|
HC HDR SKIN SURFACE 2 OR MORE CHANNELS
|
Facility
|
IP
|
$541.99
|
|
|
Service Code
|
CPT 77768
|
| Hospital Charge Code |
33300054
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$352.29 |
| Max. Negotiated Rate |
$487.79 |
| Rate for Payer: Aetna Commercial |
$460.69
|
| Rate for Payer: BCBS Trust/PPO |
$442.43
|
| Rate for Payer: BCN Commercial |
$418.85
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cofinity Commercial |
$466.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.59
|
| Rate for Payer: Healthscope Commercial |
$487.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.69
|
| Rate for Payer: Nomi Health Commercial |
$444.43
|
| Rate for Payer: PHP Commercial |
$460.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.29
|
| Rate for Payer: Priority Health HMO/PPO |
$471.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$363.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$476.95
|
| Rate for Payer: UHC Core |
$452.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.49
|
|
|
HC HDR SKIN SURFACE 2 OR MORE CHANNELS
|
Facility
|
OP
|
$541.99
|
|
|
Service Code
|
CPT 77768
|
| Hospital Charge Code |
33300054
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$128.72 |
| Max. Negotiated Rate |
$487.79 |
| Rate for Payer: Aetna Commercial |
$460.69
|
| Rate for Payer: Aetna Medicare |
$140.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.37
|
| Rate for Payer: BCBS Complete |
$199.65
|
| Rate for Payer: BCBS MAPPO |
$135.50
|
| Rate for Payer: BCBS Trust/PPO |
$445.57
|
| Rate for Payer: BCN Commercial |
$421.40
|
| Rate for Payer: BCN Medicare Advantage |
$135.50
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cofinity Commercial |
$466.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.50
|
| Rate for Payer: Healthscope Commercial |
$487.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.49
|
| Rate for Payer: Mclaren Medicaid |
$190.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.27
|
| Rate for Payer: Meridian Medicaid |
$199.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$155.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.69
|
| Rate for Payer: Nomi Health Commercial |
$444.43
|
| Rate for Payer: PACE Senior Care Partners |
$128.72
|
| Rate for Payer: PACE SWMI |
$135.50
|
| Rate for Payer: PHP Commercial |
$460.69
|
| Rate for Payer: PHP Medicare Advantage |
$135.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$190.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.29
|
| Rate for Payer: Priority Health HMO/PPO |
$471.53
|
| Rate for Payer: Priority Health Medicare |
$136.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$363.13
|
| Rate for Payer: Railroad Medicare Medicare |
$135.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$476.95
|
| Rate for Payer: UHC Core |
$452.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$135.50
|
| Rate for Payer: UHC Exchange |
$135.50
|
| Rate for Payer: UHC Medicare Advantage |
$135.50
|
| Rate for Payer: UHCCP Medicaid |
$190.13
|
| Rate for Payer: VA VA |
$135.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.49
|
|
|
HC HEALTH & BEHAV ASSESS OR REASSESS
|
Facility
|
IP
|
$122.77
|
|
|
Service Code
|
CPT 96156
|
| Hospital Charge Code |
91400009
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$79.80 |
| Max. Negotiated Rate |
$110.49 |
| Rate for Payer: Aetna Commercial |
$104.35
|
| Rate for Payer: BCBS Trust/PPO |
$100.22
|
| Rate for Payer: BCN Commercial |
$94.88
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$105.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.22
|
| Rate for Payer: Healthscope Commercial |
$110.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.35
|
| Rate for Payer: Nomi Health Commercial |
$100.67
|
| Rate for Payer: PHP Commercial |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: Priority Health HMO/PPO |
$106.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.04
|
| Rate for Payer: UHC Core |
$102.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.08
|
|
|
HC HEALTH & BEHAV ASSESS OR REASSESS
|
Facility
|
OP
|
$122.77
|
|
|
Service Code
|
CPT 96156
|
| Hospital Charge Code |
91400009
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$29.16 |
| Max. Negotiated Rate |
$110.49 |
| Rate for Payer: Aetna Commercial |
$104.35
|
| Rate for Payer: Aetna Medicare |
$31.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.37
|
| Rate for Payer: BCBS Complete |
$70.23
|
| Rate for Payer: BCBS MAPPO |
$30.69
|
| Rate for Payer: BCBS Trust/PPO |
$100.93
|
| Rate for Payer: BCN Commercial |
$95.45
|
| Rate for Payer: BCN Medicare Advantage |
$30.69
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$105.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.69
|
| Rate for Payer: Healthscope Commercial |
$110.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.08
|
| Rate for Payer: Mclaren Medicaid |
$66.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.23
|
| Rate for Payer: Meridian Medicaid |
$70.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.35
|
| Rate for Payer: Nomi Health Commercial |
$100.67
|
| Rate for Payer: PACE Senior Care Partners |
$29.16
|
| Rate for Payer: PACE SWMI |
$30.69
|
| Rate for Payer: PHP Commercial |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$30.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: Priority Health HMO/PPO |
$106.81
|
| Rate for Payer: Priority Health Medicare |
$31.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.26
|
| Rate for Payer: Railroad Medicare Medicare |
$30.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.04
|
| Rate for Payer: UHC Core |
$102.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.69
|
| Rate for Payer: UHC Exchange |
$30.69
|
| Rate for Payer: UHC Medicare Advantage |
$30.69
|
| Rate for Payer: UHCCP Medicaid |
$66.88
|
| Rate for Payer: VA VA |
$30.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.08
|
|
|
HC HEALTH & BEHAV INTERVENT INDIV EA ADD 15 MIN
|
Facility
|
OP
|
$61.38
|
|
|
Service Code
|
CPT 96159
|
| Hospital Charge Code |
91400011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$14.58 |
| Max. Negotiated Rate |
$55.24 |
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: Aetna Medicare |
$15.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.18
|
| Rate for Payer: BCBS Complete |
$24.55
|
| Rate for Payer: BCBS MAPPO |
$15.35
|
| Rate for Payer: BCBS Trust/PPO |
$50.46
|
| Rate for Payer: BCN Commercial |
$47.72
|
| Rate for Payer: BCN Medicare Advantage |
$15.35
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$52.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.35
|
| Rate for Payer: Healthscope Commercial |
$55.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: Nomi Health Commercial |
$50.33
|
| Rate for Payer: PACE Senior Care Partners |
$14.58
|
| Rate for Payer: PACE SWMI |
$15.35
|
| Rate for Payer: PHP Commercial |
$52.17
|
| Rate for Payer: PHP Medicare Advantage |
$15.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO |
$53.40
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.12
|
| Rate for Payer: Railroad Medicare Medicare |
$15.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.01
|
| Rate for Payer: UHC Core |
$51.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.35
|
| Rate for Payer: UHC Exchange |
$15.35
|
| Rate for Payer: UHC Medicare Advantage |
$15.35
|
| Rate for Payer: VA VA |
$15.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.03
|
|
|
HC HEALTH & BEHAV INTERVENT INDIV EA ADD 15 MIN
|
Facility
|
IP
|
$61.38
|
|
|
Service Code
|
CPT 96159
|
| Hospital Charge Code |
91400011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$39.90 |
| Max. Negotiated Rate |
$55.24 |
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: BCBS Trust/PPO |
$50.10
|
| Rate for Payer: BCN Commercial |
$47.43
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$52.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Healthscope Commercial |
$55.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: Nomi Health Commercial |
$50.33
|
| Rate for Payer: PHP Commercial |
$52.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO |
$53.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.01
|
| Rate for Payer: UHC Core |
$51.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.03
|
|
|
HC HEALTH & BEHAV INTERVENT INDIV INIT 30 MIN
|
Facility
|
IP
|
$122.77
|
|
|
Service Code
|
CPT 96158
|
| Hospital Charge Code |
91400010
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$79.80 |
| Max. Negotiated Rate |
$110.49 |
| Rate for Payer: Aetna Commercial |
$104.35
|
| Rate for Payer: BCBS Trust/PPO |
$100.22
|
| Rate for Payer: BCN Commercial |
$94.88
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$105.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.22
|
| Rate for Payer: Healthscope Commercial |
$110.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.35
|
| Rate for Payer: Nomi Health Commercial |
$100.67
|
| Rate for Payer: PHP Commercial |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: Priority Health HMO/PPO |
$106.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.04
|
| Rate for Payer: UHC Core |
$102.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.08
|
|
|
HC HEALTH & BEHAV INTERVENT INDIV INIT 30 MIN
|
Facility
|
OP
|
$122.77
|
|
|
Service Code
|
CPT 96158
|
| Hospital Charge Code |
91400010
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$29.16 |
| Max. Negotiated Rate |
$121.98 |
| Rate for Payer: Aetna Commercial |
$104.35
|
| Rate for Payer: Aetna Medicare |
$31.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.37
|
| Rate for Payer: BCBS Complete |
$121.98
|
| Rate for Payer: BCBS MAPPO |
$30.69
|
| Rate for Payer: BCBS Trust/PPO |
$100.93
|
| Rate for Payer: BCN Commercial |
$95.45
|
| Rate for Payer: BCN Medicare Advantage |
$30.69
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cash Price |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$105.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.69
|
| Rate for Payer: Healthscope Commercial |
$110.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.08
|
| Rate for Payer: Mclaren Medicaid |
$116.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.23
|
| Rate for Payer: Meridian Medicaid |
$121.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.35
|
| Rate for Payer: Nomi Health Commercial |
$100.67
|
| Rate for Payer: PACE Senior Care Partners |
$29.16
|
| Rate for Payer: PACE SWMI |
$30.69
|
| Rate for Payer: PHP Commercial |
$104.35
|
| Rate for Payer: PHP Medicare Advantage |
$30.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: Priority Health HMO/PPO |
$106.81
|
| Rate for Payer: Priority Health Medicare |
$31.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.26
|
| Rate for Payer: Railroad Medicare Medicare |
$30.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.04
|
| Rate for Payer: UHC Core |
$102.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.69
|
| Rate for Payer: UHC Exchange |
$30.69
|
| Rate for Payer: UHC Medicare Advantage |
$30.69
|
| Rate for Payer: UHCCP Medicaid |
$116.16
|
| Rate for Payer: VA VA |
$30.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.08
|
|
|
HC HEARING AID CHECK BINAURAL
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 92593
|
| Hospital Charge Code |
76100499
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$14.54 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$24.48
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$50.31
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health HMO/PPO |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.00
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Exchange |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.30
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC HEARING AID CHECK BINAURAL
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 92593
|
| Hospital Charge Code |
76100499
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$39.78 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$49.96
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health HMO/PPO |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC HEARING AID CHECK MONAURAL
|
Facility
|
OP
|
$54.06
|
|
|
Service Code
|
CPT 92592
|
| Hospital Charge Code |
47100402
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$12.84 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna Medicare |
$14.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.89
|
| Rate for Payer: BCBS Complete |
$21.62
|
| Rate for Payer: BCBS MAPPO |
$13.52
|
| Rate for Payer: BCBS Trust/PPO |
$44.44
|
| Rate for Payer: BCN Commercial |
$42.03
|
| Rate for Payer: BCN Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.52
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.95
|
| Rate for Payer: Nomi Health Commercial |
$44.33
|
| Rate for Payer: PACE Senior Care Partners |
$12.84
|
| Rate for Payer: PACE SWMI |
$13.52
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: PHP Medicare Advantage |
$13.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.14
|
| Rate for Payer: Priority Health HMO/PPO |
$47.03
|
| Rate for Payer: Priority Health Medicare |
$13.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.22
|
| Rate for Payer: Railroad Medicare Medicare |
$13.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.57
|
| Rate for Payer: UHC Core |
$45.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.52
|
| Rate for Payer: UHC Exchange |
$13.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.52
|
| Rate for Payer: VA VA |
$13.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.55
|
|
|
HC HEARING AID CHECK MONAURAL
|
Facility
|
IP
|
$54.06
|
|
|
Service Code
|
CPT 92592
|
| Hospital Charge Code |
47100402
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$35.14 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: BCBS Trust/PPO |
$44.13
|
| Rate for Payer: BCN Commercial |
$41.78
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.95
|
| Rate for Payer: Nomi Health Commercial |
$44.33
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.14
|
| Rate for Payer: Priority Health HMO/PPO |
$47.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.57
|
| Rate for Payer: UHC Core |
$45.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.55
|
|
|
HC HEARING AID EXAM BOTH EARS
|
Facility
|
OP
|
$121.38
|
|
|
Service Code
|
CPT 92591
|
| Hospital Charge Code |
76100504
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$28.83 |
| Max. Negotiated Rate |
$109.24 |
| Rate for Payer: Aetna Commercial |
$103.17
|
| Rate for Payer: Aetna Medicare |
$31.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.93
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$30.34
|
| Rate for Payer: BCBS Trust/PPO |
$99.79
|
| Rate for Payer: BCN Commercial |
$94.37
|
| Rate for Payer: BCN Medicare Advantage |
$30.34
|
| Rate for Payer: Cash Price |
$97.10
|
| Rate for Payer: Cofinity Commercial |
$104.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.34
|
| Rate for Payer: Healthscope Commercial |
$109.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.17
|
| Rate for Payer: Nomi Health Commercial |
$99.53
|
| Rate for Payer: PACE Senior Care Partners |
$28.83
|
| Rate for Payer: PACE SWMI |
$30.34
|
| Rate for Payer: PHP Commercial |
$103.17
|
| Rate for Payer: PHP Medicare Advantage |
$30.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.90
|
| Rate for Payer: Priority Health HMO/PPO |
$105.60
|
| Rate for Payer: Priority Health Medicare |
$30.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.32
|
| Rate for Payer: Railroad Medicare Medicare |
$30.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.81
|
| Rate for Payer: UHC Core |
$101.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.34
|
| Rate for Payer: UHC Exchange |
$30.34
|
| Rate for Payer: UHC Medicare Advantage |
$30.34
|
| Rate for Payer: VA VA |
$30.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.03
|
|
|
HC HEARING AID EXAM BOTH EARS
|
Facility
|
IP
|
$121.38
|
|
|
Service Code
|
CPT 92591
|
| Hospital Charge Code |
76100504
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$78.90 |
| Max. Negotiated Rate |
$109.24 |
| Rate for Payer: Aetna Commercial |
$103.17
|
| Rate for Payer: BCBS Trust/PPO |
$99.08
|
| Rate for Payer: BCN Commercial |
$93.80
|
| Rate for Payer: Cash Price |
$97.10
|
| Rate for Payer: Cofinity Commercial |
$104.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.10
|
| Rate for Payer: Healthscope Commercial |
$109.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.17
|
| Rate for Payer: Nomi Health Commercial |
$99.53
|
| Rate for Payer: PHP Commercial |
$103.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.90
|
| Rate for Payer: Priority Health HMO/PPO |
$105.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.81
|
| Rate for Payer: UHC Core |
$101.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.03
|
|
|
HC HEARING AID EXAM ONE EAR
|
Facility
|
IP
|
$111.18
|
|
|
Service Code
|
CPT 92590
|
| Hospital Charge Code |
76100505
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$72.27 |
| Max. Negotiated Rate |
$100.06 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: BCBS Trust/PPO |
$90.76
|
| Rate for Payer: BCN Commercial |
$85.92
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cofinity Commercial |
$95.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.94
|
| Rate for Payer: Healthscope Commercial |
$100.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.50
|
| Rate for Payer: Nomi Health Commercial |
$91.17
|
| Rate for Payer: PHP Commercial |
$94.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.27
|
| Rate for Payer: Priority Health HMO/PPO |
$96.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.84
|
| Rate for Payer: UHC Core |
$92.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.39
|
|
|
HC HEARING AID EXAM ONE EAR
|
Facility
|
OP
|
$111.18
|
|
|
Service Code
|
CPT 92590
|
| Hospital Charge Code |
76100505
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$100.06 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: Aetna Medicare |
$28.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.74
|
| Rate for Payer: BCBS Complete |
$44.47
|
| Rate for Payer: BCBS MAPPO |
$27.80
|
| Rate for Payer: BCBS Trust/PPO |
$91.40
|
| Rate for Payer: BCN Commercial |
$86.44
|
| Rate for Payer: BCN Medicare Advantage |
$27.80
|
| Rate for Payer: Cash Price |
$88.94
|
| Rate for Payer: Cofinity Commercial |
$95.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.80
|
| Rate for Payer: Healthscope Commercial |
$100.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.50
|
| Rate for Payer: Nomi Health Commercial |
$91.17
|
| Rate for Payer: PACE Senior Care Partners |
$26.41
|
| Rate for Payer: PACE SWMI |
$27.80
|
| Rate for Payer: PHP Commercial |
$94.50
|
| Rate for Payer: PHP Medicare Advantage |
$27.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.27
|
| Rate for Payer: Priority Health HMO/PPO |
$96.73
|
| Rate for Payer: Priority Health Medicare |
$28.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.49
|
| Rate for Payer: Railroad Medicare Medicare |
$27.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.84
|
| Rate for Payer: UHC Core |
$92.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.80
|
| Rate for Payer: UHC Exchange |
$27.80
|
| Rate for Payer: UHC Medicare Advantage |
$27.80
|
| Rate for Payer: VA VA |
$27.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.39
|
|
|
HC HEART CATH CORONARIES CABG'S
|
Facility
|
OP
|
$12,212.39
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100018
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,325.46 |
| Max. Negotiated Rate |
$10,991.15 |
| Rate for Payer: Aetna Commercial |
$10,380.53
|
| Rate for Payer: Aetna Medicare |
$3,175.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,816.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,816.37
|
| Rate for Payer: BCBS Complete |
$2,441.90
|
| Rate for Payer: BCBS MAPPO |
$3,053.10
|
| Rate for Payer: BCBS Trust/PPO |
$10,039.81
|
| Rate for Payer: BCN Commercial |
$9,495.13
|
| Rate for Payer: BCN Medicare Advantage |
$3,053.10
|
| Rate for Payer: Cash Price |
$9,769.91
|
| Rate for Payer: Cash Price |
$9,769.91
|
| Rate for Payer: Cofinity Commercial |
$10,502.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,769.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,053.10
|
| Rate for Payer: Healthscope Commercial |
$10,991.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,159.29
|
| Rate for Payer: Mclaren Medicaid |
$2,325.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,205.75
|
| Rate for Payer: Meridian Medicaid |
$2,441.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,511.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,380.53
|
| Rate for Payer: Nomi Health Commercial |
$10,014.16
|
| Rate for Payer: PACE Senior Care Partners |
$2,900.44
|
| Rate for Payer: PACE SWMI |
$3,053.10
|
| Rate for Payer: PHP Commercial |
$10,380.53
|
| Rate for Payer: PHP Medicare Advantage |
$3,053.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,325.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,938.05
|
| Rate for Payer: Priority Health HMO/PPO |
$10,624.78
|
| Rate for Payer: Priority Health Medicare |
$3,083.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,182.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,053.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,746.90
|
| Rate for Payer: UHC Core |
$10,197.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,053.10
|
| Rate for Payer: UHC Exchange |
$3,053.10
|
| Rate for Payer: UHC Medicare Advantage |
$3,053.10
|
| Rate for Payer: UHCCP Medicaid |
$2,325.46
|
| Rate for Payer: VA VA |
$3,053.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,159.29
|
|
|
HC HEART CATH CORONARIES CABG'S
|
Facility
|
IP
|
$12,212.39
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100018
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,938.05 |
| Max. Negotiated Rate |
$10,991.15 |
| Rate for Payer: Aetna Commercial |
$10,380.53
|
| Rate for Payer: BCBS Trust/PPO |
$9,968.97
|
| Rate for Payer: BCN Commercial |
$9,437.73
|
| Rate for Payer: Cash Price |
$9,769.91
|
| Rate for Payer: Cofinity Commercial |
$10,502.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,769.91
|
| Rate for Payer: Healthscope Commercial |
$10,991.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,159.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,380.53
|
| Rate for Payer: Nomi Health Commercial |
$10,014.16
|
| Rate for Payer: PHP Commercial |
$10,380.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,938.05
|
| Rate for Payer: Priority Health HMO/PPO |
$10,624.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,182.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,746.90
|
| Rate for Payer: UHC Core |
$10,197.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,159.29
|
|
|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
OP
|
$54.58
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.96 |
| Max. Negotiated Rate |
$49.12 |
| Rate for Payer: Aetna Commercial |
$46.39
|
| Rate for Payer: Aetna Medicare |
$14.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.06
|
| Rate for Payer: BCBS Complete |
$21.83
|
| Rate for Payer: BCBS MAPPO |
$13.64
|
| Rate for Payer: BCBS Trust/PPO |
$44.87
|
| Rate for Payer: BCN Commercial |
$42.44
|
| Rate for Payer: BCN Medicare Advantage |
$13.64
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.64
|
| Rate for Payer: Healthscope Commercial |
$49.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: Nomi Health Commercial |
$44.76
|
| Rate for Payer: PACE Senior Care Partners |
$12.96
|
| Rate for Payer: PACE SWMI |
$13.64
|
| Rate for Payer: PHP Commercial |
$46.39
|
| Rate for Payer: PHP Medicare Advantage |
$13.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: Priority Health HMO/PPO |
$47.48
|
| Rate for Payer: Priority Health Medicare |
$13.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.57
|
| Rate for Payer: Railroad Medicare Medicare |
$13.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.03
|
| Rate for Payer: UHC Core |
$45.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.64
|
| Rate for Payer: UHC Exchange |
$13.64
|
| Rate for Payer: UHC Medicare Advantage |
$13.64
|
| Rate for Payer: VA VA |
$13.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.94
|
|
|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
IP
|
$54.58
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.48 |
| Max. Negotiated Rate |
$49.12 |
| Rate for Payer: Aetna Commercial |
$46.39
|
| Rate for Payer: BCBS Trust/PPO |
$44.55
|
| Rate for Payer: BCN Commercial |
$42.18
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cofinity Commercial |
$46.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.66
|
| Rate for Payer: Healthscope Commercial |
$49.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.39
|
| Rate for Payer: Nomi Health Commercial |
$44.76
|
| Rate for Payer: PHP Commercial |
$46.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.48
|
| Rate for Payer: Priority Health HMO/PPO |
$47.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.03
|
| Rate for Payer: UHC Core |
$45.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.94
|
|
|
HC HEART CATH LT ONLY
|
Facility
|
OP
|
$8,481.03
|
|
|
Service Code
|
CPT 93452
|
| Hospital Charge Code |
48100011
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,014.24 |
| Max. Negotiated Rate |
$7,632.93 |
| Rate for Payer: Aetna Commercial |
$7,208.88
|
| Rate for Payer: Aetna Medicare |
$2,205.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,650.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,650.32
|
| Rate for Payer: BCBS Complete |
$2,441.90
|
| Rate for Payer: BCBS MAPPO |
$2,120.26
|
| Rate for Payer: BCBS Trust/PPO |
$6,972.25
|
| Rate for Payer: BCN Commercial |
$6,594.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,120.26
|
| Rate for Payer: Cash Price |
$6,784.82
|
| Rate for Payer: Cash Price |
$6,784.82
|
| Rate for Payer: Cofinity Commercial |
$7,293.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,784.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,120.26
|
| Rate for Payer: Healthscope Commercial |
$7,632.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,360.77
|
| Rate for Payer: Mclaren Medicaid |
$2,325.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,226.27
|
| Rate for Payer: Meridian Medicaid |
$2,441.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,438.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,208.88
|
| Rate for Payer: Nomi Health Commercial |
$6,954.44
|
| Rate for Payer: PACE Senior Care Partners |
$2,014.24
|
| Rate for Payer: PACE SWMI |
$2,120.26
|
| Rate for Payer: PHP Commercial |
$7,208.88
|
| Rate for Payer: PHP Medicare Advantage |
$2,120.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,325.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,512.67
|
| Rate for Payer: Priority Health HMO/PPO |
$7,378.50
|
| Rate for Payer: Priority Health Medicare |
$2,141.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,682.29
|
| Rate for Payer: Railroad Medicare Medicare |
$2,120.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,463.31
|
| Rate for Payer: UHC Core |
$7,081.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,120.26
|
| Rate for Payer: UHC Exchange |
$2,120.26
|
| Rate for Payer: UHC Medicare Advantage |
$2,120.26
|
| Rate for Payer: UHCCP Medicaid |
$2,325.46
|
| Rate for Payer: VA VA |
$2,120.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,360.77
|
|
|
HC HEART CATH LT ONLY
|
Facility
|
IP
|
$8,481.03
|
|
|
Service Code
|
CPT 93452
|
| Hospital Charge Code |
48100011
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,512.67 |
| Max. Negotiated Rate |
$7,632.93 |
| Rate for Payer: Aetna Commercial |
$7,208.88
|
| Rate for Payer: BCBS Trust/PPO |
$6,923.06
|
| Rate for Payer: BCN Commercial |
$6,554.14
|
| Rate for Payer: Cash Price |
$6,784.82
|
| Rate for Payer: Cofinity Commercial |
$7,293.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,784.82
|
| Rate for Payer: Healthscope Commercial |
$7,632.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,360.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,208.88
|
| Rate for Payer: Nomi Health Commercial |
$6,954.44
|
| Rate for Payer: PHP Commercial |
$7,208.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,512.67
|
| Rate for Payer: Priority Health HMO/PPO |
$7,378.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,682.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,463.31
|
| Rate for Payer: UHC Core |
$7,081.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,360.77
|
|
|
HC HEART CATH LT/RT/C/CABGS
|
Facility
|
OP
|
$15,100.65
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100052
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,325.46 |
| Max. Negotiated Rate |
$13,590.58 |
| Rate for Payer: Aetna Commercial |
$12,835.55
|
| Rate for Payer: Aetna Medicare |
$3,926.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,718.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,718.95
|
| Rate for Payer: BCBS Complete |
$2,441.90
|
| Rate for Payer: BCBS MAPPO |
$3,775.16
|
| Rate for Payer: BCBS Trust/PPO |
$12,414.24
|
| Rate for Payer: BCN Commercial |
$11,740.76
|
| Rate for Payer: BCN Medicare Advantage |
$3,775.16
|
| Rate for Payer: Cash Price |
$12,080.52
|
| Rate for Payer: Cash Price |
$12,080.52
|
| Rate for Payer: Cofinity Commercial |
$12,986.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,080.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,775.16
|
| Rate for Payer: Healthscope Commercial |
$13,590.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,325.49
|
| Rate for Payer: Mclaren Medicaid |
$2,325.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,963.92
|
| Rate for Payer: Meridian Medicaid |
$2,441.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,341.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,835.55
|
| Rate for Payer: Nomi Health Commercial |
$12,382.53
|
| Rate for Payer: PACE Senior Care Partners |
$3,586.40
|
| Rate for Payer: PACE SWMI |
$3,775.16
|
| Rate for Payer: PHP Commercial |
$12,835.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,775.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,325.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,815.42
|
| Rate for Payer: Priority Health HMO/PPO |
$13,137.57
|
| Rate for Payer: Priority Health Medicare |
$3,812.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,117.44
|
| Rate for Payer: Railroad Medicare Medicare |
$3,775.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,288.57
|
| Rate for Payer: UHC Core |
$12,609.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,775.16
|
| Rate for Payer: UHC Exchange |
$3,775.16
|
| Rate for Payer: UHC Medicare Advantage |
$3,775.16
|
| Rate for Payer: UHCCP Medicaid |
$2,325.46
|
| Rate for Payer: VA VA |
$3,775.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,325.49
|
|
|
HC HEART CATH LT/RT/C/CABGS
|
Facility
|
IP
|
$15,100.65
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100052
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,815.42 |
| Max. Negotiated Rate |
$13,590.58 |
| Rate for Payer: Aetna Commercial |
$12,835.55
|
| Rate for Payer: BCBS Trust/PPO |
$12,326.66
|
| Rate for Payer: BCN Commercial |
$11,669.78
|
| Rate for Payer: Cash Price |
$12,080.52
|
| Rate for Payer: Cofinity Commercial |
$12,986.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,080.52
|
| Rate for Payer: Healthscope Commercial |
$13,590.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,325.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,835.55
|
| Rate for Payer: Nomi Health Commercial |
$12,382.53
|
| Rate for Payer: PHP Commercial |
$12,835.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,815.42
|
| Rate for Payer: Priority Health HMO/PPO |
$13,137.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,117.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,288.57
|
| Rate for Payer: UHC Core |
$12,609.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,325.49
|
|
|
HC HEART CATH LT/RT CORONARIES
|
Facility
|
IP
|
$12,764.58
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100019
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,296.98 |
| Max. Negotiated Rate |
$11,488.12 |
| Rate for Payer: Aetna Commercial |
$10,849.89
|
| Rate for Payer: BCBS Trust/PPO |
$10,419.73
|
| Rate for Payer: BCN Commercial |
$9,864.47
|
| Rate for Payer: Cash Price |
$10,211.66
|
| Rate for Payer: Cofinity Commercial |
$10,977.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,211.66
|
| Rate for Payer: Healthscope Commercial |
$11,488.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,573.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,849.89
|
| Rate for Payer: Nomi Health Commercial |
$10,466.96
|
| Rate for Payer: PHP Commercial |
$10,849.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,296.98
|
| Rate for Payer: Priority Health HMO/PPO |
$11,105.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,552.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,232.83
|
| Rate for Payer: UHC Core |
$10,658.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,573.43
|
|
