|
HC EP+PVI ABL
|
Facility
|
IP
|
$9,080.04
|
|
|
Service Code
|
CPT 93656
|
| Hospital Charge Code |
48100094
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,319.71 |
| Max. Negotiated Rate |
$8,172.04 |
| Rate for Payer: Aetna Commercial |
$7,718.03
|
| Rate for Payer: BCBS Trust/PPO |
$7,499.21
|
| Rate for Payer: BCN Commercial |
$7,499.21
|
| Rate for Payer: Cash Price |
$7,264.03
|
| Rate for Payer: Cofinity Commercial |
$7,808.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,264.03
|
| Rate for Payer: Healthscope Commercial |
$8,172.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,810.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,718.03
|
| Rate for Payer: Nomi Health Commercial |
$7,445.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,810.03
|
| Rate for Payer: PHP Commercial |
$7,718.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,899.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,319.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,990.44
|
| Rate for Payer: UHC Core |
$7,581.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,810.03
|
|
|
HC EPSTEIN BARR AB-IGG & IGM
|
Facility
|
IP
|
$38.20
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200353
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: BCBS Trust/PPO |
$31.55
|
| Rate for Payer: BCN Commercial |
$31.55
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$31.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PHP Commercial |
$32.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.62
|
| Rate for Payer: UHC Core |
$31.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.65
|
|
|
HC EPSTEIN BARR AB-IGG & IGM
|
Facility
|
OP
|
$38.20
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200353
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: Aetna Medicare |
$9.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.94
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS MAPPO |
$9.55
|
| Rate for Payer: BCBS Trust/PPO |
$31.40
|
| Rate for Payer: BCN Commercial |
$31.40
|
| Rate for Payer: BCN Medicare Advantage |
$9.55
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.55
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.65
|
| Rate for Payer: Mclaren Medicaid |
$6.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.03
|
| Rate for Payer: Meridian Medicaid |
$7.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$31.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PACE Senior Care Partners |
$9.07
|
| Rate for Payer: PACE SWMI |
$9.55
|
| Rate for Payer: PHP Commercial |
$32.47
|
| Rate for Payer: PHP Medicare Advantage |
$9.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.23
|
| Rate for Payer: Priority Health Medicare |
$9.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.59
|
| Rate for Payer: Railroad Medicare Medicare |
$9.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.62
|
| Rate for Payer: UHC Core |
$31.90
|
| Rate for Payer: UHC Exchange |
$9.55
|
| Rate for Payer: UHC Medicaid |
$6.73
|
| Rate for Payer: UHC Medicare Advantage |
$9.55
|
| Rate for Payer: UHCCP Medicaid |
$6.73
|
| Rate for Payer: VA VA |
$9.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.65
|
|
|
HC EPSTEIN BARR ANTIBODY
|
Facility
|
OP
|
$38.20
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200268
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: Aetna Medicare |
$9.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.94
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS MAPPO |
$9.55
|
| Rate for Payer: BCBS Trust/PPO |
$31.40
|
| Rate for Payer: BCN Commercial |
$31.40
|
| Rate for Payer: BCN Medicare Advantage |
$9.55
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.55
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.65
|
| Rate for Payer: Mclaren Medicaid |
$6.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.03
|
| Rate for Payer: Meridian Medicaid |
$7.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$31.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PACE Senior Care Partners |
$9.07
|
| Rate for Payer: PACE SWMI |
$9.55
|
| Rate for Payer: PHP Commercial |
$32.47
|
| Rate for Payer: PHP Medicare Advantage |
$9.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.23
|
| Rate for Payer: Priority Health Medicare |
$9.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.59
|
| Rate for Payer: Railroad Medicare Medicare |
$9.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.62
|
| Rate for Payer: UHC Core |
$31.90
|
| Rate for Payer: UHC Exchange |
$9.55
|
| Rate for Payer: UHC Medicaid |
$6.73
|
| Rate for Payer: UHC Medicare Advantage |
$9.55
|
| Rate for Payer: UHCCP Medicaid |
$6.73
|
| Rate for Payer: VA VA |
$9.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.65
|
|
|
HC EPSTEIN BARR ANTIBODY
|
Facility
|
IP
|
$38.20
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200268
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: BCBS Trust/PPO |
$31.55
|
| Rate for Payer: BCN Commercial |
$31.55
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$31.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PHP Commercial |
$32.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.62
|
| Rate for Payer: UHC Core |
$31.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.65
|
|
|
HC EPSTEIN-BARR ANTIBODY NUCLEAR ANTIGEN
|
Facility
|
OP
|
$38.20
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200267
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: Aetna Medicare |
$9.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.94
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS MAPPO |
$9.55
|
| Rate for Payer: BCBS Trust/PPO |
$31.40
|
| Rate for Payer: BCN Commercial |
$31.40
|
| Rate for Payer: BCN Medicare Advantage |
$9.55
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.55
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.65
|
| Rate for Payer: Mclaren Medicaid |
$6.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.03
|
| Rate for Payer: Meridian Medicaid |
$7.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$31.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PACE Senior Care Partners |
$9.07
|
| Rate for Payer: PACE SWMI |
$9.55
|
| Rate for Payer: PHP Commercial |
$32.47
|
| Rate for Payer: PHP Medicare Advantage |
$9.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.23
|
| Rate for Payer: Priority Health Medicare |
$9.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.59
|
| Rate for Payer: Railroad Medicare Medicare |
$9.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.62
|
| Rate for Payer: UHC Core |
$31.90
|
| Rate for Payer: UHC Exchange |
$9.55
|
| Rate for Payer: UHC Medicaid |
$6.73
|
| Rate for Payer: UHC Medicare Advantage |
$9.55
|
| Rate for Payer: UHCCP Medicaid |
$6.73
|
| Rate for Payer: VA VA |
$9.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.65
|
|
|
HC EPSTEIN-BARR ANTIBODY NUCLEAR ANTIGEN
|
Facility
|
IP
|
$38.20
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200267
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: BCBS Trust/PPO |
$31.55
|
| Rate for Payer: BCN Commercial |
$31.55
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$31.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PHP Commercial |
$32.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.62
|
| Rate for Payer: UHC Core |
$31.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.65
|
|
|
HC EPSTEIN BARR EA AG
|
Facility
|
IP
|
$38.20
|
|
|
Service Code
|
CPT 86663
|
| Hospital Charge Code |
30200365
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: BCBS Trust/PPO |
$31.55
|
| Rate for Payer: BCN Commercial |
$31.55
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$31.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PHP Commercial |
$32.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.62
|
| Rate for Payer: UHC Core |
$31.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.65
|
|
|
HC EPSTEIN BARR EA AG
|
Facility
|
OP
|
$38.20
|
|
|
Service Code
|
CPT 86663
|
| Hospital Charge Code |
30200365
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$34.38 |
| Rate for Payer: Aetna Commercial |
$32.47
|
| Rate for Payer: Aetna Medicare |
$9.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.94
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS MAPPO |
$9.55
|
| Rate for Payer: BCBS Trust/PPO |
$31.40
|
| Rate for Payer: BCN Commercial |
$31.40
|
| Rate for Payer: BCN Medicare Advantage |
$9.55
|
| Rate for Payer: Cash Price |
$30.56
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.55
|
| Rate for Payer: Healthscope Commercial |
$34.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.65
|
| Rate for Payer: Mclaren Medicaid |
$6.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.03
|
| Rate for Payer: Meridian Medicaid |
$7.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.47
|
| Rate for Payer: Nomi Health Commercial |
$31.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.65
|
| Rate for Payer: PACE Senior Care Partners |
$9.07
|
| Rate for Payer: PACE SWMI |
$9.55
|
| Rate for Payer: PHP Commercial |
$32.47
|
| Rate for Payer: PHP Medicare Advantage |
$9.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.23
|
| Rate for Payer: Priority Health Medicare |
$9.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.59
|
| Rate for Payer: Railroad Medicare Medicare |
$9.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.62
|
| Rate for Payer: UHC Core |
$31.90
|
| Rate for Payer: UHC Exchange |
$9.55
|
| Rate for Payer: UHC Medicaid |
$6.73
|
| Rate for Payer: UHC Medicare Advantage |
$9.55
|
| Rate for Payer: UHCCP Medicaid |
$6.73
|
| Rate for Payer: VA VA |
$9.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.65
|
|
|
HC EPSTEIN BARR VIRUS BY PCR FLUID
|
Facility
|
OP
|
$124.16
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600171
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.89 |
| Max. Negotiated Rate |
$111.74 |
| Rate for Payer: Aetna Commercial |
$105.54
|
| Rate for Payer: Aetna Medicare |
$32.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.80
|
| Rate for Payer: BCBS Complete |
$22.98
|
| Rate for Payer: BCBS MAPPO |
$31.04
|
| Rate for Payer: BCBS Trust/PPO |
$102.07
|
| Rate for Payer: BCN Commercial |
$102.07
|
| Rate for Payer: BCN Medicare Advantage |
$31.04
|
| Rate for Payer: Cash Price |
$99.33
|
| Rate for Payer: Cofinity Commercial |
$106.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.04
|
| Rate for Payer: Healthscope Commercial |
$111.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.12
|
| Rate for Payer: Mclaren Medicaid |
$21.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.59
|
| Rate for Payer: Meridian Medicaid |
$22.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.54
|
| Rate for Payer: Nomi Health Commercial |
$101.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.12
|
| Rate for Payer: PACE Senior Care Partners |
$29.49
|
| Rate for Payer: PACE SWMI |
$31.04
|
| Rate for Payer: PHP Commercial |
$105.54
|
| Rate for Payer: PHP Medicare Advantage |
$31.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$108.02
|
| Rate for Payer: Priority Health Medicare |
$31.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.42
|
| Rate for Payer: Railroad Medicare Medicare |
$31.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.26
|
| Rate for Payer: UHC Core |
$103.67
|
| Rate for Payer: UHC Exchange |
$31.04
|
| Rate for Payer: UHC Medicaid |
$21.89
|
| Rate for Payer: UHC Medicare Advantage |
$31.04
|
| Rate for Payer: UHCCP Medicaid |
$21.89
|
| Rate for Payer: VA VA |
$31.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.12
|
|
|
HC EPSTEIN BARR VIRUS BY PCR FLUID
|
Facility
|
IP
|
$124.16
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600171
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$86.42 |
| Max. Negotiated Rate |
$111.74 |
| Rate for Payer: Aetna Commercial |
$105.54
|
| Rate for Payer: BCBS Trust/PPO |
$102.54
|
| Rate for Payer: BCN Commercial |
$102.54
|
| Rate for Payer: Cash Price |
$99.33
|
| Rate for Payer: Cofinity Commercial |
$106.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.33
|
| Rate for Payer: Healthscope Commercial |
$111.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.54
|
| Rate for Payer: Nomi Health Commercial |
$101.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.12
|
| Rate for Payer: PHP Commercial |
$105.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$108.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.26
|
| Rate for Payer: UHC Core |
$103.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.12
|
|
|
HC EPSTEIN BARR VIRUS PCR BLOOD
|
Facility
|
OP
|
$124.16
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600172
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.89 |
| Max. Negotiated Rate |
$111.74 |
| Rate for Payer: Aetna Commercial |
$105.54
|
| Rate for Payer: Aetna Medicare |
$32.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.80
|
| Rate for Payer: BCBS Complete |
$22.98
|
| Rate for Payer: BCBS MAPPO |
$31.04
|
| Rate for Payer: BCBS Trust/PPO |
$102.07
|
| Rate for Payer: BCN Commercial |
$102.07
|
| Rate for Payer: BCN Medicare Advantage |
$31.04
|
| Rate for Payer: Cash Price |
$99.33
|
| Rate for Payer: Cofinity Commercial |
$106.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.04
|
| Rate for Payer: Healthscope Commercial |
$111.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.12
|
| Rate for Payer: Mclaren Medicaid |
$21.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.59
|
| Rate for Payer: Meridian Medicaid |
$22.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.54
|
| Rate for Payer: Nomi Health Commercial |
$101.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.12
|
| Rate for Payer: PACE Senior Care Partners |
$29.49
|
| Rate for Payer: PACE SWMI |
$31.04
|
| Rate for Payer: PHP Commercial |
$105.54
|
| Rate for Payer: PHP Medicare Advantage |
$31.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$108.02
|
| Rate for Payer: Priority Health Medicare |
$31.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.42
|
| Rate for Payer: Railroad Medicare Medicare |
$31.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.26
|
| Rate for Payer: UHC Core |
$103.67
|
| Rate for Payer: UHC Exchange |
$31.04
|
| Rate for Payer: UHC Medicaid |
$21.89
|
| Rate for Payer: UHC Medicare Advantage |
$31.04
|
| Rate for Payer: UHCCP Medicaid |
$21.89
|
| Rate for Payer: VA VA |
$31.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.12
|
|
|
HC EPSTEIN BARR VIRUS PCR BLOOD
|
Facility
|
IP
|
$124.16
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600172
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$86.42 |
| Max. Negotiated Rate |
$111.74 |
| Rate for Payer: Aetna Commercial |
$105.54
|
| Rate for Payer: BCBS Trust/PPO |
$102.54
|
| Rate for Payer: BCN Commercial |
$102.54
|
| Rate for Payer: Cash Price |
$99.33
|
| Rate for Payer: Cofinity Commercial |
$106.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.33
|
| Rate for Payer: Healthscope Commercial |
$111.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.54
|
| Rate for Payer: Nomi Health Commercial |
$101.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.12
|
| Rate for Payer: PHP Commercial |
$105.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$108.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.26
|
| Rate for Payer: UHC Core |
$103.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.12
|
|
|
HC EP UPPER EXTREMITY SOMATOSENSO
|
Facility
|
OP
|
$1,142.70
|
|
|
Service Code
|
CPT 95925
|
| Hospital Charge Code |
92200014
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$201.46 |
| Max. Negotiated Rate |
$1,028.43 |
| Rate for Payer: Aetna Commercial |
$971.29
|
| Rate for Payer: Aetna Medicare |
$297.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$357.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$357.09
|
| Rate for Payer: BCBS Complete |
$211.51
|
| Rate for Payer: BCBS MAPPO |
$285.68
|
| Rate for Payer: BCBS Trust/PPO |
$939.41
|
| Rate for Payer: BCN Commercial |
$939.41
|
| Rate for Payer: BCN Medicare Advantage |
$285.68
|
| Rate for Payer: Cash Price |
$914.16
|
| Rate for Payer: Cofinity Commercial |
$982.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$914.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.68
|
| Rate for Payer: Healthscope Commercial |
$1,028.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$857.02
|
| Rate for Payer: Mclaren Medicaid |
$201.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.96
|
| Rate for Payer: Meridian Medicaid |
$211.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$328.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$314.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$971.29
|
| Rate for Payer: Nomi Health Commercial |
$937.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$857.02
|
| Rate for Payer: PACE Senior Care Partners |
$271.39
|
| Rate for Payer: PACE SWMI |
$285.68
|
| Rate for Payer: PHP Commercial |
$971.29
|
| Rate for Payer: PHP Medicare Advantage |
$285.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$994.15
|
| Rate for Payer: Priority Health Medicare |
$288.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$795.32
|
| Rate for Payer: Railroad Medicare Medicare |
$285.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,005.58
|
| Rate for Payer: UHC Core |
$954.15
|
| Rate for Payer: UHC Exchange |
$285.68
|
| Rate for Payer: UHC Medicaid |
$201.46
|
| Rate for Payer: UHC Medicare Advantage |
$285.68
|
| Rate for Payer: UHCCP Medicaid |
$201.46
|
| Rate for Payer: VA VA |
$285.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$857.02
|
|
|
HC EP UPPER EXTREMITY SOMATOSENSO
|
Facility
|
IP
|
$1,142.70
|
|
|
Service Code
|
CPT 95925
|
| Hospital Charge Code |
92200014
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$795.32 |
| Max. Negotiated Rate |
$1,028.43 |
| Rate for Payer: Aetna Commercial |
$971.29
|
| Rate for Payer: BCBS Trust/PPO |
$943.76
|
| Rate for Payer: BCN Commercial |
$943.76
|
| Rate for Payer: Cash Price |
$914.16
|
| Rate for Payer: Cofinity Commercial |
$982.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$914.16
|
| Rate for Payer: Healthscope Commercial |
$1,028.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$857.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$971.29
|
| Rate for Payer: Nomi Health Commercial |
$937.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$857.02
|
| Rate for Payer: PHP Commercial |
$971.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$994.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$795.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,005.58
|
| Rate for Payer: UHC Core |
$954.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$857.02
|
|
|
HC EP UPPER/LOWER EXT. SOMATOSENSORY
|
Facility
|
IP
|
$2,557.06
|
|
|
Service Code
|
CPT 95938
|
| Hospital Charge Code |
92200025
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$1,779.71 |
| Max. Negotiated Rate |
$2,301.35 |
| Rate for Payer: Aetna Commercial |
$2,173.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,111.88
|
| Rate for Payer: BCN Commercial |
$2,111.88
|
| Rate for Payer: Cash Price |
$2,045.65
|
| Rate for Payer: Cofinity Commercial |
$2,199.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,045.65
|
| Rate for Payer: Healthscope Commercial |
$2,301.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,917.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,173.50
|
| Rate for Payer: Nomi Health Commercial |
$2,096.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,917.80
|
| Rate for Payer: PHP Commercial |
$2,173.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,224.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,779.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,250.21
|
| Rate for Payer: UHC Core |
$2,135.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,917.80
|
|
|
HC EP UPPER/LOWER EXT. SOMATOSENSORY
|
Facility
|
OP
|
$2,557.06
|
|
|
Service Code
|
CPT 95938
|
| Hospital Charge Code |
92200025
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$450.81 |
| Max. Negotiated Rate |
$2,301.35 |
| Rate for Payer: Aetna Commercial |
$2,173.50
|
| Rate for Payer: Aetna Medicare |
$664.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$799.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$799.08
|
| Rate for Payer: BCBS Complete |
$473.31
|
| Rate for Payer: BCBS MAPPO |
$639.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,102.16
|
| Rate for Payer: BCN Commercial |
$2,102.16
|
| Rate for Payer: BCN Medicare Advantage |
$639.26
|
| Rate for Payer: Cash Price |
$2,045.65
|
| Rate for Payer: Cofinity Commercial |
$2,199.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,045.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$639.26
|
| Rate for Payer: Healthscope Commercial |
$2,301.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,917.80
|
| Rate for Payer: Mclaren Medicaid |
$450.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$671.23
|
| Rate for Payer: Meridian Medicaid |
$473.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$735.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$703.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,173.50
|
| Rate for Payer: Nomi Health Commercial |
$2,096.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,917.80
|
| Rate for Payer: PACE Senior Care Partners |
$607.30
|
| Rate for Payer: PACE SWMI |
$639.26
|
| Rate for Payer: PHP Commercial |
$2,173.50
|
| Rate for Payer: PHP Medicare Advantage |
$639.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$450.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,224.64
|
| Rate for Payer: Priority Health Medicare |
$645.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,779.71
|
| Rate for Payer: Railroad Medicare Medicare |
$639.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,250.21
|
| Rate for Payer: UHC Core |
$2,135.15
|
| Rate for Payer: UHC Exchange |
$639.26
|
| Rate for Payer: UHC Medicaid |
$450.81
|
| Rate for Payer: UHC Medicare Advantage |
$639.26
|
| Rate for Payer: UHCCP Medicaid |
$450.81
|
| Rate for Payer: VA VA |
$639.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,917.80
|
|
|
HC EP VISUAL
|
Facility
|
OP
|
$801.64
|
|
|
Service Code
|
CPT 95930
|
| Hospital Charge Code |
92200018
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$141.33 |
| Max. Negotiated Rate |
$721.48 |
| Rate for Payer: Aetna Commercial |
$681.39
|
| Rate for Payer: Aetna Medicare |
$208.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$250.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$250.51
|
| Rate for Payer: BCBS Complete |
$148.38
|
| Rate for Payer: BCBS MAPPO |
$200.41
|
| Rate for Payer: BCBS Trust/PPO |
$659.03
|
| Rate for Payer: BCN Commercial |
$659.03
|
| Rate for Payer: BCN Medicare Advantage |
$200.41
|
| Rate for Payer: Cash Price |
$641.31
|
| Rate for Payer: Cofinity Commercial |
$689.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.41
|
| Rate for Payer: Healthscope Commercial |
$721.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$601.23
|
| Rate for Payer: Mclaren Medicaid |
$141.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.43
|
| Rate for Payer: Meridian Medicaid |
$148.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$230.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$220.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$681.39
|
| Rate for Payer: Nomi Health Commercial |
$657.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$601.23
|
| Rate for Payer: PACE Senior Care Partners |
$190.39
|
| Rate for Payer: PACE SWMI |
$200.41
|
| Rate for Payer: PHP Commercial |
$681.39
|
| Rate for Payer: PHP Medicare Advantage |
$200.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$141.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$697.43
|
| Rate for Payer: Priority Health Medicare |
$202.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$557.94
|
| Rate for Payer: Railroad Medicare Medicare |
$200.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$705.44
|
| Rate for Payer: UHC Core |
$669.37
|
| Rate for Payer: UHC Exchange |
$200.41
|
| Rate for Payer: UHC Medicaid |
$141.33
|
| Rate for Payer: UHC Medicare Advantage |
$200.41
|
| Rate for Payer: UHCCP Medicaid |
$141.33
|
| Rate for Payer: VA VA |
$200.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$601.23
|
|
|
HC EP VISUAL
|
Facility
|
IP
|
$801.64
|
|
|
Service Code
|
CPT 95930
|
| Hospital Charge Code |
92200018
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$557.94 |
| Max. Negotiated Rate |
$721.48 |
| Rate for Payer: Aetna Commercial |
$681.39
|
| Rate for Payer: BCBS Trust/PPO |
$662.07
|
| Rate for Payer: BCN Commercial |
$662.07
|
| Rate for Payer: Cash Price |
$641.31
|
| Rate for Payer: Cofinity Commercial |
$689.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.31
|
| Rate for Payer: Healthscope Commercial |
$721.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$601.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$681.39
|
| Rate for Payer: Nomi Health Commercial |
$657.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$601.23
|
| Rate for Payer: PHP Commercial |
$681.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$697.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$557.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$705.44
|
| Rate for Payer: UHC Core |
$669.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$601.23
|
|
|
HC ER BURN CARE
|
Facility
|
OP
|
$412.15
|
|
| Hospital Charge Code |
45000038
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$72.66 |
| Max. Negotiated Rate |
$370.94 |
| Rate for Payer: Aetna Commercial |
$350.33
|
| Rate for Payer: Aetna Medicare |
$107.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$128.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$128.80
|
| Rate for Payer: BCBS Complete |
$76.29
|
| Rate for Payer: BCBS MAPPO |
$103.04
|
| Rate for Payer: BCBS Trust/PPO |
$338.83
|
| Rate for Payer: BCN Commercial |
$338.83
|
| Rate for Payer: BCN Medicare Advantage |
$103.04
|
| Rate for Payer: Cash Price |
$329.72
|
| Rate for Payer: Cash Price |
$329.72
|
| Rate for Payer: Cofinity Commercial |
$354.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.04
|
| Rate for Payer: Healthscope Commercial |
$370.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.11
|
| Rate for Payer: Mclaren Medicaid |
$72.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.19
|
| Rate for Payer: Meridian Medicaid |
$76.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$113.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.33
|
| Rate for Payer: Nomi Health Commercial |
$337.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$309.11
|
| Rate for Payer: PACE Senior Care Partners |
$97.89
|
| Rate for Payer: PACE SWMI |
$103.04
|
| Rate for Payer: PHP Commercial |
$350.33
|
| Rate for Payer: PHP Medicare Advantage |
$103.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$358.57
|
| Rate for Payer: Priority Health Medicare |
$104.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$286.86
|
| Rate for Payer: Railroad Medicare Medicare |
$103.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.69
|
| Rate for Payer: UHC Core |
$344.15
|
| Rate for Payer: UHC Exchange |
$103.04
|
| Rate for Payer: UHC Medicaid |
$72.66
|
| Rate for Payer: UHC Medicare Advantage |
$103.04
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$103.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.11
|
|
|
HC ER BURN CARE
|
Facility
|
IP
|
$412.15
|
|
| Hospital Charge Code |
45000038
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$286.86 |
| Max. Negotiated Rate |
$370.94 |
| Rate for Payer: Aetna Commercial |
$350.33
|
| Rate for Payer: BCBS Trust/PPO |
$340.39
|
| Rate for Payer: BCN Commercial |
$340.39
|
| Rate for Payer: Cash Price |
$329.72
|
| Rate for Payer: Cofinity Commercial |
$354.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.72
|
| Rate for Payer: Healthscope Commercial |
$370.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.33
|
| Rate for Payer: Nomi Health Commercial |
$337.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$309.11
|
| Rate for Payer: PHP Commercial |
$350.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$358.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$286.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.69
|
| Rate for Payer: UHC Core |
$344.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.11
|
|
|
HC ERCP
|
Facility
|
IP
|
$3,464.90
|
|
| Hospital Charge Code |
36000039
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,411.57 |
| Max. Negotiated Rate |
$3,118.41 |
| Rate for Payer: Aetna Commercial |
$2,945.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,861.66
|
| Rate for Payer: BCN Commercial |
$2,861.66
|
| Rate for Payer: Cash Price |
$2,771.92
|
| Rate for Payer: Cofinity Commercial |
$2,979.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,771.92
|
| Rate for Payer: Healthscope Commercial |
$3,118.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,598.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,945.16
|
| Rate for Payer: Nomi Health Commercial |
$2,841.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,598.68
|
| Rate for Payer: PHP Commercial |
$2,945.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,014.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,411.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,049.11
|
| Rate for Payer: UHC Core |
$2,893.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,598.68
|
|
|
HC ERCP
|
Facility
|
OP
|
$3,464.90
|
|
| Hospital Charge Code |
36000039
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$610.86 |
| Max. Negotiated Rate |
$3,118.41 |
| Rate for Payer: Aetna Commercial |
$2,945.16
|
| Rate for Payer: Aetna Medicare |
$900.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,082.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,082.78
|
| Rate for Payer: BCBS Complete |
$641.35
|
| Rate for Payer: BCBS MAPPO |
$866.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,848.49
|
| Rate for Payer: BCN Commercial |
$2,848.49
|
| Rate for Payer: BCN Medicare Advantage |
$866.23
|
| Rate for Payer: Cash Price |
$2,771.92
|
| Rate for Payer: Cofinity Commercial |
$2,979.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,771.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$866.23
|
| Rate for Payer: Healthscope Commercial |
$3,118.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,598.68
|
| Rate for Payer: Mclaren Medicaid |
$610.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$909.54
|
| Rate for Payer: Meridian Medicaid |
$641.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$996.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$952.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,945.16
|
| Rate for Payer: Nomi Health Commercial |
$2,841.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,598.68
|
| Rate for Payer: PACE Senior Care Partners |
$822.91
|
| Rate for Payer: PACE SWMI |
$866.23
|
| Rate for Payer: PHP Commercial |
$2,945.16
|
| Rate for Payer: PHP Medicare Advantage |
$866.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$610.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,014.46
|
| Rate for Payer: Priority Health Medicare |
$874.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,411.57
|
| Rate for Payer: Railroad Medicare Medicare |
$866.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,049.11
|
| Rate for Payer: UHC Core |
$2,893.19
|
| Rate for Payer: UHC Exchange |
$866.23
|
| Rate for Payer: UHC Medicaid |
$610.86
|
| Rate for Payer: UHC Medicare Advantage |
$866.23
|
| Rate for Payer: UHCCP Medicaid |
$610.86
|
| Rate for Payer: VA VA |
$866.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,598.68
|
|
|
HC ERCP SPHINCTEROTOMY
|
Facility
|
OP
|
$4,126.82
|
|
| Hospital Charge Code |
36000040
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$727.56 |
| Max. Negotiated Rate |
$3,714.14 |
| Rate for Payer: Aetna Commercial |
$3,507.80
|
| Rate for Payer: Aetna Medicare |
$1,072.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,289.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,289.63
|
| Rate for Payer: BCBS Complete |
$763.87
|
| Rate for Payer: BCBS MAPPO |
$1,031.70
|
| Rate for Payer: BCBS Trust/PPO |
$3,392.66
|
| Rate for Payer: BCN Commercial |
$3,392.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,031.70
|
| Rate for Payer: Cash Price |
$3,301.46
|
| Rate for Payer: Cofinity Commercial |
$3,549.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,301.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,031.70
|
| Rate for Payer: Healthscope Commercial |
$3,714.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,095.11
|
| Rate for Payer: Mclaren Medicaid |
$727.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,083.29
|
| Rate for Payer: Meridian Medicaid |
$763.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,186.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,134.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,507.80
|
| Rate for Payer: Nomi Health Commercial |
$3,383.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,095.11
|
| Rate for Payer: PACE Senior Care Partners |
$980.12
|
| Rate for Payer: PACE SWMI |
$1,031.70
|
| Rate for Payer: PHP Commercial |
$3,507.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,031.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$727.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,590.33
|
| Rate for Payer: Priority Health Medicare |
$1,042.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,872.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,031.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,631.60
|
| Rate for Payer: UHC Core |
$3,445.89
|
| Rate for Payer: UHC Exchange |
$1,031.70
|
| Rate for Payer: UHC Medicaid |
$727.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,031.70
|
| Rate for Payer: UHCCP Medicaid |
$727.56
|
| Rate for Payer: VA VA |
$1,031.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,095.11
|
|
|
HC ERCP SPHINCTEROTOMY
|
Facility
|
IP
|
$4,126.82
|
|
| Hospital Charge Code |
36000040
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,872.27 |
| Max. Negotiated Rate |
$3,714.14 |
| Rate for Payer: Aetna Commercial |
$3,507.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,408.34
|
| Rate for Payer: BCN Commercial |
$3,408.34
|
| Rate for Payer: Cash Price |
$3,301.46
|
| Rate for Payer: Cofinity Commercial |
$3,549.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,301.46
|
| Rate for Payer: Healthscope Commercial |
$3,714.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,095.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,507.80
|
| Rate for Payer: Nomi Health Commercial |
$3,383.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,095.11
|
| Rate for Payer: PHP Commercial |
$3,507.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,590.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,872.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,631.60
|
| Rate for Payer: UHC Core |
$3,445.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,095.11
|
|
