|
HC DSDNA AB WITH REFLEX, IGG, S
|
Facility
|
IP
|
$39.51
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200505
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.68 |
| Max. Negotiated Rate |
$35.56 |
| Rate for Payer: Aetna Commercial |
$33.58
|
| Rate for Payer: BCBS Trust/PPO |
$32.25
|
| Rate for Payer: BCN Commercial |
$30.53
|
| Rate for Payer: Cash Price |
$31.61
|
| Rate for Payer: Cofinity Commercial |
$33.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.61
|
| Rate for Payer: Healthscope Commercial |
$35.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.58
|
| Rate for Payer: Nomi Health Commercial |
$32.40
|
| Rate for Payer: PHP Commercial |
$33.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.68
|
| Rate for Payer: Priority Health HMO/PPO |
$34.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.77
|
| Rate for Payer: UHC Core |
$32.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.63
|
|
|
HC DSDNA AB WITH REFLEX, IGG, S
|
Facility
|
OP
|
$39.51
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200505
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$35.56 |
| Rate for Payer: Aetna Commercial |
$33.58
|
| Rate for Payer: Aetna Medicare |
$10.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.35
|
| Rate for Payer: BCBS Complete |
$10.43
|
| Rate for Payer: BCBS MAPPO |
$9.88
|
| Rate for Payer: BCBS Trust/PPO |
$32.48
|
| Rate for Payer: BCN Commercial |
$30.72
|
| Rate for Payer: BCN Medicare Advantage |
$9.88
|
| Rate for Payer: Cash Price |
$31.61
|
| Rate for Payer: Cash Price |
$31.61
|
| Rate for Payer: Cofinity Commercial |
$33.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.88
|
| Rate for Payer: Healthscope Commercial |
$35.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.63
|
| Rate for Payer: Mclaren Medicaid |
$9.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.37
|
| Rate for Payer: Meridian Medicaid |
$10.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.58
|
| Rate for Payer: Nomi Health Commercial |
$32.40
|
| Rate for Payer: PACE Senior Care Partners |
$9.38
|
| Rate for Payer: PACE SWMI |
$9.88
|
| Rate for Payer: PHP Commercial |
$33.58
|
| Rate for Payer: PHP Medicare Advantage |
$9.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.68
|
| Rate for Payer: Priority Health HMO/PPO |
$34.37
|
| Rate for Payer: Priority Health Medicare |
$9.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.47
|
| Rate for Payer: Railroad Medicare Medicare |
$9.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.77
|
| Rate for Payer: UHC Core |
$32.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.88
|
| Rate for Payer: UHC Exchange |
$9.88
|
| Rate for Payer: UHC Medicare Advantage |
$9.88
|
| Rate for Payer: UHCCP Medicaid |
$9.93
|
| Rate for Payer: VA VA |
$9.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.63
|
|
|
HC DSMA TC 99M PER STUDY
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
HCPCS A9551
|
| Hospital Charge Code |
34300004
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$92.32 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna Medicare |
$101.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.47
|
| Rate for Payer: BCBS Complete |
$155.48
|
| Rate for Payer: BCBS MAPPO |
$97.18
|
| Rate for Payer: BCBS Trust/PPO |
$319.56
|
| Rate for Payer: BCN Commercial |
$302.22
|
| Rate for Payer: BCN Medicare Advantage |
$97.18
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.18
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PACE Senior Care Partners |
$92.32
|
| Rate for Payer: PACE SWMI |
$97.18
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: PHP Medicare Advantage |
$97.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Medicare |
$98.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: Railroad Medicare Medicare |
$97.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.18
|
| Rate for Payer: UHC Exchange |
$97.18
|
| Rate for Payer: UHC Medicare Advantage |
$97.18
|
| Rate for Payer: VA VA |
$97.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC DSMA TC 99M PER STUDY
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
HCPCS A9551
|
| Hospital Charge Code |
34300004
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$252.66 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: BCBS Trust/PPO |
$317.30
|
| Rate for Payer: BCN Commercial |
$300.40
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$318.74
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO |
$338.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.06
|
| Rate for Payer: UHC Core |
$324.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC DTAP HEPB IPV VACCINE INTRAMUSCULAR
|
Facility
|
IP
|
$176.19
|
|
|
Service Code
|
CPT 90723
|
| Hospital Charge Code |
63600137
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$114.52 |
| Max. Negotiated Rate |
$158.57 |
| Rate for Payer: Aetna Commercial |
$149.76
|
| Rate for Payer: BCBS Trust/PPO |
$143.82
|
| Rate for Payer: BCN Commercial |
$136.16
|
| Rate for Payer: Cash Price |
$140.95
|
| Rate for Payer: Cofinity Commercial |
$151.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.95
|
| Rate for Payer: Healthscope Commercial |
$158.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.76
|
| Rate for Payer: Nomi Health Commercial |
$144.48
|
| Rate for Payer: PHP Commercial |
$149.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.52
|
| Rate for Payer: Priority Health HMO/PPO |
$153.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.05
|
| Rate for Payer: UHC Core |
$147.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.14
|
|
|
HC DTAP HEPB IPV VACCINE INTRAMUSCULAR
|
Facility
|
OP
|
$176.19
|
|
|
Service Code
|
CPT 90723
|
| Hospital Charge Code |
63600137
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.85 |
| Max. Negotiated Rate |
$158.57 |
| Rate for Payer: Aetna Commercial |
$149.76
|
| Rate for Payer: Aetna Medicare |
$45.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.06
|
| Rate for Payer: BCBS Complete |
$70.48
|
| Rate for Payer: BCBS MAPPO |
$44.05
|
| Rate for Payer: BCBS Trust/PPO |
$144.85
|
| Rate for Payer: BCN Commercial |
$136.99
|
| Rate for Payer: BCN Medicare Advantage |
$44.05
|
| Rate for Payer: Cash Price |
$140.95
|
| Rate for Payer: Cofinity Commercial |
$151.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.05
|
| Rate for Payer: Healthscope Commercial |
$158.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.76
|
| Rate for Payer: Nomi Health Commercial |
$144.48
|
| Rate for Payer: PACE Senior Care Partners |
$41.85
|
| Rate for Payer: PACE SWMI |
$44.05
|
| Rate for Payer: PHP Commercial |
$149.76
|
| Rate for Payer: PHP Medicare Advantage |
$44.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.52
|
| Rate for Payer: Priority Health HMO/PPO |
$153.29
|
| Rate for Payer: Priority Health Medicare |
$44.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.05
|
| Rate for Payer: Railroad Medicare Medicare |
$44.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.05
|
| Rate for Payer: UHC Core |
$147.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.05
|
| Rate for Payer: UHC Exchange |
$44.05
|
| Rate for Payer: UHC Medicare Advantage |
$44.05
|
| Rate for Payer: VA VA |
$44.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.14
|
|
|
HC DTAP-IPV VACCINE 4-6 YEARS IM
|
Facility
|
OP
|
$76.67
|
|
|
Service Code
|
CPT 90696
|
| Hospital Charge Code |
63600120
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.21 |
| Max. Negotiated Rate |
$69.00 |
| Rate for Payer: Aetna Commercial |
$65.17
|
| Rate for Payer: Aetna Medicare |
$19.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.96
|
| Rate for Payer: BCBS Complete |
$30.67
|
| Rate for Payer: BCBS MAPPO |
$19.17
|
| Rate for Payer: BCBS Trust/PPO |
$63.03
|
| Rate for Payer: BCN Commercial |
$59.61
|
| Rate for Payer: BCN Medicare Advantage |
$19.17
|
| Rate for Payer: Cash Price |
$61.34
|
| Rate for Payer: Cofinity Commercial |
$65.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.17
|
| Rate for Payer: Healthscope Commercial |
$69.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.17
|
| Rate for Payer: Nomi Health Commercial |
$62.87
|
| Rate for Payer: PACE Senior Care Partners |
$18.21
|
| Rate for Payer: PACE SWMI |
$19.17
|
| Rate for Payer: PHP Commercial |
$65.17
|
| Rate for Payer: PHP Medicare Advantage |
$19.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.84
|
| Rate for Payer: Priority Health HMO/PPO |
$66.70
|
| Rate for Payer: Priority Health Medicare |
$19.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.37
|
| Rate for Payer: Railroad Medicare Medicare |
$19.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.47
|
| Rate for Payer: UHC Core |
$64.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.17
|
| Rate for Payer: UHC Exchange |
$19.17
|
| Rate for Payer: UHC Medicare Advantage |
$19.17
|
| Rate for Payer: VA VA |
$19.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.50
|
|
|
HC DTAP-IPV VACCINE 4-6 YEARS IM
|
Facility
|
IP
|
$76.67
|
|
|
Service Code
|
CPT 90696
|
| Hospital Charge Code |
63600120
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$49.84 |
| Max. Negotiated Rate |
$69.00 |
| Rate for Payer: Aetna Commercial |
$65.17
|
| Rate for Payer: BCBS Trust/PPO |
$62.59
|
| Rate for Payer: BCN Commercial |
$59.25
|
| Rate for Payer: Cash Price |
$61.34
|
| Rate for Payer: Cofinity Commercial |
$65.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.34
|
| Rate for Payer: Healthscope Commercial |
$69.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.17
|
| Rate for Payer: Nomi Health Commercial |
$62.87
|
| Rate for Payer: PHP Commercial |
$65.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.84
|
| Rate for Payer: Priority Health HMO/PPO |
$66.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.47
|
| Rate for Payer: UHC Core |
$64.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.50
|
|
|
HC DTAP-IVP-HIB-HEPB INTRAMUSCULAR
|
Facility
|
OP
|
$166.46
|
|
|
Service Code
|
CPT 90697
|
| Hospital Charge Code |
63600207
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$39.53 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: Aetna Medicare |
$43.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.02
|
| Rate for Payer: BCBS Complete |
$66.58
|
| Rate for Payer: BCBS MAPPO |
$41.62
|
| Rate for Payer: BCBS Trust/PPO |
$136.85
|
| Rate for Payer: BCN Commercial |
$129.42
|
| Rate for Payer: BCN Medicare Advantage |
$41.62
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$136.50
|
| Rate for Payer: PACE Senior Care Partners |
$39.53
|
| Rate for Payer: PACE SWMI |
$41.62
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: PHP Medicare Advantage |
$41.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.20
|
| Rate for Payer: Priority Health HMO/PPO |
$144.82
|
| Rate for Payer: Priority Health Medicare |
$42.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.53
|
| Rate for Payer: Railroad Medicare Medicare |
$41.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.48
|
| Rate for Payer: UHC Core |
$138.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.62
|
| Rate for Payer: UHC Exchange |
$41.62
|
| Rate for Payer: UHC Medicare Advantage |
$41.62
|
| Rate for Payer: VA VA |
$41.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.84
|
|
|
HC DTAP-IVP-HIB-HEPB INTRAMUSCULAR
|
Facility
|
IP
|
$166.46
|
|
|
Service Code
|
CPT 90697
|
| Hospital Charge Code |
63600207
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$108.20 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: BCBS Trust/PPO |
$135.88
|
| Rate for Payer: BCN Commercial |
$128.64
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$136.50
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.20
|
| Rate for Payer: Priority Health HMO/PPO |
$144.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.48
|
| Rate for Payer: UHC Core |
$138.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.84
|
|
|
HC DTPA PER STUDY
|
Facility
|
OP
|
$170.17
|
|
|
Service Code
|
HCPCS A9539
|
| Hospital Charge Code |
34300005
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$40.42 |
| Max. Negotiated Rate |
$153.15 |
| Rate for Payer: Aetna Commercial |
$144.64
|
| Rate for Payer: Aetna Medicare |
$44.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.18
|
| Rate for Payer: BCBS Complete |
$68.07
|
| Rate for Payer: BCBS MAPPO |
$42.54
|
| Rate for Payer: BCBS Trust/PPO |
$139.90
|
| Rate for Payer: BCN Commercial |
$132.31
|
| Rate for Payer: BCN Medicare Advantage |
$42.54
|
| Rate for Payer: Cash Price |
$136.14
|
| Rate for Payer: Cofinity Commercial |
$146.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.54
|
| Rate for Payer: Healthscope Commercial |
$153.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.64
|
| Rate for Payer: Nomi Health Commercial |
$139.54
|
| Rate for Payer: PACE Senior Care Partners |
$40.42
|
| Rate for Payer: PACE SWMI |
$42.54
|
| Rate for Payer: PHP Commercial |
$144.64
|
| Rate for Payer: PHP Medicare Advantage |
$42.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.61
|
| Rate for Payer: Priority Health HMO/PPO |
$148.05
|
| Rate for Payer: Priority Health Medicare |
$42.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.01
|
| Rate for Payer: Railroad Medicare Medicare |
$42.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.75
|
| Rate for Payer: UHC Core |
$142.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.54
|
| Rate for Payer: UHC Exchange |
$42.54
|
| Rate for Payer: UHC Medicare Advantage |
$42.54
|
| Rate for Payer: VA VA |
$42.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.63
|
|
|
HC DTPA PER STUDY
|
Facility
|
IP
|
$170.17
|
|
|
Service Code
|
HCPCS A9539
|
| Hospital Charge Code |
34300005
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$110.61 |
| Max. Negotiated Rate |
$153.15 |
| Rate for Payer: Aetna Commercial |
$144.64
|
| Rate for Payer: BCBS Trust/PPO |
$138.91
|
| Rate for Payer: BCN Commercial |
$131.51
|
| Rate for Payer: Cash Price |
$136.14
|
| Rate for Payer: Cofinity Commercial |
$146.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.14
|
| Rate for Payer: Healthscope Commercial |
$153.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.64
|
| Rate for Payer: Nomi Health Commercial |
$139.54
|
| Rate for Payer: PHP Commercial |
$144.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.61
|
| Rate for Payer: Priority Health HMO/PPO |
$148.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.75
|
| Rate for Payer: UHC Core |
$142.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.63
|
|
|
HC DUAL LEAD INSERTION
|
Facility
|
IP
|
$12,710.35
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
36100066
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,261.73 |
| Max. Negotiated Rate |
$11,439.32 |
| Rate for Payer: Aetna Commercial |
$10,803.80
|
| Rate for Payer: BCBS Trust/PPO |
$10,375.46
|
| Rate for Payer: BCN Commercial |
$9,822.56
|
| Rate for Payer: Cash Price |
$10,168.28
|
| Rate for Payer: Cofinity Commercial |
$10,930.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,168.28
|
| Rate for Payer: Healthscope Commercial |
$11,439.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,532.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,803.80
|
| Rate for Payer: Nomi Health Commercial |
$10,422.49
|
| Rate for Payer: PHP Commercial |
$10,803.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,261.73
|
| Rate for Payer: Priority Health HMO/PPO |
$11,058.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,515.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,185.11
|
| Rate for Payer: UHC Core |
$10,613.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,532.76
|
|
|
HC DUAL LEAD INSERTION
|
Facility
|
OP
|
$12,710.35
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
36100066
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,018.71 |
| Max. Negotiated Rate |
$11,439.32 |
| Rate for Payer: Aetna Commercial |
$10,803.80
|
| Rate for Payer: Aetna Medicare |
$3,304.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.98
|
| Rate for Payer: BCBS Complete |
$6,283.12
|
| Rate for Payer: BCBS MAPPO |
$3,177.59
|
| Rate for Payer: BCBS Trust/PPO |
$10,449.18
|
| Rate for Payer: BCN Commercial |
$9,882.30
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.59
|
| Rate for Payer: Cash Price |
$10,168.28
|
| Rate for Payer: Cash Price |
$10,168.28
|
| Rate for Payer: Cofinity Commercial |
$10,930.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,168.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.59
|
| Rate for Payer: Healthscope Commercial |
$11,439.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,532.76
|
| Rate for Payer: Mclaren Medicaid |
$5,983.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.47
|
| Rate for Payer: Meridian Medicaid |
$6,283.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,803.80
|
| Rate for Payer: Nomi Health Commercial |
$10,422.49
|
| Rate for Payer: PACE Senior Care Partners |
$3,018.71
|
| Rate for Payer: PACE SWMI |
$3,177.59
|
| Rate for Payer: PHP Commercial |
$10,803.80
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,983.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,261.73
|
| Rate for Payer: Priority Health HMO/PPO |
$11,058.00
|
| Rate for Payer: Priority Health Medicare |
$3,209.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,515.93
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,185.11
|
| Rate for Payer: UHC Core |
$10,613.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.59
|
| Rate for Payer: UHC Exchange |
$3,177.59
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.59
|
| Rate for Payer: UHCCP Medicaid |
$5,983.53
|
| Rate for Payer: VA VA |
$3,177.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,532.76
|
|
|
HC DUCK FEATHERS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200083
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC DUCK FEATHERS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200083
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC DUODENOSCOPY/COLONOSCOPY
|
Facility
|
OP
|
$4,399.77
|
|
| Hospital Charge Code |
36000033
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,044.95 |
| Max. Negotiated Rate |
$3,959.79 |
| Rate for Payer: Aetna Commercial |
$3,739.80
|
| Rate for Payer: Aetna Medicare |
$1,143.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,374.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,374.93
|
| Rate for Payer: BCBS Complete |
$1,759.91
|
| Rate for Payer: BCBS MAPPO |
$1,099.94
|
| Rate for Payer: BCBS Trust/PPO |
$3,617.05
|
| Rate for Payer: BCN Commercial |
$3,420.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,099.94
|
| Rate for Payer: Cash Price |
$3,519.82
|
| Rate for Payer: Cofinity Commercial |
$3,783.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,519.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,099.94
|
| Rate for Payer: Healthscope Commercial |
$3,959.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,299.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,154.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,264.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,739.80
|
| Rate for Payer: Nomi Health Commercial |
$3,607.81
|
| Rate for Payer: PACE Senior Care Partners |
$1,044.95
|
| Rate for Payer: PACE SWMI |
$1,099.94
|
| Rate for Payer: PHP Commercial |
$3,739.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,099.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,859.85
|
| Rate for Payer: Priority Health HMO/PPO |
$3,827.80
|
| Rate for Payer: Priority Health Medicare |
$1,110.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,947.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,099.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,871.80
|
| Rate for Payer: UHC Core |
$3,673.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,099.94
|
| Rate for Payer: UHC Exchange |
$1,099.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,099.94
|
| Rate for Payer: VA VA |
$1,099.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,299.83
|
|
|
HC DUODENOSCOPY/COLONOSCOPY
|
Facility
|
IP
|
$4,399.77
|
|
| Hospital Charge Code |
36000033
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,859.85 |
| Max. Negotiated Rate |
$3,959.79 |
| Rate for Payer: Aetna Commercial |
$3,739.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,591.53
|
| Rate for Payer: BCN Commercial |
$3,400.14
|
| Rate for Payer: Cash Price |
$3,519.82
|
| Rate for Payer: Cofinity Commercial |
$3,783.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,519.82
|
| Rate for Payer: Healthscope Commercial |
$3,959.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,299.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,739.80
|
| Rate for Payer: Nomi Health Commercial |
$3,607.81
|
| Rate for Payer: PHP Commercial |
$3,739.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,859.85
|
| Rate for Payer: Priority Health HMO/PPO |
$3,827.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,947.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,871.80
|
| Rate for Payer: UHC Core |
$3,673.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,299.83
|
|
|
HC DUODENOSCOPY (EGD)
|
Facility
|
OP
|
$2,193.58
|
|
| Hospital Charge Code |
36000029
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$520.98 |
| Max. Negotiated Rate |
$1,974.22 |
| Rate for Payer: Aetna Commercial |
$1,864.54
|
| Rate for Payer: Aetna Medicare |
$570.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$685.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$685.49
|
| Rate for Payer: BCBS Complete |
$877.43
|
| Rate for Payer: BCBS MAPPO |
$548.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,803.34
|
| Rate for Payer: BCN Commercial |
$1,705.51
|
| Rate for Payer: BCN Medicare Advantage |
$548.39
|
| Rate for Payer: Cash Price |
$1,754.86
|
| Rate for Payer: Cofinity Commercial |
$1,886.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,754.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$548.39
|
| Rate for Payer: Healthscope Commercial |
$1,974.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,645.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$575.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$630.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,864.54
|
| Rate for Payer: Nomi Health Commercial |
$1,798.74
|
| Rate for Payer: PACE Senior Care Partners |
$520.98
|
| Rate for Payer: PACE SWMI |
$548.39
|
| Rate for Payer: PHP Commercial |
$1,864.54
|
| Rate for Payer: PHP Medicare Advantage |
$548.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,425.83
|
| Rate for Payer: Priority Health HMO/PPO |
$1,908.41
|
| Rate for Payer: Priority Health Medicare |
$553.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,469.70
|
| Rate for Payer: Railroad Medicare Medicare |
$548.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,930.35
|
| Rate for Payer: UHC Core |
$1,831.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$548.39
|
| Rate for Payer: UHC Exchange |
$548.39
|
| Rate for Payer: UHC Medicare Advantage |
$548.39
|
| Rate for Payer: VA VA |
$548.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,645.18
|
|
|
HC DUODENOSCOPY (EGD)
|
Facility
|
IP
|
$2,193.58
|
|
| Hospital Charge Code |
36000029
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,425.83 |
| Max. Negotiated Rate |
$1,974.22 |
| Rate for Payer: Aetna Commercial |
$1,864.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,790.62
|
| Rate for Payer: BCN Commercial |
$1,695.20
|
| Rate for Payer: Cash Price |
$1,754.86
|
| Rate for Payer: Cofinity Commercial |
$1,886.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,754.86
|
| Rate for Payer: Healthscope Commercial |
$1,974.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,645.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,864.54
|
| Rate for Payer: Nomi Health Commercial |
$1,798.74
|
| Rate for Payer: PHP Commercial |
$1,864.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,425.83
|
| Rate for Payer: Priority Health HMO/PPO |
$1,908.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,469.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,930.35
|
| Rate for Payer: UHC Core |
$1,831.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,645.18
|
|
|
HC DUODENUM/FLEX SIGMOID
|
Facility
|
IP
|
$3,894.00
|
|
| Hospital Charge Code |
36000034
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,531.10 |
| Max. Negotiated Rate |
$3,504.60 |
| Rate for Payer: Aetna Commercial |
$3,309.90
|
| Rate for Payer: BCBS Trust/PPO |
$3,178.67
|
| Rate for Payer: BCN Commercial |
$3,009.28
|
| Rate for Payer: Cash Price |
$3,115.20
|
| Rate for Payer: Cofinity Commercial |
$3,348.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,115.20
|
| Rate for Payer: Healthscope Commercial |
$3,504.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,920.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,309.90
|
| Rate for Payer: Nomi Health Commercial |
$3,193.08
|
| Rate for Payer: PHP Commercial |
$3,309.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,531.10
|
| Rate for Payer: Priority Health HMO/PPO |
$3,387.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,608.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,426.72
|
| Rate for Payer: UHC Core |
$3,251.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,920.50
|
|
|
HC DUODENUM/FLEX SIGMOID
|
Facility
|
OP
|
$3,894.00
|
|
| Hospital Charge Code |
36000034
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$924.83 |
| Max. Negotiated Rate |
$3,504.60 |
| Rate for Payer: Aetna Commercial |
$3,309.90
|
| Rate for Payer: Aetna Medicare |
$1,012.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,216.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,216.88
|
| Rate for Payer: BCBS Complete |
$1,557.60
|
| Rate for Payer: BCBS MAPPO |
$973.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,201.26
|
| Rate for Payer: BCN Commercial |
$3,027.59
|
| Rate for Payer: BCN Medicare Advantage |
$973.50
|
| Rate for Payer: Cash Price |
$3,115.20
|
| Rate for Payer: Cofinity Commercial |
$3,348.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,115.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$973.50
|
| Rate for Payer: Healthscope Commercial |
$3,504.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,920.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,022.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,119.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,309.90
|
| Rate for Payer: Nomi Health Commercial |
$3,193.08
|
| Rate for Payer: PACE Senior Care Partners |
$924.83
|
| Rate for Payer: PACE SWMI |
$973.50
|
| Rate for Payer: PHP Commercial |
$3,309.90
|
| Rate for Payer: PHP Medicare Advantage |
$973.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,531.10
|
| Rate for Payer: Priority Health HMO/PPO |
$3,387.78
|
| Rate for Payer: Priority Health Medicare |
$983.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,608.98
|
| Rate for Payer: Railroad Medicare Medicare |
$973.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,426.72
|
| Rate for Payer: UHC Core |
$3,251.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$973.50
|
| Rate for Payer: UHC Exchange |
$973.50
|
| Rate for Payer: UHC Medicare Advantage |
$973.50
|
| Rate for Payer: VA VA |
$973.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,920.50
|
|
|
HC DUODERM CGF 4X4
|
Facility
|
OP
|
$47.73
|
|
| Hospital Charge Code |
27100010
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.34 |
| Max. Negotiated Rate |
$42.96 |
| Rate for Payer: Aetna Commercial |
$40.57
|
| Rate for Payer: Aetna Medicare |
$12.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.92
|
| Rate for Payer: BCBS Complete |
$19.09
|
| Rate for Payer: BCBS MAPPO |
$11.93
|
| Rate for Payer: BCBS Trust/PPO |
$39.24
|
| Rate for Payer: BCN Commercial |
$37.11
|
| Rate for Payer: BCN Medicare Advantage |
$11.93
|
| Rate for Payer: Cash Price |
$38.18
|
| Rate for Payer: Cofinity Commercial |
$41.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.93
|
| Rate for Payer: Healthscope Commercial |
$42.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.57
|
| Rate for Payer: Nomi Health Commercial |
$39.14
|
| Rate for Payer: PACE Senior Care Partners |
$11.34
|
| Rate for Payer: PACE SWMI |
$11.93
|
| Rate for Payer: PHP Commercial |
$40.57
|
| Rate for Payer: PHP Medicare Advantage |
$11.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.02
|
| Rate for Payer: Priority Health HMO/PPO |
$41.53
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.98
|
| Rate for Payer: Railroad Medicare Medicare |
$11.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.00
|
| Rate for Payer: UHC Core |
$39.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.93
|
| Rate for Payer: UHC Exchange |
$11.93
|
| Rate for Payer: UHC Medicare Advantage |
$11.93
|
| Rate for Payer: VA VA |
$11.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.80
|
|
|
HC DUODERM CGF 4X4
|
Facility
|
IP
|
$47.73
|
|
| Hospital Charge Code |
27100010
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$31.02 |
| Max. Negotiated Rate |
$42.96 |
| Rate for Payer: Aetna Commercial |
$40.57
|
| Rate for Payer: BCBS Trust/PPO |
$38.96
|
| Rate for Payer: BCN Commercial |
$36.89
|
| Rate for Payer: Cash Price |
$38.18
|
| Rate for Payer: Cofinity Commercial |
$41.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.18
|
| Rate for Payer: Healthscope Commercial |
$42.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.57
|
| Rate for Payer: Nomi Health Commercial |
$39.14
|
| Rate for Payer: PHP Commercial |
$40.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.02
|
| Rate for Payer: Priority Health HMO/PPO |
$41.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.00
|
| Rate for Payer: UHC Core |
$39.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.80
|
|
|
HC DUODERM CGF 6X6
|
Facility
|
OP
|
$75.60
|
|
| Hospital Charge Code |
27100011
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$68.04 |
| Rate for Payer: Aetna Commercial |
$64.26
|
| Rate for Payer: Aetna Medicare |
$19.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.62
|
| Rate for Payer: BCBS Complete |
$30.24
|
| Rate for Payer: BCBS MAPPO |
$18.90
|
| Rate for Payer: BCBS Trust/PPO |
$62.15
|
| Rate for Payer: BCN Commercial |
$58.78
|
| Rate for Payer: BCN Medicare Advantage |
$18.90
|
| Rate for Payer: Cash Price |
$60.48
|
| Rate for Payer: Cofinity Commercial |
$65.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.90
|
| Rate for Payer: Healthscope Commercial |
$68.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.26
|
| Rate for Payer: Nomi Health Commercial |
$61.99
|
| Rate for Payer: PACE Senior Care Partners |
$17.95
|
| Rate for Payer: PACE SWMI |
$18.90
|
| Rate for Payer: PHP Commercial |
$64.26
|
| Rate for Payer: PHP Medicare Advantage |
$18.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.14
|
| Rate for Payer: Priority Health HMO/PPO |
$65.77
|
| Rate for Payer: Priority Health Medicare |
$19.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.65
|
| Rate for Payer: Railroad Medicare Medicare |
$18.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.53
|
| Rate for Payer: UHC Core |
$63.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.90
|
| Rate for Payer: UHC Exchange |
$18.90
|
| Rate for Payer: UHC Medicare Advantage |
$18.90
|
| Rate for Payer: VA VA |
$18.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.70
|
|
