|
HC CARDIOLIPIN AB IGG
|
Facility
|
OP
|
$51.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200144
|
|
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
|
|
|
HC CARDIOLIPIN AB IGG
|
Facility
|
IP
|
$51.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200144
|
|
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 IGM
|
Facility
|
IP
|
$51.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
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 IGM
|
Facility
|
OP
|
$51.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
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
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
IP
|
$515.54
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$335.10 |
| Max. Negotiated Rate |
$463.99 |
| Rate for Payer: Aetna Commercial |
$438.21
|
| Rate for Payer: BCBS Trust/PPO |
$420.84
|
| Rate for Payer: BCN Commercial |
$398.41
|
| Rate for Payer: Cash Price |
$412.43
|
| Rate for Payer: Cofinity Commercial |
$443.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$412.43
|
| Rate for Payer: Healthscope Commercial |
$463.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$386.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$438.21
|
| Rate for Payer: Nomi Health Commercial |
$422.74
|
| Rate for Payer: PHP Commercial |
$438.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$335.10
|
| Rate for Payer: Priority Health HMO/PPO |
$448.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$345.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$453.68
|
| Rate for Payer: UHC Core |
$430.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$386.66
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
OP
|
$515.54
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$122.44 |
| Max. Negotiated Rate |
$463.99 |
| Rate for Payer: Aetna Commercial |
$438.21
|
| Rate for Payer: Aetna Medicare |
$134.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$161.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$161.11
|
| Rate for Payer: BCBS Complete |
$206.22
|
| Rate for Payer: BCBS MAPPO |
$128.88
|
| Rate for Payer: BCBS Trust/PPO |
$423.83
|
| Rate for Payer: BCN Commercial |
$400.83
|
| Rate for Payer: BCN Medicare Advantage |
$128.88
|
| Rate for Payer: Cash Price |
$412.43
|
| Rate for Payer: Cofinity Commercial |
$443.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$412.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.88
|
| Rate for Payer: Healthscope Commercial |
$463.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$386.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$438.21
|
| Rate for Payer: Nomi Health Commercial |
$422.74
|
| Rate for Payer: PACE Senior Care Partners |
$122.44
|
| Rate for Payer: PACE SWMI |
$128.88
|
| Rate for Payer: PHP Commercial |
$438.21
|
| Rate for Payer: PHP Medicare Advantage |
$128.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$335.10
|
| Rate for Payer: Priority Health HMO/PPO |
$448.52
|
| Rate for Payer: Priority Health Medicare |
$130.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$345.41
|
| Rate for Payer: Railroad Medicare Medicare |
$128.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$453.68
|
| Rate for Payer: UHC Core |
$430.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.88
|
| Rate for Payer: UHC Exchange |
$128.88
|
| Rate for Payer: UHC Medicare Advantage |
$128.88
|
| Rate for Payer: VA VA |
$128.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$386.66
|
|
|
HC CARDIOPULMONARY EX TEST
|
Facility
|
OP
|
$1,122.69
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
46000007
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$220.59 |
| Max. Negotiated Rate |
$1,010.42 |
| Rate for Payer: Aetna Commercial |
$954.29
|
| Rate for Payer: Aetna Medicare |
$291.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$350.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$350.84
|
| Rate for Payer: BCBS Complete |
$231.63
|
| Rate for Payer: BCBS MAPPO |
$280.67
|
| Rate for Payer: BCBS Trust/PPO |
$922.96
|
| Rate for Payer: BCN Commercial |
$872.89
|
| Rate for Payer: BCN Medicare Advantage |
$280.67
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$965.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.67
|
| Rate for Payer: Healthscope Commercial |
$1,010.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$842.02
|
| Rate for Payer: Mclaren Medicaid |
$220.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.71
|
| Rate for Payer: Meridian Medicaid |
$231.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$322.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.29
|
| Rate for Payer: Nomi Health Commercial |
$920.61
|
| Rate for Payer: PACE Senior Care Partners |
$266.64
|
| Rate for Payer: PACE SWMI |
$280.67
|
| Rate for Payer: PHP Commercial |
$954.29
|
| Rate for Payer: PHP Medicare Advantage |
$280.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.75
|
| Rate for Payer: Priority Health HMO/PPO |
$976.74
|
| Rate for Payer: Priority Health Medicare |
$283.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$752.20
|
| Rate for Payer: Railroad Medicare Medicare |
$280.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.97
|
| Rate for Payer: UHC Core |
$937.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$280.67
|
| Rate for Payer: UHC Exchange |
$280.67
|
| Rate for Payer: UHC Medicare Advantage |
$280.67
|
| Rate for Payer: UHCCP Medicaid |
$220.59
|
| Rate for Payer: VA VA |
$280.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$842.02
|
|
|
HC CARDIOPULMONARY EX TEST
|
Facility
|
IP
|
$1,122.69
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
46000007
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$729.75 |
| Max. Negotiated Rate |
$1,010.42 |
| Rate for Payer: Aetna Commercial |
$954.29
|
| Rate for Payer: BCBS Trust/PPO |
$916.45
|
| Rate for Payer: BCN Commercial |
$867.61
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$965.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.15
|
| Rate for Payer: Healthscope Commercial |
$1,010.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$842.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.29
|
| Rate for Payer: Nomi Health Commercial |
$920.61
|
| Rate for Payer: PHP Commercial |
$954.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.75
|
| Rate for Payer: Priority Health HMO/PPO |
$976.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$752.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.97
|
| Rate for Payer: UHC Core |
$937.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$842.02
|
|
|
HC CARDIOVERSION
|
Facility
|
OP
|
$1,197.85
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
48000002
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$284.49 |
| Max. Negotiated Rate |
$1,078.06 |
| Rate for Payer: Aetna Commercial |
$1,018.17
|
| Rate for Payer: Aetna Medicare |
$311.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$374.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$374.33
|
| Rate for Payer: BCBS Complete |
$486.76
|
| Rate for Payer: BCBS MAPPO |
$299.46
|
| Rate for Payer: BCBS Trust/PPO |
$984.75
|
| Rate for Payer: BCN Commercial |
$931.33
|
| Rate for Payer: BCN Medicare Advantage |
$299.46
|
| Rate for Payer: Cash Price |
$958.28
|
| Rate for Payer: Cash Price |
$958.28
|
| Rate for Payer: Cofinity Commercial |
$1,030.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$958.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$299.46
|
| Rate for Payer: Healthscope Commercial |
$1,078.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$898.39
|
| Rate for Payer: Mclaren Medicaid |
$463.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.44
|
| Rate for Payer: Meridian Medicaid |
$486.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$344.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,018.17
|
| Rate for Payer: Nomi Health Commercial |
$982.24
|
| Rate for Payer: PACE Senior Care Partners |
$284.49
|
| Rate for Payer: PACE SWMI |
$299.46
|
| Rate for Payer: PHP Commercial |
$1,018.17
|
| Rate for Payer: PHP Medicare Advantage |
$299.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,042.13
|
| Rate for Payer: Priority Health Medicare |
$302.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$802.56
|
| Rate for Payer: Railroad Medicare Medicare |
$299.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,054.11
|
| Rate for Payer: UHC Core |
$1,000.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$299.46
|
| Rate for Payer: UHC Exchange |
$299.46
|
| Rate for Payer: UHC Medicare Advantage |
$299.46
|
| Rate for Payer: UHCCP Medicaid |
$463.55
|
| Rate for Payer: VA VA |
$299.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$898.39
|
|
|
HC CARDIOVERSION
|
Facility
|
IP
|
$1,197.85
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
48000002
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$778.60 |
| Max. Negotiated Rate |
$1,078.06 |
| Rate for Payer: Aetna Commercial |
$1,018.17
|
| Rate for Payer: BCBS Trust/PPO |
$977.80
|
| Rate for Payer: BCN Commercial |
$925.70
|
| Rate for Payer: Cash Price |
$958.28
|
| Rate for Payer: Cofinity Commercial |
$1,030.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$958.28
|
| Rate for Payer: Healthscope Commercial |
$1,078.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$898.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,018.17
|
| Rate for Payer: Nomi Health Commercial |
$982.24
|
| Rate for Payer: PHP Commercial |
$1,018.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,042.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$802.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,054.11
|
| Rate for Payer: UHC Core |
$1,000.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$898.39
|
|
|
HC CARDIOVERSION EXT
|
Facility
|
OP
|
$998.20
|
|
| Hospital Charge Code |
45000034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$237.07 |
| Max. Negotiated Rate |
$898.38 |
| Rate for Payer: Aetna Commercial |
$848.47
|
| Rate for Payer: Aetna Medicare |
$259.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.94
|
| Rate for Payer: BCBS Complete |
$399.28
|
| Rate for Payer: BCBS MAPPO |
$249.55
|
| Rate for Payer: BCBS Trust/PPO |
$820.62
|
| Rate for Payer: BCN Commercial |
$776.10
|
| Rate for Payer: BCN Medicare Advantage |
$249.55
|
| Rate for Payer: Cash Price |
$798.56
|
| Rate for Payer: Cofinity Commercial |
$858.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$798.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$249.55
|
| Rate for Payer: Healthscope Commercial |
$898.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$748.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$262.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$848.47
|
| Rate for Payer: Nomi Health Commercial |
$818.52
|
| Rate for Payer: PACE Senior Care Partners |
$237.07
|
| Rate for Payer: PACE SWMI |
$249.55
|
| Rate for Payer: PHP Commercial |
$848.47
|
| Rate for Payer: PHP Medicare Advantage |
$249.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.83
|
| Rate for Payer: Priority Health HMO/PPO |
$868.43
|
| Rate for Payer: Priority Health Medicare |
$252.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$668.79
|
| Rate for Payer: Railroad Medicare Medicare |
$249.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$878.42
|
| Rate for Payer: UHC Core |
$833.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$249.55
|
| Rate for Payer: UHC Exchange |
$249.55
|
| Rate for Payer: UHC Medicare Advantage |
$249.55
|
| Rate for Payer: VA VA |
$249.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$748.65
|
|
|
HC CARDIOVERSION EXT
|
Facility
|
IP
|
$998.20
|
|
| Hospital Charge Code |
45000034
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$648.83 |
| Max. Negotiated Rate |
$898.38 |
| Rate for Payer: Aetna Commercial |
$848.47
|
| Rate for Payer: BCBS Trust/PPO |
$814.83
|
| Rate for Payer: BCN Commercial |
$771.41
|
| Rate for Payer: Cash Price |
$798.56
|
| Rate for Payer: Cofinity Commercial |
$858.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$798.56
|
| Rate for Payer: Healthscope Commercial |
$898.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$748.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$848.47
|
| Rate for Payer: Nomi Health Commercial |
$818.52
|
| Rate for Payer: PHP Commercial |
$848.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.83
|
| Rate for Payer: Priority Health HMO/PPO |
$868.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$668.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$878.42
|
| Rate for Payer: UHC Core |
$833.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$748.65
|
|
|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$22.16
|
| Rate for Payer: BCBS MAPPO |
$13.26
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$41.25
|
| Rate for Payer: BCN Medicare Advantage |
$13.26
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.26
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$21.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$22.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.26
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.55
|
| Rate for Payer: Railroad Medicare Medicare |
$13.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.26
|
| Rate for Payer: UHC Exchange |
$13.26
|
| Rate for Payer: UHC Medicare Advantage |
$13.26
|
| Rate for Payer: UHCCP Medicaid |
$21.10
|
| Rate for Payer: VA VA |
$13.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC CAREGIVER HEALTH RISK ASSMT
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 96161
|
| Hospital Charge Code |
51000095
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$34.49 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.31
|
| Rate for Payer: BCN Commercial |
$41.00
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC CAREGIVER TRAINING 1ST 30 MIN
|
Facility
|
OP
|
$129.54
|
|
|
Service Code
|
CPT 97550
|
| Hospital Charge Code |
42000065
|
| Min. Negotiated Rate |
$30.77 |
| Max. Negotiated Rate |
$116.59 |
| Rate for Payer: Aetna Commercial |
$110.11
|
| Rate for Payer: Aetna Medicare |
$33.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.48
|
| Rate for Payer: BCBS Complete |
$51.82
|
| Rate for Payer: BCBS MAPPO |
$32.38
|
| Rate for Payer: BCBS Trust/PPO |
$106.49
|
| Rate for Payer: BCN Commercial |
$100.72
|
| Rate for Payer: BCN Medicare Advantage |
$32.38
|
| Rate for Payer: Cash Price |
$103.63
|
| Rate for Payer: Cofinity Commercial |
$111.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.38
|
| Rate for Payer: Healthscope Commercial |
$116.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.11
|
| Rate for Payer: Nomi Health Commercial |
$106.22
|
| Rate for Payer: PACE Senior Care Partners |
$30.77
|
| Rate for Payer: PACE SWMI |
$32.38
|
| Rate for Payer: PHP Commercial |
$110.11
|
| Rate for Payer: PHP Medicare Advantage |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.20
|
| Rate for Payer: Priority Health HMO/PPO |
$112.70
|
| Rate for Payer: Priority Health Medicare |
$32.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.79
|
| Rate for Payer: Railroad Medicare Medicare |
$32.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.00
|
| Rate for Payer: UHC Core |
$108.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.38
|
| Rate for Payer: UHC Exchange |
$32.38
|
| Rate for Payer: UHC Medicare Advantage |
$32.38
|
| Rate for Payer: VA VA |
$32.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.16
|
|
|
HC CAREGIVER TRAINING 1ST 30 MIN
|
Facility
|
IP
|
$129.54
|
|
|
Service Code
|
CPT 97550
|
| Hospital Charge Code |
42000065
|
| Min. Negotiated Rate |
$84.20 |
| Max. Negotiated Rate |
$116.59 |
| Rate for Payer: Aetna Commercial |
$110.11
|
| Rate for Payer: BCBS Trust/PPO |
$105.74
|
| Rate for Payer: BCN Commercial |
$100.11
|
| Rate for Payer: Cash Price |
$103.63
|
| Rate for Payer: Cofinity Commercial |
$111.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.63
|
| Rate for Payer: Healthscope Commercial |
$116.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.11
|
| Rate for Payer: Nomi Health Commercial |
$106.22
|
| Rate for Payer: PHP Commercial |
$110.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.20
|
| Rate for Payer: Priority Health HMO/PPO |
$112.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.00
|
| Rate for Payer: UHC Core |
$108.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.16
|
|
|
HC CAREGIVER TRAINING EA ADDL 15 MIN
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 97551
|
| Hospital Charge Code |
42000066
|
| Min. Negotiated Rate |
$39.78 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$49.96
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health HMO/PPO |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC CAREGIVER TRAINING EA ADDL 15 MIN
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 97551
|
| Hospital Charge Code |
42000066
|
| Min. Negotiated Rate |
$14.54 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$24.48
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$50.31
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health HMO/PPO |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.00
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Exchange |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.30
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Facility
|
OP
|
$82.19
|
|
|
Service Code
|
CPT 99484
|
| Hospital Charge Code |
51000107
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.52 |
| Max. Negotiated Rate |
$73.97 |
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: Aetna Medicare |
$21.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.68
|
| Rate for Payer: BCBS Complete |
$22.16
|
| Rate for Payer: BCBS MAPPO |
$20.55
|
| Rate for Payer: BCBS Trust/PPO |
$67.57
|
| Rate for Payer: BCN Commercial |
$63.90
|
| Rate for Payer: BCN Medicare Advantage |
$20.55
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.55
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.64
|
| Rate for Payer: Mclaren Medicaid |
$21.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.57
|
| Rate for Payer: Meridian Medicaid |
$22.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Nomi Health Commercial |
$67.40
|
| Rate for Payer: PACE Senior Care Partners |
$19.52
|
| Rate for Payer: PACE SWMI |
$20.55
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: PHP Medicare Advantage |
$20.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.42
|
| Rate for Payer: Priority Health HMO/PPO |
$71.51
|
| Rate for Payer: Priority Health Medicare |
$20.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.07
|
| Rate for Payer: Railroad Medicare Medicare |
$20.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.33
|
| Rate for Payer: UHC Core |
$68.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.55
|
| Rate for Payer: UHC Exchange |
$20.55
|
| Rate for Payer: UHC Medicare Advantage |
$20.55
|
| Rate for Payer: UHCCP Medicaid |
$21.10
|
| Rate for Payer: VA VA |
$20.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.64
|
|
|
HC CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS
|
Facility
|
IP
|
$82.19
|
|
|
Service Code
|
CPT 99484
|
| Hospital Charge Code |
51000107
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$53.42 |
| Max. Negotiated Rate |
$73.97 |
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: BCBS Trust/PPO |
$67.09
|
| Rate for Payer: BCN Commercial |
$63.52
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Nomi Health Commercial |
$67.40
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.42
|
| Rate for Payer: Priority Health HMO/PPO |
$71.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.33
|
| Rate for Payer: UHC Core |
$68.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.64
|
|
|
HC CARNITINE
|
Facility
|
OP
|
$59.16
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.20 |
| Max. Negotiated Rate |
$53.24 |
| Rate for Payer: Aetna Commercial |
$50.29
|
| Rate for Payer: Aetna Medicare |
$15.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.49
|
| Rate for Payer: BCBS Complete |
$12.81
|
| Rate for Payer: BCBS MAPPO |
$14.79
|
| Rate for Payer: BCBS Trust/PPO |
$48.64
|
| Rate for Payer: BCN Commercial |
$46.00
|
| Rate for Payer: BCN Medicare Advantage |
$14.79
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$50.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.79
|
| Rate for Payer: Healthscope Commercial |
$53.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.37
|
| Rate for Payer: Mclaren Medicaid |
$12.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.53
|
| Rate for Payer: Meridian Medicaid |
$12.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.29
|
| Rate for Payer: Nomi Health Commercial |
$48.51
|
| Rate for Payer: PACE Senior Care Partners |
$14.05
|
| Rate for Payer: PACE SWMI |
$14.79
|
| Rate for Payer: PHP Commercial |
$50.29
|
| Rate for Payer: PHP Medicare Advantage |
$14.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.45
|
| Rate for Payer: Priority Health HMO/PPO |
$51.47
|
| Rate for Payer: Priority Health Medicare |
$14.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.64
|
| Rate for Payer: Railroad Medicare Medicare |
$14.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.06
|
| Rate for Payer: UHC Core |
$49.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.79
|
| Rate for Payer: UHC Exchange |
$14.79
|
| Rate for Payer: UHC Medicare Advantage |
$14.79
|
| Rate for Payer: UHCCP Medicaid |
$12.20
|
| Rate for Payer: VA VA |
$14.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.37
|
|
|
HC CARNITINE
|
Facility
|
IP
|
$59.16
|
|
|
Service Code
|
CPT 82379
|
| Hospital Charge Code |
30100136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.45 |
| Max. Negotiated Rate |
$53.24 |
| Rate for Payer: Aetna Commercial |
$50.29
|
| Rate for Payer: BCBS Trust/PPO |
$48.29
|
| Rate for Payer: BCN Commercial |
$45.72
|
| Rate for Payer: Cash Price |
$47.33
|
| Rate for Payer: Cofinity Commercial |
$50.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.33
|
| Rate for Payer: Healthscope Commercial |
$53.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.29
|
| Rate for Payer: Nomi Health Commercial |
$48.51
|
| Rate for Payer: PHP Commercial |
$50.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.45
|
| Rate for Payer: Priority Health HMO/PPO |
$51.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.06
|
| Rate for Payer: UHC Core |
$49.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.37
|
|
|
HC CAR OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$34.46 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna Medicare |
$37.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.34
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS MAPPO |
$36.27
|
| Rate for Payer: BCBS Trust/PPO |
$119.27
|
| Rate for Payer: BCN Commercial |
$112.80
|
| Rate for Payer: BCN Medicare Advantage |
$36.27
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.27
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: PACE Senior Care Partners |
$34.46
|
| Rate for Payer: PACE SWMI |
$36.27
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: PHP Medicare Advantage |
$36.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO |
$126.22
|
| Rate for Payer: Priority Health Medicare |
$36.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.20
|
| Rate for Payer: Railroad Medicare Medicare |
$36.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.67
|
| Rate for Payer: UHC Core |
$121.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.27
|
| Rate for Payer: UHC Exchange |
$36.27
|
| Rate for Payer: UHC Medicare Advantage |
$36.27
|
| Rate for Payer: VA VA |
$36.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC CAR OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200010
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: BCBS Trust/PPO |
$118.43
|
| Rate for Payer: BCN Commercial |
$112.12
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO |
$126.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.67
|
| Rate for Payer: UHC Core |
$121.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC CAROTENE
|
Facility
|
OP
|
$150.96
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
30100137
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.67 |
| Max. Negotiated Rate |
$135.86 |
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna Medicare |
$39.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.18
|
| Rate for Payer: BCBS Complete |
$7.00
|
| Rate for Payer: BCBS MAPPO |
$37.74
|
| Rate for Payer: BCBS Trust/PPO |
$124.10
|
| Rate for Payer: BCN Commercial |
$117.37
|
| Rate for Payer: BCN Medicare Advantage |
$37.74
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cofinity Commercial |
$129.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.74
|
| Rate for Payer: Healthscope Commercial |
$135.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.22
|
| Rate for Payer: Mclaren Medicaid |
$6.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.63
|
| Rate for Payer: Meridian Medicaid |
$7.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.32
|
| Rate for Payer: Nomi Health Commercial |
$123.79
|
| Rate for Payer: PACE Senior Care Partners |
$35.85
|
| Rate for Payer: PACE SWMI |
$37.74
|
| Rate for Payer: PHP Commercial |
$128.32
|
| Rate for Payer: PHP Medicare Advantage |
$37.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.12
|
| Rate for Payer: Priority Health HMO/PPO |
$131.34
|
| Rate for Payer: Priority Health Medicare |
$38.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.14
|
| Rate for Payer: Railroad Medicare Medicare |
$37.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.84
|
| Rate for Payer: UHC Core |
$126.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.74
|
| Rate for Payer: UHC Exchange |
$37.74
|
| Rate for Payer: UHC Medicare Advantage |
$37.74
|
| Rate for Payer: UHCCP Medicaid |
$6.67
|
| Rate for Payer: VA VA |
$37.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.22
|
|
