|
HC EXTERNAL PACER
|
Facility
|
IP
|
$576.43
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
48000001
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$374.68 |
| Max. Negotiated Rate |
$518.79 |
| Rate for Payer: Aetna Commercial |
$489.97
|
| Rate for Payer: BCBS Trust/PPO |
$470.54
|
| Rate for Payer: BCN Commercial |
$445.47
|
| Rate for Payer: Cash Price |
$461.14
|
| Rate for Payer: Cofinity Commercial |
$495.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.14
|
| Rate for Payer: Healthscope Commercial |
$518.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.97
|
| Rate for Payer: Nomi Health Commercial |
$472.67
|
| Rate for Payer: PHP Commercial |
$489.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.68
|
| Rate for Payer: Priority Health HMO/PPO |
$501.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$386.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$507.26
|
| Rate for Payer: UHC Core |
$481.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.32
|
|
|
HC EXTERNAL VERSION
|
Facility
|
IP
|
$2,838.32
|
|
|
Service Code
|
CPT 59412
|
| Hospital Charge Code |
36100121
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,844.91 |
| Max. Negotiated Rate |
$2,554.49 |
| Rate for Payer: Aetna Commercial |
$2,412.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,316.92
|
| Rate for Payer: BCN Commercial |
$2,193.45
|
| Rate for Payer: Cash Price |
$2,270.66
|
| Rate for Payer: Cofinity Commercial |
$2,440.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,270.66
|
| Rate for Payer: Healthscope Commercial |
$2,554.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,128.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,412.57
|
| Rate for Payer: Nomi Health Commercial |
$2,327.42
|
| Rate for Payer: PHP Commercial |
$2,412.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.91
|
| Rate for Payer: Priority Health HMO/PPO |
$2,469.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,901.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,497.72
|
| Rate for Payer: UHC Core |
$2,370.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,128.74
|
|
|
HC EXTERNAL VERSION
|
Facility
|
OP
|
$2,838.32
|
|
|
Service Code
|
CPT 59412
|
| Hospital Charge Code |
36100121
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$674.10 |
| Max. Negotiated Rate |
$2,554.49 |
| Rate for Payer: Aetna Commercial |
$2,412.57
|
| Rate for Payer: Aetna Medicare |
$737.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$886.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$886.98
|
| Rate for Payer: BCBS Complete |
$2,413.90
|
| Rate for Payer: BCBS MAPPO |
$709.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,333.38
|
| Rate for Payer: BCN Commercial |
$2,206.79
|
| Rate for Payer: BCN Medicare Advantage |
$709.58
|
| Rate for Payer: Cash Price |
$2,270.66
|
| Rate for Payer: Cash Price |
$2,270.66
|
| Rate for Payer: Cofinity Commercial |
$2,440.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,270.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$709.58
|
| Rate for Payer: Healthscope Commercial |
$2,554.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,128.74
|
| Rate for Payer: Mclaren Medicaid |
$2,298.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$745.06
|
| Rate for Payer: Meridian Medicaid |
$2,413.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$816.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,412.57
|
| Rate for Payer: Nomi Health Commercial |
$2,327.42
|
| Rate for Payer: PACE Senior Care Partners |
$674.10
|
| Rate for Payer: PACE SWMI |
$709.58
|
| Rate for Payer: PHP Commercial |
$2,412.57
|
| Rate for Payer: PHP Medicare Advantage |
$709.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,298.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.91
|
| Rate for Payer: Priority Health HMO/PPO |
$2,469.34
|
| Rate for Payer: Priority Health Medicare |
$716.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,901.67
|
| Rate for Payer: Railroad Medicare Medicare |
$709.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,497.72
|
| Rate for Payer: UHC Core |
$2,370.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$709.58
|
| Rate for Payer: UHC Exchange |
$709.58
|
| Rate for Payer: UHC Medicare Advantage |
$709.58
|
| Rate for Payer: UHCCP Medicaid |
$2,298.80
|
| Rate for Payer: VA VA |
$709.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,128.74
|
|
|
HC EXTRAORAL INC AND DRAIN ABSC, CYST, HEMATOMA FLOOR OF MOUTH SUBLING
|
Facility
|
OP
|
$390.69
|
|
|
Service Code
|
CPT 41015
|
| Hospital Charge Code |
76100137
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$92.79 |
| Max. Negotiated Rate |
$386.62 |
| Rate for Payer: Aetna Commercial |
$332.09
|
| Rate for Payer: Aetna Medicare |
$101.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.09
|
| Rate for Payer: BCBS Complete |
$386.62
|
| Rate for Payer: BCBS MAPPO |
$97.67
|
| Rate for Payer: BCBS Trust/PPO |
$321.19
|
| Rate for Payer: BCN Commercial |
$303.76
|
| Rate for Payer: BCN Medicare Advantage |
$97.67
|
| Rate for Payer: Cash Price |
$312.55
|
| Rate for Payer: Cash Price |
$312.55
|
| Rate for Payer: Cofinity Commercial |
$335.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.67
|
| Rate for Payer: Healthscope Commercial |
$351.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$293.02
|
| Rate for Payer: Mclaren Medicaid |
$368.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.56
|
| Rate for Payer: Meridian Medicaid |
$386.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.09
|
| Rate for Payer: Nomi Health Commercial |
$320.37
|
| Rate for Payer: PACE Senior Care Partners |
$92.79
|
| Rate for Payer: PACE SWMI |
$97.67
|
| Rate for Payer: PHP Commercial |
$332.09
|
| Rate for Payer: PHP Medicare Advantage |
$97.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$368.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.95
|
| Rate for Payer: Priority Health HMO/PPO |
$339.90
|
| Rate for Payer: Priority Health Medicare |
$98.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.76
|
| Rate for Payer: Railroad Medicare Medicare |
$97.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.81
|
| Rate for Payer: UHC Core |
$326.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.67
|
| Rate for Payer: UHC Exchange |
$97.67
|
| Rate for Payer: UHC Medicare Advantage |
$97.67
|
| Rate for Payer: UHCCP Medicaid |
$368.19
|
| Rate for Payer: VA VA |
$97.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$293.02
|
|
|
HC EXTRAORAL INC AND DRAIN ABSC, CYST, HEMATOMA FLOOR OF MOUTH SUBLING
|
Facility
|
IP
|
$390.69
|
|
|
Service Code
|
CPT 41015
|
| Hospital Charge Code |
76100137
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$253.95 |
| Max. Negotiated Rate |
$351.62 |
| Rate for Payer: Aetna Commercial |
$332.09
|
| Rate for Payer: BCBS Trust/PPO |
$318.92
|
| Rate for Payer: BCN Commercial |
$301.93
|
| Rate for Payer: Cash Price |
$312.55
|
| Rate for Payer: Cofinity Commercial |
$335.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.55
|
| Rate for Payer: Healthscope Commercial |
$351.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$293.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.09
|
| Rate for Payer: Nomi Health Commercial |
$320.37
|
| Rate for Payer: PHP Commercial |
$332.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.95
|
| Rate for Payer: Priority Health HMO/PPO |
$339.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.81
|
| Rate for Payer: UHC Core |
$326.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$293.02
|
|
|
HC EZPAP SUPPLY
|
Facility
|
OP
|
$127.99
|
|
| Hospital Charge Code |
27000072
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$115.19 |
| Rate for Payer: Aetna Commercial |
$108.79
|
| Rate for Payer: Aetna Medicare |
$33.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.00
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS MAPPO |
$32.00
|
| Rate for Payer: BCBS Trust/PPO |
$105.22
|
| Rate for Payer: BCN Commercial |
$99.51
|
| Rate for Payer: BCN Medicare Advantage |
$32.00
|
| Rate for Payer: Cash Price |
$102.39
|
| Rate for Payer: Cofinity Commercial |
$110.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.00
|
| Rate for Payer: Healthscope Commercial |
$115.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.79
|
| Rate for Payer: Nomi Health Commercial |
$104.95
|
| Rate for Payer: PACE Senior Care Partners |
$30.40
|
| Rate for Payer: PACE SWMI |
$32.00
|
| Rate for Payer: PHP Commercial |
$108.79
|
| Rate for Payer: PHP Medicare Advantage |
$32.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.19
|
| Rate for Payer: Priority Health HMO/PPO |
$111.35
|
| Rate for Payer: Priority Health Medicare |
$32.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.75
|
| Rate for Payer: Railroad Medicare Medicare |
$32.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.63
|
| Rate for Payer: UHC Core |
$106.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.00
|
| Rate for Payer: UHC Exchange |
$32.00
|
| Rate for Payer: UHC Medicare Advantage |
$32.00
|
| Rate for Payer: VA VA |
$32.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.99
|
|
|
HC EZPAP SUPPLY
|
Facility
|
IP
|
$127.99
|
|
| Hospital Charge Code |
27000072
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$83.19 |
| Max. Negotiated Rate |
$115.19 |
| Rate for Payer: Aetna Commercial |
$108.79
|
| Rate for Payer: BCBS Trust/PPO |
$104.48
|
| Rate for Payer: BCN Commercial |
$98.91
|
| Rate for Payer: Cash Price |
$102.39
|
| Rate for Payer: Cofinity Commercial |
$110.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.39
|
| Rate for Payer: Healthscope Commercial |
$115.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.79
|
| Rate for Payer: Nomi Health Commercial |
$104.95
|
| Rate for Payer: PHP Commercial |
$108.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.19
|
| Rate for Payer: Priority Health HMO/PPO |
$111.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.63
|
| Rate for Payer: UHC Core |
$106.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.99
|
|
|
HC F-18 SODIUM FLUORIDE <=30MCI
|
Facility
|
IP
|
$484.74
|
|
|
Service Code
|
HCPCS A9580
|
| Hospital Charge Code |
34300028
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$315.08 |
| Max. Negotiated Rate |
$436.27 |
| Rate for Payer: Aetna Commercial |
$412.03
|
| Rate for Payer: BCBS Trust/PPO |
$395.69
|
| Rate for Payer: BCN Commercial |
$374.61
|
| Rate for Payer: Cash Price |
$387.79
|
| Rate for Payer: Cofinity Commercial |
$416.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.79
|
| Rate for Payer: Healthscope Commercial |
$436.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$412.03
|
| Rate for Payer: Nomi Health Commercial |
$397.49
|
| Rate for Payer: PHP Commercial |
$412.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.08
|
| Rate for Payer: Priority Health HMO/PPO |
$421.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$324.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.57
|
| Rate for Payer: UHC Core |
$404.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.56
|
|
|
HC F-18 SODIUM FLUORIDE <=30MCI
|
Facility
|
OP
|
$484.74
|
|
|
Service Code
|
HCPCS A9580
|
| Hospital Charge Code |
34300028
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$115.13 |
| Max. Negotiated Rate |
$436.27 |
| Rate for Payer: Aetna Commercial |
$412.03
|
| Rate for Payer: Aetna Medicare |
$126.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$151.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$151.48
|
| Rate for Payer: BCBS Complete |
$193.90
|
| Rate for Payer: BCBS MAPPO |
$121.19
|
| Rate for Payer: BCBS Trust/PPO |
$398.50
|
| Rate for Payer: BCN Commercial |
$376.89
|
| Rate for Payer: BCN Medicare Advantage |
$121.19
|
| Rate for Payer: Cash Price |
$387.79
|
| Rate for Payer: Cofinity Commercial |
$416.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.19
|
| Rate for Payer: Healthscope Commercial |
$436.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$412.03
|
| Rate for Payer: Nomi Health Commercial |
$397.49
|
| Rate for Payer: PACE Senior Care Partners |
$115.13
|
| Rate for Payer: PACE SWMI |
$121.19
|
| Rate for Payer: PHP Commercial |
$412.03
|
| Rate for Payer: PHP Medicare Advantage |
$121.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.08
|
| Rate for Payer: Priority Health HMO/PPO |
$421.72
|
| Rate for Payer: Priority Health Medicare |
$122.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$324.78
|
| Rate for Payer: Railroad Medicare Medicare |
$121.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.57
|
| Rate for Payer: UHC Core |
$404.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.19
|
| Rate for Payer: UHC Exchange |
$121.19
|
| Rate for Payer: UHC Medicare Advantage |
$121.19
|
| Rate for Payer: VA VA |
$121.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.56
|
|
|
HC F232 OVALBUMIN
|
Facility
|
IP
|
$29.33
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200439
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.06 |
| Max. Negotiated Rate |
$26.40 |
| Rate for Payer: Aetna Commercial |
$24.93
|
| Rate for Payer: BCBS Trust/PPO |
$23.94
|
| Rate for Payer: BCN Commercial |
$22.67
|
| Rate for Payer: Cash Price |
$23.46
|
| Rate for Payer: Cofinity Commercial |
$25.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.46
|
| Rate for Payer: Healthscope Commercial |
$26.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.93
|
| Rate for Payer: Nomi Health Commercial |
$24.05
|
| Rate for Payer: PHP Commercial |
$24.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.06
|
| Rate for Payer: Priority Health HMO/PPO |
$25.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.81
|
| Rate for Payer: UHC Core |
$24.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.00
|
|
|
HC F232 OVALBUMIN
|
Facility
|
OP
|
$29.33
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200439
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.97 |
| Max. Negotiated Rate |
$26.40 |
| Rate for Payer: Aetna Commercial |
$24.93
|
| Rate for Payer: Aetna Medicare |
$7.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.17
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$7.33
|
| Rate for Payer: BCBS Trust/PPO |
$24.11
|
| Rate for Payer: BCN Commercial |
$22.80
|
| Rate for Payer: BCN Medicare Advantage |
$7.33
|
| Rate for Payer: Cash Price |
$23.46
|
| Rate for Payer: Cash Price |
$23.46
|
| Rate for Payer: Cofinity Commercial |
$25.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.33
|
| Rate for Payer: Healthscope Commercial |
$26.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.00
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.70
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.93
|
| Rate for Payer: Nomi Health Commercial |
$24.05
|
| Rate for Payer: PACE Senior Care Partners |
$6.97
|
| Rate for Payer: PACE SWMI |
$7.33
|
| Rate for Payer: PHP Commercial |
$24.93
|
| Rate for Payer: PHP Medicare Advantage |
$7.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.06
|
| Rate for Payer: Priority Health HMO/PPO |
$25.52
|
| Rate for Payer: Priority Health Medicare |
$7.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.65
|
| Rate for Payer: Railroad Medicare Medicare |
$7.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.81
|
| Rate for Payer: UHC Core |
$24.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.33
|
| Rate for Payer: UHC Exchange |
$7.33
|
| Rate for Payer: UHC Medicare Advantage |
$7.33
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$7.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.00
|
|
|
HC F233 OVOMUCOID
|
Facility
|
IP
|
$29.33
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200440
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.06 |
| Max. Negotiated Rate |
$26.40 |
| Rate for Payer: Aetna Commercial |
$24.93
|
| Rate for Payer: BCBS Trust/PPO |
$23.94
|
| Rate for Payer: BCN Commercial |
$22.67
|
| Rate for Payer: Cash Price |
$23.46
|
| Rate for Payer: Cofinity Commercial |
$25.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.46
|
| Rate for Payer: Healthscope Commercial |
$26.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.93
|
| Rate for Payer: Nomi Health Commercial |
$24.05
|
| Rate for Payer: PHP Commercial |
$24.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.06
|
| Rate for Payer: Priority Health HMO/PPO |
$25.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.81
|
| Rate for Payer: UHC Core |
$24.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.00
|
|
|
HC F233 OVOMUCOID
|
Facility
|
OP
|
$29.33
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200440
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.97 |
| Max. Negotiated Rate |
$26.40 |
| Rate for Payer: Aetna Commercial |
$24.93
|
| Rate for Payer: Aetna Medicare |
$7.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.17
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$7.33
|
| Rate for Payer: BCBS Trust/PPO |
$24.11
|
| Rate for Payer: BCN Commercial |
$22.80
|
| Rate for Payer: BCN Medicare Advantage |
$7.33
|
| Rate for Payer: Cash Price |
$23.46
|
| Rate for Payer: Cash Price |
$23.46
|
| Rate for Payer: Cofinity Commercial |
$25.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.33
|
| Rate for Payer: Healthscope Commercial |
$26.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.00
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.70
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.93
|
| Rate for Payer: Nomi Health Commercial |
$24.05
|
| Rate for Payer: PACE Senior Care Partners |
$6.97
|
| Rate for Payer: PACE SWMI |
$7.33
|
| Rate for Payer: PHP Commercial |
$24.93
|
| Rate for Payer: PHP Medicare Advantage |
$7.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.06
|
| Rate for Payer: Priority Health HMO/PPO |
$25.52
|
| Rate for Payer: Priority Health Medicare |
$7.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.65
|
| Rate for Payer: Railroad Medicare Medicare |
$7.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.81
|
| Rate for Payer: UHC Core |
$24.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.33
|
| Rate for Payer: UHC Exchange |
$7.33
|
| Rate for Payer: UHC Medicare Advantage |
$7.33
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$7.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.00
|
|
|
HC F352 RARA H8 PR-10 PEANUT
|
Facility
|
IP
|
$31.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200450
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.47 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna Commercial |
$26.77
|
| Rate for Payer: BCBS Trust/PPO |
$25.71
|
| Rate for Payer: BCN Commercial |
$24.34
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$27.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.19
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.77
|
| Rate for Payer: Nomi Health Commercial |
$25.82
|
| Rate for Payer: PHP Commercial |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.47
|
| Rate for Payer: Priority Health HMO/PPO |
$27.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.71
|
| Rate for Payer: UHC Core |
$26.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
HC F352 RARA H8 PR-10 PEANUT
|
Facility
|
OP
|
$31.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200450
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna Commercial |
$26.77
|
| Rate for Payer: Aetna Medicare |
$8.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.84
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$7.87
|
| Rate for Payer: BCBS Trust/PPO |
$25.89
|
| Rate for Payer: BCN Commercial |
$24.48
|
| Rate for Payer: BCN Medicare Advantage |
$7.87
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$27.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.87
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.27
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.77
|
| Rate for Payer: Nomi Health Commercial |
$25.82
|
| Rate for Payer: PACE Senior Care Partners |
$7.48
|
| Rate for Payer: PACE SWMI |
$7.87
|
| Rate for Payer: PHP Commercial |
$26.77
|
| Rate for Payer: PHP Medicare Advantage |
$7.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.47
|
| Rate for Payer: Priority Health HMO/PPO |
$27.40
|
| Rate for Payer: Priority Health Medicare |
$7.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.10
|
| Rate for Payer: Railroad Medicare Medicare |
$7.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.71
|
| Rate for Payer: UHC Core |
$26.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.87
|
| Rate for Payer: UHC Exchange |
$7.87
|
| Rate for Payer: UHC Medicare Advantage |
$7.87
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$7.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
HC F422 RARA H1 PEANUT
|
Facility
|
OP
|
$31.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200446
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna Commercial |
$26.77
|
| Rate for Payer: Aetna Medicare |
$8.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.84
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$7.87
|
| Rate for Payer: BCBS Trust/PPO |
$25.89
|
| Rate for Payer: BCN Commercial |
$24.48
|
| Rate for Payer: BCN Medicare Advantage |
$7.87
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$27.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.87
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.27
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.77
|
| Rate for Payer: Nomi Health Commercial |
$25.82
|
| Rate for Payer: PACE Senior Care Partners |
$7.48
|
| Rate for Payer: PACE SWMI |
$7.87
|
| Rate for Payer: PHP Commercial |
$26.77
|
| Rate for Payer: PHP Medicare Advantage |
$7.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.47
|
| Rate for Payer: Priority Health HMO/PPO |
$27.40
|
| Rate for Payer: Priority Health Medicare |
$7.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.10
|
| Rate for Payer: Railroad Medicare Medicare |
$7.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.71
|
| Rate for Payer: UHC Core |
$26.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.87
|
| Rate for Payer: UHC Exchange |
$7.87
|
| Rate for Payer: UHC Medicare Advantage |
$7.87
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$7.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
HC F422 RARA H1 PEANUT
|
Facility
|
IP
|
$31.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200446
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.47 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna Commercial |
$26.77
|
| Rate for Payer: BCBS Trust/PPO |
$25.71
|
| Rate for Payer: BCN Commercial |
$24.34
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$27.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.19
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.77
|
| Rate for Payer: Nomi Health Commercial |
$25.82
|
| Rate for Payer: PHP Commercial |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.47
|
| Rate for Payer: Priority Health HMO/PPO |
$27.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.71
|
| Rate for Payer: UHC Core |
$26.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
HC F423 RARA H2 PEANUT
|
Facility
|
OP
|
$31.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200447
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna Commercial |
$26.77
|
| Rate for Payer: Aetna Medicare |
$8.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.84
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$7.87
|
| Rate for Payer: BCBS Trust/PPO |
$25.89
|
| Rate for Payer: BCN Commercial |
$24.48
|
| Rate for Payer: BCN Medicare Advantage |
$7.87
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$27.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.87
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.27
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.77
|
| Rate for Payer: Nomi Health Commercial |
$25.82
|
| Rate for Payer: PACE Senior Care Partners |
$7.48
|
| Rate for Payer: PACE SWMI |
$7.87
|
| Rate for Payer: PHP Commercial |
$26.77
|
| Rate for Payer: PHP Medicare Advantage |
$7.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.47
|
| Rate for Payer: Priority Health HMO/PPO |
$27.40
|
| Rate for Payer: Priority Health Medicare |
$7.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.10
|
| Rate for Payer: Railroad Medicare Medicare |
$7.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.71
|
| Rate for Payer: UHC Core |
$26.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.87
|
| Rate for Payer: UHC Exchange |
$7.87
|
| Rate for Payer: UHC Medicare Advantage |
$7.87
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$7.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
HC F423 RARA H2 PEANUT
|
Facility
|
IP
|
$31.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200447
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.47 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna Commercial |
$26.77
|
| Rate for Payer: BCBS Trust/PPO |
$25.71
|
| Rate for Payer: BCN Commercial |
$24.34
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$27.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.19
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.77
|
| Rate for Payer: Nomi Health Commercial |
$25.82
|
| Rate for Payer: PHP Commercial |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.47
|
| Rate for Payer: Priority Health HMO/PPO |
$27.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.71
|
| Rate for Payer: UHC Core |
$26.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
HC F424 RARA H3 PEANUT
|
Facility
|
OP
|
$31.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200448
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna Commercial |
$26.77
|
| Rate for Payer: Aetna Medicare |
$8.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.84
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$7.87
|
| Rate for Payer: BCBS Trust/PPO |
$25.89
|
| Rate for Payer: BCN Commercial |
$24.48
|
| Rate for Payer: BCN Medicare Advantage |
$7.87
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$27.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.87
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.27
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.77
|
| Rate for Payer: Nomi Health Commercial |
$25.82
|
| Rate for Payer: PACE Senior Care Partners |
$7.48
|
| Rate for Payer: PACE SWMI |
$7.87
|
| Rate for Payer: PHP Commercial |
$26.77
|
| Rate for Payer: PHP Medicare Advantage |
$7.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.47
|
| Rate for Payer: Priority Health HMO/PPO |
$27.40
|
| Rate for Payer: Priority Health Medicare |
$7.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.10
|
| Rate for Payer: Railroad Medicare Medicare |
$7.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.71
|
| Rate for Payer: UHC Core |
$26.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.87
|
| Rate for Payer: UHC Exchange |
$7.87
|
| Rate for Payer: UHC Medicare Advantage |
$7.87
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$7.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
HC F424 RARA H3 PEANUT
|
Facility
|
IP
|
$31.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200448
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.47 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna Commercial |
$26.77
|
| Rate for Payer: BCBS Trust/PPO |
$25.71
|
| Rate for Payer: BCN Commercial |
$24.34
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$27.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.19
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.77
|
| Rate for Payer: Nomi Health Commercial |
$25.82
|
| Rate for Payer: PHP Commercial |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.47
|
| Rate for Payer: Priority Health HMO/PPO |
$27.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.71
|
| Rate for Payer: UHC Core |
$26.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
HC F427 RARA H9 LTP PEANUT
|
Facility
|
OP
|
$31.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200451
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna Commercial |
$26.77
|
| Rate for Payer: Aetna Medicare |
$8.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.84
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$7.87
|
| Rate for Payer: BCBS Trust/PPO |
$25.89
|
| Rate for Payer: BCN Commercial |
$24.48
|
| Rate for Payer: BCN Medicare Advantage |
$7.87
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$27.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.87
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.27
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.77
|
| Rate for Payer: Nomi Health Commercial |
$25.82
|
| Rate for Payer: PACE Senior Care Partners |
$7.48
|
| Rate for Payer: PACE SWMI |
$7.87
|
| Rate for Payer: PHP Commercial |
$26.77
|
| Rate for Payer: PHP Medicare Advantage |
$7.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.47
|
| Rate for Payer: Priority Health HMO/PPO |
$27.40
|
| Rate for Payer: Priority Health Medicare |
$7.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.10
|
| Rate for Payer: Railroad Medicare Medicare |
$7.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.71
|
| Rate for Payer: UHC Core |
$26.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.87
|
| Rate for Payer: UHC Exchange |
$7.87
|
| Rate for Payer: UHC Medicare Advantage |
$7.87
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$7.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
HC F427 RARA H9 LTP PEANUT
|
Facility
|
IP
|
$31.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200451
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.47 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna Commercial |
$26.77
|
| Rate for Payer: BCBS Trust/PPO |
$25.71
|
| Rate for Payer: BCN Commercial |
$24.34
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$27.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.19
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.77
|
| Rate for Payer: Nomi Health Commercial |
$25.82
|
| Rate for Payer: PHP Commercial |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.47
|
| Rate for Payer: Priority Health HMO/PPO |
$27.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.71
|
| Rate for Payer: UHC Core |
$26.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
HC F447 RARA H6 PEANUT
|
Facility
|
IP
|
$31.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200449
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.47 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna Commercial |
$26.77
|
| Rate for Payer: BCBS Trust/PPO |
$25.71
|
| Rate for Payer: BCN Commercial |
$24.34
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$27.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.19
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.77
|
| Rate for Payer: Nomi Health Commercial |
$25.82
|
| Rate for Payer: PHP Commercial |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.47
|
| Rate for Payer: Priority Health HMO/PPO |
$27.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.71
|
| Rate for Payer: UHC Core |
$26.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
HC F447 RARA H6 PEANUT
|
Facility
|
OP
|
$31.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200449
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna Commercial |
$26.77
|
| Rate for Payer: Aetna Medicare |
$8.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.84
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$7.87
|
| Rate for Payer: BCBS Trust/PPO |
$25.89
|
| Rate for Payer: BCN Commercial |
$24.48
|
| Rate for Payer: BCN Medicare Advantage |
$7.87
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$27.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.87
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.27
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.77
|
| Rate for Payer: Nomi Health Commercial |
$25.82
|
| Rate for Payer: PACE Senior Care Partners |
$7.48
|
| Rate for Payer: PACE SWMI |
$7.87
|
| Rate for Payer: PHP Commercial |
$26.77
|
| Rate for Payer: PHP Medicare Advantage |
$7.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.47
|
| Rate for Payer: Priority Health HMO/PPO |
$27.40
|
| Rate for Payer: Priority Health Medicare |
$7.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.10
|
| Rate for Payer: Railroad Medicare Medicare |
$7.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.71
|
| Rate for Payer: UHC Core |
$26.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.87
|
| Rate for Payer: UHC Exchange |
$7.87
|
| Rate for Payer: UHC Medicare Advantage |
$7.87
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$7.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
