|
HC ELEC ALYS IMPLT NPGT PHYS/QHP W/O PRGM
|
Facility
|
IP
|
$170.14
|
|
|
Service Code
|
CPT 95970
|
| Hospital Charge Code |
92000030
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$110.59 |
| Max. Negotiated Rate |
$153.13 |
| Rate for Payer: Aetna Commercial |
$144.62
|
| Rate for Payer: BCBS Trust/PPO |
$138.89
|
| Rate for Payer: BCN Commercial |
$131.48
|
| Rate for Payer: Cash Price |
$136.11
|
| Rate for Payer: Cofinity Commercial |
$146.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.11
|
| Rate for Payer: Healthscope Commercial |
$153.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.62
|
| Rate for Payer: Nomi Health Commercial |
$139.51
|
| Rate for Payer: PHP Commercial |
$144.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.59
|
| Rate for Payer: Priority Health HMO/PPO |
$148.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.72
|
| Rate for Payer: UHC Core |
$142.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.60
|
|
|
HC ELEC ALYS IMPLT NPGT PHYS/QHP W/O PRGM
|
Facility
|
OP
|
$170.14
|
|
|
Service Code
|
CPT 95970
|
| Hospital Charge Code |
92000030
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$40.41 |
| Max. Negotiated Rate |
$153.13 |
| Rate for Payer: Aetna Commercial |
$144.62
|
| Rate for Payer: Aetna Medicare |
$44.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.17
|
| Rate for Payer: BCBS Complete |
$95.88
|
| Rate for Payer: BCBS MAPPO |
$42.54
|
| Rate for Payer: BCBS Trust/PPO |
$139.87
|
| Rate for Payer: BCN Commercial |
$132.28
|
| Rate for Payer: BCN Medicare Advantage |
$42.54
|
| Rate for Payer: Cash Price |
$136.11
|
| Rate for Payer: Cash Price |
$136.11
|
| Rate for Payer: Cofinity Commercial |
$146.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.54
|
| Rate for Payer: Healthscope Commercial |
$153.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.60
|
| Rate for Payer: Mclaren Medicaid |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.66
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.62
|
| Rate for Payer: Nomi Health Commercial |
$139.51
|
| Rate for Payer: PACE Senior Care Partners |
$40.41
|
| Rate for Payer: PACE SWMI |
$42.54
|
| Rate for Payer: PHP Commercial |
$144.62
|
| Rate for Payer: PHP Medicare Advantage |
$42.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.59
|
| Rate for Payer: Priority Health HMO/PPO |
$148.02
|
| Rate for Payer: Priority Health Medicare |
$42.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.99
|
| Rate for Payer: Railroad Medicare Medicare |
$42.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.72
|
| Rate for Payer: UHC Core |
$142.07
|
| 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: UHCCP Medicaid |
$91.31
|
| Rate for Payer: VA VA |
$42.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.60
|
|
|
HC ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGM
|
Facility
|
IP
|
$176.99
|
|
|
Service Code
|
CPT 95971
|
| Hospital Charge Code |
92000031
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$115.04 |
| Max. Negotiated Rate |
$159.29 |
| Rate for Payer: Aetna Commercial |
$150.44
|
| Rate for Payer: BCBS Trust/PPO |
$144.48
|
| Rate for Payer: BCN Commercial |
$136.78
|
| Rate for Payer: Cash Price |
$141.59
|
| Rate for Payer: Cofinity Commercial |
$152.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.59
|
| Rate for Payer: Healthscope Commercial |
$159.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.44
|
| Rate for Payer: Nomi Health Commercial |
$145.13
|
| Rate for Payer: PHP Commercial |
$150.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.04
|
| Rate for Payer: Priority Health HMO/PPO |
$153.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.75
|
| Rate for Payer: UHC Core |
$147.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.74
|
|
|
HC ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGM
|
Facility
|
OP
|
$176.99
|
|
|
Service Code
|
CPT 95971
|
| Hospital Charge Code |
92000031
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$42.04 |
| Max. Negotiated Rate |
$159.29 |
| Rate for Payer: Aetna Commercial |
$150.44
|
| Rate for Payer: Aetna Medicare |
$46.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.31
|
| Rate for Payer: BCBS Complete |
$68.27
|
| Rate for Payer: BCBS MAPPO |
$44.25
|
| Rate for Payer: BCBS Trust/PPO |
$145.50
|
| Rate for Payer: BCN Commercial |
$137.61
|
| Rate for Payer: BCN Medicare Advantage |
$44.25
|
| Rate for Payer: Cash Price |
$141.59
|
| Rate for Payer: Cash Price |
$141.59
|
| Rate for Payer: Cofinity Commercial |
$152.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.25
|
| Rate for Payer: Healthscope Commercial |
$159.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.74
|
| Rate for Payer: Mclaren Medicaid |
$65.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.46
|
| Rate for Payer: Meridian Medicaid |
$68.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.44
|
| Rate for Payer: Nomi Health Commercial |
$145.13
|
| Rate for Payer: PACE Senior Care Partners |
$42.04
|
| Rate for Payer: PACE SWMI |
$44.25
|
| Rate for Payer: PHP Commercial |
$150.44
|
| Rate for Payer: PHP Medicare Advantage |
$44.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.04
|
| Rate for Payer: Priority Health HMO/PPO |
$153.98
|
| Rate for Payer: Priority Health Medicare |
$44.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.58
|
| Rate for Payer: Railroad Medicare Medicare |
$44.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.75
|
| Rate for Payer: UHC Core |
$147.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.25
|
| Rate for Payer: UHC Exchange |
$44.25
|
| Rate for Payer: UHC Medicare Advantage |
$44.25
|
| Rate for Payer: UHCCP Medicaid |
$65.02
|
| Rate for Payer: VA VA |
$44.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.74
|
|
|
HC ELEC BREAST PUMP KI (OB)
|
Facility
|
OP
|
$206.55
|
|
| Hospital Charge Code |
27000069
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.06 |
| Max. Negotiated Rate |
$185.90 |
| Rate for Payer: Aetna Commercial |
$175.57
|
| Rate for Payer: Aetna Medicare |
$53.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.55
|
| Rate for Payer: BCBS Complete |
$82.62
|
| Rate for Payer: BCBS MAPPO |
$51.64
|
| Rate for Payer: BCBS Trust/PPO |
$169.80
|
| Rate for Payer: BCN Commercial |
$160.59
|
| Rate for Payer: BCN Medicare Advantage |
$51.64
|
| Rate for Payer: Cash Price |
$165.24
|
| Rate for Payer: Cofinity Commercial |
$177.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.64
|
| Rate for Payer: Healthscope Commercial |
$185.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.57
|
| Rate for Payer: Nomi Health Commercial |
$169.37
|
| Rate for Payer: PACE Senior Care Partners |
$49.06
|
| Rate for Payer: PACE SWMI |
$51.64
|
| Rate for Payer: PHP Commercial |
$175.57
|
| Rate for Payer: PHP Medicare Advantage |
$51.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.26
|
| Rate for Payer: Priority Health HMO/PPO |
$179.70
|
| Rate for Payer: Priority Health Medicare |
$52.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.39
|
| Rate for Payer: Railroad Medicare Medicare |
$51.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.76
|
| Rate for Payer: UHC Core |
$172.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.64
|
| Rate for Payer: UHC Exchange |
$51.64
|
| Rate for Payer: UHC Medicare Advantage |
$51.64
|
| Rate for Payer: VA VA |
$51.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.91
|
|
|
HC ELEC BREAST PUMP KI (OB)
|
Facility
|
IP
|
$206.55
|
|
| Hospital Charge Code |
27000069
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$134.26 |
| Max. Negotiated Rate |
$185.90 |
| Rate for Payer: Aetna Commercial |
$175.57
|
| Rate for Payer: BCBS Trust/PPO |
$168.61
|
| Rate for Payer: BCN Commercial |
$159.62
|
| Rate for Payer: Cash Price |
$165.24
|
| Rate for Payer: Cofinity Commercial |
$177.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.24
|
| Rate for Payer: Healthscope Commercial |
$185.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.57
|
| Rate for Payer: Nomi Health Commercial |
$169.37
|
| Rate for Payer: PHP Commercial |
$175.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.26
|
| Rate for Payer: Priority Health HMO/PPO |
$179.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.76
|
| Rate for Payer: UHC Core |
$172.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.91
|
|
|
HC ELECTRICAL STIM UNATTENDED
|
Facility
|
IP
|
$92.60
|
|
|
Service Code
|
CPT 97014
|
| Hospital Charge Code |
42000010
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$60.19 |
| Max. Negotiated Rate |
$83.34 |
| Rate for Payer: Aetna Commercial |
$78.71
|
| Rate for Payer: BCBS Trust/PPO |
$75.59
|
| Rate for Payer: BCN Commercial |
$71.56
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cofinity Commercial |
$79.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.08
|
| Rate for Payer: Healthscope Commercial |
$83.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.71
|
| Rate for Payer: Nomi Health Commercial |
$75.93
|
| Rate for Payer: PHP Commercial |
$78.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.19
|
| Rate for Payer: Priority Health HMO/PPO |
$80.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.49
|
| Rate for Payer: UHC Core |
$77.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.45
|
|
|
HC ELECTRICAL STIM UNATTENDED
|
Facility
|
OP
|
$92.60
|
|
|
Service Code
|
CPT 97014
|
| Hospital Charge Code |
42000010
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.99 |
| Max. Negotiated Rate |
$83.34 |
| Rate for Payer: Aetna Commercial |
$78.71
|
| Rate for Payer: Aetna Medicare |
$24.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.94
|
| Rate for Payer: BCBS Complete |
$37.04
|
| Rate for Payer: BCBS MAPPO |
$23.15
|
| Rate for Payer: BCBS Trust/PPO |
$76.13
|
| Rate for Payer: BCN Commercial |
$72.00
|
| Rate for Payer: BCN Medicare Advantage |
$23.15
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cofinity Commercial |
$79.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.15
|
| Rate for Payer: Healthscope Commercial |
$83.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.71
|
| Rate for Payer: Nomi Health Commercial |
$75.93
|
| Rate for Payer: PACE Senior Care Partners |
$21.99
|
| Rate for Payer: PACE SWMI |
$23.15
|
| Rate for Payer: PHP Commercial |
$78.71
|
| Rate for Payer: PHP Medicare Advantage |
$23.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.19
|
| Rate for Payer: Priority Health HMO/PPO |
$80.56
|
| Rate for Payer: Priority Health Medicare |
$23.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.04
|
| Rate for Payer: Railroad Medicare Medicare |
$23.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.49
|
| Rate for Payer: UHC Core |
$77.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.15
|
| Rate for Payer: UHC Exchange |
$23.15
|
| Rate for Payer: UHC Medicare Advantage |
$23.15
|
| Rate for Payer: VA VA |
$23.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.45
|
|
|
HC ELECTRICAL STIM UNATTENDED FOR PRESSURE
|
Facility
|
OP
|
$102.44
|
|
|
Service Code
|
HCPCS G0281
|
| Hospital Charge Code |
42000057
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$24.33 |
| Max. Negotiated Rate |
$92.20 |
| Rate for Payer: Aetna Commercial |
$87.07
|
| Rate for Payer: Aetna Medicare |
$26.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.01
|
| Rate for Payer: BCBS Complete |
$40.98
|
| Rate for Payer: BCBS MAPPO |
$25.61
|
| Rate for Payer: BCBS Trust/PPO |
$84.22
|
| Rate for Payer: BCN Commercial |
$79.65
|
| Rate for Payer: BCN Medicare Advantage |
$25.61
|
| Rate for Payer: Cash Price |
$81.95
|
| Rate for Payer: Cofinity Commercial |
$88.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.61
|
| Rate for Payer: Healthscope Commercial |
$92.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.07
|
| Rate for Payer: Nomi Health Commercial |
$84.00
|
| Rate for Payer: PACE Senior Care Partners |
$24.33
|
| Rate for Payer: PACE SWMI |
$25.61
|
| Rate for Payer: PHP Commercial |
$87.07
|
| Rate for Payer: PHP Medicare Advantage |
$25.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.59
|
| Rate for Payer: Priority Health HMO/PPO |
$89.12
|
| Rate for Payer: Priority Health Medicare |
$25.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.63
|
| Rate for Payer: Railroad Medicare Medicare |
$25.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.15
|
| Rate for Payer: UHC Core |
$85.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.61
|
| Rate for Payer: UHC Exchange |
$25.61
|
| Rate for Payer: UHC Medicare Advantage |
$25.61
|
| Rate for Payer: VA VA |
$25.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.83
|
|
|
HC ELECTRICAL STIM UNATTENDED FOR PRESSURE
|
Facility
|
IP
|
$102.44
|
|
|
Service Code
|
HCPCS G0281
|
| Hospital Charge Code |
42000057
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$66.59 |
| Max. Negotiated Rate |
$92.20 |
| Rate for Payer: Aetna Commercial |
$87.07
|
| Rate for Payer: BCBS Trust/PPO |
$83.62
|
| Rate for Payer: BCN Commercial |
$79.17
|
| Rate for Payer: Cash Price |
$81.95
|
| Rate for Payer: Cofinity Commercial |
$88.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.95
|
| Rate for Payer: Healthscope Commercial |
$92.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.07
|
| Rate for Payer: Nomi Health Commercial |
$84.00
|
| Rate for Payer: PHP Commercial |
$87.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.59
|
| Rate for Payer: Priority Health HMO/PPO |
$89.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.15
|
| Rate for Payer: UHC Core |
$85.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.83
|
|
|
HC ELECTRICAL STIM UNATTENDED NOT PRESSURE
|
Facility
|
OP
|
$132.76
|
|
|
Service Code
|
HCPCS G0283
|
| Hospital Charge Code |
42000058
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$31.53 |
| Max. Negotiated Rate |
$119.48 |
| Rate for Payer: Aetna Commercial |
$112.85
|
| Rate for Payer: Aetna Medicare |
$34.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.49
|
| Rate for Payer: BCBS Complete |
$53.10
|
| Rate for Payer: BCBS MAPPO |
$33.19
|
| Rate for Payer: BCBS Trust/PPO |
$109.14
|
| Rate for Payer: BCN Commercial |
$103.22
|
| Rate for Payer: BCN Medicare Advantage |
$33.19
|
| Rate for Payer: Cash Price |
$106.21
|
| Rate for Payer: Cofinity Commercial |
$114.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.19
|
| Rate for Payer: Healthscope Commercial |
$119.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.85
|
| Rate for Payer: Nomi Health Commercial |
$108.86
|
| Rate for Payer: PACE Senior Care Partners |
$31.53
|
| Rate for Payer: PACE SWMI |
$33.19
|
| Rate for Payer: PHP Commercial |
$112.85
|
| Rate for Payer: PHP Medicare Advantage |
$33.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.29
|
| Rate for Payer: Priority Health HMO/PPO |
$115.50
|
| Rate for Payer: Priority Health Medicare |
$33.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.95
|
| Rate for Payer: Railroad Medicare Medicare |
$33.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.83
|
| Rate for Payer: UHC Core |
$110.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.19
|
| Rate for Payer: UHC Exchange |
$33.19
|
| Rate for Payer: UHC Medicare Advantage |
$33.19
|
| Rate for Payer: VA VA |
$33.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.57
|
|
|
HC ELECTRICAL STIM UNATTENDED NOT PRESSURE
|
Facility
|
IP
|
$132.76
|
|
|
Service Code
|
HCPCS G0283
|
| Hospital Charge Code |
42000058
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$86.29 |
| Max. Negotiated Rate |
$119.48 |
| Rate for Payer: Aetna Commercial |
$112.85
|
| Rate for Payer: BCBS Trust/PPO |
$108.37
|
| Rate for Payer: BCN Commercial |
$102.60
|
| Rate for Payer: Cash Price |
$106.21
|
| Rate for Payer: Cofinity Commercial |
$114.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.21
|
| Rate for Payer: Healthscope Commercial |
$119.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.85
|
| Rate for Payer: Nomi Health Commercial |
$108.86
|
| Rate for Payer: PHP Commercial |
$112.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.29
|
| Rate for Payer: Priority Health HMO/PPO |
$115.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.83
|
| Rate for Payer: UHC Core |
$110.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.57
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST BINAURAL
|
Facility
|
IP
|
$78.54
|
|
|
Service Code
|
CPT 92595
|
| Hospital Charge Code |
76100494
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$51.05 |
| Max. Negotiated Rate |
$70.69 |
| Rate for Payer: Aetna Commercial |
$66.76
|
| Rate for Payer: BCBS Trust/PPO |
$64.11
|
| Rate for Payer: BCN Commercial |
$60.70
|
| Rate for Payer: Cash Price |
$62.83
|
| Rate for Payer: Cofinity Commercial |
$67.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.83
|
| Rate for Payer: Healthscope Commercial |
$70.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.76
|
| Rate for Payer: Nomi Health Commercial |
$64.40
|
| Rate for Payer: PHP Commercial |
$66.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.05
|
| Rate for Payer: Priority Health HMO/PPO |
$68.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.12
|
| Rate for Payer: UHC Core |
$65.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.90
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST BINAURAL
|
Facility
|
OP
|
$78.54
|
|
|
Service Code
|
CPT 92595
|
| Hospital Charge Code |
76100494
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$18.65 |
| Max. Negotiated Rate |
$70.69 |
| Rate for Payer: Aetna Commercial |
$66.76
|
| Rate for Payer: Aetna Medicare |
$20.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.54
|
| Rate for Payer: BCBS Complete |
$31.42
|
| Rate for Payer: BCBS MAPPO |
$19.64
|
| Rate for Payer: BCBS Trust/PPO |
$64.57
|
| Rate for Payer: BCN Commercial |
$61.06
|
| Rate for Payer: BCN Medicare Advantage |
$19.64
|
| Rate for Payer: Cash Price |
$62.83
|
| Rate for Payer: Cofinity Commercial |
$67.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.64
|
| Rate for Payer: Healthscope Commercial |
$70.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.76
|
| Rate for Payer: Nomi Health Commercial |
$64.40
|
| Rate for Payer: PACE Senior Care Partners |
$18.65
|
| Rate for Payer: PACE SWMI |
$19.64
|
| Rate for Payer: PHP Commercial |
$66.76
|
| Rate for Payer: PHP Medicare Advantage |
$19.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.05
|
| Rate for Payer: Priority Health HMO/PPO |
$68.33
|
| Rate for Payer: Priority Health Medicare |
$19.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.62
|
| Rate for Payer: Railroad Medicare Medicare |
$19.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.12
|
| Rate for Payer: UHC Core |
$65.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.64
|
| Rate for Payer: UHC Exchange |
$19.64
|
| Rate for Payer: UHC Medicare Advantage |
$19.64
|
| Rate for Payer: VA VA |
$19.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.90
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST MONAURAL
|
Facility
|
OP
|
$89.76
|
|
|
Service Code
|
CPT 92594
|
| Hospital Charge Code |
76100493
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$21.32 |
| Max. Negotiated Rate |
$80.78 |
| Rate for Payer: Aetna Commercial |
$76.30
|
| Rate for Payer: Aetna Medicare |
$23.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.05
|
| Rate for Payer: BCBS Complete |
$35.90
|
| Rate for Payer: BCBS MAPPO |
$22.44
|
| Rate for Payer: BCBS Trust/PPO |
$73.79
|
| Rate for Payer: BCN Commercial |
$69.79
|
| Rate for Payer: BCN Medicare Advantage |
$22.44
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cofinity Commercial |
$77.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.44
|
| Rate for Payer: Healthscope Commercial |
$80.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.30
|
| Rate for Payer: Nomi Health Commercial |
$73.60
|
| Rate for Payer: PACE Senior Care Partners |
$21.32
|
| Rate for Payer: PACE SWMI |
$22.44
|
| Rate for Payer: PHP Commercial |
$76.30
|
| Rate for Payer: PHP Medicare Advantage |
$22.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.34
|
| Rate for Payer: Priority Health HMO/PPO |
$78.09
|
| Rate for Payer: Priority Health Medicare |
$22.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.14
|
| Rate for Payer: Railroad Medicare Medicare |
$22.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.99
|
| Rate for Payer: UHC Core |
$74.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.44
|
| Rate for Payer: UHC Exchange |
$22.44
|
| Rate for Payer: UHC Medicare Advantage |
$22.44
|
| Rate for Payer: VA VA |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.32
|
|
|
HC ELECTROACOUSTIC HEARNG AID TEST MONAURAL
|
Facility
|
IP
|
$89.76
|
|
|
Service Code
|
CPT 92594
|
| Hospital Charge Code |
76100493
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$58.34 |
| Max. Negotiated Rate |
$80.78 |
| Rate for Payer: Aetna Commercial |
$76.30
|
| Rate for Payer: BCBS Trust/PPO |
$73.27
|
| Rate for Payer: BCN Commercial |
$69.37
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cofinity Commercial |
$77.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.81
|
| Rate for Payer: Healthscope Commercial |
$80.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.30
|
| Rate for Payer: Nomi Health Commercial |
$73.60
|
| Rate for Payer: PHP Commercial |
$76.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.34
|
| Rate for Payer: Priority Health HMO/PPO |
$78.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.99
|
| Rate for Payer: UHC Core |
$74.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.32
|
|
|
HC ELECTROCARDIOGRAM
|
Facility
|
OP
|
$217.40
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
73000001
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$42.08 |
| Max. Negotiated Rate |
$195.66 |
| Rate for Payer: Aetna Commercial |
$184.79
|
| Rate for Payer: Aetna Medicare |
$56.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.94
|
| Rate for Payer: BCBS Complete |
$44.19
|
| Rate for Payer: BCBS MAPPO |
$54.35
|
| Rate for Payer: BCBS Trust/PPO |
$178.72
|
| Rate for Payer: BCN Commercial |
$169.03
|
| Rate for Payer: BCN Medicare Advantage |
$54.35
|
| Rate for Payer: Cash Price |
$173.92
|
| Rate for Payer: Cash Price |
$173.92
|
| Rate for Payer: Cofinity Commercial |
$186.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.35
|
| Rate for Payer: Healthscope Commercial |
$195.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.05
|
| Rate for Payer: Mclaren Medicaid |
$42.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.07
|
| Rate for Payer: Meridian Medicaid |
$44.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.79
|
| Rate for Payer: Nomi Health Commercial |
$178.27
|
| Rate for Payer: PACE Senior Care Partners |
$51.63
|
| Rate for Payer: PACE SWMI |
$54.35
|
| Rate for Payer: PHP Commercial |
$184.79
|
| Rate for Payer: PHP Medicare Advantage |
$54.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.31
|
| Rate for Payer: Priority Health HMO/PPO |
$189.14
|
| Rate for Payer: Priority Health Medicare |
$54.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.66
|
| Rate for Payer: Railroad Medicare Medicare |
$54.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.31
|
| Rate for Payer: UHC Core |
$181.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.35
|
| Rate for Payer: UHC Exchange |
$54.35
|
| Rate for Payer: UHC Medicare Advantage |
$54.35
|
| Rate for Payer: UHCCP Medicaid |
$42.08
|
| Rate for Payer: VA VA |
$54.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.05
|
|
|
HC ELECTROCARDIOGRAM
|
Facility
|
IP
|
$217.40
|
|
|
Service Code
|
CPT 93005
|
| Hospital Charge Code |
73000001
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$141.31 |
| Max. Negotiated Rate |
$195.66 |
| Rate for Payer: Aetna Commercial |
$184.79
|
| Rate for Payer: BCBS Trust/PPO |
$177.46
|
| Rate for Payer: BCN Commercial |
$168.01
|
| Rate for Payer: Cash Price |
$173.92
|
| Rate for Payer: Cofinity Commercial |
$186.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.92
|
| Rate for Payer: Healthscope Commercial |
$195.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.79
|
| Rate for Payer: Nomi Health Commercial |
$178.27
|
| Rate for Payer: PHP Commercial |
$184.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.31
|
| Rate for Payer: Priority Health HMO/PPO |
$189.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.31
|
| Rate for Payer: UHC Core |
$181.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.05
|
|
|
HC ELECTROCORTICOGRAM IMPLTD BRN NPGT <30 D
|
Facility
|
OP
|
$75.95
|
|
|
Service Code
|
CPT 95836
|
| Hospital Charge Code |
74000033
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$18.04 |
| Max. Negotiated Rate |
$68.36 |
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna Medicare |
$19.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.73
|
| Rate for Payer: BCBS Complete |
$27.74
|
| Rate for Payer: BCBS MAPPO |
$18.99
|
| Rate for Payer: BCBS Trust/PPO |
$62.44
|
| Rate for Payer: BCN Commercial |
$59.05
|
| Rate for Payer: BCN Medicare Advantage |
$18.99
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cofinity Commercial |
$65.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.99
|
| Rate for Payer: Healthscope Commercial |
$68.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.96
|
| Rate for Payer: Mclaren Medicaid |
$26.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.94
|
| Rate for Payer: Meridian Medicaid |
$27.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.56
|
| Rate for Payer: Nomi Health Commercial |
$62.28
|
| Rate for Payer: PACE Senior Care Partners |
$18.04
|
| Rate for Payer: PACE SWMI |
$18.99
|
| Rate for Payer: PHP Commercial |
$64.56
|
| Rate for Payer: PHP Medicare Advantage |
$18.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.37
|
| Rate for Payer: Priority Health HMO/PPO |
$66.08
|
| Rate for Payer: Priority Health Medicare |
$19.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.89
|
| Rate for Payer: Railroad Medicare Medicare |
$18.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.84
|
| Rate for Payer: UHC Core |
$63.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.99
|
| Rate for Payer: UHC Exchange |
$18.99
|
| Rate for Payer: UHC Medicare Advantage |
$18.99
|
| Rate for Payer: UHCCP Medicaid |
$26.42
|
| Rate for Payer: VA VA |
$18.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.96
|
|
|
HC ELECTROCORTICOGRAM IMPLTD BRN NPGT <30 D
|
Facility
|
IP
|
$75.95
|
|
|
Service Code
|
CPT 95836
|
| Hospital Charge Code |
74000033
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$49.37 |
| Max. Negotiated Rate |
$68.36 |
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: BCBS Trust/PPO |
$62.00
|
| Rate for Payer: BCN Commercial |
$58.69
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cofinity Commercial |
$65.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.76
|
| Rate for Payer: Healthscope Commercial |
$68.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.56
|
| Rate for Payer: Nomi Health Commercial |
$62.28
|
| Rate for Payer: PHP Commercial |
$64.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.37
|
| Rate for Payer: Priority Health HMO/PPO |
$66.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.84
|
| Rate for Payer: UHC Core |
$63.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.96
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
IP
|
$28.09
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.26 |
| Max. Negotiated Rate |
$25.28 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: BCBS Trust/PPO |
$22.93
|
| Rate for Payer: BCN Commercial |
$21.71
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$24.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Healthscope Commercial |
$25.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| Rate for Payer: PHP Commercial |
$23.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health HMO/PPO |
$24.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.72
|
| Rate for Payer: UHC Core |
$23.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.07
|
|
|
HC ELECTROLYTE PANEL
|
Facility
|
OP
|
$28.09
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$25.28 |
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: Aetna Medicare |
$7.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.78
|
| Rate for Payer: BCBS Complete |
$5.32
|
| Rate for Payer: BCBS MAPPO |
$7.02
|
| Rate for Payer: BCBS Trust/PPO |
$23.09
|
| Rate for Payer: BCN Commercial |
$21.84
|
| Rate for Payer: BCN Medicare Advantage |
$7.02
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$24.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.02
|
| Rate for Payer: Healthscope Commercial |
$25.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.07
|
| Rate for Payer: Mclaren Medicaid |
$5.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.37
|
| Rate for Payer: Meridian Medicaid |
$5.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| Rate for Payer: PACE Senior Care Partners |
$6.67
|
| Rate for Payer: PACE SWMI |
$7.02
|
| Rate for Payer: PHP Commercial |
$23.88
|
| Rate for Payer: PHP Medicare Advantage |
$7.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health HMO/PPO |
$24.44
|
| Rate for Payer: Priority Health Medicare |
$7.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.82
|
| Rate for Payer: Railroad Medicare Medicare |
$7.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.72
|
| Rate for Payer: UHC Core |
$23.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.02
|
| Rate for Payer: UHC Exchange |
$7.02
|
| Rate for Payer: UHC Medicare Advantage |
$7.02
|
| Rate for Payer: UHCCP Medicaid |
$5.07
|
| Rate for Payer: VA VA |
$7.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.07
|
|
|
HC ELECTROLYTES WHOLE BLOOD
|
Facility
|
OP
|
$87.82
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100490
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$79.04 |
| Rate for Payer: Aetna Commercial |
$74.65
|
| Rate for Payer: Aetna Medicare |
$22.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.44
|
| Rate for Payer: BCBS Complete |
$5.32
|
| Rate for Payer: BCBS MAPPO |
$21.96
|
| Rate for Payer: BCBS Trust/PPO |
$72.20
|
| Rate for Payer: BCN Commercial |
$68.28
|
| Rate for Payer: BCN Medicare Advantage |
$21.96
|
| Rate for Payer: Cash Price |
$70.26
|
| Rate for Payer: Cash Price |
$70.26
|
| Rate for Payer: Cofinity Commercial |
$75.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.96
|
| Rate for Payer: Healthscope Commercial |
$79.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.86
|
| Rate for Payer: Mclaren Medicaid |
$5.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.05
|
| Rate for Payer: Meridian Medicaid |
$5.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.65
|
| Rate for Payer: Nomi Health Commercial |
$72.01
|
| Rate for Payer: PACE Senior Care Partners |
$20.86
|
| Rate for Payer: PACE SWMI |
$21.96
|
| Rate for Payer: PHP Commercial |
$74.65
|
| Rate for Payer: PHP Medicare Advantage |
$21.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.08
|
| Rate for Payer: Priority Health HMO/PPO |
$76.40
|
| Rate for Payer: Priority Health Medicare |
$22.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.84
|
| Rate for Payer: Railroad Medicare Medicare |
$21.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.28
|
| Rate for Payer: UHC Core |
$73.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.96
|
| Rate for Payer: UHC Exchange |
$21.96
|
| Rate for Payer: UHC Medicare Advantage |
$21.96
|
| Rate for Payer: UHCCP Medicaid |
$5.07
|
| Rate for Payer: VA VA |
$21.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.86
|
|
|
HC ELECTROLYTES WHOLE BLOOD
|
Facility
|
IP
|
$87.82
|
|
|
Service Code
|
CPT 80051
|
| Hospital Charge Code |
30100490
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.08 |
| Max. Negotiated Rate |
$79.04 |
| Rate for Payer: Aetna Commercial |
$74.65
|
| Rate for Payer: BCBS Trust/PPO |
$71.69
|
| Rate for Payer: BCN Commercial |
$67.87
|
| Rate for Payer: Cash Price |
$70.26
|
| Rate for Payer: Cofinity Commercial |
$75.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.26
|
| Rate for Payer: Healthscope Commercial |
$79.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.65
|
| Rate for Payer: Nomi Health Commercial |
$72.01
|
| Rate for Payer: PHP Commercial |
$74.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.08
|
| Rate for Payer: Priority Health HMO/PPO |
$76.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.28
|
| Rate for Payer: UHC Core |
$73.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.86
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPINGLEVEL 31
|
Facility
|
IP
|
$3,150.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200369
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,047.50 |
| Max. Negotiated Rate |
$2,835.00 |
| Rate for Payer: Aetna Commercial |
$2,677.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,571.34
|
| Rate for Payer: BCN Commercial |
$2,434.32
|
| Rate for Payer: Cash Price |
$2,520.00
|
| Rate for Payer: Cofinity Commercial |
$2,709.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,520.00
|
| Rate for Payer: Healthscope Commercial |
$2,835.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,362.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,677.50
|
| Rate for Payer: Nomi Health Commercial |
$2,583.00
|
| Rate for Payer: PHP Commercial |
$2,677.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,047.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,740.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,110.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,772.00
|
| Rate for Payer: UHC Core |
$2,630.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,362.50
|
|
