|
HC INFUSION CATH LVL 8
|
Facility
|
IP
|
$843.51
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
27200309
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$587.08 |
| Max. Negotiated Rate |
$759.16 |
| Rate for Payer: Aetna Commercial |
$716.98
|
| Rate for Payer: BCBS Trust/PPO |
$696.65
|
| Rate for Payer: BCN Commercial |
$696.65
|
| Rate for Payer: Cash Price |
$674.81
|
| Rate for Payer: Cofinity Commercial |
$725.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$674.81
|
| Rate for Payer: Healthscope Commercial |
$759.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$632.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$716.98
|
| Rate for Payer: Nomi Health Commercial |
$691.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$632.63
|
| Rate for Payer: PHP Commercial |
$716.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$733.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$587.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$742.29
|
| Rate for Payer: UHC Core |
$704.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$632.63
|
|
|
HC INGESTION CHALLENGE TEST EA ADDL 60 MIN
|
Facility
|
OP
|
$228.89
|
|
|
Service Code
|
CPT 95079
|
| Hospital Charge Code |
51000115
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$40.35 |
| Max. Negotiated Rate |
$206.00 |
| Rate for Payer: Aetna Commercial |
$194.56
|
| Rate for Payer: Aetna Medicare |
$59.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.53
|
| Rate for Payer: BCBS Complete |
$42.37
|
| Rate for Payer: BCBS MAPPO |
$57.22
|
| Rate for Payer: BCBS Trust/PPO |
$188.17
|
| Rate for Payer: BCN Commercial |
$188.17
|
| Rate for Payer: BCN Medicare Advantage |
$57.22
|
| Rate for Payer: Cash Price |
$183.11
|
| Rate for Payer: Cofinity Commercial |
$196.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.22
|
| Rate for Payer: Healthscope Commercial |
$206.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.67
|
| Rate for Payer: Mclaren Medicaid |
$40.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.08
|
| Rate for Payer: Meridian Medicaid |
$42.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.56
|
| Rate for Payer: Nomi Health Commercial |
$187.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.67
|
| Rate for Payer: PACE Senior Care Partners |
$54.36
|
| Rate for Payer: PACE SWMI |
$57.22
|
| Rate for Payer: PHP Commercial |
$194.56
|
| Rate for Payer: PHP Medicare Advantage |
$57.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$199.13
|
| Rate for Payer: Priority Health Medicare |
$57.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$159.31
|
| Rate for Payer: Railroad Medicare Medicare |
$57.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.42
|
| Rate for Payer: UHC Core |
$191.12
|
| Rate for Payer: UHC Exchange |
$57.22
|
| Rate for Payer: UHC Medicaid |
$40.35
|
| Rate for Payer: UHC Medicare Advantage |
$57.22
|
| Rate for Payer: UHCCP Medicaid |
$40.35
|
| Rate for Payer: VA VA |
$57.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.67
|
|
|
HC INGESTION CHALLENGE TEST EA ADDL 60 MIN
|
Facility
|
IP
|
$228.89
|
|
|
Service Code
|
CPT 95079
|
| Hospital Charge Code |
51000115
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$159.31 |
| Max. Negotiated Rate |
$206.00 |
| Rate for Payer: Aetna Commercial |
$194.56
|
| Rate for Payer: BCBS Trust/PPO |
$189.04
|
| Rate for Payer: BCN Commercial |
$189.04
|
| Rate for Payer: Cash Price |
$183.11
|
| Rate for Payer: Cofinity Commercial |
$196.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.11
|
| Rate for Payer: Healthscope Commercial |
$206.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.56
|
| Rate for Payer: Nomi Health Commercial |
$187.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.67
|
| Rate for Payer: PHP Commercial |
$194.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$199.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$159.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.42
|
| Rate for Payer: UHC Core |
$191.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.67
|
|
|
HC INGESTION CHALLENGE TEST INIT 120 MIN
|
Facility
|
IP
|
$1,458.59
|
|
|
Service Code
|
CPT 95076
|
| Hospital Charge Code |
51000114
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,015.18 |
| Max. Negotiated Rate |
$1,312.73 |
| Rate for Payer: Aetna Commercial |
$1,239.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,204.65
|
| Rate for Payer: BCN Commercial |
$1,204.65
|
| Rate for Payer: Cash Price |
$1,166.87
|
| Rate for Payer: Cofinity Commercial |
$1,254.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,166.87
|
| Rate for Payer: Healthscope Commercial |
$1,312.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,093.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,239.80
|
| Rate for Payer: Nomi Health Commercial |
$1,196.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,093.94
|
| Rate for Payer: PHP Commercial |
$1,239.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,268.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,015.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,283.56
|
| Rate for Payer: UHC Core |
$1,217.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,093.94
|
|
|
HC INGESTION CHALLENGE TEST INIT 120 MIN
|
Facility
|
OP
|
$1,458.59
|
|
|
Service Code
|
CPT 95076
|
| Hospital Charge Code |
51000114
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$257.15 |
| Max. Negotiated Rate |
$1,312.73 |
| Rate for Payer: Aetna Commercial |
$1,239.80
|
| Rate for Payer: Aetna Medicare |
$379.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$455.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$455.81
|
| Rate for Payer: BCBS Complete |
$269.99
|
| Rate for Payer: BCBS MAPPO |
$364.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,199.11
|
| Rate for Payer: BCN Commercial |
$1,199.11
|
| Rate for Payer: BCN Medicare Advantage |
$364.65
|
| Rate for Payer: Cash Price |
$1,166.87
|
| Rate for Payer: Cofinity Commercial |
$1,254.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,166.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$364.65
|
| Rate for Payer: Healthscope Commercial |
$1,312.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,093.94
|
| Rate for Payer: Mclaren Medicaid |
$257.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$382.88
|
| Rate for Payer: Meridian Medicaid |
$269.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$419.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$401.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,239.80
|
| Rate for Payer: Nomi Health Commercial |
$1,196.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,093.94
|
| Rate for Payer: PACE Senior Care Partners |
$346.42
|
| Rate for Payer: PACE SWMI |
$364.65
|
| Rate for Payer: PHP Commercial |
$1,239.80
|
| Rate for Payer: PHP Medicare Advantage |
$364.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$257.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,268.97
|
| Rate for Payer: Priority Health Medicare |
$368.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,015.18
|
| Rate for Payer: Railroad Medicare Medicare |
$364.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,283.56
|
| Rate for Payer: UHC Core |
$1,217.92
|
| Rate for Payer: UHC Exchange |
$364.65
|
| Rate for Payer: UHC Medicaid |
$257.15
|
| Rate for Payer: UHC Medicare Advantage |
$364.65
|
| Rate for Payer: UHCCP Medicaid |
$257.15
|
| Rate for Payer: VA VA |
$364.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,093.94
|
|
|
HC INHALATION BRONCHIAL CHALLENGE TESTING
|
Facility
|
IP
|
$504.95
|
|
|
Service Code
|
CPT 95070
|
| Hospital Charge Code |
46000028
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$351.45 |
| Max. Negotiated Rate |
$454.45 |
| Rate for Payer: Aetna Commercial |
$429.21
|
| Rate for Payer: BCBS Trust/PPO |
$417.04
|
| Rate for Payer: BCN Commercial |
$417.04
|
| Rate for Payer: Cash Price |
$403.96
|
| Rate for Payer: Cofinity Commercial |
$434.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$403.96
|
| Rate for Payer: Healthscope Commercial |
$454.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.21
|
| Rate for Payer: Nomi Health Commercial |
$414.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.71
|
| Rate for Payer: PHP Commercial |
$429.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$439.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$351.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$444.36
|
| Rate for Payer: UHC Core |
$421.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.71
|
|
|
HC INHALATION BRONCHIAL CHALLENGE TESTING
|
Facility
|
OP
|
$504.95
|
|
|
Service Code
|
CPT 95070
|
| Hospital Charge Code |
46000028
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$89.02 |
| Max. Negotiated Rate |
$454.45 |
| Rate for Payer: Aetna Commercial |
$429.21
|
| Rate for Payer: Aetna Medicare |
$131.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.80
|
| Rate for Payer: BCBS Complete |
$93.47
|
| Rate for Payer: BCBS MAPPO |
$126.24
|
| Rate for Payer: BCBS Trust/PPO |
$415.12
|
| Rate for Payer: BCN Commercial |
$415.12
|
| Rate for Payer: BCN Medicare Advantage |
$126.24
|
| Rate for Payer: Cash Price |
$403.96
|
| Rate for Payer: Cofinity Commercial |
$434.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$403.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.24
|
| Rate for Payer: Healthscope Commercial |
$454.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.71
|
| Rate for Payer: Mclaren Medicaid |
$89.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.55
|
| Rate for Payer: Meridian Medicaid |
$93.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$138.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.21
|
| Rate for Payer: Nomi Health Commercial |
$414.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.71
|
| Rate for Payer: PACE Senior Care Partners |
$119.93
|
| Rate for Payer: PACE SWMI |
$126.24
|
| Rate for Payer: PHP Commercial |
$429.21
|
| Rate for Payer: PHP Medicare Advantage |
$126.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$439.31
|
| Rate for Payer: Priority Health Medicare |
$127.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$351.45
|
| Rate for Payer: Railroad Medicare Medicare |
$126.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$444.36
|
| Rate for Payer: UHC Core |
$421.63
|
| Rate for Payer: UHC Exchange |
$126.24
|
| Rate for Payer: UHC Medicaid |
$89.02
|
| Rate for Payer: UHC Medicare Advantage |
$126.24
|
| Rate for Payer: UHCCP Medicaid |
$89.02
|
| Rate for Payer: VA VA |
$126.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.71
|
|
|
HC INHIBIN A, TUMOR MARKER, S
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 86336
|
| Hospital Charge Code |
30200460
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$52.14 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: BCBS Trust/PPO |
$61.87
|
| Rate for Payer: BCN Commercial |
$61.87
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.92
|
| Rate for Payer: UHC Core |
$62.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.18
|
|
|
HC INHIBIN A, TUMOR MARKER, S
|
Facility
|
OP
|
$74.91
|
|
|
Service Code
|
CPT 86336
|
| Hospital Charge Code |
30200460
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: Aetna Medicare |
$19.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.41
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCBS MAPPO |
$18.73
|
| Rate for Payer: BCBS Trust/PPO |
$61.58
|
| Rate for Payer: BCN Commercial |
$61.58
|
| Rate for Payer: BCN Medicare Advantage |
$18.73
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.73
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.18
|
| Rate for Payer: Mclaren Medicaid |
$13.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.66
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.18
|
| Rate for Payer: PACE Senior Care Partners |
$17.79
|
| Rate for Payer: PACE SWMI |
$18.73
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: PHP Medicare Advantage |
$18.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.17
|
| Rate for Payer: Priority Health Medicare |
$18.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.14
|
| Rate for Payer: Railroad Medicare Medicare |
$18.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.92
|
| Rate for Payer: UHC Core |
$62.55
|
| Rate for Payer: UHC Exchange |
$18.73
|
| Rate for Payer: UHC Medicaid |
$13.21
|
| Rate for Payer: UHC Medicare Advantage |
$18.73
|
| Rate for Payer: UHCCP Medicaid |
$13.21
|
| Rate for Payer: VA VA |
$18.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.18
|
|
|
HC INHIBIN B, CMPT
|
Facility
|
IP
|
$50.94
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100693
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.45 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: BCBS Trust/PPO |
$42.07
|
| Rate for Payer: BCN Commercial |
$42.07
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$41.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.83
|
| Rate for Payer: UHC Core |
$42.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.20
|
|
|
HC INHIBIN B, CMPT
|
Facility
|
OP
|
$50.94
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100693
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.92
|
| Rate for Payer: BCBS Complete |
$9.43
|
| Rate for Payer: BCBS MAPPO |
$12.73
|
| Rate for Payer: BCBS Trust/PPO |
$41.88
|
| Rate for Payer: BCN Commercial |
$41.88
|
| Rate for Payer: BCN Medicare Advantage |
$12.73
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.73
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$8.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.37
|
| Rate for Payer: Meridian Medicaid |
$9.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$41.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PACE Senior Care Partners |
$12.10
|
| Rate for Payer: PACE SWMI |
$12.73
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: PHP Medicare Advantage |
$12.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.32
|
| Rate for Payer: Priority Health Medicare |
$12.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.45
|
| Rate for Payer: Railroad Medicare Medicare |
$12.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.83
|
| Rate for Payer: UHC Core |
$42.53
|
| Rate for Payer: UHC Exchange |
$12.73
|
| Rate for Payer: UHC Medicaid |
$8.98
|
| Rate for Payer: UHC Medicare Advantage |
$12.73
|
| Rate for Payer: UHCCP Medicaid |
$8.98
|
| Rate for Payer: VA VA |
$12.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.20
|
|
|
HC INITIAL PREV PHYS EXAM, FIRST 12MOS MEDICARE ENROLLMENT
|
Facility
|
IP
|
$184.55
|
|
|
Service Code
|
CPT G0402
|
| Hospital Charge Code |
51000096
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$128.45 |
| Max. Negotiated Rate |
$166.09 |
| Rate for Payer: Aetna Commercial |
$156.87
|
| Rate for Payer: BCBS Trust/PPO |
$152.42
|
| Rate for Payer: BCN Commercial |
$152.42
|
| Rate for Payer: Cash Price |
$147.64
|
| Rate for Payer: Cofinity Commercial |
$158.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.64
|
| Rate for Payer: Healthscope Commercial |
$166.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.87
|
| Rate for Payer: Nomi Health Commercial |
$151.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.41
|
| Rate for Payer: PHP Commercial |
$156.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$160.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.40
|
| Rate for Payer: UHC Core |
$154.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.41
|
|
|
HC INITIAL PREV PHYS EXAM, FIRST 12MOS MEDICARE ENROLLMENT
|
Facility
|
OP
|
$184.55
|
|
|
Service Code
|
CPT G0402
|
| Hospital Charge Code |
51000096
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$32.54 |
| Max. Negotiated Rate |
$166.09 |
| Rate for Payer: Aetna Commercial |
$156.87
|
| Rate for Payer: Aetna Medicare |
$47.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.67
|
| Rate for Payer: BCBS Complete |
$34.16
|
| Rate for Payer: BCBS MAPPO |
$46.14
|
| Rate for Payer: BCBS Trust/PPO |
$151.72
|
| Rate for Payer: BCN Commercial |
$151.72
|
| Rate for Payer: BCN Medicare Advantage |
$46.14
|
| Rate for Payer: Cash Price |
$147.64
|
| Rate for Payer: Cofinity Commercial |
$158.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.14
|
| Rate for Payer: Healthscope Commercial |
$166.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.41
|
| Rate for Payer: Mclaren Medicaid |
$32.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.44
|
| Rate for Payer: Meridian Medicaid |
$34.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$50.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.87
|
| Rate for Payer: Nomi Health Commercial |
$151.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.41
|
| Rate for Payer: PACE Senior Care Partners |
$43.83
|
| Rate for Payer: PACE SWMI |
$46.14
|
| Rate for Payer: PHP Commercial |
$156.87
|
| Rate for Payer: PHP Medicare Advantage |
$46.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$160.56
|
| Rate for Payer: Priority Health Medicare |
$46.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.45
|
| Rate for Payer: Railroad Medicare Medicare |
$46.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.40
|
| Rate for Payer: UHC Core |
$154.10
|
| Rate for Payer: UHC Exchange |
$46.14
|
| Rate for Payer: UHC Medicaid |
$32.54
|
| Rate for Payer: UHC Medicare Advantage |
$46.14
|
| Rate for Payer: UHCCP Medicaid |
$32.54
|
| Rate for Payer: VA VA |
$46.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.41
|
|
|
HC INITIATION PROLONGED INFUSION REQUIRING PUMP
|
Facility
|
IP
|
$591.27
|
|
|
Service Code
|
HCPCS C8957
|
| Hospital Charge Code |
26000012
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$411.52 |
| Max. Negotiated Rate |
$532.14 |
| Rate for Payer: Aetna Commercial |
$502.58
|
| Rate for Payer: BCBS Trust/PPO |
$488.33
|
| Rate for Payer: BCN Commercial |
$488.33
|
| Rate for Payer: Cash Price |
$473.02
|
| Rate for Payer: Cofinity Commercial |
$508.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.02
|
| Rate for Payer: Healthscope Commercial |
$532.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$443.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$502.58
|
| Rate for Payer: Nomi Health Commercial |
$484.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$443.45
|
| Rate for Payer: PHP Commercial |
$502.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$514.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$411.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$520.32
|
| Rate for Payer: UHC Core |
$493.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$443.45
|
|
|
HC INITIATION PROLONGED INFUSION REQUIRING PUMP
|
Facility
|
OP
|
$591.27
|
|
|
Service Code
|
HCPCS C8957
|
| Hospital Charge Code |
26000012
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$104.24 |
| Max. Negotiated Rate |
$532.14 |
| Rate for Payer: Aetna Commercial |
$502.58
|
| Rate for Payer: Aetna Medicare |
$153.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$184.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$184.77
|
| Rate for Payer: BCBS Complete |
$109.44
|
| Rate for Payer: BCBS MAPPO |
$147.82
|
| Rate for Payer: BCBS Trust/PPO |
$486.08
|
| Rate for Payer: BCN Commercial |
$486.08
|
| Rate for Payer: BCN Medicare Advantage |
$147.82
|
| Rate for Payer: Cash Price |
$473.02
|
| Rate for Payer: Cofinity Commercial |
$508.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.82
|
| Rate for Payer: Healthscope Commercial |
$532.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$443.45
|
| Rate for Payer: Mclaren Medicaid |
$104.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.21
|
| Rate for Payer: Meridian Medicaid |
$109.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$162.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$502.58
|
| Rate for Payer: Nomi Health Commercial |
$484.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$443.45
|
| Rate for Payer: PACE Senior Care Partners |
$140.43
|
| Rate for Payer: PACE SWMI |
$147.82
|
| Rate for Payer: PHP Commercial |
$502.58
|
| Rate for Payer: PHP Medicare Advantage |
$147.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$514.40
|
| Rate for Payer: Priority Health Medicare |
$149.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$411.52
|
| Rate for Payer: Railroad Medicare Medicare |
$147.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$520.32
|
| Rate for Payer: UHC Core |
$493.71
|
| Rate for Payer: UHC Exchange |
$147.82
|
| Rate for Payer: UHC Medicaid |
$104.24
|
| Rate for Payer: UHC Medicare Advantage |
$147.82
|
| Rate for Payer: UHCCP Medicaid |
$104.24
|
| Rate for Payer: VA VA |
$147.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$443.45
|
|
|
HC INITIAT MED TX IN ER
|
Facility
|
IP
|
$161.26
|
|
|
Service Code
|
HCPCS G2213
|
| Hospital Charge Code |
45000106
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$112.24 |
| Max. Negotiated Rate |
$145.13 |
| Rate for Payer: Aetna Commercial |
$137.07
|
| Rate for Payer: BCBS Trust/PPO |
$133.18
|
| Rate for Payer: BCN Commercial |
$133.18
|
| Rate for Payer: Cash Price |
$129.01
|
| Rate for Payer: Cofinity Commercial |
$138.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.01
|
| Rate for Payer: Healthscope Commercial |
$145.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.07
|
| Rate for Payer: Nomi Health Commercial |
$132.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.94
|
| Rate for Payer: PHP Commercial |
$137.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$140.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.91
|
| Rate for Payer: UHC Core |
$134.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.94
|
|
|
HC INITIAT MED TX IN ER
|
Facility
|
OP
|
$161.26
|
|
|
Service Code
|
HCPCS G2213
|
| Hospital Charge Code |
45000106
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$28.43 |
| Max. Negotiated Rate |
$145.13 |
| Rate for Payer: Aetna Commercial |
$137.07
|
| Rate for Payer: Aetna Medicare |
$41.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.39
|
| Rate for Payer: BCBS Complete |
$29.85
|
| Rate for Payer: BCBS MAPPO |
$40.31
|
| Rate for Payer: BCBS Trust/PPO |
$132.57
|
| Rate for Payer: BCN Commercial |
$132.57
|
| Rate for Payer: BCN Medicare Advantage |
$40.31
|
| Rate for Payer: Cash Price |
$129.01
|
| Rate for Payer: Cash Price |
$129.01
|
| Rate for Payer: Cofinity Commercial |
$138.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.31
|
| Rate for Payer: Healthscope Commercial |
$145.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.94
|
| Rate for Payer: Mclaren Medicaid |
$28.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.33
|
| Rate for Payer: Meridian Medicaid |
$29.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.07
|
| Rate for Payer: Nomi Health Commercial |
$132.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.94
|
| Rate for Payer: PACE Senior Care Partners |
$38.30
|
| Rate for Payer: PACE SWMI |
$40.31
|
| Rate for Payer: PHP Commercial |
$137.07
|
| Rate for Payer: PHP Medicare Advantage |
$40.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$140.30
|
| Rate for Payer: Priority Health Medicare |
$40.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.24
|
| Rate for Payer: Railroad Medicare Medicare |
$40.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.91
|
| Rate for Payer: UHC Core |
$134.65
|
| Rate for Payer: UHC Exchange |
$40.31
|
| Rate for Payer: UHC Medicaid |
$28.43
|
| Rate for Payer: UHC Medicare Advantage |
$40.31
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$40.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.94
|
|
|
HC INIT SUB PSYCH 1ST 30 MIN
|
Facility
|
OP
|
$129.47
|
|
|
Service Code
|
HCPCS G2214
|
| Hospital Charge Code |
76100344
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$22.83 |
| Max. Negotiated Rate |
$116.52 |
| Rate for Payer: Aetna Commercial |
$110.05
|
| Rate for Payer: Aetna Medicare |
$33.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.46
|
| Rate for Payer: BCBS Complete |
$23.96
|
| Rate for Payer: BCBS MAPPO |
$32.37
|
| Rate for Payer: BCBS Trust/PPO |
$106.44
|
| Rate for Payer: BCN Commercial |
$106.44
|
| Rate for Payer: BCN Medicare Advantage |
$32.37
|
| Rate for Payer: Cash Price |
$103.58
|
| Rate for Payer: Cofinity Commercial |
$111.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.37
|
| Rate for Payer: Healthscope Commercial |
$116.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.10
|
| Rate for Payer: Mclaren Medicaid |
$22.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.99
|
| Rate for Payer: Meridian Medicaid |
$23.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.05
|
| Rate for Payer: Nomi Health Commercial |
$106.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.10
|
| Rate for Payer: PACE Senior Care Partners |
$30.75
|
| Rate for Payer: PACE SWMI |
$32.37
|
| Rate for Payer: PHP Commercial |
$110.05
|
| Rate for Payer: PHP Medicare Advantage |
$32.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$112.64
|
| Rate for Payer: Priority Health Medicare |
$32.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.11
|
| Rate for Payer: Railroad Medicare Medicare |
$32.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.93
|
| Rate for Payer: UHC Core |
$108.11
|
| Rate for Payer: UHC Exchange |
$32.37
|
| Rate for Payer: UHC Medicaid |
$22.83
|
| Rate for Payer: UHC Medicare Advantage |
$32.37
|
| Rate for Payer: UHCCP Medicaid |
$22.83
|
| Rate for Payer: VA VA |
$32.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.10
|
|
|
HC INIT SUB PSYCH 1ST 30 MIN
|
Facility
|
IP
|
$129.47
|
|
|
Service Code
|
HCPCS G2214
|
| Hospital Charge Code |
76100344
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$90.11 |
| Max. Negotiated Rate |
$116.52 |
| Rate for Payer: Aetna Commercial |
$110.05
|
| Rate for Payer: BCBS Trust/PPO |
$106.93
|
| Rate for Payer: BCN Commercial |
$106.93
|
| Rate for Payer: Cash Price |
$103.58
|
| Rate for Payer: Cofinity Commercial |
$111.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.58
|
| Rate for Payer: Healthscope Commercial |
$116.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.05
|
| Rate for Payer: Nomi Health Commercial |
$106.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.10
|
| Rate for Payer: PHP Commercial |
$110.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$112.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.93
|
| Rate for Payer: UHC Core |
$108.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.10
|
|
|
HC INJ AIR CONTRAST PERITONEAL CAVITY
|
Facility
|
IP
|
$983.76
|
|
|
Service Code
|
CPT 49400
|
| Hospital Charge Code |
36100446
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$684.70 |
| Max. Negotiated Rate |
$885.38 |
| Rate for Payer: Aetna Commercial |
$836.20
|
| Rate for Payer: BCBS Trust/PPO |
$812.49
|
| Rate for Payer: BCN Commercial |
$812.49
|
| Rate for Payer: Cash Price |
$787.01
|
| Rate for Payer: Cofinity Commercial |
$846.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.01
|
| Rate for Payer: Healthscope Commercial |
$885.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.20
|
| Rate for Payer: Nomi Health Commercial |
$806.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$737.82
|
| Rate for Payer: PHP Commercial |
$836.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$855.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.71
|
| Rate for Payer: UHC Core |
$821.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.82
|
|
|
HC INJ AIR CONTRAST PERITONEAL CAVITY
|
Facility
|
OP
|
$983.76
|
|
|
Service Code
|
CPT 49400
|
| Hospital Charge Code |
36100446
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$173.44 |
| Max. Negotiated Rate |
$885.38 |
| Rate for Payer: Aetna Commercial |
$836.20
|
| Rate for Payer: Aetna Medicare |
$255.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$307.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$307.43
|
| Rate for Payer: BCBS Complete |
$182.09
|
| Rate for Payer: BCBS MAPPO |
$245.94
|
| Rate for Payer: BCBS Trust/PPO |
$808.75
|
| Rate for Payer: BCN Commercial |
$808.75
|
| Rate for Payer: BCN Medicare Advantage |
$245.94
|
| Rate for Payer: Cash Price |
$787.01
|
| Rate for Payer: Cofinity Commercial |
$846.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.94
|
| Rate for Payer: Healthscope Commercial |
$885.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.82
|
| Rate for Payer: Mclaren Medicaid |
$173.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$258.24
|
| Rate for Payer: Meridian Medicaid |
$182.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$282.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$270.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.20
|
| Rate for Payer: Nomi Health Commercial |
$806.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$737.82
|
| Rate for Payer: PACE Senior Care Partners |
$233.64
|
| Rate for Payer: PACE SWMI |
$245.94
|
| Rate for Payer: PHP Commercial |
$836.20
|
| Rate for Payer: PHP Medicare Advantage |
$245.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$855.87
|
| Rate for Payer: Priority Health Medicare |
$248.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.70
|
| Rate for Payer: Railroad Medicare Medicare |
$245.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.71
|
| Rate for Payer: UHC Core |
$821.44
|
| Rate for Payer: UHC Exchange |
$245.94
|
| Rate for Payer: UHC Medicaid |
$173.44
|
| Rate for Payer: UHC Medicare Advantage |
$245.94
|
| Rate for Payer: UHCCP Medicaid |
$173.44
|
| Rate for Payer: VA VA |
$245.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.82
|
|
|
HC INJ ANES CELIAC PLEXUS
|
Facility
|
IP
|
$1,292.55
|
|
|
Service Code
|
CPT 64517
|
| Hospital Charge Code |
36100605
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$899.61 |
| Max. Negotiated Rate |
$1,163.30 |
| Rate for Payer: Aetna Commercial |
$1,098.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,067.52
|
| Rate for Payer: BCN Commercial |
$1,067.52
|
| Rate for Payer: Cash Price |
$1,034.04
|
| Rate for Payer: Cofinity Commercial |
$1,111.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.04
|
| Rate for Payer: Healthscope Commercial |
$1,163.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$969.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.67
|
| Rate for Payer: Nomi Health Commercial |
$1,059.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.41
|
| Rate for Payer: PHP Commercial |
$1,098.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,124.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,137.44
|
| Rate for Payer: UHC Core |
$1,079.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$969.41
|
|
|
HC INJ ANES CELIAC PLEXUS
|
Facility
|
OP
|
$1,292.55
|
|
|
Service Code
|
CPT 64517
|
| Hospital Charge Code |
36100605
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$227.88 |
| Max. Negotiated Rate |
$1,163.30 |
| Rate for Payer: Aetna Commercial |
$1,098.67
|
| Rate for Payer: Aetna Medicare |
$336.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$403.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$403.92
|
| Rate for Payer: BCBS Complete |
$239.25
|
| Rate for Payer: BCBS MAPPO |
$323.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.61
|
| Rate for Payer: BCN Commercial |
$1,062.61
|
| Rate for Payer: BCN Medicare Advantage |
$323.14
|
| Rate for Payer: Cash Price |
$1,034.04
|
| Rate for Payer: Cofinity Commercial |
$1,111.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.14
|
| Rate for Payer: Healthscope Commercial |
$1,163.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$969.41
|
| Rate for Payer: Mclaren Medicaid |
$227.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.29
|
| Rate for Payer: Meridian Medicaid |
$239.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$371.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$355.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,098.67
|
| Rate for Payer: Nomi Health Commercial |
$1,059.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.41
|
| Rate for Payer: PACE Senior Care Partners |
$306.98
|
| Rate for Payer: PACE SWMI |
$323.14
|
| Rate for Payer: PHP Commercial |
$1,098.67
|
| Rate for Payer: PHP Medicare Advantage |
$323.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,124.52
|
| Rate for Payer: Priority Health Medicare |
$326.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$899.61
|
| Rate for Payer: Railroad Medicare Medicare |
$323.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,137.44
|
| Rate for Payer: UHC Core |
$1,079.28
|
| Rate for Payer: UHC Exchange |
$323.14
|
| Rate for Payer: UHC Medicaid |
$227.88
|
| Rate for Payer: UHC Medicare Advantage |
$323.14
|
| Rate for Payer: UHCCP Medicaid |
$227.88
|
| Rate for Payer: VA VA |
$323.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$969.41
|
|
|
HC INJ ANES FEMORAL CONT
|
Facility
|
IP
|
$1,892.32
|
|
|
Service Code
|
CPT 64448
|
| Hospital Charge Code |
36100395
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,317.05 |
| Max. Negotiated Rate |
$1,703.09 |
| Rate for Payer: Aetna Commercial |
$1,608.47
|
| Rate for Payer: Aetna Commercial |
$2,412.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,562.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,344.31
|
| Rate for Payer: BCN Commercial |
$1,562.87
|
| Rate for Payer: BCN Commercial |
$2,344.31
|
| Rate for Payer: Cash Price |
$1,513.86
|
| Rate for Payer: Cash Price |
$2,270.79
|
| Rate for Payer: Cofinity Commercial |
$2,441.10
|
| Rate for Payer: Cofinity Commercial |
$1,627.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,270.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,513.86
|
| Rate for Payer: Healthscope Commercial |
$1,703.09
|
| Rate for Payer: Healthscope Commercial |
$2,554.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,419.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,128.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,608.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,412.72
|
| Rate for Payer: Nomi Health Commercial |
$1,551.70
|
| Rate for Payer: Nomi Health Commercial |
$2,327.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,419.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,128.87
|
| Rate for Payer: PHP Commercial |
$2,412.72
|
| Rate for Payer: PHP Commercial |
$1,608.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,469.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,646.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,317.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,975.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,665.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,497.87
|
| Rate for Payer: UHC Core |
$1,580.09
|
| Rate for Payer: UHC Core |
$2,370.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,419.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,128.87
|
|
|
HC INJ ANES FEMORAL CONT
|
Facility
|
OP
|
$1,892.32
|
|
|
Service Code
|
CPT 64448
|
| Hospital Charge Code |
36100395
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$333.62 |
| Max. Negotiated Rate |
$1,703.09 |
| Rate for Payer: Aetna Commercial |
$1,608.47
|
| Rate for Payer: Aetna Commercial |
$2,412.72
|
| Rate for Payer: Aetna Medicare |
$738.01
|
| Rate for Payer: Aetna Medicare |
$492.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$887.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$591.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$591.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$887.03
|
| Rate for Payer: BCBS Complete |
$350.27
|
| Rate for Payer: BCBS Complete |
$525.40
|
| Rate for Payer: BCBS MAPPO |
$473.08
|
| Rate for Payer: BCBS MAPPO |
$709.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,555.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,333.52
|
| Rate for Payer: BCN Commercial |
$2,333.52
|
| Rate for Payer: BCN Commercial |
$1,555.68
|
| Rate for Payer: BCN Medicare Advantage |
$709.62
|
| Rate for Payer: BCN Medicare Advantage |
$473.08
|
| Rate for Payer: Cash Price |
$1,513.86
|
| Rate for Payer: Cash Price |
$2,270.79
|
| Rate for Payer: Cofinity Commercial |
$1,627.40
|
| Rate for Payer: Cofinity Commercial |
$2,441.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,270.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,513.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$709.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.08
|
| Rate for Payer: Healthscope Commercial |
$1,703.09
|
| Rate for Payer: Healthscope Commercial |
$2,554.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,419.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,128.87
|
| Rate for Payer: Mclaren Medicaid |
$500.43
|
| Rate for Payer: Mclaren Medicaid |
$333.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$745.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$496.73
|
| Rate for Payer: Meridian Medicaid |
$350.27
|
| Rate for Payer: Meridian Medicaid |
$525.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$816.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$544.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$780.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$520.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,412.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,608.47
|
| Rate for Payer: Nomi Health Commercial |
$2,327.56
|
| Rate for Payer: Nomi Health Commercial |
$1,551.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,419.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,128.87
|
| Rate for Payer: PACE Senior Care Partners |
$674.14
|
| Rate for Payer: PACE Senior Care Partners |
$449.43
|
| Rate for Payer: PACE SWMI |
$709.62
|
| Rate for Payer: PACE SWMI |
$473.08
|
| Rate for Payer: PHP Commercial |
$1,608.47
|
| Rate for Payer: PHP Commercial |
$2,412.72
|
| Rate for Payer: PHP Medicare Advantage |
$473.08
|
| Rate for Payer: PHP Medicare Advantage |
$709.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$500.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,469.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,646.32
|
| Rate for Payer: Priority Health Medicare |
$716.72
|
| Rate for Payer: Priority Health Medicare |
$477.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,317.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,975.59
|
| Rate for Payer: Railroad Medicare Medicare |
$473.08
|
| Rate for Payer: Railroad Medicare Medicare |
$709.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,665.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,497.87
|
| Rate for Payer: UHC Core |
$2,370.14
|
| Rate for Payer: UHC Core |
$1,580.09
|
| Rate for Payer: UHC Exchange |
$709.62
|
| Rate for Payer: UHC Exchange |
$473.08
|
| Rate for Payer: UHC Medicaid |
$500.43
|
| Rate for Payer: UHC Medicaid |
$333.62
|
| Rate for Payer: UHC Medicare Advantage |
$473.08
|
| Rate for Payer: UHC Medicare Advantage |
$709.62
|
| Rate for Payer: UHCCP Medicaid |
$333.62
|
| Rate for Payer: UHCCP Medicaid |
$500.43
|
| Rate for Payer: VA VA |
$473.08
|
| Rate for Payer: VA VA |
$709.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,128.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,419.24
|
|
