|
HC FOREIGN BODY REMOVAL EAR
|
Facility
|
IP
|
$216.75
|
|
|
Service Code
|
CPT 69200
|
| Hospital Charge Code |
45000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$140.89 |
| Max. Negotiated Rate |
$195.07 |
| Rate for Payer: Aetna Commercial |
$184.24
|
| Rate for Payer: BCBS Trust/PPO |
$176.93
|
| Rate for Payer: BCN Commercial |
$167.50
|
| Rate for Payer: Cash Price |
$173.40
|
| Rate for Payer: Cofinity Commercial |
$186.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.40
|
| Rate for Payer: Healthscope Commercial |
$195.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.24
|
| Rate for Payer: Nomi Health Commercial |
$177.74
|
| Rate for Payer: PHP Commercial |
$184.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.89
|
| Rate for Payer: Priority Health HMO/PPO |
$188.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.74
|
| Rate for Payer: UHC Core |
$180.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.56
|
|
|
HC FOREIGN BODY REMOVAL MUSCLE OR TENDON SHEATH SIMPLE
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
76100133
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$279.31 |
| Max. Negotiated Rate |
$1,230.09 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna Medicare |
$305.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$367.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$367.52
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$294.01
|
| Rate for Payer: BCBS Trust/PPO |
$966.83
|
| Rate for Payer: BCN Commercial |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$294.01
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.01
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.71
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$338.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PACE Senior Care Partners |
$279.31
|
| Rate for Payer: PACE SWMI |
$294.01
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: PHP Medicare Advantage |
$294.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,023.16
|
| Rate for Payer: Priority Health Medicare |
$296.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.95
|
| Rate for Payer: Railroad Medicare Medicare |
$294.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.92
|
| Rate for Payer: UHC Core |
$982.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.01
|
| Rate for Payer: UHC Exchange |
$294.01
|
| Rate for Payer: UHC Medicare Advantage |
$294.01
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$294.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC FOREIGN BODY REMOVAL MUSCLE OR TENDON SHEATH SIMPLE
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
76100133
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: BCBS Trust/PPO |
$960.01
|
| Rate for Payer: BCN Commercial |
$908.85
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO |
$1,023.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$787.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,034.92
|
| Rate for Payer: UHC Core |
$982.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC FOREIGN BODY REMOVAL NOSE
|
Facility
|
IP
|
$231.65
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
45000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$150.57 |
| Max. Negotiated Rate |
$208.49 |
| Rate for Payer: Aetna Commercial |
$196.90
|
| Rate for Payer: BCBS Trust/PPO |
$189.10
|
| Rate for Payer: BCN Commercial |
$179.02
|
| Rate for Payer: Cash Price |
$185.32
|
| Rate for Payer: Cofinity Commercial |
$199.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.32
|
| Rate for Payer: Healthscope Commercial |
$208.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.90
|
| Rate for Payer: Nomi Health Commercial |
$189.95
|
| Rate for Payer: PHP Commercial |
$196.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.57
|
| Rate for Payer: Priority Health HMO/PPO |
$201.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.85
|
| Rate for Payer: UHC Core |
$193.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.74
|
|
|
HC FOREIGN BODY REMOVAL NOSE
|
Facility
|
OP
|
$231.65
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
45000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.02 |
| Max. Negotiated Rate |
$208.49 |
| Rate for Payer: Aetna Commercial |
$196.90
|
| Rate for Payer: Aetna Medicare |
$60.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.39
|
| Rate for Payer: BCBS Complete |
$97.86
|
| Rate for Payer: BCBS MAPPO |
$57.91
|
| Rate for Payer: BCBS Trust/PPO |
$190.44
|
| Rate for Payer: BCN Commercial |
$180.11
|
| Rate for Payer: BCN Medicare Advantage |
$57.91
|
| Rate for Payer: Cash Price |
$185.32
|
| Rate for Payer: Cash Price |
$185.32
|
| Rate for Payer: Cofinity Commercial |
$199.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.91
|
| Rate for Payer: Healthscope Commercial |
$208.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.74
|
| Rate for Payer: Mclaren Medicaid |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.81
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.90
|
| Rate for Payer: Nomi Health Commercial |
$189.95
|
| Rate for Payer: PACE Senior Care Partners |
$55.02
|
| Rate for Payer: PACE SWMI |
$57.91
|
| Rate for Payer: PHP Commercial |
$196.90
|
| Rate for Payer: PHP Medicare Advantage |
$57.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.57
|
| Rate for Payer: Priority Health HMO/PPO |
$201.54
|
| Rate for Payer: Priority Health Medicare |
$58.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.21
|
| Rate for Payer: Railroad Medicare Medicare |
$57.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.85
|
| Rate for Payer: UHC Core |
$193.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.91
|
| Rate for Payer: UHC Exchange |
$57.91
|
| Rate for Payer: UHC Medicare Advantage |
$57.91
|
| Rate for Payer: UHCCP Medicaid |
$93.19
|
| Rate for Payer: VA VA |
$57.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.74
|
|
|
HC FOREIGN BODY RETRIEV (VASC)
|
Facility
|
OP
|
$3,897.02
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
36100375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$925.54 |
| Max. Negotiated Rate |
$3,507.32 |
| Rate for Payer: Aetna Commercial |
$3,312.47
|
| Rate for Payer: Aetna Medicare |
$1,013.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,217.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,217.82
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$974.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,203.74
|
| Rate for Payer: BCN Commercial |
$3,029.93
|
| Rate for Payer: BCN Medicare Advantage |
$974.25
|
| Rate for Payer: Cash Price |
$3,117.62
|
| Rate for Payer: Cash Price |
$3,117.62
|
| Rate for Payer: Cofinity Commercial |
$3,351.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,117.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$974.25
|
| Rate for Payer: Healthscope Commercial |
$3,507.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,922.76
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,022.97
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,120.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,312.47
|
| Rate for Payer: Nomi Health Commercial |
$3,195.56
|
| Rate for Payer: PACE Senior Care Partners |
$925.54
|
| Rate for Payer: PACE SWMI |
$974.25
|
| Rate for Payer: PHP Commercial |
$3,312.47
|
| Rate for Payer: PHP Medicare Advantage |
$974.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,533.06
|
| Rate for Payer: Priority Health HMO/PPO |
$3,390.41
|
| Rate for Payer: Priority Health Medicare |
$984.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,611.00
|
| Rate for Payer: Railroad Medicare Medicare |
$974.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,429.38
|
| Rate for Payer: UHC Core |
$3,254.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$974.25
|
| Rate for Payer: UHC Exchange |
$974.25
|
| Rate for Payer: UHC Medicare Advantage |
$974.25
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$974.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,922.76
|
|
|
HC FOREIGN BODY RETRIEV (VASC)
|
Facility
|
IP
|
$3,897.02
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
36100375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,533.06 |
| Max. Negotiated Rate |
$3,507.32 |
| Rate for Payer: Aetna Commercial |
$3,312.47
|
| Rate for Payer: BCBS Trust/PPO |
$3,181.14
|
| Rate for Payer: BCN Commercial |
$3,011.62
|
| Rate for Payer: Cash Price |
$3,117.62
|
| Rate for Payer: Cofinity Commercial |
$3,351.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,117.62
|
| Rate for Payer: Healthscope Commercial |
$3,507.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,922.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,312.47
|
| Rate for Payer: Nomi Health Commercial |
$3,195.56
|
| Rate for Payer: PHP Commercial |
$3,312.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,533.06
|
| Rate for Payer: Priority Health HMO/PPO |
$3,390.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,611.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,429.38
|
| Rate for Payer: UHC Core |
$3,254.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,922.76
|
|
|
HC FORESKIN MANIP W LYSIS ADH AND STRETCH
|
Facility
|
IP
|
$366.59
|
|
|
Service Code
|
CPT 54450
|
| Hospital Charge Code |
76100269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.28 |
| Max. Negotiated Rate |
$329.93 |
| Rate for Payer: Aetna Commercial |
$311.60
|
| Rate for Payer: BCBS Trust/PPO |
$299.25
|
| Rate for Payer: BCN Commercial |
$283.30
|
| Rate for Payer: Cash Price |
$293.27
|
| Rate for Payer: Cofinity Commercial |
$315.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.27
|
| Rate for Payer: Healthscope Commercial |
$329.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.60
|
| Rate for Payer: Nomi Health Commercial |
$300.60
|
| Rate for Payer: PHP Commercial |
$311.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.28
|
| Rate for Payer: Priority Health HMO/PPO |
$318.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$245.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.60
|
| Rate for Payer: UHC Core |
$306.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.94
|
|
|
HC FORESKIN MANIP W LYSIS ADH AND STRETCH
|
Facility
|
OP
|
$366.59
|
|
|
Service Code
|
CPT 54450
|
| Hospital Charge Code |
76100269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$87.07 |
| Max. Negotiated Rate |
$329.93 |
| Rate for Payer: Aetna Commercial |
$311.60
|
| Rate for Payer: Aetna Medicare |
$95.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.56
|
| Rate for Payer: BCBS Complete |
$184.65
|
| Rate for Payer: BCBS MAPPO |
$91.65
|
| Rate for Payer: BCBS Trust/PPO |
$301.37
|
| Rate for Payer: BCN Commercial |
$285.02
|
| Rate for Payer: BCN Medicare Advantage |
$91.65
|
| Rate for Payer: Cash Price |
$293.27
|
| Rate for Payer: Cash Price |
$293.27
|
| Rate for Payer: Cofinity Commercial |
$315.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.65
|
| Rate for Payer: Healthscope Commercial |
$329.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.94
|
| Rate for Payer: Mclaren Medicaid |
$175.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.23
|
| Rate for Payer: Meridian Medicaid |
$184.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.60
|
| Rate for Payer: Nomi Health Commercial |
$300.60
|
| Rate for Payer: PACE Senior Care Partners |
$87.07
|
| Rate for Payer: PACE SWMI |
$91.65
|
| Rate for Payer: PHP Commercial |
$311.60
|
| Rate for Payer: PHP Medicare Advantage |
$91.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.28
|
| Rate for Payer: Priority Health HMO/PPO |
$318.93
|
| Rate for Payer: Priority Health Medicare |
$92.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$245.62
|
| Rate for Payer: Railroad Medicare Medicare |
$91.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.60
|
| Rate for Payer: UHC Core |
$306.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.65
|
| Rate for Payer: UHC Exchange |
$91.65
|
| Rate for Payer: UHC Medicare Advantage |
$91.65
|
| Rate for Payer: UHCCP Medicaid |
$175.84
|
| Rate for Payer: VA VA |
$91.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.94
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN
|
Facility
|
IP
|
$24.13
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200017
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.68 |
| Max. Negotiated Rate |
$21.72 |
| Rate for Payer: Aetna Commercial |
$20.51
|
| Rate for Payer: BCBS Trust/PPO |
$19.70
|
| Rate for Payer: BCN Commercial |
$18.65
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cofinity Commercial |
$20.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.30
|
| Rate for Payer: Healthscope Commercial |
$21.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.51
|
| Rate for Payer: Nomi Health Commercial |
$19.79
|
| Rate for Payer: PHP Commercial |
$20.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.68
|
| Rate for Payer: Priority Health HMO/PPO |
$20.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.23
|
| Rate for Payer: UHC Core |
$20.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.10
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN
|
Facility
|
OP
|
$24.13
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200017
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$21.72 |
| Rate for Payer: Aetna Commercial |
$20.51
|
| Rate for Payer: Aetna Medicare |
$6.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.54
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.03
|
| Rate for Payer: BCBS Trust/PPO |
$19.84
|
| Rate for Payer: BCN Commercial |
$18.76
|
| Rate for Payer: BCN Medicare Advantage |
$6.03
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cofinity Commercial |
$20.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.03
|
| Rate for Payer: Healthscope Commercial |
$21.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.10
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.33
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.51
|
| Rate for Payer: Nomi Health Commercial |
$19.79
|
| Rate for Payer: PACE Senior Care Partners |
$5.73
|
| Rate for Payer: PACE SWMI |
$6.03
|
| Rate for Payer: PHP Commercial |
$20.51
|
| Rate for Payer: PHP Medicare Advantage |
$6.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.68
|
| Rate for Payer: Priority Health HMO/PPO |
$20.99
|
| Rate for Payer: Priority Health Medicare |
$6.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.17
|
| Rate for Payer: Railroad Medicare Medicare |
$6.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.23
|
| Rate for Payer: UHC Core |
$20.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.03
|
| Rate for Payer: UHC Exchange |
$6.03
|
| Rate for Payer: UHC Medicare Advantage |
$6.03
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.10
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN REF LAB
|
Facility
|
OP
|
$35.37
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200125
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna Medicare |
$9.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.05
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$8.84
|
| Rate for Payer: BCBS Trust/PPO |
$29.08
|
| Rate for Payer: BCN Commercial |
$27.50
|
| Rate for Payer: BCN Medicare Advantage |
$8.84
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.84
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.28
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: PACE Senior Care Partners |
$8.40
|
| Rate for Payer: PACE SWMI |
$8.84
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: PHP Medicare Advantage |
$8.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health HMO/PPO |
$30.77
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.70
|
| Rate for Payer: Railroad Medicare Medicare |
$8.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.13
|
| Rate for Payer: UHC Core |
$29.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.84
|
| Rate for Payer: UHC Exchange |
$8.84
|
| Rate for Payer: UHC Medicare Advantage |
$8.84
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$8.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN REF LAB
|
Facility
|
IP
|
$35.37
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200125
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: BCBS Trust/PPO |
$28.87
|
| Rate for Payer: BCN Commercial |
$27.33
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health HMO/PPO |
$30.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.13
|
| Rate for Payer: UHC Core |
$29.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL 1
|
Facility
|
OP
|
$690.61
|
|
| Hospital Charge Code |
45000044
|
|
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 FRACTURE/DISLOCATION TX LEVEL 1
|
Facility
|
IP
|
$690.61
|
|
| Hospital Charge Code |
45000044
|
|
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 FRACTURE/DISLOCATION TX LEVEL II
|
Facility
|
OP
|
$3,041.50
|
|
| Hospital Charge Code |
45000104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$722.36 |
| Max. Negotiated Rate |
$2,737.35 |
| Rate for Payer: Aetna Commercial |
$2,585.28
|
| Rate for Payer: Aetna Medicare |
$790.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$950.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$950.47
|
| Rate for Payer: BCBS Complete |
$1,216.60
|
| Rate for Payer: BCBS MAPPO |
$760.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,500.42
|
| Rate for Payer: BCN Commercial |
$2,364.77
|
| Rate for Payer: BCN Medicare Advantage |
$760.38
|
| Rate for Payer: Cash Price |
$2,433.20
|
| Rate for Payer: Cofinity Commercial |
$2,615.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,433.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$760.38
|
| Rate for Payer: Healthscope Commercial |
$2,737.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,281.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$798.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$874.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,585.28
|
| Rate for Payer: Nomi Health Commercial |
$2,494.03
|
| Rate for Payer: PACE Senior Care Partners |
$722.36
|
| Rate for Payer: PACE SWMI |
$760.38
|
| Rate for Payer: PHP Commercial |
$2,585.28
|
| Rate for Payer: PHP Medicare Advantage |
$760.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,976.97
|
| Rate for Payer: Priority Health HMO/PPO |
$2,646.11
|
| Rate for Payer: Priority Health Medicare |
$767.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,037.81
|
| Rate for Payer: Railroad Medicare Medicare |
$760.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,676.52
|
| Rate for Payer: UHC Core |
$2,539.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$760.38
|
| Rate for Payer: UHC Exchange |
$760.38
|
| Rate for Payer: UHC Medicare Advantage |
$760.38
|
| Rate for Payer: VA VA |
$760.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,281.12
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL II
|
Facility
|
IP
|
$3,041.50
|
|
| Hospital Charge Code |
45000104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,976.97 |
| Max. Negotiated Rate |
$2,737.35 |
| Rate for Payer: Aetna Commercial |
$2,585.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,482.78
|
| Rate for Payer: BCN Commercial |
$2,350.47
|
| Rate for Payer: Cash Price |
$2,433.20
|
| Rate for Payer: Cofinity Commercial |
$2,615.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,433.20
|
| Rate for Payer: Healthscope Commercial |
$2,737.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,281.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,585.28
|
| Rate for Payer: Nomi Health Commercial |
$2,494.03
|
| Rate for Payer: PHP Commercial |
$2,585.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,976.97
|
| Rate for Payer: Priority Health HMO/PPO |
$2,646.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,037.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,676.52
|
| Rate for Payer: UHC Core |
$2,539.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,281.12
|
|
|
HC FRAGILEX ANALYSIS
|
Facility
|
IP
|
$438.60
|
|
|
Service Code
|
CPT 81243
|
| Hospital Charge Code |
31000099
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$285.09 |
| Max. Negotiated Rate |
$394.74 |
| Rate for Payer: Aetna Commercial |
$372.81
|
| Rate for Payer: BCBS Trust/PPO |
$358.03
|
| Rate for Payer: BCN Commercial |
$338.95
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cofinity Commercial |
$377.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.88
|
| Rate for Payer: Healthscope Commercial |
$394.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.81
|
| Rate for Payer: Nomi Health Commercial |
$359.65
|
| Rate for Payer: PHP Commercial |
$372.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.09
|
| Rate for Payer: Priority Health HMO/PPO |
$381.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.97
|
| Rate for Payer: UHC Core |
$366.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.95
|
|
|
HC FRAGILEX ANALYSIS
|
Facility
|
OP
|
$438.60
|
|
|
Service Code
|
CPT 81243
|
| Hospital Charge Code |
31000099
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$41.24 |
| Max. Negotiated Rate |
$394.74 |
| Rate for Payer: Aetna Commercial |
$372.81
|
| Rate for Payer: Aetna Medicare |
$114.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.06
|
| Rate for Payer: BCBS Complete |
$43.30
|
| Rate for Payer: BCBS MAPPO |
$109.65
|
| Rate for Payer: BCBS Trust/PPO |
$360.57
|
| Rate for Payer: BCN Commercial |
$341.01
|
| Rate for Payer: BCN Medicare Advantage |
$109.65
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cofinity Commercial |
$377.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.65
|
| Rate for Payer: Healthscope Commercial |
$394.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.95
|
| Rate for Payer: Mclaren Medicaid |
$41.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.13
|
| Rate for Payer: Meridian Medicaid |
$43.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.81
|
| Rate for Payer: Nomi Health Commercial |
$359.65
|
| Rate for Payer: PACE Senior Care Partners |
$104.17
|
| Rate for Payer: PACE SWMI |
$109.65
|
| Rate for Payer: PHP Commercial |
$372.81
|
| Rate for Payer: PHP Medicare Advantage |
$109.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.09
|
| Rate for Payer: Priority Health HMO/PPO |
$381.58
|
| Rate for Payer: Priority Health Medicare |
$110.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.86
|
| Rate for Payer: Railroad Medicare Medicare |
$109.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.97
|
| Rate for Payer: UHC Core |
$366.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.65
|
| Rate for Payer: UHC Exchange |
$109.65
|
| Rate for Payer: UHC Medicare Advantage |
$109.65
|
| Rate for Payer: UHCCP Medicaid |
$41.24
|
| Rate for Payer: VA VA |
$109.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.95
|
|
|
HC FRAGILE X FOLLOW UP
|
Facility
|
OP
|
$257.04
|
|
|
Service Code
|
CPT 81244
|
| Hospital Charge Code |
30000113
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.46 |
| Max. Negotiated Rate |
$231.34 |
| Rate for Payer: Aetna Commercial |
$218.48
|
| Rate for Payer: Aetna Medicare |
$66.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.33
|
| Rate for Payer: BCBS Complete |
$34.08
|
| Rate for Payer: BCBS MAPPO |
$64.26
|
| Rate for Payer: BCBS Trust/PPO |
$211.31
|
| Rate for Payer: BCN Commercial |
$199.85
|
| Rate for Payer: BCN Medicare Advantage |
$64.26
|
| Rate for Payer: Cash Price |
$205.63
|
| Rate for Payer: Cash Price |
$205.63
|
| Rate for Payer: Cofinity Commercial |
$221.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.26
|
| Rate for Payer: Healthscope Commercial |
$231.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.78
|
| Rate for Payer: Mclaren Medicaid |
$32.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.47
|
| Rate for Payer: Meridian Medicaid |
$34.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218.48
|
| Rate for Payer: Nomi Health Commercial |
$210.77
|
| Rate for Payer: PACE Senior Care Partners |
$61.05
|
| Rate for Payer: PACE SWMI |
$64.26
|
| Rate for Payer: PHP Commercial |
$218.48
|
| Rate for Payer: PHP Medicare Advantage |
$64.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.08
|
| Rate for Payer: Priority Health HMO/PPO |
$223.62
|
| Rate for Payer: Priority Health Medicare |
$64.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.22
|
| Rate for Payer: Railroad Medicare Medicare |
$64.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.20
|
| Rate for Payer: UHC Core |
$214.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.26
|
| Rate for Payer: UHC Exchange |
$64.26
|
| Rate for Payer: UHC Medicare Advantage |
$64.26
|
| Rate for Payer: UHCCP Medicaid |
$32.46
|
| Rate for Payer: VA VA |
$64.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.78
|
|
|
HC FRAGILE X FOLLOW UP
|
Facility
|
IP
|
$257.04
|
|
|
Service Code
|
CPT 81244
|
| Hospital Charge Code |
30000113
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$167.08 |
| Max. Negotiated Rate |
$231.34 |
| Rate for Payer: Aetna Commercial |
$218.48
|
| Rate for Payer: BCBS Trust/PPO |
$209.82
|
| Rate for Payer: BCN Commercial |
$198.64
|
| Rate for Payer: Cash Price |
$205.63
|
| Rate for Payer: Cofinity Commercial |
$221.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.63
|
| Rate for Payer: Healthscope Commercial |
$231.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218.48
|
| Rate for Payer: Nomi Health Commercial |
$210.77
|
| Rate for Payer: PHP Commercial |
$218.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.08
|
| Rate for Payer: Priority Health HMO/PPO |
$223.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.20
|
| Rate for Payer: UHC Core |
$214.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.78
|
|
|
HC FREE FATTY ACIDS
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
30100201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.44 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: BCBS Trust/PPO |
$50.79
|
| Rate for Payer: BCN Commercial |
$48.08
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO |
$54.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC FREE FATTY ACIDS
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
30100201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.44
|
| Rate for Payer: BCBS Complete |
$14.25
|
| Rate for Payer: BCBS MAPPO |
$15.55
|
| Rate for Payer: BCBS Trust/PPO |
$51.15
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$15.55
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.55
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Mclaren Medicaid |
$13.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.33
|
| Rate for Payer: Meridian Medicaid |
$14.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.78
|
| Rate for Payer: PACE SWMI |
$15.55
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: PHP Medicare Advantage |
$15.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO |
$54.13
|
| Rate for Payer: Priority Health Medicare |
$15.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.69
|
| Rate for Payer: Railroad Medicare Medicare |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.55
|
| Rate for Payer: UHC Exchange |
$15.55
|
| Rate for Payer: UHC Medicare Advantage |
$15.55
|
| Rate for Payer: UHCCP Medicaid |
$13.57
|
| Rate for Payer: VA VA |
$15.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC FREE PLASMA HEMOGLOBIN
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 83051
|
| Hospital Charge Code |
30100240
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.09 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.35
|
| Rate for Payer: BCBS Trust/PPO |
$54.12
|
| Rate for Payer: BCN Commercial |
$51.24
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.35
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PHP Commercial |
$56.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.09
|
| Rate for Payer: Priority Health HMO/PPO |
$57.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.73
|
|
|
HC FREE PLASMA HEMOGLOBIN
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 83051
|
| Hospital Charge Code |
30100240
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.29 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.35
|
| Rate for Payer: Aetna Medicare |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.72
|
| Rate for Payer: BCBS Complete |
$5.55
|
| Rate for Payer: BCBS MAPPO |
$16.57
|
| Rate for Payer: BCBS Trust/PPO |
$54.51
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: BCN Medicare Advantage |
$16.57
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.57
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.73
|
| Rate for Payer: Mclaren Medicaid |
$5.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.40
|
| Rate for Payer: Meridian Medicaid |
$5.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.35
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PACE Senior Care Partners |
$15.75
|
| Rate for Payer: PACE SWMI |
$16.57
|
| Rate for Payer: PHP Commercial |
$56.35
|
| Rate for Payer: PHP Medicare Advantage |
$16.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.09
|
| Rate for Payer: Priority Health HMO/PPO |
$57.68
|
| Rate for Payer: Priority Health Medicare |
$16.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.42
|
| Rate for Payer: Railroad Medicare Medicare |
$16.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.57
|
| Rate for Payer: UHC Exchange |
$16.57
|
| Rate for Payer: UHC Medicare Advantage |
$16.57
|
| Rate for Payer: UHCCP Medicaid |
$5.29
|
| Rate for Payer: VA VA |
$16.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.73
|
|
