|
HC HALO RING & VEST
|
Facility
|
IP
|
$6,162.09
|
|
| Hospital Charge Code |
27000084
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3,758.26 |
| Max. Negotiated Rate |
$5,545.88 |
| Rate for Payer: Aetna Commercial |
$5,237.78
|
| Rate for Payer: BCBS Trust/PPO |
$4,762.06
|
| Rate for Payer: BCN Commercial |
$4,762.06
|
| Rate for Payer: Cash Price |
$4,929.67
|
| Rate for Payer: Cofinity Commercial |
$5,299.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,929.67
|
| Rate for Payer: Healthscope Commercial |
$5,545.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,621.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,237.78
|
| Rate for Payer: PHP Commercial |
$5,237.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,313.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,361.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,758.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,422.64
|
| Rate for Payer: UHC Core |
$5,145.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,621.57
|
|
|
HC HALO VEST APPLICATION
|
Facility
|
OP
|
$5,653.12
|
|
| Hospital Charge Code |
27000086
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,342.62 |
| Max. Negotiated Rate |
$5,087.81 |
| Rate for Payer: Aetna Commercial |
$4,805.15
|
| Rate for Payer: Aetna Medicare |
$1,469.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,766.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,766.60
|
| Rate for Payer: BCBS Complete |
$2,261.25
|
| Rate for Payer: BCBS MAPPO |
$1,413.28
|
| Rate for Payer: BCBS Trust/PPO |
$4,395.30
|
| Rate for Payer: BCN Commercial |
$4,395.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,413.28
|
| Rate for Payer: Cash Price |
$4,522.50
|
| Rate for Payer: Cofinity Commercial |
$4,861.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,522.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,413.28
|
| Rate for Payer: Healthscope Commercial |
$5,087.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,239.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,483.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,625.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,805.15
|
| Rate for Payer: PACE Senior Care Partners |
$1,342.62
|
| Rate for Payer: PACE SWMI |
$1,413.28
|
| Rate for Payer: PHP Commercial |
$4,805.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,413.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,957.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,918.21
|
| Rate for Payer: Priority Health Medicare |
$1,413.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,447.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,413.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,974.75
|
| Rate for Payer: UHC Core |
$4,720.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,413.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,455.68
|
| Rate for Payer: VA VA |
$1,413.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,239.84
|
|
|
HC HALO VEST APPLICATION
|
Facility
|
IP
|
$5,653.12
|
|
| Hospital Charge Code |
27000086
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3,447.84 |
| Max. Negotiated Rate |
$5,087.81 |
| Rate for Payer: Aetna Commercial |
$4,805.15
|
| Rate for Payer: BCBS Trust/PPO |
$4,368.73
|
| Rate for Payer: BCN Commercial |
$4,368.73
|
| Rate for Payer: Cash Price |
$4,522.50
|
| Rate for Payer: Cofinity Commercial |
$4,861.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,522.50
|
| Rate for Payer: Healthscope Commercial |
$5,087.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,239.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,805.15
|
| Rate for Payer: PHP Commercial |
$4,805.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,957.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,918.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,447.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,974.75
|
| Rate for Payer: UHC Core |
$4,720.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,239.84
|
|
|
HC HAPTOGLOGIN
|
Facility
|
IP
|
$83.00
|
|
|
Service Code
|
CPT 83010
|
| Hospital Charge Code |
30100234
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.62 |
| Max. Negotiated Rate |
$74.70 |
| Rate for Payer: Aetna Commercial |
$70.55
|
| Rate for Payer: BCBS Trust/PPO |
$64.14
|
| Rate for Payer: BCN Commercial |
$64.14
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cofinity Commercial |
$71.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.40
|
| Rate for Payer: Healthscope Commercial |
$74.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.55
|
| Rate for Payer: PHP Commercial |
$70.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.04
|
| Rate for Payer: UHC Core |
$69.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.25
|
|
|
HC HAPTOGLOGIN
|
Facility
|
OP
|
$83.00
|
|
|
Service Code
|
CPT 83010
|
| Hospital Charge Code |
30100234
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$74.70 |
| Rate for Payer: Aetna Commercial |
$70.55
|
| Rate for Payer: Aetna Medicare |
$21.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.94
|
| Rate for Payer: BCBS Complete |
$9.75
|
| Rate for Payer: BCBS MAPPO |
$20.75
|
| Rate for Payer: BCBS Trust/PPO |
$64.53
|
| Rate for Payer: BCN Commercial |
$64.53
|
| Rate for Payer: BCN Medicare Advantage |
$20.75
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cofinity Commercial |
$71.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.75
|
| Rate for Payer: Healthscope Commercial |
$74.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.25
|
| Rate for Payer: Mclaren Medicaid |
$9.28
|
| Rate for Payer: Meridian Medicaid |
$9.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.55
|
| Rate for Payer: PACE Senior Care Partners |
$19.71
|
| Rate for Payer: PACE SWMI |
$20.75
|
| Rate for Payer: PHP Commercial |
$70.55
|
| Rate for Payer: PHP Medicare Advantage |
$20.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.21
|
| Rate for Payer: Priority Health Medicare |
$20.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.62
|
| Rate for Payer: Railroad Medicare Medicare |
$20.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.04
|
| Rate for Payer: UHC Core |
$69.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.75
|
| Rate for Payer: UHC Medicare Advantage |
$21.37
|
| Rate for Payer: VA VA |
$20.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.25
|
|
|
HC HAZELNUT FILBERT IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200043
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC HAZELNUT FILBERT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200043
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC HBO PER 30 MINUTES
|
Facility
|
OP
|
$641.40
|
|
|
Service Code
|
HCPCS G0277
|
| Hospital Charge Code |
41300001
|
|
Hospital Revenue Code
|
413
|
| Min. Negotiated Rate |
$91.02 |
| Max. Negotiated Rate |
$577.26 |
| Rate for Payer: Aetna Commercial |
$545.19
|
| Rate for Payer: Aetna Medicare |
$166.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$200.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$200.44
|
| Rate for Payer: BCBS Complete |
$95.58
|
| Rate for Payer: BCBS MAPPO |
$160.35
|
| Rate for Payer: BCBS Trust/PPO |
$498.69
|
| Rate for Payer: BCN Commercial |
$498.69
|
| Rate for Payer: BCN Medicare Advantage |
$160.35
|
| Rate for Payer: Cash Price |
$513.12
|
| Rate for Payer: Cash Price |
$513.12
|
| Rate for Payer: Cofinity Commercial |
$551.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$513.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.35
|
| Rate for Payer: Healthscope Commercial |
$577.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$481.05
|
| Rate for Payer: Mclaren Medicaid |
$91.02
|
| Rate for Payer: Meridian Medicaid |
$95.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$168.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$184.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$545.19
|
| Rate for Payer: PACE Senior Care Partners |
$152.33
|
| Rate for Payer: PACE SWMI |
$160.35
|
| Rate for Payer: PHP Commercial |
$545.19
|
| Rate for Payer: PHP Medicare Advantage |
$160.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$448.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$558.02
|
| Rate for Payer: Priority Health Medicare |
$160.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$391.19
|
| Rate for Payer: Railroad Medicare Medicare |
$160.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.43
|
| Rate for Payer: UHC Core |
$535.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$160.35
|
| Rate for Payer: UHC Medicare Advantage |
$165.16
|
| Rate for Payer: VA VA |
$160.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$481.05
|
|
|
HC HBO PER 30 MINUTES
|
Facility
|
IP
|
$641.40
|
|
|
Service Code
|
HCPCS G0277
|
| Hospital Charge Code |
41300001
|
|
Hospital Revenue Code
|
413
|
| Min. Negotiated Rate |
$391.19 |
| Max. Negotiated Rate |
$577.26 |
| Rate for Payer: Aetna Commercial |
$545.19
|
| Rate for Payer: BCBS Trust/PPO |
$495.67
|
| Rate for Payer: BCN Commercial |
$495.67
|
| Rate for Payer: Cash Price |
$513.12
|
| Rate for Payer: Cofinity Commercial |
$551.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$513.12
|
| Rate for Payer: Healthscope Commercial |
$577.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$481.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$545.19
|
| Rate for Payer: PHP Commercial |
$545.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$448.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$558.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$391.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.43
|
| Rate for Payer: UHC Core |
$535.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$481.05
|
|
|
HC HBO TCPO2 ARTERIAL STUDY COMPLETE
|
Facility
|
OP
|
$819.04
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100005
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$102.47 |
| Max. Negotiated Rate |
$737.14 |
| Rate for Payer: Aetna Commercial |
$696.18
|
| Rate for Payer: Aetna Medicare |
$212.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$255.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$255.95
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$204.76
|
| Rate for Payer: BCBS Trust/PPO |
$636.80
|
| Rate for Payer: BCN Commercial |
$636.80
|
| Rate for Payer: BCN Medicare Advantage |
$204.76
|
| Rate for Payer: Cash Price |
$655.23
|
| Rate for Payer: Cash Price |
$655.23
|
| Rate for Payer: Cofinity Commercial |
$704.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.76
|
| Rate for Payer: Healthscope Commercial |
$737.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$614.28
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$215.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$235.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$696.18
|
| Rate for Payer: PACE Senior Care Partners |
$194.52
|
| Rate for Payer: PACE SWMI |
$204.76
|
| Rate for Payer: PHP Commercial |
$696.18
|
| Rate for Payer: PHP Medicare Advantage |
$204.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$712.56
|
| Rate for Payer: Priority Health Medicare |
$204.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$499.53
|
| Rate for Payer: Railroad Medicare Medicare |
$204.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$720.76
|
| Rate for Payer: UHC Core |
$683.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.76
|
| Rate for Payer: UHC Medicare Advantage |
$210.90
|
| Rate for Payer: VA VA |
$204.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$614.28
|
|
|
HC HBO TCPO2 ARTERIAL STUDY COMPLETE
|
Facility
|
IP
|
$819.04
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100005
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$499.53 |
| Max. Negotiated Rate |
$737.14 |
| Rate for Payer: Aetna Commercial |
$696.18
|
| Rate for Payer: BCBS Trust/PPO |
$632.95
|
| Rate for Payer: BCN Commercial |
$632.95
|
| Rate for Payer: Cash Price |
$655.23
|
| Rate for Payer: Cofinity Commercial |
$704.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$655.23
|
| Rate for Payer: Healthscope Commercial |
$737.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$614.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$696.18
|
| Rate for Payer: PHP Commercial |
$696.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$712.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$499.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$720.76
|
| Rate for Payer: UHC Core |
$683.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$614.28
|
|
|
HC HBO TCPO2 ARTERIAL STUDY UNILATERAL OR LIMITED
|
Facility
|
OP
|
$525.25
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100033
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$83.80 |
| Max. Negotiated Rate |
$472.72 |
| Rate for Payer: Aetna Commercial |
$446.46
|
| Rate for Payer: Aetna Medicare |
$136.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$164.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$164.14
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$131.31
|
| Rate for Payer: BCBS Trust/PPO |
$408.38
|
| Rate for Payer: BCN Commercial |
$408.38
|
| Rate for Payer: BCN Medicare Advantage |
$131.31
|
| Rate for Payer: Cash Price |
$420.20
|
| Rate for Payer: Cash Price |
$420.20
|
| Rate for Payer: Cofinity Commercial |
$451.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.31
|
| Rate for Payer: Healthscope Commercial |
$472.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.94
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$151.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$446.46
|
| Rate for Payer: PACE Senior Care Partners |
$124.75
|
| Rate for Payer: PACE SWMI |
$131.31
|
| Rate for Payer: PHP Commercial |
$446.46
|
| Rate for Payer: PHP Medicare Advantage |
$131.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.97
|
| Rate for Payer: Priority Health Medicare |
$131.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$320.35
|
| Rate for Payer: Railroad Medicare Medicare |
$131.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.22
|
| Rate for Payer: UHC Core |
$438.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.31
|
| Rate for Payer: UHC Medicare Advantage |
$135.25
|
| Rate for Payer: VA VA |
$131.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.94
|
|
|
HC HBO TCPO2 ARTERIAL STUDY UNILATERAL OR LIMITED
|
Facility
|
IP
|
$525.25
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100033
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$320.35 |
| Max. Negotiated Rate |
$472.72 |
| Rate for Payer: Aetna Commercial |
$446.46
|
| Rate for Payer: BCBS Trust/PPO |
$405.91
|
| Rate for Payer: BCN Commercial |
$405.91
|
| Rate for Payer: Cash Price |
$420.20
|
| Rate for Payer: Cofinity Commercial |
$451.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.20
|
| Rate for Payer: Healthscope Commercial |
$472.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$446.46
|
| Rate for Payer: PHP Commercial |
$446.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$320.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.22
|
| Rate for Payer: UHC Core |
$438.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.94
|
|
|
HC HCCORO/CABG ANGIOS ONLY
|
Facility
|
IP
|
$6,358.90
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
48100014
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,878.29 |
| Max. Negotiated Rate |
$5,723.01 |
| Rate for Payer: Aetna Commercial |
$5,405.06
|
| Rate for Payer: BCBS Trust/PPO |
$4,914.16
|
| Rate for Payer: BCN Commercial |
$4,914.16
|
| Rate for Payer: Cash Price |
$5,087.12
|
| Rate for Payer: Cofinity Commercial |
$5,468.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,087.12
|
| Rate for Payer: Healthscope Commercial |
$5,723.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,769.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,405.06
|
| Rate for Payer: PHP Commercial |
$5,405.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,451.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,532.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,878.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,595.83
|
| Rate for Payer: UHC Core |
$5,309.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,769.18
|
|
|
HC HCCORO/CABG ANGIOS ONLY
|
Facility
|
OP
|
$6,358.90
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
48100014
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,510.24 |
| Max. Negotiated Rate |
$5,723.01 |
| Rate for Payer: Aetna Commercial |
$5,405.06
|
| Rate for Payer: Aetna Medicare |
$1,653.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,987.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,987.16
|
| Rate for Payer: BCBS Complete |
$2,244.47
|
| Rate for Payer: BCBS MAPPO |
$1,589.72
|
| Rate for Payer: BCBS Trust/PPO |
$4,944.04
|
| Rate for Payer: BCN Commercial |
$4,944.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,589.72
|
| Rate for Payer: Cash Price |
$5,087.12
|
| Rate for Payer: Cash Price |
$5,087.12
|
| Rate for Payer: Cofinity Commercial |
$5,468.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,087.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,589.72
|
| Rate for Payer: Healthscope Commercial |
$5,723.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,769.18
|
| Rate for Payer: Mclaren Medicaid |
$2,137.59
|
| Rate for Payer: Meridian Medicaid |
$2,244.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,669.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,828.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,405.06
|
| Rate for Payer: PACE Senior Care Partners |
$1,510.24
|
| Rate for Payer: PACE SWMI |
$1,589.72
|
| Rate for Payer: PHP Commercial |
$5,405.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,589.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,137.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,451.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,532.24
|
| Rate for Payer: Priority Health Medicare |
$1,589.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,878.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1,589.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,595.83
|
| Rate for Payer: UHC Core |
$5,309.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,589.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,637.42
|
| Rate for Payer: VA VA |
$1,589.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,769.18
|
|
|
HC HCG SERUM QUANTITATIVE
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
30100465
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.95 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: BCBS Trust/PPO |
$48.08
|
| Rate for Payer: BCN Commercial |
$48.08
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC HCG SERUM QUANTITATIVE
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
30100465
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.11 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.44
|
| Rate for Payer: BCBS Complete |
$11.66
|
| Rate for Payer: BCBS MAPPO |
$15.56
|
| Rate for Payer: BCBS Trust/PPO |
$48.38
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$15.56
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.56
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Mclaren Medicaid |
$11.11
|
| Rate for Payer: Meridian Medicaid |
$11.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.89
|
| Rate for Payer: PACE Senior Care Partners |
$14.78
|
| Rate for Payer: PACE SWMI |
$15.56
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: PHP Medicare Advantage |
$15.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.13
|
| Rate for Payer: Priority Health Medicare |
$15.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.95
|
| Rate for Payer: Railroad Medicare Medicare |
$15.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.56
|
| Rate for Payer: UHC Medicare Advantage |
$16.02
|
| Rate for Payer: VA VA |
$15.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC HCV GENOTYPE RESOLUTION
|
Facility
|
IP
|
$395.58
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
30600262
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$241.26 |
| Max. Negotiated Rate |
$356.02 |
| Rate for Payer: Aetna Commercial |
$336.24
|
| Rate for Payer: BCBS Trust/PPO |
$305.70
|
| Rate for Payer: BCN Commercial |
$305.70
|
| Rate for Payer: Cash Price |
$316.46
|
| Rate for Payer: Cofinity Commercial |
$340.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.46
|
| Rate for Payer: Healthscope Commercial |
$356.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$296.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$336.24
|
| Rate for Payer: PHP Commercial |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.11
|
| Rate for Payer: UHC Core |
$330.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$296.68
|
|
|
HC HCV GENOTYPE RESOLUTION
|
Facility
|
OP
|
$395.58
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
30600262
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$93.95 |
| Max. Negotiated Rate |
$356.02 |
| Rate for Payer: Aetna Commercial |
$336.24
|
| Rate for Payer: Aetna Medicare |
$102.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.62
|
| Rate for Payer: BCBS Complete |
$199.50
|
| Rate for Payer: BCBS MAPPO |
$98.90
|
| Rate for Payer: BCBS Trust/PPO |
$307.56
|
| Rate for Payer: BCN Commercial |
$307.56
|
| Rate for Payer: BCN Medicare Advantage |
$98.90
|
| Rate for Payer: Cash Price |
$316.46
|
| Rate for Payer: Cash Price |
$316.46
|
| Rate for Payer: Cofinity Commercial |
$340.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.90
|
| Rate for Payer: Healthscope Commercial |
$356.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$296.68
|
| Rate for Payer: Mclaren Medicaid |
$190.00
|
| Rate for Payer: Meridian Medicaid |
$199.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$103.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$336.24
|
| Rate for Payer: PACE Senior Care Partners |
$93.95
|
| Rate for Payer: PACE SWMI |
$98.90
|
| Rate for Payer: PHP Commercial |
$336.24
|
| Rate for Payer: PHP Medicare Advantage |
$98.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.15
|
| Rate for Payer: Priority Health Medicare |
$98.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.26
|
| Rate for Payer: Railroad Medicare Medicare |
$98.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.11
|
| Rate for Payer: UHC Core |
$330.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.90
|
| Rate for Payer: UHC Medicare Advantage |
$101.86
|
| Rate for Payer: VA VA |
$98.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$296.68
|
|
|
HC HDL CHOLESTEROL
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100282
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.04 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.56
|
| Rate for Payer: BCBS Complete |
$6.35
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$23.79
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.65
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$6.04
|
| Rate for Payer: Meridian Medicaid |
$6.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PACE Senior Care Partners |
$7.27
|
| Rate for Payer: PACE SWMI |
$7.65
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.62
|
| Rate for Payer: Priority Health Medicare |
$7.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.66
|
| Rate for Payer: Railroad Medicare Medicare |
$7.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.65
|
| Rate for Payer: UHC Medicare Advantage |
$7.88
|
| Rate for Payer: VA VA |
$7.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC HDL CHOLESTEROL
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100282
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.66 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$23.65
|
| Rate for Payer: BCN Commercial |
$23.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC HDL CHOLESTEROL LMPP
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100690
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$6.35
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$6.04
|
| Rate for Payer: Meridian Medicaid |
$6.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC HDL CHOLESTEROL LMPP
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100690
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC HDR 1 CHANNEL
|
Facility
|
OP
|
$533.00
|
|
|
Service Code
|
CPT 77770
|
| Hospital Charge Code |
33300055
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$126.59 |
| Max. Negotiated Rate |
$493.85 |
| Rate for Payer: Aetna Commercial |
$453.05
|
| Rate for Payer: Aetna Commercial |
$1,658.05
|
| Rate for Payer: Aetna Medicare |
$138.58
|
| Rate for Payer: Aetna Medicare |
$507.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$166.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$609.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$166.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$609.58
|
| Rate for Payer: BCBS Complete |
$493.85
|
| Rate for Payer: BCBS Complete |
$493.85
|
| Rate for Payer: BCBS MAPPO |
$133.25
|
| Rate for Payer: BCBS MAPPO |
$487.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,516.63
|
| Rate for Payer: BCBS Trust/PPO |
$414.41
|
| Rate for Payer: BCN Commercial |
$1,516.63
|
| Rate for Payer: BCN Commercial |
$414.41
|
| Rate for Payer: BCN Medicare Advantage |
$487.66
|
| Rate for Payer: BCN Medicare Advantage |
$133.25
|
| Rate for Payer: Cash Price |
$1,560.52
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$1,560.52
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cofinity Commercial |
$1,677.56
|
| Rate for Payer: Cofinity Commercial |
$458.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,560.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$487.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.25
|
| Rate for Payer: Healthscope Commercial |
$479.70
|
| Rate for Payer: Healthscope Commercial |
$1,755.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,462.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$399.75
|
| Rate for Payer: Mclaren Medicaid |
$470.33
|
| Rate for Payer: Mclaren Medicaid |
$470.33
|
| Rate for Payer: Meridian Medicaid |
$493.85
|
| Rate for Payer: Meridian Medicaid |
$493.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$512.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$139.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$153.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$560.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$453.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,658.05
|
| Rate for Payer: PACE Senior Care Partners |
$463.28
|
| Rate for Payer: PACE Senior Care Partners |
$126.59
|
| Rate for Payer: PACE SWMI |
$487.66
|
| Rate for Payer: PACE SWMI |
$133.25
|
| Rate for Payer: PHP Commercial |
$453.05
|
| Rate for Payer: PHP Commercial |
$1,658.05
|
| Rate for Payer: PHP Medicare Advantage |
$133.25
|
| Rate for Payer: PHP Medicare Advantage |
$487.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,365.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$463.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,697.07
|
| Rate for Payer: Priority Health Medicare |
$133.25
|
| Rate for Payer: Priority Health Medicare |
$487.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,189.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.08
|
| Rate for Payer: Railroad Medicare Medicare |
$133.25
|
| Rate for Payer: Railroad Medicare Medicare |
$487.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,716.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$469.04
|
| Rate for Payer: UHC Core |
$1,628.79
|
| Rate for Payer: UHC Core |
$445.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$487.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.25
|
| Rate for Payer: UHC Medicare Advantage |
$502.29
|
| Rate for Payer: UHC Medicare Advantage |
$137.25
|
| Rate for Payer: VA VA |
$487.66
|
| Rate for Payer: VA VA |
$133.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,462.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$399.75
|
|
|
HC HDR 1 CHANNEL
|
Facility
|
IP
|
$1,950.65
|
|
|
Service Code
|
CPT 77770
|
| Hospital Charge Code |
33300055
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,189.70 |
| Max. Negotiated Rate |
$1,755.58 |
| Rate for Payer: Aetna Commercial |
$1,658.05
|
| Rate for Payer: Aetna Commercial |
$453.05
|
| Rate for Payer: BCBS Trust/PPO |
$411.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,507.46
|
| Rate for Payer: BCN Commercial |
$411.90
|
| Rate for Payer: BCN Commercial |
$1,507.46
|
| Rate for Payer: Cash Price |
$426.40
|
| Rate for Payer: Cash Price |
$1,560.52
|
| Rate for Payer: Cofinity Commercial |
$1,677.56
|
| Rate for Payer: Cofinity Commercial |
$458.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,560.52
|
| Rate for Payer: Healthscope Commercial |
$479.70
|
| Rate for Payer: Healthscope Commercial |
$1,755.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,462.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$399.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$453.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,658.05
|
| Rate for Payer: PHP Commercial |
$453.05
|
| Rate for Payer: PHP Commercial |
$1,658.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,365.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,697.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$463.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,189.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,716.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$469.04
|
| Rate for Payer: UHC Core |
$1,628.79
|
| Rate for Payer: UHC Core |
$445.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$399.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,462.99
|
|
