|
HC GRAFIX PRIME 3 X 4 PER SQ CM
|
Facility
|
OP
|
$277.98
|
|
|
Service Code
|
HCPCS Q4133
|
| Hospital Charge Code |
63600161
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$66.02 |
| Max. Negotiated Rate |
$250.18 |
| Rate for Payer: Aetna Commercial |
$236.28
|
| Rate for Payer: Aetna Medicare |
$72.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.87
|
| Rate for Payer: BCBS Complete |
$111.19
|
| Rate for Payer: BCBS MAPPO |
$69.50
|
| Rate for Payer: BCBS Trust/PPO |
$228.53
|
| Rate for Payer: BCN Commercial |
$216.13
|
| Rate for Payer: BCN Medicare Advantage |
$69.50
|
| Rate for Payer: Cash Price |
$222.38
|
| Rate for Payer: Cofinity Commercial |
$239.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.50
|
| Rate for Payer: Healthscope Commercial |
$250.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.28
|
| Rate for Payer: Nomi Health Commercial |
$227.94
|
| Rate for Payer: PACE Senior Care Partners |
$66.02
|
| Rate for Payer: PACE SWMI |
$69.50
|
| Rate for Payer: PHP Commercial |
$236.28
|
| Rate for Payer: PHP Medicare Advantage |
$69.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.69
|
| Rate for Payer: Priority Health HMO/PPO |
$241.84
|
| Rate for Payer: Priority Health Medicare |
$70.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.25
|
| Rate for Payer: Railroad Medicare Medicare |
$69.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.62
|
| Rate for Payer: UHC Core |
$232.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.50
|
| Rate for Payer: UHC Exchange |
$69.50
|
| Rate for Payer: UHC Medicare Advantage |
$69.50
|
| Rate for Payer: VA VA |
$69.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.48
|
|
|
HC GRAFIX PRIME 3 X 4 PER SQ CM
|
Facility
|
IP
|
$277.98
|
|
|
Service Code
|
HCPCS Q4133
|
| Hospital Charge Code |
63600161
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$180.69 |
| Max. Negotiated Rate |
$250.18 |
| Rate for Payer: Aetna Commercial |
$236.28
|
| Rate for Payer: BCBS Trust/PPO |
$226.92
|
| Rate for Payer: BCN Commercial |
$214.82
|
| Rate for Payer: Cash Price |
$222.38
|
| Rate for Payer: Cofinity Commercial |
$239.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.38
|
| Rate for Payer: Healthscope Commercial |
$250.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.28
|
| Rate for Payer: Nomi Health Commercial |
$227.94
|
| Rate for Payer: PHP Commercial |
$236.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.69
|
| Rate for Payer: Priority Health HMO/PPO |
$241.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$244.62
|
| Rate for Payer: UHC Core |
$232.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.48
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM FEET, HANDS, FACE
|
Facility
|
OP
|
$2,458.78
|
|
|
Service Code
|
CPT 15115
|
| Hospital Charge Code |
76100067
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$583.96 |
| Max. Negotiated Rate |
$2,212.90 |
| Rate for Payer: Aetna Commercial |
$2,089.96
|
| Rate for Payer: Aetna Medicare |
$639.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.37
|
| Rate for Payer: BCBS Complete |
$1,360.67
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,021.36
|
| Rate for Payer: BCN Commercial |
$1,911.70
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$1,967.02
|
| Rate for Payer: Cash Price |
$1,967.02
|
| Rate for Payer: Cofinity Commercial |
$2,114.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,967.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$2,212.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,844.08
|
| Rate for Payer: Mclaren Medicaid |
$1,295.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$645.43
|
| Rate for Payer: Meridian Medicaid |
$1,360.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,089.96
|
| Rate for Payer: Nomi Health Commercial |
$2,016.20
|
| Rate for Payer: PACE Senior Care Partners |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$2,089.96
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,295.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,598.21
|
| Rate for Payer: Priority Health HMO/PPO |
$2,139.14
|
| Rate for Payer: Priority Health Medicare |
$620.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,647.38
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,163.73
|
| Rate for Payer: UHC Core |
$2,053.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.70
|
| Rate for Payer: UHC Exchange |
$614.70
|
| Rate for Payer: UHC Medicare Advantage |
$614.70
|
| Rate for Payer: UHCCP Medicaid |
$1,295.79
|
| Rate for Payer: VA VA |
$614.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,844.08
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM FEET, HANDS, FACE
|
Facility
|
IP
|
$2,458.78
|
|
|
Service Code
|
CPT 15115
|
| Hospital Charge Code |
76100067
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,598.21 |
| Max. Negotiated Rate |
$2,212.90 |
| Rate for Payer: Aetna Commercial |
$2,089.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,007.10
|
| Rate for Payer: BCN Commercial |
$1,900.15
|
| Rate for Payer: Cash Price |
$1,967.02
|
| Rate for Payer: Cofinity Commercial |
$2,114.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,967.02
|
| Rate for Payer: Healthscope Commercial |
$2,212.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,844.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,089.96
|
| Rate for Payer: Nomi Health Commercial |
$2,016.20
|
| Rate for Payer: PHP Commercial |
$2,089.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,598.21
|
| Rate for Payer: Priority Health HMO/PPO |
$2,139.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,647.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,163.73
|
| Rate for Payer: UHC Core |
$2,053.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,844.08
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM LEGS, ARMS, TRUNK
|
Facility
|
OP
|
$3,219.34
|
|
|
Service Code
|
CPT 15110
|
| Hospital Charge Code |
76100066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.59 |
| Max. Negotiated Rate |
$2,897.41 |
| Rate for Payer: Aetna Commercial |
$2,736.44
|
| Rate for Payer: Aetna Medicare |
$837.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,006.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,006.04
|
| Rate for Payer: BCBS Complete |
$1,360.67
|
| Rate for Payer: BCBS MAPPO |
$804.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,646.62
|
| Rate for Payer: BCN Commercial |
$2,503.04
|
| Rate for Payer: BCN Medicare Advantage |
$804.84
|
| Rate for Payer: Cash Price |
$2,575.47
|
| Rate for Payer: Cash Price |
$2,575.47
|
| Rate for Payer: Cofinity Commercial |
$2,768.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,575.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$804.84
|
| Rate for Payer: Healthscope Commercial |
$2,897.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,414.50
|
| Rate for Payer: Mclaren Medicaid |
$1,295.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$845.08
|
| Rate for Payer: Meridian Medicaid |
$1,360.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$925.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,736.44
|
| Rate for Payer: Nomi Health Commercial |
$2,639.86
|
| Rate for Payer: PACE Senior Care Partners |
$764.59
|
| Rate for Payer: PACE SWMI |
$804.84
|
| Rate for Payer: PHP Commercial |
$2,736.44
|
| Rate for Payer: PHP Medicare Advantage |
$804.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,295.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,092.57
|
| Rate for Payer: Priority Health HMO/PPO |
$2,800.83
|
| Rate for Payer: Priority Health Medicare |
$812.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,156.96
|
| Rate for Payer: Railroad Medicare Medicare |
$804.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,833.02
|
| Rate for Payer: UHC Core |
$2,688.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$804.84
|
| Rate for Payer: UHC Exchange |
$804.84
|
| Rate for Payer: UHC Medicare Advantage |
$804.84
|
| Rate for Payer: UHCCP Medicaid |
$1,295.79
|
| Rate for Payer: VA VA |
$804.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,414.50
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM LEGS, ARMS, TRUNK
|
Facility
|
IP
|
$3,219.34
|
|
|
Service Code
|
CPT 15110
|
| Hospital Charge Code |
76100066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,092.57 |
| Max. Negotiated Rate |
$2,897.41 |
| Rate for Payer: Aetna Commercial |
$2,736.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,627.95
|
| Rate for Payer: BCN Commercial |
$2,487.91
|
| Rate for Payer: Cash Price |
$2,575.47
|
| Rate for Payer: Cofinity Commercial |
$2,768.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,575.47
|
| Rate for Payer: Healthscope Commercial |
$2,897.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,414.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,736.44
|
| Rate for Payer: Nomi Health Commercial |
$2,639.86
|
| Rate for Payer: PHP Commercial |
$2,736.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,092.57
|
| Rate for Payer: Priority Health HMO/PPO |
$2,800.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,156.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,833.02
|
| Rate for Payer: UHC Core |
$2,688.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,414.50
|
|
|
HC GRAM STAIN
|
Facility
|
OP
|
$51.31
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600104
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: Aetna Medicare |
$13.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.03
|
| Rate for Payer: BCBS Complete |
$3.24
|
| Rate for Payer: BCBS MAPPO |
$12.83
|
| Rate for Payer: BCBS Trust/PPO |
$42.18
|
| Rate for Payer: BCN Commercial |
$39.89
|
| Rate for Payer: BCN Medicare Advantage |
$12.83
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.83
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.48
|
| Rate for Payer: Mclaren Medicaid |
$3.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.47
|
| Rate for Payer: Meridian Medicaid |
$3.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: Nomi Health Commercial |
$42.07
|
| Rate for Payer: PACE Senior Care Partners |
$12.19
|
| Rate for Payer: PACE SWMI |
$12.83
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: PHP Medicare Advantage |
$12.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: Priority Health HMO/PPO |
$44.64
|
| Rate for Payer: Priority Health Medicare |
$12.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.38
|
| Rate for Payer: Railroad Medicare Medicare |
$12.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.15
|
| Rate for Payer: UHC Core |
$42.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.83
|
| Rate for Payer: UHC Exchange |
$12.83
|
| Rate for Payer: UHC Medicare Advantage |
$12.83
|
| Rate for Payer: UHCCP Medicaid |
$3.09
|
| Rate for Payer: VA VA |
$12.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.48
|
|
|
HC GRAM STAIN
|
Facility
|
IP
|
$51.31
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600104
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.35 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: BCBS Trust/PPO |
$41.88
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: Nomi Health Commercial |
$42.07
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: Priority Health HMO/PPO |
$44.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.15
|
| Rate for Payer: UHC Core |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.48
|
|
|
HC GRANULOCYTES
|
Facility
|
OP
|
$1,925.76
|
|
|
Service Code
|
HCPCS P9050
|
| Hospital Charge Code |
39000057
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$457.37 |
| Max. Negotiated Rate |
$1,733.18 |
| Rate for Payer: Aetna Commercial |
$1,636.90
|
| Rate for Payer: Aetna Medicare |
$500.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$601.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$601.80
|
| Rate for Payer: BCBS Complete |
$770.30
|
| Rate for Payer: BCBS MAPPO |
$481.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,583.17
|
| Rate for Payer: BCN Commercial |
$1,497.28
|
| Rate for Payer: BCN Medicare Advantage |
$481.44
|
| Rate for Payer: Cash Price |
$1,540.61
|
| Rate for Payer: Cofinity Commercial |
$1,656.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$481.44
|
| Rate for Payer: Healthscope Commercial |
$1,733.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,444.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$505.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$553.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,636.90
|
| Rate for Payer: Nomi Health Commercial |
$1,579.12
|
| Rate for Payer: PACE Senior Care Partners |
$457.37
|
| Rate for Payer: PACE SWMI |
$481.44
|
| Rate for Payer: PHP Commercial |
$1,636.90
|
| Rate for Payer: PHP Medicare Advantage |
$481.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.74
|
| Rate for Payer: Priority Health HMO/PPO |
$1,675.41
|
| Rate for Payer: Priority Health Medicare |
$486.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,290.26
|
| Rate for Payer: Railroad Medicare Medicare |
$481.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,694.67
|
| Rate for Payer: UHC Core |
$1,608.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$481.44
|
| Rate for Payer: UHC Exchange |
$481.44
|
| Rate for Payer: UHC Medicare Advantage |
$481.44
|
| Rate for Payer: VA VA |
$481.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,444.32
|
|
|
HC GRANULOCYTES
|
Facility
|
IP
|
$1,925.76
|
|
|
Service Code
|
HCPCS P9050
|
| Hospital Charge Code |
39000057
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,251.74 |
| Max. Negotiated Rate |
$1,733.18 |
| Rate for Payer: Aetna Commercial |
$1,636.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,572.00
|
| Rate for Payer: BCN Commercial |
$1,488.23
|
| Rate for Payer: Cash Price |
$1,540.61
|
| Rate for Payer: Cofinity Commercial |
$1,656.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.61
|
| Rate for Payer: Healthscope Commercial |
$1,733.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,444.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,636.90
|
| Rate for Payer: Nomi Health Commercial |
$1,579.12
|
| Rate for Payer: PHP Commercial |
$1,636.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.74
|
| Rate for Payer: Priority Health HMO/PPO |
$1,675.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,290.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,694.67
|
| Rate for Payer: UHC Core |
$1,608.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,444.32
|
|
|
HC GRASS ALLERGEN PANEL
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200122
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC GRASS ALLERGEN PANEL
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200122
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC GREAT LAKES DISABILITY FILM(EACH)
|
Facility
|
IP
|
$20.00
|
|
| Hospital Charge Code |
32000267
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Aetna Commercial |
$17.00
|
| Rate for Payer: BCBS Trust/PPO |
$16.33
|
| Rate for Payer: BCN Commercial |
$15.46
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$17.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.00
|
| Rate for Payer: Healthscope Commercial |
$18.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.00
|
| Rate for Payer: Nomi Health Commercial |
$16.40
|
| Rate for Payer: PHP Commercial |
$17.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: Priority Health HMO/PPO |
$17.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.60
|
| Rate for Payer: UHC Core |
$16.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.00
|
|
|
HC GREAT LAKES DISABILITY FILM(EACH)
|
Facility
|
OP
|
$20.00
|
|
| Hospital Charge Code |
32000267
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$4.75 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Aetna Commercial |
$17.00
|
| Rate for Payer: Aetna Medicare |
$5.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.25
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$5.00
|
| Rate for Payer: BCBS Trust/PPO |
$16.44
|
| Rate for Payer: BCN Commercial |
$15.55
|
| Rate for Payer: BCN Medicare Advantage |
$5.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$17.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.00
|
| Rate for Payer: Healthscope Commercial |
$18.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.00
|
| Rate for Payer: Nomi Health Commercial |
$16.40
|
| Rate for Payer: PACE Senior Care Partners |
$4.75
|
| Rate for Payer: PACE SWMI |
$5.00
|
| Rate for Payer: PHP Commercial |
$17.00
|
| Rate for Payer: PHP Medicare Advantage |
$5.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: Priority Health HMO/PPO |
$17.40
|
| Rate for Payer: Priority Health Medicare |
$5.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.40
|
| Rate for Payer: Railroad Medicare Medicare |
$5.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.60
|
| Rate for Payer: UHC Core |
$16.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.00
|
| Rate for Payer: UHC Exchange |
$5.00
|
| Rate for Payer: UHC Medicare Advantage |
$5.00
|
| Rate for Payer: VA VA |
$5.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.00
|
|
|
HC GROIN/PSEUDO IMAGING BILATERAL
|
Facility
|
OP
|
$1,443.73
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100027
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,299.36 |
| Rate for Payer: Aetna Commercial |
$1,227.17
|
| Rate for Payer: Aetna Medicare |
$375.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$451.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$451.17
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$360.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.89
|
| Rate for Payer: BCN Commercial |
$1,122.50
|
| Rate for Payer: BCN Medicare Advantage |
$360.93
|
| Rate for Payer: Cash Price |
$1,154.98
|
| Rate for Payer: Cash Price |
$1,154.98
|
| Rate for Payer: Cofinity Commercial |
$1,241.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,154.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.93
|
| Rate for Payer: Healthscope Commercial |
$1,299.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,082.80
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$378.98
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$415.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,227.17
|
| Rate for Payer: Nomi Health Commercial |
$1,183.86
|
| Rate for Payer: PACE Senior Care Partners |
$342.89
|
| Rate for Payer: PACE SWMI |
$360.93
|
| Rate for Payer: PHP Commercial |
$1,227.17
|
| Rate for Payer: PHP Medicare Advantage |
$360.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$938.42
|
| Rate for Payer: Priority Health HMO/PPO |
$1,256.05
|
| Rate for Payer: Priority Health Medicare |
$364.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$967.30
|
| Rate for Payer: Railroad Medicare Medicare |
$360.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,270.48
|
| Rate for Payer: UHC Core |
$1,205.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$360.93
|
| Rate for Payer: UHC Exchange |
$360.93
|
| Rate for Payer: UHC Medicare Advantage |
$360.93
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$360.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,082.80
|
|
|
HC GROIN/PSEUDO IMAGING BILATERAL
|
Facility
|
IP
|
$1,443.73
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100027
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$938.42 |
| Max. Negotiated Rate |
$1,299.36 |
| Rate for Payer: Aetna Commercial |
$1,227.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,178.52
|
| Rate for Payer: BCN Commercial |
$1,115.71
|
| Rate for Payer: Cash Price |
$1,154.98
|
| Rate for Payer: Cofinity Commercial |
$1,241.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,154.98
|
| Rate for Payer: Healthscope Commercial |
$1,299.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,082.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,227.17
|
| Rate for Payer: Nomi Health Commercial |
$1,183.86
|
| Rate for Payer: PHP Commercial |
$1,227.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$938.42
|
| Rate for Payer: Priority Health HMO/PPO |
$1,256.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$967.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,270.48
|
| Rate for Payer: UHC Core |
$1,205.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,082.80
|
|
|
HC GROIN/PSEUDO IMAGING (R OR L)
|
Facility
|
OP
|
$922.21
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100026
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$75.33 |
| Max. Negotiated Rate |
$829.99 |
| Rate for Payer: Aetna Commercial |
$783.88
|
| Rate for Payer: Aetna Medicare |
$239.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$288.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$288.19
|
| Rate for Payer: BCBS Complete |
$79.10
|
| Rate for Payer: BCBS MAPPO |
$230.55
|
| Rate for Payer: BCBS Trust/PPO |
$758.15
|
| Rate for Payer: BCN Commercial |
$717.02
|
| Rate for Payer: BCN Medicare Advantage |
$230.55
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cofinity Commercial |
$793.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.55
|
| Rate for Payer: Healthscope Commercial |
$829.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.66
|
| Rate for Payer: Mclaren Medicaid |
$75.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.08
|
| Rate for Payer: Meridian Medicaid |
$79.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.88
|
| Rate for Payer: Nomi Health Commercial |
$756.21
|
| Rate for Payer: PACE Senior Care Partners |
$219.02
|
| Rate for Payer: PACE SWMI |
$230.55
|
| Rate for Payer: PHP Commercial |
$783.88
|
| Rate for Payer: PHP Medicare Advantage |
$230.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.44
|
| Rate for Payer: Priority Health HMO/PPO |
$802.32
|
| Rate for Payer: Priority Health Medicare |
$232.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.88
|
| Rate for Payer: Railroad Medicare Medicare |
$230.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$811.54
|
| Rate for Payer: UHC Core |
$770.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.55
|
| Rate for Payer: UHC Exchange |
$230.55
|
| Rate for Payer: UHC Medicare Advantage |
$230.55
|
| Rate for Payer: UHCCP Medicaid |
$75.33
|
| Rate for Payer: VA VA |
$230.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.66
|
|
|
HC GROIN/PSEUDO IMAGING (R OR L)
|
Facility
|
IP
|
$922.21
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100026
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$599.44 |
| Max. Negotiated Rate |
$829.99 |
| Rate for Payer: Aetna Commercial |
$783.88
|
| Rate for Payer: BCBS Trust/PPO |
$752.80
|
| Rate for Payer: BCN Commercial |
$712.68
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cofinity Commercial |
$793.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.77
|
| Rate for Payer: Healthscope Commercial |
$829.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.88
|
| Rate for Payer: Nomi Health Commercial |
$756.21
|
| Rate for Payer: PHP Commercial |
$783.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.44
|
| Rate for Payer: Priority Health HMO/PPO |
$802.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$617.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$811.54
|
| Rate for Payer: UHC Core |
$770.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.66
|
|
|
HC GROSHONG REPAIR KIT
|
Facility
|
IP
|
$464.18
|
|
| Hospital Charge Code |
27200125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$301.72 |
| Max. Negotiated Rate |
$417.76 |
| Rate for Payer: Aetna Commercial |
$394.55
|
| Rate for Payer: BCBS Trust/PPO |
$378.91
|
| Rate for Payer: BCN Commercial |
$358.72
|
| Rate for Payer: Cash Price |
$371.34
|
| Rate for Payer: Cofinity Commercial |
$399.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$371.34
|
| Rate for Payer: Healthscope Commercial |
$417.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$348.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394.55
|
| Rate for Payer: Nomi Health Commercial |
$380.63
|
| Rate for Payer: PHP Commercial |
$394.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.72
|
| Rate for Payer: Priority Health HMO/PPO |
$403.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$408.48
|
| Rate for Payer: UHC Core |
$387.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$348.14
|
|
|
HC GROSHONG REPAIR KIT
|
Facility
|
OP
|
$464.18
|
|
| Hospital Charge Code |
27200125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.24 |
| Max. Negotiated Rate |
$417.76 |
| Rate for Payer: Aetna Commercial |
$394.55
|
| Rate for Payer: Aetna Medicare |
$120.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$145.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$145.06
|
| Rate for Payer: BCBS Complete |
$185.67
|
| Rate for Payer: BCBS MAPPO |
$116.04
|
| Rate for Payer: BCBS Trust/PPO |
$381.60
|
| Rate for Payer: BCN Commercial |
$360.90
|
| Rate for Payer: BCN Medicare Advantage |
$116.04
|
| Rate for Payer: Cash Price |
$371.34
|
| Rate for Payer: Cofinity Commercial |
$399.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$371.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.04
|
| Rate for Payer: Healthscope Commercial |
$417.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$348.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$133.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394.55
|
| Rate for Payer: Nomi Health Commercial |
$380.63
|
| Rate for Payer: PACE Senior Care Partners |
$110.24
|
| Rate for Payer: PACE SWMI |
$116.04
|
| Rate for Payer: PHP Commercial |
$394.55
|
| Rate for Payer: PHP Medicare Advantage |
$116.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.72
|
| Rate for Payer: Priority Health HMO/PPO |
$403.84
|
| Rate for Payer: Priority Health Medicare |
$117.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.00
|
| Rate for Payer: Railroad Medicare Medicare |
$116.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$408.48
|
| Rate for Payer: UHC Core |
$387.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.04
|
| Rate for Payer: UHC Exchange |
$116.04
|
| Rate for Payer: UHC Medicare Advantage |
$116.04
|
| Rate for Payer: VA VA |
$116.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$348.14
|
|
|
HC GROUP B STREP, AMPLIFIED
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600210
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$67.63 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: BCBS Trust/PPO |
$84.93
|
| Rate for Payer: BCN Commercial |
$80.40
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC GROUP B STREP, AMPLIFIED
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600210
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna Medicare |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.51
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$85.53
|
| Rate for Payer: BCN Commercial |
$80.89
|
| Rate for Payer: BCN Medicare Advantage |
$26.01
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.01
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.31
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PACE Senior Care Partners |
$24.71
|
| Rate for Payer: PACE SWMI |
$26.01
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: PHP Medicare Advantage |
$26.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Medicare |
$26.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.71
|
| Rate for Payer: Railroad Medicare Medicare |
$26.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.01
|
| Rate for Payer: UHC Exchange |
$26.01
|
| Rate for Payer: UHC Medicare Advantage |
$26.01
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$26.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC GROUP CAREGIVER TRAINING
|
Facility
|
IP
|
$53.04
|
|
|
Service Code
|
CPT 97552
|
| Hospital Charge Code |
42000067
|
| Min. Negotiated Rate |
$34.48 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: BCBS Trust/PPO |
$43.30
|
| Rate for Payer: BCN Commercial |
$40.99
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.08
|
| Rate for Payer: Nomi Health Commercial |
$43.49
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.48
|
| Rate for Payer: Priority Health HMO/PPO |
$46.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.68
|
| Rate for Payer: UHC Core |
$44.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC GROUP CAREGIVER TRAINING
|
Facility
|
OP
|
$53.04
|
|
|
Service Code
|
CPT 97552
|
| Hospital Charge Code |
42000067
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: Aetna Medicare |
$13.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$21.22
|
| Rate for Payer: BCBS MAPPO |
$13.26
|
| Rate for Payer: BCBS Trust/PPO |
$43.60
|
| Rate for Payer: BCN Commercial |
$41.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.26
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.26
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.08
|
| Rate for Payer: Nomi Health Commercial |
$43.49
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.26
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: PHP Medicare Advantage |
$13.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.48
|
| Rate for Payer: Priority Health HMO/PPO |
$46.14
|
| Rate for Payer: Priority Health Medicare |
$13.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.54
|
| Rate for Payer: Railroad Medicare Medicare |
$13.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.68
|
| Rate for Payer: UHC Core |
$44.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.26
|
| Rate for Payer: UHC Exchange |
$13.26
|
| Rate for Payer: UHC Medicare Advantage |
$13.26
|
| Rate for Payer: VA VA |
$13.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC GROUP PSYCHOTHERAPY
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
91500001
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$23.47 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$25.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.89
|
| Rate for Payer: BCBS Complete |
$68.81
|
| Rate for Payer: BCBS MAPPO |
$24.71
|
| Rate for Payer: BCBS Trust/PPO |
$81.26
|
| Rate for Payer: BCN Commercial |
$76.85
|
| Rate for Payer: BCN Medicare Advantage |
$24.71
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.71
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Mclaren Medicaid |
$65.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.95
|
| Rate for Payer: Meridian Medicaid |
$68.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: PACE Senior Care Partners |
$23.47
|
| Rate for Payer: PACE SWMI |
$24.71
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: PHP Medicare Advantage |
$24.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Medicare |
$24.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.22
|
| Rate for Payer: Railroad Medicare Medicare |
$24.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.71
|
| Rate for Payer: UHC Exchange |
$24.71
|
| Rate for Payer: UHC Medicare Advantage |
$24.71
|
| Rate for Payer: UHCCP Medicaid |
$65.53
|
| Rate for Payer: VA VA |
$24.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
