|
HC HALO RING & VEST
|
Facility
|
OP
|
$6,285.33
|
|
| Hospital Charge Code |
27000084
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,492.77 |
| Max. Negotiated Rate |
$5,656.80 |
| Rate for Payer: Aetna Commercial |
$5,342.53
|
| Rate for Payer: Aetna Medicare |
$1,634.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,964.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,964.17
|
| Rate for Payer: BCBS Complete |
$2,514.13
|
| Rate for Payer: BCBS MAPPO |
$1,571.33
|
| Rate for Payer: BCBS Trust/PPO |
$5,167.17
|
| Rate for Payer: BCN Commercial |
$4,886.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,571.33
|
| Rate for Payer: Cash Price |
$5,028.26
|
| Rate for Payer: Cofinity Commercial |
$5,405.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,028.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,571.33
|
| Rate for Payer: Healthscope Commercial |
$5,656.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,714.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,649.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,807.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,342.53
|
| Rate for Payer: Nomi Health Commercial |
$5,153.97
|
| Rate for Payer: PACE Senior Care Partners |
$1,492.77
|
| Rate for Payer: PACE SWMI |
$1,571.33
|
| Rate for Payer: PHP Commercial |
$5,342.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,571.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,085.46
|
| Rate for Payer: Priority Health HMO/PPO |
$5,468.24
|
| Rate for Payer: Priority Health Medicare |
$1,587.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,211.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1,571.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,531.09
|
| Rate for Payer: UHC Core |
$5,248.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,571.33
|
| Rate for Payer: UHC Exchange |
$1,571.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,571.33
|
| Rate for Payer: VA VA |
$1,571.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,714.00
|
|
|
HC HALO RING & VEST
|
Facility
|
IP
|
$6,285.33
|
|
| Hospital Charge Code |
27000084
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,085.46 |
| Max. Negotiated Rate |
$5,656.80 |
| Rate for Payer: Aetna Commercial |
$5,342.53
|
| Rate for Payer: BCBS Trust/PPO |
$5,130.71
|
| Rate for Payer: BCN Commercial |
$4,857.30
|
| Rate for Payer: Cash Price |
$5,028.26
|
| Rate for Payer: Cofinity Commercial |
$5,405.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,028.26
|
| Rate for Payer: Healthscope Commercial |
$5,656.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,714.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,342.53
|
| Rate for Payer: Nomi Health Commercial |
$5,153.97
|
| Rate for Payer: PHP Commercial |
$5,342.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,085.46
|
| Rate for Payer: Priority Health HMO/PPO |
$5,468.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,211.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,531.09
|
| Rate for Payer: UHC Core |
$5,248.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,714.00
|
|
|
HC HALO VEST APPLICATION
|
Facility
|
OP
|
$5,766.18
|
|
| Hospital Charge Code |
27000086
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,369.47 |
| Max. Negotiated Rate |
$5,189.56 |
| Rate for Payer: Aetna Commercial |
$4,901.25
|
| Rate for Payer: Aetna Medicare |
$1,499.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.93
|
| Rate for Payer: BCBS Complete |
$2,306.47
|
| Rate for Payer: BCBS MAPPO |
$1,441.54
|
| Rate for Payer: BCBS Trust/PPO |
$4,740.38
|
| Rate for Payer: BCN Commercial |
$4,483.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.54
|
| Rate for Payer: Cash Price |
$4,612.94
|
| Rate for Payer: Cofinity Commercial |
$4,958.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,612.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.54
|
| Rate for Payer: Healthscope Commercial |
$5,189.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,324.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,513.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,901.25
|
| Rate for Payer: Nomi Health Commercial |
$4,728.27
|
| Rate for Payer: PACE Senior Care Partners |
$1,369.47
|
| Rate for Payer: PACE SWMI |
$1,441.54
|
| Rate for Payer: PHP Commercial |
$4,901.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,748.02
|
| Rate for Payer: Priority Health HMO/PPO |
$5,016.58
|
| Rate for Payer: Priority Health Medicare |
$1,455.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,863.34
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,074.24
|
| Rate for Payer: UHC Core |
$4,814.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.54
|
| Rate for Payer: UHC Exchange |
$1,441.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,441.54
|
| Rate for Payer: VA VA |
$1,441.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,324.64
|
|
|
HC HALO VEST APPLICATION
|
Facility
|
IP
|
$5,766.18
|
|
| Hospital Charge Code |
27000086
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3,748.02 |
| Max. Negotiated Rate |
$5,189.56 |
| Rate for Payer: Aetna Commercial |
$4,901.25
|
| Rate for Payer: BCBS Trust/PPO |
$4,706.93
|
| Rate for Payer: BCN Commercial |
$4,456.10
|
| Rate for Payer: Cash Price |
$4,612.94
|
| Rate for Payer: Cofinity Commercial |
$4,958.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,612.94
|
| Rate for Payer: Healthscope Commercial |
$5,189.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,324.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,901.25
|
| Rate for Payer: Nomi Health Commercial |
$4,728.27
|
| Rate for Payer: PHP Commercial |
$4,901.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,748.02
|
| Rate for Payer: Priority Health HMO/PPO |
$5,016.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,863.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,074.24
|
| Rate for Payer: UHC Core |
$4,814.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,324.64
|
|
|
HC HAPTOGLOGIN
|
Facility
|
OP
|
$84.66
|
|
|
Service Code
|
CPT 83010
|
| Hospital Charge Code |
30100234
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$76.19 |
| Rate for Payer: Aetna Commercial |
$71.96
|
| Rate for Payer: Aetna Medicare |
$22.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.46
|
| Rate for Payer: BCBS Complete |
$9.55
|
| Rate for Payer: BCBS MAPPO |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$69.60
|
| Rate for Payer: BCN Commercial |
$65.82
|
| Rate for Payer: BCN Medicare Advantage |
$21.16
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$72.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.16
|
| Rate for Payer: Healthscope Commercial |
$76.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.50
|
| Rate for Payer: Mclaren Medicaid |
$9.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.22
|
| Rate for Payer: Meridian Medicaid |
$9.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.96
|
| Rate for Payer: Nomi Health Commercial |
$69.42
|
| Rate for Payer: PACE Senior Care Partners |
$20.11
|
| Rate for Payer: PACE SWMI |
$21.16
|
| Rate for Payer: PHP Commercial |
$71.96
|
| Rate for Payer: PHP Medicare Advantage |
$21.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.03
|
| Rate for Payer: Priority Health HMO/PPO |
$73.65
|
| Rate for Payer: Priority Health Medicare |
$21.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.72
|
| Rate for Payer: Railroad Medicare Medicare |
$21.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.50
|
| Rate for Payer: UHC Core |
$70.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.16
|
| Rate for Payer: UHC Exchange |
$21.16
|
| Rate for Payer: UHC Medicare Advantage |
$21.16
|
| Rate for Payer: UHCCP Medicaid |
$9.10
|
| Rate for Payer: VA VA |
$21.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.50
|
|
|
HC HAPTOGLOGIN
|
Facility
|
IP
|
$84.66
|
|
|
Service Code
|
CPT 83010
|
| Hospital Charge Code |
30100234
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.03 |
| Max. Negotiated Rate |
$76.19 |
| Rate for Payer: Aetna Commercial |
$71.96
|
| Rate for Payer: BCBS Trust/PPO |
$69.11
|
| Rate for Payer: BCN Commercial |
$65.43
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$72.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Healthscope Commercial |
$76.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.96
|
| Rate for Payer: Nomi Health Commercial |
$69.42
|
| Rate for Payer: PHP Commercial |
$71.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.03
|
| Rate for Payer: Priority Health HMO/PPO |
$73.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.50
|
| Rate for Payer: UHC Core |
$70.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.50
|
|
|
HC HAZELNUT FILBERT IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200043
|
|
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 HAZELNUT FILBERT IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200043
|
|
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 HBO PER 30 MINUTES
|
Facility
|
IP
|
$654.23
|
|
|
Service Code
|
HCPCS G0277
|
| Hospital Charge Code |
41300001
|
|
Hospital Revenue Code
|
413
|
| Min. Negotiated Rate |
$425.25 |
| Max. Negotiated Rate |
$588.81 |
| Rate for Payer: Aetna Commercial |
$556.10
|
| Rate for Payer: BCBS Trust/PPO |
$534.05
|
| Rate for Payer: BCN Commercial |
$505.59
|
| Rate for Payer: Cash Price |
$523.38
|
| Rate for Payer: Cofinity Commercial |
$562.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$523.38
|
| Rate for Payer: Healthscope Commercial |
$588.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$490.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$556.10
|
| Rate for Payer: Nomi Health Commercial |
$536.47
|
| Rate for Payer: PHP Commercial |
$556.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$425.25
|
| Rate for Payer: Priority Health HMO/PPO |
$569.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$438.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$575.72
|
| Rate for Payer: UHC Core |
$546.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$490.67
|
|
|
HC HBO PER 30 MINUTES
|
Facility
|
OP
|
$654.23
|
|
|
Service Code
|
HCPCS G0277
|
| Hospital Charge Code |
41300001
|
|
Hospital Revenue Code
|
413
|
| Min. Negotiated Rate |
$97.68 |
| Max. Negotiated Rate |
$588.81 |
| Rate for Payer: Aetna Commercial |
$556.10
|
| Rate for Payer: Aetna Medicare |
$170.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.45
|
| Rate for Payer: BCBS Complete |
$102.58
|
| Rate for Payer: BCBS MAPPO |
$163.56
|
| Rate for Payer: BCBS Trust/PPO |
$537.84
|
| Rate for Payer: BCN Commercial |
$508.66
|
| Rate for Payer: BCN Medicare Advantage |
$163.56
|
| Rate for Payer: Cash Price |
$523.38
|
| Rate for Payer: Cash Price |
$523.38
|
| Rate for Payer: Cofinity Commercial |
$562.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$523.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.56
|
| Rate for Payer: Healthscope Commercial |
$588.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$490.67
|
| Rate for Payer: Mclaren Medicaid |
$97.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$171.74
|
| Rate for Payer: Meridian Medicaid |
$102.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$556.10
|
| Rate for Payer: Nomi Health Commercial |
$536.47
|
| Rate for Payer: PACE Senior Care Partners |
$155.38
|
| Rate for Payer: PACE SWMI |
$163.56
|
| Rate for Payer: PHP Commercial |
$556.10
|
| Rate for Payer: PHP Medicare Advantage |
$163.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$425.25
|
| Rate for Payer: Priority Health HMO/PPO |
$569.18
|
| Rate for Payer: Priority Health Medicare |
$165.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$438.33
|
| Rate for Payer: Railroad Medicare Medicare |
$163.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$575.72
|
| Rate for Payer: UHC Core |
$546.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.56
|
| Rate for Payer: UHC Exchange |
$163.56
|
| Rate for Payer: UHC Medicare Advantage |
$163.56
|
| Rate for Payer: UHCCP Medicaid |
$97.68
|
| Rate for Payer: VA VA |
$163.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$490.67
|
|
|
HC HBO TCPO2 ARTERIAL STUDY COMPLETE
|
Facility
|
OP
|
$835.42
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100005
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$110.84 |
| Max. Negotiated Rate |
$751.88 |
| Rate for Payer: Aetna Commercial |
$710.11
|
| Rate for Payer: Aetna Medicare |
$217.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$261.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$261.07
|
| Rate for Payer: BCBS Complete |
$116.39
|
| Rate for Payer: BCBS MAPPO |
$208.86
|
| Rate for Payer: BCBS Trust/PPO |
$686.80
|
| Rate for Payer: BCN Commercial |
$649.54
|
| Rate for Payer: BCN Medicare Advantage |
$208.86
|
| Rate for Payer: Cash Price |
$668.34
|
| Rate for Payer: Cash Price |
$668.34
|
| Rate for Payer: Cofinity Commercial |
$718.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$668.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.86
|
| Rate for Payer: Healthscope Commercial |
$751.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$626.56
|
| Rate for Payer: Mclaren Medicaid |
$110.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$219.30
|
| Rate for Payer: Meridian Medicaid |
$116.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$240.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$710.11
|
| Rate for Payer: Nomi Health Commercial |
$685.04
|
| Rate for Payer: PACE Senior Care Partners |
$198.41
|
| Rate for Payer: PACE SWMI |
$208.86
|
| Rate for Payer: PHP Commercial |
$710.11
|
| Rate for Payer: PHP Medicare Advantage |
$208.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.02
|
| Rate for Payer: Priority Health HMO/PPO |
$726.82
|
| Rate for Payer: Priority Health Medicare |
$210.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$559.73
|
| Rate for Payer: Railroad Medicare Medicare |
$208.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$735.17
|
| Rate for Payer: UHC Core |
$697.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$208.86
|
| Rate for Payer: UHC Exchange |
$208.86
|
| Rate for Payer: UHC Medicare Advantage |
$208.86
|
| Rate for Payer: UHCCP Medicaid |
$110.84
|
| Rate for Payer: VA VA |
$208.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$626.56
|
|
|
HC HBO TCPO2 ARTERIAL STUDY COMPLETE
|
Facility
|
IP
|
$835.42
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100005
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$543.02 |
| Max. Negotiated Rate |
$751.88 |
| Rate for Payer: Aetna Commercial |
$710.11
|
| Rate for Payer: BCBS Trust/PPO |
$681.95
|
| Rate for Payer: BCN Commercial |
$645.61
|
| Rate for Payer: Cash Price |
$668.34
|
| Rate for Payer: Cofinity Commercial |
$718.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$668.34
|
| Rate for Payer: Healthscope Commercial |
$751.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$626.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$710.11
|
| Rate for Payer: Nomi Health Commercial |
$685.04
|
| Rate for Payer: PHP Commercial |
$710.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.02
|
| Rate for Payer: Priority Health HMO/PPO |
$726.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$559.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$735.17
|
| Rate for Payer: UHC Core |
$697.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$626.56
|
|
|
HC HBO TCPO2 ARTERIAL STUDY UNILATERAL OR LIMITED
|
Facility
|
IP
|
$535.76
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100033
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$348.24 |
| Max. Negotiated Rate |
$482.18 |
| Rate for Payer: Aetna Commercial |
$455.40
|
| Rate for Payer: BCBS Trust/PPO |
$437.34
|
| Rate for Payer: BCN Commercial |
$414.04
|
| Rate for Payer: Cash Price |
$428.61
|
| Rate for Payer: Cofinity Commercial |
$460.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.61
|
| Rate for Payer: Healthscope Commercial |
$482.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.40
|
| Rate for Payer: Nomi Health Commercial |
$439.32
|
| Rate for Payer: PHP Commercial |
$455.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.24
|
| Rate for Payer: Priority Health HMO/PPO |
$466.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$471.47
|
| Rate for Payer: UHC Core |
$447.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.82
|
|
|
HC HBO TCPO2 ARTERIAL STUDY UNILATERAL OR LIMITED
|
Facility
|
OP
|
$535.76
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100033
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$91.31 |
| Max. Negotiated Rate |
$482.18 |
| Rate for Payer: Aetna Commercial |
$455.40
|
| Rate for Payer: Aetna Medicare |
$139.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$167.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$167.42
|
| Rate for Payer: BCBS Complete |
$95.88
|
| Rate for Payer: BCBS MAPPO |
$133.94
|
| Rate for Payer: BCBS Trust/PPO |
$440.45
|
| Rate for Payer: BCN Commercial |
$416.55
|
| Rate for Payer: BCN Medicare Advantage |
$133.94
|
| Rate for Payer: Cash Price |
$428.61
|
| Rate for Payer: Cash Price |
$428.61
|
| Rate for Payer: Cofinity Commercial |
$460.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.94
|
| Rate for Payer: Healthscope Commercial |
$482.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.82
|
| Rate for Payer: Mclaren Medicaid |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.64
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$154.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.40
|
| Rate for Payer: Nomi Health Commercial |
$439.32
|
| Rate for Payer: PACE Senior Care Partners |
$127.24
|
| Rate for Payer: PACE SWMI |
$133.94
|
| Rate for Payer: PHP Commercial |
$455.40
|
| Rate for Payer: PHP Medicare Advantage |
$133.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.24
|
| Rate for Payer: Priority Health HMO/PPO |
$466.11
|
| Rate for Payer: Priority Health Medicare |
$135.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.96
|
| Rate for Payer: Railroad Medicare Medicare |
$133.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$471.47
|
| Rate for Payer: UHC Core |
$447.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.94
|
| Rate for Payer: UHC Exchange |
$133.94
|
| Rate for Payer: UHC Medicare Advantage |
$133.94
|
| Rate for Payer: UHCCP Medicaid |
$91.31
|
| Rate for Payer: VA VA |
$133.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.82
|
|
|
HC HCCORO/CABG ANGIOS ONLY
|
Facility
|
OP
|
$6,486.08
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
48100014
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,540.44 |
| Max. Negotiated Rate |
$5,837.47 |
| Rate for Payer: Aetna Commercial |
$5,513.17
|
| Rate for Payer: Aetna Medicare |
$1,686.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.90
|
| Rate for Payer: BCBS Complete |
$2,392.52
|
| Rate for Payer: BCBS MAPPO |
$1,621.52
|
| Rate for Payer: BCBS Trust/PPO |
$5,332.21
|
| Rate for Payer: BCN Commercial |
$5,042.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,621.52
|
| Rate for Payer: Cash Price |
$5,188.86
|
| Rate for Payer: Cash Price |
$5,188.86
|
| Rate for Payer: Cofinity Commercial |
$5,578.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,188.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,621.52
|
| Rate for Payer: Healthscope Commercial |
$5,837.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,864.56
|
| Rate for Payer: Mclaren Medicaid |
$2,278.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,702.60
|
| Rate for Payer: Meridian Medicaid |
$2,392.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,513.17
|
| Rate for Payer: Nomi Health Commercial |
$5,318.59
|
| Rate for Payer: PACE Senior Care Partners |
$1,540.44
|
| Rate for Payer: PACE SWMI |
$1,621.52
|
| Rate for Payer: PHP Commercial |
$5,513.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,621.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,278.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,215.95
|
| Rate for Payer: Priority Health HMO/PPO |
$5,642.89
|
| Rate for Payer: Priority Health Medicare |
$1,637.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,345.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,621.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,707.75
|
| Rate for Payer: UHC Core |
$5,415.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,621.52
|
| Rate for Payer: UHC Exchange |
$1,621.52
|
| Rate for Payer: UHC Medicare Advantage |
$1,621.52
|
| Rate for Payer: UHCCP Medicaid |
$2,278.44
|
| Rate for Payer: VA VA |
$1,621.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,864.56
|
|
|
HC HCCORO/CABG ANGIOS ONLY
|
Facility
|
IP
|
$6,486.08
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
48100014
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,215.95 |
| Max. Negotiated Rate |
$5,837.47 |
| Rate for Payer: Aetna Commercial |
$5,513.17
|
| Rate for Payer: BCBS Trust/PPO |
$5,294.59
|
| Rate for Payer: BCN Commercial |
$5,012.44
|
| Rate for Payer: Cash Price |
$5,188.86
|
| Rate for Payer: Cofinity Commercial |
$5,578.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,188.86
|
| Rate for Payer: Healthscope Commercial |
$5,837.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,864.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,513.17
|
| Rate for Payer: Nomi Health Commercial |
$5,318.59
|
| Rate for Payer: PHP Commercial |
$5,513.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,215.95
|
| Rate for Payer: Priority Health HMO/PPO |
$5,642.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,345.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,707.75
|
| Rate for Payer: UHC Core |
$5,415.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,864.56
|
|
|
HC HCG SERUM QUANTITATIVE
|
Facility
|
OP
|
$63.46
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
30100465
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.88 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.83
|
| Rate for Payer: BCBS Complete |
$11.43
|
| Rate for Payer: BCBS MAPPO |
$15.86
|
| Rate for Payer: BCBS Trust/PPO |
$52.17
|
| Rate for Payer: BCN Commercial |
$49.34
|
| Rate for Payer: BCN Medicare Advantage |
$15.86
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.86
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.60
|
| Rate for Payer: Mclaren Medicaid |
$10.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.66
|
| Rate for Payer: Meridian Medicaid |
$11.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: PACE Senior Care Partners |
$15.07
|
| Rate for Payer: PACE SWMI |
$15.86
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: PHP Medicare Advantage |
$15.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.25
|
| Rate for Payer: Priority Health HMO/PPO |
$55.21
|
| Rate for Payer: Priority Health Medicare |
$16.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.52
|
| Rate for Payer: Railroad Medicare Medicare |
$15.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.84
|
| Rate for Payer: UHC Core |
$52.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.86
|
| Rate for Payer: UHC Exchange |
$15.86
|
| Rate for Payer: UHC Medicare Advantage |
$15.86
|
| Rate for Payer: UHCCP Medicaid |
$10.88
|
| Rate for Payer: VA VA |
$15.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.60
|
|
|
HC HCG SERUM QUANTITATIVE
|
Facility
|
IP
|
$63.46
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
30100465
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.25 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: BCBS Trust/PPO |
$51.80
|
| Rate for Payer: BCN Commercial |
$49.04
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.25
|
| Rate for Payer: Priority Health HMO/PPO |
$55.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.84
|
| Rate for Payer: UHC Core |
$52.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.60
|
|
|
HC HCV GENOTYPE RESOLUTION
|
Facility
|
OP
|
$403.49
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
30600262
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$95.83 |
| Max. Negotiated Rate |
$363.14 |
| Rate for Payer: Aetna Commercial |
$342.97
|
| Rate for Payer: Aetna Medicare |
$104.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.09
|
| Rate for Payer: BCBS Complete |
$195.46
|
| Rate for Payer: BCBS MAPPO |
$100.87
|
| Rate for Payer: BCBS Trust/PPO |
$331.71
|
| Rate for Payer: BCN Commercial |
$313.71
|
| Rate for Payer: BCN Medicare Advantage |
$100.87
|
| Rate for Payer: Cash Price |
$322.79
|
| Rate for Payer: Cash Price |
$322.79
|
| Rate for Payer: Cofinity Commercial |
$347.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.87
|
| Rate for Payer: Healthscope Commercial |
$363.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$302.62
|
| Rate for Payer: Mclaren Medicaid |
$186.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.92
|
| Rate for Payer: Meridian Medicaid |
$195.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.97
|
| Rate for Payer: Nomi Health Commercial |
$330.86
|
| Rate for Payer: PACE Senior Care Partners |
$95.83
|
| Rate for Payer: PACE SWMI |
$100.87
|
| Rate for Payer: PHP Commercial |
$342.97
|
| Rate for Payer: PHP Medicare Advantage |
$100.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.27
|
| Rate for Payer: Priority Health HMO/PPO |
$351.04
|
| Rate for Payer: Priority Health Medicare |
$101.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$270.34
|
| Rate for Payer: Railroad Medicare Medicare |
$100.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.07
|
| Rate for Payer: UHC Core |
$336.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.87
|
| Rate for Payer: UHC Exchange |
$100.87
|
| Rate for Payer: UHC Medicare Advantage |
$100.87
|
| Rate for Payer: UHCCP Medicaid |
$186.14
|
| Rate for Payer: VA VA |
$100.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$302.62
|
|
|
HC HCV GENOTYPE RESOLUTION
|
Facility
|
IP
|
$403.49
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
30600262
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$262.27 |
| Max. Negotiated Rate |
$363.14 |
| Rate for Payer: Aetna Commercial |
$342.97
|
| Rate for Payer: BCBS Trust/PPO |
$329.37
|
| Rate for Payer: BCN Commercial |
$311.82
|
| Rate for Payer: Cash Price |
$322.79
|
| Rate for Payer: Cofinity Commercial |
$347.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.79
|
| Rate for Payer: Healthscope Commercial |
$363.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$302.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.97
|
| Rate for Payer: Nomi Health Commercial |
$330.86
|
| Rate for Payer: PHP Commercial |
$342.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.27
|
| Rate for Payer: Priority Health HMO/PPO |
$351.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$270.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.07
|
| Rate for Payer: UHC Core |
$336.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$302.62
|
|
|
HC HDL CHOLESTEROL
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100282
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.92 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$8.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.75
|
| Rate for Payer: BCBS Complete |
$6.22
|
| Rate for Payer: BCBS MAPPO |
$7.80
|
| Rate for Payer: BCBS Trust/PPO |
$25.66
|
| Rate for Payer: BCN Commercial |
$24.27
|
| Rate for Payer: BCN Medicare Advantage |
$7.80
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.80
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$5.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.19
|
| Rate for Payer: Meridian Medicaid |
$6.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: PACE Senior Care Partners |
$7.41
|
| Rate for Payer: PACE SWMI |
$7.80
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$7.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Medicare |
$7.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.91
|
| Rate for Payer: Railroad Medicare Medicare |
$7.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.80
|
| Rate for Payer: UHC Exchange |
$7.80
|
| Rate for Payer: UHC Medicare Advantage |
$7.80
|
| Rate for Payer: UHCCP Medicaid |
$5.92
|
| Rate for Payer: VA VA |
$7.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC HDL CHOLESTEROL
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100282
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.29 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$25.48
|
| Rate for Payer: BCN Commercial |
$24.12
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC HDL CHOLESTEROL LMPP
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100690
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$16.99
|
| Rate for Payer: BCN Commercial |
$16.08
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC HDL CHOLESTEROL LMPP
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
30100690
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$6.22
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.11
|
| Rate for Payer: BCN Commercial |
$16.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$5.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: Meridian Medicaid |
$6.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Exchange |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
| Rate for Payer: UHCCP Medicaid |
$5.92
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC HDR 1 CHANNEL
|
Facility
|
OP
|
$1,989.66
|
|
|
Service Code
|
CPT 77770
|
| Hospital Charge Code |
33300055
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$472.54 |
| Max. Negotiated Rate |
$1,790.69 |
| Rate for Payer: Aetna Commercial |
$1,691.21
|
| Rate for Payer: Aetna Medicare |
$517.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$621.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$621.77
|
| Rate for Payer: BCBS Complete |
$516.09
|
| Rate for Payer: BCBS MAPPO |
$497.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,635.70
|
| Rate for Payer: BCN Commercial |
$1,546.96
|
| Rate for Payer: BCN Medicare Advantage |
$497.42
|
| Rate for Payer: Cash Price |
$1,591.73
|
| Rate for Payer: Cash Price |
$1,591.73
|
| Rate for Payer: Cofinity Commercial |
$1,711.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,591.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$497.42
|
| Rate for Payer: Healthscope Commercial |
$1,790.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,492.24
|
| Rate for Payer: Mclaren Medicaid |
$491.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$522.29
|
| Rate for Payer: Meridian Medicaid |
$516.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$572.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,691.21
|
| Rate for Payer: Nomi Health Commercial |
$1,631.52
|
| Rate for Payer: PACE Senior Care Partners |
$472.54
|
| Rate for Payer: PACE SWMI |
$497.42
|
| Rate for Payer: PHP Commercial |
$1,691.21
|
| Rate for Payer: PHP Medicare Advantage |
$497.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$491.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,293.28
|
| Rate for Payer: Priority Health HMO/PPO |
$1,731.00
|
| Rate for Payer: Priority Health Medicare |
$502.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,333.07
|
| Rate for Payer: Railroad Medicare Medicare |
$497.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,750.90
|
| Rate for Payer: UHC Core |
$1,661.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$497.42
|
| Rate for Payer: UHC Exchange |
$497.42
|
| Rate for Payer: UHC Medicare Advantage |
$497.42
|
| Rate for Payer: UHCCP Medicaid |
$491.48
|
| Rate for Payer: VA VA |
$497.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,492.24
|
|
