|
HC MECH CHEST WALL OSCILLATION
|
Facility
|
IP
|
$314.32
|
|
|
Service Code
|
CPT 94669
|
| Hospital Charge Code |
41000043
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$191.70 |
| Max. Negotiated Rate |
$282.89 |
| Rate for Payer: Aetna Commercial |
$267.17
|
| Rate for Payer: BCBS Trust/PPO |
$242.91
|
| Rate for Payer: BCN Commercial |
$242.91
|
| 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: Healthscope Commercial |
$282.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$235.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$267.17
|
| Rate for Payer: PHP Commercial |
$267.17
|
| 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 Narrow/Tiered Network |
$191.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$276.60
|
| Rate for Payer: UHC Core |
$262.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$235.74
|
|
|
HC MECH VENT INITIAL DAY
|
Facility
|
OP
|
$1,477.22
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000002
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$350.84 |
| Max. Negotiated Rate |
$1,329.50 |
| Rate for Payer: Aetna Commercial |
$1,255.64
|
| Rate for Payer: Aetna Medicare |
$384.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$461.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$461.63
|
| Rate for Payer: BCBS Complete |
$431.64
|
| Rate for Payer: BCBS MAPPO |
$369.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,148.54
|
| Rate for Payer: BCN Commercial |
$1,148.54
|
| Rate for Payer: BCN Medicare Advantage |
$369.30
|
| Rate for Payer: Cash Price |
$1,181.78
|
| Rate for Payer: Cash Price |
$1,181.78
|
| Rate for Payer: Cofinity Commercial |
$1,270.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,181.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$369.30
|
| Rate for Payer: Healthscope Commercial |
$1,329.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,107.92
|
| Rate for Payer: Mclaren Medicaid |
$411.09
|
| Rate for Payer: Meridian Medicaid |
$431.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$387.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$424.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,255.64
|
| Rate for Payer: PACE Senior Care Partners |
$350.84
|
| Rate for Payer: PACE SWMI |
$369.30
|
| Rate for Payer: PHP Commercial |
$1,255.64
|
| Rate for Payer: PHP Medicare Advantage |
$369.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,285.18
|
| Rate for Payer: Priority Health Medicare |
$369.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$900.96
|
| Rate for Payer: Railroad Medicare Medicare |
$369.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,299.95
|
| Rate for Payer: UHC Core |
$1,233.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$369.30
|
| Rate for Payer: UHC Medicare Advantage |
$380.38
|
| Rate for Payer: VA VA |
$369.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,107.92
|
|
|
HC MECH VENT INITIAL DAY
|
Facility
|
IP
|
$1,477.22
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000002
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$900.96 |
| Max. Negotiated Rate |
$1,329.50 |
| Rate for Payer: Aetna Commercial |
$1,255.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,141.60
|
| Rate for Payer: BCN Commercial |
$1,141.60
|
| Rate for Payer: Cash Price |
$1,181.78
|
| Rate for Payer: Cofinity Commercial |
$1,270.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,181.78
|
| Rate for Payer: Healthscope Commercial |
$1,329.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,107.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,255.64
|
| Rate for Payer: PHP Commercial |
$1,255.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,285.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$900.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,299.95
|
| Rate for Payer: UHC Core |
$1,233.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,107.92
|
|
|
HC MECH VENT SUBS DAYS
|
Facility
|
OP
|
$1,286.86
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000003
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$305.63 |
| Max. Negotiated Rate |
$1,158.17 |
| Rate for Payer: Aetna Commercial |
$1,093.83
|
| Rate for Payer: Aetna Medicare |
$334.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$402.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$402.14
|
| Rate for Payer: BCBS Complete |
$431.64
|
| Rate for Payer: BCBS MAPPO |
$321.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,000.53
|
| Rate for Payer: BCN Commercial |
$1,000.53
|
| Rate for Payer: BCN Medicare Advantage |
$321.72
|
| Rate for Payer: Cash Price |
$1,029.49
|
| Rate for Payer: Cash Price |
$1,029.49
|
| Rate for Payer: Cofinity Commercial |
$1,106.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,029.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$321.72
|
| Rate for Payer: Healthscope Commercial |
$1,158.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$965.14
|
| Rate for Payer: Mclaren Medicaid |
$411.09
|
| Rate for Payer: Meridian Medicaid |
$431.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$337.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$369.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,093.83
|
| Rate for Payer: PACE Senior Care Partners |
$305.63
|
| Rate for Payer: PACE SWMI |
$321.72
|
| Rate for Payer: PHP Commercial |
$1,093.83
|
| Rate for Payer: PHP Medicare Advantage |
$321.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,119.57
|
| Rate for Payer: Priority Health Medicare |
$321.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$784.86
|
| Rate for Payer: Railroad Medicare Medicare |
$321.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,132.44
|
| Rate for Payer: UHC Core |
$1,074.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$321.72
|
| Rate for Payer: UHC Medicare Advantage |
$331.37
|
| Rate for Payer: VA VA |
$321.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$965.14
|
|
|
HC MECH VENT SUBS DAYS
|
Facility
|
IP
|
$1,286.86
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000003
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$784.86 |
| Max. Negotiated Rate |
$1,158.17 |
| Rate for Payer: Aetna Commercial |
$1,093.83
|
| Rate for Payer: BCBS Trust/PPO |
$994.49
|
| Rate for Payer: BCN Commercial |
$994.49
|
| Rate for Payer: Cash Price |
$1,029.49
|
| Rate for Payer: Cofinity Commercial |
$1,106.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,029.49
|
| Rate for Payer: Healthscope Commercial |
$1,158.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$965.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,093.83
|
| Rate for Payer: PHP Commercial |
$1,093.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,119.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$784.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,132.44
|
| Rate for Payer: UHC Core |
$1,074.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$965.14
|
|
|
HC MECONIUM AMPHETAMINE CONFIRM
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30000099
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$70.14 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: BCBS Trust/PPO |
$88.87
|
| Rate for Payer: BCN Commercial |
$88.87
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM AMPHETAMINE CONFIRM
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30000099
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.31 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna Medicare |
$29.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.94
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: BCBS MAPPO |
$28.75
|
| Rate for Payer: BCBS Trust/PPO |
$89.41
|
| Rate for Payer: BCN Commercial |
$89.41
|
| Rate for Payer: BCN Medicare Advantage |
$28.75
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.75
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PACE Senior Care Partners |
$27.31
|
| Rate for Payer: PACE SWMI |
$28.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Medicare |
$28.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: Railroad Medicare Medicare |
$28.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.75
|
| Rate for Payer: UHC Medicare Advantage |
$29.61
|
| Rate for Payer: VA VA |
$28.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM BENZODIAZAPINE CONFIRMATION
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30000102
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.31 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna Medicare |
$29.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.94
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: BCBS MAPPO |
$28.75
|
| Rate for Payer: BCBS Trust/PPO |
$89.41
|
| Rate for Payer: BCN Commercial |
$89.41
|
| Rate for Payer: BCN Medicare Advantage |
$28.75
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.75
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PACE Senior Care Partners |
$27.31
|
| Rate for Payer: PACE SWMI |
$28.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Medicare |
$28.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: Railroad Medicare Medicare |
$28.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.75
|
| Rate for Payer: UHC Medicare Advantage |
$29.61
|
| Rate for Payer: VA VA |
$28.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM BENZODIAZAPINE CONFIRMATION
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30000102
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$70.14 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: BCBS Trust/PPO |
$88.87
|
| Rate for Payer: BCN Commercial |
$88.87
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM BUPRENORPHINE CONFIRMATION
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30000100
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.31 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna Medicare |
$29.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.94
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: BCBS MAPPO |
$28.75
|
| Rate for Payer: BCBS Trust/PPO |
$89.41
|
| Rate for Payer: BCN Commercial |
$89.41
|
| Rate for Payer: BCN Medicare Advantage |
$28.75
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.75
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PACE Senior Care Partners |
$27.31
|
| Rate for Payer: PACE SWMI |
$28.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Medicare |
$28.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: Railroad Medicare Medicare |
$28.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.75
|
| Rate for Payer: UHC Medicare Advantage |
$29.61
|
| Rate for Payer: VA VA |
$28.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM BUPRENORPHINE CONFIRMATION
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30000100
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$70.14 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: BCBS Trust/PPO |
$88.87
|
| Rate for Payer: BCN Commercial |
$88.87
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM DRUG SCRN EA
|
Facility
|
OP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000144
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.01 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: Aetna Medicare |
$24.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.96
|
| Rate for Payer: BCBS Complete |
$48.15
|
| Rate for Payer: BCBS MAPPO |
$23.17
|
| Rate for Payer: BCBS Trust/PPO |
$72.06
|
| Rate for Payer: BCN Commercial |
$72.06
|
| Rate for Payer: BCN Medicare Advantage |
$23.17
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.17
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$48.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PACE Senior Care Partners |
$22.01
|
| Rate for Payer: PACE SWMI |
$23.17
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: PHP Medicare Advantage |
$23.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Medicare |
$23.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: Railroad Medicare Medicare |
$23.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.17
|
| Rate for Payer: UHC Medicare Advantage |
$23.87
|
| Rate for Payer: VA VA |
$23.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC MECONIUM DRUG SCRN EA
|
Facility
|
IP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000144
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.53 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: BCBS Trust/PPO |
$71.62
|
| Rate for Payer: BCN Commercial |
$71.62
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC MECONIUM DRUG SCRN MULTI DRUGS.
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100653
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.21 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: BCBS Trust/PPO |
$78.83
|
| Rate for Payer: BCN Commercial |
$78.83
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.76
|
| Rate for Payer: UHC Core |
$85.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
|
HC MECONIUM DRUG SCRN MULTI DRUGS.
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100653
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.22 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: Aetna Medicare |
$26.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.88
|
| Rate for Payer: BCBS Complete |
$48.15
|
| Rate for Payer: BCBS MAPPO |
$25.50
|
| Rate for Payer: BCBS Trust/PPO |
$79.30
|
| Rate for Payer: BCN Commercial |
$79.30
|
| Rate for Payer: BCN Medicare Advantage |
$25.50
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.50
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$48.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.70
|
| Rate for Payer: PACE Senior Care Partners |
$24.22
|
| Rate for Payer: PACE SWMI |
$25.50
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: PHP Medicare Advantage |
$25.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.74
|
| Rate for Payer: Priority Health Medicare |
$25.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.21
|
| Rate for Payer: Railroad Medicare Medicare |
$25.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.76
|
| Rate for Payer: UHC Core |
$85.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.50
|
| Rate for Payer: UHC Medicare Advantage |
$26.26
|
| Rate for Payer: VA VA |
$25.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
|
HC MECONIUM OPIATES CONFIRMATION
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100577
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.14 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: BCBS Trust/PPO |
$88.87
|
| Rate for Payer: BCN Commercial |
$88.87
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM OPIATES CONFIRMATION
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100577
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.31 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna Medicare |
$29.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.94
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: BCBS MAPPO |
$28.75
|
| Rate for Payer: BCBS Trust/PPO |
$89.41
|
| Rate for Payer: BCN Commercial |
$89.41
|
| Rate for Payer: BCN Medicare Advantage |
$28.75
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.75
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PACE Senior Care Partners |
$27.31
|
| Rate for Payer: PACE SWMI |
$28.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Medicare |
$28.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: Railroad Medicare Medicare |
$28.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.75
|
| Rate for Payer: UHC Medicare Advantage |
$29.61
|
| Rate for Payer: VA VA |
$28.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM OXYCODONE CONFIRMATION
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 80365
|
| Hospital Charge Code |
30000104
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.31 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna Medicare |
$29.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.94
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: BCBS MAPPO |
$28.75
|
| Rate for Payer: BCBS Trust/PPO |
$89.41
|
| Rate for Payer: BCN Commercial |
$89.41
|
| Rate for Payer: BCN Medicare Advantage |
$28.75
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.75
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PACE Senior Care Partners |
$27.31
|
| Rate for Payer: PACE SWMI |
$28.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Medicare |
$28.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: Railroad Medicare Medicare |
$28.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.75
|
| Rate for Payer: UHC Medicare Advantage |
$29.61
|
| Rate for Payer: VA VA |
$28.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM OXYCODONE CONFIRMATION
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 80365
|
| Hospital Charge Code |
30000104
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$70.14 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: BCBS Trust/PPO |
$88.87
|
| Rate for Payer: BCN Commercial |
$88.87
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM THC CONFIRMATION
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 80349
|
| Hospital Charge Code |
30100567
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.14 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: BCBS Trust/PPO |
$88.87
|
| Rate for Payer: BCN Commercial |
$88.87
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM THC CONFIRMATION
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 80349
|
| Hospital Charge Code |
30100567
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.31 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna Medicare |
$29.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.94
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: BCBS MAPPO |
$28.75
|
| Rate for Payer: BCBS Trust/PPO |
$89.41
|
| Rate for Payer: BCN Commercial |
$89.41
|
| Rate for Payer: BCN Medicare Advantage |
$28.75
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.75
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PACE Senior Care Partners |
$27.31
|
| Rate for Payer: PACE SWMI |
$28.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Medicare |
$28.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: Railroad Medicare Medicare |
$28.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.75
|
| Rate for Payer: UHC Medicare Advantage |
$29.61
|
| Rate for Payer: VA VA |
$28.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM TRAMADOL CONFIRMATION
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 80373
|
| Hospital Charge Code |
30000101
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.31 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna Medicare |
$29.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.94
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: BCBS MAPPO |
$28.75
|
| Rate for Payer: BCBS Trust/PPO |
$89.41
|
| Rate for Payer: BCN Commercial |
$89.41
|
| Rate for Payer: BCN Medicare Advantage |
$28.75
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.75
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PACE Senior Care Partners |
$27.31
|
| Rate for Payer: PACE SWMI |
$28.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Medicare |
$28.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: Railroad Medicare Medicare |
$28.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.75
|
| Rate for Payer: UHC Medicare Advantage |
$29.61
|
| Rate for Payer: VA VA |
$28.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM TRAMADOL CONFIRMATION
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 80373
|
| Hospital Charge Code |
30000101
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$70.14 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: BCBS Trust/PPO |
$88.87
|
| Rate for Payer: BCN Commercial |
$88.87
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.20
|
| Rate for Payer: UHC Core |
$96.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MEDICAL NUTRITION TX EACH 15"
|
Facility
|
OP
|
$63.86
|
|
|
Service Code
|
HCPCS G0270
|
| Hospital Charge Code |
94200008
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$15.17 |
| Max. Negotiated Rate |
$57.47 |
| Rate for Payer: Aetna Commercial |
$54.28
|
| Rate for Payer: Aetna Medicare |
$16.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.96
|
| Rate for Payer: BCBS Complete |
$25.54
|
| Rate for Payer: BCBS MAPPO |
$15.96
|
| Rate for Payer: BCBS Trust/PPO |
$49.65
|
| Rate for Payer: BCN Commercial |
$49.65
|
| Rate for Payer: BCN Medicare Advantage |
$15.96
|
| Rate for Payer: Cash Price |
$51.09
|
| Rate for Payer: Cofinity Commercial |
$54.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.96
|
| Rate for Payer: Healthscope Commercial |
$57.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.28
|
| Rate for Payer: PACE Senior Care Partners |
$15.17
|
| Rate for Payer: PACE SWMI |
$15.96
|
| Rate for Payer: PHP Commercial |
$54.28
|
| Rate for Payer: PHP Medicare Advantage |
$15.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.56
|
| Rate for Payer: Priority Health Medicare |
$15.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.95
|
| Rate for Payer: Railroad Medicare Medicare |
$15.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.20
|
| Rate for Payer: UHC Core |
$53.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.96
|
| Rate for Payer: UHC Medicare Advantage |
$16.44
|
| Rate for Payer: VA VA |
$15.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.90
|
|
|
HC MEDICAL NUTRITION TX EACH 15"
|
Facility
|
IP
|
$63.86
|
|
|
Service Code
|
HCPCS G0270
|
| Hospital Charge Code |
94200008
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$38.95 |
| Max. Negotiated Rate |
$57.47 |
| Rate for Payer: Aetna Commercial |
$54.28
|
| Rate for Payer: BCBS Trust/PPO |
$49.35
|
| Rate for Payer: BCN Commercial |
$49.35
|
| Rate for Payer: Cash Price |
$51.09
|
| Rate for Payer: Cofinity Commercial |
$54.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.09
|
| Rate for Payer: Healthscope Commercial |
$57.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.28
|
| Rate for Payer: PHP Commercial |
$54.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.20
|
| Rate for Payer: UHC Core |
$53.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.90
|
|
