|
HC DISP FEE CONTRALATERAL MONAURAL
|
Facility
|
OP
|
$286.11
|
|
|
Service Code
|
CPT V5200
|
| Hospital Charge Code |
27100021
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$50.44 |
| Max. Negotiated Rate |
$257.50 |
| Rate for Payer: Aetna Commercial |
$243.19
|
| Rate for Payer: Aetna Medicare |
$74.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.41
|
| Rate for Payer: BCBS Complete |
$52.96
|
| Rate for Payer: BCBS MAPPO |
$71.53
|
| Rate for Payer: BCBS Trust/PPO |
$235.21
|
| Rate for Payer: BCN Commercial |
$235.21
|
| Rate for Payer: BCN Medicare Advantage |
$71.53
|
| Rate for Payer: Cash Price |
$228.89
|
| Rate for Payer: Cofinity Commercial |
$246.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.53
|
| Rate for Payer: Healthscope Commercial |
$257.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.58
|
| Rate for Payer: Mclaren Medicaid |
$50.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.10
|
| Rate for Payer: Meridian Medicaid |
$52.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.19
|
| Rate for Payer: Nomi Health Commercial |
$234.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.58
|
| Rate for Payer: PACE Senior Care Partners |
$67.95
|
| Rate for Payer: PACE SWMI |
$71.53
|
| Rate for Payer: PHP Commercial |
$243.19
|
| Rate for Payer: PHP Medicare Advantage |
$71.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$248.92
|
| Rate for Payer: Priority Health Medicare |
$72.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.13
|
| Rate for Payer: Railroad Medicare Medicare |
$71.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.78
|
| Rate for Payer: UHC Core |
$238.90
|
| Rate for Payer: UHC Exchange |
$71.53
|
| Rate for Payer: UHC Medicaid |
$50.44
|
| Rate for Payer: UHC Medicare Advantage |
$71.53
|
| Rate for Payer: UHCCP Medicaid |
$50.44
|
| Rate for Payer: VA VA |
$71.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.58
|
|
|
HC DNA DOUBLE STRANDED AB
|
Facility
|
OP
|
$28.98
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200158
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: Aetna Medicare |
$7.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.06
|
| Rate for Payer: BCBS Complete |
$5.36
|
| Rate for Payer: BCBS MAPPO |
$7.25
|
| Rate for Payer: BCBS Trust/PPO |
$23.82
|
| Rate for Payer: BCN Commercial |
$23.82
|
| Rate for Payer: BCN Medicare Advantage |
$7.25
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.25
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.73
|
| Rate for Payer: Mclaren Medicaid |
$5.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.61
|
| Rate for Payer: Meridian Medicaid |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PACE Senior Care Partners |
$6.88
|
| Rate for Payer: PACE SWMI |
$7.25
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: PHP Medicare Advantage |
$7.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.21
|
| Rate for Payer: Priority Health Medicare |
$7.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.17
|
| Rate for Payer: Railroad Medicare Medicare |
$7.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.50
|
| Rate for Payer: UHC Core |
$24.20
|
| Rate for Payer: UHC Exchange |
$7.25
|
| Rate for Payer: UHC Medicaid |
$5.11
|
| Rate for Payer: UHC Medicare Advantage |
$7.25
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: VA VA |
$7.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.73
|
|
|
HC DNA DOUBLE STRANDED AB
|
Facility
|
IP
|
$28.98
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200158
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.17 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$23.93
|
| Rate for Payer: BCN Commercial |
$23.93
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.50
|
| Rate for Payer: UHC Core |
$24.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.73
|
|
|
HC DNA PROBES CMPT2
|
Facility
|
IP
|
$79.43
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000043
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$55.28 |
| Max. Negotiated Rate |
$71.49 |
| Rate for Payer: Aetna Commercial |
$67.52
|
| Rate for Payer: BCBS Trust/PPO |
$65.60
|
| Rate for Payer: BCN Commercial |
$65.60
|
| Rate for Payer: Cash Price |
$63.54
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.54
|
| Rate for Payer: Healthscope Commercial |
$71.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.52
|
| Rate for Payer: Nomi Health Commercial |
$65.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.57
|
| Rate for Payer: PHP Commercial |
$67.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.90
|
| Rate for Payer: UHC Core |
$66.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.57
|
|
|
HC DNA PROBES CMPT2
|
Facility
|
OP
|
$79.43
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000043
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$71.49 |
| Rate for Payer: Aetna Commercial |
$67.52
|
| Rate for Payer: Aetna Medicare |
$20.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.82
|
| Rate for Payer: BCBS Complete |
$14.70
|
| Rate for Payer: BCBS MAPPO |
$19.86
|
| Rate for Payer: BCBS Trust/PPO |
$65.30
|
| Rate for Payer: BCN Commercial |
$65.30
|
| Rate for Payer: BCN Medicare Advantage |
$19.86
|
| Rate for Payer: Cash Price |
$63.54
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.86
|
| Rate for Payer: Healthscope Commercial |
$71.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.57
|
| Rate for Payer: Mclaren Medicaid |
$14.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.85
|
| Rate for Payer: Meridian Medicaid |
$14.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.52
|
| Rate for Payer: Nomi Health Commercial |
$65.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.57
|
| Rate for Payer: PACE Senior Care Partners |
$18.86
|
| Rate for Payer: PACE SWMI |
$19.86
|
| Rate for Payer: PHP Commercial |
$67.52
|
| Rate for Payer: PHP Medicare Advantage |
$19.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.10
|
| Rate for Payer: Priority Health Medicare |
$20.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.28
|
| Rate for Payer: Railroad Medicare Medicare |
$19.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.90
|
| Rate for Payer: UHC Core |
$66.32
|
| Rate for Payer: UHC Exchange |
$19.86
|
| Rate for Payer: UHC Medicaid |
$14.00
|
| Rate for Payer: UHC Medicare Advantage |
$19.86
|
| Rate for Payer: UHCCP Medicaid |
$14.00
|
| Rate for Payer: VA VA |
$19.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.57
|
|
|
HC DOG IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200038
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC DOG IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200038
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC DOPPLER COLOR FLOW
|
Facility
|
IP
|
$449.41
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
48000007
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$312.79 |
| Max. Negotiated Rate |
$404.47 |
| Rate for Payer: Aetna Commercial |
$382.00
|
| Rate for Payer: BCBS Trust/PPO |
$371.17
|
| Rate for Payer: BCN Commercial |
$371.17
|
| Rate for Payer: Cash Price |
$359.53
|
| Rate for Payer: Cofinity Commercial |
$386.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.53
|
| Rate for Payer: Healthscope Commercial |
$404.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.00
|
| Rate for Payer: Nomi Health Commercial |
$368.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$337.06
|
| Rate for Payer: PHP Commercial |
$382.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$390.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$312.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.48
|
| Rate for Payer: UHC Core |
$375.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.06
|
|
|
HC DOPPLER COLOR FLOW
|
Facility
|
OP
|
$449.41
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
48000007
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$79.23 |
| Max. Negotiated Rate |
$404.47 |
| Rate for Payer: Aetna Commercial |
$382.00
|
| Rate for Payer: Aetna Medicare |
$116.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$140.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$140.44
|
| Rate for Payer: BCBS Complete |
$83.19
|
| Rate for Payer: BCBS MAPPO |
$112.35
|
| Rate for Payer: BCBS Trust/PPO |
$369.46
|
| Rate for Payer: BCN Commercial |
$369.46
|
| Rate for Payer: BCN Medicare Advantage |
$112.35
|
| Rate for Payer: Cash Price |
$359.53
|
| Rate for Payer: Cofinity Commercial |
$386.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.35
|
| Rate for Payer: Healthscope Commercial |
$404.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.06
|
| Rate for Payer: Mclaren Medicaid |
$79.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.97
|
| Rate for Payer: Meridian Medicaid |
$83.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.00
|
| Rate for Payer: Nomi Health Commercial |
$368.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$337.06
|
| Rate for Payer: PACE Senior Care Partners |
$106.73
|
| Rate for Payer: PACE SWMI |
$112.35
|
| Rate for Payer: PHP Commercial |
$382.00
|
| Rate for Payer: PHP Medicare Advantage |
$112.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$390.99
|
| Rate for Payer: Priority Health Medicare |
$113.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$312.79
|
| Rate for Payer: Railroad Medicare Medicare |
$112.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.48
|
| Rate for Payer: UHC Core |
$375.26
|
| Rate for Payer: UHC Exchange |
$112.35
|
| Rate for Payer: UHC Medicaid |
$79.23
|
| Rate for Payer: UHC Medicare Advantage |
$112.35
|
| Rate for Payer: UHCCP Medicaid |
$79.23
|
| Rate for Payer: VA VA |
$112.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.06
|
|
|
HC DOXYCYCLINE HYCLATE 100 MG
|
Facility
|
IP
|
$230.23
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600189
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$160.24 |
| Max. Negotiated Rate |
$207.21 |
| Rate for Payer: Aetna Commercial |
$195.70
|
| Rate for Payer: BCBS Trust/PPO |
$190.15
|
| Rate for Payer: BCN Commercial |
$190.15
|
| Rate for Payer: Cash Price |
$184.18
|
| Rate for Payer: Cofinity Commercial |
$198.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.18
|
| Rate for Payer: Healthscope Commercial |
$207.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.70
|
| Rate for Payer: Nomi Health Commercial |
$188.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.67
|
| Rate for Payer: PHP Commercial |
$195.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$200.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.60
|
| Rate for Payer: UHC Core |
$192.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.67
|
|
|
HC DOXYCYCLINE HYCLATE 100 MG
|
Facility
|
OP
|
$230.23
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600189
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.59 |
| Max. Negotiated Rate |
$207.21 |
| Rate for Payer: Aetna Commercial |
$195.70
|
| Rate for Payer: Aetna Medicare |
$59.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.95
|
| Rate for Payer: BCBS Complete |
$42.62
|
| Rate for Payer: BCBS MAPPO |
$57.56
|
| Rate for Payer: BCBS Trust/PPO |
$189.27
|
| Rate for Payer: BCN Commercial |
$189.27
|
| Rate for Payer: BCN Medicare Advantage |
$57.56
|
| Rate for Payer: Cash Price |
$184.18
|
| Rate for Payer: Cofinity Commercial |
$198.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.56
|
| Rate for Payer: Healthscope Commercial |
$207.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.67
|
| Rate for Payer: Mclaren Medicaid |
$40.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.44
|
| Rate for Payer: Meridian Medicaid |
$42.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.70
|
| Rate for Payer: Nomi Health Commercial |
$188.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.67
|
| Rate for Payer: PACE Senior Care Partners |
$54.68
|
| Rate for Payer: PACE SWMI |
$57.56
|
| Rate for Payer: PHP Commercial |
$195.70
|
| Rate for Payer: PHP Medicare Advantage |
$57.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$200.30
|
| Rate for Payer: Priority Health Medicare |
$58.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.24
|
| Rate for Payer: Railroad Medicare Medicare |
$57.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.60
|
| Rate for Payer: UHC Core |
$192.24
|
| Rate for Payer: UHC Exchange |
$57.56
|
| Rate for Payer: UHC Medicaid |
$40.59
|
| Rate for Payer: UHC Medicare Advantage |
$57.56
|
| Rate for Payer: UHCCP Medicaid |
$40.59
|
| Rate for Payer: VA VA |
$57.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.67
|
|
|
HC DOXYCYCLINE HYCLATE 1MG
|
Facility
|
OP
|
$230.23
|
|
|
Service Code
|
HCPCS J1271
|
| Hospital Charge Code |
63600269
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$40.59 |
| Max. Negotiated Rate |
$207.21 |
| Rate for Payer: Aetna Commercial |
$195.70
|
| Rate for Payer: Aetna Medicare |
$59.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.95
|
| Rate for Payer: BCBS Complete |
$42.62
|
| Rate for Payer: BCBS MAPPO |
$57.56
|
| Rate for Payer: BCBS Trust/PPO |
$189.27
|
| Rate for Payer: BCN Commercial |
$189.27
|
| Rate for Payer: BCN Medicare Advantage |
$57.56
|
| Rate for Payer: Cash Price |
$184.18
|
| Rate for Payer: Cofinity Commercial |
$198.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.56
|
| Rate for Payer: Healthscope Commercial |
$207.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.67
|
| Rate for Payer: Mclaren Medicaid |
$40.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.44
|
| Rate for Payer: Meridian Medicaid |
$42.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.70
|
| Rate for Payer: Nomi Health Commercial |
$188.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.67
|
| Rate for Payer: PACE Senior Care Partners |
$54.68
|
| Rate for Payer: PACE SWMI |
$57.56
|
| Rate for Payer: PHP Commercial |
$195.70
|
| Rate for Payer: PHP Medicare Advantage |
$57.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$200.30
|
| Rate for Payer: Priority Health Medicare |
$58.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.24
|
| Rate for Payer: Railroad Medicare Medicare |
$57.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.60
|
| Rate for Payer: UHC Core |
$192.24
|
| Rate for Payer: UHC Exchange |
$57.56
|
| Rate for Payer: UHC Medicaid |
$40.59
|
| Rate for Payer: UHC Medicare Advantage |
$57.56
|
| Rate for Payer: UHCCP Medicaid |
$40.59
|
| Rate for Payer: VA VA |
$57.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.67
|
|
|
HC DOXYCYCLINE HYCLATE 1MG
|
Facility
|
IP
|
$230.23
|
|
|
Service Code
|
HCPCS J1271
|
| Hospital Charge Code |
63600269
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$160.24 |
| Max. Negotiated Rate |
$207.21 |
| Rate for Payer: Aetna Commercial |
$195.70
|
| Rate for Payer: BCBS Trust/PPO |
$190.15
|
| Rate for Payer: BCN Commercial |
$190.15
|
| Rate for Payer: Cash Price |
$184.18
|
| Rate for Payer: Cofinity Commercial |
$198.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.18
|
| Rate for Payer: Healthscope Commercial |
$207.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.70
|
| Rate for Payer: Nomi Health Commercial |
$188.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.67
|
| Rate for Payer: PHP Commercial |
$195.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$200.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.60
|
| Rate for Payer: UHC Core |
$192.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.67
|
|
|
HC DPPX AB CBA, S
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200462
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$181.03 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: BCBS Trust/PPO |
$214.82
|
| Rate for Payer: BCN Commercial |
$214.82
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.07
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC DPPX AB CBA, S
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200462
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.86 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna Medicare |
$67.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.28
|
| Rate for Payer: BCBS Complete |
$48.14
|
| Rate for Payer: BCBS MAPPO |
$65.03
|
| Rate for Payer: BCBS Trust/PPO |
$213.83
|
| Rate for Payer: BCN Commercial |
$213.83
|
| Rate for Payer: BCN Medicare Advantage |
$65.03
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.03
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.28
|
| Rate for Payer: Meridian Medicaid |
$48.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.07
|
| Rate for Payer: PACE Senior Care Partners |
$61.77
|
| Rate for Payer: PACE SWMI |
$65.03
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: PHP Medicare Advantage |
$65.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.29
|
| Rate for Payer: Priority Health Medicare |
$65.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.03
|
| Rate for Payer: Railroad Medicare Medicare |
$65.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: UHC Exchange |
$65.03
|
| Rate for Payer: UHC Medicaid |
$45.86
|
| Rate for Payer: UHC Medicare Advantage |
$65.03
|
| Rate for Payer: UHCCP Medicaid |
$45.86
|
| Rate for Payer: VA VA |
$65.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC DPPX AB IFA, S
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200463
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.03 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna Medicare |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.87
|
| Rate for Payer: BCBS Complete |
$14.73
|
| Rate for Payer: BCBS MAPPO |
$19.90
|
| Rate for Payer: BCBS Trust/PPO |
$65.43
|
| Rate for Payer: BCN Commercial |
$65.43
|
| Rate for Payer: BCN Medicare Advantage |
$19.90
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.90
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Mclaren Medicaid |
$14.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.89
|
| Rate for Payer: Meridian Medicaid |
$14.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Senior Care Partners |
$18.90
|
| Rate for Payer: PACE SWMI |
$19.90
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: PHP Medicare Advantage |
$19.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.24
|
| Rate for Payer: Priority Health Medicare |
$20.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.39
|
| Rate for Payer: Railroad Medicare Medicare |
$19.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.04
|
| Rate for Payer: UHC Core |
$66.46
|
| Rate for Payer: UHC Exchange |
$19.90
|
| Rate for Payer: UHC Medicaid |
$14.03
|
| Rate for Payer: UHC Medicare Advantage |
$19.90
|
| Rate for Payer: UHCCP Medicaid |
$14.03
|
| Rate for Payer: VA VA |
$19.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC DPPX AB IFA, S
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200463
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$55.39 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: BCBS Trust/PPO |
$65.73
|
| Rate for Payer: BCN Commercial |
$65.73
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.04
|
| Rate for Payer: UHC Core |
$66.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC DPPX AB IFA TITER, S
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200461
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$55.39 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: BCBS Trust/PPO |
$65.73
|
| Rate for Payer: BCN Commercial |
$65.73
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.04
|
| Rate for Payer: UHC Core |
$66.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC DPPX AB IFA TITER, S
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200461
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.03 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna Medicare |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.87
|
| Rate for Payer: BCBS Complete |
$14.73
|
| Rate for Payer: BCBS MAPPO |
$19.90
|
| Rate for Payer: BCBS Trust/PPO |
$65.43
|
| Rate for Payer: BCN Commercial |
$65.43
|
| Rate for Payer: BCN Medicare Advantage |
$19.90
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.90
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Mclaren Medicaid |
$14.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.89
|
| Rate for Payer: Meridian Medicaid |
$14.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$65.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Senior Care Partners |
$18.90
|
| Rate for Payer: PACE SWMI |
$19.90
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: PHP Medicare Advantage |
$19.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.24
|
| Rate for Payer: Priority Health Medicare |
$20.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.39
|
| Rate for Payer: Railroad Medicare Medicare |
$19.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.04
|
| Rate for Payer: UHC Core |
$66.46
|
| Rate for Payer: UHC Exchange |
$19.90
|
| Rate for Payer: UHC Medicaid |
$14.03
|
| Rate for Payer: UHC Medicare Advantage |
$19.90
|
| Rate for Payer: UHCCP Medicaid |
$14.03
|
| Rate for Payer: VA VA |
$19.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC DRAINAGE ABSC CST HEMAT DENTOALVEOLAR STRUX
|
Facility
|
IP
|
$378.42
|
|
|
Service Code
|
CPT 41800
|
| Hospital Charge Code |
76100529
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$263.38 |
| Max. Negotiated Rate |
$340.58 |
| Rate for Payer: Aetna Commercial |
$321.66
|
| Rate for Payer: BCBS Trust/PPO |
$312.54
|
| Rate for Payer: BCN Commercial |
$312.54
|
| Rate for Payer: Cash Price |
$302.74
|
| Rate for Payer: Cofinity Commercial |
$325.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.74
|
| Rate for Payer: Healthscope Commercial |
$340.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.66
|
| Rate for Payer: Nomi Health Commercial |
$310.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$283.81
|
| Rate for Payer: PHP Commercial |
$321.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$329.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$263.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.01
|
| Rate for Payer: UHC Core |
$315.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.81
|
|
|
HC DRAINAGE ABSC CST HEMAT DENTOALVEOLAR STRUX
|
Facility
|
OP
|
$378.42
|
|
|
Service Code
|
CPT 41800
|
| Hospital Charge Code |
76100529
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.72 |
| Max. Negotiated Rate |
$340.58 |
| Rate for Payer: Aetna Commercial |
$321.66
|
| Rate for Payer: Aetna Medicare |
$98.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.26
|
| Rate for Payer: BCBS Complete |
$70.05
|
| Rate for Payer: BCBS MAPPO |
$94.61
|
| Rate for Payer: BCBS Trust/PPO |
$311.10
|
| Rate for Payer: BCN Commercial |
$311.10
|
| Rate for Payer: BCN Medicare Advantage |
$94.61
|
| Rate for Payer: Cash Price |
$302.74
|
| Rate for Payer: Cofinity Commercial |
$325.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.61
|
| Rate for Payer: Healthscope Commercial |
$340.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.81
|
| Rate for Payer: Mclaren Medicaid |
$66.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.34
|
| Rate for Payer: Meridian Medicaid |
$70.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.66
|
| Rate for Payer: Nomi Health Commercial |
$310.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$283.81
|
| Rate for Payer: PACE Senior Care Partners |
$89.87
|
| Rate for Payer: PACE SWMI |
$94.61
|
| Rate for Payer: PHP Commercial |
$321.66
|
| Rate for Payer: PHP Medicare Advantage |
$94.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$329.23
|
| Rate for Payer: Priority Health Medicare |
$95.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$263.38
|
| Rate for Payer: Railroad Medicare Medicare |
$94.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.01
|
| Rate for Payer: UHC Core |
$315.98
|
| Rate for Payer: UHC Exchange |
$94.61
|
| Rate for Payer: UHC Medicaid |
$66.72
|
| Rate for Payer: UHC Medicare Advantage |
$94.61
|
| Rate for Payer: UHCCP Medicaid |
$66.72
|
| Rate for Payer: VA VA |
$94.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.81
|
|
|
HC DRAINAGE ABSCESS PALATE UVULA
|
Facility
|
IP
|
$653.51
|
|
|
Service Code
|
CPT 42000
|
| Hospital Charge Code |
76100559
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$454.84 |
| Max. Negotiated Rate |
$588.16 |
| Rate for Payer: Aetna Commercial |
$555.48
|
| Rate for Payer: BCBS Trust/PPO |
$539.73
|
| Rate for Payer: BCN Commercial |
$539.73
|
| Rate for Payer: Cash Price |
$522.81
|
| Rate for Payer: Cofinity Commercial |
$562.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$522.81
|
| Rate for Payer: Healthscope Commercial |
$588.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$490.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$555.48
|
| Rate for Payer: Nomi Health Commercial |
$535.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$490.13
|
| Rate for Payer: PHP Commercial |
$555.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$568.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$454.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$575.09
|
| Rate for Payer: UHC Core |
$545.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$490.13
|
|
|
HC DRAINAGE ABSCESS PALATE UVULA
|
Facility
|
OP
|
$653.51
|
|
|
Service Code
|
CPT 42000
|
| Hospital Charge Code |
76100559
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$115.21 |
| Max. Negotiated Rate |
$588.16 |
| Rate for Payer: Aetna Commercial |
$555.48
|
| Rate for Payer: Aetna Medicare |
$169.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.22
|
| Rate for Payer: BCBS Complete |
$120.96
|
| Rate for Payer: BCBS MAPPO |
$163.38
|
| Rate for Payer: BCBS Trust/PPO |
$537.25
|
| Rate for Payer: BCN Commercial |
$537.25
|
| Rate for Payer: BCN Medicare Advantage |
$163.38
|
| Rate for Payer: Cash Price |
$522.81
|
| Rate for Payer: Cofinity Commercial |
$562.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$522.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.38
|
| Rate for Payer: Healthscope Commercial |
$588.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$490.13
|
| Rate for Payer: Mclaren Medicaid |
$115.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.55
|
| Rate for Payer: Meridian Medicaid |
$120.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$179.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$555.48
|
| Rate for Payer: Nomi Health Commercial |
$535.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$490.13
|
| Rate for Payer: PACE Senior Care Partners |
$155.21
|
| Rate for Payer: PACE SWMI |
$163.38
|
| Rate for Payer: PHP Commercial |
$555.48
|
| Rate for Payer: PHP Medicare Advantage |
$163.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$568.55
|
| Rate for Payer: Priority Health Medicare |
$165.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$454.84
|
| Rate for Payer: Railroad Medicare Medicare |
$163.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$575.09
|
| Rate for Payer: UHC Core |
$545.68
|
| Rate for Payer: UHC Exchange |
$163.38
|
| Rate for Payer: UHC Medicaid |
$115.21
|
| Rate for Payer: UHC Medicare Advantage |
$163.38
|
| Rate for Payer: UHCCP Medicaid |
$115.21
|
| Rate for Payer: VA VA |
$163.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$490.13
|
|
|
HC DRAINAGE CATHETER LVL 1
|
Facility
|
OP
|
$21.85
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna Medicare |
$5.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.83
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$5.46
|
| Rate for Payer: BCBS Trust/PPO |
$17.96
|
| Rate for Payer: BCN Commercial |
$17.96
|
| Rate for Payer: BCN Medicare Advantage |
$5.46
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.46
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.39
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.74
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.39
|
| Rate for Payer: PACE Senior Care Partners |
$5.19
|
| Rate for Payer: PACE SWMI |
$5.46
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: PHP Medicare Advantage |
$5.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.01
|
| Rate for Payer: Priority Health Medicare |
$5.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.21
|
| Rate for Payer: Railroad Medicare Medicare |
$5.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.23
|
| Rate for Payer: UHC Core |
$18.24
|
| Rate for Payer: UHC Exchange |
$5.46
|
| Rate for Payer: UHC Medicaid |
$3.85
|
| Rate for Payer: UHC Medicare Advantage |
$5.46
|
| Rate for Payer: UHCCP Medicaid |
$3.85
|
| Rate for Payer: VA VA |
$5.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.39
|
|
|
HC DRAINAGE CATHETER LVL 1
|
Facility
|
IP
|
$21.85
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.21 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: BCBS Trust/PPO |
$18.05
|
| Rate for Payer: BCN Commercial |
$18.05
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Nomi Health Commercial |
$17.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.39
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.23
|
| Rate for Payer: UHC Core |
$18.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.39
|
|
