|
HC ELEC BREAST PUMP KI (OB)
|
Facility
|
OP
|
$210.68
|
|
| Hospital Charge Code |
27000069
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.14 |
| Max. Negotiated Rate |
$189.61 |
| Rate for Payer: Aetna Commercial |
$179.08
|
| Rate for Payer: Aetna Medicare |
$54.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.84
|
| Rate for Payer: BCBS Complete |
$39.00
|
| Rate for Payer: BCBS MAPPO |
$52.67
|
| Rate for Payer: BCBS Trust/PPO |
$173.20
|
| Rate for Payer: BCN Commercial |
$173.20
|
| Rate for Payer: BCN Medicare Advantage |
$52.67
|
| Rate for Payer: Cash Price |
$168.54
|
| Rate for Payer: Cofinity Commercial |
$181.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.67
|
| Rate for Payer: Healthscope Commercial |
$189.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.01
|
| Rate for Payer: Mclaren Medicaid |
$37.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.30
|
| Rate for Payer: Meridian Medicaid |
$39.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.08
|
| Rate for Payer: Nomi Health Commercial |
$172.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.01
|
| Rate for Payer: PACE Senior Care Partners |
$50.04
|
| Rate for Payer: PACE SWMI |
$52.67
|
| Rate for Payer: PHP Commercial |
$179.08
|
| Rate for Payer: PHP Medicare Advantage |
$52.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$183.29
|
| Rate for Payer: Priority Health Medicare |
$53.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.63
|
| Rate for Payer: Railroad Medicare Medicare |
$52.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.40
|
| Rate for Payer: UHC Core |
$175.92
|
| Rate for Payer: UHC Exchange |
$52.67
|
| Rate for Payer: UHC Medicaid |
$37.14
|
| Rate for Payer: UHC Medicare Advantage |
$52.67
|
| Rate for Payer: UHCCP Medicaid |
$37.14
|
| Rate for Payer: VA VA |
$52.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.01
|
|
|
HC ELECTRICAL STIM UNATTENDED
|
Facility
|
OP
|
$94.45
|
|
|
Service Code
|
CPT 97014
|
| Hospital Charge Code |
42000010
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna Commercial |
$80.28
|
| Rate for Payer: Aetna Medicare |
$24.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.52
|
| Rate for Payer: BCBS Complete |
$17.48
|
| Rate for Payer: BCBS MAPPO |
$23.61
|
| Rate for Payer: BCBS Trust/PPO |
$77.65
|
| Rate for Payer: BCN Commercial |
$77.65
|
| Rate for Payer: BCN Medicare Advantage |
$23.61
|
| Rate for Payer: Cash Price |
$75.56
|
| Rate for Payer: Cofinity Commercial |
$81.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.61
|
| Rate for Payer: Healthscope Commercial |
$85.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.84
|
| Rate for Payer: Mclaren Medicaid |
$16.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.79
|
| Rate for Payer: Meridian Medicaid |
$17.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.28
|
| Rate for Payer: Nomi Health Commercial |
$77.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.84
|
| Rate for Payer: PACE Senior Care Partners |
$22.43
|
| Rate for Payer: PACE SWMI |
$23.61
|
| Rate for Payer: PHP Commercial |
$80.28
|
| Rate for Payer: PHP Medicare Advantage |
$23.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$82.17
|
| Rate for Payer: Priority Health Medicare |
$23.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.74
|
| Rate for Payer: Railroad Medicare Medicare |
$23.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.12
|
| Rate for Payer: UHC Core |
$78.87
|
| Rate for Payer: UHC Exchange |
$23.61
|
| Rate for Payer: UHC Medicaid |
$16.65
|
| Rate for Payer: UHC Medicare Advantage |
$23.61
|
| Rate for Payer: UHCCP Medicaid |
$16.65
|
| Rate for Payer: VA VA |
$23.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.84
|
|
|
HC ELECTRICAL STIM UNATTENDED
|
Facility
|
IP
|
$94.45
|
|
|
Service Code
|
CPT 97014
|
| Hospital Charge Code |
42000010
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$65.74 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna Commercial |
$80.28
|
| Rate for Payer: BCBS Trust/PPO |
$78.01
|
| Rate for Payer: BCN Commercial |
$78.01
|
| Rate for Payer: Cash Price |
$75.56
|
| Rate for Payer: Cofinity Commercial |
$81.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.56
|
| Rate for Payer: Healthscope Commercial |
$85.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.28
|
| Rate for Payer: Nomi Health Commercial |
$77.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.84
|
| Rate for Payer: PHP Commercial |
$80.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$82.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.12
|
| Rate for Payer: UHC Core |
$78.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.84
|
|
|
HC ELECTRICAL STIM UNATTENDED FOR PRESSURE
|
Facility
|
OP
|
$104.49
|
|
|
Service Code
|
HCPCS G0281
|
| Hospital Charge Code |
42000057
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.42 |
| Max. Negotiated Rate |
$94.04 |
| Rate for Payer: Aetna Commercial |
$88.82
|
| Rate for Payer: Aetna Medicare |
$27.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.65
|
| Rate for Payer: BCBS Complete |
$19.34
|
| Rate for Payer: BCBS MAPPO |
$26.12
|
| Rate for Payer: BCBS Trust/PPO |
$85.90
|
| Rate for Payer: BCN Commercial |
$85.90
|
| Rate for Payer: BCN Medicare Advantage |
$26.12
|
| Rate for Payer: Cash Price |
$83.59
|
| Rate for Payer: Cofinity Commercial |
$89.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.12
|
| Rate for Payer: Healthscope Commercial |
$94.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.37
|
| Rate for Payer: Mclaren Medicaid |
$18.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.43
|
| Rate for Payer: Meridian Medicaid |
$19.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.82
|
| Rate for Payer: Nomi Health Commercial |
$85.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.37
|
| Rate for Payer: PACE Senior Care Partners |
$24.82
|
| Rate for Payer: PACE SWMI |
$26.12
|
| Rate for Payer: PHP Commercial |
$88.82
|
| Rate for Payer: PHP Medicare Advantage |
$26.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.91
|
| Rate for Payer: Priority Health Medicare |
$26.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.73
|
| Rate for Payer: Railroad Medicare Medicare |
$26.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.95
|
| Rate for Payer: UHC Core |
$87.25
|
| Rate for Payer: UHC Exchange |
$26.12
|
| Rate for Payer: UHC Medicaid |
$18.42
|
| Rate for Payer: UHC Medicare Advantage |
$26.12
|
| Rate for Payer: UHCCP Medicaid |
$18.42
|
| Rate for Payer: VA VA |
$26.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.37
|
|
|
HC ELECTRICAL STIM UNATTENDED FOR PRESSURE
|
Facility
|
IP
|
$104.49
|
|
|
Service Code
|
HCPCS G0281
|
| Hospital Charge Code |
42000057
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$72.73 |
| Max. Negotiated Rate |
$94.04 |
| Rate for Payer: Aetna Commercial |
$88.82
|
| Rate for Payer: BCBS Trust/PPO |
$86.30
|
| Rate for Payer: BCN Commercial |
$86.30
|
| Rate for Payer: Cash Price |
$83.59
|
| Rate for Payer: Cofinity Commercial |
$89.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.59
|
| Rate for Payer: Healthscope Commercial |
$94.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.82
|
| Rate for Payer: Nomi Health Commercial |
$85.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.37
|
| Rate for Payer: PHP Commercial |
$88.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.95
|
| Rate for Payer: UHC Core |
$87.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.37
|
|
|
HC ELECTRICAL STIM UNATTENDED NOT PRESSURE
|
Facility
|
OP
|
$135.42
|
|
|
Service Code
|
HCPCS G0283
|
| Hospital Charge Code |
42000058
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.87 |
| Max. Negotiated Rate |
$121.88 |
| Rate for Payer: Aetna Commercial |
$115.11
|
| Rate for Payer: Aetna Medicare |
$35.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.32
|
| Rate for Payer: BCBS Complete |
$25.07
|
| Rate for Payer: BCBS MAPPO |
$33.85
|
| Rate for Payer: BCBS Trust/PPO |
$111.33
|
| Rate for Payer: BCN Commercial |
$111.33
|
| Rate for Payer: BCN Medicare Advantage |
$33.85
|
| Rate for Payer: Cash Price |
$108.34
|
| Rate for Payer: Cofinity Commercial |
$116.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.85
|
| Rate for Payer: Healthscope Commercial |
$121.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.56
|
| Rate for Payer: Mclaren Medicaid |
$23.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.55
|
| Rate for Payer: Meridian Medicaid |
$25.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.11
|
| Rate for Payer: Nomi Health Commercial |
$111.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.56
|
| Rate for Payer: PACE Senior Care Partners |
$32.16
|
| Rate for Payer: PACE SWMI |
$33.85
|
| Rate for Payer: PHP Commercial |
$115.11
|
| Rate for Payer: PHP Medicare Advantage |
$33.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$117.82
|
| Rate for Payer: Priority Health Medicare |
$34.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.25
|
| Rate for Payer: Railroad Medicare Medicare |
$33.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.17
|
| Rate for Payer: UHC Core |
$113.08
|
| Rate for Payer: UHC Exchange |
$33.85
|
| Rate for Payer: UHC Medicaid |
$23.87
|
| Rate for Payer: UHC Medicare Advantage |
$33.85
|
| Rate for Payer: UHCCP Medicaid |
$23.87
|
| Rate for Payer: VA VA |
$33.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.56
|
|
|
HC ELECTRICAL STIM UNATTENDED NOT PRESSURE
|
Facility
|
IP
|
$135.42
|
|
|
Service Code
|
HCPCS G0283
|
| Hospital Charge Code |
42000058
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$94.25 |
| Max. Negotiated Rate |
$121.88 |
| Rate for Payer: Aetna Commercial |
$115.11
|
| Rate for Payer: BCBS Trust/PPO |
$111.84
|
| Rate for Payer: BCN Commercial |
$111.84
|
| Rate for Payer: Cash Price |
$108.34
|
| Rate for Payer: Cofinity Commercial |
$116.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.34
|
| Rate for Payer: Healthscope Commercial |
$121.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.11
|
| Rate for Payer: Nomi Health Commercial |
$111.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.56
|
| Rate for Payer: PHP Commercial |
$115.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$117.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.17
|
| Rate for Payer: UHC Core |
$113.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.56
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST BINAURAL
|
Facility
|
OP
|
$80.11
|
|
|
Service Code
|
CPT 92595
|
| Hospital Charge Code |
76100494
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$14.12 |
| Max. Negotiated Rate |
$72.10 |
| Rate for Payer: Aetna Commercial |
$68.09
|
| Rate for Payer: Aetna Medicare |
$20.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.03
|
| Rate for Payer: BCBS Complete |
$14.83
|
| Rate for Payer: BCBS MAPPO |
$20.03
|
| Rate for Payer: BCBS Trust/PPO |
$65.86
|
| Rate for Payer: BCN Commercial |
$65.86
|
| Rate for Payer: BCN Medicare Advantage |
$20.03
|
| Rate for Payer: Cash Price |
$64.09
|
| Rate for Payer: Cofinity Commercial |
$68.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.03
|
| Rate for Payer: Healthscope Commercial |
$72.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.08
|
| Rate for Payer: Mclaren Medicaid |
$14.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.03
|
| Rate for Payer: Meridian Medicaid |
$14.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.09
|
| Rate for Payer: Nomi Health Commercial |
$65.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.08
|
| Rate for Payer: PACE Senior Care Partners |
$19.03
|
| Rate for Payer: PACE SWMI |
$20.03
|
| Rate for Payer: PHP Commercial |
$68.09
|
| Rate for Payer: PHP Medicare Advantage |
$20.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.70
|
| Rate for Payer: Priority Health Medicare |
$20.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.76
|
| Rate for Payer: Railroad Medicare Medicare |
$20.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.50
|
| Rate for Payer: UHC Core |
$66.89
|
| Rate for Payer: UHC Exchange |
$20.03
|
| Rate for Payer: UHC Medicaid |
$14.12
|
| Rate for Payer: UHC Medicare Advantage |
$20.03
|
| Rate for Payer: UHCCP Medicaid |
$14.12
|
| Rate for Payer: VA VA |
$20.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.08
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST BINAURAL
|
Facility
|
IP
|
$80.11
|
|
|
Service Code
|
CPT 92595
|
| Hospital Charge Code |
76100494
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$55.76 |
| Max. Negotiated Rate |
$72.10 |
| Rate for Payer: Aetna Commercial |
$68.09
|
| Rate for Payer: BCBS Trust/PPO |
$66.16
|
| Rate for Payer: BCN Commercial |
$66.16
|
| Rate for Payer: Cash Price |
$64.09
|
| Rate for Payer: Cofinity Commercial |
$68.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.09
|
| Rate for Payer: Healthscope Commercial |
$72.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.09
|
| Rate for Payer: Nomi Health Commercial |
$65.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.08
|
| Rate for Payer: PHP Commercial |
$68.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.50
|
| Rate for Payer: UHC Core |
$66.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.08
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST MONAURAL
|
Facility
|
IP
|
$91.56
|
|
|
Service Code
|
CPT 92594
|
| Hospital Charge Code |
76100493
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$63.73 |
| Max. Negotiated Rate |
$82.40 |
| Rate for Payer: Aetna Commercial |
$77.83
|
| Rate for Payer: BCBS Trust/PPO |
$75.62
|
| Rate for Payer: BCN Commercial |
$75.62
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cofinity Commercial |
$78.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.25
|
| Rate for Payer: Healthscope Commercial |
$82.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$75.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.67
|
| Rate for Payer: PHP Commercial |
$77.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$79.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.57
|
| Rate for Payer: UHC Core |
$76.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.67
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST MONAURAL
|
Facility
|
OP
|
$91.56
|
|
|
Service Code
|
CPT 92594
|
| Hospital Charge Code |
76100493
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$16.14 |
| Max. Negotiated Rate |
$82.40 |
| Rate for Payer: Aetna Commercial |
$77.83
|
| Rate for Payer: Aetna Medicare |
$23.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.61
|
| Rate for Payer: BCBS Complete |
$16.95
|
| Rate for Payer: BCBS MAPPO |
$22.89
|
| Rate for Payer: BCBS Trust/PPO |
$75.27
|
| Rate for Payer: BCN Commercial |
$75.27
|
| Rate for Payer: BCN Medicare Advantage |
$22.89
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cofinity Commercial |
$78.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.89
|
| Rate for Payer: Healthscope Commercial |
$82.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.67
|
| Rate for Payer: Mclaren Medicaid |
$16.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.03
|
| Rate for Payer: Meridian Medicaid |
$16.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$75.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.67
|
| Rate for Payer: PACE Senior Care Partners |
$21.75
|
| Rate for Payer: PACE SWMI |
$22.89
|
| Rate for Payer: PHP Commercial |
$77.83
|
| Rate for Payer: PHP Medicare Advantage |
$22.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$79.66
|
| Rate for Payer: Priority Health Medicare |
$23.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.73
|
| Rate for Payer: Railroad Medicare Medicare |
$22.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.57
|
| Rate for Payer: UHC Core |
$76.45
|
| Rate for Payer: UHC Exchange |
$22.89
|
| Rate for Payer: UHC Medicaid |
$16.14
|
| Rate for Payer: UHC Medicare Advantage |
$22.89
|
| Rate for Payer: UHCCP Medicaid |
$16.14
|
| Rate for Payer: VA VA |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.67
|
|
|
HC ELECTROCARDIOGRAM
|
Facility
|
OP
|
$221.75
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
73000001
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$39.09 |
| Max. Negotiated Rate |
$199.57 |
| Rate for Payer: Aetna Commercial |
$188.49
|
| Rate for Payer: Aetna Medicare |
$57.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.30
|
| Rate for Payer: BCBS Complete |
$41.05
|
| Rate for Payer: BCBS MAPPO |
$55.44
|
| Rate for Payer: BCBS Trust/PPO |
$182.30
|
| Rate for Payer: BCN Commercial |
$182.30
|
| Rate for Payer: BCN Medicare Advantage |
$55.44
|
| Rate for Payer: Cash Price |
$177.40
|
| Rate for Payer: Cofinity Commercial |
$190.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.44
|
| Rate for Payer: Healthscope Commercial |
$199.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.31
|
| Rate for Payer: Mclaren Medicaid |
$39.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.21
|
| Rate for Payer: Meridian Medicaid |
$41.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$63.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.49
|
| Rate for Payer: Nomi Health Commercial |
$181.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.31
|
| Rate for Payer: PACE Senior Care Partners |
$52.67
|
| Rate for Payer: PACE SWMI |
$55.44
|
| Rate for Payer: PHP Commercial |
$188.49
|
| Rate for Payer: PHP Medicare Advantage |
$55.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$192.92
|
| Rate for Payer: Priority Health Medicare |
$55.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.34
|
| Rate for Payer: Railroad Medicare Medicare |
$55.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.14
|
| Rate for Payer: UHC Core |
$185.16
|
| Rate for Payer: UHC Exchange |
$55.44
|
| Rate for Payer: UHC Medicaid |
$39.09
|
| Rate for Payer: UHC Medicare Advantage |
$55.44
|
| Rate for Payer: UHCCP Medicaid |
$39.09
|
| Rate for Payer: VA VA |
$55.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.31
|
|
|
HC ELECTROCARDIOGRAM
|
Facility
|
IP
|
$221.75
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
73000001
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$154.34 |
| Max. Negotiated Rate |
$199.57 |
| Rate for Payer: Aetna Commercial |
$188.49
|
| Rate for Payer: BCBS Trust/PPO |
$183.14
|
| Rate for Payer: BCN Commercial |
$183.14
|
| Rate for Payer: Cash Price |
$177.40
|
| Rate for Payer: Cofinity Commercial |
$190.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.40
|
| Rate for Payer: Healthscope Commercial |
$199.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.49
|
| Rate for Payer: Nomi Health Commercial |
$181.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.31
|
| Rate for Payer: PHP Commercial |
$188.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$192.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.14
|
| Rate for Payer: UHC Core |
$185.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.31
|
|
|
HC ELECTROCORTICOGRAM IMPLTD BRN NPGT <30 D
|
Facility
|
IP
|
$77.47
|
|
|
Service Code
|
CPT 95836
|
| Hospital Charge Code |
74000033
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$53.92 |
| Max. Negotiated Rate |
$69.72 |
| Rate for Payer: Aetna Commercial |
$65.85
|
| Rate for Payer: BCBS Trust/PPO |
$63.98
|
| Rate for Payer: BCN Commercial |
$63.98
|
| Rate for Payer: Cash Price |
$61.98
|
| Rate for Payer: Cofinity Commercial |
$66.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.98
|
| Rate for Payer: Healthscope Commercial |
$69.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.85
|
| Rate for Payer: Nomi Health Commercial |
$63.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.10
|
| Rate for Payer: PHP Commercial |
$65.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.17
|
| Rate for Payer: UHC Core |
$64.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.10
|
|
|
HC ELECTROCORTICOGRAM IMPLTD BRN NPGT <30 D
|
Facility
|
OP
|
$77.47
|
|
|
Service Code
|
CPT 95836
|
| Hospital Charge Code |
74000033
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$13.66 |
| Max. Negotiated Rate |
$69.72 |
| Rate for Payer: Aetna Commercial |
$65.85
|
| Rate for Payer: Aetna Medicare |
$20.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.21
|
| Rate for Payer: BCBS Complete |
$14.34
|
| Rate for Payer: BCBS MAPPO |
$19.37
|
| Rate for Payer: BCBS Trust/PPO |
$63.69
|
| Rate for Payer: BCN Commercial |
$63.69
|
| Rate for Payer: BCN Medicare Advantage |
$19.37
|
| Rate for Payer: Cash Price |
$61.98
|
| Rate for Payer: Cofinity Commercial |
$66.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.37
|
| Rate for Payer: Healthscope Commercial |
$69.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.10
|
| Rate for Payer: Mclaren Medicaid |
$13.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.34
|
| Rate for Payer: Meridian Medicaid |
$14.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.85
|
| Rate for Payer: Nomi Health Commercial |
$63.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.10
|
| Rate for Payer: PACE Senior Care Partners |
$18.40
|
| Rate for Payer: PACE SWMI |
$19.37
|
| Rate for Payer: PHP Commercial |
$65.85
|
| Rate for Payer: PHP Medicare Advantage |
$19.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.40
|
| Rate for Payer: Priority Health Medicare |
$19.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.92
|
| Rate for Payer: Railroad Medicare Medicare |
$19.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.17
|
| Rate for Payer: UHC Core |
$64.69
|
| Rate for Payer: UHC Exchange |
$19.37
|
| Rate for Payer: UHC Medicaid |
$13.66
|
| Rate for Payer: UHC Medicare Advantage |
$19.37
|
| Rate for Payer: UHCCP Medicaid |
$13.66
|
| Rate for Payer: VA VA |
$19.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.10
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
OP
|
$28.65
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.05 |
| Max. Negotiated Rate |
$25.79 |
| Rate for Payer: Aetna Commercial |
$24.35
|
| Rate for Payer: Aetna Medicare |
$7.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.95
|
| Rate for Payer: BCBS Complete |
$5.30
|
| Rate for Payer: BCBS MAPPO |
$7.16
|
| Rate for Payer: BCBS Trust/PPO |
$23.55
|
| Rate for Payer: BCN Commercial |
$23.55
|
| Rate for Payer: BCN Medicare Advantage |
$7.16
|
| Rate for Payer: Cash Price |
$22.92
|
| Rate for Payer: Cofinity Commercial |
$24.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.16
|
| Rate for Payer: Healthscope Commercial |
$25.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.49
|
| Rate for Payer: Mclaren Medicaid |
$5.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.52
|
| Rate for Payer: Meridian Medicaid |
$5.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.35
|
| Rate for Payer: Nomi Health Commercial |
$23.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.49
|
| Rate for Payer: PACE Senior Care Partners |
$6.80
|
| Rate for Payer: PACE SWMI |
$7.16
|
| Rate for Payer: PHP Commercial |
$24.35
|
| Rate for Payer: PHP Medicare Advantage |
$7.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.93
|
| Rate for Payer: Priority Health Medicare |
$7.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.94
|
| Rate for Payer: Railroad Medicare Medicare |
$7.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.21
|
| Rate for Payer: UHC Core |
$23.92
|
| Rate for Payer: UHC Exchange |
$7.16
|
| Rate for Payer: UHC Medicaid |
$5.05
|
| Rate for Payer: UHC Medicare Advantage |
$7.16
|
| Rate for Payer: UHCCP Medicaid |
$5.05
|
| Rate for Payer: VA VA |
$7.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.49
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
IP
|
$28.65
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.94 |
| Max. Negotiated Rate |
$25.79 |
| Rate for Payer: Aetna Commercial |
$24.35
|
| Rate for Payer: BCBS Trust/PPO |
$23.66
|
| Rate for Payer: BCN Commercial |
$23.66
|
| Rate for Payer: Cash Price |
$22.92
|
| Rate for Payer: Cofinity Commercial |
$24.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.92
|
| Rate for Payer: Healthscope Commercial |
$25.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.35
|
| Rate for Payer: Nomi Health Commercial |
$23.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.49
|
| Rate for Payer: PHP Commercial |
$24.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.21
|
| Rate for Payer: UHC Core |
$23.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.49
|
|
|
HC ELECTROLYTES WHOLE BLOOD
|
Facility
|
IP
|
$89.58
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100490
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.35 |
| Max. Negotiated Rate |
$80.62 |
| Rate for Payer: Aetna Commercial |
$76.14
|
| Rate for Payer: BCBS Trust/PPO |
$73.98
|
| Rate for Payer: BCN Commercial |
$73.98
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cofinity Commercial |
$77.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.66
|
| Rate for Payer: Healthscope Commercial |
$80.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.14
|
| Rate for Payer: Nomi Health Commercial |
$73.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.19
|
| Rate for Payer: PHP Commercial |
$76.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.83
|
| Rate for Payer: UHC Core |
$74.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.19
|
|
|
HC ELECTROLYTES WHOLE BLOOD
|
Facility
|
OP
|
$89.58
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100490
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.79 |
| Max. Negotiated Rate |
$80.62 |
| Rate for Payer: Aetna Commercial |
$76.14
|
| Rate for Payer: Aetna Medicare |
$23.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.99
|
| Rate for Payer: BCBS Complete |
$16.58
|
| Rate for Payer: BCBS MAPPO |
$22.39
|
| Rate for Payer: BCBS Trust/PPO |
$73.64
|
| Rate for Payer: BCN Commercial |
$73.64
|
| Rate for Payer: BCN Medicare Advantage |
$22.39
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cofinity Commercial |
$77.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.39
|
| Rate for Payer: Healthscope Commercial |
$80.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.19
|
| Rate for Payer: Mclaren Medicaid |
$15.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.51
|
| Rate for Payer: Meridian Medicaid |
$16.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.14
|
| Rate for Payer: Nomi Health Commercial |
$73.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.19
|
| Rate for Payer: PACE Senior Care Partners |
$21.28
|
| Rate for Payer: PACE SWMI |
$22.39
|
| Rate for Payer: PHP Commercial |
$76.14
|
| Rate for Payer: PHP Medicare Advantage |
$22.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.93
|
| Rate for Payer: Priority Health Medicare |
$22.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.35
|
| Rate for Payer: Railroad Medicare Medicare |
$22.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.83
|
| Rate for Payer: UHC Core |
$74.80
|
| Rate for Payer: UHC Exchange |
$22.39
|
| Rate for Payer: UHC Medicaid |
$15.79
|
| Rate for Payer: UHC Medicare Advantage |
$22.39
|
| Rate for Payer: UHCCP Medicaid |
$15.79
|
| Rate for Payer: VA VA |
$22.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.19
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 100
|
Facility
|
OP
|
$10,050.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200406
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,771.82 |
| Max. Negotiated Rate |
$9,045.00 |
| Rate for Payer: Aetna Commercial |
$8,542.50
|
| Rate for Payer: Aetna Medicare |
$2,613.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,140.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,140.62
|
| Rate for Payer: BCBS Complete |
$1,860.26
|
| Rate for Payer: BCBS MAPPO |
$2,512.50
|
| Rate for Payer: BCBS Trust/PPO |
$8,262.10
|
| Rate for Payer: BCN Commercial |
$8,262.10
|
| Rate for Payer: BCN Medicare Advantage |
$2,512.50
|
| Rate for Payer: Cash Price |
$8,040.00
|
| Rate for Payer: Cofinity Commercial |
$8,643.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,512.50
|
| Rate for Payer: Healthscope Commercial |
$9,045.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,537.50
|
| Rate for Payer: Mclaren Medicaid |
$1,771.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,638.12
|
| Rate for Payer: Meridian Medicaid |
$1,860.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,889.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,763.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,542.50
|
| Rate for Payer: Nomi Health Commercial |
$8,241.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,537.50
|
| Rate for Payer: PACE Senior Care Partners |
$2,386.88
|
| Rate for Payer: PACE SWMI |
$2,512.50
|
| Rate for Payer: PHP Commercial |
$8,542.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,512.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,771.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,743.50
|
| Rate for Payer: Priority Health Medicare |
$2,537.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,994.80
|
| Rate for Payer: Railroad Medicare Medicare |
$2,512.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,844.00
|
| Rate for Payer: UHC Core |
$8,391.75
|
| Rate for Payer: UHC Exchange |
$2,512.50
|
| Rate for Payer: UHC Medicaid |
$1,771.82
|
| Rate for Payer: UHC Medicare Advantage |
$2,512.50
|
| Rate for Payer: UHCCP Medicaid |
$1,771.82
|
| Rate for Payer: VA VA |
$2,512.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,537.50
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 100
|
Facility
|
IP
|
$10,050.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200406
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6,994.80 |
| Max. Negotiated Rate |
$9,045.00 |
| Rate for Payer: Aetna Commercial |
$8,542.50
|
| Rate for Payer: BCBS Trust/PPO |
$8,300.30
|
| Rate for Payer: BCN Commercial |
$8,300.30
|
| Rate for Payer: Cash Price |
$8,040.00
|
| Rate for Payer: Cofinity Commercial |
$8,643.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.00
|
| Rate for Payer: Healthscope Commercial |
$9,045.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,537.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,542.50
|
| Rate for Payer: Nomi Health Commercial |
$8,241.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,537.50
|
| Rate for Payer: PHP Commercial |
$8,542.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,743.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,994.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,844.00
|
| Rate for Payer: UHC Core |
$8,391.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,537.50
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPINGLEVEL 31
|
Facility
|
OP
|
$3,150.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200369
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$555.35 |
| Max. Negotiated Rate |
$2,835.00 |
| Rate for Payer: Aetna Commercial |
$2,677.50
|
| Rate for Payer: Aetna Medicare |
$819.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$984.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$984.38
|
| Rate for Payer: BCBS Complete |
$583.07
|
| Rate for Payer: BCBS MAPPO |
$787.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,589.61
|
| Rate for Payer: BCN Commercial |
$2,589.61
|
| Rate for Payer: BCN Medicare Advantage |
$787.50
|
| Rate for Payer: Cash Price |
$2,520.00
|
| Rate for Payer: Cofinity Commercial |
$2,709.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,520.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.50
|
| Rate for Payer: Healthscope Commercial |
$2,835.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,362.50
|
| Rate for Payer: Mclaren Medicaid |
$555.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$826.88
|
| Rate for Payer: Meridian Medicaid |
$583.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$905.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$866.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,677.50
|
| Rate for Payer: Nomi Health Commercial |
$2,583.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,362.50
|
| Rate for Payer: PACE Senior Care Partners |
$748.12
|
| Rate for Payer: PACE SWMI |
$787.50
|
| Rate for Payer: PHP Commercial |
$2,677.50
|
| Rate for Payer: PHP Medicare Advantage |
$787.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,740.50
|
| Rate for Payer: Priority Health Medicare |
$795.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,192.40
|
| Rate for Payer: Railroad Medicare Medicare |
$787.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,772.00
|
| Rate for Payer: UHC Core |
$2,630.25
|
| Rate for Payer: UHC Exchange |
$787.50
|
| Rate for Payer: UHC Medicaid |
$555.35
|
| Rate for Payer: UHC Medicare Advantage |
$787.50
|
| Rate for Payer: UHCCP Medicaid |
$555.35
|
| Rate for Payer: VA VA |
$787.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,362.50
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPINGLEVEL 31
|
Facility
|
IP
|
$3,150.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200369
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,192.40 |
| Max. Negotiated Rate |
$2,835.00 |
| Rate for Payer: Aetna Commercial |
$2,677.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,601.59
|
| Rate for Payer: BCN Commercial |
$2,601.59
|
| Rate for Payer: Cash Price |
$2,520.00
|
| Rate for Payer: Cofinity Commercial |
$2,709.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,520.00
|
| Rate for Payer: Healthscope Commercial |
$2,835.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,362.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,677.50
|
| Rate for Payer: Nomi Health Commercial |
$2,583.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,362.50
|
| Rate for Payer: PHP Commercial |
$2,677.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,740.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,192.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,772.00
|
| Rate for Payer: UHC Core |
$2,630.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,362.50
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 39
|
Facility
|
IP
|
$3,988.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200371
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,775.65 |
| Max. Negotiated Rate |
$3,589.20 |
| Rate for Payer: Aetna Commercial |
$3,389.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,293.69
|
| Rate for Payer: BCN Commercial |
$3,293.69
|
| Rate for Payer: Cash Price |
$3,190.40
|
| Rate for Payer: Cofinity Commercial |
$3,429.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.40
|
| Rate for Payer: Healthscope Commercial |
$3,589.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,991.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,389.80
|
| Rate for Payer: Nomi Health Commercial |
$3,270.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,991.00
|
| Rate for Payer: PHP Commercial |
$3,389.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,469.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,775.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,509.44
|
| Rate for Payer: UHC Core |
$3,329.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,991.00
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 39
|
Facility
|
OP
|
$3,988.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200371
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$703.08 |
| Max. Negotiated Rate |
$3,589.20 |
| Rate for Payer: Aetna Commercial |
$3,389.80
|
| Rate for Payer: Aetna Medicare |
$1,036.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,246.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,246.25
|
| Rate for Payer: BCBS Complete |
$738.18
|
| Rate for Payer: BCBS MAPPO |
$997.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,278.53
|
| Rate for Payer: BCN Commercial |
$3,278.53
|
| Rate for Payer: BCN Medicare Advantage |
$997.00
|
| Rate for Payer: Cash Price |
$3,190.40
|
| Rate for Payer: Cofinity Commercial |
$3,429.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$997.00
|
| Rate for Payer: Healthscope Commercial |
$3,589.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,991.00
|
| Rate for Payer: Mclaren Medicaid |
$703.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.85
|
| Rate for Payer: Meridian Medicaid |
$738.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,146.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,096.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,389.80
|
| Rate for Payer: Nomi Health Commercial |
$3,270.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,991.00
|
| Rate for Payer: PACE Senior Care Partners |
$947.15
|
| Rate for Payer: PACE SWMI |
$997.00
|
| Rate for Payer: PHP Commercial |
$3,389.80
|
| Rate for Payer: PHP Medicare Advantage |
$997.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$703.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,469.56
|
| Rate for Payer: Priority Health Medicare |
$1,006.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,775.65
|
| Rate for Payer: Railroad Medicare Medicare |
$997.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,509.44
|
| Rate for Payer: UHC Core |
$3,329.98
|
| Rate for Payer: UHC Exchange |
$997.00
|
| Rate for Payer: UHC Medicaid |
$703.08
|
| Rate for Payer: UHC Medicare Advantage |
$997.00
|
| Rate for Payer: UHCCP Medicaid |
$703.08
|
| Rate for Payer: VA VA |
$997.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,991.00
|
|
