|
HC CONT PHYSICS CONSULT
|
Facility
|
OP
|
$584.70
|
|
|
Service Code
|
CPT 77336
|
| Hospital Charge Code |
33300015
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$94.06 |
| 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 |
$98.76
|
| 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 |
$94.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.48
|
| Rate for Payer: Meridian Medicaid |
$98.76
|
| 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 |
$94.06
|
| 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 |
$94.06
|
| 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 |
$91.31 |
| 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 |
$129.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.58
|
| Rate for Payer: BCBS Complete |
$95.88
|
| 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 |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.84
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| 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 |
$91.31
|
| 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 |
$91.31
|
| Rate for Payer: VA VA |
$103.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.98
|
|
|
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 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 |
$378.80
|
| 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 |
$360.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.86
|
| Rate for Payer: Meridian Medicaid |
$378.80
|
| 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 |
$360.74
|
| 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 |
$360.74
|
| Rate for Payer: VA VA |
$188.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$565.33
|
|
|
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
|
|
|
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 |
$378.80
|
| 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 |
$360.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$352.36
|
| Rate for Payer: Meridian Medicaid |
$378.80
|
| 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 |
$360.74
|
| 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 |
$360.74
|
| Rate for Payer: VA VA |
$335.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,006.74
|
|
|
HC CONVERT EXTERNAL BILIARY DRAIN TO INTERNAL EXTERNAL
|
Facility
|
OP
|
$3,683.04
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
36100492
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$874.72 |
| Max. Negotiated Rate |
$3,314.74 |
| Rate for Payer: Aetna Commercial |
$3,130.58
|
| Rate for Payer: Aetna Medicare |
$957.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,150.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,150.95
|
| Rate for Payer: BCBS Complete |
$2,625.09
|
| Rate for Payer: BCBS MAPPO |
$920.76
|
| Rate for Payer: BCBS Trust/PPO |
$3,027.83
|
| Rate for Payer: BCN Commercial |
$2,863.56
|
| Rate for Payer: BCN Medicare Advantage |
$920.76
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cofinity Commercial |
$3,167.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,946.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$920.76
|
| Rate for Payer: Healthscope Commercial |
$3,314.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,762.28
|
| Rate for Payer: Mclaren Medicaid |
$2,499.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$966.80
|
| Rate for Payer: Meridian Medicaid |
$2,625.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,058.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,130.58
|
| Rate for Payer: Nomi Health Commercial |
$3,020.09
|
| Rate for Payer: PACE Senior Care Partners |
$874.72
|
| Rate for Payer: PACE SWMI |
$920.76
|
| Rate for Payer: PHP Commercial |
$3,130.58
|
| Rate for Payer: PHP Medicare Advantage |
$920.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,499.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,393.98
|
| Rate for Payer: Priority Health HMO/PPO |
$3,204.24
|
| Rate for Payer: Priority Health Medicare |
$929.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,467.64
|
| Rate for Payer: Railroad Medicare Medicare |
$920.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,241.08
|
| Rate for Payer: UHC Core |
$3,075.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$920.76
|
| Rate for Payer: UHC Exchange |
$920.76
|
| Rate for Payer: UHC Medicare Advantage |
$920.76
|
| Rate for Payer: UHCCP Medicaid |
$2,499.92
|
| Rate for Payer: VA VA |
$920.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,762.28
|
|
|
HC CONVERT EXTERNAL BILIARY DRAIN TO INTERNAL EXTERNAL
|
Facility
|
IP
|
$3,683.04
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
36100492
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,393.98 |
| Max. Negotiated Rate |
$3,314.74 |
| Rate for Payer: Aetna Commercial |
$3,130.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,006.47
|
| Rate for Payer: BCN Commercial |
$2,846.25
|
| Rate for Payer: Cash Price |
$2,946.43
|
| Rate for Payer: Cofinity Commercial |
$3,167.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,946.43
|
| Rate for Payer: Healthscope Commercial |
$3,314.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,762.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,130.58
|
| Rate for Payer: Nomi Health Commercial |
$3,020.09
|
| Rate for Payer: PHP Commercial |
$3,130.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,393.98
|
| Rate for Payer: Priority Health HMO/PPO |
$3,204.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,467.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,241.08
|
| Rate for Payer: UHC Core |
$3,075.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,762.28
|
|
|
HC CONVERT NEPHROSTOMY TO NEPHROURETERAL CATH
|
Facility
|
OP
|
$1,204.40
|
|
|
Service Code
|
CPT 50434
|
| Hospital Charge Code |
36100506
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$286.04 |
| Max. Negotiated Rate |
$1,523.78 |
| Rate for Payer: Aetna Commercial |
$1,023.74
|
| Rate for Payer: Aetna Medicare |
$313.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.38
|
| Rate for Payer: BCBS Complete |
$1,523.78
|
| Rate for Payer: BCBS MAPPO |
$301.10
|
| Rate for Payer: BCBS Trust/PPO |
$990.14
|
| Rate for Payer: BCN Commercial |
$936.42
|
| Rate for Payer: BCN Medicare Advantage |
$301.10
|
| Rate for Payer: Cash Price |
$963.52
|
| Rate for Payer: Cash Price |
$963.52
|
| Rate for Payer: Cofinity Commercial |
$1,035.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.10
|
| Rate for Payer: Healthscope Commercial |
$1,083.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.30
|
| Rate for Payer: Mclaren Medicaid |
$1,451.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.16
|
| Rate for Payer: Meridian Medicaid |
$1,523.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,023.74
|
| Rate for Payer: Nomi Health Commercial |
$987.61
|
| Rate for Payer: PACE Senior Care Partners |
$286.04
|
| Rate for Payer: PACE SWMI |
$301.10
|
| Rate for Payer: PHP Commercial |
$1,023.74
|
| Rate for Payer: PHP Medicare Advantage |
$301.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,451.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,047.83
|
| Rate for Payer: Priority Health Medicare |
$304.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$806.95
|
| Rate for Payer: Railroad Medicare Medicare |
$301.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,059.87
|
| Rate for Payer: UHC Core |
$1,005.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.10
|
| Rate for Payer: UHC Exchange |
$301.10
|
| Rate for Payer: UHC Medicare Advantage |
$301.10
|
| Rate for Payer: UHCCP Medicaid |
$1,451.13
|
| Rate for Payer: VA VA |
$301.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.30
|
|
|
HC CONVERT NEPHROSTOMY TO NEPHROURETERAL CATH
|
Facility
|
IP
|
$1,204.40
|
|
|
Service Code
|
CPT 50434
|
| Hospital Charge Code |
36100506
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$782.86 |
| Max. Negotiated Rate |
$1,083.96 |
| Rate for Payer: Aetna Commercial |
$1,023.74
|
| Rate for Payer: BCBS Trust/PPO |
$983.15
|
| Rate for Payer: BCN Commercial |
$930.76
|
| Rate for Payer: Cash Price |
$963.52
|
| Rate for Payer: Cofinity Commercial |
$1,035.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.52
|
| Rate for Payer: Healthscope Commercial |
$1,083.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,023.74
|
| Rate for Payer: Nomi Health Commercial |
$987.61
|
| Rate for Payer: PHP Commercial |
$1,023.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.86
|
| Rate for Payer: Priority Health HMO/PPO |
$1,047.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$806.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,059.87
|
| Rate for Payer: UHC Core |
$1,005.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.30
|
|
|
HC CONVEX WAFER
|
Facility
|
OP
|
$57.04
|
|
| Hospital Charge Code |
27000049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.55 |
| Max. Negotiated Rate |
$51.34 |
| Rate for Payer: Aetna Commercial |
$48.48
|
| Rate for Payer: Aetna Medicare |
$14.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.82
|
| Rate for Payer: BCBS Complete |
$22.82
|
| Rate for Payer: BCBS MAPPO |
$14.26
|
| Rate for Payer: BCBS Trust/PPO |
$46.89
|
| Rate for Payer: BCN Commercial |
$44.35
|
| Rate for Payer: BCN Medicare Advantage |
$14.26
|
| Rate for Payer: Cash Price |
$45.63
|
| Rate for Payer: Cofinity Commercial |
$49.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.26
|
| Rate for Payer: Healthscope Commercial |
$51.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.48
|
| Rate for Payer: Nomi Health Commercial |
$46.77
|
| Rate for Payer: PACE Senior Care Partners |
$13.55
|
| Rate for Payer: PACE SWMI |
$14.26
|
| Rate for Payer: PHP Commercial |
$48.48
|
| Rate for Payer: PHP Medicare Advantage |
$14.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.08
|
| Rate for Payer: Priority Health HMO/PPO |
$49.62
|
| Rate for Payer: Priority Health Medicare |
$14.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.22
|
| Rate for Payer: Railroad Medicare Medicare |
$14.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.20
|
| Rate for Payer: UHC Core |
$47.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.26
|
| Rate for Payer: UHC Exchange |
$14.26
|
| Rate for Payer: UHC Medicare Advantage |
$14.26
|
| Rate for Payer: VA VA |
$14.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.78
|
|
|
HC CONVEX WAFER
|
Facility
|
IP
|
$57.04
|
|
| Hospital Charge Code |
27000049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.08 |
| Max. Negotiated Rate |
$51.34 |
| Rate for Payer: Aetna Commercial |
$48.48
|
| Rate for Payer: BCBS Trust/PPO |
$46.56
|
| Rate for Payer: BCN Commercial |
$44.08
|
| Rate for Payer: Cash Price |
$45.63
|
| Rate for Payer: Cofinity Commercial |
$49.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.63
|
| Rate for Payer: Healthscope Commercial |
$51.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.48
|
| Rate for Payer: Nomi Health Commercial |
$46.77
|
| Rate for Payer: PHP Commercial |
$48.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.08
|
| Rate for Payer: Priority Health HMO/PPO |
$49.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.20
|
| Rate for Payer: UHC Core |
$47.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.78
|
|
|
HC COOK GUIDEWIRE
|
Facility
|
IP
|
$47.87
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.12 |
| Max. Negotiated Rate |
$43.08 |
| Rate for Payer: Aetna Commercial |
$40.69
|
| Rate for Payer: BCBS Trust/PPO |
$39.08
|
| Rate for Payer: BCN Commercial |
$36.99
|
| Rate for Payer: Cash Price |
$38.30
|
| Rate for Payer: Cofinity Commercial |
$41.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.30
|
| Rate for Payer: Healthscope Commercial |
$43.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.69
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PHP Commercial |
$40.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.12
|
| Rate for Payer: Priority Health HMO/PPO |
$41.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.13
|
| Rate for Payer: UHC Core |
$39.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC COOK GUIDEWIRE
|
Facility
|
OP
|
$47.87
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.37 |
| Max. Negotiated Rate |
$43.08 |
| Rate for Payer: Aetna Commercial |
$40.69
|
| Rate for Payer: Aetna Medicare |
$12.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.96
|
| Rate for Payer: BCBS Complete |
$19.15
|
| Rate for Payer: BCBS MAPPO |
$11.97
|
| Rate for Payer: BCBS Trust/PPO |
$39.35
|
| Rate for Payer: BCN Commercial |
$37.22
|
| Rate for Payer: BCN Medicare Advantage |
$11.97
|
| Rate for Payer: Cash Price |
$38.30
|
| Rate for Payer: Cofinity Commercial |
$41.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.97
|
| Rate for Payer: Healthscope Commercial |
$43.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.69
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PACE Senior Care Partners |
$11.37
|
| Rate for Payer: PACE SWMI |
$11.97
|
| Rate for Payer: PHP Commercial |
$40.69
|
| Rate for Payer: PHP Medicare Advantage |
$11.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.12
|
| Rate for Payer: Priority Health HMO/PPO |
$41.65
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.07
|
| Rate for Payer: Railroad Medicare Medicare |
$11.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.13
|
| Rate for Payer: UHC Core |
$39.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.97
|
| Rate for Payer: UHC Exchange |
$11.97
|
| Rate for Payer: UHC Medicare Advantage |
$11.97
|
| Rate for Payer: VA VA |
$11.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC COOK PIGTAIL
|
Facility
|
OP
|
$468.32
|
|
| Hospital Charge Code |
27200233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$111.23 |
| Max. Negotiated Rate |
$421.49 |
| Rate for Payer: Aetna Commercial |
$398.07
|
| Rate for Payer: Aetna Medicare |
$121.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.35
|
| Rate for Payer: BCBS Complete |
$187.33
|
| Rate for Payer: BCBS MAPPO |
$117.08
|
| Rate for Payer: BCBS Trust/PPO |
$385.01
|
| Rate for Payer: BCN Commercial |
$364.12
|
| Rate for Payer: BCN Medicare Advantage |
$117.08
|
| Rate for Payer: Cash Price |
$374.66
|
| Rate for Payer: Cofinity Commercial |
$402.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.08
|
| Rate for Payer: Healthscope Commercial |
$421.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$134.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.07
|
| Rate for Payer: Nomi Health Commercial |
$384.02
|
| Rate for Payer: PACE Senior Care Partners |
$111.23
|
| Rate for Payer: PACE SWMI |
$117.08
|
| Rate for Payer: PHP Commercial |
$398.07
|
| Rate for Payer: PHP Medicare Advantage |
$117.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.41
|
| Rate for Payer: Priority Health HMO/PPO |
$407.44
|
| Rate for Payer: Priority Health Medicare |
$118.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$313.77
|
| Rate for Payer: Railroad Medicare Medicare |
$117.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.12
|
| Rate for Payer: UHC Core |
$391.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.08
|
| Rate for Payer: UHC Exchange |
$117.08
|
| Rate for Payer: UHC Medicare Advantage |
$117.08
|
| Rate for Payer: VA VA |
$117.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.24
|
|
|
HC COOK PIGTAIL
|
Facility
|
IP
|
$468.32
|
|
| Hospital Charge Code |
27200233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$304.41 |
| Max. Negotiated Rate |
$421.49 |
| Rate for Payer: Aetna Commercial |
$398.07
|
| Rate for Payer: BCBS Trust/PPO |
$382.29
|
| Rate for Payer: BCN Commercial |
$361.92
|
| Rate for Payer: Cash Price |
$374.66
|
| Rate for Payer: Cofinity Commercial |
$402.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.66
|
| Rate for Payer: Healthscope Commercial |
$421.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.07
|
| Rate for Payer: Nomi Health Commercial |
$384.02
|
| Rate for Payer: PHP Commercial |
$398.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.41
|
| Rate for Payer: Priority Health HMO/PPO |
$407.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$313.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.12
|
| Rate for Payer: UHC Core |
$391.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.24
|
|
|
HC COOLIEF RF PROBE
|
Facility
|
IP
|
$1,912.50
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,243.12 |
| Max. Negotiated Rate |
$1,721.25 |
| Rate for Payer: Aetna Commercial |
$1,625.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,561.17
|
| Rate for Payer: BCN Commercial |
$1,477.98
|
| Rate for Payer: Cash Price |
$1,530.00
|
| Rate for Payer: Cofinity Commercial |
$1,644.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,530.00
|
| Rate for Payer: Healthscope Commercial |
$1,721.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,434.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,625.62
|
| Rate for Payer: Nomi Health Commercial |
$1,568.25
|
| Rate for Payer: PHP Commercial |
$1,625.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,243.12
|
| Rate for Payer: Priority Health HMO/PPO |
$1,663.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,281.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,683.00
|
| Rate for Payer: UHC Core |
$1,596.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,434.38
|
|
|
HC COOLIEF RF PROBE
|
Facility
|
OP
|
$1,912.50
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$454.22 |
| Max. Negotiated Rate |
$1,721.25 |
| Rate for Payer: Aetna Commercial |
$1,625.62
|
| Rate for Payer: Aetna Medicare |
$497.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$597.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$597.66
|
| Rate for Payer: BCBS Complete |
$765.00
|
| Rate for Payer: BCBS MAPPO |
$478.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,572.27
|
| Rate for Payer: BCN Commercial |
$1,486.97
|
| Rate for Payer: BCN Medicare Advantage |
$478.12
|
| Rate for Payer: Cash Price |
$1,530.00
|
| Rate for Payer: Cofinity Commercial |
$1,644.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,530.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$478.12
|
| Rate for Payer: Healthscope Commercial |
$1,721.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,434.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$502.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$549.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,625.62
|
| Rate for Payer: Nomi Health Commercial |
$1,568.25
|
| Rate for Payer: PACE Senior Care Partners |
$454.22
|
| Rate for Payer: PACE SWMI |
$478.12
|
| Rate for Payer: PHP Commercial |
$1,625.62
|
| Rate for Payer: PHP Medicare Advantage |
$478.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,243.12
|
| Rate for Payer: Priority Health HMO/PPO |
$1,663.88
|
| Rate for Payer: Priority Health Medicare |
$482.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,281.38
|
| Rate for Payer: Railroad Medicare Medicare |
$478.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,683.00
|
| Rate for Payer: UHC Core |
$1,596.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$478.12
|
| Rate for Payer: UHC Exchange |
$478.12
|
| Rate for Payer: UHC Medicare Advantage |
$478.12
|
| Rate for Payer: VA VA |
$478.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,434.38
|
|
|
HC COPPER SERUM
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.17 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: BCBS Trust/PPO |
$36.64
|
| Rate for Payer: BCN Commercial |
$34.68
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.15
|
| Rate for Payer: Nomi Health Commercial |
$36.80
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.17
|
| Rate for Payer: Priority Health HMO/PPO |
$39.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC COPPER SERUM
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.97 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna Medicare |
$11.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.02
|
| Rate for Payer: BCBS Complete |
$9.42
|
| Rate for Payer: BCBS MAPPO |
$11.22
|
| Rate for Payer: BCBS Trust/PPO |
$36.90
|
| Rate for Payer: BCN Commercial |
$34.89
|
| Rate for Payer: BCN Medicare Advantage |
$11.22
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.22
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Mclaren Medicaid |
$8.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.78
|
| Rate for Payer: Meridian Medicaid |
$9.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.15
|
| Rate for Payer: Nomi Health Commercial |
$36.80
|
| Rate for Payer: PACE Senior Care Partners |
$10.66
|
| Rate for Payer: PACE SWMI |
$11.22
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.17
|
| Rate for Payer: Priority Health HMO/PPO |
$39.05
|
| Rate for Payer: Priority Health Medicare |
$11.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.07
|
| Rate for Payer: Railroad Medicare Medicare |
$11.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.22
|
| Rate for Payer: UHC Exchange |
$11.22
|
| Rate for Payer: UHC Medicare Advantage |
$11.22
|
| Rate for Payer: UHCCP Medicaid |
$8.97
|
| Rate for Payer: VA VA |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC COPPER URINE
|
Facility
|
OP
|
$63.24
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.97 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna Commercial |
$53.75
|
| Rate for Payer: Aetna Medicare |
$16.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.76
|
| Rate for Payer: BCBS Complete |
$9.42
|
| Rate for Payer: BCBS MAPPO |
$15.81
|
| Rate for Payer: BCBS Trust/PPO |
$51.99
|
| Rate for Payer: BCN Commercial |
$49.17
|
| Rate for Payer: BCN Medicare Advantage |
$15.81
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$54.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.81
|
| Rate for Payer: Healthscope Commercial |
$56.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.43
|
| Rate for Payer: Mclaren Medicaid |
$8.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.60
|
| Rate for Payer: Meridian Medicaid |
$9.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| Rate for Payer: PACE Senior Care Partners |
$15.02
|
| Rate for Payer: PACE SWMI |
$15.81
|
| Rate for Payer: PHP Commercial |
$53.75
|
| Rate for Payer: PHP Medicare Advantage |
$15.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: Priority Health HMO/PPO |
$55.02
|
| Rate for Payer: Priority Health Medicare |
$15.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.37
|
| Rate for Payer: Railroad Medicare Medicare |
$15.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.65
|
| Rate for Payer: UHC Core |
$52.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.81
|
| Rate for Payer: UHC Exchange |
$15.81
|
| Rate for Payer: UHC Medicare Advantage |
$15.81
|
| Rate for Payer: UHCCP Medicaid |
$8.97
|
| Rate for Payer: VA VA |
$15.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.43
|
|
|
HC COPPER URINE
|
Facility
|
IP
|
$63.24
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100171
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna Commercial |
$53.75
|
| Rate for Payer: BCBS Trust/PPO |
$51.62
|
| Rate for Payer: BCN Commercial |
$48.87
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$54.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$56.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: Nomi Health Commercial |
$51.86
|
| Rate for Payer: PHP Commercial |
$53.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: Priority Health HMO/PPO |
$55.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.65
|
| Rate for Payer: UHC Core |
$52.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.43
|
|
