|
HC PATHOLOGY LEVEL IV DERM
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000106
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$67.09 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: BCBS Trust/PPO |
$85.01
|
| Rate for Payer: BCN Commercial |
$85.01
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.50
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.80
|
| Rate for Payer: UHC Core |
$91.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
HC PATHOLOGY LEVEL V
|
Facility
|
OP
|
$451.85
|
|
|
Service Code
|
CPT 88307
|
| Hospital Charge Code |
31000049
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$107.31 |
| Max. Negotiated Rate |
$406.66 |
| Rate for Payer: Aetna Commercial |
$384.07
|
| Rate for Payer: Aetna Medicare |
$117.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.20
|
| Rate for Payer: BCBS Complete |
$247.59
|
| Rate for Payer: BCBS MAPPO |
$112.96
|
| Rate for Payer: BCBS Trust/PPO |
$351.31
|
| Rate for Payer: BCCCP Commercial |
$292.71
|
| Rate for Payer: BCN Commercial |
$351.31
|
| Rate for Payer: BCN Medicare Advantage |
$112.96
|
| Rate for Payer: Cash Price |
$361.48
|
| Rate for Payer: Cash Price |
$361.48
|
| Rate for Payer: Cofinity Commercial |
$388.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$361.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.96
|
| Rate for Payer: Healthscope Commercial |
$406.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.89
|
| Rate for Payer: Mclaren Medicaid |
$235.80
|
| Rate for Payer: Meridian Medicaid |
$247.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$118.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$384.07
|
| Rate for Payer: PACE Senior Care Partners |
$107.31
|
| Rate for Payer: PACE SWMI |
$112.96
|
| Rate for Payer: PHP Commercial |
$384.07
|
| Rate for Payer: PHP Medicare Advantage |
$112.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$393.11
|
| Rate for Payer: Priority Health Medicare |
$112.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.58
|
| Rate for Payer: Railroad Medicare Medicare |
$112.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.63
|
| Rate for Payer: UHC Core |
$377.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.96
|
| Rate for Payer: UHC Medicare Advantage |
$116.35
|
| Rate for Payer: VA VA |
$112.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.89
|
|
|
HC PATHOLOGY LEVEL V
|
Facility
|
IP
|
$451.85
|
|
|
Service Code
|
CPT 88307
|
| Hospital Charge Code |
31000049
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$275.58 |
| Max. Negotiated Rate |
$406.66 |
| Rate for Payer: Aetna Commercial |
$384.07
|
| Rate for Payer: BCBS Trust/PPO |
$349.19
|
| Rate for Payer: BCN Commercial |
$349.19
|
| Rate for Payer: Cash Price |
$361.48
|
| Rate for Payer: Cofinity Commercial |
$388.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$361.48
|
| Rate for Payer: Healthscope Commercial |
$406.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$384.07
|
| Rate for Payer: PHP Commercial |
$384.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$393.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.63
|
| Rate for Payer: UHC Core |
$377.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.89
|
|
|
HC PATHOLOGY LEVEL VI
|
Facility
|
IP
|
$643.06
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
31000050
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$392.20 |
| Max. Negotiated Rate |
$578.75 |
| Rate for Payer: Aetna Commercial |
$546.60
|
| Rate for Payer: BCBS Trust/PPO |
$496.96
|
| Rate for Payer: BCN Commercial |
$496.96
|
| Rate for Payer: Cash Price |
$514.45
|
| Rate for Payer: Cofinity Commercial |
$553.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$514.45
|
| Rate for Payer: Healthscope Commercial |
$578.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$482.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$546.60
|
| Rate for Payer: PHP Commercial |
$546.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$559.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$392.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$565.89
|
| Rate for Payer: UHC Core |
$536.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$482.30
|
|
|
HC PATHOLOGY LEVEL VI
|
Facility
|
OP
|
$643.06
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
31000050
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$152.73 |
| Max. Negotiated Rate |
$592.28 |
| Rate for Payer: Aetna Commercial |
$546.60
|
| Rate for Payer: Aetna Medicare |
$167.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$200.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$200.96
|
| Rate for Payer: BCBS Complete |
$592.28
|
| Rate for Payer: BCBS MAPPO |
$160.76
|
| Rate for Payer: BCBS Trust/PPO |
$499.98
|
| Rate for Payer: BCN Commercial |
$499.98
|
| Rate for Payer: BCN Medicare Advantage |
$160.76
|
| Rate for Payer: Cash Price |
$514.45
|
| Rate for Payer: Cash Price |
$514.45
|
| Rate for Payer: Cofinity Commercial |
$553.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$514.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.76
|
| Rate for Payer: Healthscope Commercial |
$578.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$482.30
|
| Rate for Payer: Mclaren Medicaid |
$564.08
|
| Rate for Payer: Meridian Medicaid |
$592.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$168.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$184.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$546.60
|
| Rate for Payer: PACE Senior Care Partners |
$152.73
|
| Rate for Payer: PACE SWMI |
$160.76
|
| Rate for Payer: PHP Commercial |
$546.60
|
| Rate for Payer: PHP Medicare Advantage |
$160.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$564.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$559.46
|
| Rate for Payer: Priority Health Medicare |
$160.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$392.20
|
| Rate for Payer: Railroad Medicare Medicare |
$160.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$565.89
|
| Rate for Payer: UHC Core |
$536.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$160.76
|
| Rate for Payer: UHC Medicare Advantage |
$165.59
|
| Rate for Payer: VA VA |
$160.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$482.30
|
|
|
HC PATH SURGERY CYTO ADDITIONAL
|
Facility
|
OP
|
$56.10
|
|
|
Service Code
|
CPT 88334
|
| Hospital Charge Code |
30000068
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.32 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna Commercial |
$47.68
|
| Rate for Payer: Aetna Medicare |
$14.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.53
|
| Rate for Payer: BCBS Complete |
$22.44
|
| Rate for Payer: BCBS MAPPO |
$14.02
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$14.02
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.02
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.68
|
| Rate for Payer: PACE Senior Care Partners |
$13.32
|
| Rate for Payer: PACE SWMI |
$14.02
|
| Rate for Payer: PHP Commercial |
$47.68
|
| Rate for Payer: PHP Medicare Advantage |
$14.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.81
|
| Rate for Payer: Priority Health Medicare |
$14.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.22
|
| Rate for Payer: Railroad Medicare Medicare |
$14.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.37
|
| Rate for Payer: UHC Core |
$46.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.02
|
| Rate for Payer: UHC Medicare Advantage |
$14.45
|
| Rate for Payer: VA VA |
$14.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.08
|
|
|
HC PATH SURGERY CYTO ADDITIONAL
|
Facility
|
IP
|
$56.10
|
|
|
Service Code
|
CPT 88334
|
| Hospital Charge Code |
30000068
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$34.22 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna Commercial |
$47.68
|
| Rate for Payer: BCBS Trust/PPO |
$43.35
|
| Rate for Payer: BCN Commercial |
$43.35
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.68
|
| Rate for Payer: PHP Commercial |
$47.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.37
|
| Rate for Payer: UHC Core |
$46.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.08
|
|
|
HC PATH SURGERY CYTO INITIAL SITE
|
Facility
|
IP
|
$88.74
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
30000067
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.12 |
| Max. Negotiated Rate |
$79.87 |
| Rate for Payer: Aetna Commercial |
$75.43
|
| Rate for Payer: BCBS Trust/PPO |
$68.58
|
| Rate for Payer: BCN Commercial |
$68.58
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$76.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.99
|
| Rate for Payer: Healthscope Commercial |
$79.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.43
|
| Rate for Payer: PHP Commercial |
$75.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.09
|
| Rate for Payer: UHC Core |
$74.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.56
|
|
|
HC PATH SURGERY CYTO INITIAL SITE
|
Facility
|
OP
|
$88.74
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
30000067
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.08 |
| Max. Negotiated Rate |
$592.28 |
| Rate for Payer: Aetna Commercial |
$75.43
|
| Rate for Payer: Aetna Medicare |
$23.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.73
|
| Rate for Payer: BCBS Complete |
$592.28
|
| Rate for Payer: BCBS MAPPO |
$22.18
|
| Rate for Payer: BCBS Trust/PPO |
$69.00
|
| Rate for Payer: BCN Commercial |
$69.00
|
| Rate for Payer: BCN Medicare Advantage |
$22.18
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$76.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.18
|
| Rate for Payer: Healthscope Commercial |
$79.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.56
|
| Rate for Payer: Mclaren Medicaid |
$564.08
|
| Rate for Payer: Meridian Medicaid |
$592.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.43
|
| Rate for Payer: PACE Senior Care Partners |
$21.08
|
| Rate for Payer: PACE SWMI |
$22.18
|
| Rate for Payer: PHP Commercial |
$75.43
|
| Rate for Payer: PHP Medicare Advantage |
$22.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$564.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.20
|
| Rate for Payer: Priority Health Medicare |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.12
|
| Rate for Payer: Railroad Medicare Medicare |
$22.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.09
|
| Rate for Payer: UHC Core |
$74.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.18
|
| Rate for Payer: UHC Medicare Advantage |
$22.85
|
| Rate for Payer: VA VA |
$22.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.56
|
|
|
HC PCP SCREEN URIN
|
Facility
|
OP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000136
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.01 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: Aetna Medicare |
$24.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.96
|
| Rate for Payer: BCBS Complete |
$48.15
|
| Rate for Payer: BCBS MAPPO |
$23.17
|
| Rate for Payer: BCBS Trust/PPO |
$72.06
|
| Rate for Payer: BCN Commercial |
$72.06
|
| Rate for Payer: BCN Medicare Advantage |
$23.17
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.17
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$48.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PACE Senior Care Partners |
$22.01
|
| Rate for Payer: PACE SWMI |
$23.17
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: PHP Medicare Advantage |
$23.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Medicare |
$23.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: Railroad Medicare Medicare |
$23.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.17
|
| Rate for Payer: UHC Medicare Advantage |
$23.87
|
| Rate for Payer: VA VA |
$23.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC PCP SCREEN URIN
|
Facility
|
IP
|
$92.68
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000136
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$56.53 |
| Max. Negotiated Rate |
$83.41 |
| Rate for Payer: Aetna Commercial |
$78.78
|
| Rate for Payer: BCBS Trust/PPO |
$71.62
|
| Rate for Payer: BCN Commercial |
$71.62
|
| Rate for Payer: Cash Price |
$74.14
|
| Rate for Payer: Cofinity Commercial |
$79.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.14
|
| Rate for Payer: Healthscope Commercial |
$83.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.78
|
| Rate for Payer: PHP Commercial |
$78.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.56
|
| Rate for Payer: UHC Core |
$77.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.51
|
|
|
HC PCP SCREEN URN.
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.88 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$31.53
|
| Rate for Payer: BCN Commercial |
$31.53
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC PCP SCREEN URN.
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.30 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$9.76
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$31.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$9.30
|
| Rate for Payer: Meridian Medicaid |
$9.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.51
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Facility
|
OP
|
$295.80
|
|
|
Service Code
|
CPT 90677
|
| Hospital Charge Code |
63600208
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$70.25 |
| Max. Negotiated Rate |
$266.22 |
| Rate for Payer: Aetna Commercial |
$251.43
|
| Rate for Payer: Aetna Medicare |
$76.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$92.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$92.44
|
| Rate for Payer: BCBS Complete |
$118.32
|
| Rate for Payer: BCBS MAPPO |
$73.95
|
| Rate for Payer: BCBS Trust/PPO |
$229.98
|
| Rate for Payer: BCN Commercial |
$229.98
|
| Rate for Payer: BCN Medicare Advantage |
$73.95
|
| Rate for Payer: Cash Price |
$236.64
|
| Rate for Payer: Cofinity Commercial |
$254.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.95
|
| Rate for Payer: Healthscope Commercial |
$266.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$251.43
|
| Rate for Payer: PACE Senior Care Partners |
$70.25
|
| Rate for Payer: PACE SWMI |
$73.95
|
| Rate for Payer: PHP Commercial |
$251.43
|
| Rate for Payer: PHP Medicare Advantage |
$73.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$257.35
|
| Rate for Payer: Priority Health Medicare |
$73.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.41
|
| Rate for Payer: Railroad Medicare Medicare |
$73.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$260.30
|
| Rate for Payer: UHC Core |
$246.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.95
|
| Rate for Payer: UHC Medicare Advantage |
$76.17
|
| Rate for Payer: VA VA |
$73.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.85
|
|
|
HC PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Facility
|
IP
|
$295.80
|
|
|
Service Code
|
CPT 90677
|
| Hospital Charge Code |
63600208
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$180.41 |
| Max. Negotiated Rate |
$266.22 |
| Rate for Payer: Aetna Commercial |
$251.43
|
| Rate for Payer: BCBS Trust/PPO |
$228.59
|
| Rate for Payer: BCN Commercial |
$228.59
|
| Rate for Payer: Cash Price |
$236.64
|
| Rate for Payer: Cofinity Commercial |
$254.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.64
|
| Rate for Payer: Healthscope Commercial |
$266.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$251.43
|
| Rate for Payer: PHP Commercial |
$251.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$257.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$260.30
|
| Rate for Payer: UHC Core |
$246.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.85
|
|
|
HC PEAK FLOW METER
|
Facility
|
OP
|
$28.58
|
|
| Hospital Charge Code |
27000132
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.79 |
| Max. Negotiated Rate |
$25.72 |
| Rate for Payer: Aetna Commercial |
$24.29
|
| Rate for Payer: Aetna Medicare |
$7.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.93
|
| Rate for Payer: BCBS Complete |
$11.43
|
| Rate for Payer: BCBS MAPPO |
$7.14
|
| Rate for Payer: BCBS Trust/PPO |
$22.22
|
| Rate for Payer: BCN Commercial |
$22.22
|
| Rate for Payer: BCN Medicare Advantage |
$7.14
|
| Rate for Payer: Cash Price |
$22.86
|
| Rate for Payer: Cofinity Commercial |
$24.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.14
|
| Rate for Payer: Healthscope Commercial |
$25.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.29
|
| Rate for Payer: PACE Senior Care Partners |
$6.79
|
| Rate for Payer: PACE SWMI |
$7.14
|
| Rate for Payer: PHP Commercial |
$24.29
|
| Rate for Payer: PHP Medicare Advantage |
$7.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.86
|
| Rate for Payer: Priority Health Medicare |
$7.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: Railroad Medicare Medicare |
$7.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.15
|
| Rate for Payer: UHC Core |
$23.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.14
|
| Rate for Payer: UHC Medicare Advantage |
$7.36
|
| Rate for Payer: VA VA |
$7.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.44
|
|
|
HC PEAK FLOW METER
|
Facility
|
IP
|
$28.58
|
|
| Hospital Charge Code |
27000132
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.43 |
| Max. Negotiated Rate |
$25.72 |
| Rate for Payer: Aetna Commercial |
$24.29
|
| Rate for Payer: BCBS Trust/PPO |
$22.09
|
| Rate for Payer: BCN Commercial |
$22.09
|
| Rate for Payer: Cash Price |
$22.86
|
| Rate for Payer: Cofinity Commercial |
$24.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.86
|
| Rate for Payer: Healthscope Commercial |
$25.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.29
|
| Rate for Payer: PHP Commercial |
$24.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.15
|
| Rate for Payer: UHC Core |
$23.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.44
|
|
|
HC PEANUT IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200054
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC PEANUT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200054
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC PECAN NUT IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200117
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC PECAN NUT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200117
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC PED MINOR TREATMENT RM
|
Facility
|
OP
|
$126.49
|
|
| Hospital Charge Code |
51000044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.04 |
| Max. Negotiated Rate |
$113.84 |
| Rate for Payer: Aetna Commercial |
$107.52
|
| Rate for Payer: Aetna Medicare |
$32.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.53
|
| Rate for Payer: BCBS Complete |
$50.60
|
| Rate for Payer: BCBS MAPPO |
$31.62
|
| Rate for Payer: BCBS Trust/PPO |
$98.35
|
| Rate for Payer: BCN Commercial |
$98.35
|
| Rate for Payer: BCN Medicare Advantage |
$31.62
|
| Rate for Payer: Cash Price |
$101.19
|
| Rate for Payer: Cofinity Commercial |
$108.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.62
|
| Rate for Payer: Healthscope Commercial |
$113.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$107.52
|
| Rate for Payer: PACE Senior Care Partners |
$30.04
|
| Rate for Payer: PACE SWMI |
$31.62
|
| Rate for Payer: PHP Commercial |
$107.52
|
| Rate for Payer: PHP Medicare Advantage |
$31.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.05
|
| Rate for Payer: Priority Health Medicare |
$31.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.15
|
| Rate for Payer: Railroad Medicare Medicare |
$31.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.31
|
| Rate for Payer: UHC Core |
$105.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.62
|
| Rate for Payer: UHC Medicare Advantage |
$32.57
|
| Rate for Payer: VA VA |
$31.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.87
|
|
|
HC PED MINOR TREATMENT RM
|
Facility
|
IP
|
$126.49
|
|
| Hospital Charge Code |
51000044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$77.15 |
| Max. Negotiated Rate |
$113.84 |
| Rate for Payer: Aetna Commercial |
$107.52
|
| Rate for Payer: BCBS Trust/PPO |
$97.75
|
| Rate for Payer: BCN Commercial |
$97.75
|
| Rate for Payer: Cash Price |
$101.19
|
| Rate for Payer: Cofinity Commercial |
$108.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.19
|
| Rate for Payer: Healthscope Commercial |
$113.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$107.52
|
| Rate for Payer: PHP Commercial |
$107.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.31
|
| Rate for Payer: UHC Core |
$105.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.87
|
|
|
HC PED OBSERVATION PER HOUR
|
Facility
|
IP
|
$153.31
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200014
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$93.50 |
| Max. Negotiated Rate |
$137.98 |
| Rate for Payer: Aetna Commercial |
$130.31
|
| Rate for Payer: BCBS Trust/PPO |
$118.48
|
| Rate for Payer: BCN Commercial |
$118.48
|
| Rate for Payer: Cash Price |
$122.65
|
| Rate for Payer: Cofinity Commercial |
$131.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.65
|
| Rate for Payer: Healthscope Commercial |
$137.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$130.31
|
| Rate for Payer: PHP Commercial |
$130.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.91
|
| Rate for Payer: UHC Core |
$128.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.98
|
|
|
HC PED OBSERVATION PER HOUR
|
Facility
|
OP
|
$153.31
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200014
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$36.41 |
| Max. Negotiated Rate |
$137.98 |
| Rate for Payer: Aetna Commercial |
$130.31
|
| Rate for Payer: Aetna Medicare |
$39.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.91
|
| Rate for Payer: BCBS Complete |
$61.32
|
| Rate for Payer: BCBS MAPPO |
$38.33
|
| Rate for Payer: BCBS Trust/PPO |
$119.20
|
| Rate for Payer: BCN Commercial |
$119.20
|
| Rate for Payer: BCN Medicare Advantage |
$38.33
|
| Rate for Payer: Cash Price |
$122.65
|
| Rate for Payer: Cofinity Commercial |
$131.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.33
|
| Rate for Payer: Healthscope Commercial |
$137.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$130.31
|
| Rate for Payer: PACE Senior Care Partners |
$36.41
|
| Rate for Payer: PACE SWMI |
$38.33
|
| Rate for Payer: PHP Commercial |
$130.31
|
| Rate for Payer: PHP Medicare Advantage |
$38.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.38
|
| Rate for Payer: Priority Health Medicare |
$38.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.50
|
| Rate for Payer: Railroad Medicare Medicare |
$38.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.91
|
| Rate for Payer: UHC Core |
$128.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.33
|
| Rate for Payer: UHC Medicare Advantage |
$39.48
|
| Rate for Payer: VA VA |
$38.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.98
|
|
