|
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/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 (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 |
$548.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,803.34
|
| Rate for Payer: BCN Commercial |
$1,705.51
|
| Rate for Payer: BCN Medicare Advantage |
$548.40
|
| 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 |
$548.40
|
| 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 |
$548.40
|
| Rate for Payer: PHP Commercial |
$1,864.54
|
| Rate for Payer: PHP Medicare Advantage |
$548.40
|
| 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 |
$548.40
|
| 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 |
$548.40
|
| Rate for Payer: UHC Exchange |
$548.40
|
| Rate for Payer: UHC Medicare Advantage |
$548.40
|
| Rate for Payer: VA VA |
$548.40
|
| 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
|
OP
|
$3,894.00
|
|
| Hospital Charge Code |
36000034
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$924.82 |
| 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 |
$3,027.58
|
| 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 |
$1,022.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,119.52
|
| 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 |
$924.82
|
| 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 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 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
|
IP
|
$75.60
|
|
| Hospital Charge Code |
27100011
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$49.14 |
| Max. Negotiated Rate |
$68.04 |
| Rate for Payer: Aetna Commercial |
$64.26
|
| Rate for Payer: BCBS Trust/PPO |
$61.71
|
| Rate for Payer: BCN Commercial |
$58.42
|
| 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: Healthscope Commercial |
$68.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.26
|
| Rate for Payer: Nomi Health Commercial |
$61.99
|
| Rate for Payer: PHP Commercial |
$64.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.14
|
| Rate for Payer: Priority Health HMO/PPO |
$65.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.53
|
| Rate for Payer: UHC Core |
$63.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.70
|
|
|
HC DUODERM CGF 6X6
|
Facility
|
OP
|
$75.60
|
|
| Hospital Charge Code |
27100011
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.96 |
| 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 |
$21.74
|
| 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 |
$17.96
|
| 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
|
|
|
HC DUODERM CGF 8X8
|
Facility
|
IP
|
$105.53
|
|
| Hospital Charge Code |
27100012
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$68.59 |
| Max. Negotiated Rate |
$94.98 |
| Rate for Payer: Aetna Commercial |
$89.70
|
| Rate for Payer: BCBS Trust/PPO |
$86.14
|
| Rate for Payer: BCN Commercial |
$81.55
|
| Rate for Payer: Cash Price |
$84.42
|
| Rate for Payer: Cofinity Commercial |
$90.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.42
|
| Rate for Payer: Healthscope Commercial |
$94.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.70
|
| Rate for Payer: Nomi Health Commercial |
$86.53
|
| Rate for Payer: PHP Commercial |
$89.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.59
|
| Rate for Payer: Priority Health HMO/PPO |
$91.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.87
|
| Rate for Payer: UHC Core |
$88.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.15
|
|
|
HC DUODERM CGF 8X8
|
Facility
|
OP
|
$105.53
|
|
| Hospital Charge Code |
27100012
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.06 |
| Max. Negotiated Rate |
$94.98 |
| Rate for Payer: Aetna Commercial |
$89.70
|
| Rate for Payer: Aetna Medicare |
$27.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.98
|
| Rate for Payer: BCBS Complete |
$42.21
|
| Rate for Payer: BCBS MAPPO |
$26.38
|
| Rate for Payer: BCBS Trust/PPO |
$86.76
|
| Rate for Payer: BCN Commercial |
$82.05
|
| Rate for Payer: BCN Medicare Advantage |
$26.38
|
| Rate for Payer: Cash Price |
$84.42
|
| Rate for Payer: Cofinity Commercial |
$90.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.38
|
| Rate for Payer: Healthscope Commercial |
$94.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.70
|
| Rate for Payer: Nomi Health Commercial |
$86.53
|
| Rate for Payer: PACE Senior Care Partners |
$25.06
|
| Rate for Payer: PACE SWMI |
$26.38
|
| Rate for Payer: PHP Commercial |
$89.70
|
| Rate for Payer: PHP Medicare Advantage |
$26.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.59
|
| Rate for Payer: Priority Health HMO/PPO |
$91.81
|
| Rate for Payer: Priority Health Medicare |
$26.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.71
|
| Rate for Payer: Railroad Medicare Medicare |
$26.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.87
|
| Rate for Payer: UHC Core |
$88.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.38
|
| Rate for Payer: UHC Exchange |
$26.38
|
| Rate for Payer: UHC Medicare Advantage |
$26.38
|
| Rate for Payer: VA VA |
$26.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.15
|
|
|
HC DUOGLIDE CATHETER
|
Facility
|
OP
|
$650.22
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$154.43 |
| Max. Negotiated Rate |
$585.20 |
| Rate for Payer: Aetna Commercial |
$552.69
|
| Rate for Payer: Aetna Medicare |
$169.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$203.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$203.19
|
| Rate for Payer: BCBS Complete |
$260.09
|
| Rate for Payer: BCBS MAPPO |
$162.56
|
| Rate for Payer: BCBS Trust/PPO |
$534.55
|
| Rate for Payer: BCN Commercial |
$505.55
|
| Rate for Payer: BCN Medicare Advantage |
$162.56
|
| Rate for Payer: Cash Price |
$520.18
|
| Rate for Payer: Cofinity Commercial |
$559.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.56
|
| Rate for Payer: Healthscope Commercial |
$585.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$552.69
|
| Rate for Payer: Nomi Health Commercial |
$533.18
|
| Rate for Payer: PACE Senior Care Partners |
$154.43
|
| Rate for Payer: PACE SWMI |
$162.56
|
| Rate for Payer: PHP Commercial |
$552.69
|
| Rate for Payer: PHP Medicare Advantage |
$162.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.64
|
| Rate for Payer: Priority Health HMO/PPO |
$565.69
|
| Rate for Payer: Priority Health Medicare |
$164.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$435.65
|
| Rate for Payer: Railroad Medicare Medicare |
$162.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.19
|
| Rate for Payer: UHC Core |
$542.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.56
|
| Rate for Payer: UHC Exchange |
$162.56
|
| Rate for Payer: UHC Medicare Advantage |
$162.56
|
| Rate for Payer: VA VA |
$162.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.66
|
|
|
HC DUOGLIDE CATHETER
|
Facility
|
IP
|
$650.22
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$422.64 |
| Max. Negotiated Rate |
$585.20 |
| Rate for Payer: Aetna Commercial |
$552.69
|
| Rate for Payer: BCBS Trust/PPO |
$530.77
|
| Rate for Payer: BCN Commercial |
$502.49
|
| Rate for Payer: Cash Price |
$520.18
|
| Rate for Payer: Cofinity Commercial |
$559.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.18
|
| Rate for Payer: Healthscope Commercial |
$585.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$552.69
|
| Rate for Payer: Nomi Health Commercial |
$533.18
|
| Rate for Payer: PHP Commercial |
$552.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.64
|
| Rate for Payer: Priority Health HMO/PPO |
$565.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$435.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.19
|
| Rate for Payer: UHC Core |
$542.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.66
|
|
|
HC DUPLX HEMODIALYSIS ACCESS
|
Facility
|
OP
|
$967.42
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
92100017
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$870.68 |
| Rate for Payer: Aetna Commercial |
$822.31
|
| Rate for Payer: Aetna Medicare |
$251.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$302.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$302.32
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$241.86
|
| Rate for Payer: BCBS Trust/PPO |
$795.32
|
| Rate for Payer: BCN Commercial |
$752.17
|
| Rate for Payer: BCN Medicare Advantage |
$241.86
|
| Rate for Payer: Cash Price |
$773.94
|
| Rate for Payer: Cash Price |
$773.94
|
| Rate for Payer: Cofinity Commercial |
$831.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.86
|
| Rate for Payer: Healthscope Commercial |
$870.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.56
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$253.95
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$278.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$822.31
|
| Rate for Payer: Nomi Health Commercial |
$793.28
|
| Rate for Payer: PACE Senior Care Partners |
$229.76
|
| Rate for Payer: PACE SWMI |
$241.86
|
| Rate for Payer: PHP Commercial |
$822.31
|
| Rate for Payer: PHP Medicare Advantage |
$241.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$628.82
|
| Rate for Payer: Priority Health HMO/PPO |
$841.66
|
| Rate for Payer: Priority Health Medicare |
$244.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$648.17
|
| Rate for Payer: Railroad Medicare Medicare |
$241.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$851.33
|
| Rate for Payer: UHC Core |
$807.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$241.86
|
| Rate for Payer: UHC Exchange |
$241.86
|
| Rate for Payer: UHC Medicare Advantage |
$241.86
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$241.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.56
|
|
|
HC DUPLX HEMODIALYSIS ACCESS
|
Facility
|
IP
|
$967.42
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
92100017
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$628.82 |
| Max. Negotiated Rate |
$870.68 |
| Rate for Payer: Aetna Commercial |
$822.31
|
| Rate for Payer: BCBS Trust/PPO |
$789.70
|
| Rate for Payer: BCN Commercial |
$747.62
|
| Rate for Payer: Cash Price |
$773.94
|
| Rate for Payer: Cofinity Commercial |
$831.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.94
|
| Rate for Payer: Healthscope Commercial |
$870.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$822.31
|
| Rate for Payer: Nomi Health Commercial |
$793.28
|
| Rate for Payer: PHP Commercial |
$822.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$628.82
|
| Rate for Payer: Priority Health HMO/PPO |
$841.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$648.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$851.33
|
| Rate for Payer: UHC Core |
$807.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.56
|
|
|
HC DUST MITE DF IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200039
|
|
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 DUST MITE DF IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200039
|
|
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 DUST MITE DP IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200040
|
|
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 DUST MITE DP IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200040
|
|
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 DXA BONE DENSITY W FX ASSESS
|
Facility
|
OP
|
$782.86
|
|
|
Service Code
|
CPT 77085
|
| Hospital Charge Code |
32000304
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$704.57 |
| Rate for Payer: Aetna Commercial |
$665.43
|
| Rate for Payer: Aetna Medicare |
$203.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$244.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$244.64
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$195.72
|
| Rate for Payer: BCBS Trust/PPO |
$643.59
|
| Rate for Payer: BCN Commercial |
$608.67
|
| Rate for Payer: BCN Medicare Advantage |
$195.72
|
| Rate for Payer: Cash Price |
$626.29
|
| Rate for Payer: Cash Price |
$626.29
|
| Rate for Payer: Cofinity Commercial |
$673.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$626.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.72
|
| Rate for Payer: Healthscope Commercial |
$704.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$587.14
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$205.50
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$225.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$665.43
|
| Rate for Payer: Nomi Health Commercial |
$641.95
|
| Rate for Payer: PACE Senior Care Partners |
$185.93
|
| Rate for Payer: PACE SWMI |
$195.72
|
| Rate for Payer: PHP Commercial |
$665.43
|
| Rate for Payer: PHP Medicare Advantage |
$195.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.86
|
| Rate for Payer: Priority Health HMO/PPO |
$681.09
|
| Rate for Payer: Priority Health Medicare |
$197.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$524.52
|
| Rate for Payer: Railroad Medicare Medicare |
$195.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$688.92
|
| Rate for Payer: UHC Core |
$653.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$195.72
|
| Rate for Payer: UHC Exchange |
$195.72
|
| Rate for Payer: UHC Medicare Advantage |
$195.72
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$195.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$587.14
|
|
|
HC DXA BONE DENSITY W FX ASSESS
|
Facility
|
IP
|
$782.86
|
|
|
Service Code
|
CPT 77085
|
| Hospital Charge Code |
32000304
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$508.86 |
| Max. Negotiated Rate |
$704.57 |
| Rate for Payer: Aetna Commercial |
$665.43
|
| Rate for Payer: BCBS Trust/PPO |
$639.05
|
| Rate for Payer: BCN Commercial |
$604.99
|
| Rate for Payer: Cash Price |
$626.29
|
| Rate for Payer: Cofinity Commercial |
$673.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$626.29
|
| Rate for Payer: Healthscope Commercial |
$704.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$587.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$665.43
|
| Rate for Payer: Nomi Health Commercial |
$641.95
|
| Rate for Payer: PHP Commercial |
$665.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.86
|
| Rate for Payer: Priority Health HMO/PPO |
$681.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$524.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$688.92
|
| Rate for Payer: UHC Core |
$653.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$587.14
|
|
|
HC E72 MOUSE URINE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200452
|
|
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 E72 MOUSE URINE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200452
|
|
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 EAKIN SEAL 2"
|
Facility
|
OP
|
$12.54
|
|
| Hospital Charge Code |
27100013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.98 |
| Max. Negotiated Rate |
$11.29 |
| Rate for Payer: Aetna Commercial |
$10.66
|
| Rate for Payer: Aetna Medicare |
$3.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.92
|
| Rate for Payer: BCBS Complete |
$5.02
|
| Rate for Payer: BCBS MAPPO |
$3.14
|
| Rate for Payer: BCBS Trust/PPO |
$10.31
|
| Rate for Payer: BCN Commercial |
$9.75
|
| Rate for Payer: BCN Medicare Advantage |
$3.14
|
| Rate for Payer: Cash Price |
$10.03
|
| Rate for Payer: Cofinity Commercial |
$10.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.14
|
| Rate for Payer: Healthscope Commercial |
$11.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.66
|
| Rate for Payer: Nomi Health Commercial |
$10.28
|
| Rate for Payer: PACE Senior Care Partners |
$2.98
|
| Rate for Payer: PACE SWMI |
$3.14
|
| Rate for Payer: PHP Commercial |
$10.66
|
| Rate for Payer: PHP Medicare Advantage |
$3.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.15
|
| Rate for Payer: Priority Health HMO/PPO |
$10.91
|
| Rate for Payer: Priority Health Medicare |
$3.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.40
|
| Rate for Payer: Railroad Medicare Medicare |
$3.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.04
|
| Rate for Payer: UHC Core |
$10.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.14
|
| Rate for Payer: UHC Exchange |
$3.14
|
| Rate for Payer: UHC Medicare Advantage |
$3.14
|
| Rate for Payer: VA VA |
$3.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.40
|
|
