|
HC HALO VEST APPLICATION
|
Facility
|
OP
|
$5,881.50
|
|
| Hospital Charge Code |
27000086
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,036.91 |
| Max. Negotiated Rate |
$5,293.35 |
| Rate for Payer: Aetna Commercial |
$4,999.27
|
| Rate for Payer: Aetna Medicare |
$1,529.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,837.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,837.97
|
| Rate for Payer: BCBS Complete |
$1,088.67
|
| Rate for Payer: BCBS MAPPO |
$1,470.38
|
| Rate for Payer: BCBS Trust/PPO |
$4,835.18
|
| Rate for Payer: BCN Commercial |
$4,835.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,470.38
|
| Rate for Payer: Cash Price |
$4,705.20
|
| Rate for Payer: Cofinity Commercial |
$5,058.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,705.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,470.38
|
| Rate for Payer: Healthscope Commercial |
$5,293.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,411.12
|
| Rate for Payer: Mclaren Medicaid |
$1,036.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,543.89
|
| Rate for Payer: Meridian Medicaid |
$1,088.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,690.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,617.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,999.27
|
| Rate for Payer: Nomi Health Commercial |
$4,822.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,411.12
|
| Rate for Payer: PACE Senior Care Partners |
$1,396.86
|
| Rate for Payer: PACE SWMI |
$1,470.38
|
| Rate for Payer: PHP Commercial |
$4,999.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,470.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,036.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,116.90
|
| Rate for Payer: Priority Health Medicare |
$1,485.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,093.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,470.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,175.72
|
| Rate for Payer: UHC Core |
$4,911.05
|
| Rate for Payer: UHC Exchange |
$1,470.38
|
| Rate for Payer: UHC Medicaid |
$1,036.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,470.38
|
| Rate for Payer: UHCCP Medicaid |
$1,036.91
|
| Rate for Payer: VA VA |
$1,470.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,411.12
|
|
|
HC HAPTOGLOGIN
|
Facility
|
OP
|
$86.35
|
|
|
Service Code
|
CPT 83010
|
| Hospital Charge Code |
30100234
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.22 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: Aetna Medicare |
$22.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.98
|
| Rate for Payer: BCBS Complete |
$15.98
|
| Rate for Payer: BCBS MAPPO |
$21.59
|
| Rate for Payer: BCBS Trust/PPO |
$70.99
|
| Rate for Payer: BCN Commercial |
$70.99
|
| Rate for Payer: BCN Medicare Advantage |
$21.59
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.59
|
| Rate for Payer: Healthscope Commercial |
$77.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.76
|
| Rate for Payer: Mclaren Medicaid |
$15.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.67
|
| Rate for Payer: Meridian Medicaid |
$15.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$70.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.76
|
| Rate for Payer: PACE Senior Care Partners |
$20.51
|
| Rate for Payer: PACE SWMI |
$21.59
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: PHP Medicare Advantage |
$21.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75.12
|
| Rate for Payer: Priority Health Medicare |
$21.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.10
|
| Rate for Payer: Railroad Medicare Medicare |
$21.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.99
|
| Rate for Payer: UHC Core |
$72.10
|
| Rate for Payer: UHC Exchange |
$21.59
|
| Rate for Payer: UHC Medicaid |
$15.22
|
| Rate for Payer: UHC Medicare Advantage |
$21.59
|
| Rate for Payer: UHCCP Medicaid |
$15.22
|
| Rate for Payer: VA VA |
$21.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.76
|
|
|
HC HAPTOGLOGIN
|
Facility
|
IP
|
$86.35
|
|
|
Service Code
|
CPT 83010
|
| Hospital Charge Code |
30100234
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$60.10 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: BCBS Trust/PPO |
$71.32
|
| Rate for Payer: BCN Commercial |
$71.32
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Healthscope Commercial |
$77.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$70.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.76
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$75.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.99
|
| Rate for Payer: UHC Core |
$72.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.76
|
|
|
HC HAZELNUT FILBERT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200043
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC HAZELNUT FILBERT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200043
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC HBC IGM AB, S
|
Facility
|
IP
|
$51.30
|
|
|
Service Code
|
CPT 86705
|
| Hospital Charge Code |
30200515
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.70 |
| Max. Negotiated Rate |
$46.17 |
| Rate for Payer: Aetna Commercial |
$43.60
|
| Rate for Payer: BCBS Trust/PPO |
$42.37
|
| Rate for Payer: BCN Commercial |
$42.37
|
| Rate for Payer: Cash Price |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$44.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.04
|
| Rate for Payer: Healthscope Commercial |
$46.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.60
|
| Rate for Payer: Nomi Health Commercial |
$42.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.48
|
| Rate for Payer: PHP Commercial |
$43.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.14
|
| Rate for Payer: UHC Core |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.48
|
|
|
HC HBC IGM AB, S
|
Facility
|
OP
|
$51.30
|
|
|
Service Code
|
CPT 86705
|
| Hospital Charge Code |
30200515
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$46.17 |
| Rate for Payer: Aetna Commercial |
$43.60
|
| Rate for Payer: Aetna Medicare |
$13.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.03
|
| Rate for Payer: BCBS Complete |
$9.50
|
| Rate for Payer: BCBS MAPPO |
$12.82
|
| Rate for Payer: BCBS Trust/PPO |
$42.17
|
| Rate for Payer: BCN Commercial |
$42.17
|
| Rate for Payer: BCN Medicare Advantage |
$12.82
|
| Rate for Payer: Cash Price |
$41.04
|
| Rate for Payer: Cofinity Commercial |
$44.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.82
|
| Rate for Payer: Healthscope Commercial |
$46.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.48
|
| Rate for Payer: Mclaren Medicaid |
$9.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.47
|
| Rate for Payer: Meridian Medicaid |
$9.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.60
|
| Rate for Payer: Nomi Health Commercial |
$42.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.48
|
| Rate for Payer: PACE Senior Care Partners |
$12.18
|
| Rate for Payer: PACE SWMI |
$12.82
|
| Rate for Payer: PHP Commercial |
$43.60
|
| Rate for Payer: PHP Medicare Advantage |
$12.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.63
|
| Rate for Payer: Priority Health Medicare |
$12.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.70
|
| Rate for Payer: Railroad Medicare Medicare |
$12.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.14
|
| Rate for Payer: UHC Core |
$42.84
|
| Rate for Payer: UHC Exchange |
$12.82
|
| Rate for Payer: UHC Medicaid |
$9.04
|
| Rate for Payer: UHC Medicare Advantage |
$12.82
|
| Rate for Payer: UHCCP Medicaid |
$9.04
|
| Rate for Payer: VA VA |
$12.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.48
|
|
|
HC HBO PER 30 MINUTES
|
Facility
|
OP
|
$667.31
|
|
|
Service Code
|
HCPCS G0277
|
| Hospital Charge Code |
41300001
|
|
Hospital Revenue Code
|
413
|
| Min. Negotiated Rate |
$117.65 |
| Max. Negotiated Rate |
$600.58 |
| Rate for Payer: Aetna Commercial |
$567.21
|
| Rate for Payer: Aetna Medicare |
$173.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$208.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$208.53
|
| Rate for Payer: BCBS Complete |
$123.52
|
| Rate for Payer: BCBS MAPPO |
$166.83
|
| Rate for Payer: BCBS Trust/PPO |
$548.60
|
| Rate for Payer: BCN Commercial |
$548.60
|
| Rate for Payer: BCN Medicare Advantage |
$166.83
|
| Rate for Payer: Cash Price |
$533.85
|
| Rate for Payer: Cofinity Commercial |
$573.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.83
|
| Rate for Payer: Healthscope Commercial |
$600.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$500.48
|
| Rate for Payer: Mclaren Medicaid |
$117.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.17
|
| Rate for Payer: Meridian Medicaid |
$123.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$191.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$183.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$567.21
|
| Rate for Payer: Nomi Health Commercial |
$547.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$500.48
|
| Rate for Payer: PACE Senior Care Partners |
$158.49
|
| Rate for Payer: PACE SWMI |
$166.83
|
| Rate for Payer: PHP Commercial |
$567.21
|
| Rate for Payer: PHP Medicare Advantage |
$166.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$580.56
|
| Rate for Payer: Priority Health Medicare |
$168.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$464.45
|
| Rate for Payer: Railroad Medicare Medicare |
$166.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$587.23
|
| Rate for Payer: UHC Core |
$557.20
|
| Rate for Payer: UHC Exchange |
$166.83
|
| Rate for Payer: UHC Medicaid |
$117.65
|
| Rate for Payer: UHC Medicare Advantage |
$166.83
|
| Rate for Payer: UHCCP Medicaid |
$117.65
|
| Rate for Payer: VA VA |
$166.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$500.48
|
|
|
HC HBO PER 30 MINUTES
|
Facility
|
IP
|
$667.31
|
|
|
Service Code
|
HCPCS G0277
|
| Hospital Charge Code |
41300001
|
|
Hospital Revenue Code
|
413
|
| Min. Negotiated Rate |
$464.45 |
| Max. Negotiated Rate |
$600.58 |
| Rate for Payer: Aetna Commercial |
$567.21
|
| Rate for Payer: BCBS Trust/PPO |
$551.13
|
| Rate for Payer: BCN Commercial |
$551.13
|
| Rate for Payer: Cash Price |
$533.85
|
| Rate for Payer: Cofinity Commercial |
$573.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.85
|
| Rate for Payer: Healthscope Commercial |
$600.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$500.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$567.21
|
| Rate for Payer: Nomi Health Commercial |
$547.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$500.48
|
| Rate for Payer: PHP Commercial |
$567.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$580.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$464.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$587.23
|
| Rate for Payer: UHC Core |
$557.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$500.48
|
|
|
HC HBO TCPO2 ARTERIAL STUDY COMPLETE
|
Facility
|
IP
|
$852.13
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100005
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$593.08 |
| Max. Negotiated Rate |
$766.92 |
| Rate for Payer: Aetna Commercial |
$724.31
|
| Rate for Payer: BCBS Trust/PPO |
$703.77
|
| Rate for Payer: BCN Commercial |
$703.77
|
| Rate for Payer: Cash Price |
$681.70
|
| Rate for Payer: Cofinity Commercial |
$732.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$681.70
|
| Rate for Payer: Healthscope Commercial |
$766.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$639.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$724.31
|
| Rate for Payer: Nomi Health Commercial |
$698.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$639.10
|
| Rate for Payer: PHP Commercial |
$724.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$741.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$593.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$749.87
|
| Rate for Payer: UHC Core |
$711.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$639.10
|
|
|
HC HBO TCPO2 ARTERIAL STUDY COMPLETE
|
Facility
|
OP
|
$852.13
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100005
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$150.23 |
| Max. Negotiated Rate |
$766.92 |
| Rate for Payer: Aetna Commercial |
$724.31
|
| Rate for Payer: Aetna Medicare |
$221.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$266.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$266.29
|
| Rate for Payer: BCBS Complete |
$157.73
|
| Rate for Payer: BCBS MAPPO |
$213.03
|
| Rate for Payer: BCBS Trust/PPO |
$700.54
|
| Rate for Payer: BCN Commercial |
$700.54
|
| Rate for Payer: BCN Medicare Advantage |
$213.03
|
| Rate for Payer: Cash Price |
$681.70
|
| Rate for Payer: Cofinity Commercial |
$732.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$681.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.03
|
| Rate for Payer: Healthscope Commercial |
$766.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$639.10
|
| Rate for Payer: Mclaren Medicaid |
$150.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$223.68
|
| Rate for Payer: Meridian Medicaid |
$157.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$244.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$234.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$724.31
|
| Rate for Payer: Nomi Health Commercial |
$698.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$639.10
|
| Rate for Payer: PACE Senior Care Partners |
$202.38
|
| Rate for Payer: PACE SWMI |
$213.03
|
| Rate for Payer: PHP Commercial |
$724.31
|
| Rate for Payer: PHP Medicare Advantage |
$213.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$741.35
|
| Rate for Payer: Priority Health Medicare |
$215.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$593.08
|
| Rate for Payer: Railroad Medicare Medicare |
$213.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$749.87
|
| Rate for Payer: UHC Core |
$711.53
|
| Rate for Payer: UHC Exchange |
$213.03
|
| Rate for Payer: UHC Medicaid |
$150.23
|
| Rate for Payer: UHC Medicare Advantage |
$213.03
|
| Rate for Payer: UHCCP Medicaid |
$150.23
|
| Rate for Payer: VA VA |
$213.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$639.10
|
|
|
HC HBO TCPO2 ARTERIAL STUDY UNILATERAL OR LIMITED
|
Facility
|
OP
|
$546.48
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100033
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$96.34 |
| Max. Negotiated Rate |
$491.83 |
| Rate for Payer: Aetna Commercial |
$464.51
|
| Rate for Payer: Aetna Medicare |
$142.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$170.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$170.78
|
| Rate for Payer: BCBS Complete |
$101.15
|
| Rate for Payer: BCBS MAPPO |
$136.62
|
| Rate for Payer: BCBS Trust/PPO |
$449.26
|
| Rate for Payer: BCN Commercial |
$449.26
|
| Rate for Payer: BCN Medicare Advantage |
$136.62
|
| Rate for Payer: Cash Price |
$437.18
|
| Rate for Payer: Cofinity Commercial |
$469.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$437.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.62
|
| Rate for Payer: Healthscope Commercial |
$491.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.86
|
| Rate for Payer: Mclaren Medicaid |
$96.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.45
|
| Rate for Payer: Meridian Medicaid |
$101.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$157.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$464.51
|
| Rate for Payer: Nomi Health Commercial |
$448.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.86
|
| Rate for Payer: PACE Senior Care Partners |
$129.79
|
| Rate for Payer: PACE SWMI |
$136.62
|
| Rate for Payer: PHP Commercial |
$464.51
|
| Rate for Payer: PHP Medicare Advantage |
$136.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$475.44
|
| Rate for Payer: Priority Health Medicare |
$137.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$380.35
|
| Rate for Payer: Railroad Medicare Medicare |
$136.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.90
|
| Rate for Payer: UHC Core |
$456.31
|
| Rate for Payer: UHC Exchange |
$136.62
|
| Rate for Payer: UHC Medicaid |
$96.34
|
| Rate for Payer: UHC Medicare Advantage |
$136.62
|
| Rate for Payer: UHCCP Medicaid |
$96.34
|
| Rate for Payer: VA VA |
$136.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.86
|
|
|
HC HBO TCPO2 ARTERIAL STUDY UNILATERAL OR LIMITED
|
Facility
|
IP
|
$546.48
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100033
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$380.35 |
| Max. Negotiated Rate |
$491.83 |
| Rate for Payer: Aetna Commercial |
$464.51
|
| Rate for Payer: BCBS Trust/PPO |
$451.34
|
| Rate for Payer: BCN Commercial |
$451.34
|
| Rate for Payer: Cash Price |
$437.18
|
| Rate for Payer: Cofinity Commercial |
$469.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$437.18
|
| Rate for Payer: Healthscope Commercial |
$491.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$464.51
|
| Rate for Payer: Nomi Health Commercial |
$448.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.86
|
| Rate for Payer: PHP Commercial |
$464.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$475.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$380.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.90
|
| Rate for Payer: UHC Core |
$456.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.86
|
|
|
HC HCCORO/CABG ANGIOS ONLY
|
Facility
|
OP
|
$6,615.80
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
48100014
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,166.37 |
| Max. Negotiated Rate |
$5,954.22 |
| Rate for Payer: Aetna Commercial |
$5,623.43
|
| Rate for Payer: Aetna Medicare |
$1,720.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,067.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,067.44
|
| Rate for Payer: BCBS Complete |
$1,224.58
|
| Rate for Payer: BCBS MAPPO |
$1,653.95
|
| Rate for Payer: BCBS Trust/PPO |
$5,438.85
|
| Rate for Payer: BCN Commercial |
$5,438.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,653.95
|
| Rate for Payer: Cash Price |
$5,292.64
|
| Rate for Payer: Cofinity Commercial |
$5,689.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,292.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,653.95
|
| Rate for Payer: Healthscope Commercial |
$5,954.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,961.85
|
| Rate for Payer: Mclaren Medicaid |
$1,166.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,736.65
|
| Rate for Payer: Meridian Medicaid |
$1,224.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,902.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,819.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,623.43
|
| Rate for Payer: Nomi Health Commercial |
$5,424.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,961.85
|
| Rate for Payer: PACE Senior Care Partners |
$1,571.25
|
| Rate for Payer: PACE SWMI |
$1,653.95
|
| Rate for Payer: PHP Commercial |
$5,623.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,653.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,166.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,755.75
|
| Rate for Payer: Priority Health Medicare |
$1,670.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,604.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,653.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,821.90
|
| Rate for Payer: UHC Core |
$5,524.19
|
| Rate for Payer: UHC Exchange |
$1,653.95
|
| Rate for Payer: UHC Medicaid |
$1,166.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,653.95
|
| Rate for Payer: UHCCP Medicaid |
$1,166.37
|
| Rate for Payer: VA VA |
$1,653.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,961.85
|
|
|
HC HCCORO/CABG ANGIOS ONLY
|
Facility
|
IP
|
$6,615.80
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
48100014
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,604.60 |
| Max. Negotiated Rate |
$5,954.22 |
| Rate for Payer: Aetna Commercial |
$5,623.43
|
| Rate for Payer: BCBS Trust/PPO |
$5,463.99
|
| Rate for Payer: BCN Commercial |
$5,463.99
|
| Rate for Payer: Cash Price |
$5,292.64
|
| Rate for Payer: Cofinity Commercial |
$5,689.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,292.64
|
| Rate for Payer: Healthscope Commercial |
$5,954.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,961.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,623.43
|
| Rate for Payer: Nomi Health Commercial |
$5,424.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,961.85
|
| Rate for Payer: PHP Commercial |
$5,623.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,755.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,604.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,821.90
|
| Rate for Payer: UHC Core |
$5,524.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,961.85
|
|
|
HC HCG SERUM QUANTITATIVE
|
Facility
|
IP
|
$64.73
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
30100465
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.05 |
| Max. Negotiated Rate |
$58.26 |
| Rate for Payer: Aetna Commercial |
$55.02
|
| Rate for Payer: BCBS Trust/PPO |
$53.46
|
| Rate for Payer: BCN Commercial |
$53.46
|
| Rate for Payer: Cash Price |
$51.78
|
| Rate for Payer: Cofinity Commercial |
$55.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.78
|
| Rate for Payer: Healthscope Commercial |
$58.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.02
|
| Rate for Payer: Nomi Health Commercial |
$53.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.55
|
| Rate for Payer: PHP Commercial |
$55.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.96
|
| Rate for Payer: UHC Core |
$54.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.55
|
|
|
HC HCG SERUM QUANTITATIVE
|
Facility
|
OP
|
$64.73
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
30100465
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.41 |
| Max. Negotiated Rate |
$58.26 |
| Rate for Payer: Aetna Commercial |
$55.02
|
| Rate for Payer: Aetna Medicare |
$16.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.23
|
| Rate for Payer: BCBS Complete |
$11.98
|
| Rate for Payer: BCBS MAPPO |
$16.18
|
| Rate for Payer: BCBS Trust/PPO |
$53.21
|
| Rate for Payer: BCN Commercial |
$53.21
|
| Rate for Payer: BCN Medicare Advantage |
$16.18
|
| Rate for Payer: Cash Price |
$51.78
|
| Rate for Payer: Cofinity Commercial |
$55.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.18
|
| Rate for Payer: Healthscope Commercial |
$58.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.55
|
| Rate for Payer: Mclaren Medicaid |
$11.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.99
|
| Rate for Payer: Meridian Medicaid |
$11.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.02
|
| Rate for Payer: Nomi Health Commercial |
$53.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.55
|
| Rate for Payer: PACE Senior Care Partners |
$15.37
|
| Rate for Payer: PACE SWMI |
$16.18
|
| Rate for Payer: PHP Commercial |
$55.02
|
| Rate for Payer: PHP Medicare Advantage |
$16.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.32
|
| Rate for Payer: Priority Health Medicare |
$16.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.05
|
| Rate for Payer: Railroad Medicare Medicare |
$16.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.96
|
| Rate for Payer: UHC Core |
$54.05
|
| Rate for Payer: UHC Exchange |
$16.18
|
| Rate for Payer: UHC Medicaid |
$11.41
|
| Rate for Payer: UHC Medicare Advantage |
$16.18
|
| Rate for Payer: UHCCP Medicaid |
$11.41
|
| Rate for Payer: VA VA |
$16.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.55
|
|
|
HC HCV GENOTYPE RESOLUTION
|
Facility
|
OP
|
$411.56
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
30600262
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$72.56 |
| Max. Negotiated Rate |
$370.40 |
| Rate for Payer: Aetna Commercial |
$349.83
|
| Rate for Payer: Aetna Medicare |
$107.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$128.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$128.61
|
| Rate for Payer: BCBS Complete |
$76.18
|
| Rate for Payer: BCBS MAPPO |
$102.89
|
| Rate for Payer: BCBS Trust/PPO |
$338.34
|
| Rate for Payer: BCN Commercial |
$338.34
|
| Rate for Payer: BCN Medicare Advantage |
$102.89
|
| Rate for Payer: Cash Price |
$329.25
|
| Rate for Payer: Cofinity Commercial |
$353.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.89
|
| Rate for Payer: Healthscope Commercial |
$370.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$308.67
|
| Rate for Payer: Mclaren Medicaid |
$72.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.03
|
| Rate for Payer: Meridian Medicaid |
$76.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$113.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.83
|
| Rate for Payer: Nomi Health Commercial |
$337.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$308.67
|
| Rate for Payer: PACE Senior Care Partners |
$97.75
|
| Rate for Payer: PACE SWMI |
$102.89
|
| Rate for Payer: PHP Commercial |
$349.83
|
| Rate for Payer: PHP Medicare Advantage |
$102.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$358.06
|
| Rate for Payer: Priority Health Medicare |
$103.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$286.45
|
| Rate for Payer: Railroad Medicare Medicare |
$102.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.17
|
| Rate for Payer: UHC Core |
$343.65
|
| Rate for Payer: UHC Exchange |
$102.89
|
| Rate for Payer: UHC Medicaid |
$72.56
|
| Rate for Payer: UHC Medicare Advantage |
$102.89
|
| Rate for Payer: UHCCP Medicaid |
$72.56
|
| Rate for Payer: VA VA |
$102.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$308.67
|
|
|
HC HCV GENOTYPE RESOLUTION
|
Facility
|
IP
|
$411.56
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
30600262
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$286.45 |
| Max. Negotiated Rate |
$370.40 |
| Rate for Payer: Aetna Commercial |
$349.83
|
| Rate for Payer: BCBS Trust/PPO |
$339.91
|
| Rate for Payer: BCN Commercial |
$339.91
|
| Rate for Payer: Cash Price |
$329.25
|
| Rate for Payer: Cofinity Commercial |
$353.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.25
|
| Rate for Payer: Healthscope Commercial |
$370.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$308.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.83
|
| Rate for Payer: Nomi Health Commercial |
$337.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$308.67
|
| Rate for Payer: PHP Commercial |
$349.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$358.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$286.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.17
|
| Rate for Payer: UHC Core |
$343.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$308.67
|
|
|
HC HDL CHOLESTEROL
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100282
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.15 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: BCBS Trust/PPO |
$26.29
|
| Rate for Payer: BCN Commercial |
$26.29
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.01
|
| Rate for Payer: UHC Core |
$26.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC HDL CHOLESTEROL
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100282
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Medicare |
$8.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.95
|
| Rate for Payer: BCBS Complete |
$5.89
|
| Rate for Payer: BCBS MAPPO |
$7.96
|
| Rate for Payer: BCBS Trust/PPO |
$26.17
|
| Rate for Payer: BCN Commercial |
$26.17
|
| Rate for Payer: BCN Medicare Advantage |
$7.96
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.96
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Mclaren Medicaid |
$5.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.36
|
| Rate for Payer: Meridian Medicaid |
$5.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PACE Senior Care Partners |
$7.56
|
| Rate for Payer: PACE SWMI |
$7.96
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: PHP Medicare Advantage |
$7.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.69
|
| Rate for Payer: Priority Health Medicare |
$8.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.15
|
| Rate for Payer: Railroad Medicare Medicare |
$7.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.01
|
| Rate for Payer: UHC Core |
$26.58
|
| Rate for Payer: UHC Exchange |
$7.96
|
| Rate for Payer: UHC Medicaid |
$5.61
|
| Rate for Payer: UHC Medicare Advantage |
$7.96
|
| Rate for Payer: UHCCP Medicaid |
$5.61
|
| Rate for Payer: VA VA |
$7.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC HDL CHOLESTEROL LMPP
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100690
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$17.53
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC HDL CHOLESTEROL LMPP
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100690
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC HDR 1 CHANNEL
|
Facility
|
IP
|
$2,029.45
|
|
|
Service Code
|
CPT 77770
|
| Hospital Charge Code |
33300055
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,412.50 |
| Max. Negotiated Rate |
$1,826.51 |
| Rate for Payer: Aetna Commercial |
$1,725.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,676.12
|
| Rate for Payer: BCN Commercial |
$1,676.12
|
| Rate for Payer: Cash Price |
$1,623.56
|
| Rate for Payer: Cofinity Commercial |
$1,745.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,623.56
|
| Rate for Payer: Healthscope Commercial |
$1,826.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,522.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,725.03
|
| Rate for Payer: Nomi Health Commercial |
$1,664.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,522.09
|
| Rate for Payer: PHP Commercial |
$1,725.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,765.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,412.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,785.92
|
| Rate for Payer: UHC Core |
$1,694.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,522.09
|
|
|
HC HDR 1 CHANNEL
|
Facility
|
OP
|
$2,029.45
|
|
|
Service Code
|
CPT 77770
|
| Hospital Charge Code |
33300055
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$357.79 |
| Max. Negotiated Rate |
$1,826.51 |
| Rate for Payer: Aetna Commercial |
$1,725.03
|
| Rate for Payer: Aetna Medicare |
$527.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$634.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$634.20
|
| Rate for Payer: BCBS Complete |
$375.65
|
| Rate for Payer: BCBS MAPPO |
$507.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,668.41
|
| Rate for Payer: BCN Commercial |
$1,668.41
|
| Rate for Payer: BCN Medicare Advantage |
$507.36
|
| Rate for Payer: Cash Price |
$1,623.56
|
| Rate for Payer: Cofinity Commercial |
$1,745.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,623.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$507.36
|
| Rate for Payer: Healthscope Commercial |
$1,826.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,522.09
|
| Rate for Payer: Mclaren Medicaid |
$357.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$532.73
|
| Rate for Payer: Meridian Medicaid |
$375.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$583.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$558.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,725.03
|
| Rate for Payer: Nomi Health Commercial |
$1,664.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,522.09
|
| Rate for Payer: PACE Senior Care Partners |
$481.99
|
| Rate for Payer: PACE SWMI |
$507.36
|
| Rate for Payer: PHP Commercial |
$1,725.03
|
| Rate for Payer: PHP Medicare Advantage |
$507.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,765.62
|
| Rate for Payer: Priority Health Medicare |
$512.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,412.50
|
| Rate for Payer: Railroad Medicare Medicare |
$507.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,785.92
|
| Rate for Payer: UHC Core |
$1,694.59
|
| Rate for Payer: UHC Exchange |
$507.36
|
| Rate for Payer: UHC Medicaid |
$357.79
|
| Rate for Payer: UHC Medicare Advantage |
$507.36
|
| Rate for Payer: UHCCP Medicaid |
$357.79
|
| Rate for Payer: VA VA |
$507.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,522.09
|
|
