|
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 |
$1,078.07 |
| 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 |
$496.81
|
| 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 |
$1,078.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$898.39
|
| Rate for Payer: Mclaren Medicaid |
$473.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$314.44
|
| Rate for Payer: Meridian Medicaid |
$496.81
|
| 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 |
$473.12
|
| 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 |
$473.12
|
| Rate for Payer: VA VA |
$299.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$898.39
|
|
|
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 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 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 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 |
$22.62
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$41.25
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| 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 |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$21.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$22.62
|
| 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 |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.54
|
| 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 |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.27
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$21.54
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
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 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 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 |
$16.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.59
|
| 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
|
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 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 |
$22.62
|
| 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 |
$21.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.57
|
| Rate for Payer: Meridian Medicaid |
$22.62
|
| 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 |
$21.54
|
| 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 |
$21.54
|
| Rate for Payer: VA VA |
$20.55
|
| 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
|
IP
|
$150.96
|
|
|
Service Code
|
CPT 82380
|
| Hospital Charge Code |
30100137
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$98.12 |
| Max. Negotiated Rate |
$135.86 |
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: BCBS Trust/PPO |
$123.23
|
| Rate for Payer: BCN Commercial |
$116.66
|
| 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: Healthscope Commercial |
$135.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.32
|
| Rate for Payer: Nomi Health Commercial |
$123.79
|
| Rate for Payer: PHP Commercial |
$128.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.12
|
| Rate for Payer: Priority Health HMO/PPO |
$131.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.84
|
| Rate for Payer: UHC Core |
$126.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.22
|
|
|
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 |
$47.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.17
|
| 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
|
|
|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
OP
|
$726.53
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.88 |
| Max. Negotiated Rate |
$653.88 |
| Rate for Payer: Aetna Commercial |
$617.55
|
| Rate for Payer: Aetna Medicare |
$188.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$227.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$227.04
|
| Rate for Payer: BCBS Complete |
$80.73
|
| Rate for Payer: BCBS MAPPO |
$181.63
|
| Rate for Payer: BCBS Trust/PPO |
$597.28
|
| Rate for Payer: BCN Commercial |
$564.88
|
| Rate for Payer: BCN Medicare Advantage |
$181.63
|
| Rate for Payer: Cash Price |
$581.22
|
| Rate for Payer: Cash Price |
$581.22
|
| Rate for Payer: Cofinity Commercial |
$624.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$581.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.63
|
| Rate for Payer: Healthscope Commercial |
$653.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$544.90
|
| Rate for Payer: Mclaren Medicaid |
$76.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.71
|
| Rate for Payer: Meridian Medicaid |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$208.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$617.55
|
| Rate for Payer: Nomi Health Commercial |
$595.75
|
| Rate for Payer: PACE Senior Care Partners |
$172.55
|
| Rate for Payer: PACE SWMI |
$181.63
|
| Rate for Payer: PHP Commercial |
$617.55
|
| Rate for Payer: PHP Medicare Advantage |
$181.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.24
|
| Rate for Payer: Priority Health HMO/PPO |
$632.08
|
| Rate for Payer: Priority Health Medicare |
$183.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$486.78
|
| Rate for Payer: Railroad Medicare Medicare |
$181.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$639.35
|
| Rate for Payer: UHC Core |
$606.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$181.63
|
| Rate for Payer: UHC Exchange |
$181.63
|
| Rate for Payer: UHC Medicare Advantage |
$181.63
|
| Rate for Payer: UHCCP Medicaid |
$76.88
|
| Rate for Payer: VA VA |
$181.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$544.90
|
|
|
HC CAROTID/VERTEBRAL LIMITED
|
Facility
|
IP
|
$726.53
|
|
|
Service Code
|
CPT 93882
|
| Hospital Charge Code |
40200054
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$472.24 |
| Max. Negotiated Rate |
$653.88 |
| Rate for Payer: Aetna Commercial |
$617.55
|
| Rate for Payer: BCBS Trust/PPO |
$593.07
|
| Rate for Payer: BCN Commercial |
$561.46
|
| Rate for Payer: Cash Price |
$581.22
|
| Rate for Payer: Cofinity Commercial |
$624.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$581.22
|
| Rate for Payer: Healthscope Commercial |
$653.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$544.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$617.55
|
| Rate for Payer: Nomi Health Commercial |
$595.75
|
| Rate for Payer: PHP Commercial |
$617.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.24
|
| Rate for Payer: Priority Health HMO/PPO |
$632.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$486.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$639.35
|
| Rate for Payer: UHC Core |
$606.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$544.90
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
IP
|
$1,382.09
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$898.36 |
| Max. Negotiated Rate |
$1,243.88 |
| Rate for Payer: Aetna Commercial |
$1,174.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.20
|
| Rate for Payer: BCN Commercial |
$1,068.08
|
| Rate for Payer: Cash Price |
$1,105.67
|
| Rate for Payer: Cofinity Commercial |
$1,188.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,105.67
|
| Rate for Payer: Healthscope Commercial |
$1,243.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,036.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,174.78
|
| Rate for Payer: Nomi Health Commercial |
$1,133.31
|
| Rate for Payer: PHP Commercial |
$1,174.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.36
|
| Rate for Payer: Priority Health HMO/PPO |
$1,202.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$926.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,216.24
|
| Rate for Payer: UHC Core |
$1,154.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,036.57
|
|
|
HC CAROTID/VERTEBRAL ULTRASOUND
|
Facility
|
OP
|
$1,382.09
|
|
|
Service Code
|
CPT 93880
|
| Hospital Charge Code |
92100001
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$174.76 |
| Max. Negotiated Rate |
$1,243.88 |
| Rate for Payer: Aetna Commercial |
$1,174.78
|
| Rate for Payer: Aetna Medicare |
$359.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$431.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$431.90
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$345.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,136.22
|
| Rate for Payer: BCN Commercial |
$1,074.57
|
| Rate for Payer: BCN Medicare Advantage |
$345.52
|
| Rate for Payer: Cash Price |
$1,105.67
|
| Rate for Payer: Cash Price |
$1,105.67
|
| Rate for Payer: Cofinity Commercial |
$1,188.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,105.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.52
|
| Rate for Payer: Healthscope Commercial |
$1,243.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,036.57
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.80
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$397.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,174.78
|
| Rate for Payer: Nomi Health Commercial |
$1,133.31
|
| Rate for Payer: PACE Senior Care Partners |
$328.25
|
| Rate for Payer: PACE SWMI |
$345.52
|
| Rate for Payer: PHP Commercial |
$1,174.78
|
| Rate for Payer: PHP Medicare Advantage |
$345.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.36
|
| Rate for Payer: Priority Health HMO/PPO |
$1,202.42
|
| Rate for Payer: Priority Health Medicare |
$348.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$926.00
|
| Rate for Payer: Railroad Medicare Medicare |
$345.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,216.24
|
| Rate for Payer: UHC Core |
$1,154.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.52
|
| Rate for Payer: UHC Exchange |
$345.52
|
| Rate for Payer: UHC Medicare Advantage |
$345.52
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$345.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,036.57
|
|
|
HC CASHEW IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CASHEW IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200030
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CASSETTES QUEST
|
Facility
|
OP
|
$76.50
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.17 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$30.60
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$62.89
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Exchange |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.12
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC CASSETTES QUEST
|
Facility
|
IP
|
$76.50
|
|
| Hospital Charge Code |
27000458
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$49.73 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: BCBS Trust/PPO |
$62.45
|
| Rate for Payer: BCN Commercial |
$59.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
