|
HC KOH PREPARATION
|
Facility
|
OP
|
$23.46
|
|
|
Service Code
|
CPT 87220
|
| Hospital Charge Code |
30600111
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$21.11 |
| Rate for Payer: Aetna Commercial |
$19.94
|
| Rate for Payer: Aetna Medicare |
$6.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.33
|
| Rate for Payer: BCBS Complete |
$3.31
|
| Rate for Payer: BCBS MAPPO |
$5.86
|
| Rate for Payer: BCBS Trust/PPO |
$18.24
|
| Rate for Payer: BCN Commercial |
$18.24
|
| Rate for Payer: BCN Medicare Advantage |
$5.86
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$20.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.86
|
| Rate for Payer: Healthscope Commercial |
$21.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.60
|
| Rate for Payer: Mclaren Medicaid |
$3.15
|
| Rate for Payer: Meridian Medicaid |
$3.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.94
|
| Rate for Payer: PACE Senior Care Partners |
$5.57
|
| Rate for Payer: PACE SWMI |
$5.86
|
| Rate for Payer: PHP Commercial |
$19.94
|
| Rate for Payer: PHP Medicare Advantage |
$5.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.41
|
| Rate for Payer: Priority Health Medicare |
$5.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.31
|
| Rate for Payer: Railroad Medicare Medicare |
$5.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.64
|
| Rate for Payer: UHC Core |
$19.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.86
|
| Rate for Payer: UHC Medicare Advantage |
$6.04
|
| Rate for Payer: VA VA |
$5.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.60
|
|
|
HC KOH PREPARATION
|
Facility
|
IP
|
$23.46
|
|
|
Service Code
|
CPT 87220
|
| Hospital Charge Code |
30600111
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.31 |
| Max. Negotiated Rate |
$21.11 |
| Rate for Payer: Aetna Commercial |
$19.94
|
| Rate for Payer: BCBS Trust/PPO |
$18.13
|
| Rate for Payer: BCN Commercial |
$18.13
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$20.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Healthscope Commercial |
$21.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.94
|
| Rate for Payer: PHP Commercial |
$19.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.64
|
| Rate for Payer: UHC Core |
$19.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.60
|
|
|
HC KYLEENA 19.5MG
|
Facility
|
OP
|
$2,878.85
|
|
|
Service Code
|
CPT J7296
|
| Hospital Charge Code |
63600165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$683.73 |
| Max. Negotiated Rate |
$2,590.96 |
| Rate for Payer: Aetna Commercial |
$2,447.02
|
| Rate for Payer: Aetna Medicare |
$748.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$899.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$899.64
|
| Rate for Payer: BCBS Complete |
$1,151.54
|
| Rate for Payer: BCBS MAPPO |
$719.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,238.31
|
| Rate for Payer: BCN Commercial |
$2,238.31
|
| Rate for Payer: BCN Medicare Advantage |
$719.71
|
| Rate for Payer: Cash Price |
$2,303.08
|
| Rate for Payer: Cofinity Commercial |
$2,475.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,303.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.71
|
| Rate for Payer: Healthscope Commercial |
$2,590.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,159.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$755.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$827.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,447.02
|
| Rate for Payer: PACE Senior Care Partners |
$683.73
|
| Rate for Payer: PACE SWMI |
$719.71
|
| Rate for Payer: PHP Commercial |
$2,447.02
|
| Rate for Payer: PHP Medicare Advantage |
$719.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,504.60
|
| Rate for Payer: Priority Health Medicare |
$719.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,755.81
|
| Rate for Payer: Railroad Medicare Medicare |
$719.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,533.39
|
| Rate for Payer: UHC Core |
$2,403.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$719.71
|
| Rate for Payer: UHC Medicare Advantage |
$741.30
|
| Rate for Payer: VA VA |
$719.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,159.14
|
|
|
HC KYLEENA 19.5MG
|
Facility
|
IP
|
$2,878.85
|
|
|
Service Code
|
CPT J7296
|
| Hospital Charge Code |
63600165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,755.81 |
| Max. Negotiated Rate |
$2,590.96 |
| Rate for Payer: Aetna Commercial |
$2,447.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,224.78
|
| Rate for Payer: BCN Commercial |
$2,224.78
|
| Rate for Payer: Cash Price |
$2,303.08
|
| Rate for Payer: Cofinity Commercial |
$2,475.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,303.08
|
| Rate for Payer: Healthscope Commercial |
$2,590.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,159.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,447.02
|
| Rate for Payer: PHP Commercial |
$2,447.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,504.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,755.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,533.39
|
| Rate for Payer: UHC Core |
$2,403.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,159.14
|
|
|
HC LAAC IMPLANT
|
Facility
|
OP
|
$18,207.00
|
|
| Hospital Charge Code |
27800117
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,324.16 |
| Max. Negotiated Rate |
$16,386.30 |
| Rate for Payer: Aetna Commercial |
$15,475.95
|
| Rate for Payer: Aetna Medicare |
$4,733.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,689.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,689.69
|
| Rate for Payer: BCBS Complete |
$7,282.80
|
| Rate for Payer: BCBS MAPPO |
$4,551.75
|
| Rate for Payer: BCBS Trust/PPO |
$14,155.94
|
| Rate for Payer: BCN Commercial |
$14,155.94
|
| Rate for Payer: BCN Medicare Advantage |
$4,551.75
|
| Rate for Payer: Cash Price |
$14,565.60
|
| Rate for Payer: Cofinity Commercial |
$15,658.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,565.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,551.75
|
| Rate for Payer: Healthscope Commercial |
$16,386.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,655.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,779.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,234.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,475.95
|
| Rate for Payer: PACE Senior Care Partners |
$4,324.16
|
| Rate for Payer: PACE SWMI |
$4,551.75
|
| Rate for Payer: PHP Commercial |
$15,475.95
|
| Rate for Payer: PHP Medicare Advantage |
$4,551.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,744.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,840.09
|
| Rate for Payer: Priority Health Medicare |
$4,551.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,104.45
|
| Rate for Payer: Railroad Medicare Medicare |
$4,551.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,022.16
|
| Rate for Payer: UHC Core |
$15,202.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,551.75
|
| Rate for Payer: UHC Medicare Advantage |
$4,688.30
|
| Rate for Payer: VA VA |
$4,551.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,655.25
|
|
|
HC LAAC IMPLANT
|
Facility
|
IP
|
$18,207.00
|
|
| Hospital Charge Code |
27800117
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,104.45 |
| Max. Negotiated Rate |
$16,386.30 |
| Rate for Payer: Aetna Commercial |
$15,475.95
|
| Rate for Payer: BCBS Trust/PPO |
$14,070.37
|
| Rate for Payer: BCN Commercial |
$14,070.37
|
| Rate for Payer: Cash Price |
$14,565.60
|
| Rate for Payer: Cofinity Commercial |
$15,658.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,565.60
|
| Rate for Payer: Healthscope Commercial |
$16,386.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,655.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,475.95
|
| Rate for Payer: PHP Commercial |
$15,475.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,744.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,840.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,104.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,022.16
|
| Rate for Payer: UHC Core |
$15,202.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,655.25
|
|
|
HC LABOR CAT (1) 0-2HRS
|
Facility
|
IP
|
$1,500.99
|
|
| Hospital Charge Code |
72000001
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$915.45 |
| Max. Negotiated Rate |
$1,350.89 |
| Rate for Payer: Aetna Commercial |
$1,275.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,159.97
|
| Rate for Payer: BCN Commercial |
$1,159.97
|
| Rate for Payer: Cash Price |
$1,200.79
|
| Rate for Payer: Cofinity Commercial |
$1,290.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.79
|
| Rate for Payer: Healthscope Commercial |
$1,350.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,275.84
|
| Rate for Payer: PHP Commercial |
$1,275.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,305.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$915.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,320.87
|
| Rate for Payer: UHC Core |
$1,253.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.74
|
|
|
HC LABOR CAT (1) 0-2HRS
|
Facility
|
OP
|
$1,500.99
|
|
| Hospital Charge Code |
72000001
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$356.49 |
| Max. Negotiated Rate |
$1,350.89 |
| Rate for Payer: Aetna Commercial |
$1,275.84
|
| Rate for Payer: Aetna Medicare |
$390.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$469.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$469.06
|
| Rate for Payer: BCBS Complete |
$600.40
|
| Rate for Payer: BCBS MAPPO |
$375.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,167.02
|
| Rate for Payer: BCN Commercial |
$1,167.02
|
| Rate for Payer: BCN Medicare Advantage |
$375.25
|
| Rate for Payer: Cash Price |
$1,200.79
|
| Rate for Payer: Cofinity Commercial |
$1,290.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$375.25
|
| Rate for Payer: Healthscope Commercial |
$1,350.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$394.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$431.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,275.84
|
| Rate for Payer: PACE Senior Care Partners |
$356.49
|
| Rate for Payer: PACE SWMI |
$375.25
|
| Rate for Payer: PHP Commercial |
$1,275.84
|
| Rate for Payer: PHP Medicare Advantage |
$375.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,305.86
|
| Rate for Payer: Priority Health Medicare |
$375.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$915.45
|
| Rate for Payer: Railroad Medicare Medicare |
$375.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,320.87
|
| Rate for Payer: UHC Core |
$1,253.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$375.25
|
| Rate for Payer: UHC Medicare Advantage |
$386.50
|
| Rate for Payer: VA VA |
$375.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.74
|
|
|
HC LABOR CAT (2) 2-5HRS
|
Facility
|
OP
|
$2,001.38
|
|
| Hospital Charge Code |
72000002
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$475.33 |
| Max. Negotiated Rate |
$1,801.24 |
| Rate for Payer: Aetna Commercial |
$1,701.17
|
| Rate for Payer: Aetna Medicare |
$520.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$625.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$625.43
|
| Rate for Payer: BCBS Complete |
$800.55
|
| Rate for Payer: BCBS MAPPO |
$500.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,556.07
|
| Rate for Payer: BCN Commercial |
$1,556.07
|
| Rate for Payer: BCN Medicare Advantage |
$500.34
|
| Rate for Payer: Cash Price |
$1,601.10
|
| Rate for Payer: Cofinity Commercial |
$1,721.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,601.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.34
|
| Rate for Payer: Healthscope Commercial |
$1,801.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,501.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$525.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$575.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,701.17
|
| Rate for Payer: PACE Senior Care Partners |
$475.33
|
| Rate for Payer: PACE SWMI |
$500.34
|
| Rate for Payer: PHP Commercial |
$1,701.17
|
| Rate for Payer: PHP Medicare Advantage |
$500.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,400.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,741.20
|
| Rate for Payer: Priority Health Medicare |
$500.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,220.64
|
| Rate for Payer: Railroad Medicare Medicare |
$500.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,761.21
|
| Rate for Payer: UHC Core |
$1,671.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.34
|
| Rate for Payer: UHC Medicare Advantage |
$515.36
|
| Rate for Payer: VA VA |
$500.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,501.04
|
|
|
HC LABOR CAT (2) 2-5HRS
|
Facility
|
IP
|
$2,001.38
|
|
| Hospital Charge Code |
72000002
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,220.64 |
| Max. Negotiated Rate |
$1,801.24 |
| Rate for Payer: Aetna Commercial |
$1,701.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,546.67
|
| Rate for Payer: BCN Commercial |
$1,546.67
|
| Rate for Payer: Cash Price |
$1,601.10
|
| Rate for Payer: Cofinity Commercial |
$1,721.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,601.10
|
| Rate for Payer: Healthscope Commercial |
$1,801.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,501.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,701.17
|
| Rate for Payer: PHP Commercial |
$1,701.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,400.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,741.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,220.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,761.21
|
| Rate for Payer: UHC Core |
$1,671.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,501.04
|
|
|
HC LABOR CAT (3) 5-8HRS
|
Facility
|
OP
|
$2,501.62
|
|
| Hospital Charge Code |
72000003
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$594.13 |
| Max. Negotiated Rate |
$2,251.46 |
| Rate for Payer: Aetna Commercial |
$2,126.38
|
| Rate for Payer: Aetna Medicare |
$650.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.76
|
| Rate for Payer: BCBS Complete |
$1,000.65
|
| Rate for Payer: BCBS MAPPO |
$625.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,945.01
|
| Rate for Payer: BCN Commercial |
$1,945.01
|
| Rate for Payer: BCN Medicare Advantage |
$625.40
|
| Rate for Payer: Cash Price |
$2,001.30
|
| Rate for Payer: Cofinity Commercial |
$2,151.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,001.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.40
|
| Rate for Payer: Healthscope Commercial |
$2,251.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,876.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,126.38
|
| Rate for Payer: PACE Senior Care Partners |
$594.13
|
| Rate for Payer: PACE SWMI |
$625.40
|
| Rate for Payer: PHP Commercial |
$2,126.38
|
| Rate for Payer: PHP Medicare Advantage |
$625.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,751.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,176.41
|
| Rate for Payer: Priority Health Medicare |
$625.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,525.74
|
| Rate for Payer: Railroad Medicare Medicare |
$625.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,201.43
|
| Rate for Payer: UHC Core |
$2,088.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.40
|
| Rate for Payer: UHC Medicare Advantage |
$644.17
|
| Rate for Payer: VA VA |
$625.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,876.22
|
|
|
HC LABOR CAT (3) 5-8HRS
|
Facility
|
IP
|
$2,501.62
|
|
| Hospital Charge Code |
72000003
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,525.74 |
| Max. Negotiated Rate |
$2,251.46 |
| Rate for Payer: Aetna Commercial |
$2,126.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,933.25
|
| Rate for Payer: BCN Commercial |
$1,933.25
|
| Rate for Payer: Cash Price |
$2,001.30
|
| Rate for Payer: Cofinity Commercial |
$2,151.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,001.30
|
| Rate for Payer: Healthscope Commercial |
$2,251.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,876.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,126.38
|
| Rate for Payer: PHP Commercial |
$2,126.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,751.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,176.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,201.43
|
| Rate for Payer: UHC Core |
$2,088.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,876.22
|
|
|
HC LABOR CAT (4) 8-12HRS
|
Facility
|
IP
|
$3,001.99
|
|
| Hospital Charge Code |
72000004
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,830.91 |
| Max. Negotiated Rate |
$2,701.79 |
| Rate for Payer: Aetna Commercial |
$2,551.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,319.94
|
| Rate for Payer: BCN Commercial |
$2,319.94
|
| Rate for Payer: Cash Price |
$2,401.59
|
| Rate for Payer: Cofinity Commercial |
$2,581.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,401.59
|
| Rate for Payer: Healthscope Commercial |
$2,701.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,251.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,551.69
|
| Rate for Payer: PHP Commercial |
$2,551.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,101.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,611.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,830.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,641.75
|
| Rate for Payer: UHC Core |
$2,506.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,251.49
|
|
|
HC LABOR CAT (4) 8-12HRS
|
Facility
|
OP
|
$3,001.99
|
|
| Hospital Charge Code |
72000004
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$712.97 |
| Max. Negotiated Rate |
$2,701.79 |
| Rate for Payer: Aetna Commercial |
$2,551.69
|
| Rate for Payer: Aetna Medicare |
$780.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$938.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$938.12
|
| Rate for Payer: BCBS Complete |
$1,200.80
|
| Rate for Payer: BCBS MAPPO |
$750.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,334.05
|
| Rate for Payer: BCN Commercial |
$2,334.05
|
| Rate for Payer: BCN Medicare Advantage |
$750.50
|
| Rate for Payer: Cash Price |
$2,401.59
|
| Rate for Payer: Cofinity Commercial |
$2,581.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,401.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$750.50
|
| Rate for Payer: Healthscope Commercial |
$2,701.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,251.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$788.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$863.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,551.69
|
| Rate for Payer: PACE Senior Care Partners |
$712.97
|
| Rate for Payer: PACE SWMI |
$750.50
|
| Rate for Payer: PHP Commercial |
$2,551.69
|
| Rate for Payer: PHP Medicare Advantage |
$750.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,101.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,611.73
|
| Rate for Payer: Priority Health Medicare |
$750.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,830.91
|
| Rate for Payer: Railroad Medicare Medicare |
$750.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,641.75
|
| Rate for Payer: UHC Core |
$2,506.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$750.50
|
| Rate for Payer: UHC Medicare Advantage |
$773.01
|
| Rate for Payer: VA VA |
$750.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,251.49
|
|
|
HC LABOR CAT (5) 12-17HRS
|
Facility
|
IP
|
$4,499.56
|
|
| Hospital Charge Code |
72000007
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$2,744.28 |
| Max. Negotiated Rate |
$4,049.60 |
| Rate for Payer: Aetna Commercial |
$3,824.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,477.26
|
| Rate for Payer: BCN Commercial |
$3,477.26
|
| Rate for Payer: Cash Price |
$3,599.65
|
| Rate for Payer: Cofinity Commercial |
$3,869.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,599.65
|
| Rate for Payer: Healthscope Commercial |
$4,049.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,374.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,824.63
|
| Rate for Payer: PHP Commercial |
$3,824.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,149.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,914.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,744.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,959.61
|
| Rate for Payer: UHC Core |
$3,757.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,374.67
|
|
|
HC LABOR CAT (5) 12-17HRS
|
Facility
|
OP
|
$4,499.56
|
|
| Hospital Charge Code |
72000007
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,068.65 |
| Max. Negotiated Rate |
$4,049.60 |
| Rate for Payer: Aetna Commercial |
$3,824.63
|
| Rate for Payer: Aetna Medicare |
$1,169.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,406.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,406.11
|
| Rate for Payer: BCBS Complete |
$1,799.82
|
| Rate for Payer: BCBS MAPPO |
$1,124.89
|
| Rate for Payer: BCBS Trust/PPO |
$3,498.41
|
| Rate for Payer: BCN Commercial |
$3,498.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,124.89
|
| Rate for Payer: Cash Price |
$3,599.65
|
| Rate for Payer: Cofinity Commercial |
$3,869.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,599.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,124.89
|
| Rate for Payer: Healthscope Commercial |
$4,049.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,374.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,181.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,293.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,824.63
|
| Rate for Payer: PACE Senior Care Partners |
$1,068.65
|
| Rate for Payer: PACE SWMI |
$1,124.89
|
| Rate for Payer: PHP Commercial |
$3,824.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,124.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,149.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,914.62
|
| Rate for Payer: Priority Health Medicare |
$1,124.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,744.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1,124.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,959.61
|
| Rate for Payer: UHC Core |
$3,757.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,124.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,158.64
|
| Rate for Payer: VA VA |
$1,124.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,374.67
|
|
|
HC LABOR CAT (6) 17 OR MORE HRS
|
Facility
|
IP
|
$6,656.91
|
|
| Hospital Charge Code |
72000008
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$4,060.05 |
| Max. Negotiated Rate |
$5,991.22 |
| Rate for Payer: Aetna Commercial |
$5,658.37
|
| Rate for Payer: BCBS Trust/PPO |
$5,144.46
|
| Rate for Payer: BCN Commercial |
$5,144.46
|
| Rate for Payer: Cash Price |
$5,325.53
|
| Rate for Payer: Cofinity Commercial |
$5,724.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,325.53
|
| Rate for Payer: Healthscope Commercial |
$5,991.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,992.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,658.37
|
| Rate for Payer: PHP Commercial |
$5,658.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,659.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,791.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,060.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,858.08
|
| Rate for Payer: UHC Core |
$5,558.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,992.68
|
|
|
HC LABOR CAT (6) 17 OR MORE HRS
|
Facility
|
OP
|
$6,656.91
|
|
| Hospital Charge Code |
72000008
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,581.02 |
| Max. Negotiated Rate |
$5,991.22 |
| Rate for Payer: Aetna Commercial |
$5,658.37
|
| Rate for Payer: Aetna Medicare |
$1,730.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,080.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,080.28
|
| Rate for Payer: BCBS Complete |
$2,662.76
|
| Rate for Payer: BCBS MAPPO |
$1,664.23
|
| Rate for Payer: BCBS Trust/PPO |
$5,175.75
|
| Rate for Payer: BCN Commercial |
$5,175.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,664.23
|
| Rate for Payer: Cash Price |
$5,325.53
|
| Rate for Payer: Cofinity Commercial |
$5,724.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,325.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,664.23
|
| Rate for Payer: Healthscope Commercial |
$5,991.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,992.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,747.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,913.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,658.37
|
| Rate for Payer: PACE Senior Care Partners |
$1,581.02
|
| Rate for Payer: PACE SWMI |
$1,664.23
|
| Rate for Payer: PHP Commercial |
$5,658.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,664.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,659.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,791.51
|
| Rate for Payer: Priority Health Medicare |
$1,664.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,060.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,664.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,858.08
|
| Rate for Payer: UHC Core |
$5,558.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,664.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,714.15
|
| Rate for Payer: VA VA |
$1,664.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,992.68
|
|
|
HC LABYRINTHOTOMY TRANSCANAL
|
Facility
|
OP
|
$3,937.00
|
|
|
Service Code
|
CPT 69801
|
| Hospital Charge Code |
76100487
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$935.04 |
| Max. Negotiated Rate |
$3,543.30 |
| Rate for Payer: Aetna Commercial |
$3,346.45
|
| Rate for Payer: Aetna Medicare |
$1,023.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,230.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,230.31
|
| Rate for Payer: BCBS Complete |
$1,050.44
|
| Rate for Payer: BCBS MAPPO |
$984.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,061.02
|
| Rate for Payer: BCN Commercial |
$3,061.02
|
| Rate for Payer: BCN Medicare Advantage |
$984.25
|
| Rate for Payer: Cash Price |
$3,149.60
|
| Rate for Payer: Cash Price |
$3,149.60
|
| Rate for Payer: Cofinity Commercial |
$3,385.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,149.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$984.25
|
| Rate for Payer: Healthscope Commercial |
$3,543.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,952.75
|
| Rate for Payer: Mclaren Medicaid |
$1,000.42
|
| Rate for Payer: Meridian Medicaid |
$1,050.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,033.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,131.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,346.45
|
| Rate for Payer: PACE Senior Care Partners |
$935.04
|
| Rate for Payer: PACE SWMI |
$984.25
|
| Rate for Payer: PHP Commercial |
$3,346.45
|
| Rate for Payer: PHP Medicare Advantage |
$984.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,000.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,755.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,425.19
|
| Rate for Payer: Priority Health Medicare |
$984.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,401.18
|
| Rate for Payer: Railroad Medicare Medicare |
$984.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,464.56
|
| Rate for Payer: UHC Core |
$3,287.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$984.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,013.78
|
| Rate for Payer: VA VA |
$984.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,952.75
|
|
|
HC LABYRINTHOTOMY TRANSCANAL
|
Facility
|
IP
|
$3,937.00
|
|
|
Service Code
|
CPT 69801
|
| Hospital Charge Code |
76100487
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,401.18 |
| Max. Negotiated Rate |
$3,543.30 |
| Rate for Payer: Aetna Commercial |
$3,346.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,042.51
|
| Rate for Payer: BCN Commercial |
$3,042.51
|
| Rate for Payer: Cash Price |
$3,149.60
|
| Rate for Payer: Cofinity Commercial |
$3,385.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,149.60
|
| Rate for Payer: Healthscope Commercial |
$3,543.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,952.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,346.45
|
| Rate for Payer: PHP Commercial |
$3,346.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,755.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,425.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,401.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,464.56
|
| Rate for Payer: UHC Core |
$3,287.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,952.75
|
|
|
HC LA/CS PACING + RECORDING
|
Facility
|
OP
|
$1,525.40
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
48100038
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$362.28 |
| Max. Negotiated Rate |
$1,372.86 |
| Rate for Payer: Aetna Commercial |
$1,296.59
|
| Rate for Payer: Aetna Medicare |
$396.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$476.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$476.69
|
| Rate for Payer: BCBS Complete |
$610.16
|
| Rate for Payer: BCBS MAPPO |
$381.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.00
|
| Rate for Payer: BCN Commercial |
$1,186.00
|
| Rate for Payer: BCN Medicare Advantage |
$381.35
|
| Rate for Payer: Cash Price |
$1,220.32
|
| Rate for Payer: Cofinity Commercial |
$1,311.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,220.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$381.35
|
| Rate for Payer: Healthscope Commercial |
$1,372.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,144.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$400.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$438.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,296.59
|
| Rate for Payer: PACE Senior Care Partners |
$362.28
|
| Rate for Payer: PACE SWMI |
$381.35
|
| Rate for Payer: PHP Commercial |
$1,296.59
|
| Rate for Payer: PHP Medicare Advantage |
$381.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,067.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,327.10
|
| Rate for Payer: Priority Health Medicare |
$381.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$930.34
|
| Rate for Payer: Railroad Medicare Medicare |
$381.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,342.35
|
| Rate for Payer: UHC Core |
$1,273.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$381.35
|
| Rate for Payer: UHC Medicare Advantage |
$392.79
|
| Rate for Payer: VA VA |
$381.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,144.05
|
|
|
HC LA/CS PACING + RECORDING
|
Facility
|
IP
|
$1,525.40
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
48100038
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$930.34 |
| Max. Negotiated Rate |
$1,372.86 |
| Rate for Payer: Aetna Commercial |
$1,296.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,178.83
|
| Rate for Payer: BCN Commercial |
$1,178.83
|
| Rate for Payer: Cash Price |
$1,220.32
|
| Rate for Payer: Cofinity Commercial |
$1,311.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,220.32
|
| Rate for Payer: Healthscope Commercial |
$1,372.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,144.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,296.59
|
| Rate for Payer: PHP Commercial |
$1,296.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,067.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,327.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$930.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,342.35
|
| Rate for Payer: UHC Core |
$1,273.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,144.05
|
|
|
HC LACTATE DEHYDROGENASE
|
Facility
|
IP
|
$21.76
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
30100272
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.27 |
| Max. Negotiated Rate |
$19.58 |
| Rate for Payer: Aetna Commercial |
$18.50
|
| Rate for Payer: BCBS Trust/PPO |
$16.82
|
| Rate for Payer: BCN Commercial |
$16.82
|
| Rate for Payer: Cash Price |
$17.41
|
| Rate for Payer: Cofinity Commercial |
$18.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.41
|
| Rate for Payer: Healthscope Commercial |
$19.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.50
|
| Rate for Payer: PHP Commercial |
$18.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.15
|
| Rate for Payer: UHC Core |
$18.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.32
|
|
|
HC LACTATE DEHYDROGENASE
|
Facility
|
OP
|
$21.76
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
30100272
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.46 |
| Max. Negotiated Rate |
$19.58 |
| Rate for Payer: Aetna Commercial |
$18.50
|
| Rate for Payer: Aetna Medicare |
$5.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.80
|
| Rate for Payer: BCBS Complete |
$4.68
|
| Rate for Payer: BCBS MAPPO |
$5.44
|
| Rate for Payer: BCBS Trust/PPO |
$16.92
|
| Rate for Payer: BCN Commercial |
$16.92
|
| Rate for Payer: BCN Medicare Advantage |
$5.44
|
| Rate for Payer: Cash Price |
$17.41
|
| Rate for Payer: Cash Price |
$17.41
|
| Rate for Payer: Cofinity Commercial |
$18.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.44
|
| Rate for Payer: Healthscope Commercial |
$19.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.32
|
| Rate for Payer: Mclaren Medicaid |
$4.46
|
| Rate for Payer: Meridian Medicaid |
$4.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.50
|
| Rate for Payer: PACE Senior Care Partners |
$5.17
|
| Rate for Payer: PACE SWMI |
$5.44
|
| Rate for Payer: PHP Commercial |
$18.50
|
| Rate for Payer: PHP Medicare Advantage |
$5.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.93
|
| Rate for Payer: Priority Health Medicare |
$5.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.27
|
| Rate for Payer: Railroad Medicare Medicare |
$5.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.15
|
| Rate for Payer: UHC Core |
$18.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.44
|
| Rate for Payer: UHC Medicare Advantage |
$5.60
|
| Rate for Payer: VA VA |
$5.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.32
|
|
|
HC LACTATE LACTIC ACID
|
Facility
|
IP
|
$58.14
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100270
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.46 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: BCBS Trust/PPO |
$44.93
|
| Rate for Payer: BCN Commercial |
$44.93
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.42
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.16
|
| Rate for Payer: UHC Core |
$48.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
