|
HC ER LEVEL TWO 99282
|
Facility
|
IP
|
$512.06
|
|
|
Service Code
|
CPT 99282
|
| Hospital Charge Code |
45000021
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$332.84 |
| Max. Negotiated Rate |
$460.85 |
| Rate for Payer: Aetna Commercial |
$435.25
|
| Rate for Payer: BCBS Trust/PPO |
$417.99
|
| Rate for Payer: BCN Commercial |
$395.72
|
| Rate for Payer: Cash Price |
$409.65
|
| Rate for Payer: Cofinity Commercial |
$440.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$409.65
|
| Rate for Payer: Healthscope Commercial |
$460.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$384.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$435.25
|
| Rate for Payer: Nomi Health Commercial |
$419.89
|
| Rate for Payer: PHP Commercial |
$435.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.84
|
| Rate for Payer: Priority Health HMO/PPO |
$445.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$343.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$450.61
|
| Rate for Payer: UHC Core |
$427.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$384.05
|
|
|
HC ER OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200002
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$34.46 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna Medicare |
$37.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.34
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS MAPPO |
$36.27
|
| Rate for Payer: BCBS Trust/PPO |
$119.27
|
| Rate for Payer: BCN Commercial |
$112.80
|
| Rate for Payer: BCN Medicare Advantage |
$36.27
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.27
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: PACE Senior Care Partners |
$34.46
|
| Rate for Payer: PACE SWMI |
$36.27
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: PHP Medicare Advantage |
$36.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO |
$126.22
|
| Rate for Payer: Priority Health Medicare |
$36.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.20
|
| Rate for Payer: Railroad Medicare Medicare |
$36.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.67
|
| Rate for Payer: UHC Core |
$121.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.27
|
| Rate for Payer: UHC Exchange |
$36.27
|
| Rate for Payer: UHC Medicare Advantage |
$36.27
|
| Rate for Payer: VA VA |
$36.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC ER OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200002
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: BCBS Trust/PPO |
$118.43
|
| Rate for Payer: BCN Commercial |
$112.12
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO |
$126.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.67
|
| Rate for Payer: UHC Core |
$121.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC ERO OR PACU R&B
|
Facility
|
IP
|
$3,356.84
|
|
| Hospital Charge Code |
12000001
|
|
Hospital Revenue Code
|
120
|
| Min. Negotiated Rate |
$2,181.95 |
| Max. Negotiated Rate |
$3,021.16 |
| Rate for Payer: Aetna Commercial |
$2,853.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,740.19
|
| Rate for Payer: BCN Commercial |
$2,594.17
|
| Rate for Payer: Cash Price |
$2,685.47
|
| Rate for Payer: Cofinity Commercial |
$2,886.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,685.47
|
| Rate for Payer: Healthscope Commercial |
$3,021.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,517.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,853.31
|
| Rate for Payer: Nomi Health Commercial |
$2,752.61
|
| Rate for Payer: PHP Commercial |
$2,853.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,181.95
|
| Rate for Payer: Priority Health HMO/PPO |
$2,920.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,249.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,954.02
|
| Rate for Payer: UHC Core |
$2,802.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,517.63
|
|
|
HC ER REDUCTION/DISLOCATION LEVEL 1
|
Facility
|
OP
|
$690.61
|
|
| Hospital Charge Code |
45000039
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$164.02 |
| Max. Negotiated Rate |
$621.55 |
| Rate for Payer: Aetna Commercial |
$587.02
|
| Rate for Payer: Aetna Medicare |
$179.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$215.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$215.82
|
| Rate for Payer: BCBS Complete |
$276.24
|
| Rate for Payer: BCBS MAPPO |
$172.65
|
| Rate for Payer: BCBS Trust/PPO |
$567.75
|
| Rate for Payer: BCN Commercial |
$536.95
|
| Rate for Payer: BCN Medicare Advantage |
$172.65
|
| Rate for Payer: Cash Price |
$552.49
|
| Rate for Payer: Cofinity Commercial |
$593.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.65
|
| Rate for Payer: Healthscope Commercial |
$621.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$517.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.02
|
| Rate for Payer: Nomi Health Commercial |
$566.30
|
| Rate for Payer: PACE Senior Care Partners |
$164.02
|
| Rate for Payer: PACE SWMI |
$172.65
|
| Rate for Payer: PHP Commercial |
$587.02
|
| Rate for Payer: PHP Medicare Advantage |
$172.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$448.90
|
| Rate for Payer: Priority Health HMO/PPO |
$600.83
|
| Rate for Payer: Priority Health Medicare |
$174.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$462.71
|
| Rate for Payer: Railroad Medicare Medicare |
$172.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.74
|
| Rate for Payer: UHC Core |
$576.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.65
|
| Rate for Payer: UHC Exchange |
$172.65
|
| Rate for Payer: UHC Medicare Advantage |
$172.65
|
| Rate for Payer: VA VA |
$172.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$517.96
|
|
|
HC ER REDUCTION/DISLOCATION LEVEL 1
|
Facility
|
IP
|
$690.61
|
|
| Hospital Charge Code |
45000039
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$448.90 |
| Max. Negotiated Rate |
$621.55 |
| Rate for Payer: Aetna Commercial |
$587.02
|
| Rate for Payer: BCBS Trust/PPO |
$563.74
|
| Rate for Payer: BCN Commercial |
$533.70
|
| Rate for Payer: Cash Price |
$552.49
|
| Rate for Payer: Cofinity Commercial |
$593.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.49
|
| Rate for Payer: Healthscope Commercial |
$621.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$517.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.02
|
| Rate for Payer: Nomi Health Commercial |
$566.30
|
| Rate for Payer: PHP Commercial |
$587.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$448.90
|
| Rate for Payer: Priority Health HMO/PPO |
$600.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$462.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.74
|
| Rate for Payer: UHC Core |
$576.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$517.96
|
|
|
HC ER SURGICAL HAND/FOOT CARE
|
Facility
|
OP
|
$690.61
|
|
| Hospital Charge Code |
45000040
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$164.02 |
| Max. Negotiated Rate |
$621.55 |
| Rate for Payer: Aetna Commercial |
$587.02
|
| Rate for Payer: Aetna Medicare |
$179.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$215.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$215.82
|
| Rate for Payer: BCBS Complete |
$276.24
|
| Rate for Payer: BCBS MAPPO |
$172.65
|
| Rate for Payer: BCBS Trust/PPO |
$567.75
|
| Rate for Payer: BCN Commercial |
$536.95
|
| Rate for Payer: BCN Medicare Advantage |
$172.65
|
| Rate for Payer: Cash Price |
$552.49
|
| Rate for Payer: Cofinity Commercial |
$593.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.65
|
| Rate for Payer: Healthscope Commercial |
$621.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$517.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.02
|
| Rate for Payer: Nomi Health Commercial |
$566.30
|
| Rate for Payer: PACE Senior Care Partners |
$164.02
|
| Rate for Payer: PACE SWMI |
$172.65
|
| Rate for Payer: PHP Commercial |
$587.02
|
| Rate for Payer: PHP Medicare Advantage |
$172.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$448.90
|
| Rate for Payer: Priority Health HMO/PPO |
$600.83
|
| Rate for Payer: Priority Health Medicare |
$174.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$462.71
|
| Rate for Payer: Railroad Medicare Medicare |
$172.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.74
|
| Rate for Payer: UHC Core |
$576.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.65
|
| Rate for Payer: UHC Exchange |
$172.65
|
| Rate for Payer: UHC Medicare Advantage |
$172.65
|
| Rate for Payer: VA VA |
$172.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$517.96
|
|
|
HC ER SURGICAL HAND/FOOT CARE
|
Facility
|
IP
|
$690.61
|
|
| Hospital Charge Code |
45000040
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$448.90 |
| Max. Negotiated Rate |
$621.55 |
| Rate for Payer: Aetna Commercial |
$587.02
|
| Rate for Payer: BCBS Trust/PPO |
$563.74
|
| Rate for Payer: BCN Commercial |
$533.70
|
| Rate for Payer: Cash Price |
$552.49
|
| Rate for Payer: Cofinity Commercial |
$593.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.49
|
| Rate for Payer: Healthscope Commercial |
$621.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$517.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.02
|
| Rate for Payer: Nomi Health Commercial |
$566.30
|
| Rate for Payer: PHP Commercial |
$587.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$448.90
|
| Rate for Payer: Priority Health HMO/PPO |
$600.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$462.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.74
|
| Rate for Payer: UHC Core |
$576.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$517.96
|
|
|
HC ERYTHROPOIETIN
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 82668
|
| Hospital Charge Code |
30100191
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.88 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$14.27
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$13.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$14.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$13.59
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC ERYTHROPOIETIN
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 82668
|
| Hospital Charge Code |
30100191
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC ESCHERICHIA COLI K1
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600268
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC ESCHERICHIA COLI K1
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600268
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.01
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC ESOPHAGOSCOPY
|
Facility
|
IP
|
$1,377.23
|
|
| Hospital Charge Code |
36000041
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$895.20 |
| Max. Negotiated Rate |
$1,239.51 |
| Rate for Payer: Aetna Commercial |
$1,170.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,124.23
|
| Rate for Payer: BCN Commercial |
$1,064.32
|
| Rate for Payer: Cash Price |
$1,101.78
|
| Rate for Payer: Cofinity Commercial |
$1,184.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.78
|
| Rate for Payer: Healthscope Commercial |
$1,239.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.65
|
| Rate for Payer: Nomi Health Commercial |
$1,129.33
|
| Rate for Payer: PHP Commercial |
$1,170.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,198.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,211.96
|
| Rate for Payer: UHC Core |
$1,149.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.92
|
|
|
HC ESOPHAGOSCOPY
|
Facility
|
OP
|
$1,377.23
|
|
| Hospital Charge Code |
36000041
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$327.09 |
| Max. Negotiated Rate |
$1,239.51 |
| Rate for Payer: Aetna Commercial |
$1,170.65
|
| Rate for Payer: Aetna Medicare |
$358.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$430.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$430.38
|
| Rate for Payer: BCBS Complete |
$550.89
|
| Rate for Payer: BCBS MAPPO |
$344.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,132.22
|
| Rate for Payer: BCN Commercial |
$1,070.80
|
| Rate for Payer: BCN Medicare Advantage |
$344.31
|
| Rate for Payer: Cash Price |
$1,101.78
|
| Rate for Payer: Cofinity Commercial |
$1,184.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.31
|
| Rate for Payer: Healthscope Commercial |
$1,239.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$395.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.65
|
| Rate for Payer: Nomi Health Commercial |
$1,129.33
|
| Rate for Payer: PACE Senior Care Partners |
$327.09
|
| Rate for Payer: PACE SWMI |
$344.31
|
| Rate for Payer: PHP Commercial |
$1,170.65
|
| Rate for Payer: PHP Medicare Advantage |
$344.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.20
|
| Rate for Payer: Priority Health HMO/PPO |
$1,198.19
|
| Rate for Payer: Priority Health Medicare |
$347.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$922.74
|
| Rate for Payer: Railroad Medicare Medicare |
$344.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,211.96
|
| Rate for Payer: UHC Core |
$1,149.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$344.31
|
| Rate for Payer: UHC Exchange |
$344.31
|
| Rate for Payer: UHC Medicare Advantage |
$344.31
|
| Rate for Payer: VA VA |
$344.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.92
|
|
|
HC ESOPHGL FUNC G-ESOP RFLX IMPD ELTRD PROLNG
|
Facility
|
IP
|
$2,391.90
|
|
|
Service Code
|
CPT 91038
|
| Hospital Charge Code |
76100426
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,554.73 |
| Max. Negotiated Rate |
$2,152.71 |
| Rate for Payer: Aetna Commercial |
$2,033.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,952.51
|
| Rate for Payer: BCN Commercial |
$1,848.46
|
| Rate for Payer: Cash Price |
$1,913.52
|
| Rate for Payer: Cofinity Commercial |
$2,057.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,913.52
|
| Rate for Payer: Healthscope Commercial |
$2,152.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,793.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,033.12
|
| Rate for Payer: Nomi Health Commercial |
$1,961.36
|
| Rate for Payer: PHP Commercial |
$2,033.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,554.73
|
| Rate for Payer: Priority Health HMO/PPO |
$2,080.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,602.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,104.87
|
| Rate for Payer: UHC Core |
$1,997.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,793.92
|
|
|
HC ESOPHGL FUNC G-ESOP RFLX IMPD ELTRD PROLNG
|
Facility
|
OP
|
$2,391.90
|
|
|
Service Code
|
CPT 91038
|
| Hospital Charge Code |
76100426
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$383.62 |
| Max. Negotiated Rate |
$2,152.71 |
| Rate for Payer: Aetna Commercial |
$2,033.12
|
| Rate for Payer: Aetna Medicare |
$621.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$747.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$747.47
|
| Rate for Payer: BCBS Complete |
$402.83
|
| Rate for Payer: BCBS MAPPO |
$597.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,966.38
|
| Rate for Payer: BCN Commercial |
$1,859.70
|
| Rate for Payer: BCN Medicare Advantage |
$597.98
|
| Rate for Payer: Cash Price |
$1,913.52
|
| Rate for Payer: Cash Price |
$1,913.52
|
| Rate for Payer: Cofinity Commercial |
$2,057.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,913.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.98
|
| Rate for Payer: Healthscope Commercial |
$2,152.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,793.92
|
| Rate for Payer: Mclaren Medicaid |
$383.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$627.87
|
| Rate for Payer: Meridian Medicaid |
$402.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$687.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,033.12
|
| Rate for Payer: Nomi Health Commercial |
$1,961.36
|
| Rate for Payer: PACE Senior Care Partners |
$568.08
|
| Rate for Payer: PACE SWMI |
$597.98
|
| Rate for Payer: PHP Commercial |
$2,033.12
|
| Rate for Payer: PHP Medicare Advantage |
$597.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,554.73
|
| Rate for Payer: Priority Health HMO/PPO |
$2,080.95
|
| Rate for Payer: Priority Health Medicare |
$603.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,602.57
|
| Rate for Payer: Railroad Medicare Medicare |
$597.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,104.87
|
| Rate for Payer: UHC Core |
$1,997.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.98
|
| Rate for Payer: UHC Exchange |
$597.98
|
| Rate for Payer: UHC Medicare Advantage |
$597.98
|
| Rate for Payer: UHCCP Medicaid |
$383.62
|
| Rate for Payer: VA VA |
$597.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,793.92
|
|
|
HC ESOPH IMPEDENCE MONITOR/MANOMETRY
|
Facility
|
IP
|
$1,451.42
|
|
| Hospital Charge Code |
75000003
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$943.42 |
| Max. Negotiated Rate |
$1,306.28 |
| Rate for Payer: Aetna Commercial |
$1,233.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,184.79
|
| Rate for Payer: BCN Commercial |
$1,121.66
|
| Rate for Payer: Cash Price |
$1,161.14
|
| Rate for Payer: Cofinity Commercial |
$1,248.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,161.14
|
| Rate for Payer: Healthscope Commercial |
$1,306.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,088.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,233.71
|
| Rate for Payer: Nomi Health Commercial |
$1,190.16
|
| Rate for Payer: PHP Commercial |
$1,233.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$943.42
|
| Rate for Payer: Priority Health HMO/PPO |
$1,262.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$972.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,277.25
|
| Rate for Payer: UHC Core |
$1,211.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,088.57
|
|
|
HC ESOPH IMPEDENCE MONITOR/MANOMETRY
|
Facility
|
OP
|
$1,451.42
|
|
| Hospital Charge Code |
75000003
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$344.71 |
| Max. Negotiated Rate |
$1,306.28 |
| Rate for Payer: Aetna Commercial |
$1,233.71
|
| Rate for Payer: Aetna Medicare |
$377.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$453.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$453.57
|
| Rate for Payer: BCBS Complete |
$580.57
|
| Rate for Payer: BCBS MAPPO |
$362.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,193.21
|
| Rate for Payer: BCN Commercial |
$1,128.48
|
| Rate for Payer: BCN Medicare Advantage |
$362.86
|
| Rate for Payer: Cash Price |
$1,161.14
|
| Rate for Payer: Cofinity Commercial |
$1,248.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,161.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.86
|
| Rate for Payer: Healthscope Commercial |
$1,306.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,088.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$381.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$417.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,233.71
|
| Rate for Payer: Nomi Health Commercial |
$1,190.16
|
| Rate for Payer: PACE Senior Care Partners |
$344.71
|
| Rate for Payer: PACE SWMI |
$362.86
|
| Rate for Payer: PHP Commercial |
$1,233.71
|
| Rate for Payer: PHP Medicare Advantage |
$362.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$943.42
|
| Rate for Payer: Priority Health HMO/PPO |
$1,262.74
|
| Rate for Payer: Priority Health Medicare |
$366.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$972.45
|
| Rate for Payer: Railroad Medicare Medicare |
$362.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,277.25
|
| Rate for Payer: UHC Core |
$1,211.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$362.86
|
| Rate for Payer: UHC Exchange |
$362.86
|
| Rate for Payer: UHC Medicare Advantage |
$362.86
|
| Rate for Payer: VA VA |
$362.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,088.57
|
|
|
HC ESOSURE ESOPHAGEAL DEVICE
|
Facility
|
IP
|
$1,232.87
|
|
| Hospital Charge Code |
27200326
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$801.37 |
| Max. Negotiated Rate |
$1,109.58 |
| Rate for Payer: Aetna Commercial |
$1,047.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,006.39
|
| Rate for Payer: BCN Commercial |
$952.76
|
| Rate for Payer: Cash Price |
$986.30
|
| Rate for Payer: Cofinity Commercial |
$1,060.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.30
|
| Rate for Payer: Healthscope Commercial |
$1,109.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.94
|
| Rate for Payer: Nomi Health Commercial |
$1,010.95
|
| Rate for Payer: PHP Commercial |
$1,047.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.37
|
| Rate for Payer: Priority Health HMO/PPO |
$1,072.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$826.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,084.93
|
| Rate for Payer: UHC Core |
$1,029.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.65
|
|
|
HC ESOSURE ESOPHAGEAL DEVICE
|
Facility
|
OP
|
$1,232.87
|
|
| Hospital Charge Code |
27200326
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$292.81 |
| Max. Negotiated Rate |
$1,109.58 |
| Rate for Payer: Aetna Commercial |
$1,047.94
|
| Rate for Payer: Aetna Medicare |
$320.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$385.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$385.27
|
| Rate for Payer: BCBS Complete |
$493.15
|
| Rate for Payer: BCBS MAPPO |
$308.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,013.54
|
| Rate for Payer: BCN Commercial |
$958.56
|
| Rate for Payer: BCN Medicare Advantage |
$308.22
|
| Rate for Payer: Cash Price |
$986.30
|
| Rate for Payer: Cofinity Commercial |
$1,060.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.22
|
| Rate for Payer: Healthscope Commercial |
$1,109.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$354.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.94
|
| Rate for Payer: Nomi Health Commercial |
$1,010.95
|
| Rate for Payer: PACE Senior Care Partners |
$292.81
|
| Rate for Payer: PACE SWMI |
$308.22
|
| Rate for Payer: PHP Commercial |
$1,047.94
|
| Rate for Payer: PHP Medicare Advantage |
$308.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$801.37
|
| Rate for Payer: Priority Health HMO/PPO |
$1,072.60
|
| Rate for Payer: Priority Health Medicare |
$311.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$826.02
|
| Rate for Payer: Railroad Medicare Medicare |
$308.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,084.93
|
| Rate for Payer: UHC Core |
$1,029.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.22
|
| Rate for Payer: UHC Exchange |
$308.22
|
| Rate for Payer: UHC Medicare Advantage |
$308.22
|
| Rate for Payer: VA VA |
$308.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.65
|
|
|
HC E- STIM ATTENDED PER 15 MIN
|
Facility
|
IP
|
$106.12
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
42000014
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$68.98 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: BCBS Trust/PPO |
$86.63
|
| Rate for Payer: BCN Commercial |
$82.01
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$87.02
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.98
|
| Rate for Payer: Priority Health HMO/PPO |
$92.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.39
|
| Rate for Payer: UHC Core |
$88.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC E- STIM ATTENDED PER 15 MIN
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
42000014
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna Medicare |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.16
|
| Rate for Payer: BCBS Complete |
$42.45
|
| Rate for Payer: BCBS MAPPO |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$87.24
|
| Rate for Payer: BCN Commercial |
$82.51
|
| Rate for Payer: BCN Medicare Advantage |
$26.53
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.53
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$87.02
|
| Rate for Payer: PACE Senior Care Partners |
$25.20
|
| Rate for Payer: PACE SWMI |
$26.53
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: PHP Medicare Advantage |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.98
|
| Rate for Payer: Priority Health HMO/PPO |
$92.32
|
| Rate for Payer: Priority Health Medicare |
$26.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.10
|
| Rate for Payer: Railroad Medicare Medicare |
$26.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.39
|
| Rate for Payer: UHC Core |
$88.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.53
|
| Rate for Payer: UHC Exchange |
$26.53
|
| Rate for Payer: UHC Medicare Advantage |
$26.53
|
| Rate for Payer: VA VA |
$26.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC ESTRADIAL, MASS SPEC, S
|
Facility
|
OP
|
$55.08
|
|
|
Service Code
|
CPT 82670
|
| Hospital Charge Code |
30100737
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.08 |
| Max. Negotiated Rate |
$49.57 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$14.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.21
|
| Rate for Payer: BCBS Complete |
$21.21
|
| Rate for Payer: BCBS MAPPO |
$13.77
|
| Rate for Payer: BCBS Trust/PPO |
$45.28
|
| Rate for Payer: BCN Commercial |
$42.82
|
| Rate for Payer: BCN Medicare Advantage |
$13.77
|
| Rate for Payer: Cash Price |
$44.06
|
| Rate for Payer: Cash Price |
$44.06
|
| Rate for Payer: Cofinity Commercial |
$47.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.77
|
| Rate for Payer: Healthscope Commercial |
$49.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.31
|
| Rate for Payer: Mclaren Medicaid |
$20.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.46
|
| Rate for Payer: Meridian Medicaid |
$21.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.82
|
| Rate for Payer: Nomi Health Commercial |
$45.17
|
| Rate for Payer: PACE Senior Care Partners |
$13.08
|
| Rate for Payer: PACE SWMI |
$13.77
|
| Rate for Payer: PHP Commercial |
$46.82
|
| Rate for Payer: PHP Medicare Advantage |
$13.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.80
|
| Rate for Payer: Priority Health HMO/PPO |
$47.92
|
| Rate for Payer: Priority Health Medicare |
$13.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.90
|
| Rate for Payer: Railroad Medicare Medicare |
$13.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.47
|
| Rate for Payer: UHC Core |
$45.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.77
|
| Rate for Payer: UHC Exchange |
$13.77
|
| Rate for Payer: UHC Medicare Advantage |
$13.77
|
| Rate for Payer: UHCCP Medicaid |
$20.20
|
| Rate for Payer: VA VA |
$13.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.31
|
|
|
HC ESTRADIAL, MASS SPEC, S
|
Facility
|
IP
|
$55.08
|
|
|
Service Code
|
CPT 82670
|
| Hospital Charge Code |
30100737
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.80 |
| Max. Negotiated Rate |
$49.57 |
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: BCBS Trust/PPO |
$44.96
|
| Rate for Payer: BCN Commercial |
$42.57
|
| Rate for Payer: Cash Price |
$44.06
|
| Rate for Payer: Cofinity Commercial |
$47.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.06
|
| Rate for Payer: Healthscope Commercial |
$49.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.82
|
| Rate for Payer: Nomi Health Commercial |
$45.17
|
| Rate for Payer: PHP Commercial |
$46.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.80
|
| Rate for Payer: Priority Health HMO/PPO |
$47.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.47
|
| Rate for Payer: UHC Core |
$45.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.31
|
|
|
HC ESTRADIOL LEVEL
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 82670
|
| Hospital Charge Code |
30100192
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.53 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.38
|
| Rate for Payer: BCBS Complete |
$21.21
|
| Rate for Payer: BCBS MAPPO |
$19.51
|
| Rate for Payer: BCBS Trust/PPO |
$64.15
|
| Rate for Payer: BCN Commercial |
$60.67
|
| Rate for Payer: BCN Medicare Advantage |
$19.51
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.51
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$20.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.48
|
| Rate for Payer: Meridian Medicaid |
$21.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: PACE Senior Care Partners |
$18.53
|
| Rate for Payer: PACE SWMI |
$19.51
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Medicare |
$19.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.28
|
| Rate for Payer: Railroad Medicare Medicare |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.51
|
| Rate for Payer: UHC Exchange |
$19.51
|
| Rate for Payer: UHC Medicare Advantage |
$19.51
|
| Rate for Payer: UHCCP Medicaid |
$20.20
|
| Rate for Payer: VA VA |
$19.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
