|
HC MATERNAL SCRN INTEGRATED SERUM 1
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 84163
|
| Hospital Charge Code |
30100641
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.09 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: BCBS Trust/PPO |
$85.01
|
| Rate for Payer: BCN Commercial |
$85.01
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.50
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.80
|
| Rate for Payer: UHC Core |
$91.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
HC MATERNAL SCRN INTEGRATED SERUM 1
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 84163
|
| Hospital Charge Code |
30100641
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.11 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna Medicare |
$28.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.38
|
| Rate for Payer: BCBS Complete |
$11.66
|
| Rate for Payer: BCBS MAPPO |
$27.50
|
| Rate for Payer: BCBS Trust/PPO |
$85.52
|
| Rate for Payer: BCN Commercial |
$85.52
|
| Rate for Payer: BCN Medicare Advantage |
$27.50
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.50
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Mclaren Medicaid |
$11.11
|
| Rate for Payer: Meridian Medicaid |
$11.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.50
|
| Rate for Payer: PACE Senior Care Partners |
$26.12
|
| Rate for Payer: PACE SWMI |
$27.50
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: PHP Medicare Advantage |
$27.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.70
|
| Rate for Payer: Priority Health Medicare |
$27.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.09
|
| Rate for Payer: Railroad Medicare Medicare |
$27.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.80
|
| Rate for Payer: UHC Core |
$91.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.50
|
| Rate for Payer: UHC Medicare Advantage |
$28.32
|
| Rate for Payer: VA VA |
$27.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
HC MATERNAL SCRN INTEGRATED SERUM 2
|
Facility
|
IP
|
$237.60
|
|
|
Service Code
|
CPT 81511
|
| Hospital Charge Code |
30100654
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$144.91 |
| Max. Negotiated Rate |
$213.84 |
| Rate for Payer: Aetna Commercial |
$201.96
|
| Rate for Payer: BCBS Trust/PPO |
$183.62
|
| Rate for Payer: BCN Commercial |
$183.62
|
| Rate for Payer: Cash Price |
$190.08
|
| Rate for Payer: Cofinity Commercial |
$204.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.08
|
| Rate for Payer: Healthscope Commercial |
$213.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$201.96
|
| Rate for Payer: PHP Commercial |
$201.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$206.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.09
|
| Rate for Payer: UHC Core |
$198.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.20
|
|
|
HC MATERNAL SCRN INTEGRATED SERUM 2
|
Facility
|
OP
|
$237.60
|
|
|
Service Code
|
CPT 81511
|
| Hospital Charge Code |
30100654
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.43 |
| Max. Negotiated Rate |
$213.84 |
| Rate for Payer: Aetna Commercial |
$201.96
|
| Rate for Payer: Aetna Medicare |
$61.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.25
|
| Rate for Payer: BCBS Complete |
$118.95
|
| Rate for Payer: BCBS MAPPO |
$59.40
|
| Rate for Payer: BCBS Trust/PPO |
$184.73
|
| Rate for Payer: BCN Commercial |
$184.73
|
| Rate for Payer: BCN Medicare Advantage |
$59.40
|
| Rate for Payer: Cash Price |
$190.08
|
| Rate for Payer: Cash Price |
$190.08
|
| Rate for Payer: Cofinity Commercial |
$204.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.40
|
| Rate for Payer: Healthscope Commercial |
$213.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.20
|
| Rate for Payer: Mclaren Medicaid |
$113.28
|
| Rate for Payer: Meridian Medicaid |
$118.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$62.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$201.96
|
| Rate for Payer: PACE Senior Care Partners |
$56.43
|
| Rate for Payer: PACE SWMI |
$59.40
|
| Rate for Payer: PHP Commercial |
$201.96
|
| Rate for Payer: PHP Medicare Advantage |
$59.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$206.71
|
| Rate for Payer: Priority Health Medicare |
$59.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.91
|
| Rate for Payer: Railroad Medicare Medicare |
$59.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.09
|
| Rate for Payer: UHC Core |
$198.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.40
|
| Rate for Payer: UHC Medicare Advantage |
$61.18
|
| Rate for Payer: VA VA |
$59.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.20
|
|
|
HC MAXIMUM VOLUNTARY VENTILATION
|
Facility
|
OP
|
$120.23
|
|
|
Service Code
|
CPT 94200
|
| Hospital Charge Code |
46000022
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$28.55 |
| Max. Negotiated Rate |
$108.21 |
| Rate for Payer: Aetna Commercial |
$102.20
|
| Rate for Payer: Aetna Medicare |
$31.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.57
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$30.06
|
| Rate for Payer: BCBS Trust/PPO |
$93.48
|
| Rate for Payer: BCN Commercial |
$93.48
|
| Rate for Payer: BCN Medicare Advantage |
$30.06
|
| Rate for Payer: Cash Price |
$96.18
|
| Rate for Payer: Cash Price |
$96.18
|
| Rate for Payer: Cofinity Commercial |
$103.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.06
|
| Rate for Payer: Healthscope Commercial |
$108.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.17
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.20
|
| Rate for Payer: PACE Senior Care Partners |
$28.55
|
| Rate for Payer: PACE SWMI |
$30.06
|
| Rate for Payer: PHP Commercial |
$102.20
|
| Rate for Payer: PHP Medicare Advantage |
$30.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.60
|
| Rate for Payer: Priority Health Medicare |
$30.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.33
|
| Rate for Payer: Railroad Medicare Medicare |
$30.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.80
|
| Rate for Payer: UHC Core |
$100.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.06
|
| Rate for Payer: UHC Medicare Advantage |
$30.96
|
| Rate for Payer: VA VA |
$30.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.17
|
|
|
HC MAXIMUM VOLUNTARY VENTILATION
|
Facility
|
IP
|
$120.23
|
|
|
Service Code
|
CPT 94200
|
| Hospital Charge Code |
46000022
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$73.33 |
| Max. Negotiated Rate |
$108.21 |
| Rate for Payer: Aetna Commercial |
$102.20
|
| Rate for Payer: BCBS Trust/PPO |
$92.91
|
| Rate for Payer: BCN Commercial |
$92.91
|
| Rate for Payer: Cash Price |
$96.18
|
| Rate for Payer: Cofinity Commercial |
$103.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.18
|
| Rate for Payer: Healthscope Commercial |
$108.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.20
|
| Rate for Payer: PHP Commercial |
$102.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.80
|
| Rate for Payer: UHC Core |
$100.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.17
|
|
|
HC MAYO CHROMOGENIC FACTOR 8
|
Facility
|
IP
|
$331.60
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500105
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$202.24 |
| Max. Negotiated Rate |
$298.44 |
| Rate for Payer: Aetna Commercial |
$281.86
|
| Rate for Payer: BCBS Trust/PPO |
$256.26
|
| Rate for Payer: BCN Commercial |
$256.26
|
| Rate for Payer: Cash Price |
$265.28
|
| Rate for Payer: Cofinity Commercial |
$285.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.28
|
| Rate for Payer: Healthscope Commercial |
$298.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$281.86
|
| Rate for Payer: PHP Commercial |
$281.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$288.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$202.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.81
|
| Rate for Payer: UHC Core |
$276.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.70
|
|
|
HC MAYO CHROMOGENIC FACTOR 8
|
Facility
|
OP
|
$331.60
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500105
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.77 |
| Max. Negotiated Rate |
$298.44 |
| Rate for Payer: Aetna Commercial |
$281.86
|
| Rate for Payer: Aetna Medicare |
$86.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.62
|
| Rate for Payer: BCBS Complete |
$9.21
|
| Rate for Payer: BCBS MAPPO |
$82.90
|
| Rate for Payer: BCBS Trust/PPO |
$257.82
|
| Rate for Payer: BCN Commercial |
$257.82
|
| Rate for Payer: BCN Medicare Advantage |
$82.90
|
| Rate for Payer: Cash Price |
$265.28
|
| Rate for Payer: Cash Price |
$265.28
|
| Rate for Payer: Cofinity Commercial |
$285.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.90
|
| Rate for Payer: Healthscope Commercial |
$298.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.70
|
| Rate for Payer: Mclaren Medicaid |
$8.77
|
| Rate for Payer: Meridian Medicaid |
$9.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$281.86
|
| Rate for Payer: PACE Senior Care Partners |
$78.76
|
| Rate for Payer: PACE SWMI |
$82.90
|
| Rate for Payer: PHP Commercial |
$281.86
|
| Rate for Payer: PHP Medicare Advantage |
$82.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$288.49
|
| Rate for Payer: Priority Health Medicare |
$82.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$202.24
|
| Rate for Payer: Railroad Medicare Medicare |
$82.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.81
|
| Rate for Payer: UHC Core |
$276.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.90
|
| Rate for Payer: UHC Medicare Advantage |
$85.39
|
| Rate for Payer: VA VA |
$82.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.70
|
|
|
HC MAYO CHROMOGENIC FACTOR 9
|
Facility
|
OP
|
$351.53
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500104
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.77 |
| Max. Negotiated Rate |
$316.38 |
| Rate for Payer: Aetna Commercial |
$298.80
|
| Rate for Payer: Aetna Medicare |
$91.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.85
|
| Rate for Payer: BCBS Complete |
$9.21
|
| Rate for Payer: BCBS MAPPO |
$87.88
|
| Rate for Payer: BCBS Trust/PPO |
$273.31
|
| Rate for Payer: BCN Commercial |
$273.31
|
| Rate for Payer: BCN Medicare Advantage |
$87.88
|
| Rate for Payer: Cash Price |
$281.22
|
| Rate for Payer: Cash Price |
$281.22
|
| Rate for Payer: Cofinity Commercial |
$302.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.88
|
| Rate for Payer: Healthscope Commercial |
$316.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.65
|
| Rate for Payer: Mclaren Medicaid |
$8.77
|
| Rate for Payer: Meridian Medicaid |
$9.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$92.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$298.80
|
| Rate for Payer: PACE Senior Care Partners |
$83.49
|
| Rate for Payer: PACE SWMI |
$87.88
|
| Rate for Payer: PHP Commercial |
$298.80
|
| Rate for Payer: PHP Medicare Advantage |
$87.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$305.83
|
| Rate for Payer: Priority Health Medicare |
$87.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.40
|
| Rate for Payer: Railroad Medicare Medicare |
$87.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.35
|
| Rate for Payer: UHC Core |
$293.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.88
|
| Rate for Payer: UHC Medicare Advantage |
$90.52
|
| Rate for Payer: VA VA |
$87.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.65
|
|
|
HC MAYO CHROMOGENIC FACTOR 9
|
Facility
|
IP
|
$351.53
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500104
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$214.40 |
| Max. Negotiated Rate |
$316.38 |
| Rate for Payer: Aetna Commercial |
$298.80
|
| Rate for Payer: BCBS Trust/PPO |
$271.66
|
| Rate for Payer: BCN Commercial |
$271.66
|
| Rate for Payer: Cash Price |
$281.22
|
| Rate for Payer: Cofinity Commercial |
$302.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.22
|
| Rate for Payer: Healthscope Commercial |
$316.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$298.80
|
| Rate for Payer: PHP Commercial |
$298.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$305.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.35
|
| Rate for Payer: UHC Core |
$293.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.65
|
|
|
HC MAYOCOMPLETE MYELOID NEOPLASMS, NGS
|
Facility
|
OP
|
$1,925.00
|
|
|
Service Code
|
CPT 81450
|
| Hospital Charge Code |
31000084
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$457.19 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: Aetna Commercial |
$1,636.25
|
| Rate for Payer: Aetna Medicare |
$500.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$601.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$601.56
|
| Rate for Payer: BCBS Complete |
$588.56
|
| Rate for Payer: BCBS MAPPO |
$481.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,496.69
|
| Rate for Payer: BCN Commercial |
$1,496.69
|
| Rate for Payer: BCN Medicare Advantage |
$481.25
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cofinity Commercial |
$1,655.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$481.25
|
| Rate for Payer: Healthscope Commercial |
$1,732.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,443.75
|
| Rate for Payer: Mclaren Medicaid |
$560.53
|
| Rate for Payer: Meridian Medicaid |
$588.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$505.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$553.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,636.25
|
| Rate for Payer: PACE Senior Care Partners |
$457.19
|
| Rate for Payer: PACE SWMI |
$481.25
|
| Rate for Payer: PHP Commercial |
$1,636.25
|
| Rate for Payer: PHP Medicare Advantage |
$481.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$560.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,674.75
|
| Rate for Payer: Priority Health Medicare |
$481.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,174.06
|
| Rate for Payer: Railroad Medicare Medicare |
$481.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,694.00
|
| Rate for Payer: UHC Core |
$1,607.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$481.25
|
| Rate for Payer: UHC Medicare Advantage |
$495.69
|
| Rate for Payer: VA VA |
$481.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,443.75
|
|
|
HC MAYOCOMPLETE MYELOID NEOPLASMS, NGS
|
Facility
|
IP
|
$1,925.00
|
|
|
Service Code
|
CPT 81450
|
| Hospital Charge Code |
31000084
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,174.06 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: Aetna Commercial |
$1,636.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,487.64
|
| Rate for Payer: BCN Commercial |
$1,487.64
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cofinity Commercial |
$1,655.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.00
|
| Rate for Payer: Healthscope Commercial |
$1,732.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,443.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,636.25
|
| Rate for Payer: PHP Commercial |
$1,636.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,674.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,174.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,694.00
|
| Rate for Payer: UHC Core |
$1,607.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,443.75
|
|
|
HC MAYO CREATININE, URINE CMPT
|
Facility
|
IP
|
$10.57
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100734
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$9.51 |
| Rate for Payer: Aetna Commercial |
$8.98
|
| Rate for Payer: BCBS Trust/PPO |
$8.17
|
| Rate for Payer: BCN Commercial |
$8.17
|
| Rate for Payer: Cash Price |
$8.46
|
| Rate for Payer: Cofinity Commercial |
$9.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.46
|
| Rate for Payer: Healthscope Commercial |
$9.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.98
|
| Rate for Payer: PHP Commercial |
$8.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.30
|
| Rate for Payer: UHC Core |
$8.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.93
|
|
|
HC MAYO CREATININE, URINE CMPT
|
Facility
|
OP
|
$10.57
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100734
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.51 |
| Max. Negotiated Rate |
$9.51 |
| Rate for Payer: Aetna Commercial |
$8.98
|
| Rate for Payer: Aetna Medicare |
$2.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.30
|
| Rate for Payer: BCBS Complete |
$4.01
|
| Rate for Payer: BCBS MAPPO |
$2.64
|
| Rate for Payer: BCBS Trust/PPO |
$8.22
|
| Rate for Payer: BCN Commercial |
$8.22
|
| Rate for Payer: BCN Medicare Advantage |
$2.64
|
| Rate for Payer: Cash Price |
$8.46
|
| Rate for Payer: Cash Price |
$8.46
|
| Rate for Payer: Cofinity Commercial |
$9.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.64
|
| Rate for Payer: Healthscope Commercial |
$9.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.93
|
| Rate for Payer: Mclaren Medicaid |
$3.82
|
| Rate for Payer: Meridian Medicaid |
$4.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.98
|
| Rate for Payer: PACE Senior Care Partners |
$2.51
|
| Rate for Payer: PACE SWMI |
$2.64
|
| Rate for Payer: PHP Commercial |
$8.98
|
| Rate for Payer: PHP Medicare Advantage |
$2.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.20
|
| Rate for Payer: Priority Health Medicare |
$2.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.45
|
| Rate for Payer: Railroad Medicare Medicare |
$2.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.30
|
| Rate for Payer: UHC Core |
$8.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.64
|
| Rate for Payer: UHC Medicare Advantage |
$2.72
|
| Rate for Payer: VA VA |
$2.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.93
|
|
|
HC MDI TREATMENT
|
Facility
|
IP
|
$146.74
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000004
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$89.50 |
| Max. Negotiated Rate |
$132.07 |
| Rate for Payer: Aetna Commercial |
$124.73
|
| Rate for Payer: BCBS Trust/PPO |
$113.40
|
| Rate for Payer: BCN Commercial |
$113.40
|
| Rate for Payer: Cash Price |
$117.39
|
| Rate for Payer: Cofinity Commercial |
$126.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.39
|
| Rate for Payer: Healthscope Commercial |
$132.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.73
|
| Rate for Payer: PHP Commercial |
$124.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.13
|
| Rate for Payer: UHC Core |
$122.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.06
|
|
|
HC MDI TREATMENT
|
Facility
|
OP
|
$146.74
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000004
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$34.85 |
| Max. Negotiated Rate |
$146.91 |
| Rate for Payer: Aetna Commercial |
$124.73
|
| Rate for Payer: Aetna Medicare |
$38.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.86
|
| Rate for Payer: BCBS Complete |
$146.91
|
| Rate for Payer: BCBS MAPPO |
$36.68
|
| Rate for Payer: BCBS Trust/PPO |
$114.09
|
| Rate for Payer: BCN Commercial |
$114.09
|
| Rate for Payer: BCN Medicare Advantage |
$36.68
|
| Rate for Payer: Cash Price |
$117.39
|
| Rate for Payer: Cash Price |
$117.39
|
| Rate for Payer: Cofinity Commercial |
$126.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.68
|
| Rate for Payer: Healthscope Commercial |
$132.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.06
|
| Rate for Payer: Mclaren Medicaid |
$139.92
|
| Rate for Payer: Meridian Medicaid |
$146.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.73
|
| Rate for Payer: PACE Senior Care Partners |
$34.85
|
| Rate for Payer: PACE SWMI |
$36.68
|
| Rate for Payer: PHP Commercial |
$124.73
|
| Rate for Payer: PHP Medicare Advantage |
$36.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.66
|
| Rate for Payer: Priority Health Medicare |
$36.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.50
|
| Rate for Payer: Railroad Medicare Medicare |
$36.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.13
|
| Rate for Payer: UHC Core |
$122.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.68
|
| Rate for Payer: UHC Medicare Advantage |
$37.79
|
| Rate for Payer: VA VA |
$36.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.06
|
|
|
HC MEADOW FESCUE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200092
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC MEADOW FESCUE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200092
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC MEASLES (RUBEOLA) IGM
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200398
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna Medicare |
$12.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.62
|
| Rate for Payer: BCBS Complete |
$9.98
|
| Rate for Payer: BCBS MAPPO |
$12.50
|
| Rate for Payer: BCBS Trust/PPO |
$38.86
|
| Rate for Payer: BCN Commercial |
$38.86
|
| Rate for Payer: BCN Medicare Advantage |
$12.50
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.50
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Mclaren Medicaid |
$9.51
|
| Rate for Payer: Meridian Medicaid |
$9.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Senior Care Partners |
$11.87
|
| Rate for Payer: PACE SWMI |
$12.50
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.48
|
| Rate for Payer: Priority Health Medicare |
$12.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.48
|
| Rate for Payer: Railroad Medicare Medicare |
$12.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.50
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: VA VA |
$12.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC MEASLES (RUBEOLA) IGM
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200398
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.48 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: BCBS Trust/PPO |
$38.62
|
| Rate for Payer: BCN Commercial |
$38.62
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.98
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC MECHANICAL REMOVAL OBSTRC CVD
|
Facility
|
IP
|
$1,537.29
|
|
|
Service Code
|
CPT 36596
|
| Hospital Charge Code |
36100143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$937.59 |
| Max. Negotiated Rate |
$1,383.56 |
| Rate for Payer: Aetna Commercial |
$1,306.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,188.02
|
| Rate for Payer: BCN Commercial |
$1,188.02
|
| Rate for Payer: Cash Price |
$1,229.83
|
| Rate for Payer: Cofinity Commercial |
$1,322.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.83
|
| Rate for Payer: Healthscope Commercial |
$1,383.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,306.70
|
| Rate for Payer: PHP Commercial |
$1,306.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,337.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$937.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.82
|
| Rate for Payer: UHC Core |
$1,283.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.97
|
|
|
HC MECHANICAL REMOVAL OBSTRC CVD
|
Facility
|
OP
|
$1,537.29
|
|
|
Service Code
|
CPT 36596
|
| Hospital Charge Code |
36100143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$365.11 |
| Max. Negotiated Rate |
$1,383.56 |
| Rate for Payer: Aetna Commercial |
$1,306.70
|
| Rate for Payer: Aetna Medicare |
$399.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$480.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$480.40
|
| Rate for Payer: BCBS Complete |
$1,103.12
|
| Rate for Payer: BCBS MAPPO |
$384.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,195.24
|
| Rate for Payer: BCN Commercial |
$1,195.24
|
| Rate for Payer: BCN Medicare Advantage |
$384.32
|
| Rate for Payer: Cash Price |
$1,229.83
|
| Rate for Payer: Cash Price |
$1,229.83
|
| Rate for Payer: Cofinity Commercial |
$1,322.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.32
|
| Rate for Payer: Healthscope Commercial |
$1,383.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.97
|
| Rate for Payer: Mclaren Medicaid |
$1,050.59
|
| Rate for Payer: Meridian Medicaid |
$1,103.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$403.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$441.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,306.70
|
| Rate for Payer: PACE Senior Care Partners |
$365.11
|
| Rate for Payer: PACE SWMI |
$384.32
|
| Rate for Payer: PHP Commercial |
$1,306.70
|
| Rate for Payer: PHP Medicare Advantage |
$384.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,050.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,337.44
|
| Rate for Payer: Priority Health Medicare |
$384.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$937.59
|
| Rate for Payer: Railroad Medicare Medicare |
$384.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.82
|
| Rate for Payer: UHC Core |
$1,283.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$384.32
|
| Rate for Payer: UHC Medicare Advantage |
$395.85
|
| Rate for Payer: VA VA |
$384.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.97
|
|
|
HC MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTION
|
Facility
|
OP
|
$2,904.48
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
36100142
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$689.81 |
| Max. Negotiated Rate |
$2,614.03 |
| Rate for Payer: Aetna Commercial |
$2,468.81
|
| Rate for Payer: Aetna Medicare |
$755.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$907.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$907.65
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$726.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,258.23
|
| Rate for Payer: BCN Commercial |
$2,258.23
|
| Rate for Payer: BCN Medicare Advantage |
$726.12
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,497.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$726.12
|
| Rate for Payer: Healthscope Commercial |
$2,614.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,178.36
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$762.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$835.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PACE Senior Care Partners |
$689.81
|
| Rate for Payer: PACE SWMI |
$726.12
|
| Rate for Payer: PHP Commercial |
$2,468.81
|
| Rate for Payer: PHP Medicare Advantage |
$726.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,526.90
|
| Rate for Payer: Priority Health Medicare |
$726.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,771.44
|
| Rate for Payer: Railroad Medicare Medicare |
$726.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,555.94
|
| Rate for Payer: UHC Core |
$2,425.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$726.12
|
| Rate for Payer: UHC Medicare Advantage |
$747.90
|
| Rate for Payer: VA VA |
$726.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,178.36
|
|
|
HC MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTION
|
Facility
|
IP
|
$2,904.48
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
36100142
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,771.44 |
| Max. Negotiated Rate |
$2,614.03 |
| Rate for Payer: Aetna Commercial |
$2,468.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,244.58
|
| Rate for Payer: BCN Commercial |
$2,244.58
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,497.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.58
|
| Rate for Payer: Healthscope Commercial |
$2,614.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,178.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PHP Commercial |
$2,468.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,526.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,771.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,555.94
|
| Rate for Payer: UHC Core |
$2,425.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,178.36
|
|
|
HC MECH CHEST WALL OSCILLATION
|
Facility
|
OP
|
$314.32
|
|
|
Service Code
|
CPT 94669
|
| Hospital Charge Code |
41000043
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$74.65 |
| Max. Negotiated Rate |
$282.89 |
| Rate for Payer: Aetna Commercial |
$267.17
|
| Rate for Payer: Aetna Medicare |
$81.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.22
|
| Rate for Payer: BCBS Complete |
$146.91
|
| Rate for Payer: BCBS MAPPO |
$78.58
|
| Rate for Payer: BCBS Trust/PPO |
$244.38
|
| Rate for Payer: BCN Commercial |
$244.38
|
| Rate for Payer: BCN Medicare Advantage |
$78.58
|
| Rate for Payer: Cash Price |
$251.46
|
| Rate for Payer: Cash Price |
$251.46
|
| Rate for Payer: Cofinity Commercial |
$270.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.58
|
| Rate for Payer: Healthscope Commercial |
$282.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$235.74
|
| Rate for Payer: Mclaren Medicaid |
$139.92
|
| Rate for Payer: Meridian Medicaid |
$146.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$82.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$267.17
|
| Rate for Payer: PACE Senior Care Partners |
$74.65
|
| Rate for Payer: PACE SWMI |
$78.58
|
| Rate for Payer: PHP Commercial |
$267.17
|
| Rate for Payer: PHP Medicare Advantage |
$78.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$273.46
|
| Rate for Payer: Priority Health Medicare |
$78.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.70
|
| Rate for Payer: Railroad Medicare Medicare |
$78.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$276.60
|
| Rate for Payer: UHC Core |
$262.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.58
|
| Rate for Payer: UHC Medicare Advantage |
$80.94
|
| Rate for Payer: VA VA |
$78.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$235.74
|
|
