|
HC PHYSICAL PERF TEST EA 15 MIN
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 97750
|
| Hospital Charge Code |
42000038
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$55.99 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: BCBS Trust/PPO |
$70.94
|
| Rate for Payer: BCN Commercial |
$70.94
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.03
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC PHYSICAL PERF TEST EA 15 MIN
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 97750
|
| Hospital Charge Code |
42000038
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.69
|
| Rate for Payer: BCBS Complete |
$36.72
|
| Rate for Payer: BCBS MAPPO |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$71.37
|
| Rate for Payer: BCN Commercial |
$71.37
|
| Rate for Payer: BCN Medicare Advantage |
$22.95
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.95
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.03
|
| Rate for Payer: PACE Senior Care Partners |
$21.80
|
| Rate for Payer: PACE SWMI |
$22.95
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Medicare Advantage |
$22.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.87
|
| Rate for Payer: Priority Health Medicare |
$22.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.99
|
| Rate for Payer: Railroad Medicare Medicare |
$22.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.95
|
| Rate for Payer: UHC Medicare Advantage |
$23.64
|
| Rate for Payer: VA VA |
$22.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC PICC INTRODUCER
|
Facility
|
IP
|
$96.39
|
|
| Hospital Charge Code |
27200147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.79 |
| Max. Negotiated Rate |
$86.75 |
| Rate for Payer: Aetna Commercial |
$81.93
|
| Rate for Payer: BCBS Trust/PPO |
$74.49
|
| Rate for Payer: BCN Commercial |
$74.49
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cofinity Commercial |
$82.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.11
|
| Rate for Payer: Healthscope Commercial |
$86.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.93
|
| Rate for Payer: PHP Commercial |
$81.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.82
|
| Rate for Payer: UHC Core |
$80.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.29
|
|
|
HC PICC INTRODUCER
|
Facility
|
OP
|
$96.39
|
|
| Hospital Charge Code |
27200147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$86.75 |
| Rate for Payer: Aetna Commercial |
$81.93
|
| Rate for Payer: Aetna Medicare |
$25.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.12
|
| Rate for Payer: BCBS Complete |
$38.56
|
| Rate for Payer: BCBS MAPPO |
$24.10
|
| Rate for Payer: BCBS Trust/PPO |
$74.94
|
| Rate for Payer: BCN Commercial |
$74.94
|
| Rate for Payer: BCN Medicare Advantage |
$24.10
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cofinity Commercial |
$82.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.10
|
| Rate for Payer: Healthscope Commercial |
$86.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.93
|
| Rate for Payer: PACE Senior Care Partners |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.10
|
| Rate for Payer: PHP Commercial |
$81.93
|
| Rate for Payer: PHP Medicare Advantage |
$24.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.86
|
| Rate for Payer: Priority Health Medicare |
$24.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.79
|
| Rate for Payer: Railroad Medicare Medicare |
$24.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.82
|
| Rate for Payer: UHC Core |
$80.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.10
|
| Rate for Payer: UHC Medicare Advantage |
$24.82
|
| Rate for Payer: VA VA |
$24.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.29
|
|
|
HC PICU 30" NITROUS OXIDE SED RECOVERY
|
Facility
|
OP
|
$110.38
|
|
| Hospital Charge Code |
37000019
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$26.22 |
| Max. Negotiated Rate |
$99.34 |
| Rate for Payer: Aetna Commercial |
$93.82
|
| Rate for Payer: Aetna Medicare |
$28.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.49
|
| Rate for Payer: BCBS Complete |
$44.15
|
| Rate for Payer: BCBS MAPPO |
$27.60
|
| Rate for Payer: BCBS Trust/PPO |
$85.82
|
| Rate for Payer: BCN Commercial |
$85.82
|
| Rate for Payer: BCN Medicare Advantage |
$27.60
|
| Rate for Payer: Cash Price |
$88.30
|
| Rate for Payer: Cofinity Commercial |
$94.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.60
|
| Rate for Payer: Healthscope Commercial |
$99.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.82
|
| Rate for Payer: PACE Senior Care Partners |
$26.22
|
| Rate for Payer: PACE SWMI |
$27.60
|
| Rate for Payer: PHP Commercial |
$93.82
|
| Rate for Payer: PHP Medicare Advantage |
$27.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.03
|
| Rate for Payer: Priority Health Medicare |
$27.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.32
|
| Rate for Payer: Railroad Medicare Medicare |
$27.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.13
|
| Rate for Payer: UHC Core |
$92.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.60
|
| Rate for Payer: UHC Medicare Advantage |
$28.42
|
| Rate for Payer: VA VA |
$27.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.78
|
|
|
HC PICU 30" NITROUS OXIDE SED RECOVERY
|
Facility
|
IP
|
$110.38
|
|
| Hospital Charge Code |
37000019
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$67.32 |
| Max. Negotiated Rate |
$99.34 |
| Rate for Payer: Aetna Commercial |
$93.82
|
| Rate for Payer: BCBS Trust/PPO |
$85.30
|
| Rate for Payer: BCN Commercial |
$85.30
|
| Rate for Payer: Cash Price |
$88.30
|
| Rate for Payer: Cofinity Commercial |
$94.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.30
|
| Rate for Payer: Healthscope Commercial |
$99.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.82
|
| Rate for Payer: PHP Commercial |
$93.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.13
|
| Rate for Payer: UHC Core |
$92.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.78
|
|
|
HC PICU OBSERVATION PER HOUR
|
Facility
|
OP
|
$186.06
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200017
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$44.19 |
| Max. Negotiated Rate |
$167.45 |
| Rate for Payer: Aetna Commercial |
$158.15
|
| Rate for Payer: Aetna Medicare |
$48.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.14
|
| Rate for Payer: BCBS Complete |
$74.42
|
| Rate for Payer: BCBS MAPPO |
$46.52
|
| Rate for Payer: BCBS Trust/PPO |
$144.66
|
| Rate for Payer: BCN Commercial |
$144.66
|
| Rate for Payer: BCN Medicare Advantage |
$46.52
|
| Rate for Payer: Cash Price |
$148.85
|
| Rate for Payer: Cofinity Commercial |
$160.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.52
|
| Rate for Payer: Healthscope Commercial |
$167.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$48.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$158.15
|
| Rate for Payer: PACE Senior Care Partners |
$44.19
|
| Rate for Payer: PACE SWMI |
$46.52
|
| Rate for Payer: PHP Commercial |
$158.15
|
| Rate for Payer: PHP Medicare Advantage |
$46.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.87
|
| Rate for Payer: Priority Health Medicare |
$46.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.48
|
| Rate for Payer: Railroad Medicare Medicare |
$46.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.73
|
| Rate for Payer: UHC Core |
$155.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.52
|
| Rate for Payer: UHC Medicare Advantage |
$47.91
|
| Rate for Payer: VA VA |
$46.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.54
|
|
|
HC PICU OBSERVATION PER HOUR
|
Facility
|
IP
|
$186.06
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200017
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$113.48 |
| Max. Negotiated Rate |
$167.45 |
| Rate for Payer: Aetna Commercial |
$158.15
|
| Rate for Payer: BCBS Trust/PPO |
$143.79
|
| Rate for Payer: BCN Commercial |
$143.79
|
| Rate for Payer: Cash Price |
$148.85
|
| Rate for Payer: Cofinity Commercial |
$160.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.85
|
| Rate for Payer: Healthscope Commercial |
$167.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$158.15
|
| Rate for Payer: PHP Commercial |
$158.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.73
|
| Rate for Payer: UHC Core |
$155.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.54
|
|
|
HC PICU OR PED CRITICAL CARE R&B
|
Facility
|
IP
|
$7,648.92
|
|
| Hospital Charge Code |
20300001
|
|
Hospital Revenue Code
|
203
|
| Min. Negotiated Rate |
$1,577.95 |
| Max. Negotiated Rate |
$166,100.00 |
| Rate for Payer: Aetna Commercial |
$6,501.58
|
| Rate for Payer: Aetna Medicare |
$1,727.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,076.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,076.25
|
| Rate for Payer: BCBS MAPPO |
$1,661.00
|
| Rate for Payer: BCBS Trust/PPO |
$5,911.09
|
| Rate for Payer: BCN Commercial |
$5,911.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,661.00
|
| Rate for Payer: Cash Price |
$6,119.14
|
| Rate for Payer: Cash Price |
$6,119.14
|
| Rate for Payer: Cash Price |
$6,119.14
|
| Rate for Payer: Cofinity Commercial |
$6,578.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,119.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,661.00
|
| Rate for Payer: Healthscope Commercial |
$6,884.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,736.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,744.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,910.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,501.58
|
| Rate for Payer: PACE Senior Care Partners |
$1,577.95
|
| Rate for Payer: PACE SWMI |
$1,661.00
|
| Rate for Payer: PHP Commercial |
$6,501.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,661.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,354.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,654.56
|
| Rate for Payer: Priority Health Medicare |
$1,661.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,665.08
|
| Rate for Payer: Railroad Medicare Medicare |
$1,661.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,731.05
|
| Rate for Payer: UHC Core |
$6,386.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$166,100.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,710.83
|
| Rate for Payer: VA VA |
$1,661.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,736.69
|
|
|
HC PICU OR PED INTERMEDIATE CARE R&B
|
Facility
|
IP
|
$6,382.60
|
|
| Hospital Charge Code |
20600002
|
|
Hospital Revenue Code
|
206
|
| Min. Negotiated Rate |
$1,577.95 |
| Max. Negotiated Rate |
$166,100.00 |
| Rate for Payer: Aetna Commercial |
$5,425.21
|
| Rate for Payer: Aetna Medicare |
$1,727.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,076.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,076.25
|
| Rate for Payer: BCBS MAPPO |
$1,661.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,932.47
|
| Rate for Payer: BCN Commercial |
$4,932.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,661.00
|
| Rate for Payer: Cash Price |
$5,106.08
|
| Rate for Payer: Cash Price |
$5,106.08
|
| Rate for Payer: Cash Price |
$5,106.08
|
| Rate for Payer: Cofinity Commercial |
$5,489.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,106.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,661.00
|
| Rate for Payer: Healthscope Commercial |
$5,744.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,786.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,744.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,910.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,425.21
|
| Rate for Payer: PACE Senior Care Partners |
$1,577.95
|
| Rate for Payer: PACE SWMI |
$1,661.00
|
| Rate for Payer: PHP Commercial |
$5,425.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,661.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,467.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,552.86
|
| Rate for Payer: Priority Health Medicare |
$1,661.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,892.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,661.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,616.69
|
| Rate for Payer: UHC Core |
$5,329.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$166,100.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,710.83
|
| Rate for Payer: VA VA |
$1,661.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,786.95
|
|
|
HC PICU/PEDS 30" SEDATION RECOVERY
|
Facility
|
OP
|
$308.88
|
|
| Hospital Charge Code |
71000009
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$73.36 |
| Max. Negotiated Rate |
$277.99 |
| Rate for Payer: Aetna Commercial |
$262.55
|
| Rate for Payer: Aetna Medicare |
$80.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.52
|
| Rate for Payer: BCBS Complete |
$123.55
|
| Rate for Payer: BCBS MAPPO |
$77.22
|
| Rate for Payer: BCBS Trust/PPO |
$240.15
|
| Rate for Payer: BCN Commercial |
$240.15
|
| Rate for Payer: BCN Medicare Advantage |
$77.22
|
| Rate for Payer: Cash Price |
$247.10
|
| Rate for Payer: Cofinity Commercial |
$265.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.22
|
| Rate for Payer: Healthscope Commercial |
$277.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$81.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$262.55
|
| Rate for Payer: PACE Senior Care Partners |
$73.36
|
| Rate for Payer: PACE SWMI |
$77.22
|
| Rate for Payer: PHP Commercial |
$262.55
|
| Rate for Payer: PHP Medicare Advantage |
$77.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$268.73
|
| Rate for Payer: Priority Health Medicare |
$77.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.39
|
| Rate for Payer: Railroad Medicare Medicare |
$77.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$271.81
|
| Rate for Payer: UHC Core |
$257.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.22
|
| Rate for Payer: UHC Medicare Advantage |
$79.54
|
| Rate for Payer: VA VA |
$77.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.66
|
|
|
HC PICU/PEDS 30" SEDATION RECOVERY
|
Facility
|
IP
|
$308.88
|
|
| Hospital Charge Code |
71000009
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$188.39 |
| Max. Negotiated Rate |
$277.99 |
| Rate for Payer: Aetna Commercial |
$262.55
|
| Rate for Payer: BCBS Trust/PPO |
$238.70
|
| Rate for Payer: BCN Commercial |
$238.70
|
| Rate for Payer: Cash Price |
$247.10
|
| Rate for Payer: Cofinity Commercial |
$265.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.10
|
| Rate for Payer: Healthscope Commercial |
$277.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$262.55
|
| Rate for Payer: PHP Commercial |
$262.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$268.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$271.81
|
| Rate for Payer: UHC Core |
$257.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.66
|
|
|
HC PIFLUFOLASTAT PER MILLICURIE
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
CPT A9595
|
| Hospital Charge Code |
34300369
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$933.15 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.38
|
| Rate for Payer: BCN Commercial |
$1,182.38
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,331.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$933.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,346.40
|
| Rate for Payer: UHC Core |
$1,277.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC PIFLUFOLASTAT PER MILLICURIE
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
CPT A9595
|
| Hospital Charge Code |
34300369
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$363.38 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna Medicare |
$397.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$478.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$478.12
|
| Rate for Payer: BCBS Complete |
$449.71
|
| Rate for Payer: BCBS MAPPO |
$382.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,189.58
|
| Rate for Payer: BCN Commercial |
$1,189.58
|
| Rate for Payer: BCN Medicare Advantage |
$382.50
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.50
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Mclaren Medicaid |
$428.30
|
| Rate for Payer: Meridian Medicaid |
$449.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$401.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$439.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PACE Senior Care Partners |
$363.38
|
| Rate for Payer: PACE SWMI |
$382.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: PHP Medicare Advantage |
$382.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$428.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,331.10
|
| Rate for Payer: Priority Health Medicare |
$382.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$933.15
|
| Rate for Payer: Railroad Medicare Medicare |
$382.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,346.40
|
| Rate for Payer: UHC Core |
$1,277.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.50
|
| Rate for Payer: UHC Medicare Advantage |
$393.98
|
| Rate for Payer: VA VA |
$382.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC PIGWEED IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200098
|
|
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 PIGWEED IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200098
|
|
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 PI LINKED ANTIGEN
|
Facility
|
IP
|
$167.43
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000004
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$102.12 |
| Max. Negotiated Rate |
$150.69 |
| Rate for Payer: Aetna Commercial |
$142.32
|
| Rate for Payer: BCBS Trust/PPO |
$129.39
|
| Rate for Payer: BCN Commercial |
$129.39
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Cofinity Commercial |
$143.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.94
|
| Rate for Payer: Healthscope Commercial |
$150.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.32
|
| Rate for Payer: PHP Commercial |
$142.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.34
|
| Rate for Payer: UHC Core |
$139.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.57
|
|
|
HC PI LINKED ANTIGEN
|
Facility
|
OP
|
$167.43
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000004
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$39.76 |
| Max. Negotiated Rate |
$247.59 |
| Rate for Payer: Aetna Commercial |
$142.32
|
| Rate for Payer: Aetna Medicare |
$43.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.32
|
| Rate for Payer: BCBS Complete |
$247.59
|
| Rate for Payer: BCBS MAPPO |
$41.86
|
| Rate for Payer: BCBS Trust/PPO |
$130.18
|
| Rate for Payer: BCN Commercial |
$130.18
|
| Rate for Payer: BCN Medicare Advantage |
$41.86
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Cofinity Commercial |
$143.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.86
|
| Rate for Payer: Healthscope Commercial |
$150.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.57
|
| Rate for Payer: Mclaren Medicaid |
$235.80
|
| Rate for Payer: Meridian Medicaid |
$247.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.32
|
| Rate for Payer: PACE Senior Care Partners |
$39.76
|
| Rate for Payer: PACE SWMI |
$41.86
|
| Rate for Payer: PHP Commercial |
$142.32
|
| Rate for Payer: PHP Medicare Advantage |
$41.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.66
|
| Rate for Payer: Priority Health Medicare |
$41.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.12
|
| Rate for Payer: Railroad Medicare Medicare |
$41.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.34
|
| Rate for Payer: UHC Core |
$139.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.86
|
| Rate for Payer: UHC Medicare Advantage |
$43.11
|
| Rate for Payer: VA VA |
$41.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.57
|
|
|
HC PI LINKED ANTIGEN CMPT
|
Facility
|
IP
|
$167.43
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000005
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$102.12 |
| Max. Negotiated Rate |
$150.69 |
| Rate for Payer: Aetna Commercial |
$142.32
|
| Rate for Payer: BCBS Trust/PPO |
$129.39
|
| Rate for Payer: BCN Commercial |
$129.39
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Cofinity Commercial |
$143.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.94
|
| Rate for Payer: Healthscope Commercial |
$150.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.32
|
| Rate for Payer: PHP Commercial |
$142.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.34
|
| Rate for Payer: UHC Core |
$139.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.57
|
|
|
HC PI LINKED ANTIGEN CMPT
|
Facility
|
OP
|
$167.43
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000005
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$39.76 |
| Max. Negotiated Rate |
$247.59 |
| Rate for Payer: Aetna Commercial |
$142.32
|
| Rate for Payer: Aetna Medicare |
$43.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.32
|
| Rate for Payer: BCBS Complete |
$247.59
|
| Rate for Payer: BCBS MAPPO |
$41.86
|
| Rate for Payer: BCBS Trust/PPO |
$130.18
|
| Rate for Payer: BCN Commercial |
$130.18
|
| Rate for Payer: BCN Medicare Advantage |
$41.86
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Cofinity Commercial |
$143.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.86
|
| Rate for Payer: Healthscope Commercial |
$150.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.57
|
| Rate for Payer: Mclaren Medicaid |
$235.80
|
| Rate for Payer: Meridian Medicaid |
$247.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.32
|
| Rate for Payer: PACE Senior Care Partners |
$39.76
|
| Rate for Payer: PACE SWMI |
$41.86
|
| Rate for Payer: PHP Commercial |
$142.32
|
| Rate for Payer: PHP Medicare Advantage |
$41.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.66
|
| Rate for Payer: Priority Health Medicare |
$41.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.12
|
| Rate for Payer: Railroad Medicare Medicare |
$41.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.34
|
| Rate for Payer: UHC Core |
$139.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.86
|
| Rate for Payer: UHC Medicare Advantage |
$43.11
|
| Rate for Payer: VA VA |
$41.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.57
|
|
|
HC PI LINKED ANTIGEN CMPT2
|
Facility
|
IP
|
$53.75
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$32.78 |
| Max. Negotiated Rate |
$48.38 |
| Rate for Payer: Aetna Commercial |
$45.69
|
| Rate for Payer: BCBS Trust/PPO |
$41.54
|
| Rate for Payer: BCN Commercial |
$41.54
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cofinity Commercial |
$46.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.69
|
| Rate for Payer: PHP Commercial |
$45.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.30
|
| Rate for Payer: UHC Core |
$44.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.31
|
|
|
HC PI LINKED ANTIGEN CMPT2
|
Facility
|
OP
|
$53.75
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.77 |
| Max. Negotiated Rate |
$48.38 |
| Rate for Payer: Aetna Commercial |
$45.69
|
| Rate for Payer: Aetna Medicare |
$13.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.80
|
| Rate for Payer: BCBS Complete |
$21.50
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$41.79
|
| Rate for Payer: BCN Commercial |
$41.79
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$43.00
|
| Rate for Payer: Cofinity Commercial |
$46.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$48.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.69
|
| Rate for Payer: PACE Senior Care Partners |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$45.69
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.76
|
| Rate for Payer: Priority Health Medicare |
$13.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.78
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.30
|
| Rate for Payer: UHC Core |
$44.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.44
|
| Rate for Payer: UHC Medicare Advantage |
$13.84
|
| Rate for Payer: VA VA |
$13.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.31
|
|
|
HC PINWORM EXAM
|
Facility
|
IP
|
$54.40
|
|
|
Service Code
|
CPT 87172
|
| Hospital Charge Code |
30600094
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.18 |
| Max. Negotiated Rate |
$48.96 |
| Rate for Payer: Aetna Commercial |
$46.24
|
| Rate for Payer: BCBS Trust/PPO |
$42.04
|
| Rate for Payer: BCN Commercial |
$42.04
|
| Rate for Payer: Cash Price |
$43.52
|
| Rate for Payer: Cofinity Commercial |
$46.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.52
|
| Rate for Payer: Healthscope Commercial |
$48.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.24
|
| Rate for Payer: PHP Commercial |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.87
|
| Rate for Payer: UHC Core |
$45.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.80
|
|
|
HC PINWORM EXAM
|
Facility
|
OP
|
$54.40
|
|
|
Service Code
|
CPT 87172
|
| Hospital Charge Code |
30600094
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$48.96 |
| Rate for Payer: Aetna Commercial |
$46.24
|
| Rate for Payer: Aetna Medicare |
$14.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.00
|
| Rate for Payer: BCBS Complete |
$3.31
|
| Rate for Payer: BCBS MAPPO |
$13.60
|
| Rate for Payer: BCBS Trust/PPO |
$42.30
|
| Rate for Payer: BCN Commercial |
$42.30
|
| Rate for Payer: BCN Medicare Advantage |
$13.60
|
| Rate for Payer: Cash Price |
$43.52
|
| Rate for Payer: Cash Price |
$43.52
|
| Rate for Payer: Cofinity Commercial |
$46.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.60
|
| Rate for Payer: Healthscope Commercial |
$48.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.80
|
| Rate for Payer: Mclaren Medicaid |
$3.15
|
| Rate for Payer: Meridian Medicaid |
$3.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.24
|
| Rate for Payer: PACE Senior Care Partners |
$12.92
|
| Rate for Payer: PACE SWMI |
$13.60
|
| Rate for Payer: PHP Commercial |
$46.24
|
| Rate for Payer: PHP Medicare Advantage |
$13.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.33
|
| Rate for Payer: Priority Health Medicare |
$13.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.18
|
| Rate for Payer: Railroad Medicare Medicare |
$13.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.87
|
| Rate for Payer: UHC Core |
$45.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.60
|
| Rate for Payer: UHC Medicare Advantage |
$14.01
|
| Rate for Payer: VA VA |
$13.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.80
|
|
|
HC PIONEER RE-ENTRY CATHETER
|
Facility
|
OP
|
$9,134.11
|
|
|
Service Code
|
HCPCS C1753
|
| Hospital Charge Code |
27200063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,169.35 |
| Max. Negotiated Rate |
$8,220.70 |
| Rate for Payer: Aetna Commercial |
$7,763.99
|
| Rate for Payer: Aetna Medicare |
$2,374.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,854.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,854.41
|
| Rate for Payer: BCBS Complete |
$3,653.64
|
| Rate for Payer: BCBS MAPPO |
$2,283.53
|
| Rate for Payer: BCBS Trust/PPO |
$7,101.77
|
| Rate for Payer: BCN Commercial |
$7,101.77
|
| Rate for Payer: BCN Medicare Advantage |
$2,283.53
|
| Rate for Payer: Cash Price |
$7,307.29
|
| Rate for Payer: Cofinity Commercial |
$7,855.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,307.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,283.53
|
| Rate for Payer: Healthscope Commercial |
$8,220.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,850.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,397.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,626.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,763.99
|
| Rate for Payer: PACE Senior Care Partners |
$2,169.35
|
| Rate for Payer: PACE SWMI |
$2,283.53
|
| Rate for Payer: PHP Commercial |
$7,763.99
|
| Rate for Payer: PHP Medicare Advantage |
$2,283.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,393.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,946.68
|
| Rate for Payer: Priority Health Medicare |
$2,283.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,570.89
|
| Rate for Payer: Railroad Medicare Medicare |
$2,283.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,038.02
|
| Rate for Payer: UHC Core |
$7,626.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,283.53
|
| Rate for Payer: UHC Medicare Advantage |
$2,352.03
|
| Rate for Payer: VA VA |
$2,283.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,850.58
|
|
