|
HC MICRA VV LEADLESS PACEMAKER
|
Facility
|
IP
|
$17,269.88
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500012
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$10,532.90 |
| Max. Negotiated Rate |
$15,542.89 |
| Rate for Payer: Aetna Commercial |
$14,679.40
|
| Rate for Payer: BCBS Trust/PPO |
$13,346.16
|
| Rate for Payer: BCN Commercial |
$13,346.16
|
| Rate for Payer: Cash Price |
$13,815.90
|
| Rate for Payer: Cofinity Commercial |
$14,852.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,815.90
|
| Rate for Payer: Healthscope Commercial |
$15,542.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,952.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,679.40
|
| Rate for Payer: PHP Commercial |
$14,679.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,088.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,024.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,532.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,197.49
|
| Rate for Payer: UHC Core |
$14,420.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,952.41
|
|
|
HC MICRA VV LEADLESS PACEMAKER
|
Facility
|
OP
|
$17,269.88
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500012
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,101.60 |
| Max. Negotiated Rate |
$15,542.89 |
| Rate for Payer: Aetna Commercial |
$14,679.40
|
| Rate for Payer: Aetna Medicare |
$4,490.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,396.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,396.84
|
| Rate for Payer: BCBS Complete |
$6,907.95
|
| Rate for Payer: BCBS MAPPO |
$4,317.47
|
| Rate for Payer: BCBS Trust/PPO |
$13,427.33
|
| Rate for Payer: BCN Commercial |
$13,427.33
|
| Rate for Payer: BCN Medicare Advantage |
$4,317.47
|
| Rate for Payer: Cash Price |
$13,815.90
|
| Rate for Payer: Cofinity Commercial |
$14,852.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,815.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,317.47
|
| Rate for Payer: Healthscope Commercial |
$15,542.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,952.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,533.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,965.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,679.40
|
| Rate for Payer: PACE Senior Care Partners |
$4,101.60
|
| Rate for Payer: PACE SWMI |
$4,317.47
|
| Rate for Payer: PHP Commercial |
$14,679.40
|
| Rate for Payer: PHP Medicare Advantage |
$4,317.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,088.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,024.80
|
| Rate for Payer: Priority Health Medicare |
$4,317.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,532.90
|
| Rate for Payer: Railroad Medicare Medicare |
$4,317.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,197.49
|
| Rate for Payer: UHC Core |
$14,420.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,317.47
|
| Rate for Payer: UHC Medicare Advantage |
$4,446.99
|
| Rate for Payer: VA VA |
$4,317.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,952.41
|
|
|
HC MICRO ALBUMIN URINE
|
Facility
|
OP
|
$75.40
|
|
|
Service Code
|
CPT 82043
|
| Hospital Charge Code |
30100075
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.27 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: Aetna Commercial |
$64.09
|
| Rate for Payer: Aetna Medicare |
$19.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.56
|
| Rate for Payer: BCBS Complete |
$4.48
|
| Rate for Payer: BCBS MAPPO |
$18.85
|
| Rate for Payer: BCBS Trust/PPO |
$58.62
|
| Rate for Payer: BCN Commercial |
$58.62
|
| Rate for Payer: BCN Medicare Advantage |
$18.85
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.85
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.55
|
| Rate for Payer: Mclaren Medicaid |
$4.27
|
| Rate for Payer: Meridian Medicaid |
$4.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PACE Senior Care Partners |
$17.91
|
| Rate for Payer: PACE SWMI |
$18.85
|
| Rate for Payer: PHP Commercial |
$64.09
|
| Rate for Payer: PHP Medicare Advantage |
$18.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.60
|
| Rate for Payer: Priority Health Medicare |
$18.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.99
|
| Rate for Payer: Railroad Medicare Medicare |
$18.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Core |
$62.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.85
|
| Rate for Payer: UHC Medicare Advantage |
$19.42
|
| Rate for Payer: VA VA |
$18.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.55
|
|
|
HC MICRO ALBUMIN URINE
|
Facility
|
IP
|
$75.40
|
|
|
Service Code
|
CPT 82043
|
| Hospital Charge Code |
30100075
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.99 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: Aetna Commercial |
$64.09
|
| Rate for Payer: BCBS Trust/PPO |
$58.27
|
| Rate for Payer: BCN Commercial |
$58.27
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PHP Commercial |
$64.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Core |
$62.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.55
|
|
|
HC MICROSPORIDIA DETECTION
|
Facility
|
OP
|
$22.44
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600070
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.93 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: Aetna Medicare |
$5.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.01
|
| Rate for Payer: BCBS Complete |
$5.18
|
| Rate for Payer: BCBS MAPPO |
$5.61
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.61
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.61
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Mclaren Medicaid |
$4.93
|
| Rate for Payer: Meridian Medicaid |
$5.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PACE Senior Care Partners |
$5.33
|
| Rate for Payer: PACE SWMI |
$5.61
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: PHP Medicare Advantage |
$5.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.52
|
| Rate for Payer: Priority Health Medicare |
$5.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.69
|
| Rate for Payer: Railroad Medicare Medicare |
$5.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.75
|
| Rate for Payer: UHC Core |
$18.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.61
|
| Rate for Payer: UHC Medicare Advantage |
$5.78
|
| Rate for Payer: VA VA |
$5.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC MICROSPORIDIA DETECTION
|
Facility
|
IP
|
$22.44
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600070
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.69 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: BCBS Trust/PPO |
$17.34
|
| Rate for Payer: BCN Commercial |
$17.34
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.75
|
| Rate for Payer: UHC Core |
$18.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC MICROSPORIDIA DETECTION CMPT
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600107
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.42 |
| Max. Negotiated Rate |
$28.80 |
| Rate for Payer: Aetna Commercial |
$27.20
|
| Rate for Payer: Aetna Medicare |
$8.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.00
|
| Rate for Payer: BCBS Complete |
$4.64
|
| Rate for Payer: BCBS MAPPO |
$8.00
|
| Rate for Payer: BCBS Trust/PPO |
$24.88
|
| Rate for Payer: BCN Commercial |
$24.88
|
| Rate for Payer: BCN Medicare Advantage |
$8.00
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$27.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.00
|
| Rate for Payer: Healthscope Commercial |
$28.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.00
|
| Rate for Payer: Mclaren Medicaid |
$4.42
|
| Rate for Payer: Meridian Medicaid |
$4.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.20
|
| Rate for Payer: PACE Senior Care Partners |
$7.60
|
| Rate for Payer: PACE SWMI |
$8.00
|
| Rate for Payer: PHP Commercial |
$27.20
|
| Rate for Payer: PHP Medicare Advantage |
$8.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.84
|
| Rate for Payer: Priority Health Medicare |
$8.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.52
|
| Rate for Payer: Railroad Medicare Medicare |
$8.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.16
|
| Rate for Payer: UHC Core |
$26.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.00
|
| Rate for Payer: UHC Medicare Advantage |
$8.24
|
| Rate for Payer: VA VA |
$8.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.00
|
|
|
HC MICROSPORIDIA DETECTION CMPT
|
Facility
|
IP
|
$32.00
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600107
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.52 |
| Max. Negotiated Rate |
$28.80 |
| Rate for Payer: Aetna Commercial |
$27.20
|
| Rate for Payer: BCBS Trust/PPO |
$24.73
|
| Rate for Payer: BCN Commercial |
$24.73
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$27.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.60
|
| Rate for Payer: Healthscope Commercial |
$28.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.20
|
| Rate for Payer: PHP Commercial |
$27.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.16
|
| Rate for Payer: UHC Core |
$26.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.00
|
|
|
HC MICROSPORIDIA PCR
|
Facility
|
OP
|
$368.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600285
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.90 |
| Max. Negotiated Rate |
$331.20 |
| Rate for Payer: Aetna Commercial |
$312.80
|
| Rate for Payer: Aetna Medicare |
$95.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.00
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$92.00
|
| Rate for Payer: BCBS Trust/PPO |
$286.12
|
| Rate for Payer: BCN Commercial |
$286.12
|
| Rate for Payer: BCN Medicare Advantage |
$92.00
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cofinity Commercial |
$316.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$331.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.00
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$96.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.80
|
| Rate for Payer: PACE Senior Care Partners |
$87.40
|
| Rate for Payer: PACE SWMI |
$92.00
|
| Rate for Payer: PHP Commercial |
$312.80
|
| Rate for Payer: PHP Medicare Advantage |
$92.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.16
|
| Rate for Payer: Priority Health Medicare |
$92.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.44
|
| Rate for Payer: Railroad Medicare Medicare |
$92.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.84
|
| Rate for Payer: UHC Core |
$307.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.00
|
| Rate for Payer: UHC Medicare Advantage |
$94.76
|
| Rate for Payer: VA VA |
$92.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.00
|
|
|
HC MICROSPORIDIA PCR
|
Facility
|
IP
|
$368.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600285
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$224.44 |
| Max. Negotiated Rate |
$331.20 |
| Rate for Payer: Aetna Commercial |
$312.80
|
| Rate for Payer: BCBS Trust/PPO |
$284.39
|
| Rate for Payer: BCN Commercial |
$284.39
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cofinity Commercial |
$316.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.40
|
| Rate for Payer: Healthscope Commercial |
$331.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.80
|
| Rate for Payer: PHP Commercial |
$312.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$224.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.84
|
| Rate for Payer: UHC Core |
$307.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.00
|
|
|
HC MICROVENTION LVIS
|
Facility
|
IP
|
$11,245.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27200303
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6,858.63 |
| Max. Negotiated Rate |
$10,120.95 |
| Rate for Payer: Aetna Commercial |
$9,558.68
|
| Rate for Payer: BCBS Trust/PPO |
$8,690.52
|
| Rate for Payer: BCN Commercial |
$8,690.52
|
| Rate for Payer: Cash Price |
$8,996.40
|
| Rate for Payer: Cofinity Commercial |
$9,671.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,996.40
|
| Rate for Payer: Healthscope Commercial |
$10,120.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,434.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,558.68
|
| Rate for Payer: PHP Commercial |
$9,558.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,871.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,783.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,896.04
|
| Rate for Payer: UHC Core |
$9,389.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,434.12
|
|
|
HC MICROVENTION LVIS
|
Facility
|
OP
|
$11,245.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27200303
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,670.81 |
| Max. Negotiated Rate |
$10,120.95 |
| Rate for Payer: Aetna Commercial |
$9,558.68
|
| Rate for Payer: Aetna Medicare |
$2,923.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,514.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,514.22
|
| Rate for Payer: BCBS Complete |
$4,498.20
|
| Rate for Payer: BCBS MAPPO |
$2,811.38
|
| Rate for Payer: BCBS Trust/PPO |
$8,743.38
|
| Rate for Payer: BCN Commercial |
$8,743.38
|
| Rate for Payer: BCN Medicare Advantage |
$2,811.38
|
| Rate for Payer: Cash Price |
$8,996.40
|
| Rate for Payer: Cofinity Commercial |
$9,671.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,996.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,811.38
|
| Rate for Payer: Healthscope Commercial |
$10,120.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,434.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,951.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,233.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,558.68
|
| Rate for Payer: PACE Senior Care Partners |
$2,670.81
|
| Rate for Payer: PACE SWMI |
$2,811.38
|
| Rate for Payer: PHP Commercial |
$9,558.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,811.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,871.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,783.58
|
| Rate for Payer: Priority Health Medicare |
$2,811.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,858.63
|
| Rate for Payer: Railroad Medicare Medicare |
$2,811.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,896.04
|
| Rate for Payer: UHC Core |
$9,389.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,811.38
|
| Rate for Payer: UHC Medicare Advantage |
$2,895.72
|
| Rate for Payer: VA VA |
$2,811.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,434.12
|
|
|
HC MICU OBSERVATION PER HOUR
|
Facility
|
OP
|
$186.06
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200005
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$44.19 |
| Max. Negotiated Rate |
$167.45 |
| Rate for Payer: Aetna Commercial |
$158.15
|
| Rate for Payer: Aetna Medicare |
$48.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.14
|
| Rate for Payer: BCBS Complete |
$74.42
|
| Rate for Payer: BCBS MAPPO |
$46.52
|
| Rate for Payer: BCBS Trust/PPO |
$144.66
|
| Rate for Payer: BCN Commercial |
$144.66
|
| Rate for Payer: BCN Medicare Advantage |
$46.52
|
| Rate for Payer: Cash Price |
$148.85
|
| Rate for Payer: Cofinity Commercial |
$160.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.52
|
| Rate for Payer: Healthscope Commercial |
$167.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$48.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$158.15
|
| Rate for Payer: PACE Senior Care Partners |
$44.19
|
| Rate for Payer: PACE SWMI |
$46.52
|
| Rate for Payer: PHP Commercial |
$158.15
|
| Rate for Payer: PHP Medicare Advantage |
$46.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.87
|
| Rate for Payer: Priority Health Medicare |
$46.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.48
|
| Rate for Payer: Railroad Medicare Medicare |
$46.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.73
|
| Rate for Payer: UHC Core |
$155.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.52
|
| Rate for Payer: UHC Medicare Advantage |
$47.91
|
| Rate for Payer: VA VA |
$46.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.54
|
|
|
HC MICU OBSERVATION PER HOUR
|
Facility
|
IP
|
$186.06
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200005
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$113.48 |
| Max. Negotiated Rate |
$167.45 |
| Rate for Payer: Aetna Commercial |
$158.15
|
| Rate for Payer: BCBS Trust/PPO |
$143.79
|
| Rate for Payer: BCN Commercial |
$143.79
|
| Rate for Payer: Cash Price |
$148.85
|
| Rate for Payer: Cofinity Commercial |
$160.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.85
|
| Rate for Payer: Healthscope Commercial |
$167.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$158.15
|
| Rate for Payer: PHP Commercial |
$158.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.73
|
| Rate for Payer: UHC Core |
$155.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.54
|
|
|
HC MILK IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200047
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC MILK IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200047
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC MINI BAL PROCEDURE
|
Facility
|
IP
|
$303.20
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
41000014
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$184.92 |
| Max. Negotiated Rate |
$272.88 |
| Rate for Payer: Aetna Commercial |
$257.72
|
| Rate for Payer: BCBS Trust/PPO |
$234.31
|
| Rate for Payer: BCN Commercial |
$234.31
|
| Rate for Payer: Cash Price |
$242.56
|
| Rate for Payer: Cofinity Commercial |
$260.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.56
|
| Rate for Payer: Healthscope Commercial |
$272.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$257.72
|
| Rate for Payer: PHP Commercial |
$257.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$263.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.82
|
| Rate for Payer: UHC Core |
$253.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.40
|
|
|
HC MINI BAL PROCEDURE
|
Facility
|
OP
|
$303.20
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
41000014
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$72.01 |
| Max. Negotiated Rate |
$272.88 |
| Rate for Payer: Aetna Commercial |
$257.72
|
| Rate for Payer: Aetna Medicare |
$78.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.75
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$75.80
|
| Rate for Payer: BCBS Trust/PPO |
$235.74
|
| Rate for Payer: BCN Commercial |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$75.80
|
| Rate for Payer: Cash Price |
$242.56
|
| Rate for Payer: Cash Price |
$242.56
|
| Rate for Payer: Cofinity Commercial |
$260.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.80
|
| Rate for Payer: Healthscope Commercial |
$272.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.40
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$79.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$257.72
|
| Rate for Payer: PACE Senior Care Partners |
$72.01
|
| Rate for Payer: PACE SWMI |
$75.80
|
| Rate for Payer: PHP Commercial |
$257.72
|
| Rate for Payer: PHP Medicare Advantage |
$75.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$263.78
|
| Rate for Payer: Priority Health Medicare |
$75.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.92
|
| Rate for Payer: Railroad Medicare Medicare |
$75.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.82
|
| Rate for Payer: UHC Core |
$253.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.80
|
| Rate for Payer: UHC Medicare Advantage |
$78.07
|
| Rate for Payer: VA VA |
$75.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.40
|
|
|
HC MINIMUM BACTERICIDAL CONCENTRA
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
30600103
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: Aetna Medicare |
$7.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.38
|
| Rate for Payer: BCBS Complete |
$5.15
|
| Rate for Payer: BCBS MAPPO |
$7.50
|
| Rate for Payer: BCBS Trust/PPO |
$23.32
|
| Rate for Payer: BCN Commercial |
$23.32
|
| Rate for Payer: BCN Medicare Advantage |
$7.50
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.50
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Mclaren Medicaid |
$4.90
|
| Rate for Payer: Meridian Medicaid |
$5.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PACE Senior Care Partners |
$7.12
|
| Rate for Payer: PACE SWMI |
$7.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: PHP Medicare Advantage |
$7.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.10
|
| Rate for Payer: Priority Health Medicare |
$7.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.30
|
| Rate for Payer: Railroad Medicare Medicare |
$7.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.40
|
| Rate for Payer: UHC Core |
$25.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.50
|
| Rate for Payer: UHC Medicare Advantage |
$7.72
|
| Rate for Payer: VA VA |
$7.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC MINIMUM BACTERICIDAL CONCENTRA
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
30600103
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.30 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: BCBS Trust/PPO |
$23.18
|
| Rate for Payer: BCN Commercial |
$23.18
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.40
|
| Rate for Payer: UHC Core |
$25.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC MINIMUM LETHAL CONCENTRATION (MLC)
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 87187
|
| Hospital Charge Code |
30600102
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.90 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$11.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.34
|
| Rate for Payer: BCBS Complete |
$31.13
|
| Rate for Payer: BCBS MAPPO |
$11.48
|
| Rate for Payer: BCBS Trust/PPO |
$35.69
|
| Rate for Payer: BCN Commercial |
$35.69
|
| Rate for Payer: BCN Medicare Advantage |
$11.48
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.48
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$29.65
|
| Rate for Payer: Meridian Medicaid |
$31.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Senior Care Partners |
$10.90
|
| Rate for Payer: PACE SWMI |
$11.48
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$11.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.93
|
| Rate for Payer: Priority Health Medicare |
$11.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.99
|
| Rate for Payer: Railroad Medicare Medicare |
$11.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.48
|
| Rate for Payer: UHC Medicare Advantage |
$11.82
|
| Rate for Payer: VA VA |
$11.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC MINIMUM LETHAL CONCENTRATION (MLC)
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 87187
|
| Hospital Charge Code |
30600102
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.99 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$35.47
|
| Rate for Payer: BCN Commercial |
$35.47
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC MINOR PROCEDURE WO SEDATION
|
Facility
|
OP
|
$521.12
|
|
| Hospital Charge Code |
36000076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$123.77 |
| Max. Negotiated Rate |
$469.01 |
| Rate for Payer: Aetna Commercial |
$442.95
|
| Rate for Payer: Aetna Medicare |
$135.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$162.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$162.85
|
| Rate for Payer: BCBS Complete |
$208.45
|
| Rate for Payer: BCBS MAPPO |
$130.28
|
| Rate for Payer: BCBS Trust/PPO |
$405.17
|
| Rate for Payer: BCN Commercial |
$405.17
|
| Rate for Payer: BCN Medicare Advantage |
$130.28
|
| Rate for Payer: Cash Price |
$416.90
|
| Rate for Payer: Cofinity Commercial |
$448.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.28
|
| Rate for Payer: Healthscope Commercial |
$469.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$136.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$149.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$442.95
|
| Rate for Payer: PACE Senior Care Partners |
$123.77
|
| Rate for Payer: PACE SWMI |
$130.28
|
| Rate for Payer: PHP Commercial |
$442.95
|
| Rate for Payer: PHP Medicare Advantage |
$130.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.37
|
| Rate for Payer: Priority Health Medicare |
$130.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$317.83
|
| Rate for Payer: Railroad Medicare Medicare |
$130.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.59
|
| Rate for Payer: UHC Core |
$435.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$130.28
|
| Rate for Payer: UHC Medicare Advantage |
$134.19
|
| Rate for Payer: VA VA |
$130.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.84
|
|
|
HC MINOR PROCEDURE WO SEDATION
|
Facility
|
IP
|
$521.12
|
|
| Hospital Charge Code |
36000076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$317.83 |
| Max. Negotiated Rate |
$469.01 |
| Rate for Payer: Aetna Commercial |
$442.95
|
| Rate for Payer: BCBS Trust/PPO |
$402.72
|
| Rate for Payer: BCN Commercial |
$402.72
|
| Rate for Payer: Cash Price |
$416.90
|
| Rate for Payer: Cofinity Commercial |
$448.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.90
|
| Rate for Payer: Healthscope Commercial |
$469.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$442.95
|
| Rate for Payer: PHP Commercial |
$442.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$317.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.59
|
| Rate for Payer: UHC Core |
$435.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.84
|
|
|
HC MINOR PROCEDURE W SEDATION
|
Facility
|
IP
|
$603.84
|
|
| Hospital Charge Code |
36000075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$368.28 |
| Max. Negotiated Rate |
$543.46 |
| Rate for Payer: Aetna Commercial |
$513.26
|
| Rate for Payer: BCBS Trust/PPO |
$466.65
|
| Rate for Payer: BCN Commercial |
$466.65
|
| Rate for Payer: Cash Price |
$483.07
|
| Rate for Payer: Cofinity Commercial |
$519.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$483.07
|
| Rate for Payer: Healthscope Commercial |
$543.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$452.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$513.26
|
| Rate for Payer: PHP Commercial |
$513.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$525.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$368.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$531.38
|
| Rate for Payer: UHC Core |
$504.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$452.88
|
|
