|
HC MENENCEPH CMPT 4
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200250
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$11.15
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$10.62
|
| Rate for Payer: Meridian Medicaid |
$11.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 5
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200253
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$13.06 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$12.44
|
| Rate for Payer: Meridian Medicaid |
$13.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 5
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200253
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 6
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
30200257
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$10.22
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$9.73
|
| Rate for Payer: Meridian Medicaid |
$10.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 6
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
30200257
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 7
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
30200282
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 7
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
30200282
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$10.22
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$9.73
|
| Rate for Payer: Meridian Medicaid |
$10.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 8
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
30200284
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 8
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
30200284
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$14.99 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$14.99
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$14.28
|
| Rate for Payer: Meridian Medicaid |
$14.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 9
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86727
|
| Hospital Charge Code |
30200304
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENENCEPH CMPT 9
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86727
|
| Hospital Charge Code |
30200304
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$9.97
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$9.50
|
| Rate for Payer: Meridian Medicaid |
$9.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENIGOCOCCAL, QUADRIVALENT (MCV4 OR MENACWY) IM
|
Facility
|
IP
|
$157.08
|
|
|
Service Code
|
CPT 90734
|
| Hospital Charge Code |
63600085
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$95.80 |
| Max. Negotiated Rate |
$141.37 |
| Rate for Payer: Aetna Commercial |
$133.52
|
| Rate for Payer: BCBS Trust/PPO |
$121.39
|
| Rate for Payer: BCN Commercial |
$121.39
|
| Rate for Payer: Cash Price |
$125.66
|
| Rate for Payer: Cofinity Commercial |
$135.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.66
|
| Rate for Payer: Healthscope Commercial |
$141.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.52
|
| Rate for Payer: PHP Commercial |
$133.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.23
|
| Rate for Payer: UHC Core |
$131.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.81
|
|
|
HC MENIGOCOCCAL, QUADRIVALENT (MCV4 OR MENACWY) IM
|
Facility
|
OP
|
$157.08
|
|
|
Service Code
|
CPT 90734
|
| Hospital Charge Code |
63600085
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$37.31 |
| Max. Negotiated Rate |
$141.37 |
| Rate for Payer: Aetna Commercial |
$133.52
|
| Rate for Payer: Aetna Medicare |
$40.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.09
|
| Rate for Payer: BCBS Complete |
$62.83
|
| Rate for Payer: BCBS MAPPO |
$39.27
|
| Rate for Payer: BCBS Trust/PPO |
$122.13
|
| Rate for Payer: BCN Commercial |
$122.13
|
| Rate for Payer: BCN Medicare Advantage |
$39.27
|
| Rate for Payer: Cash Price |
$125.66
|
| Rate for Payer: Cofinity Commercial |
$135.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.27
|
| Rate for Payer: Healthscope Commercial |
$141.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.52
|
| Rate for Payer: PACE Senior Care Partners |
$37.31
|
| Rate for Payer: PACE SWMI |
$39.27
|
| Rate for Payer: PHP Commercial |
$133.52
|
| Rate for Payer: PHP Medicare Advantage |
$39.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.66
|
| Rate for Payer: Priority Health Medicare |
$39.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.80
|
| Rate for Payer: Railroad Medicare Medicare |
$39.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.23
|
| Rate for Payer: UHC Core |
$131.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.27
|
| Rate for Payer: UHC Medicare Advantage |
$40.45
|
| Rate for Payer: VA VA |
$39.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.81
|
|
|
HC MENINGITIS/ENCEPHALITIS PANEL
|
Facility
|
OP
|
$714.00
|
|
|
Service Code
|
CPT 87483
|
| Hospital Charge Code |
30600287
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$169.58 |
| Max. Negotiated Rate |
$642.60 |
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: Aetna Medicare |
$185.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$223.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$223.12
|
| Rate for Payer: BCBS Complete |
$322.96
|
| Rate for Payer: BCBS MAPPO |
$178.50
|
| Rate for Payer: BCBS Trust/PPO |
$555.14
|
| Rate for Payer: BCN Commercial |
$555.14
|
| Rate for Payer: BCN Medicare Advantage |
$178.50
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.50
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| Rate for Payer: Mclaren Medicaid |
$307.58
|
| Rate for Payer: Meridian Medicaid |
$322.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$187.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$606.90
|
| Rate for Payer: PACE Senior Care Partners |
$169.58
|
| Rate for Payer: PACE SWMI |
$178.50
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: PHP Medicare Advantage |
$178.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$499.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$621.18
|
| Rate for Payer: Priority Health Medicare |
$178.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$435.47
|
| Rate for Payer: Railroad Medicare Medicare |
$178.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.32
|
| Rate for Payer: UHC Core |
$596.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$178.50
|
| Rate for Payer: UHC Medicare Advantage |
$183.86
|
| Rate for Payer: VA VA |
$178.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
|
|
HC MENINGITIS/ENCEPHALITIS PANEL
|
Facility
|
IP
|
$714.00
|
|
|
Service Code
|
CPT 87483
|
| Hospital Charge Code |
30600287
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$435.47 |
| Max. Negotiated Rate |
$642.60 |
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: BCBS Trust/PPO |
$551.78
|
| Rate for Payer: BCN Commercial |
$551.78
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$606.90
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$499.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$621.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$435.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.32
|
| Rate for Payer: UHC Core |
$596.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
IP
|
$9.18
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200218
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$8.26 |
| Rate for Payer: Aetna Commercial |
$7.80
|
| Rate for Payer: BCBS Trust/PPO |
$7.09
|
| Rate for Payer: BCN Commercial |
$7.09
|
| Rate for Payer: Cash Price |
$7.34
|
| Rate for Payer: Cofinity Commercial |
$7.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.34
|
| Rate for Payer: Healthscope Commercial |
$8.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7.80
|
| Rate for Payer: PHP Commercial |
$7.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.08
|
| Rate for Payer: UHC Core |
$7.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.88
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
OP
|
$9.18
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200218
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$9.97 |
| Rate for Payer: Aetna Commercial |
$7.80
|
| Rate for Payer: Aetna Medicare |
$2.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.87
|
| Rate for Payer: BCBS Complete |
$9.97
|
| Rate for Payer: BCBS MAPPO |
$2.30
|
| Rate for Payer: BCBS Trust/PPO |
$7.14
|
| Rate for Payer: BCN Commercial |
$7.14
|
| Rate for Payer: BCN Medicare Advantage |
$2.30
|
| Rate for Payer: Cash Price |
$7.34
|
| Rate for Payer: Cash Price |
$7.34
|
| Rate for Payer: Cofinity Commercial |
$7.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.30
|
| Rate for Payer: Healthscope Commercial |
$8.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.88
|
| Rate for Payer: Mclaren Medicaid |
$9.50
|
| Rate for Payer: Meridian Medicaid |
$9.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7.80
|
| Rate for Payer: PACE Senior Care Partners |
$2.18
|
| Rate for Payer: PACE SWMI |
$2.30
|
| Rate for Payer: PHP Commercial |
$7.80
|
| Rate for Payer: PHP Medicare Advantage |
$2.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.99
|
| Rate for Payer: Priority Health Medicare |
$2.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.60
|
| Rate for Payer: Railroad Medicare Medicare |
$2.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.08
|
| Rate for Payer: UHC Core |
$7.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.30
|
| Rate for Payer: UHC Medicare Advantage |
$2.36
|
| Rate for Payer: VA VA |
$2.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.88
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
IP
|
$13.87
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200356
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.46 |
| Max. Negotiated Rate |
$12.48 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: BCBS Trust/PPO |
$10.72
|
| Rate for Payer: BCN Commercial |
$10.72
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
OP
|
$13.87
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200356
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$13.06 |
| Rate for Payer: Aetna Commercial |
$11.79
|
| Rate for Payer: Aetna Medicare |
$3.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.33
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: BCBS MAPPO |
$3.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$3.47
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cash Price |
$11.10
|
| Rate for Payer: Cofinity Commercial |
$11.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$12.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.40
|
| Rate for Payer: Mclaren Medicaid |
$12.44
|
| Rate for Payer: Meridian Medicaid |
$13.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.79
|
| Rate for Payer: PACE Senior Care Partners |
$3.29
|
| Rate for Payer: PACE SWMI |
$3.47
|
| Rate for Payer: PHP Commercial |
$11.79
|
| Rate for Payer: PHP Medicare Advantage |
$3.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.07
|
| Rate for Payer: Priority Health Medicare |
$3.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.21
|
| Rate for Payer: UHC Core |
$11.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.47
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: VA VA |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.40
|
|
|
HC MENINGOENCEPHALITIS PANEL SERUM
|
Facility
|
OP
|
$14.28
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200217
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$12.85 |
| Rate for Payer: Aetna Commercial |
$12.14
|
| Rate for Payer: Aetna Medicare |
$3.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.46
|
| Rate for Payer: BCBS Complete |
$9.97
|
| Rate for Payer: BCBS MAPPO |
$3.57
|
| Rate for Payer: BCBS Trust/PPO |
$11.10
|
| Rate for Payer: BCN Commercial |
$11.10
|
| Rate for Payer: BCN Medicare Advantage |
$3.57
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cofinity Commercial |
$12.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.57
|
| Rate for Payer: Healthscope Commercial |
$12.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.71
|
| Rate for Payer: Mclaren Medicaid |
$9.50
|
| Rate for Payer: Meridian Medicaid |
$9.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.14
|
| Rate for Payer: PACE Senior Care Partners |
$3.39
|
| Rate for Payer: PACE SWMI |
$3.57
|
| Rate for Payer: PHP Commercial |
$12.14
|
| Rate for Payer: PHP Medicare Advantage |
$3.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.42
|
| Rate for Payer: Priority Health Medicare |
$3.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.71
|
| Rate for Payer: Railroad Medicare Medicare |
$3.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.57
|
| Rate for Payer: UHC Core |
$11.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.57
|
| Rate for Payer: UHC Medicare Advantage |
$3.68
|
| Rate for Payer: VA VA |
$3.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.71
|
|
|
HC MENINGOENCEPHALITIS PANEL SERUM
|
Facility
|
IP
|
$14.28
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200217
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$12.85 |
| Rate for Payer: Aetna Commercial |
$12.14
|
| Rate for Payer: BCBS Trust/PPO |
$11.04
|
| Rate for Payer: BCN Commercial |
$11.04
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cofinity Commercial |
$12.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.42
|
| Rate for Payer: Healthscope Commercial |
$12.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.14
|
| Rate for Payer: PHP Commercial |
$12.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.57
|
| Rate for Payer: UHC Core |
$11.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.71
|
|
|
HC MERCURY
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100291
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.63 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$41.62
|
| Rate for Payer: Aetna Medicare |
$12.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.30
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$12.24
|
| Rate for Payer: BCBS Trust/PPO |
$38.07
|
| Rate for Payer: BCN Commercial |
$38.07
|
| Rate for Payer: BCN Medicare Advantage |
$12.24
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.72
|
| Rate for Payer: Mclaren Medicaid |
$12.00
|
| Rate for Payer: Meridian Medicaid |
$12.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.62
|
| Rate for Payer: PACE Senior Care Partners |
$11.63
|
| Rate for Payer: PACE SWMI |
$12.24
|
| Rate for Payer: PHP Commercial |
$41.62
|
| Rate for Payer: PHP Medicare Advantage |
$12.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.60
|
| Rate for Payer: Priority Health Medicare |
$12.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.86
|
| Rate for Payer: Railroad Medicare Medicare |
$12.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.08
|
| Rate for Payer: UHC Core |
$40.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.24
|
| Rate for Payer: UHC Medicare Advantage |
$12.61
|
| Rate for Payer: VA VA |
$12.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.72
|
|
|
HC MERCURY
|
Facility
|
IP
|
$48.96
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100291
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.86 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$41.62
|
| Rate for Payer: BCBS Trust/PPO |
$37.84
|
| Rate for Payer: BCN Commercial |
$37.84
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$41.62
|
| Rate for Payer: PHP Commercial |
$41.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.08
|
| Rate for Payer: UHC Core |
$40.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.72
|
|
|
HC MESH
|
Facility
|
OP
|
$4,555.20
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27800022
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,081.86 |
| Max. Negotiated Rate |
$4,099.68 |
| Rate for Payer: Aetna Commercial |
$3,871.92
|
| Rate for Payer: Aetna Medicare |
$1,184.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,423.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,423.50
|
| Rate for Payer: BCBS Complete |
$1,822.08
|
| Rate for Payer: BCBS MAPPO |
$1,138.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,541.67
|
| Rate for Payer: BCN Commercial |
$3,541.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,138.80
|
| Rate for Payer: Cash Price |
$3,644.16
|
| Rate for Payer: Cofinity Commercial |
$3,917.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,644.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,138.80
|
| Rate for Payer: Healthscope Commercial |
$4,099.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,416.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,195.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,309.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,871.92
|
| Rate for Payer: PACE Senior Care Partners |
$1,081.86
|
| Rate for Payer: PACE SWMI |
$1,138.80
|
| Rate for Payer: PHP Commercial |
$3,871.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,138.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,188.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,963.02
|
| Rate for Payer: Priority Health Medicare |
$1,138.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,778.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,138.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,008.58
|
| Rate for Payer: UHC Core |
$3,803.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,138.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,172.96
|
| Rate for Payer: VA VA |
$1,138.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,416.40
|
|
|
HC MESH
|
Facility
|
IP
|
$4,555.20
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27800022
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,778.22 |
| Max. Negotiated Rate |
$4,099.68 |
| Rate for Payer: Aetna Commercial |
$3,871.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,520.26
|
| Rate for Payer: BCN Commercial |
$3,520.26
|
| Rate for Payer: Cash Price |
$3,644.16
|
| Rate for Payer: Cofinity Commercial |
$3,917.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,644.16
|
| Rate for Payer: Healthscope Commercial |
$4,099.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,416.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,871.92
|
| Rate for Payer: PHP Commercial |
$3,871.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,188.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,963.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,778.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,008.58
|
| Rate for Payer: UHC Core |
$3,803.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,416.40
|
|
