
| Rate for Payer: UHC Exchange |
$11.19
|
| Rate for Payer: UHC Medicare Advantage |
$11.19
|
| Rate for Payer: UHCCP Medicaid |
$13.48
|
| Rate for Payer: VA VA |
$11.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.57
|
|
|
HC CARBAMAZEPINE 10 11 EPOXIDE
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100022
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.53 |
| 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 |
$11.06
|
| Rate for Payer: BCBS MAPPO |
$11.44
|
| Rate for Payer: BCBS Trust/PPO |
$37.64
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: BCN Medicare Advantage |
$11.44
|
| Rate for Payer: Cash Price |
$36.62
|
| 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 |
$11.44
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Mclaren Medicaid |
$10.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.02
|
| Rate for Payer: Meridian Medicaid |
$11.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: PACE Senior Care Partners |
$10.87
|
| Rate for Payer: PACE SWMI |
$11.44
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: PHP Medicare Advantage |
$11.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO |
$39.83
|
| Rate for Payer: Priority Health Medicare |
$11.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.67
|
| Rate for Payer: Railroad Medicare Medicare |
$11.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.29
|
| Rate for Payer: UHC Core |
$38.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.44
|
| Rate for Payer: UHC Exchange |
$11.44
|
| Rate for Payer: UHC Medicare Advantage |
$11.44
|
| Rate for Payer: UHCCP Medicaid |
$10.53
|
| Rate for Payer: VA VA |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC CARBAMAZEPINE 10 11 EPOXIDE
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100022
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: BCBS Trust/PPO |
$37.37
|
| Rate for Payer: BCN Commercial |
$35.38
|
| 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: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO |
$39.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.67
|
| 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 CARBAMAZEPINE 10 11 EPOXIDE CMPT
|
Facility
|
OP
|
$44.74
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100060
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.63 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: Aetna Medicare |
$11.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.98
|
| Rate for Payer: BCBS Complete |
$14.15
|
| Rate for Payer: BCBS MAPPO |
$11.18
|
| Rate for Payer: BCBS Trust/PPO |
$36.78
|
| Rate for Payer: BCN Commercial |
$34.79
|
| Rate for Payer: BCN Medicare Advantage |
$11.18
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.18
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.56
|
| Rate for Payer: Mclaren Medicaid |
$13.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.74
|
| Rate for Payer: Meridian Medicaid |
$14.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: PACE Senior Care Partners |
$10.63
|
| Rate for Payer: PACE SWMI |
$11.18
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: PHP Medicare Advantage |
$11.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health HMO/PPO |
$38.92
|
| Rate for Payer: Priority Health Medicare |
$11.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.98
|
| Rate for Payer: Railroad Medicare Medicare |
$11.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.37
|
| Rate for Payer: UHC Core |
$37.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.18
|
| Rate for Payer: UHC Exchange |
$11.18
|
| Rate for Payer: UHC Medicare Advantage |
$11.18
|
| Rate for Payer: UHCCP Medicaid |
$13.48
|
| Rate for Payer: VA VA |
$11.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.56
|
|
|
HC CARBAMAZEPINE 10 11 EPOXIDE CMPT
|
Facility
|
IP
|
$44.74
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100060
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.08 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: BCBS Trust/PPO |
$36.52
|
| Rate for Payer: BCN Commercial |
$34.58
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.08
|
| Rate for Payer: Priority Health HMO/PPO |
$38.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.37
|
| Rate for Payer: UHC Core |
$37.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.56
|
|
|
HC CARBON DIOXIDE (BICARB)
|
Facility
|
OP
|
$21.64
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100133
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: Aetna Medicare |
$5.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.76
|
| Rate for Payer: BCBS Complete |
$3.70
|
| Rate for Payer: BCBS MAPPO |
$5.41
|
| Rate for Payer: BCBS Trust/PPO |
$17.79
|
| Rate for Payer: BCN Commercial |
$16.83
|
| Rate for Payer: BCN Medicare Advantage |
$5.41
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.41
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.23
|
| Rate for Payer: Mclaren Medicaid |
$3.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.68
|
| Rate for Payer: Meridian Medicaid |
$3.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Nomi Health Commercial |
$17.74
|
| Rate for Payer: PACE Senior Care Partners |
$5.14
|
| Rate for Payer: PACE SWMI |
$5.41
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: PHP Medicare Advantage |
$5.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.07
|
| Rate for Payer: Priority Health HMO/PPO |
$18.83
|
| Rate for Payer: Priority Health Medicare |
$5.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.50
|
| Rate for Payer: Railroad Medicare Medicare |
$5.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.04
|
| Rate for Payer: UHC Core |
$18.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.41
|
| Rate for Payer: UHC Exchange |
$5.41
|
| Rate for Payer: UHC Medicare Advantage |
$5.41
|
| Rate for Payer: UHCCP Medicaid |
$3.53
|
| Rate for Payer: VA VA |
$5.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.23
|
|
|
HC CARBON DIOXIDE (BICARB)
|
Facility
|
IP
|
$21.64
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100133
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.07 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: BCBS Trust/PPO |
$17.66
|
| Rate for Payer: BCN Commercial |
$16.72
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Nomi Health Commercial |
$17.74
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.07
|
| Rate for Payer: Priority Health HMO/PPO |
$18.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.04
|
| Rate for Payer: UHC Core |
$18.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.23
|
|
|
HC CARBOXYHEMOGLOBIN
|
Facility
|
OP
|
$78.45
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
30100134
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.91 |
| Max. Negotiated Rate |
$70.60 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna Medicare |
$20.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.52
|
| Rate for Payer: BCBS Complete |
$9.35
|
| Rate for Payer: BCBS MAPPO |
$19.61
|
| Rate for Payer: BCBS Trust/PPO |
$64.49
|
| Rate for Payer: BCN Commercial |
$60.99
|
| Rate for Payer: BCN Medicare Advantage |
$19.61
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.61
|
| Rate for Payer: Healthscope Commercial |
$70.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Mclaren Medicaid |
$8.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.59
|
| Rate for Payer: Meridian Medicaid |
$9.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: PACE Senior Care Partners |
$18.63
|
| Rate for Payer: PACE SWMI |
$19.61
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: PHP Medicare Advantage |
$19.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.99
|
| Rate for Payer: Priority Health HMO/PPO |
$68.25
|
| Rate for Payer: Priority Health Medicare |
$19.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.56
|
| Rate for Payer: Railroad Medicare Medicare |
$19.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.04
|
| Rate for Payer: UHC Core |
$65.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.61
|
| Rate for Payer: UHC Exchange |
$19.61
|
| Rate for Payer: UHC Medicare Advantage |
$19.61
|
| Rate for Payer: UHCCP Medicaid |
$8.91
|
| Rate for Payer: VA VA |
$19.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
|
HC CARBOXYHEMOGLOBIN
|
Facility
|
IP
|
$78.45
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
30100134
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.99 |
| Max. Negotiated Rate |
$70.60 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: BCBS Trust/PPO |
$64.04
|
| Rate for Payer: BCN Commercial |
$60.63
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$70.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.99
|
| Rate for Payer: Priority Health HMO/PPO |
$68.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.04
|
| Rate for Payer: UHC Core |
$65.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
|
HC CARDIAC REH OP PH 2 WO MONITOR
|
Facility
|
OP
|
$197.91
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
94300007
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$178.12 |
| Rate for Payer: Aetna Commercial |
$168.22
|
| Rate for Payer: Aetna Medicare |
$51.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.85
|
| Rate for Payer: BCBS Complete |
$93.65
|
| Rate for Payer: BCBS MAPPO |
$49.48
|
| Rate for Payer: BCBS Trust/PPO |
$162.70
|
| Rate for Payer: BCN Commercial |
$153.88
|
| Rate for Payer: BCN Medicare Advantage |
$49.48
|
| Rate for Payer: Cash Price |
$158.33
|
| Rate for Payer: Cash Price |
$158.33
|
| Rate for Payer: Cofinity Commercial |
$170.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.48
|
| Rate for Payer: Healthscope Commercial |
$178.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.43
|
| Rate for Payer: Mclaren Medicaid |
$89.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.95
|
| Rate for Payer: Meridian Medicaid |
$93.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.22
|
| Rate for Payer: Nomi Health Commercial |
$162.29
|
| Rate for Payer: PACE Senior Care Partners |
$47.00
|
| Rate for Payer: PACE SWMI |
$49.48
|
| Rate for Payer: PHP Commercial |
$168.22
|
| Rate for Payer: PHP Medicare Advantage |
$49.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.64
|
| Rate for Payer: Priority Health HMO/PPO |
$172.18
|
| Rate for Payer: Priority Health Medicare |
$49.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.60
|
| Rate for Payer: Railroad Medicare Medicare |
$49.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.16
|
| Rate for Payer: UHC Core |
$165.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.48
|
| Rate for Payer: UHC Exchange |
$49.48
|
| Rate for Payer: UHC Medicare Advantage |
$49.48
|
| Rate for Payer: UHCCP Medicaid |
$89.19
|
| Rate for Payer: VA VA |
$49.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.43
|
|
|
HC CARDIAC REH OP PH 2 WO MONITOR
|
Facility
|
IP
|
$197.91
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
94300007
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$128.64 |
| Max. Negotiated Rate |
$178.12 |
| Rate for Payer: Aetna Commercial |
$168.22
|
| Rate for Payer: BCBS Trust/PPO |
$161.55
|
| Rate for Payer: BCN Commercial |
$152.94
|
| Rate for Payer: Cash Price |
$158.33
|
| Rate for Payer: Cofinity Commercial |
$170.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.33
|
| Rate for Payer: Healthscope Commercial |
$178.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.22
|
| Rate for Payer: Nomi Health Commercial |
$162.29
|
| Rate for Payer: PHP Commercial |
$168.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.64
|
| Rate for Payer: Priority Health HMO/PPO |
$172.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.16
|
| Rate for Payer: UHC Core |
$165.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.43
|
|
|
HC CARDIOLIPIN AB IGA
|
Facility
|
IP
|
$51.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200146
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.26 |
| Max. Negotiated Rate |
$46.05 |
| Rate for Payer: Aetna Commercial |
$43.49
|
| Rate for Payer: BCBS Trust/PPO |
$41.77
|
| Rate for Payer: BCN Commercial |
$39.54
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.94
|
| Rate for Payer: Healthscope Commercial |
$46.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.49
|
| Rate for Payer: Nomi Health Commercial |
$41.96
|
| Rate for Payer: PHP Commercial |
$43.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.26
|
| Rate for Payer: Priority Health HMO/PPO |
$44.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.03
|
| Rate for Payer: UHC Core |
$42.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.38
|
|
|
HC CARDIOLIPIN AB IGA
|
Facility
|
OP
|
$51.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200146
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.15 |
| Max. Negotiated Rate |
$46.05 |
| Rate for Payer: Aetna Commercial |
$43.49
|
| Rate for Payer: Aetna Medicare |
$13.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.99
|
| Rate for Payer: BCBS Complete |
$19.32
|
| Rate for Payer: BCBS MAPPO |
$12.79
|
| Rate for Payer: BCBS Trust/PPO |
$42.07
|
| Rate for Payer: BCN Commercial |
$39.78
|
| Rate for Payer: BCN Medicare Advantage |
$12.79
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Cofinity Commercial |
$44.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.79
|
| Rate for Payer: Healthscope Commercial |
$46.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.38
|
| Rate for Payer: Mclaren Medicaid |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.43
|
| Rate for Payer: Meridian Medicaid |
$19.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.49
|
| Rate for Payer: Nomi Health Commercial |
$41.96
|
| Rate for Payer: PACE Senior Care Partners |
$12.15
|
| Rate for Payer: PACE SWMI |
$12.79
|
| Rate for Payer: PHP Commercial |
$43.49
|
| Rate for Payer: PHP Medicare Advantage |
$12.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.26
|
| Rate for Payer: Priority Health HMO/PPO |
$44.52
|
| Rate for Payer: Priority Health Medicare |
$12.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.28
|
| Rate for Payer: Railroad Medicare Medicare |
$12.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.03
|
| Rate for Payer: UHC Core |
$42.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.79
|
| Rate for Payer: UHC Exchange |
$12.79
|
| Rate for Payer: UHC Medicare Advantage |
$12.79
|
| Rate for Payer: UHCCP Medicaid |
$18.40
|
| Rate for Payer: VA VA |
$12.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.38
|
|
