|
HC EXTRAORAL INC AND DRAIN ABSC, CYST, HEMATOMA FLOOR OF MOUTH SUBLING
|
Facility
|
IP
|
$398.50
|
|
|
Service Code
|
CPT 41015
|
| Hospital Charge Code |
76100137
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$277.36 |
| Max. Negotiated Rate |
$358.65 |
| Rate for Payer: Aetna Commercial |
$338.73
|
| Rate for Payer: BCBS Trust/PPO |
$329.12
|
| Rate for Payer: BCN Commercial |
$329.12
|
| Rate for Payer: Cash Price |
$318.80
|
| Rate for Payer: Cofinity Commercial |
$342.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.80
|
| Rate for Payer: Healthscope Commercial |
$358.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.73
|
| Rate for Payer: Nomi Health Commercial |
$326.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.88
|
| Rate for Payer: PHP Commercial |
$338.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$346.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$277.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.68
|
| Rate for Payer: UHC Core |
$332.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.88
|
|
|
HC EXTRA VASCULAR ICD
|
Facility
|
OP
|
$26,875.00
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800160
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,738.06 |
| Max. Negotiated Rate |
$24,187.50 |
| Rate for Payer: Aetna Commercial |
$22,843.75
|
| Rate for Payer: Aetna Medicare |
$6,987.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,398.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,398.44
|
| Rate for Payer: BCBS Complete |
$4,974.56
|
| Rate for Payer: BCBS MAPPO |
$6,718.75
|
| Rate for Payer: BCBS Trust/PPO |
$22,093.94
|
| Rate for Payer: BCN Commercial |
$22,093.94
|
| Rate for Payer: BCN Medicare Advantage |
$6,718.75
|
| Rate for Payer: Cash Price |
$21,500.00
|
| Rate for Payer: Cofinity Commercial |
$23,112.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,500.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,718.75
|
| Rate for Payer: Healthscope Commercial |
$24,187.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,156.25
|
| Rate for Payer: Mclaren Medicaid |
$4,738.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,054.69
|
| Rate for Payer: Meridian Medicaid |
$4,974.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,726.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,390.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,843.75
|
| Rate for Payer: Nomi Health Commercial |
$22,037.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,156.25
|
| Rate for Payer: PACE Senior Care Partners |
$6,382.81
|
| Rate for Payer: PACE SWMI |
$6,718.75
|
| Rate for Payer: PHP Commercial |
$22,843.75
|
| Rate for Payer: PHP Medicare Advantage |
$6,718.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,738.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23,381.25
|
| Rate for Payer: Priority Health Medicare |
$6,785.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,705.00
|
| Rate for Payer: Railroad Medicare Medicare |
$6,718.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,650.00
|
| Rate for Payer: UHC Core |
$22,440.62
|
| Rate for Payer: UHC Exchange |
$6,718.75
|
| Rate for Payer: UHC Medicaid |
$4,738.06
|
| Rate for Payer: UHC Medicare Advantage |
$6,718.75
|
| Rate for Payer: UHCCP Medicaid |
$4,738.06
|
| Rate for Payer: VA VA |
$6,718.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,156.25
|
|
|
HC EXTRA VASCULAR ICD
|
Facility
|
IP
|
$26,875.00
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800160
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18,705.00 |
| Max. Negotiated Rate |
$24,187.50 |
| Rate for Payer: Aetna Commercial |
$22,843.75
|
| Rate for Payer: BCBS Trust/PPO |
$22,196.06
|
| Rate for Payer: BCN Commercial |
$22,196.06
|
| Rate for Payer: Cash Price |
$21,500.00
|
| Rate for Payer: Cofinity Commercial |
$23,112.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,500.00
|
| Rate for Payer: Healthscope Commercial |
$24,187.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,156.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,843.75
|
| Rate for Payer: Nomi Health Commercial |
$22,037.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,156.25
|
| Rate for Payer: PHP Commercial |
$22,843.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23,381.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,705.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,650.00
|
| Rate for Payer: UHC Core |
$22,440.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,156.25
|
|
|
HC EXTRA VASCULAR LEAD
|
Facility
|
IP
|
$8,085.00
|
|
|
Service Code
|
HCPCS C1896
|
| Hospital Charge Code |
27800161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,627.16 |
| Max. Negotiated Rate |
$7,276.50 |
| Rate for Payer: Aetna Commercial |
$6,872.25
|
| Rate for Payer: BCBS Trust/PPO |
$6,677.40
|
| Rate for Payer: BCN Commercial |
$6,677.40
|
| Rate for Payer: Cash Price |
$6,468.00
|
| Rate for Payer: Cofinity Commercial |
$6,953.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,468.00
|
| Rate for Payer: Healthscope Commercial |
$7,276.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,063.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,872.25
|
| Rate for Payer: Nomi Health Commercial |
$6,629.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,063.75
|
| Rate for Payer: PHP Commercial |
$6,872.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,033.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,627.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,114.80
|
| Rate for Payer: UHC Core |
$6,750.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,063.75
|
|
|
HC EXTRA VASCULAR LEAD
|
Facility
|
OP
|
$8,085.00
|
|
|
Service Code
|
HCPCS C1896
|
| Hospital Charge Code |
27800161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,425.39 |
| Max. Negotiated Rate |
$7,276.50 |
| Rate for Payer: Aetna Commercial |
$6,872.25
|
| Rate for Payer: Aetna Medicare |
$2,102.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,526.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,526.56
|
| Rate for Payer: BCBS Complete |
$1,496.53
|
| Rate for Payer: BCBS MAPPO |
$2,021.25
|
| Rate for Payer: BCBS Trust/PPO |
$6,646.68
|
| Rate for Payer: BCN Commercial |
$6,646.68
|
| Rate for Payer: BCN Medicare Advantage |
$2,021.25
|
| Rate for Payer: Cash Price |
$6,468.00
|
| Rate for Payer: Cofinity Commercial |
$6,953.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,468.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,021.25
|
| Rate for Payer: Healthscope Commercial |
$7,276.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,063.75
|
| Rate for Payer: Mclaren Medicaid |
$1,425.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,122.31
|
| Rate for Payer: Meridian Medicaid |
$1,496.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,324.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,223.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,872.25
|
| Rate for Payer: Nomi Health Commercial |
$6,629.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,063.75
|
| Rate for Payer: PACE Senior Care Partners |
$1,920.19
|
| Rate for Payer: PACE SWMI |
$2,021.25
|
| Rate for Payer: PHP Commercial |
$6,872.25
|
| Rate for Payer: PHP Medicare Advantage |
$2,021.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,425.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,033.95
|
| Rate for Payer: Priority Health Medicare |
$2,041.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,627.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,021.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,114.80
|
| Rate for Payer: UHC Core |
$6,750.98
|
| Rate for Payer: UHC Exchange |
$2,021.25
|
| Rate for Payer: UHC Medicaid |
$1,425.39
|
| Rate for Payer: UHC Medicare Advantage |
$2,021.25
|
| Rate for Payer: UHCCP Medicaid |
$1,425.39
|
| Rate for Payer: VA VA |
$2,021.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,063.75
|
|
|
HC EXTRA VASCULAR STERNAL TUNNELING TOOL
|
Facility
|
IP
|
$1,500.00
|
|
| Hospital Charge Code |
27200398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,044.00 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna Commercial |
$1,275.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,238.85
|
| Rate for Payer: BCN Commercial |
$1,238.85
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cofinity Commercial |
$1,290.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.00
|
| Rate for Payer: Healthscope Commercial |
$1,350.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,275.00
|
| Rate for Payer: Nomi Health Commercial |
$1,230.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,125.00
|
| Rate for Payer: PHP Commercial |
$1,275.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,305.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,044.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,320.00
|
| Rate for Payer: UHC Core |
$1,252.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.00
|
|
|
HC EXTRA VASCULAR STERNAL TUNNELING TOOL
|
Facility
|
OP
|
$1,500.00
|
|
| Hospital Charge Code |
27200398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$264.45 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna Commercial |
$1,275.00
|
| Rate for Payer: Aetna Medicare |
$390.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$468.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$468.75
|
| Rate for Payer: BCBS Complete |
$277.65
|
| Rate for Payer: BCBS MAPPO |
$375.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,233.15
|
| Rate for Payer: BCN Commercial |
$1,233.15
|
| Rate for Payer: BCN Medicare Advantage |
$375.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cofinity Commercial |
$1,290.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$375.00
|
| Rate for Payer: Healthscope Commercial |
$1,350.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.00
|
| Rate for Payer: Mclaren Medicaid |
$264.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$393.75
|
| Rate for Payer: Meridian Medicaid |
$277.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$431.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$412.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,275.00
|
| Rate for Payer: Nomi Health Commercial |
$1,230.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,125.00
|
| Rate for Payer: PACE Senior Care Partners |
$356.25
|
| Rate for Payer: PACE SWMI |
$375.00
|
| Rate for Payer: PHP Commercial |
$1,275.00
|
| Rate for Payer: PHP Medicare Advantage |
$375.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,305.00
|
| Rate for Payer: Priority Health Medicare |
$378.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,044.00
|
| Rate for Payer: Railroad Medicare Medicare |
$375.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,320.00
|
| Rate for Payer: UHC Core |
$1,252.50
|
| Rate for Payer: UHC Exchange |
$375.00
|
| Rate for Payer: UHC Medicaid |
$264.45
|
| Rate for Payer: UHC Medicare Advantage |
$375.00
|
| Rate for Payer: UHCCP Medicaid |
$264.45
|
| Rate for Payer: VA VA |
$375.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.00
|
|
|
HC EXTRA VASCULAR TRANSVERSE TUNNELING TOOL
|
Facility
|
IP
|
$1,500.00
|
|
| Hospital Charge Code |
27200399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,044.00 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna Commercial |
$1,275.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,238.85
|
| Rate for Payer: BCN Commercial |
$1,238.85
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cofinity Commercial |
$1,290.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.00
|
| Rate for Payer: Healthscope Commercial |
$1,350.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,275.00
|
| Rate for Payer: Nomi Health Commercial |
$1,230.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,125.00
|
| Rate for Payer: PHP Commercial |
$1,275.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,305.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,044.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,320.00
|
| Rate for Payer: UHC Core |
$1,252.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.00
|
|
|
HC EXTRA VASCULAR TRANSVERSE TUNNELING TOOL
|
Facility
|
OP
|
$1,500.00
|
|
| Hospital Charge Code |
27200399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$264.45 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna Commercial |
$1,275.00
|
| Rate for Payer: Aetna Medicare |
$390.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$468.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$468.75
|
| Rate for Payer: BCBS Complete |
$277.65
|
| Rate for Payer: BCBS MAPPO |
$375.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,233.15
|
| Rate for Payer: BCN Commercial |
$1,233.15
|
| Rate for Payer: BCN Medicare Advantage |
$375.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cofinity Commercial |
$1,290.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$375.00
|
| Rate for Payer: Healthscope Commercial |
$1,350.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.00
|
| Rate for Payer: Mclaren Medicaid |
$264.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$393.75
|
| Rate for Payer: Meridian Medicaid |
$277.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$431.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$412.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,275.00
|
| Rate for Payer: Nomi Health Commercial |
$1,230.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,125.00
|
| Rate for Payer: PACE Senior Care Partners |
$356.25
|
| Rate for Payer: PACE SWMI |
$375.00
|
| Rate for Payer: PHP Commercial |
$1,275.00
|
| Rate for Payer: PHP Medicare Advantage |
$375.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,305.00
|
| Rate for Payer: Priority Health Medicare |
$378.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,044.00
|
| Rate for Payer: Railroad Medicare Medicare |
$375.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,320.00
|
| Rate for Payer: UHC Core |
$1,252.50
|
| Rate for Payer: UHC Exchange |
$375.00
|
| Rate for Payer: UHC Medicaid |
$264.45
|
| Rate for Payer: UHC Medicare Advantage |
$375.00
|
| Rate for Payer: UHCCP Medicaid |
$264.45
|
| Rate for Payer: VA VA |
$375.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.00
|
|
|
HC EZPAP SUPPLY
|
Facility
|
OP
|
$130.55
|
|
| Hospital Charge Code |
27000072
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.02 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna Commercial |
$110.97
|
| Rate for Payer: Aetna Medicare |
$33.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.80
|
| Rate for Payer: BCBS Complete |
$24.16
|
| Rate for Payer: BCBS MAPPO |
$32.64
|
| Rate for Payer: BCBS Trust/PPO |
$107.33
|
| Rate for Payer: BCN Commercial |
$107.33
|
| Rate for Payer: BCN Medicare Advantage |
$32.64
|
| Rate for Payer: Cash Price |
$104.44
|
| Rate for Payer: Cofinity Commercial |
$112.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.91
|
| Rate for Payer: Mclaren Medicaid |
$23.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.27
|
| Rate for Payer: Meridian Medicaid |
$24.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.97
|
| Rate for Payer: Nomi Health Commercial |
$107.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.91
|
| Rate for Payer: PACE Senior Care Partners |
$31.01
|
| Rate for Payer: PACE SWMI |
$32.64
|
| Rate for Payer: PHP Commercial |
$110.97
|
| Rate for Payer: PHP Medicare Advantage |
$32.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.58
|
| Rate for Payer: Priority Health Medicare |
$32.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.86
|
| Rate for Payer: Railroad Medicare Medicare |
$32.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.88
|
| Rate for Payer: UHC Core |
$109.01
|
| Rate for Payer: UHC Exchange |
$32.64
|
| Rate for Payer: UHC Medicaid |
$23.02
|
| Rate for Payer: UHC Medicare Advantage |
$32.64
|
| Rate for Payer: UHCCP Medicaid |
$23.02
|
| Rate for Payer: VA VA |
$32.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.91
|
|
|
HC EZPAP SUPPLY
|
Facility
|
IP
|
$130.55
|
|
| Hospital Charge Code |
27000072
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$90.86 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna Commercial |
$110.97
|
| Rate for Payer: BCBS Trust/PPO |
$107.82
|
| Rate for Payer: BCN Commercial |
$107.82
|
| Rate for Payer: Cash Price |
$104.44
|
| Rate for Payer: Cofinity Commercial |
$112.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.44
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.97
|
| Rate for Payer: Nomi Health Commercial |
$107.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.91
|
| Rate for Payer: PHP Commercial |
$110.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.88
|
| Rate for Payer: UHC Core |
$109.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.91
|
|
|
HC F-18 SODIUM FLUORIDE <=30MCI
|
Facility
|
IP
|
$494.43
|
|
|
Service Code
|
HCPCS A9580
|
| Hospital Charge Code |
34300028
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$344.12 |
| Max. Negotiated Rate |
$444.99 |
| Rate for Payer: Aetna Commercial |
$420.27
|
| Rate for Payer: BCBS Trust/PPO |
$408.35
|
| Rate for Payer: BCN Commercial |
$408.35
|
| Rate for Payer: Cash Price |
$395.54
|
| Rate for Payer: Cofinity Commercial |
$425.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.54
|
| Rate for Payer: Healthscope Commercial |
$444.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.27
|
| Rate for Payer: Nomi Health Commercial |
$405.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.82
|
| Rate for Payer: PHP Commercial |
$420.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$430.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$435.10
|
| Rate for Payer: UHC Core |
$412.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.82
|
|
|
HC F-18 SODIUM FLUORIDE <=30MCI
|
Facility
|
OP
|
$494.43
|
|
|
Service Code
|
HCPCS A9580
|
| Hospital Charge Code |
34300028
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$87.17 |
| Max. Negotiated Rate |
$444.99 |
| Rate for Payer: Aetna Commercial |
$420.27
|
| Rate for Payer: Aetna Medicare |
$128.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$154.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$154.51
|
| Rate for Payer: BCBS Complete |
$91.52
|
| Rate for Payer: BCBS MAPPO |
$123.61
|
| Rate for Payer: BCBS Trust/PPO |
$406.47
|
| Rate for Payer: BCN Commercial |
$406.47
|
| Rate for Payer: BCN Medicare Advantage |
$123.61
|
| Rate for Payer: Cash Price |
$395.54
|
| Rate for Payer: Cofinity Commercial |
$425.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.61
|
| Rate for Payer: Healthscope Commercial |
$444.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.82
|
| Rate for Payer: Mclaren Medicaid |
$87.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.79
|
| Rate for Payer: Meridian Medicaid |
$91.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$135.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.27
|
| Rate for Payer: Nomi Health Commercial |
$405.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.82
|
| Rate for Payer: PACE Senior Care Partners |
$117.43
|
| Rate for Payer: PACE SWMI |
$123.61
|
| Rate for Payer: PHP Commercial |
$420.27
|
| Rate for Payer: PHP Medicare Advantage |
$123.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$430.15
|
| Rate for Payer: Priority Health Medicare |
$124.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.12
|
| Rate for Payer: Railroad Medicare Medicare |
$123.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$435.10
|
| Rate for Payer: UHC Core |
$412.85
|
| Rate for Payer: UHC Exchange |
$123.61
|
| Rate for Payer: UHC Medicaid |
$87.17
|
| Rate for Payer: UHC Medicare Advantage |
$123.61
|
| Rate for Payer: UHCCP Medicaid |
$87.17
|
| Rate for Payer: VA VA |
$123.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.82
|
|
|
HC F232 OVALBUMIN
|
Facility
|
OP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200439
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.03
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS MAPPO |
$8.03
|
| Rate for Payer: BCBS Trust/PPO |
$26.39
|
| Rate for Payer: BCN Commercial |
$26.39
|
| Rate for Payer: BCN Medicare Advantage |
$8.03
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.03
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Mclaren Medicaid |
$5.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.43
|
| Rate for Payer: Meridian Medicaid |
$5.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PACE Senior Care Partners |
$7.62
|
| Rate for Payer: PACE SWMI |
$8.03
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: PHP Medicare Advantage |
$8.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Medicare |
$8.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: Railroad Medicare Medicare |
$8.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicaid |
$5.66
|
| Rate for Payer: UHC Medicare Advantage |
$8.03
|
| Rate for Payer: UHCCP Medicaid |
$5.66
|
| Rate for Payer: VA VA |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F232 OVALBUMIN
|
Facility
|
IP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200439
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: BCBS Trust/PPO |
$26.51
|
| Rate for Payer: BCN Commercial |
$26.51
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F233 OVOMUCOID
|
Facility
|
IP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200440
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: BCBS Trust/PPO |
$26.51
|
| Rate for Payer: BCN Commercial |
$26.51
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F233 OVOMUCOID
|
Facility
|
OP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200440
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.03
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS MAPPO |
$8.03
|
| Rate for Payer: BCBS Trust/PPO |
$26.39
|
| Rate for Payer: BCN Commercial |
$26.39
|
| Rate for Payer: BCN Medicare Advantage |
$8.03
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.03
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Mclaren Medicaid |
$5.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.43
|
| Rate for Payer: Meridian Medicaid |
$5.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PACE Senior Care Partners |
$7.62
|
| Rate for Payer: PACE SWMI |
$8.03
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: PHP Medicare Advantage |
$8.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Medicare |
$8.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: Railroad Medicare Medicare |
$8.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicaid |
$5.66
|
| Rate for Payer: UHC Medicare Advantage |
$8.03
|
| Rate for Payer: UHCCP Medicaid |
$5.66
|
| Rate for Payer: VA VA |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F352 RARA H8 PR-10 PEANUT
|
Facility
|
IP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200450
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: BCBS Trust/PPO |
$26.51
|
| Rate for Payer: BCN Commercial |
$26.51
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F352 RARA H8 PR-10 PEANUT
|
Facility
|
OP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200450
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.03
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS MAPPO |
$8.03
|
| Rate for Payer: BCBS Trust/PPO |
$26.39
|
| Rate for Payer: BCN Commercial |
$26.39
|
| Rate for Payer: BCN Medicare Advantage |
$8.03
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.03
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Mclaren Medicaid |
$5.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.43
|
| Rate for Payer: Meridian Medicaid |
$5.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PACE Senior Care Partners |
$7.62
|
| Rate for Payer: PACE SWMI |
$8.03
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: PHP Medicare Advantage |
$8.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Medicare |
$8.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: Railroad Medicare Medicare |
$8.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicaid |
$5.66
|
| Rate for Payer: UHC Medicare Advantage |
$8.03
|
| Rate for Payer: UHCCP Medicaid |
$5.66
|
| Rate for Payer: VA VA |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F422 RARA H1 PEANUT
|
Facility
|
IP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200446
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: BCBS Trust/PPO |
$26.51
|
| Rate for Payer: BCN Commercial |
$26.51
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F422 RARA H1 PEANUT
|
Facility
|
OP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200446
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.03
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS MAPPO |
$8.03
|
| Rate for Payer: BCBS Trust/PPO |
$26.39
|
| Rate for Payer: BCN Commercial |
$26.39
|
| Rate for Payer: BCN Medicare Advantage |
$8.03
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.03
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Mclaren Medicaid |
$5.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.43
|
| Rate for Payer: Meridian Medicaid |
$5.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PACE Senior Care Partners |
$7.62
|
| Rate for Payer: PACE SWMI |
$8.03
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: PHP Medicare Advantage |
$8.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Medicare |
$8.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: Railroad Medicare Medicare |
$8.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicaid |
$5.66
|
| Rate for Payer: UHC Medicare Advantage |
$8.03
|
| Rate for Payer: UHCCP Medicaid |
$5.66
|
| Rate for Payer: VA VA |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F423 RARA H2 PEANUT
|
Facility
|
OP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200447
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.03
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS MAPPO |
$8.03
|
| Rate for Payer: BCBS Trust/PPO |
$26.39
|
| Rate for Payer: BCN Commercial |
$26.39
|
| Rate for Payer: BCN Medicare Advantage |
$8.03
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.03
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Mclaren Medicaid |
$5.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.43
|
| Rate for Payer: Meridian Medicaid |
$5.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PACE Senior Care Partners |
$7.62
|
| Rate for Payer: PACE SWMI |
$8.03
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: PHP Medicare Advantage |
$8.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Medicare |
$8.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: Railroad Medicare Medicare |
$8.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicaid |
$5.66
|
| Rate for Payer: UHC Medicare Advantage |
$8.03
|
| Rate for Payer: UHCCP Medicaid |
$5.66
|
| Rate for Payer: VA VA |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F423 RARA H2 PEANUT
|
Facility
|
IP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200447
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: BCBS Trust/PPO |
$26.51
|
| Rate for Payer: BCN Commercial |
$26.51
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F424 RARA H3 PEANUT
|
Facility
|
IP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200448
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: BCBS Trust/PPO |
$26.51
|
| Rate for Payer: BCN Commercial |
$26.51
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F424 RARA H3 PEANUT
|
Facility
|
OP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200448
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.03
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS MAPPO |
$8.03
|
| Rate for Payer: BCBS Trust/PPO |
$26.39
|
| Rate for Payer: BCN Commercial |
$26.39
|
| Rate for Payer: BCN Medicare Advantage |
$8.03
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.03
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Mclaren Medicaid |
$5.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.43
|
| Rate for Payer: Meridian Medicaid |
$5.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PACE Senior Care Partners |
$7.62
|
| Rate for Payer: PACE SWMI |
$8.03
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: PHP Medicare Advantage |
$8.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Medicare |
$8.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: Railroad Medicare Medicare |
$8.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicaid |
$5.66
|
| Rate for Payer: UHC Medicare Advantage |
$8.03
|
| Rate for Payer: UHCCP Medicaid |
$5.66
|
| Rate for Payer: VA VA |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
