|
HC CONNECTOR ST 3/8 OR 1/4
|
Facility
|
IP
|
$5.36
|
|
| Hospital Charge Code |
27000685
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.48 |
| Max. Negotiated Rate |
$4.82 |
| Rate for Payer: Aetna Commercial |
$4.56
|
| Rate for Payer: BCBS Trust/PPO |
$4.38
|
| Rate for Payer: BCN Commercial |
$4.14
|
| Rate for Payer: Cash Price |
$4.29
|
| Rate for Payer: Cofinity Commercial |
$4.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$4.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.56
|
| Rate for Payer: Nomi Health Commercial |
$4.40
|
| Rate for Payer: PHP Commercial |
$4.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.48
|
| Rate for Payer: Priority Health HMO/PPO |
$4.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.72
|
| Rate for Payer: UHC Core |
$4.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.02
|
|
|
HC CONNECTOR V
|
Facility
|
OP
|
$7.65
|
|
| Hospital Charge Code |
27000678
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$6.88 |
| Rate for Payer: Aetna Commercial |
$6.50
|
| Rate for Payer: Aetna Medicare |
$1.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.39
|
| Rate for Payer: BCBS Complete |
$3.06
|
| Rate for Payer: BCBS MAPPO |
$1.91
|
| Rate for Payer: BCBS Trust/PPO |
$6.29
|
| Rate for Payer: BCN Commercial |
$5.95
|
| Rate for Payer: BCN Medicare Advantage |
$1.91
|
| Rate for Payer: Cash Price |
$6.12
|
| Rate for Payer: Cofinity Commercial |
$6.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.91
|
| Rate for Payer: Healthscope Commercial |
$6.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.50
|
| Rate for Payer: Nomi Health Commercial |
$6.27
|
| Rate for Payer: PACE Senior Care Partners |
$1.82
|
| Rate for Payer: PACE SWMI |
$1.91
|
| Rate for Payer: PHP Commercial |
$6.50
|
| Rate for Payer: PHP Medicare Advantage |
$1.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.97
|
| Rate for Payer: Priority Health HMO/PPO |
$6.66
|
| Rate for Payer: Priority Health Medicare |
$1.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.73
|
| Rate for Payer: UHC Core |
$6.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.91
|
| Rate for Payer: UHC Exchange |
$1.91
|
| Rate for Payer: UHC Medicare Advantage |
$1.91
|
| Rate for Payer: VA VA |
$1.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.74
|
|
|
HC CONNECTOR V
|
Facility
|
IP
|
$7.65
|
|
| Hospital Charge Code |
27000678
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.97 |
| Max. Negotiated Rate |
$6.88 |
| Rate for Payer: Aetna Commercial |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$6.24
|
| Rate for Payer: BCN Commercial |
$5.91
|
| Rate for Payer: Cash Price |
$6.12
|
| Rate for Payer: Cofinity Commercial |
$6.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.12
|
| Rate for Payer: Healthscope Commercial |
$6.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.50
|
| Rate for Payer: Nomi Health Commercial |
$6.27
|
| Rate for Payer: PHP Commercial |
$6.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.97
|
| Rate for Payer: Priority Health HMO/PPO |
$6.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.73
|
| Rate for Payer: UHC Core |
$6.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.74
|
|
|
HC CONNECTOR Y
|
Facility
|
IP
|
$5.36
|
|
| Hospital Charge Code |
27000048
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.48 |
| Max. Negotiated Rate |
$4.82 |
| Rate for Payer: Aetna Commercial |
$4.56
|
| Rate for Payer: BCBS Trust/PPO |
$4.38
|
| Rate for Payer: BCN Commercial |
$4.14
|
| Rate for Payer: Cash Price |
$4.29
|
| Rate for Payer: Cofinity Commercial |
$4.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$4.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.56
|
| Rate for Payer: Nomi Health Commercial |
$4.40
|
| Rate for Payer: PHP Commercial |
$4.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.48
|
| Rate for Payer: Priority Health HMO/PPO |
$4.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.72
|
| Rate for Payer: UHC Core |
$4.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.02
|
|
|
HC CONNECTOR Y
|
Facility
|
OP
|
$5.36
|
|
| Hospital Charge Code |
27000048
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.27 |
| Max. Negotiated Rate |
$4.82 |
| Rate for Payer: Aetna Commercial |
$4.56
|
| Rate for Payer: Aetna Medicare |
$1.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.68
|
| Rate for Payer: BCBS Complete |
$2.14
|
| Rate for Payer: BCBS MAPPO |
$1.34
|
| Rate for Payer: BCBS Trust/PPO |
$4.41
|
| Rate for Payer: BCN Commercial |
$4.17
|
| Rate for Payer: BCN Medicare Advantage |
$1.34
|
| Rate for Payer: Cash Price |
$4.29
|
| Rate for Payer: Cofinity Commercial |
$4.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.34
|
| Rate for Payer: Healthscope Commercial |
$4.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.56
|
| Rate for Payer: Nomi Health Commercial |
$4.40
|
| Rate for Payer: PACE Senior Care Partners |
$1.27
|
| Rate for Payer: PACE SWMI |
$1.34
|
| Rate for Payer: PHP Commercial |
$4.56
|
| Rate for Payer: PHP Medicare Advantage |
$1.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.48
|
| Rate for Payer: Priority Health HMO/PPO |
$4.66
|
| Rate for Payer: Priority Health Medicare |
$1.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.72
|
| Rate for Payer: UHC Core |
$4.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.34
|
| Rate for Payer: UHC Exchange |
$1.34
|
| Rate for Payer: UHC Medicare Advantage |
$1.34
|
| Rate for Payer: VA VA |
$1.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.02
|
|
|
HC CONSULT NUTRITIONAL
|
Facility
|
OP
|
$34.96
|
|
| Hospital Charge Code |
94200010
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$8.30 |
| Max. Negotiated Rate |
$31.46 |
| Rate for Payer: Aetna Commercial |
$29.72
|
| Rate for Payer: Aetna Medicare |
$9.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.93
|
| Rate for Payer: BCBS Complete |
$13.98
|
| Rate for Payer: BCBS MAPPO |
$8.74
|
| Rate for Payer: BCBS Trust/PPO |
$28.74
|
| Rate for Payer: BCN Commercial |
$27.18
|
| Rate for Payer: BCN Medicare Advantage |
$8.74
|
| Rate for Payer: Cash Price |
$27.97
|
| Rate for Payer: Cofinity Commercial |
$30.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.74
|
| Rate for Payer: Healthscope Commercial |
$31.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.72
|
| Rate for Payer: Nomi Health Commercial |
$28.67
|
| Rate for Payer: PACE Senior Care Partners |
$8.30
|
| Rate for Payer: PACE SWMI |
$8.74
|
| Rate for Payer: PHP Commercial |
$29.72
|
| Rate for Payer: PHP Medicare Advantage |
$8.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
| Rate for Payer: Priority Health HMO/PPO |
$30.42
|
| Rate for Payer: Priority Health Medicare |
$8.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.42
|
| Rate for Payer: Railroad Medicare Medicare |
$8.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.76
|
| Rate for Payer: UHC Core |
$29.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.74
|
| Rate for Payer: UHC Exchange |
$8.74
|
| Rate for Payer: UHC Medicare Advantage |
$8.74
|
| Rate for Payer: VA VA |
$8.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.22
|
|
|
HC CONSULT NUTRITIONAL
|
Facility
|
IP
|
$34.96
|
|
| Hospital Charge Code |
94200010
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$22.72 |
| Max. Negotiated Rate |
$31.46 |
| Rate for Payer: Aetna Commercial |
$29.72
|
| Rate for Payer: BCBS Trust/PPO |
$28.54
|
| Rate for Payer: BCN Commercial |
$27.02
|
| Rate for Payer: Cash Price |
$27.97
|
| Rate for Payer: Cofinity Commercial |
$30.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.97
|
| Rate for Payer: Healthscope Commercial |
$31.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.72
|
| Rate for Payer: Nomi Health Commercial |
$28.67
|
| Rate for Payer: PHP Commercial |
$29.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.72
|
| Rate for Payer: Priority Health HMO/PPO |
$30.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.76
|
| Rate for Payer: UHC Core |
$29.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.22
|
|
|
HC CONT GLUCOSE MONITOR OFFICE EQUIP
|
Facility
|
IP
|
$984.59
|
|
|
Service Code
|
CPT 95250
|
| Hospital Charge Code |
94200001
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$639.98 |
| Max. Negotiated Rate |
$886.13 |
| Rate for Payer: Aetna Commercial |
$836.90
|
| Rate for Payer: BCBS Trust/PPO |
$803.72
|
| Rate for Payer: BCN Commercial |
$760.89
|
| Rate for Payer: Cash Price |
$787.67
|
| Rate for Payer: Cofinity Commercial |
$846.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.67
|
| Rate for Payer: Healthscope Commercial |
$886.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$738.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.90
|
| Rate for Payer: Nomi Health Commercial |
$807.36
|
| Rate for Payer: PHP Commercial |
$836.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.98
|
| Rate for Payer: Priority Health HMO/PPO |
$856.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$659.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$866.44
|
| Rate for Payer: UHC Core |
$822.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$738.44
|
|
|
HC CONT GLUCOSE MONITOR OFFICE EQUIP
|
Facility
|
OP
|
$984.59
|
|
|
Service Code
|
CPT 95250
|
| Hospital Charge Code |
94200001
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$93.17 |
| Max. Negotiated Rate |
$886.13 |
| Rate for Payer: Aetna Commercial |
$836.90
|
| Rate for Payer: Aetna Medicare |
$255.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.68
|
| Rate for Payer: BCBS Complete |
$97.84
|
| Rate for Payer: BCBS MAPPO |
$246.15
|
| Rate for Payer: BCBS Trust/PPO |
$809.43
|
| Rate for Payer: BCN Commercial |
$765.52
|
| Rate for Payer: BCN Medicare Advantage |
$246.15
|
| Rate for Payer: Cash Price |
$787.67
|
| Rate for Payer: Cash Price |
$787.67
|
| Rate for Payer: Cofinity Commercial |
$846.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$246.15
|
| Rate for Payer: Healthscope Commercial |
$886.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$738.44
|
| Rate for Payer: Mclaren Medicaid |
$93.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.45
|
| Rate for Payer: Meridian Medicaid |
$97.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$283.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.90
|
| Rate for Payer: Nomi Health Commercial |
$807.36
|
| Rate for Payer: PACE Senior Care Partners |
$233.84
|
| Rate for Payer: PACE SWMI |
$246.15
|
| Rate for Payer: PHP Commercial |
$836.90
|
| Rate for Payer: PHP Medicare Advantage |
$246.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.98
|
| Rate for Payer: Priority Health HMO/PPO |
$856.59
|
| Rate for Payer: Priority Health Medicare |
$248.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$659.68
|
| Rate for Payer: Railroad Medicare Medicare |
$246.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$866.44
|
| Rate for Payer: UHC Core |
$822.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$246.15
|
| Rate for Payer: UHC Exchange |
$246.15
|
| Rate for Payer: UHC Medicare Advantage |
$246.15
|
| Rate for Payer: UHCCP Medicaid |
$93.17
|
| Rate for Payer: VA VA |
$246.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$738.44
|
|
|
HC CONT GLUCOSE MONITOR PATIENT EQUIP
|
Facility
|
OP
|
$384.44
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
94200038
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$42.95 |
| Max. Negotiated Rate |
$346.00 |
| Rate for Payer: Aetna Commercial |
$326.77
|
| Rate for Payer: Aetna Medicare |
$99.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$120.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$120.14
|
| Rate for Payer: BCBS Complete |
$45.10
|
| Rate for Payer: BCBS MAPPO |
$96.11
|
| Rate for Payer: BCBS Trust/PPO |
$316.05
|
| Rate for Payer: BCN Commercial |
$298.90
|
| Rate for Payer: BCN Medicare Advantage |
$96.11
|
| Rate for Payer: Cash Price |
$307.55
|
| Rate for Payer: Cash Price |
$307.55
|
| Rate for Payer: Cofinity Commercial |
$330.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.11
|
| Rate for Payer: Healthscope Commercial |
$346.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.33
|
| Rate for Payer: Mclaren Medicaid |
$42.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.92
|
| Rate for Payer: Meridian Medicaid |
$45.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.77
|
| Rate for Payer: Nomi Health Commercial |
$315.24
|
| Rate for Payer: PACE Senior Care Partners |
$91.30
|
| Rate for Payer: PACE SWMI |
$96.11
|
| Rate for Payer: PHP Commercial |
$326.77
|
| Rate for Payer: PHP Medicare Advantage |
$96.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.89
|
| Rate for Payer: Priority Health HMO/PPO |
$334.46
|
| Rate for Payer: Priority Health Medicare |
$97.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$257.57
|
| Rate for Payer: Railroad Medicare Medicare |
$96.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.31
|
| Rate for Payer: UHC Core |
$321.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.11
|
| Rate for Payer: UHC Exchange |
$96.11
|
| Rate for Payer: UHC Medicare Advantage |
$96.11
|
| Rate for Payer: UHCCP Medicaid |
$42.95
|
| Rate for Payer: VA VA |
$96.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.33
|
|
|
HC CONT GLUCOSE MONITOR PATIENT EQUIP
|
Facility
|
IP
|
$384.44
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
94200038
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$249.89 |
| Max. Negotiated Rate |
$346.00 |
| Rate for Payer: Aetna Commercial |
$326.77
|
| Rate for Payer: BCBS Trust/PPO |
$313.82
|
| Rate for Payer: BCN Commercial |
$297.10
|
| Rate for Payer: Cash Price |
$307.55
|
| Rate for Payer: Cofinity Commercial |
$330.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.55
|
| Rate for Payer: Healthscope Commercial |
$346.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.77
|
| Rate for Payer: Nomi Health Commercial |
$315.24
|
| Rate for Payer: PHP Commercial |
$326.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.89
|
| Rate for Payer: Priority Health HMO/PPO |
$334.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$257.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.31
|
| Rate for Payer: UHC Core |
$321.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.33
|
|
|
HC CONTINUOUS NEB SUBSEQUENT HR
|
Facility
|
OP
|
$104.53
|
|
|
Service Code
|
CPT 94645
|
| Hospital Charge Code |
41000007
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$94.08 |
| Rate for Payer: Aetna Commercial |
$88.85
|
| Rate for Payer: Aetna Medicare |
$27.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.67
|
| Rate for Payer: BCBS Complete |
$41.81
|
| Rate for Payer: BCBS MAPPO |
$26.13
|
| Rate for Payer: BCBS Trust/PPO |
$85.93
|
| Rate for Payer: BCN Commercial |
$81.27
|
| Rate for Payer: BCN Medicare Advantage |
$26.13
|
| Rate for Payer: Cash Price |
$83.62
|
| Rate for Payer: Cofinity Commercial |
$89.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.13
|
| Rate for Payer: Healthscope Commercial |
$94.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.85
|
| Rate for Payer: Nomi Health Commercial |
$85.71
|
| Rate for Payer: PACE Senior Care Partners |
$24.83
|
| Rate for Payer: PACE SWMI |
$26.13
|
| Rate for Payer: PHP Commercial |
$88.85
|
| Rate for Payer: PHP Medicare Advantage |
$26.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.94
|
| Rate for Payer: Priority Health HMO/PPO |
$90.94
|
| Rate for Payer: Priority Health Medicare |
$26.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.04
|
| Rate for Payer: Railroad Medicare Medicare |
$26.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.99
|
| Rate for Payer: UHC Core |
$87.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.13
|
| Rate for Payer: UHC Exchange |
$26.13
|
| Rate for Payer: UHC Medicare Advantage |
$26.13
|
| Rate for Payer: VA VA |
$26.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.40
|
|
|
HC CONTINUOUS NEB SUBSEQUENT HR
|
Facility
|
IP
|
$104.53
|
|
|
Service Code
|
CPT 94645
|
| Hospital Charge Code |
41000007
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$67.94 |
| Max. Negotiated Rate |
$94.08 |
| Rate for Payer: Aetna Commercial |
$88.85
|
| Rate for Payer: BCBS Trust/PPO |
$85.33
|
| Rate for Payer: BCN Commercial |
$80.78
|
| Rate for Payer: Cash Price |
$83.62
|
| Rate for Payer: Cofinity Commercial |
$89.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.62
|
| Rate for Payer: Healthscope Commercial |
$94.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.85
|
| Rate for Payer: Nomi Health Commercial |
$85.71
|
| Rate for Payer: PHP Commercial |
$88.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.94
|
| Rate for Payer: Priority Health HMO/PPO |
$90.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.99
|
| Rate for Payer: UHC Core |
$87.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.40
|
|
|
HC CONTINUOUS NEB TX INITIAL HOUR
|
Facility
|
OP
|
$375.42
|
|
|
Service Code
|
CPT 94644
|
| Hospital Charge Code |
41000006
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$89.16 |
| Max. Negotiated Rate |
$337.88 |
| Rate for Payer: Aetna Commercial |
$319.11
|
| Rate for Payer: Aetna Medicare |
$97.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$117.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$117.32
|
| Rate for Payer: BCBS Complete |
$97.86
|
| Rate for Payer: BCBS MAPPO |
$93.86
|
| Rate for Payer: BCBS Trust/PPO |
$308.63
|
| Rate for Payer: BCN Commercial |
$291.89
|
| Rate for Payer: BCN Medicare Advantage |
$93.86
|
| Rate for Payer: Cash Price |
$300.34
|
| Rate for Payer: Cash Price |
$300.34
|
| Rate for Payer: Cofinity Commercial |
$322.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.86
|
| Rate for Payer: Healthscope Commercial |
$337.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.56
|
| Rate for Payer: Mclaren Medicaid |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.55
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.11
|
| Rate for Payer: Nomi Health Commercial |
$307.84
|
| Rate for Payer: PACE Senior Care Partners |
$89.16
|
| Rate for Payer: PACE SWMI |
$93.86
|
| Rate for Payer: PHP Commercial |
$319.11
|
| Rate for Payer: PHP Medicare Advantage |
$93.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.02
|
| Rate for Payer: Priority Health HMO/PPO |
$326.62
|
| Rate for Payer: Priority Health Medicare |
$94.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$251.53
|
| Rate for Payer: Railroad Medicare Medicare |
$93.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.37
|
| Rate for Payer: UHC Core |
$313.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.86
|
| Rate for Payer: UHC Exchange |
$93.86
|
| Rate for Payer: UHC Medicare Advantage |
$93.86
|
| Rate for Payer: UHCCP Medicaid |
$93.19
|
| Rate for Payer: VA VA |
$93.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.56
|
|
|
HC CONTINUOUS NEB TX INITIAL HOUR
|
Facility
|
IP
|
$375.42
|
|
|
Service Code
|
CPT 94644
|
| Hospital Charge Code |
41000006
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$244.02 |
| Max. Negotiated Rate |
$337.88 |
| Rate for Payer: Aetna Commercial |
$319.11
|
| Rate for Payer: BCBS Trust/PPO |
$306.46
|
| Rate for Payer: BCN Commercial |
$290.12
|
| Rate for Payer: Cash Price |
$300.34
|
| Rate for Payer: Cofinity Commercial |
$322.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.34
|
| Rate for Payer: Healthscope Commercial |
$337.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.11
|
| Rate for Payer: Nomi Health Commercial |
$307.84
|
| Rate for Payer: PHP Commercial |
$319.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.02
|
| Rate for Payer: Priority Health HMO/PPO |
$326.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$251.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.37
|
| Rate for Payer: UHC Core |
$313.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.56
|
|
|
HC CONT PHYSICS CONSULT
|
Facility
|
IP
|
$584.70
|
|
|
Service Code
|
CPT 77336
|
| Hospital Charge Code |
33300015
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$380.06 |
| Max. Negotiated Rate |
$526.23 |
| Rate for Payer: Aetna Commercial |
$497.00
|
| Rate for Payer: BCBS Trust/PPO |
$477.29
|
| Rate for Payer: BCN Commercial |
$451.86
|
| Rate for Payer: Cash Price |
$467.76
|
| Rate for Payer: Cofinity Commercial |
$502.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.76
|
| Rate for Payer: Healthscope Commercial |
$526.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.00
|
| Rate for Payer: Nomi Health Commercial |
$479.45
|
| Rate for Payer: PHP Commercial |
$497.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$380.06
|
| Rate for Payer: Priority Health HMO/PPO |
$508.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$391.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.54
|
| Rate for Payer: UHC Core |
$488.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.52
|
|
|
HC CONT PHYSICS CONSULT
|
Facility
|
OP
|
$584.70
|
|
|
Service Code
|
CPT 77336
|
| Hospital Charge Code |
33300015
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$95.99 |
| Max. Negotiated Rate |
$526.23 |
| Rate for Payer: Aetna Commercial |
$497.00
|
| Rate for Payer: Aetna Medicare |
$152.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$182.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$182.72
|
| Rate for Payer: BCBS Complete |
$100.80
|
| Rate for Payer: BCBS MAPPO |
$146.18
|
| Rate for Payer: BCBS Trust/PPO |
$480.68
|
| Rate for Payer: BCN Commercial |
$454.60
|
| Rate for Payer: BCN Medicare Advantage |
$146.18
|
| Rate for Payer: Cash Price |
$467.76
|
| Rate for Payer: Cash Price |
$467.76
|
| Rate for Payer: Cofinity Commercial |
$502.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.18
|
| Rate for Payer: Healthscope Commercial |
$526.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.52
|
| Rate for Payer: Mclaren Medicaid |
$95.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.48
|
| Rate for Payer: Meridian Medicaid |
$100.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$168.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.00
|
| Rate for Payer: Nomi Health Commercial |
$479.45
|
| Rate for Payer: PACE Senior Care Partners |
$138.87
|
| Rate for Payer: PACE SWMI |
$146.18
|
| Rate for Payer: PHP Commercial |
$497.00
|
| Rate for Payer: PHP Medicare Advantage |
$146.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$380.06
|
| Rate for Payer: Priority Health HMO/PPO |
$508.69
|
| Rate for Payer: Priority Health Medicare |
$147.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$391.75
|
| Rate for Payer: Railroad Medicare Medicare |
$146.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$514.54
|
| Rate for Payer: UHC Core |
$488.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.18
|
| Rate for Payer: UHC Exchange |
$146.18
|
| Rate for Payer: UHC Medicare Advantage |
$146.18
|
| Rate for Payer: UHCCP Medicaid |
$95.99
|
| Rate for Payer: VA VA |
$146.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.52
|
|
|
HC CONTRAST BATHS EACH 15 MIN
|
Facility
|
IP
|
$105.77
|
|
|
Service Code
|
CPT 97034
|
| Hospital Charge Code |
42000017
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$68.75 |
| Max. Negotiated Rate |
$95.19 |
| Rate for Payer: Aetna Commercial |
$89.90
|
| Rate for Payer: BCBS Trust/PPO |
$86.34
|
| Rate for Payer: BCN Commercial |
$81.74
|
| Rate for Payer: Cash Price |
$84.62
|
| Rate for Payer: Cofinity Commercial |
$90.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.62
|
| Rate for Payer: Healthscope Commercial |
$95.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.90
|
| Rate for Payer: Nomi Health Commercial |
$86.73
|
| Rate for Payer: PHP Commercial |
$89.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.75
|
| Rate for Payer: Priority Health HMO/PPO |
$92.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.08
|
| Rate for Payer: UHC Core |
$88.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.33
|
|
|
HC CONTRAST BATHS EACH 15 MIN
|
Facility
|
OP
|
$105.77
|
|
|
Service Code
|
CPT 97034
|
| Hospital Charge Code |
42000017
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$25.12 |
| Max. Negotiated Rate |
$95.19 |
| Rate for Payer: Aetna Commercial |
$89.90
|
| Rate for Payer: Aetna Medicare |
$27.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.05
|
| Rate for Payer: BCBS Complete |
$42.31
|
| Rate for Payer: BCBS MAPPO |
$26.44
|
| Rate for Payer: BCBS Trust/PPO |
$86.95
|
| Rate for Payer: BCN Commercial |
$82.24
|
| Rate for Payer: BCN Medicare Advantage |
$26.44
|
| Rate for Payer: Cash Price |
$84.62
|
| Rate for Payer: Cofinity Commercial |
$90.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.44
|
| Rate for Payer: Healthscope Commercial |
$95.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.90
|
| Rate for Payer: Nomi Health Commercial |
$86.73
|
| Rate for Payer: PACE Senior Care Partners |
$25.12
|
| Rate for Payer: PACE SWMI |
$26.44
|
| Rate for Payer: PHP Commercial |
$89.90
|
| Rate for Payer: PHP Medicare Advantage |
$26.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.75
|
| Rate for Payer: Priority Health HMO/PPO |
$92.02
|
| Rate for Payer: Priority Health Medicare |
$26.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.87
|
| Rate for Payer: Railroad Medicare Medicare |
$26.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.08
|
| Rate for Payer: UHC Core |
$88.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.44
|
| Rate for Payer: UHC Exchange |
$26.44
|
| Rate for Payer: UHC Medicare Advantage |
$26.44
|
| Rate for Payer: VA VA |
$26.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.33
|
|
|
HC CONTROL NOSEBLEED ANTERIOR SIMPLE
|
Facility
|
IP
|
$414.64
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
45000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$269.52 |
| Max. Negotiated Rate |
$373.18 |
| Rate for Payer: Aetna Commercial |
$352.44
|
| Rate for Payer: BCBS Trust/PPO |
$338.47
|
| Rate for Payer: BCN Commercial |
$320.43
|
| Rate for Payer: Cash Price |
$331.71
|
| Rate for Payer: Cofinity Commercial |
$356.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.71
|
| Rate for Payer: Healthscope Commercial |
$373.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.44
|
| Rate for Payer: Nomi Health Commercial |
$340.00
|
| Rate for Payer: PHP Commercial |
$352.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.52
|
| Rate for Payer: Priority Health HMO/PPO |
$360.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.88
|
| Rate for Payer: UHC Core |
$346.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.98
|
|
|
HC CONTROL NOSEBLEED ANTERIOR SIMPLE
|
Facility
|
OP
|
$414.64
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
45000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.19 |
| Max. Negotiated Rate |
$373.18 |
| Rate for Payer: Aetna Commercial |
$352.44
|
| Rate for Payer: Aetna Medicare |
$107.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.57
|
| Rate for Payer: BCBS Complete |
$97.86
|
| Rate for Payer: BCBS MAPPO |
$103.66
|
| Rate for Payer: BCBS Trust/PPO |
$340.88
|
| Rate for Payer: BCN Commercial |
$322.38
|
| Rate for Payer: BCN Medicare Advantage |
$103.66
|
| Rate for Payer: Cash Price |
$331.71
|
| Rate for Payer: Cash Price |
$331.71
|
| Rate for Payer: Cofinity Commercial |
$356.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.66
|
| Rate for Payer: Healthscope Commercial |
$373.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.98
|
| Rate for Payer: Mclaren Medicaid |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.84
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.44
|
| Rate for Payer: Nomi Health Commercial |
$340.00
|
| Rate for Payer: PACE Senior Care Partners |
$98.48
|
| Rate for Payer: PACE SWMI |
$103.66
|
| Rate for Payer: PHP Commercial |
$352.44
|
| Rate for Payer: PHP Medicare Advantage |
$103.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.52
|
| Rate for Payer: Priority Health HMO/PPO |
$360.74
|
| Rate for Payer: Priority Health Medicare |
$104.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.81
|
| Rate for Payer: Railroad Medicare Medicare |
$103.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.88
|
| Rate for Payer: UHC Core |
$346.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.66
|
| Rate for Payer: UHC Exchange |
$103.66
|
| Rate for Payer: UHC Medicare Advantage |
$103.66
|
| Rate for Payer: UHCCP Medicaid |
$93.19
|
| Rate for Payer: VA VA |
$103.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.98
|
|
|
HC CONTROL OROPHARYNGEAL HEM SIMPLE
|
Facility
|
OP
|
$753.77
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
45000100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$179.02 |
| Max. Negotiated Rate |
$678.39 |
| Rate for Payer: Aetna Commercial |
$640.70
|
| Rate for Payer: Aetna Medicare |
$195.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$235.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$235.55
|
| Rate for Payer: BCBS Complete |
$386.62
|
| Rate for Payer: BCBS MAPPO |
$188.44
|
| Rate for Payer: BCBS Trust/PPO |
$619.67
|
| Rate for Payer: BCN Commercial |
$586.06
|
| Rate for Payer: BCN Medicare Advantage |
$188.44
|
| Rate for Payer: Cash Price |
$603.02
|
| Rate for Payer: Cash Price |
$603.02
|
| Rate for Payer: Cofinity Commercial |
$648.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$603.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.44
|
| Rate for Payer: Healthscope Commercial |
$678.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$565.33
|
| Rate for Payer: Mclaren Medicaid |
$368.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.86
|
| Rate for Payer: Meridian Medicaid |
$386.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$216.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$640.70
|
| Rate for Payer: Nomi Health Commercial |
$618.09
|
| Rate for Payer: PACE Senior Care Partners |
$179.02
|
| Rate for Payer: PACE SWMI |
$188.44
|
| Rate for Payer: PHP Commercial |
$640.70
|
| Rate for Payer: PHP Medicare Advantage |
$188.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$489.95
|
| Rate for Payer: Priority Health HMO/PPO |
$655.78
|
| Rate for Payer: Priority Health Medicare |
$190.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$505.03
|
| Rate for Payer: Railroad Medicare Medicare |
$188.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.32
|
| Rate for Payer: UHC Core |
$629.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.44
|
| Rate for Payer: UHC Exchange |
$188.44
|
| Rate for Payer: UHC Medicare Advantage |
$188.44
|
| Rate for Payer: UHCCP Medicaid |
$368.19
|
| Rate for Payer: VA VA |
$188.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$565.33
|
|
|
HC CONTROL OROPHARYNGEAL HEM SIMPLE
|
Facility
|
IP
|
$753.77
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
45000100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$489.95 |
| Max. Negotiated Rate |
$678.39 |
| Rate for Payer: Aetna Commercial |
$640.70
|
| Rate for Payer: BCBS Trust/PPO |
$615.30
|
| Rate for Payer: BCN Commercial |
$582.51
|
| Rate for Payer: Cash Price |
$603.02
|
| Rate for Payer: Cofinity Commercial |
$648.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$603.02
|
| Rate for Payer: Healthscope Commercial |
$678.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$565.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$640.70
|
| Rate for Payer: Nomi Health Commercial |
$618.09
|
| Rate for Payer: PHP Commercial |
$640.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$489.95
|
| Rate for Payer: Priority Health HMO/PPO |
$655.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$505.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.32
|
| Rate for Payer: UHC Core |
$629.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$565.33
|
|
|
HC CONTROL OROPHARYNG HEMORRHAGE SIMPLE
|
Facility
|
OP
|
$1,342.32
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
76100478
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$318.80 |
| Max. Negotiated Rate |
$1,208.09 |
| Rate for Payer: Aetna Commercial |
$1,140.97
|
| Rate for Payer: Aetna Medicare |
$349.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$419.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$419.48
|
| Rate for Payer: BCBS Complete |
$386.62
|
| Rate for Payer: BCBS MAPPO |
$335.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,103.52
|
| Rate for Payer: BCN Commercial |
$1,043.65
|
| Rate for Payer: BCN Medicare Advantage |
$335.58
|
| Rate for Payer: Cash Price |
$1,073.86
|
| Rate for Payer: Cash Price |
$1,073.86
|
| Rate for Payer: Cofinity Commercial |
$1,154.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,073.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$335.58
|
| Rate for Payer: Healthscope Commercial |
$1,208.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,006.74
|
| Rate for Payer: Mclaren Medicaid |
$368.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.36
|
| Rate for Payer: Meridian Medicaid |
$386.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$385.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,140.97
|
| Rate for Payer: Nomi Health Commercial |
$1,100.70
|
| Rate for Payer: PACE Senior Care Partners |
$318.80
|
| Rate for Payer: PACE SWMI |
$335.58
|
| Rate for Payer: PHP Commercial |
$1,140.97
|
| Rate for Payer: PHP Medicare Advantage |
$335.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.51
|
| Rate for Payer: Priority Health HMO/PPO |
$1,167.82
|
| Rate for Payer: Priority Health Medicare |
$338.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.35
|
| Rate for Payer: Railroad Medicare Medicare |
$335.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,181.24
|
| Rate for Payer: UHC Core |
$1,120.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$335.58
|
| Rate for Payer: UHC Exchange |
$335.58
|
| Rate for Payer: UHC Medicare Advantage |
$335.58
|
| Rate for Payer: UHCCP Medicaid |
$368.19
|
| Rate for Payer: VA VA |
$335.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,006.74
|
|
|
HC CONTROL OROPHARYNG HEMORRHAGE SIMPLE
|
Facility
|
IP
|
$1,342.32
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
76100478
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$872.51 |
| Max. Negotiated Rate |
$1,208.09 |
| Rate for Payer: Aetna Commercial |
$1,140.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,095.74
|
| Rate for Payer: BCN Commercial |
$1,037.34
|
| Rate for Payer: Cash Price |
$1,073.86
|
| Rate for Payer: Cofinity Commercial |
$1,154.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,073.86
|
| Rate for Payer: Healthscope Commercial |
$1,208.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,006.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,140.97
|
| Rate for Payer: Nomi Health Commercial |
$1,100.70
|
| Rate for Payer: PHP Commercial |
$1,140.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.51
|
| Rate for Payer: Priority Health HMO/PPO |
$1,167.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,181.24
|
| Rate for Payer: UHC Core |
$1,120.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,006.74
|
|
