|
HC LEAD NEUROSTIMULATOR
|
Facility
|
OP
|
$7,656.00
|
|
|
Service Code
|
HCPCS C1778
|
| Hospital Charge Code |
27800017
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,818.30 |
| Max. Negotiated Rate |
$6,890.40 |
| Rate for Payer: Aetna Commercial |
$6,507.60
|
| Rate for Payer: Aetna Medicare |
$1,990.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,392.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,392.50
|
| Rate for Payer: BCBS Complete |
$3,062.40
|
| Rate for Payer: BCBS MAPPO |
$1,914.00
|
| Rate for Payer: BCBS Trust/PPO |
$5,952.54
|
| Rate for Payer: BCN Commercial |
$5,952.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,914.00
|
| Rate for Payer: Cash Price |
$6,124.80
|
| Rate for Payer: Cofinity Commercial |
$6,584.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,124.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,914.00
|
| Rate for Payer: Healthscope Commercial |
$6,890.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,742.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,009.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,201.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,507.60
|
| Rate for Payer: PACE Senior Care Partners |
$1,818.30
|
| Rate for Payer: PACE SWMI |
$1,914.00
|
| Rate for Payer: PHP Commercial |
$6,507.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,914.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,359.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,660.72
|
| Rate for Payer: Priority Health Medicare |
$1,914.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,669.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,914.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,737.28
|
| Rate for Payer: UHC Core |
$6,392.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,914.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,971.42
|
| Rate for Payer: VA VA |
$1,914.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,742.00
|
|
|
HC LEAD NOS LVL 1
|
Facility
|
OP
|
$195.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$46.31 |
| Max. Negotiated Rate |
$175.50 |
| Rate for Payer: Aetna Commercial |
$165.75
|
| Rate for Payer: Aetna Medicare |
$50.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.94
|
| Rate for Payer: BCBS Complete |
$78.00
|
| Rate for Payer: BCBS MAPPO |
$48.75
|
| Rate for Payer: BCBS Trust/PPO |
$151.61
|
| Rate for Payer: BCN Commercial |
$151.61
|
| Rate for Payer: BCN Medicare Advantage |
$48.75
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cofinity Commercial |
$167.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.75
|
| Rate for Payer: Healthscope Commercial |
$175.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$51.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.75
|
| Rate for Payer: PACE Senior Care Partners |
$46.31
|
| Rate for Payer: PACE SWMI |
$48.75
|
| Rate for Payer: PHP Commercial |
$165.75
|
| Rate for Payer: PHP Medicare Advantage |
$48.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.65
|
| Rate for Payer: Priority Health Medicare |
$48.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.93
|
| Rate for Payer: Railroad Medicare Medicare |
$48.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.60
|
| Rate for Payer: UHC Core |
$162.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.75
|
| Rate for Payer: UHC Medicare Advantage |
$50.21
|
| Rate for Payer: VA VA |
$48.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.25
|
|
|
HC LEAD NOS LVL 1
|
Facility
|
IP
|
$195.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$118.93 |
| Max. Negotiated Rate |
$175.50 |
| Rate for Payer: Aetna Commercial |
$165.75
|
| Rate for Payer: BCBS Trust/PPO |
$150.70
|
| Rate for Payer: BCN Commercial |
$150.70
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cofinity Commercial |
$167.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.00
|
| Rate for Payer: Healthscope Commercial |
$175.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.75
|
| Rate for Payer: PHP Commercial |
$165.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.60
|
| Rate for Payer: UHC Core |
$162.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.25
|
|
|
HC LEAD REMOVAL DUAL
|
Facility
|
IP
|
$2,868.17
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
36100074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,749.30 |
| Max. Negotiated Rate |
$2,581.35 |
| Rate for Payer: Aetna Commercial |
$2,437.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,216.52
|
| Rate for Payer: BCN Commercial |
$2,216.52
|
| Rate for Payer: Cash Price |
$2,294.54
|
| Rate for Payer: Cofinity Commercial |
$2,466.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,294.54
|
| Rate for Payer: Healthscope Commercial |
$2,581.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,151.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,437.94
|
| Rate for Payer: PHP Commercial |
$2,437.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,007.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,495.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,749.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,523.99
|
| Rate for Payer: UHC Core |
$2,394.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,151.13
|
|
|
HC LEAD REMOVAL DUAL
|
Facility
|
OP
|
$2,868.17
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
36100074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$681.19 |
| Max. Negotiated Rate |
$2,704.89 |
| Rate for Payer: Aetna Commercial |
$2,437.94
|
| Rate for Payer: Aetna Medicare |
$745.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$896.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$896.30
|
| Rate for Payer: BCBS Complete |
$2,704.89
|
| Rate for Payer: BCBS MAPPO |
$717.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,230.00
|
| Rate for Payer: BCN Commercial |
$2,230.00
|
| Rate for Payer: BCN Medicare Advantage |
$717.04
|
| Rate for Payer: Cash Price |
$2,294.54
|
| Rate for Payer: Cash Price |
$2,294.54
|
| Rate for Payer: Cofinity Commercial |
$2,466.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,294.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$717.04
|
| Rate for Payer: Healthscope Commercial |
$2,581.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,151.13
|
| Rate for Payer: Mclaren Medicaid |
$2,576.08
|
| Rate for Payer: Meridian Medicaid |
$2,704.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$752.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$824.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,437.94
|
| Rate for Payer: PACE Senior Care Partners |
$681.19
|
| Rate for Payer: PACE SWMI |
$717.04
|
| Rate for Payer: PHP Commercial |
$2,437.94
|
| Rate for Payer: PHP Medicare Advantage |
$717.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,576.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,007.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,495.31
|
| Rate for Payer: Priority Health Medicare |
$717.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,749.30
|
| Rate for Payer: Railroad Medicare Medicare |
$717.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,523.99
|
| Rate for Payer: UHC Core |
$2,394.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$717.04
|
| Rate for Payer: UHC Medicare Advantage |
$738.55
|
| Rate for Payer: VA VA |
$717.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,151.13
|
|
|
HC LEAD REMOVAL SINGLE
|
Facility
|
IP
|
$3,632.23
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
36100073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,215.30 |
| Max. Negotiated Rate |
$3,269.01 |
| Rate for Payer: Aetna Commercial |
$3,087.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,806.99
|
| Rate for Payer: BCN Commercial |
$2,806.99
|
| Rate for Payer: Cash Price |
$2,905.78
|
| Rate for Payer: Cofinity Commercial |
$3,123.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,905.78
|
| Rate for Payer: Healthscope Commercial |
$3,269.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,724.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,087.40
|
| Rate for Payer: PHP Commercial |
$3,087.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,542.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,160.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,215.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,196.36
|
| Rate for Payer: UHC Core |
$3,032.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,724.17
|
|
|
HC LEAD REMOVAL SINGLE
|
Facility
|
OP
|
$3,632.23
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
36100073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$862.65 |
| Max. Negotiated Rate |
$3,269.01 |
| Rate for Payer: Aetna Commercial |
$3,087.40
|
| Rate for Payer: Aetna Medicare |
$944.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,135.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,135.07
|
| Rate for Payer: BCBS Complete |
$2,704.89
|
| Rate for Payer: BCBS MAPPO |
$908.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,824.06
|
| Rate for Payer: BCN Commercial |
$2,824.06
|
| Rate for Payer: BCN Medicare Advantage |
$908.06
|
| Rate for Payer: Cash Price |
$2,905.78
|
| Rate for Payer: Cash Price |
$2,905.78
|
| Rate for Payer: Cofinity Commercial |
$3,123.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,905.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$908.06
|
| Rate for Payer: Healthscope Commercial |
$3,269.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,724.17
|
| Rate for Payer: Mclaren Medicaid |
$2,576.08
|
| Rate for Payer: Meridian Medicaid |
$2,704.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$953.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,044.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,087.40
|
| Rate for Payer: PACE Senior Care Partners |
$862.65
|
| Rate for Payer: PACE SWMI |
$908.06
|
| Rate for Payer: PHP Commercial |
$3,087.40
|
| Rate for Payer: PHP Medicare Advantage |
$908.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,576.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,542.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,160.04
|
| Rate for Payer: Priority Health Medicare |
$908.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,215.30
|
| Rate for Payer: Railroad Medicare Medicare |
$908.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,196.36
|
| Rate for Payer: UHC Core |
$3,032.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$908.06
|
| Rate for Payer: UHC Medicare Advantage |
$935.30
|
| Rate for Payer: VA VA |
$908.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,724.17
|
|
|
HC LECITHIN-SPHINGOMYELIN
|
Facility
|
IP
|
$95.00
|
|
|
Service Code
|
CPT 83661
|
| Hospital Charge Code |
30100634
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.94 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Aetna Commercial |
$80.75
|
| Rate for Payer: BCBS Trust/PPO |
$73.42
|
| Rate for Payer: BCN Commercial |
$73.42
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$81.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.00
|
| Rate for Payer: Healthscope Commercial |
$85.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.75
|
| Rate for Payer: PHP Commercial |
$80.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.60
|
| Rate for Payer: UHC Core |
$79.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.25
|
|
|
HC LECITHIN-SPHINGOMYELIN
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
CPT 83661
|
| Hospital Charge Code |
30100634
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.23 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Aetna Commercial |
$80.75
|
| Rate for Payer: Aetna Medicare |
$24.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.69
|
| Rate for Payer: BCBS Complete |
$17.04
|
| Rate for Payer: BCBS MAPPO |
$23.75
|
| Rate for Payer: BCBS Trust/PPO |
$73.86
|
| Rate for Payer: BCN Commercial |
$73.86
|
| Rate for Payer: BCN Medicare Advantage |
$23.75
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$81.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.75
|
| Rate for Payer: Healthscope Commercial |
$85.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.25
|
| Rate for Payer: Mclaren Medicaid |
$16.23
|
| Rate for Payer: Meridian Medicaid |
$17.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.75
|
| Rate for Payer: PACE Senior Care Partners |
$22.56
|
| Rate for Payer: PACE SWMI |
$23.75
|
| Rate for Payer: PHP Commercial |
$80.75
|
| Rate for Payer: PHP Medicare Advantage |
$23.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.65
|
| Rate for Payer: Priority Health Medicare |
$23.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.94
|
| Rate for Payer: Railroad Medicare Medicare |
$23.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.60
|
| Rate for Payer: UHC Core |
$79.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.75
|
| Rate for Payer: UHC Medicare Advantage |
$24.46
|
| Rate for Payer: VA VA |
$23.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.25
|
|
|
HC LEFT ATRIAL APPENDAGE CLOS WITH ENDOCARDIAL IMPLANT
|
Facility
|
OP
|
$28,917.00
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
48100112
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,867.79 |
| Max. Negotiated Rate |
$26,025.30 |
| Rate for Payer: Aetna Commercial |
$24,579.45
|
| Rate for Payer: Aetna Medicare |
$7,518.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,036.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,036.56
|
| Rate for Payer: BCBS Complete |
$11,566.80
|
| Rate for Payer: BCBS MAPPO |
$7,229.25
|
| Rate for Payer: BCBS Trust/PPO |
$22,482.97
|
| Rate for Payer: BCN Commercial |
$22,482.97
|
| Rate for Payer: BCN Medicare Advantage |
$7,229.25
|
| Rate for Payer: Cash Price |
$23,133.60
|
| Rate for Payer: Cofinity Commercial |
$24,868.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,133.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,229.25
|
| Rate for Payer: Healthscope Commercial |
$26,025.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,687.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,590.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,313.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,579.45
|
| Rate for Payer: PACE Senior Care Partners |
$6,867.79
|
| Rate for Payer: PACE SWMI |
$7,229.25
|
| Rate for Payer: PHP Commercial |
$24,579.45
|
| Rate for Payer: PHP Medicare Advantage |
$7,229.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,241.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,157.79
|
| Rate for Payer: Priority Health Medicare |
$7,229.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,636.48
|
| Rate for Payer: Railroad Medicare Medicare |
$7,229.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,446.96
|
| Rate for Payer: UHC Core |
$24,145.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,229.25
|
| Rate for Payer: UHC Medicare Advantage |
$7,446.13
|
| Rate for Payer: VA VA |
$7,229.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,687.75
|
|
|
HC LEFT ATRIAL APPENDAGE CLOS WITH ENDOCARDIAL IMPLANT
|
Facility
|
IP
|
$28,917.00
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
48100112
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$17,636.48 |
| Max. Negotiated Rate |
$26,025.30 |
| Rate for Payer: Aetna Commercial |
$24,579.45
|
| Rate for Payer: BCBS Trust/PPO |
$22,347.06
|
| Rate for Payer: BCN Commercial |
$22,347.06
|
| Rate for Payer: Cash Price |
$23,133.60
|
| Rate for Payer: Cofinity Commercial |
$24,868.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,133.60
|
| Rate for Payer: Healthscope Commercial |
$26,025.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,687.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,579.45
|
| Rate for Payer: PHP Commercial |
$24,579.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,241.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,157.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,636.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,446.96
|
| Rate for Payer: UHC Core |
$24,145.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,687.75
|
|
|
HC LEFT CATH W INTERVENTION
|
Facility
|
OP
|
$9,660.80
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100049
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,137.59 |
| Max. Negotiated Rate |
$8,694.72 |
| Rate for Payer: Aetna Commercial |
$8,211.68
|
| Rate for Payer: Aetna Medicare |
$2,511.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,019.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,019.00
|
| Rate for Payer: BCBS Complete |
$2,244.47
|
| Rate for Payer: BCBS MAPPO |
$2,415.20
|
| Rate for Payer: BCBS Trust/PPO |
$7,511.27
|
| Rate for Payer: BCN Commercial |
$7,511.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,415.20
|
| Rate for Payer: Cash Price |
$7,728.64
|
| Rate for Payer: Cash Price |
$7,728.64
|
| Rate for Payer: Cofinity Commercial |
$8,308.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,728.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,415.20
|
| Rate for Payer: Healthscope Commercial |
$8,694.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,245.60
|
| Rate for Payer: Mclaren Medicaid |
$2,137.59
|
| Rate for Payer: Meridian Medicaid |
$2,244.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,535.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,777.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,211.68
|
| Rate for Payer: PACE Senior Care Partners |
$2,294.44
|
| Rate for Payer: PACE SWMI |
$2,415.20
|
| Rate for Payer: PHP Commercial |
$8,211.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,415.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,137.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,762.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,404.90
|
| Rate for Payer: Priority Health Medicare |
$2,415.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,892.12
|
| Rate for Payer: Railroad Medicare Medicare |
$2,415.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,501.50
|
| Rate for Payer: UHC Core |
$8,066.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,415.20
|
| Rate for Payer: UHC Medicare Advantage |
$2,487.66
|
| Rate for Payer: VA VA |
$2,415.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,245.60
|
|
|
HC LEFT CATH W INTERVENTION
|
Facility
|
IP
|
$9,660.80
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100049
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,892.12 |
| Max. Negotiated Rate |
$8,694.72 |
| Rate for Payer: Aetna Commercial |
$8,211.68
|
| Rate for Payer: BCBS Trust/PPO |
$7,465.87
|
| Rate for Payer: BCN Commercial |
$7,465.87
|
| Rate for Payer: Cash Price |
$7,728.64
|
| Rate for Payer: Cofinity Commercial |
$8,308.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,728.64
|
| Rate for Payer: Healthscope Commercial |
$8,694.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,245.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,211.68
|
| Rate for Payer: PHP Commercial |
$8,211.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,762.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,404.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,892.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,501.50
|
| Rate for Payer: UHC Core |
$8,066.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,245.60
|
|
|
HC LEGAL BLOOD DRAW KZO CO/STATE/OTHER
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000049
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: Aetna Medicare |
$26.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.25
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: BCBS MAPPO |
$25.00
|
| Rate for Payer: BCBS Trust/PPO |
$77.75
|
| Rate for Payer: BCN Commercial |
$77.75
|
| Rate for Payer: BCN Medicare Advantage |
$25.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: City of Battle Creek Police Dept Commercial |
$50.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: Mclaren Medicaid |
$6.32
|
| Rate for Payer: Meridian Medicaid |
$6.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.75
|
| Rate for Payer: Michigan State Police Michigan State Police |
$50.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.00
|
| Rate for Payer: PACE Senior Care Partners |
$23.75
|
| Rate for Payer: PACE SWMI |
$25.00
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: PHP Medicare Advantage |
$25.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.00
|
| Rate for Payer: Priority Health Medicare |
$25.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.99
|
| Rate for Payer: Railroad Medicare Medicare |
$25.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.00
|
| Rate for Payer: UHC Core |
$83.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.00
|
| Rate for Payer: UHC Medicare Advantage |
$25.75
|
| Rate for Payer: VA VA |
$25.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC LEGAL BLOOD DRAW KZO CO/STATE/OTHER
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000049
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$60.99 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: BCBS Trust/PPO |
$77.28
|
| Rate for Payer: BCN Commercial |
$77.28
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.00
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.00
|
| Rate for Payer: UHC Core |
$83.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC LEGIONELLA
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600300
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: BCBS Trust/PPO |
$38.62
|
| Rate for Payer: BCN Commercial |
$38.62
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC LEGIONELLA
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600300
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.86 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna Medicare |
$12.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.62
|
| Rate for Payer: BCBS Complete |
$12.45
|
| Rate for Payer: BCBS MAPPO |
$12.50
|
| Rate for Payer: BCBS Trust/PPO |
$38.86
|
| Rate for Payer: BCN Commercial |
$38.86
|
| Rate for Payer: BCN Medicare Advantage |
$12.50
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.50
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Mclaren Medicaid |
$11.86
|
| Rate for Payer: Meridian Medicaid |
$12.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Senior Care Partners |
$11.87
|
| Rate for Payer: PACE SWMI |
$12.50
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.48
|
| Rate for Payer: Priority Health Medicare |
$12.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.48
|
| Rate for Payer: Railroad Medicare Medicare |
$12.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.50
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: VA VA |
$12.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC LEGIONELLA AG
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600255
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.86 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna Medicare |
$12.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.62
|
| Rate for Payer: BCBS Complete |
$12.45
|
| Rate for Payer: BCBS MAPPO |
$12.50
|
| Rate for Payer: BCBS Trust/PPO |
$38.86
|
| Rate for Payer: BCN Commercial |
$38.86
|
| Rate for Payer: BCN Medicare Advantage |
$12.50
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.50
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Mclaren Medicaid |
$11.86
|
| Rate for Payer: Meridian Medicaid |
$12.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Senior Care Partners |
$11.87
|
| Rate for Payer: PACE SWMI |
$12.50
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.48
|
| Rate for Payer: Priority Health Medicare |
$12.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.48
|
| Rate for Payer: Railroad Medicare Medicare |
$12.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.50
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: VA VA |
$12.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC LEGIONELLA AG
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600255
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: BCBS Trust/PPO |
$38.62
|
| Rate for Payer: BCN Commercial |
$38.62
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC LEGIONELLA AG, URINE
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600258
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.86 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna Medicare |
$12.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.62
|
| Rate for Payer: BCBS Complete |
$12.45
|
| Rate for Payer: BCBS MAPPO |
$12.50
|
| Rate for Payer: BCBS Trust/PPO |
$38.86
|
| Rate for Payer: BCN Commercial |
$38.86
|
| Rate for Payer: BCN Medicare Advantage |
$12.50
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.50
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Mclaren Medicaid |
$11.86
|
| Rate for Payer: Meridian Medicaid |
$12.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Senior Care Partners |
$11.87
|
| Rate for Payer: PACE SWMI |
$12.50
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.48
|
| Rate for Payer: Priority Health Medicare |
$12.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.48
|
| Rate for Payer: Railroad Medicare Medicare |
$12.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.50
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: VA VA |
$12.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC LEGIONELLA AG, URINE
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600258
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: BCBS Trust/PPO |
$38.62
|
| Rate for Payer: BCN Commercial |
$38.62
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC LEGIONELLA ANTIGEN TISSUE/FLUID/URINE
|
Facility
|
IP
|
$107.60
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600146
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$65.63 |
| Max. Negotiated Rate |
$96.84 |
| Rate for Payer: Aetna Commercial |
$91.46
|
| Rate for Payer: BCBS Trust/PPO |
$83.15
|
| Rate for Payer: BCN Commercial |
$83.15
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cofinity Commercial |
$92.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.08
|
| Rate for Payer: Healthscope Commercial |
$96.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.46
|
| Rate for Payer: PHP Commercial |
$91.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.69
|
| Rate for Payer: UHC Core |
$89.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.70
|
|
|
HC LEGIONELLA ANTIGEN TISSUE/FLUID/URINE
|
Facility
|
OP
|
$107.60
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600146
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.84 |
| Max. Negotiated Rate |
$96.84 |
| Rate for Payer: Aetna Commercial |
$91.46
|
| Rate for Payer: Aetna Medicare |
$27.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.62
|
| Rate for Payer: BCBS Complete |
$9.28
|
| Rate for Payer: BCBS MAPPO |
$26.90
|
| Rate for Payer: BCBS Trust/PPO |
$83.66
|
| Rate for Payer: BCN Commercial |
$83.66
|
| Rate for Payer: BCN Medicare Advantage |
$26.90
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cofinity Commercial |
$92.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.90
|
| Rate for Payer: Healthscope Commercial |
$96.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.70
|
| Rate for Payer: Mclaren Medicaid |
$8.84
|
| Rate for Payer: Meridian Medicaid |
$9.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.46
|
| Rate for Payer: PACE Senior Care Partners |
$25.56
|
| Rate for Payer: PACE SWMI |
$26.90
|
| Rate for Payer: PHP Commercial |
$91.46
|
| Rate for Payer: PHP Medicare Advantage |
$26.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.61
|
| Rate for Payer: Priority Health Medicare |
$26.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.63
|
| Rate for Payer: Railroad Medicare Medicare |
$26.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.69
|
| Rate for Payer: UHC Core |
$89.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.90
|
| Rate for Payer: UHC Medicare Advantage |
$27.71
|
| Rate for Payer: VA VA |
$26.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.70
|
|
|
HC LEGIONELLA BY RAPID PCR
|
Facility
|
IP
|
$122.40
|
|
|
Service Code
|
CPT 87541
|
| Hospital Charge Code |
30600220
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$74.65 |
| Max. Negotiated Rate |
$110.16 |
| Rate for Payer: Aetna Commercial |
$104.04
|
| Rate for Payer: BCBS Trust/PPO |
$94.59
|
| Rate for Payer: BCN Commercial |
$94.59
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$105.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Healthscope Commercial |
$110.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.04
|
| Rate for Payer: PHP Commercial |
$104.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.71
|
| Rate for Payer: UHC Core |
$102.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.80
|
|
|
HC LEGIONELLA BY RAPID PCR
|
Facility
|
OP
|
$122.40
|
|
|
Service Code
|
CPT 87541
|
| Hospital Charge Code |
30600220
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.90 |
| Max. Negotiated Rate |
$110.16 |
| Rate for Payer: Aetna Commercial |
$104.04
|
| Rate for Payer: Aetna Medicare |
$31.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.25
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$30.60
|
| Rate for Payer: BCBS Trust/PPO |
$95.17
|
| Rate for Payer: BCN Commercial |
$95.17
|
| Rate for Payer: BCN Medicare Advantage |
$30.60
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$105.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.60
|
| Rate for Payer: Healthscope Commercial |
$110.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.80
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.04
|
| Rate for Payer: PACE Senior Care Partners |
$29.07
|
| Rate for Payer: PACE SWMI |
$30.60
|
| Rate for Payer: PHP Commercial |
$104.04
|
| Rate for Payer: PHP Medicare Advantage |
$30.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.49
|
| Rate for Payer: Priority Health Medicare |
$30.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.65
|
| Rate for Payer: Railroad Medicare Medicare |
$30.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.71
|
| Rate for Payer: UHC Core |
$102.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.60
|
| Rate for Payer: UHC Medicare Advantage |
$31.52
|
| Rate for Payer: VA VA |
$30.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.80
|
|
