HC LACTATE LACTIC ACID
|
Facility
|
OP
|
$58.14
|
|
Service Code
|
CPT 83605
|
Hospital Charge Code |
30100270
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$8.54 |
Max. Negotiated Rate |
$52.33 |
Rate for Payer: Aetna Commercial |
$49.42
|
Rate for Payer: Aetna Medicare |
$15.12
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.17
|
Rate for Payer: Amish Plain Church Group Commercial |
$18.17
|
Rate for Payer: BCBS Complete |
$8.97
|
Rate for Payer: BCBS MAPPO |
$14.54
|
Rate for Payer: BCBS Trust/PPO |
$45.20
|
Rate for Payer: BCN Commercial |
$45.20
|
Rate for Payer: BCN Medicare Advantage |
$14.54
|
Rate for Payer: Cash Price |
$46.51
|
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: Health Alliance Plan Medicare Advantage |
$14.54
|
Rate for Payer: Healthscope Commercial |
$52.33
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
Rate for Payer: Mclaren Medicaid |
$8.54
|
Rate for Payer: Meridian Medicaid |
$8.97
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.26
|
Rate for Payer: MI Amish Medical Board Commercial |
$16.72
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.42
|
Rate for Payer: PACE Senior Care Partners |
$13.81
|
Rate for Payer: PACE SWMI |
$14.54
|
Rate for Payer: PHP Commercial |
$49.42
|
Rate for Payer: PHP Medicare Advantage |
$14.54
|
Rate for Payer: Priority Health Choice Medicaid |
$8.54
|
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 Medicare |
$14.54
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$35.46
|
Rate for Payer: Railroad Medicare Medicare |
$14.54
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$51.16
|
Rate for Payer: UHC Core |
$48.55
|
Rate for Payer: UHC Dual Complete DSNP |
$14.54
|
Rate for Payer: UHC Medicare Advantage |
$14.97
|
Rate for Payer: VA VA |
$14.54
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
HC LACTOSE TOLERANCE
|
Facility
|
OP
|
$92.21
|
|
Service Code
|
CPT 82951
|
Hospital Charge Code |
30100226
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$9.50 |
Max. Negotiated Rate |
$82.99 |
Rate for Payer: Aetna Commercial |
$78.38
|
Rate for Payer: Aetna Medicare |
$23.97
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.82
|
Rate for Payer: Amish Plain Church Group Commercial |
$28.82
|
Rate for Payer: BCBS Complete |
$9.97
|
Rate for Payer: BCBS MAPPO |
$23.05
|
Rate for Payer: BCBS Trust/PPO |
$71.69
|
Rate for Payer: BCN Commercial |
$71.69
|
Rate for Payer: BCN Medicare Advantage |
$23.05
|
Rate for Payer: Cash Price |
$73.77
|
Rate for Payer: Cash Price |
$73.77
|
Rate for Payer: Cofinity Commercial |
$79.30
|
Rate for Payer: Encore Health Key Benefits Commercial |
$73.77
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.05
|
Rate for Payer: Healthscope Commercial |
$82.99
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.16
|
Rate for Payer: Mclaren Medicaid |
$9.50
|
Rate for Payer: Meridian Medicaid |
$9.97
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.21
|
Rate for Payer: MI Amish Medical Board Commercial |
$26.51
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.38
|
Rate for Payer: PACE Senior Care Partners |
$21.90
|
Rate for Payer: PACE SWMI |
$23.05
|
Rate for Payer: PHP Commercial |
$78.38
|
Rate for Payer: PHP Medicare Advantage |
$23.05
|
Rate for Payer: Priority Health Choice Medicaid |
$9.50
|
Rate for Payer: Priority Health Cigna Priority Health |
$64.55
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.22
|
Rate for Payer: Priority Health Medicare |
$23.05
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$56.24
|
Rate for Payer: Railroad Medicare Medicare |
$23.05
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$81.14
|
Rate for Payer: UHC Core |
$77.00
|
Rate for Payer: UHC Dual Complete DSNP |
$23.05
|
Rate for Payer: UHC Medicare Advantage |
$23.74
|
Rate for Payer: VA VA |
$23.05
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.16
|
|
HC LACTOSE TOLERANCE
|
Facility
|
IP
|
$92.21
|
|
Service Code
|
CPT 82951
|
Hospital Charge Code |
30100226
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$56.24 |
Max. Negotiated Rate |
$82.99 |
Rate for Payer: Aetna Commercial |
$78.38
|
Rate for Payer: BCBS Trust/PPO |
$71.26
|
Rate for Payer: BCN Commercial |
$71.26
|
Rate for Payer: Cash Price |
$73.77
|
Rate for Payer: Cofinity Commercial |
$79.30
|
Rate for Payer: Encore Health Key Benefits Commercial |
$73.77
|
Rate for Payer: Healthscope Commercial |
$82.99
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.16
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.38
|
Rate for Payer: PHP Commercial |
$78.38
|
Rate for Payer: Priority Health Cigna Priority Health |
$64.55
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.22
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$56.24
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$81.14
|
Rate for Payer: UHC Core |
$77.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.16
|
|
HC LAMBDA FREE LIGHT CHAIN SERUM
|
Facility
|
IP
|
$75.90
|
|
Service Code
|
CPT 83521
|
Hospital Charge Code |
30100308
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$46.29 |
Max. Negotiated Rate |
$68.31 |
Rate for Payer: Aetna Commercial |
$64.52
|
Rate for Payer: BCBS Trust/PPO |
$58.66
|
Rate for Payer: BCN Commercial |
$58.66
|
Rate for Payer: Cash Price |
$60.72
|
Rate for Payer: Cofinity Commercial |
$65.27
|
Rate for Payer: Encore Health Key Benefits Commercial |
$60.72
|
Rate for Payer: Healthscope Commercial |
$68.31
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.92
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.52
|
Rate for Payer: PHP Commercial |
$64.52
|
Rate for Payer: Priority Health Cigna Priority Health |
$53.13
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.03
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$46.29
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$66.79
|
Rate for Payer: UHC Core |
$63.38
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.92
|
|
HC LAMBDA FREE LIGHT CHAIN SERUM
|
Facility
|
OP
|
$75.90
|
|
Service Code
|
CPT 83521
|
Hospital Charge Code |
30100308
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$12.75 |
Max. Negotiated Rate |
$68.31 |
Rate for Payer: Aetna Commercial |
$64.52
|
Rate for Payer: Aetna Medicare |
$19.73
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.72
|
Rate for Payer: Amish Plain Church Group Commercial |
$23.72
|
Rate for Payer: BCBS Complete |
$13.38
|
Rate for Payer: BCBS MAPPO |
$18.98
|
Rate for Payer: BCBS Trust/PPO |
$59.01
|
Rate for Payer: BCN Commercial |
$59.01
|
Rate for Payer: BCN Medicare Advantage |
$18.98
|
Rate for Payer: Cash Price |
$60.72
|
Rate for Payer: Cash Price |
$60.72
|
Rate for Payer: Cofinity Commercial |
$65.27
|
Rate for Payer: Encore Health Key Benefits Commercial |
$60.72
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.98
|
Rate for Payer: Healthscope Commercial |
$68.31
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.92
|
Rate for Payer: Mclaren Medicaid |
$12.75
|
Rate for Payer: Meridian Medicaid |
$13.38
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.92
|
Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.52
|
Rate for Payer: PACE Senior Care Partners |
$18.03
|
Rate for Payer: PACE SWMI |
$18.98
|
Rate for Payer: PHP Commercial |
$64.52
|
Rate for Payer: PHP Medicare Advantage |
$18.98
|
Rate for Payer: Priority Health Choice Medicaid |
$12.75
|
Rate for Payer: Priority Health Cigna Priority Health |
$53.13
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.03
|
Rate for Payer: Priority Health Medicare |
$18.98
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$46.29
|
Rate for Payer: Railroad Medicare Medicare |
$18.98
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$66.79
|
Rate for Payer: UHC Core |
$63.38
|
Rate for Payer: UHC Dual Complete DSNP |
$18.98
|
Rate for Payer: UHC Medicare Advantage |
$19.54
|
Rate for Payer: VA VA |
$18.98
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.92
|
|
HC LAMBS QUARTERS IGE
|
Facility
|
OP
|
$24.89
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
30200091
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.85 |
Max. Negotiated Rate |
$22.40 |
Rate for Payer: Aetna Commercial |
$21.16
|
Rate for Payer: Aetna Medicare |
$6.47
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
Rate for Payer: BCBS Complete |
$4.04
|
Rate for Payer: BCBS MAPPO |
$6.22
|
Rate for Payer: BCBS Trust/PPO |
$19.35
|
Rate for Payer: BCN Commercial |
$19.35
|
Rate for Payer: BCN Medicare Advantage |
$6.22
|
Rate for Payer: Cash Price |
$19.91
|
Rate for Payer: Cash Price |
$19.91
|
Rate for Payer: Cofinity Commercial |
$21.41
|
Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
Rate for Payer: Healthscope Commercial |
$22.40
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
Rate for Payer: Mclaren Medicaid |
$3.85
|
Rate for Payer: Meridian Medicaid |
$4.04
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
Rate for Payer: PACE Senior Care Partners |
$5.91
|
Rate for Payer: PACE SWMI |
$6.22
|
Rate for Payer: PHP Commercial |
$21.16
|
Rate for Payer: PHP Medicare Advantage |
$6.22
|
Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
Rate for Payer: Priority Health Medicare |
$6.22
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
Rate for Payer: Railroad Medicare Medicare |
$6.22
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
Rate for Payer: UHC Core |
$20.78
|
Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
Rate for Payer: UHC Medicare Advantage |
$6.41
|
Rate for Payer: VA VA |
$6.22
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
HC LAMBS QUARTERS IGE
|
Facility
|
IP
|
$24.89
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
30200091
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$15.18 |
Max. Negotiated Rate |
$22.40 |
Rate for Payer: Aetna Commercial |
$21.16
|
Rate for Payer: BCBS Trust/PPO |
$19.23
|
Rate for Payer: BCN Commercial |
$19.23
|
Rate for Payer: Cash Price |
$19.91
|
Rate for Payer: Cofinity Commercial |
$21.41
|
Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
Rate for Payer: Healthscope Commercial |
$22.40
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
Rate for Payer: PHP Commercial |
$21.16
|
Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
Rate for Payer: UHC Core |
$20.78
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
OP
|
$70.00
|
|
Service Code
|
CPT 83664
|
Hospital Charge Code |
30100278
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$14.26 |
Max. Negotiated Rate |
$63.00 |
Rate for Payer: Aetna Commercial |
$59.50
|
Rate for Payer: Aetna Medicare |
$18.20
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.88
|
Rate for Payer: Amish Plain Church Group Commercial |
$21.88
|
Rate for Payer: BCBS Complete |
$14.97
|
Rate for Payer: BCBS MAPPO |
$17.50
|
Rate for Payer: BCBS Trust/PPO |
$54.42
|
Rate for Payer: BCN Commercial |
$54.42
|
Rate for Payer: BCN Medicare Advantage |
$17.50
|
Rate for Payer: Cash Price |
$56.00
|
Rate for Payer: Cash Price |
$56.00
|
Rate for Payer: Cofinity Commercial |
$60.20
|
Rate for Payer: Encore Health Key Benefits Commercial |
$56.00
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.50
|
Rate for Payer: Healthscope Commercial |
$63.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.50
|
Rate for Payer: Mclaren Medicaid |
$14.26
|
Rate for Payer: Meridian Medicaid |
$14.97
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.38
|
Rate for Payer: MI Amish Medical Board Commercial |
$20.12
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.50
|
Rate for Payer: PACE Senior Care Partners |
$16.62
|
Rate for Payer: PACE SWMI |
$17.50
|
Rate for Payer: PHP Commercial |
$59.50
|
Rate for Payer: PHP Medicare Advantage |
$17.50
|
Rate for Payer: Priority Health Choice Medicaid |
$14.26
|
Rate for Payer: Priority Health Cigna Priority Health |
$49.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.90
|
Rate for Payer: Priority Health Medicare |
$17.50
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$42.69
|
Rate for Payer: Railroad Medicare Medicare |
$17.50
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$61.60
|
Rate for Payer: UHC Core |
$58.45
|
Rate for Payer: UHC Dual Complete DSNP |
$17.50
|
Rate for Payer: UHC Medicare Advantage |
$18.02
|
Rate for Payer: VA VA |
$17.50
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.50
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
IP
|
$70.00
|
|
Service Code
|
CPT 83664
|
Hospital Charge Code |
30100278
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$42.69 |
Max. Negotiated Rate |
$63.00 |
Rate for Payer: Aetna Commercial |
$59.50
|
Rate for Payer: BCBS Trust/PPO |
$54.10
|
Rate for Payer: BCN Commercial |
$54.10
|
Rate for Payer: Cash Price |
$56.00
|
Rate for Payer: Cofinity Commercial |
$60.20
|
Rate for Payer: Encore Health Key Benefits Commercial |
$56.00
|
Rate for Payer: Healthscope Commercial |
$63.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.50
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$59.50
|
Rate for Payer: PHP Commercial |
$59.50
|
Rate for Payer: Priority Health Cigna Priority Health |
$49.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.90
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$42.69
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$61.60
|
Rate for Payer: UHC Core |
$58.45
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.50
|
|
HC LAMICTAL LEVEL
|
Facility
|
IP
|
$53.04
|
|
Service Code
|
CPT 80175
|
Hospital Charge Code |
30100054
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$32.35 |
Max. Negotiated Rate |
$47.74 |
Rate for Payer: Aetna Commercial |
$45.08
|
Rate for Payer: BCBS Trust/PPO |
$40.99
|
Rate for Payer: BCN Commercial |
$40.99
|
Rate for Payer: Cash Price |
$42.43
|
Rate for Payer: Cofinity Commercial |
$45.61
|
Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
Rate for Payer: Healthscope Commercial |
$47.74
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
Rate for Payer: PHP Commercial |
$45.08
|
Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.14
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$32.35
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$46.68
|
Rate for Payer: UHC Core |
$44.29
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
HC LAMICTAL LEVEL
|
Facility
|
OP
|
$53.04
|
|
Service Code
|
CPT 80175
|
Hospital Charge Code |
30100054
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$9.78 |
Max. Negotiated Rate |
$47.74 |
Rate for Payer: Aetna Commercial |
$45.08
|
Rate for Payer: Aetna Medicare |
$13.79
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
Rate for Payer: BCBS Complete |
$10.27
|
Rate for Payer: BCBS MAPPO |
$13.26
|
Rate for Payer: BCBS Trust/PPO |
$41.24
|
Rate for Payer: BCN Commercial |
$41.24
|
Rate for Payer: BCN Medicare Advantage |
$13.26
|
Rate for Payer: Cash Price |
$42.43
|
Rate for Payer: Cash Price |
$42.43
|
Rate for Payer: Cofinity Commercial |
$45.61
|
Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.26
|
Rate for Payer: Healthscope Commercial |
$47.74
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
Rate for Payer: Mclaren Medicaid |
$9.78
|
Rate for Payer: Meridian Medicaid |
$10.27
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.92
|
Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
Rate for Payer: PACE Senior Care Partners |
$12.60
|
Rate for Payer: PACE SWMI |
$13.26
|
Rate for Payer: PHP Commercial |
$45.08
|
Rate for Payer: PHP Medicare Advantage |
$13.26
|
Rate for Payer: Priority Health Choice Medicaid |
$9.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.14
|
Rate for Payer: Priority Health Medicare |
$13.26
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$32.35
|
Rate for Payer: Railroad Medicare Medicare |
$13.26
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$46.68
|
Rate for Payer: UHC Core |
$44.29
|
Rate for Payer: UHC Dual Complete DSNP |
$13.26
|
Rate for Payer: UHC Medicare Advantage |
$13.66
|
Rate for Payer: VA VA |
$13.26
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
HC LA RO SSB SJOGRENS AB
|
Facility
|
OP
|
$34.48
|
|
Service Code
|
CPT 86235
|
Hospital Charge Code |
30200160
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$8.19 |
Max. Negotiated Rate |
$31.03 |
Rate for Payer: Aetna Commercial |
$29.31
|
Rate for Payer: Aetna Medicare |
$8.96
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
Rate for Payer: BCBS Complete |
$13.89
|
Rate for Payer: BCBS MAPPO |
$8.62
|
Rate for Payer: BCBS Trust/PPO |
$26.81
|
Rate for Payer: BCN Commercial |
$26.81
|
Rate for Payer: BCN Medicare Advantage |
$8.62
|
Rate for Payer: Cash Price |
$27.58
|
Rate for Payer: Cash Price |
$27.58
|
Rate for Payer: Cofinity Commercial |
$29.65
|
Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
Rate for Payer: Healthscope Commercial |
$31.03
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
Rate for Payer: Mclaren Medicaid |
$13.23
|
Rate for Payer: Meridian Medicaid |
$13.89
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.05
|
Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
Rate for Payer: PACE Senior Care Partners |
$8.19
|
Rate for Payer: PACE SWMI |
$8.62
|
Rate for Payer: PHP Commercial |
$29.31
|
Rate for Payer: PHP Medicare Advantage |
$8.62
|
Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
Rate for Payer: Priority Health Medicare |
$8.62
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
Rate for Payer: Railroad Medicare Medicare |
$8.62
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
Rate for Payer: UHC Core |
$28.79
|
Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
Rate for Payer: UHC Medicare Advantage |
$8.88
|
Rate for Payer: VA VA |
$8.62
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
HC LA RO SSB SJOGRENS AB
|
Facility
|
IP
|
$34.48
|
|
Service Code
|
CPT 86235
|
Hospital Charge Code |
30200160
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$21.03 |
Max. Negotiated Rate |
$31.03 |
Rate for Payer: Aetna Commercial |
$29.31
|
Rate for Payer: BCBS Trust/PPO |
$26.65
|
Rate for Payer: BCN Commercial |
$26.65
|
Rate for Payer: Cash Price |
$27.58
|
Rate for Payer: Cofinity Commercial |
$29.65
|
Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
Rate for Payer: Healthscope Commercial |
$31.03
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
Rate for Payer: PHP Commercial |
$29.31
|
Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
Rate for Payer: UHC Core |
$28.79
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
HC LARYNGOSCOPY
|
Facility
|
IP
|
$2,514.51
|
|
Hospital Charge Code |
36000113
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$1,533.60 |
Max. Negotiated Rate |
$2,263.06 |
Rate for Payer: Aetna Commercial |
$2,137.33
|
Rate for Payer: BCBS Trust/PPO |
$1,943.21
|
Rate for Payer: BCN Commercial |
$1,943.21
|
Rate for Payer: Cash Price |
$2,011.61
|
Rate for Payer: Cofinity Commercial |
$2,162.48
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,011.61
|
Rate for Payer: Healthscope Commercial |
$2,263.06
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,885.88
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,137.33
|
Rate for Payer: PHP Commercial |
$2,137.33
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,760.16
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,187.62
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,533.60
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$2,212.77
|
Rate for Payer: UHC Core |
$2,099.62
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,885.88
|
|
HC LARYNGOSCOPY
|
Facility
|
OP
|
$2,514.51
|
|
Hospital Charge Code |
36000113
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$597.20 |
Max. Negotiated Rate |
$2,263.06 |
Rate for Payer: Aetna Commercial |
$2,137.33
|
Rate for Payer: Aetna Medicare |
$653.77
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$785.78
|
Rate for Payer: Amish Plain Church Group Commercial |
$785.78
|
Rate for Payer: BCBS Complete |
$1,005.80
|
Rate for Payer: BCBS MAPPO |
$628.63
|
Rate for Payer: BCBS Trust/PPO |
$1,955.03
|
Rate for Payer: BCN Commercial |
$1,955.03
|
Rate for Payer: BCN Medicare Advantage |
$628.63
|
Rate for Payer: Cash Price |
$2,011.61
|
Rate for Payer: Cofinity Commercial |
$2,162.48
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,011.61
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$628.63
|
Rate for Payer: Healthscope Commercial |
$2,263.06
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,885.88
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$660.06
|
Rate for Payer: MI Amish Medical Board Commercial |
$722.92
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,137.33
|
Rate for Payer: PACE Senior Care Partners |
$597.20
|
Rate for Payer: PACE SWMI |
$628.63
|
Rate for Payer: PHP Commercial |
$2,137.33
|
Rate for Payer: PHP Medicare Advantage |
$628.63
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,760.16
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,187.62
|
Rate for Payer: Priority Health Medicare |
$628.63
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$1,533.60
|
Rate for Payer: Railroad Medicare Medicare |
$628.63
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$2,212.77
|
Rate for Payer: UHC Core |
$2,099.62
|
Rate for Payer: UHC Dual Complete DSNP |
$628.63
|
Rate for Payer: UHC Medicare Advantage |
$647.49
|
Rate for Payer: VA VA |
$628.63
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,885.88
|
|
HC LARYNGOSCOPY FIBEROPTIC
|
Facility
|
IP
|
$311.92
|
|
Service Code
|
CPT 31575
|
Hospital Charge Code |
36100443
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$190.24 |
Max. Negotiated Rate |
$280.73 |
Rate for Payer: Aetna Commercial |
$265.13
|
Rate for Payer: BCBS Trust/PPO |
$241.05
|
Rate for Payer: BCN Commercial |
$241.05
|
Rate for Payer: Cash Price |
$249.54
|
Rate for Payer: Cofinity Commercial |
$268.25
|
Rate for Payer: Encore Health Key Benefits Commercial |
$249.54
|
Rate for Payer: Healthscope Commercial |
$280.73
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.94
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$265.13
|
Rate for Payer: PHP Commercial |
$265.13
|
Rate for Payer: Priority Health Cigna Priority Health |
$218.34
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.37
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$190.24
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$274.49
|
Rate for Payer: UHC Core |
$260.45
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.94
|
|
HC LARYNGOSCOPY FIBEROPTIC
|
Facility
|
OP
|
$311.92
|
|
Service Code
|
CPT 31575
|
Hospital Charge Code |
36100443
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$74.08 |
Max. Negotiated Rate |
$280.73 |
Rate for Payer: Aetna Commercial |
$265.13
|
Rate for Payer: Aetna Medicare |
$81.10
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$97.48
|
Rate for Payer: Amish Plain Church Group Commercial |
$97.48
|
Rate for Payer: BCBS Complete |
$136.44
|
Rate for Payer: BCBS MAPPO |
$77.98
|
Rate for Payer: BCBS Trust/PPO |
$242.52
|
Rate for Payer: BCN Commercial |
$242.52
|
Rate for Payer: BCN Medicare Advantage |
$77.98
|
Rate for Payer: Cash Price |
$249.54
|
Rate for Payer: Cash Price |
$249.54
|
Rate for Payer: Cofinity Commercial |
$268.25
|
Rate for Payer: Encore Health Key Benefits Commercial |
$249.54
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.98
|
Rate for Payer: Healthscope Commercial |
$280.73
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.94
|
Rate for Payer: Mclaren Medicaid |
$129.94
|
Rate for Payer: Meridian Medicaid |
$136.44
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$81.88
|
Rate for Payer: MI Amish Medical Board Commercial |
$89.68
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$265.13
|
Rate for Payer: PACE Senior Care Partners |
$74.08
|
Rate for Payer: PACE SWMI |
$77.98
|
Rate for Payer: PHP Commercial |
$265.13
|
Rate for Payer: PHP Medicare Advantage |
$77.98
|
Rate for Payer: Priority Health Choice Medicaid |
$129.94
|
Rate for Payer: Priority Health Cigna Priority Health |
$218.34
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.37
|
Rate for Payer: Priority Health Medicare |
$77.98
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$190.24
|
Rate for Payer: Railroad Medicare Medicare |
$77.98
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$274.49
|
Rate for Payer: UHC Core |
$260.45
|
Rate for Payer: UHC Dual Complete DSNP |
$77.98
|
Rate for Payer: UHC Medicare Advantage |
$80.32
|
Rate for Payer: VA VA |
$77.98
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.94
|
|
HC LARYNGOSCOPY FLX/RGD TELESCOP W/STROBOSCOP
|
Facility
|
IP
|
$1,100.00
|
|
Service Code
|
CPT 31579
|
Hospital Charge Code |
76100455
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$670.89 |
Max. Negotiated Rate |
$990.00 |
Rate for Payer: Aetna Commercial |
$935.00
|
Rate for Payer: BCBS Trust/PPO |
$850.08
|
Rate for Payer: BCN Commercial |
$850.08
|
Rate for Payer: Cash Price |
$880.00
|
Rate for Payer: Cofinity Commercial |
$946.00
|
Rate for Payer: Encore Health Key Benefits Commercial |
$880.00
|
Rate for Payer: Healthscope Commercial |
$990.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$825.00
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.00
|
Rate for Payer: PHP Commercial |
$935.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$770.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$957.00
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$670.89
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$968.00
|
Rate for Payer: UHC Core |
$918.50
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$825.00
|
|
HC LARYNGOSCOPY FLX/RGD TELESCOP W/STROBOSCOP
|
Facility
|
OP
|
$1,100.00
|
|
Service Code
|
CPT 31579
|
Hospital Charge Code |
76100455
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$261.25 |
Max. Negotiated Rate |
$990.00 |
Rate for Payer: Aetna Commercial |
$935.00
|
Rate for Payer: Aetna Medicare |
$286.00
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$343.75
|
Rate for Payer: Amish Plain Church Group Commercial |
$343.75
|
Rate for Payer: BCBS Complete |
$281.25
|
Rate for Payer: BCBS MAPPO |
$275.00
|
Rate for Payer: BCBS Trust/PPO |
$855.25
|
Rate for Payer: BCN Commercial |
$855.25
|
Rate for Payer: BCN Medicare Advantage |
$275.00
|
Rate for Payer: Cash Price |
$880.00
|
Rate for Payer: Cash Price |
$880.00
|
Rate for Payer: Cofinity Commercial |
$946.00
|
Rate for Payer: Encore Health Key Benefits Commercial |
$880.00
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.00
|
Rate for Payer: Healthscope Commercial |
$990.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$825.00
|
Rate for Payer: Mclaren Medicaid |
$267.86
|
Rate for Payer: Meridian Medicaid |
$281.25
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$288.75
|
Rate for Payer: MI Amish Medical Board Commercial |
$316.25
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.00
|
Rate for Payer: PACE Senior Care Partners |
$261.25
|
Rate for Payer: PACE SWMI |
$275.00
|
Rate for Payer: PHP Commercial |
$935.00
|
Rate for Payer: PHP Medicare Advantage |
$275.00
|
Rate for Payer: Priority Health Choice Medicaid |
$267.86
|
Rate for Payer: Priority Health Cigna Priority Health |
$770.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$957.00
|
Rate for Payer: Priority Health Medicare |
$275.00
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$670.89
|
Rate for Payer: Railroad Medicare Medicare |
$275.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$968.00
|
Rate for Payer: UHC Core |
$918.50
|
Rate for Payer: UHC Dual Complete DSNP |
$275.00
|
Rate for Payer: UHC Medicare Advantage |
$283.25
|
Rate for Payer: VA VA |
$275.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$825.00
|
|
HC LASER CATHETER
|
Facility
|
IP
|
$4,842.47
|
|
Service Code
|
HCPCS C1885
|
Hospital Charge Code |
27200054
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2,953.42 |
Max. Negotiated Rate |
$4,358.22 |
Rate for Payer: Aetna Commercial |
$4,116.10
|
Rate for Payer: BCBS Trust/PPO |
$3,742.26
|
Rate for Payer: BCN Commercial |
$3,742.26
|
Rate for Payer: Cash Price |
$3,873.98
|
Rate for Payer: Cofinity Commercial |
$4,164.52
|
Rate for Payer: Encore Health Key Benefits Commercial |
$3,873.98
|
Rate for Payer: Healthscope Commercial |
$4,358.22
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,631.85
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,116.10
|
Rate for Payer: PHP Commercial |
$4,116.10
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,389.73
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,212.95
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,953.42
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$4,261.37
|
Rate for Payer: UHC Core |
$4,043.46
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,631.85
|
|
HC LASER CATHETER
|
Facility
|
OP
|
$4,842.47
|
|
Service Code
|
HCPCS C1885
|
Hospital Charge Code |
27200054
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$1,150.09 |
Max. Negotiated Rate |
$4,358.22 |
Rate for Payer: Aetna Commercial |
$4,116.10
|
Rate for Payer: Aetna Medicare |
$1,259.04
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,513.27
|
Rate for Payer: Amish Plain Church Group Commercial |
$1,513.27
|
Rate for Payer: BCBS Complete |
$1,936.99
|
Rate for Payer: BCBS MAPPO |
$1,210.62
|
Rate for Payer: BCBS Trust/PPO |
$3,765.02
|
Rate for Payer: BCN Commercial |
$3,765.02
|
Rate for Payer: BCN Medicare Advantage |
$1,210.62
|
Rate for Payer: Cash Price |
$3,873.98
|
Rate for Payer: Cofinity Commercial |
$4,164.52
|
Rate for Payer: Encore Health Key Benefits Commercial |
$3,873.98
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,210.62
|
Rate for Payer: Healthscope Commercial |
$4,358.22
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,631.85
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,271.15
|
Rate for Payer: MI Amish Medical Board Commercial |
$1,392.21
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,116.10
|
Rate for Payer: PACE Senior Care Partners |
$1,150.09
|
Rate for Payer: PACE SWMI |
$1,210.62
|
Rate for Payer: PHP Commercial |
$4,116.10
|
Rate for Payer: PHP Medicare Advantage |
$1,210.62
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,389.73
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,212.95
|
Rate for Payer: Priority Health Medicare |
$1,210.62
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2,953.42
|
Rate for Payer: Railroad Medicare Medicare |
$1,210.62
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$4,261.37
|
Rate for Payer: UHC Core |
$4,043.46
|
Rate for Payer: UHC Dual Complete DSNP |
$1,210.62
|
Rate for Payer: UHC Medicare Advantage |
$1,246.94
|
Rate for Payer: VA VA |
$1,210.62
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,631.85
|
|
HC LATEX IGE
|
Facility
|
IP
|
$35.09
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
30200044
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$21.40 |
Max. Negotiated Rate |
$31.58 |
Rate for Payer: Aetna Commercial |
$29.83
|
Rate for Payer: BCBS Trust/PPO |
$27.12
|
Rate for Payer: BCN Commercial |
$27.12
|
Rate for Payer: Cash Price |
$28.07
|
Rate for Payer: Cofinity Commercial |
$30.18
|
Rate for Payer: Encore Health Key Benefits Commercial |
$28.07
|
Rate for Payer: Healthscope Commercial |
$31.58
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.32
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.83
|
Rate for Payer: PHP Commercial |
$29.83
|
Rate for Payer: Priority Health Cigna Priority Health |
$24.56
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.53
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$21.40
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$30.88
|
Rate for Payer: UHC Core |
$29.30
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.32
|
|
HC LATEX IGE
|
Facility
|
OP
|
$35.09
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
30200044
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.85 |
Max. Negotiated Rate |
$31.58 |
Rate for Payer: Aetna Commercial |
$29.83
|
Rate for Payer: Aetna Medicare |
$9.12
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.97
|
Rate for Payer: Amish Plain Church Group Commercial |
$10.97
|
Rate for Payer: BCBS Complete |
$4.04
|
Rate for Payer: BCBS MAPPO |
$8.77
|
Rate for Payer: BCBS Trust/PPO |
$27.28
|
Rate for Payer: BCN Commercial |
$27.28
|
Rate for Payer: BCN Medicare Advantage |
$8.77
|
Rate for Payer: Cash Price |
$28.07
|
Rate for Payer: Cash Price |
$28.07
|
Rate for Payer: Cofinity Commercial |
$30.18
|
Rate for Payer: Encore Health Key Benefits Commercial |
$28.07
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.77
|
Rate for Payer: Healthscope Commercial |
$31.58
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.32
|
Rate for Payer: Mclaren Medicaid |
$3.85
|
Rate for Payer: Meridian Medicaid |
$4.04
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.21
|
Rate for Payer: MI Amish Medical Board Commercial |
$10.09
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.83
|
Rate for Payer: PACE Senior Care Partners |
$8.33
|
Rate for Payer: PACE SWMI |
$8.77
|
Rate for Payer: PHP Commercial |
$29.83
|
Rate for Payer: PHP Medicare Advantage |
$8.77
|
Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
Rate for Payer: Priority Health Cigna Priority Health |
$24.56
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.53
|
Rate for Payer: Priority Health Medicare |
$8.77
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$21.40
|
Rate for Payer: Railroad Medicare Medicare |
$8.77
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$30.88
|
Rate for Payer: UHC Core |
$29.30
|
Rate for Payer: UHC Dual Complete DSNP |
$8.77
|
Rate for Payer: UHC Medicare Advantage |
$9.04
|
Rate for Payer: VA VA |
$8.77
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.32
|
|
HC LAYR CLOS WND REST BODY <2.5 CM
|
Facility
|
OP
|
$488.86
|
|
Service Code
|
CPT 12041
|
Hospital Charge Code |
76100228
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$116.10 |
Max. Negotiated Rate |
$439.97 |
Rate for Payer: Aetna Commercial |
$415.53
|
Rate for Payer: Aetna Medicare |
$127.10
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.77
|
Rate for Payer: Amish Plain Church Group Commercial |
$152.77
|
Rate for Payer: BCBS Complete |
$274.65
|
Rate for Payer: BCBS MAPPO |
$122.22
|
Rate for Payer: BCBS Trust/PPO |
$380.09
|
Rate for Payer: BCN Commercial |
$380.09
|
Rate for Payer: BCN Medicare Advantage |
$122.22
|
Rate for Payer: Cash Price |
$391.09
|
Rate for Payer: Cash Price |
$391.09
|
Rate for Payer: Cofinity Commercial |
$420.42
|
Rate for Payer: Encore Health Key Benefits Commercial |
$391.09
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.22
|
Rate for Payer: Healthscope Commercial |
$439.97
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$366.64
|
Rate for Payer: Mclaren Medicaid |
$261.57
|
Rate for Payer: Meridian Medicaid |
$274.65
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.33
|
Rate for Payer: MI Amish Medical Board Commercial |
$140.55
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$415.53
|
Rate for Payer: PACE Senior Care Partners |
$116.10
|
Rate for Payer: PACE SWMI |
$122.22
|
Rate for Payer: PHP Commercial |
$415.53
|
Rate for Payer: PHP Medicare Advantage |
$122.22
|
Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
Rate for Payer: Priority Health Cigna Priority Health |
$342.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.31
|
Rate for Payer: Priority Health Medicare |
$122.22
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$298.16
|
Rate for Payer: Railroad Medicare Medicare |
$122.22
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$430.20
|
Rate for Payer: UHC Core |
$408.20
|
Rate for Payer: UHC Dual Complete DSNP |
$122.22
|
Rate for Payer: UHC Medicare Advantage |
$125.88
|
Rate for Payer: VA VA |
$122.22
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$366.64
|
|
HC LAYR CLOS WND REST BODY <2.5 CM
|
Facility
|
IP
|
$488.86
|
|
Service Code
|
CPT 12041
|
Hospital Charge Code |
76100228
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$298.16 |
Max. Negotiated Rate |
$439.97 |
Rate for Payer: Aetna Commercial |
$415.53
|
Rate for Payer: BCBS Trust/PPO |
$377.79
|
Rate for Payer: BCN Commercial |
$377.79
|
Rate for Payer: Cash Price |
$391.09
|
Rate for Payer: Cofinity Commercial |
$420.42
|
Rate for Payer: Encore Health Key Benefits Commercial |
$391.09
|
Rate for Payer: Healthscope Commercial |
$439.97
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$366.64
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$415.53
|
Rate for Payer: PHP Commercial |
$415.53
|
Rate for Payer: Priority Health Cigna Priority Health |
$342.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$425.31
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$298.16
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$430.20
|
Rate for Payer: UHC Core |
$408.20
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$366.64
|
|