|
HC HYSTEROSCOPY REMOVE MYOMA
|
Facility
|
IP
|
$13,353.53
|
|
|
Service Code
|
CPT 58561
|
| Hospital Charge Code |
76100338
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8,679.79 |
| Max. Negotiated Rate |
$12,018.18 |
| Rate for Payer: Aetna Commercial |
$11,350.50
|
| Rate for Payer: BCBS Trust/PPO |
$10,900.49
|
| Rate for Payer: BCN Commercial |
$10,319.61
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$11,484.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Healthscope Commercial |
$12,018.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,015.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: Nomi Health Commercial |
$10,949.89
|
| Rate for Payer: PHP Commercial |
$11,350.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: Priority Health HMO/PPO |
$11,617.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,946.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,751.11
|
| Rate for Payer: UHC Core |
$11,150.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,015.15
|
|
|
HC HYSTEROSCOPY RESECT SEPTUM
|
Facility
|
OP
|
$13,353.53
|
|
|
Service Code
|
CPT 58560
|
| Hospital Charge Code |
76100337
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,171.46 |
| Max. Negotiated Rate |
$12,018.18 |
| Rate for Payer: Aetna Commercial |
$11,350.50
|
| Rate for Payer: Aetna Medicare |
$3,471.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,172.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,172.98
|
| Rate for Payer: BCBS Complete |
$3,671.97
|
| Rate for Payer: BCBS MAPPO |
$3,338.38
|
| Rate for Payer: BCBS Trust/PPO |
$10,977.94
|
| Rate for Payer: BCN Commercial |
$10,382.37
|
| Rate for Payer: BCN Medicare Advantage |
$3,338.38
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$11,484.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,338.38
|
| Rate for Payer: Healthscope Commercial |
$12,018.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,015.15
|
| Rate for Payer: Mclaren Medicaid |
$3,496.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,505.30
|
| Rate for Payer: Meridian Medicaid |
$3,671.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,839.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: Nomi Health Commercial |
$10,949.89
|
| Rate for Payer: PACE Senior Care Partners |
$3,171.46
|
| Rate for Payer: PACE SWMI |
$3,338.38
|
| Rate for Payer: PHP Commercial |
$11,350.50
|
| Rate for Payer: PHP Medicare Advantage |
$3,338.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,496.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: Priority Health HMO/PPO |
$11,617.57
|
| Rate for Payer: Priority Health Medicare |
$3,371.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,946.87
|
| Rate for Payer: Railroad Medicare Medicare |
$3,338.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,751.11
|
| Rate for Payer: UHC Core |
$11,150.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,338.38
|
| Rate for Payer: UHC Exchange |
$3,338.38
|
| Rate for Payer: UHC Medicare Advantage |
$3,338.38
|
| Rate for Payer: UHCCP Medicaid |
$3,496.88
|
| Rate for Payer: VA VA |
$3,338.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,015.15
|
|
|
HC HYSTEROSCOPY RESECT SEPTUM
|
Facility
|
IP
|
$13,353.53
|
|
|
Service Code
|
CPT 58560
|
| Hospital Charge Code |
76100337
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8,679.79 |
| Max. Negotiated Rate |
$12,018.18 |
| Rate for Payer: Aetna Commercial |
$11,350.50
|
| Rate for Payer: BCBS Trust/PPO |
$10,900.49
|
| Rate for Payer: BCN Commercial |
$10,319.61
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$11,484.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Healthscope Commercial |
$12,018.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,015.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: Nomi Health Commercial |
$10,949.89
|
| Rate for Payer: PHP Commercial |
$11,350.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: Priority Health HMO/PPO |
$11,617.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,946.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,751.11
|
| Rate for Payer: UHC Core |
$11,150.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,015.15
|
|
|
HC HYSTEROSCOPY W BX AND/OR POLYPECTOMY W OR WO D&C
|
Facility
|
IP
|
$4,093.79
|
|
|
Service Code
|
CPT 58558
|
| Hospital Charge Code |
76100304
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,660.96 |
| Max. Negotiated Rate |
$3,684.41 |
| Rate for Payer: Aetna Commercial |
$3,479.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,341.76
|
| Rate for Payer: BCN Commercial |
$3,163.68
|
| Rate for Payer: Cash Price |
$3,275.03
|
| Rate for Payer: Cofinity Commercial |
$3,520.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,275.03
|
| Rate for Payer: Healthscope Commercial |
$3,684.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,070.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,479.72
|
| Rate for Payer: Nomi Health Commercial |
$3,356.91
|
| Rate for Payer: PHP Commercial |
$3,479.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,660.96
|
| Rate for Payer: Priority Health HMO/PPO |
$3,561.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,742.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,602.54
|
| Rate for Payer: UHC Core |
$3,418.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,070.34
|
|
|
HC HYSTEROSCOPY W BX AND/OR POLYPECTOMY W OR WO D&C
|
Facility
|
OP
|
$4,093.79
|
|
|
Service Code
|
CPT 58558
|
| Hospital Charge Code |
76100304
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$972.28 |
| Max. Negotiated Rate |
$3,684.41 |
| Rate for Payer: Aetna Commercial |
$3,479.72
|
| Rate for Payer: Aetna Medicare |
$1,064.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,279.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,279.31
|
| Rate for Payer: BCBS Complete |
$2,365.09
|
| Rate for Payer: BCBS MAPPO |
$1,023.45
|
| Rate for Payer: BCBS Trust/PPO |
$3,365.50
|
| Rate for Payer: BCN Commercial |
$3,182.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,023.45
|
| Rate for Payer: Cash Price |
$3,275.03
|
| Rate for Payer: Cash Price |
$3,275.03
|
| Rate for Payer: Cofinity Commercial |
$3,520.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,275.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,023.45
|
| Rate for Payer: Healthscope Commercial |
$3,684.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,070.34
|
| Rate for Payer: Mclaren Medicaid |
$2,252.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,074.62
|
| Rate for Payer: Meridian Medicaid |
$2,365.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,176.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,479.72
|
| Rate for Payer: Nomi Health Commercial |
$3,356.91
|
| Rate for Payer: PACE Senior Care Partners |
$972.28
|
| Rate for Payer: PACE SWMI |
$1,023.45
|
| Rate for Payer: PHP Commercial |
$3,479.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,023.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,252.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,660.96
|
| Rate for Payer: Priority Health HMO/PPO |
$3,561.60
|
| Rate for Payer: Priority Health Medicare |
$1,033.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,742.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,023.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,602.54
|
| Rate for Payer: UHC Core |
$3,418.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,023.45
|
| Rate for Payer: UHC Exchange |
$1,023.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,023.45
|
| Rate for Payer: UHCCP Medicaid |
$2,252.32
|
| Rate for Payer: VA VA |
$1,023.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,070.34
|
|
|
HC I-123 CAPSULE PER 100 UCI
|
Facility
|
OP
|
$105.67
|
|
|
Service Code
|
HCPCS A9516
|
| Hospital Charge Code |
34300009
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$25.10 |
| Max. Negotiated Rate |
$95.10 |
| Rate for Payer: Aetna Commercial |
$89.82
|
| Rate for Payer: Aetna Medicare |
$27.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.02
|
| Rate for Payer: BCBS Complete |
$42.27
|
| Rate for Payer: BCBS MAPPO |
$26.42
|
| Rate for Payer: BCBS Trust/PPO |
$86.87
|
| Rate for Payer: BCN Commercial |
$82.16
|
| Rate for Payer: BCN Medicare Advantage |
$26.42
|
| Rate for Payer: Cash Price |
$84.54
|
| Rate for Payer: Cofinity Commercial |
$90.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.42
|
| Rate for Payer: Healthscope Commercial |
$95.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.82
|
| Rate for Payer: Nomi Health Commercial |
$86.65
|
| Rate for Payer: PACE Senior Care Partners |
$25.10
|
| Rate for Payer: PACE SWMI |
$26.42
|
| Rate for Payer: PHP Commercial |
$89.82
|
| Rate for Payer: PHP Medicare Advantage |
$26.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.69
|
| Rate for Payer: Priority Health HMO/PPO |
$91.93
|
| Rate for Payer: Priority Health Medicare |
$26.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.80
|
| Rate for Payer: Railroad Medicare Medicare |
$26.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.99
|
| Rate for Payer: UHC Core |
$88.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.42
|
| Rate for Payer: UHC Exchange |
$26.42
|
| Rate for Payer: UHC Medicare Advantage |
$26.42
|
| Rate for Payer: VA VA |
$26.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.25
|
|
|
HC I-123 CAPSULE PER 100 UCI
|
Facility
|
IP
|
$105.67
|
|
|
Service Code
|
HCPCS A9516
|
| Hospital Charge Code |
34300009
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$68.69 |
| Max. Negotiated Rate |
$95.10 |
| Rate for Payer: Aetna Commercial |
$89.82
|
| Rate for Payer: BCBS Trust/PPO |
$86.26
|
| Rate for Payer: BCN Commercial |
$81.66
|
| Rate for Payer: Cash Price |
$84.54
|
| Rate for Payer: Cofinity Commercial |
$90.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.54
|
| Rate for Payer: Healthscope Commercial |
$95.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.82
|
| Rate for Payer: Nomi Health Commercial |
$86.65
|
| Rate for Payer: PHP Commercial |
$89.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.69
|
| Rate for Payer: Priority Health HMO/PPO |
$91.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.99
|
| Rate for Payer: UHC Core |
$88.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.25
|
|
|
HC I-123 MIBG PER STUDY
|
Facility
|
IP
|
$12,176.80
|
|
|
Service Code
|
HCPCS A9582
|
| Hospital Charge Code |
34300010
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$7,914.92 |
| Max. Negotiated Rate |
$10,959.12 |
| Rate for Payer: Aetna Commercial |
$10,350.28
|
| Rate for Payer: BCBS Trust/PPO |
$9,939.92
|
| Rate for Payer: BCN Commercial |
$9,410.23
|
| Rate for Payer: Cash Price |
$9,741.44
|
| Rate for Payer: Cofinity Commercial |
$10,472.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,741.44
|
| Rate for Payer: Healthscope Commercial |
$10,959.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,132.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,350.28
|
| Rate for Payer: Nomi Health Commercial |
$9,984.98
|
| Rate for Payer: PHP Commercial |
$10,350.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,914.92
|
| Rate for Payer: Priority Health HMO/PPO |
$10,593.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,158.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,715.58
|
| Rate for Payer: UHC Core |
$10,167.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,132.60
|
|
|
HC I-123 MIBG PER STUDY
|
Facility
|
OP
|
$12,176.80
|
|
|
Service Code
|
HCPCS A9582
|
| Hospital Charge Code |
34300010
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,500.09 |
| Max. Negotiated Rate |
$10,959.12 |
| Rate for Payer: Aetna Commercial |
$10,350.28
|
| Rate for Payer: Aetna Medicare |
$3,165.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,805.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,805.25
|
| Rate for Payer: BCBS Complete |
$1,575.20
|
| Rate for Payer: BCBS MAPPO |
$3,044.20
|
| Rate for Payer: BCBS Trust/PPO |
$10,010.55
|
| Rate for Payer: BCN Commercial |
$9,467.46
|
| Rate for Payer: BCN Medicare Advantage |
$3,044.20
|
| Rate for Payer: Cash Price |
$9,741.44
|
| Rate for Payer: Cash Price |
$9,741.44
|
| Rate for Payer: Cofinity Commercial |
$10,472.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,741.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,044.20
|
| Rate for Payer: Healthscope Commercial |
$10,959.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,132.60
|
| Rate for Payer: Mclaren Medicaid |
$1,500.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,196.41
|
| Rate for Payer: Meridian Medicaid |
$1,575.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,500.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,350.28
|
| Rate for Payer: Nomi Health Commercial |
$9,984.98
|
| Rate for Payer: PACE Senior Care Partners |
$2,891.99
|
| Rate for Payer: PACE SWMI |
$3,044.20
|
| Rate for Payer: PHP Commercial |
$10,350.28
|
| Rate for Payer: PHP Medicare Advantage |
$3,044.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,500.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,914.92
|
| Rate for Payer: Priority Health HMO/PPO |
$10,593.82
|
| Rate for Payer: Priority Health Medicare |
$3,074.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,158.46
|
| Rate for Payer: Railroad Medicare Medicare |
$3,044.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,715.58
|
| Rate for Payer: UHC Core |
$10,167.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,044.20
|
| Rate for Payer: UHC Exchange |
$3,044.20
|
| Rate for Payer: UHC Medicare Advantage |
$3,044.20
|
| Rate for Payer: UHCCP Medicaid |
$1,500.09
|
| Rate for Payer: VA VA |
$3,044.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,132.60
|
|
|
HC I-131 CAP (DX) PER MCI
|
Facility
|
OP
|
$74.94
|
|
|
Service Code
|
HCPCS A9528
|
| Hospital Charge Code |
34300011
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$17.80 |
| Max. Negotiated Rate |
$67.45 |
| Rate for Payer: Aetna Commercial |
$63.70
|
| Rate for Payer: Aetna Medicare |
$19.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.42
|
| Rate for Payer: BCBS Complete |
$29.98
|
| Rate for Payer: BCBS MAPPO |
$18.74
|
| Rate for Payer: BCBS Trust/PPO |
$61.61
|
| Rate for Payer: BCN Commercial |
$58.27
|
| Rate for Payer: BCN Medicare Advantage |
$18.74
|
| Rate for Payer: Cash Price |
$59.95
|
| Rate for Payer: Cofinity Commercial |
$64.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.74
|
| Rate for Payer: Healthscope Commercial |
$67.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.70
|
| Rate for Payer: Nomi Health Commercial |
$61.45
|
| Rate for Payer: PACE Senior Care Partners |
$17.80
|
| Rate for Payer: PACE SWMI |
$18.74
|
| Rate for Payer: PHP Commercial |
$63.70
|
| Rate for Payer: PHP Medicare Advantage |
$18.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.71
|
| Rate for Payer: Priority Health HMO/PPO |
$65.20
|
| Rate for Payer: Priority Health Medicare |
$18.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.21
|
| Rate for Payer: Railroad Medicare Medicare |
$18.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.95
|
| Rate for Payer: UHC Core |
$62.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.74
|
| Rate for Payer: UHC Exchange |
$18.74
|
| Rate for Payer: UHC Medicare Advantage |
$18.74
|
| Rate for Payer: VA VA |
$18.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.20
|
|
|
HC I-131 CAP (DX) PER MCI
|
Facility
|
IP
|
$74.94
|
|
|
Service Code
|
HCPCS A9528
|
| Hospital Charge Code |
34300011
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$48.71 |
| Max. Negotiated Rate |
$67.45 |
| Rate for Payer: Aetna Commercial |
$63.70
|
| Rate for Payer: BCBS Trust/PPO |
$61.17
|
| Rate for Payer: BCN Commercial |
$57.91
|
| Rate for Payer: Cash Price |
$59.95
|
| Rate for Payer: Cofinity Commercial |
$64.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.95
|
| Rate for Payer: Healthscope Commercial |
$67.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.70
|
| Rate for Payer: Nomi Health Commercial |
$61.45
|
| Rate for Payer: PHP Commercial |
$63.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.71
|
| Rate for Payer: Priority Health HMO/PPO |
$65.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.95
|
| Rate for Payer: UHC Core |
$62.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.20
|
|
|
HC I-131 CAP (TX) PER MCI
|
Facility
|
OP
|
$68.13
|
|
|
Service Code
|
HCPCS A9517
|
| Hospital Charge Code |
34400001
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$16.18 |
| Max. Negotiated Rate |
$61.32 |
| Rate for Payer: Aetna Commercial |
$57.91
|
| Rate for Payer: Aetna Medicare |
$17.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.29
|
| Rate for Payer: BCBS Complete |
$17.56
|
| Rate for Payer: BCBS MAPPO |
$17.03
|
| Rate for Payer: BCBS Trust/PPO |
$56.01
|
| Rate for Payer: BCN Commercial |
$52.97
|
| Rate for Payer: BCN Medicare Advantage |
$17.03
|
| Rate for Payer: Cash Price |
$54.50
|
| Rate for Payer: Cash Price |
$54.50
|
| Rate for Payer: Cofinity Commercial |
$58.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.03
|
| Rate for Payer: Healthscope Commercial |
$61.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.10
|
| Rate for Payer: Mclaren Medicaid |
$16.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.88
|
| Rate for Payer: Meridian Medicaid |
$17.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.91
|
| Rate for Payer: Nomi Health Commercial |
$55.87
|
| Rate for Payer: PACE Senior Care Partners |
$16.18
|
| Rate for Payer: PACE SWMI |
$17.03
|
| Rate for Payer: PHP Commercial |
$57.91
|
| Rate for Payer: PHP Medicare Advantage |
$17.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.28
|
| Rate for Payer: Priority Health HMO/PPO |
$59.27
|
| Rate for Payer: Priority Health Medicare |
$17.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.65
|
| Rate for Payer: Railroad Medicare Medicare |
$17.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.95
|
| Rate for Payer: UHC Core |
$56.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.03
|
| Rate for Payer: UHC Exchange |
$17.03
|
| Rate for Payer: UHC Medicare Advantage |
$17.03
|
| Rate for Payer: UHCCP Medicaid |
$16.72
|
| Rate for Payer: VA VA |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.10
|
|
|
HC I-131 CAP (TX) PER MCI
|
Facility
|
IP
|
$68.13
|
|
|
Service Code
|
HCPCS A9517
|
| Hospital Charge Code |
34400001
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$44.28 |
| Max. Negotiated Rate |
$61.32 |
| Rate for Payer: Aetna Commercial |
$57.91
|
| Rate for Payer: BCBS Trust/PPO |
$55.61
|
| Rate for Payer: BCN Commercial |
$52.65
|
| Rate for Payer: Cash Price |
$54.50
|
| Rate for Payer: Cofinity Commercial |
$58.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.50
|
| Rate for Payer: Healthscope Commercial |
$61.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.91
|
| Rate for Payer: Nomi Health Commercial |
$55.87
|
| Rate for Payer: PHP Commercial |
$57.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.28
|
| Rate for Payer: Priority Health HMO/PPO |
$59.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.95
|
| Rate for Payer: UHC Core |
$56.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.10
|
|
|
HC I-131 SOD IODIDE DIAG PER UCI
|
Facility
|
IP
|
$47.86
|
|
|
Service Code
|
HCPCS A9531
|
| Hospital Charge Code |
34300031
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$31.11 |
| Max. Negotiated Rate |
$43.07 |
| Rate for Payer: Aetna Commercial |
$40.68
|
| Rate for Payer: BCBS Trust/PPO |
$39.07
|
| Rate for Payer: BCN Commercial |
$36.99
|
| Rate for Payer: Cash Price |
$38.29
|
| Rate for Payer: Cofinity Commercial |
$41.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.29
|
| Rate for Payer: Healthscope Commercial |
$43.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.68
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PHP Commercial |
$40.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.11
|
| Rate for Payer: Priority Health HMO/PPO |
$41.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.12
|
| Rate for Payer: UHC Core |
$39.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC I-131 SOD IODIDE DIAG PER UCI
|
Facility
|
OP
|
$47.86
|
|
|
Service Code
|
HCPCS A9531
|
| Hospital Charge Code |
34300031
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$11.37 |
| Max. Negotiated Rate |
$43.07 |
| Rate for Payer: Aetna Commercial |
$40.68
|
| Rate for Payer: Aetna Medicare |
$12.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.96
|
| Rate for Payer: BCBS Complete |
$19.14
|
| Rate for Payer: BCBS MAPPO |
$11.96
|
| Rate for Payer: BCBS Trust/PPO |
$39.35
|
| Rate for Payer: BCN Commercial |
$37.21
|
| Rate for Payer: BCN Medicare Advantage |
$11.96
|
| Rate for Payer: Cash Price |
$38.29
|
| Rate for Payer: Cofinity Commercial |
$41.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.96
|
| Rate for Payer: Healthscope Commercial |
$43.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.68
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PACE Senior Care Partners |
$11.37
|
| Rate for Payer: PACE SWMI |
$11.96
|
| Rate for Payer: PHP Commercial |
$40.68
|
| Rate for Payer: PHP Medicare Advantage |
$11.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.11
|
| Rate for Payer: Priority Health HMO/PPO |
$41.64
|
| Rate for Payer: Priority Health Medicare |
$12.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.07
|
| Rate for Payer: Railroad Medicare Medicare |
$11.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.12
|
| Rate for Payer: UHC Core |
$39.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.96
|
| Rate for Payer: UHC Exchange |
$11.96
|
| Rate for Payer: UHC Medicare Advantage |
$11.96
|
| Rate for Payer: VA VA |
$11.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC I-131 SOL (DX) PER MCI
|
Facility
|
OP
|
$47.87
|
|
|
Service Code
|
HCPCS A9529
|
| Hospital Charge Code |
34300012
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$11.37 |
| Max. Negotiated Rate |
$43.08 |
| Rate for Payer: Aetna Commercial |
$40.69
|
| Rate for Payer: Aetna Medicare |
$12.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.96
|
| Rate for Payer: BCBS Complete |
$19.15
|
| Rate for Payer: BCBS MAPPO |
$11.97
|
| Rate for Payer: BCBS Trust/PPO |
$39.35
|
| Rate for Payer: BCN Commercial |
$37.22
|
| Rate for Payer: BCN Medicare Advantage |
$11.97
|
| Rate for Payer: Cash Price |
$38.30
|
| Rate for Payer: Cofinity Commercial |
$41.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.97
|
| Rate for Payer: Healthscope Commercial |
$43.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.69
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PACE Senior Care Partners |
$11.37
|
| Rate for Payer: PACE SWMI |
$11.97
|
| Rate for Payer: PHP Commercial |
$40.69
|
| Rate for Payer: PHP Medicare Advantage |
$11.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.12
|
| Rate for Payer: Priority Health HMO/PPO |
$41.65
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.07
|
| Rate for Payer: Railroad Medicare Medicare |
$11.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.13
|
| Rate for Payer: UHC Core |
$39.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.97
|
| Rate for Payer: UHC Exchange |
$11.97
|
| Rate for Payer: UHC Medicare Advantage |
$11.97
|
| Rate for Payer: VA VA |
$11.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC I-131 SOL (DX) PER MCI
|
Facility
|
IP
|
$47.87
|
|
|
Service Code
|
HCPCS A9529
|
| Hospital Charge Code |
34300012
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$31.12 |
| Max. Negotiated Rate |
$43.08 |
| Rate for Payer: Aetna Commercial |
$40.69
|
| Rate for Payer: BCBS Trust/PPO |
$39.08
|
| Rate for Payer: BCN Commercial |
$36.99
|
| Rate for Payer: Cash Price |
$38.30
|
| Rate for Payer: Cofinity Commercial |
$41.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.30
|
| Rate for Payer: Healthscope Commercial |
$43.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.69
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PHP Commercial |
$40.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.12
|
| Rate for Payer: Priority Health HMO/PPO |
$41.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.13
|
| Rate for Payer: UHC Core |
$39.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC I-131 SOL (TX) PER MCI
|
Facility
|
IP
|
$47.87
|
|
|
Service Code
|
HCPCS A9530
|
| Hospital Charge Code |
34400002
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$31.12 |
| Max. Negotiated Rate |
$43.08 |
| Rate for Payer: Aetna Commercial |
$40.69
|
| Rate for Payer: BCBS Trust/PPO |
$39.08
|
| Rate for Payer: BCN Commercial |
$36.99
|
| Rate for Payer: Cash Price |
$38.30
|
| Rate for Payer: Cofinity Commercial |
$41.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.30
|
| Rate for Payer: Healthscope Commercial |
$43.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.69
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PHP Commercial |
$40.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.12
|
| Rate for Payer: Priority Health HMO/PPO |
$41.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.13
|
| Rate for Payer: UHC Core |
$39.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC I-131 SOL (TX) PER MCI
|
Facility
|
OP
|
$47.87
|
|
|
Service Code
|
HCPCS A9530
|
| Hospital Charge Code |
34400002
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$11.37 |
| Max. Negotiated Rate |
$43.08 |
| Rate for Payer: Aetna Commercial |
$40.69
|
| Rate for Payer: Aetna Medicare |
$12.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.96
|
| Rate for Payer: BCBS Complete |
$15.85
|
| Rate for Payer: BCBS MAPPO |
$11.97
|
| Rate for Payer: BCBS Trust/PPO |
$39.35
|
| Rate for Payer: BCN Commercial |
$37.22
|
| Rate for Payer: BCN Medicare Advantage |
$11.97
|
| Rate for Payer: Cash Price |
$38.30
|
| Rate for Payer: Cash Price |
$38.30
|
| Rate for Payer: Cofinity Commercial |
$41.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.97
|
| Rate for Payer: Healthscope Commercial |
$43.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Mclaren Medicaid |
$15.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.57
|
| Rate for Payer: Meridian Medicaid |
$15.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.69
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PACE Senior Care Partners |
$11.37
|
| Rate for Payer: PACE SWMI |
$11.97
|
| Rate for Payer: PHP Commercial |
$40.69
|
| Rate for Payer: PHP Medicare Advantage |
$11.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.12
|
| Rate for Payer: Priority Health HMO/PPO |
$41.65
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.07
|
| Rate for Payer: Railroad Medicare Medicare |
$11.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.13
|
| Rate for Payer: UHC Core |
$39.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.97
|
| Rate for Payer: UHC Exchange |
$11.97
|
| Rate for Payer: UHC Medicare Advantage |
$11.97
|
| Rate for Payer: UHCCP Medicaid |
$15.10
|
| Rate for Payer: VA VA |
$11.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC IAAD NOS EACH ORGANISM AG IA
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600341
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.66 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$89.25
|
| Rate for Payer: Aetna Medicare |
$27.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.81
|
| Rate for Payer: BCBS Complete |
$9.10
|
| Rate for Payer: BCBS MAPPO |
$26.25
|
| Rate for Payer: BCBS Trust/PPO |
$86.32
|
| Rate for Payer: BCN Commercial |
$81.64
|
| Rate for Payer: BCN Medicare Advantage |
$26.25
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$90.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.25
|
| Rate for Payer: Healthscope Commercial |
$94.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.75
|
| Rate for Payer: Mclaren Medicaid |
$8.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.56
|
| Rate for Payer: Meridian Medicaid |
$9.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.25
|
| Rate for Payer: Nomi Health Commercial |
$86.10
|
| Rate for Payer: PACE Senior Care Partners |
$24.94
|
| Rate for Payer: PACE SWMI |
$26.25
|
| Rate for Payer: PHP Commercial |
$89.25
|
| Rate for Payer: PHP Medicare Advantage |
$26.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.25
|
| Rate for Payer: Priority Health HMO/PPO |
$91.35
|
| Rate for Payer: Priority Health Medicare |
$26.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.35
|
| Rate for Payer: Railroad Medicare Medicare |
$26.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.40
|
| Rate for Payer: UHC Core |
$87.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.25
|
| Rate for Payer: UHC Exchange |
$26.25
|
| Rate for Payer: UHC Medicare Advantage |
$26.25
|
| Rate for Payer: UHCCP Medicaid |
$8.66
|
| Rate for Payer: VA VA |
$26.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.75
|
|
|
HC IAAD NOS EACH ORGANISM AG IA
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600341
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$68.25 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$89.25
|
| Rate for Payer: BCBS Trust/PPO |
$85.71
|
| Rate for Payer: BCN Commercial |
$81.14
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$90.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.00
|
| Rate for Payer: Healthscope Commercial |
$94.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.25
|
| Rate for Payer: Nomi Health Commercial |
$86.10
|
| Rate for Payer: PHP Commercial |
$89.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.25
|
| Rate for Payer: Priority Health HMO/PPO |
$91.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.40
|
| Rate for Payer: UHC Core |
$87.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.75
|
|
|
HC IAPB MONITORING SERVICES HOURL
|
Facility
|
OP
|
$408.67
|
|
| Hospital Charge Code |
27000118
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$97.06 |
| Max. Negotiated Rate |
$367.80 |
| Rate for Payer: Aetna Commercial |
$347.37
|
| Rate for Payer: Aetna Medicare |
$106.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$127.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$127.71
|
| Rate for Payer: BCBS Complete |
$163.47
|
| Rate for Payer: BCBS MAPPO |
$102.17
|
| Rate for Payer: BCBS Trust/PPO |
$335.97
|
| Rate for Payer: BCN Commercial |
$317.74
|
| Rate for Payer: BCN Medicare Advantage |
$102.17
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$351.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.17
|
| Rate for Payer: Healthscope Commercial |
$367.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.37
|
| Rate for Payer: Nomi Health Commercial |
$335.11
|
| Rate for Payer: PACE Senior Care Partners |
$97.06
|
| Rate for Payer: PACE SWMI |
$102.17
|
| Rate for Payer: PHP Commercial |
$347.37
|
| Rate for Payer: PHP Medicare Advantage |
$102.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.64
|
| Rate for Payer: Priority Health HMO/PPO |
$355.54
|
| Rate for Payer: Priority Health Medicare |
$103.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.81
|
| Rate for Payer: Railroad Medicare Medicare |
$102.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.63
|
| Rate for Payer: UHC Core |
$341.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.17
|
| Rate for Payer: UHC Exchange |
$102.17
|
| Rate for Payer: UHC Medicare Advantage |
$102.17
|
| Rate for Payer: VA VA |
$102.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.50
|
|
|
HC IAPB MONITORING SERVICES HOURL
|
Facility
|
IP
|
$408.67
|
|
| Hospital Charge Code |
27000118
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$265.64 |
| Max. Negotiated Rate |
$367.80 |
| Rate for Payer: Aetna Commercial |
$347.37
|
| Rate for Payer: BCBS Trust/PPO |
$333.60
|
| Rate for Payer: BCN Commercial |
$315.82
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$351.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Healthscope Commercial |
$367.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.37
|
| Rate for Payer: Nomi Health Commercial |
$335.11
|
| Rate for Payer: PHP Commercial |
$347.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.64
|
| Rate for Payer: Priority Health HMO/PPO |
$355.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.63
|
| Rate for Payer: UHC Core |
$341.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.50
|
|
|
HC IAP CHEMO ADMINISTRATON
|
Facility
|
IP
|
$398.44
|
|
|
Service Code
|
CPT 96420
|
| Hospital Charge Code |
33500010
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$258.99 |
| Max. Negotiated Rate |
$358.60 |
| Rate for Payer: Aetna Commercial |
$338.67
|
| Rate for Payer: BCBS Trust/PPO |
$325.25
|
| Rate for Payer: BCN Commercial |
$307.91
|
| Rate for Payer: Cash Price |
$318.75
|
| Rate for Payer: Cofinity Commercial |
$342.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.75
|
| Rate for Payer: Healthscope Commercial |
$358.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.67
|
| Rate for Payer: Nomi Health Commercial |
$326.72
|
| Rate for Payer: PHP Commercial |
$338.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.99
|
| Rate for Payer: Priority Health HMO/PPO |
$346.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.63
|
| Rate for Payer: UHC Core |
$332.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.83
|
|
|
HC IAP CHEMO ADMINISTRATON
|
Facility
|
OP
|
$398.44
|
|
|
Service Code
|
CPT 96420
|
| Hospital Charge Code |
33500010
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$94.63 |
| Max. Negotiated Rate |
$358.60 |
| Rate for Payer: Aetna Commercial |
$338.67
|
| Rate for Payer: Aetna Medicare |
$103.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$124.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$124.51
|
| Rate for Payer: BCBS Complete |
$246.72
|
| Rate for Payer: BCBS MAPPO |
$99.61
|
| Rate for Payer: BCBS Trust/PPO |
$327.56
|
| Rate for Payer: BCN Commercial |
$309.79
|
| Rate for Payer: BCN Medicare Advantage |
$99.61
|
| Rate for Payer: Cash Price |
$318.75
|
| Rate for Payer: Cash Price |
$318.75
|
| Rate for Payer: Cofinity Commercial |
$342.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.61
|
| Rate for Payer: Healthscope Commercial |
$358.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.83
|
| Rate for Payer: Mclaren Medicaid |
$234.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.59
|
| Rate for Payer: Meridian Medicaid |
$246.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.67
|
| Rate for Payer: Nomi Health Commercial |
$326.72
|
| Rate for Payer: PACE Senior Care Partners |
$94.63
|
| Rate for Payer: PACE SWMI |
$99.61
|
| Rate for Payer: PHP Commercial |
$338.67
|
| Rate for Payer: PHP Medicare Advantage |
$99.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.99
|
| Rate for Payer: Priority Health HMO/PPO |
$346.64
|
| Rate for Payer: Priority Health Medicare |
$100.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.95
|
| Rate for Payer: Railroad Medicare Medicare |
$99.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.63
|
| Rate for Payer: UHC Core |
$332.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.61
|
| Rate for Payer: UHC Exchange |
$99.61
|
| Rate for Payer: UHC Medicare Advantage |
$99.61
|
| Rate for Payer: UHCCP Medicaid |
$234.96
|
| Rate for Payer: VA VA |
$99.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.83
|
|
