|
HC LAMBS QUARTERS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200091
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC LAMBS QUARTERS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200091
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
OP
|
$72.83
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
30100278
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.84 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: Aetna Medicare |
$18.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.76
|
| Rate for Payer: BCBS Complete |
$13.48
|
| Rate for Payer: BCBS MAPPO |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$59.87
|
| Rate for Payer: BCN Commercial |
$59.87
|
| Rate for Payer: BCN Medicare Advantage |
$18.21
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.21
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: Mclaren Medicaid |
$12.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.12
|
| Rate for Payer: Meridian Medicaid |
$13.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PACE Senior Care Partners |
$17.30
|
| Rate for Payer: PACE SWMI |
$18.21
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: PHP Medicare Advantage |
$18.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.36
|
| Rate for Payer: Priority Health Medicare |
$18.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.69
|
| Rate for Payer: Railroad Medicare Medicare |
$18.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.09
|
| Rate for Payer: UHC Core |
$60.81
|
| Rate for Payer: UHC Exchange |
$18.21
|
| Rate for Payer: UHC Medicaid |
$12.84
|
| Rate for Payer: UHC Medicare Advantage |
$18.21
|
| Rate for Payer: UHCCP Medicaid |
$12.84
|
| Rate for Payer: VA VA |
$18.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
IP
|
$72.83
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
30100278
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.69 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: BCBS Trust/PPO |
$60.15
|
| Rate for Payer: BCN Commercial |
$60.15
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.09
|
| Rate for Payer: UHC Core |
$60.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC LAMICTAL LEVEL
|
Facility
|
OP
|
$55.18
|
|
|
Service Code
|
CPT 80175
|
| Hospital Charge Code |
30100054
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.73 |
| Max. Negotiated Rate |
$49.66 |
| Rate for Payer: Aetna Commercial |
$46.90
|
| Rate for Payer: Aetna Medicare |
$14.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.24
|
| Rate for Payer: BCBS Complete |
$10.21
|
| Rate for Payer: BCBS MAPPO |
$13.79
|
| Rate for Payer: BCBS Trust/PPO |
$45.36
|
| Rate for Payer: BCN Commercial |
$45.36
|
| Rate for Payer: BCN Medicare Advantage |
$13.79
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.79
|
| Rate for Payer: Healthscope Commercial |
$49.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.38
|
| Rate for Payer: Mclaren Medicaid |
$9.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.48
|
| Rate for Payer: Meridian Medicaid |
$10.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Nomi Health Commercial |
$45.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PACE Senior Care Partners |
$13.11
|
| Rate for Payer: PACE SWMI |
$13.79
|
| Rate for Payer: PHP Commercial |
$46.90
|
| Rate for Payer: PHP Medicare Advantage |
$13.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.01
|
| Rate for Payer: Priority Health Medicare |
$13.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.41
|
| Rate for Payer: Railroad Medicare Medicare |
$13.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.56
|
| Rate for Payer: UHC Core |
$46.08
|
| Rate for Payer: UHC Exchange |
$13.79
|
| Rate for Payer: UHC Medicaid |
$9.73
|
| Rate for Payer: UHC Medicare Advantage |
$13.79
|
| Rate for Payer: UHCCP Medicaid |
$9.73
|
| Rate for Payer: VA VA |
$13.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.38
|
|
|
HC LAMICTAL LEVEL
|
Facility
|
IP
|
$55.18
|
|
|
Service Code
|
CPT 80175
|
| Hospital Charge Code |
30100054
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.41 |
| Max. Negotiated Rate |
$49.66 |
| Rate for Payer: Aetna Commercial |
$46.90
|
| Rate for Payer: BCBS Trust/PPO |
$45.57
|
| Rate for Payer: BCN Commercial |
$45.57
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Healthscope Commercial |
$49.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Nomi Health Commercial |
$45.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PHP Commercial |
$46.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.56
|
| Rate for Payer: UHC Core |
$46.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.38
|
|
|
HC LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Facility
|
IP
|
$10,689.60
|
|
|
Service Code
|
CPT 31571
|
| Hospital Charge Code |
76100432
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7,439.96 |
| Max. Negotiated Rate |
$9,620.64 |
| Rate for Payer: Aetna Commercial |
$9,086.16
|
| Rate for Payer: BCBS Trust/PPO |
$8,828.54
|
| Rate for Payer: BCN Commercial |
$8,828.54
|
| Rate for Payer: Cash Price |
$8,551.68
|
| Rate for Payer: Cofinity Commercial |
$9,193.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,551.68
|
| Rate for Payer: Healthscope Commercial |
$9,620.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,017.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,086.16
|
| Rate for Payer: Nomi Health Commercial |
$8,765.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,017.20
|
| Rate for Payer: PHP Commercial |
$9,086.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,299.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,439.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,406.85
|
| Rate for Payer: UHC Core |
$8,925.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,017.20
|
|
|
HC LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Facility
|
OP
|
$10,689.60
|
|
|
Service Code
|
CPT 31571
|
| Hospital Charge Code |
76100432
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,884.58 |
| Max. Negotiated Rate |
$9,620.64 |
| Rate for Payer: Aetna Commercial |
$9,086.16
|
| Rate for Payer: Aetna Medicare |
$2,779.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,340.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,340.50
|
| Rate for Payer: BCBS Complete |
$1,978.64
|
| Rate for Payer: BCBS MAPPO |
$2,672.40
|
| Rate for Payer: BCBS Trust/PPO |
$8,787.92
|
| Rate for Payer: BCN Commercial |
$8,787.92
|
| Rate for Payer: BCN Medicare Advantage |
$2,672.40
|
| Rate for Payer: Cash Price |
$8,551.68
|
| Rate for Payer: Cofinity Commercial |
$9,193.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,551.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,672.40
|
| Rate for Payer: Healthscope Commercial |
$9,620.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,017.20
|
| Rate for Payer: Mclaren Medicaid |
$1,884.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,806.02
|
| Rate for Payer: Meridian Medicaid |
$1,978.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,073.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,939.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,086.16
|
| Rate for Payer: Nomi Health Commercial |
$8,765.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,017.20
|
| Rate for Payer: PACE Senior Care Partners |
$2,538.78
|
| Rate for Payer: PACE SWMI |
$2,672.40
|
| Rate for Payer: PHP Commercial |
$9,086.16
|
| Rate for Payer: PHP Medicare Advantage |
$2,672.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,884.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,299.95
|
| Rate for Payer: Priority Health Medicare |
$2,699.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,439.96
|
| Rate for Payer: Railroad Medicare Medicare |
$2,672.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,406.85
|
| Rate for Payer: UHC Core |
$8,925.82
|
| Rate for Payer: UHC Exchange |
$2,672.40
|
| Rate for Payer: UHC Medicaid |
$1,884.58
|
| Rate for Payer: UHC Medicare Advantage |
$2,672.40
|
| Rate for Payer: UHCCP Medicaid |
$1,884.58
|
| Rate for Payer: VA VA |
$2,672.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,017.20
|
|
|
HC LA RO SSB SJOGRENS AB
|
Facility
|
OP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200160
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: Aetna Medicare |
$9.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.21
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: BCBS MAPPO |
$8.97
|
| Rate for Payer: BCBS Trust/PPO |
$29.49
|
| Rate for Payer: BCN Commercial |
$29.49
|
| Rate for Payer: BCN Medicare Advantage |
$8.97
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.97
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Mclaren Medicaid |
$6.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.42
|
| Rate for Payer: Meridian Medicaid |
$6.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PACE Senior Care Partners |
$8.52
|
| Rate for Payer: PACE SWMI |
$8.97
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: PHP Medicare Advantage |
$8.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.21
|
| Rate for Payer: Priority Health Medicare |
$9.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.97
|
| Rate for Payer: Railroad Medicare Medicare |
$8.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.57
|
| Rate for Payer: UHC Core |
$29.95
|
| Rate for Payer: UHC Exchange |
$8.97
|
| Rate for Payer: UHC Medicaid |
$6.32
|
| Rate for Payer: UHC Medicare Advantage |
$8.97
|
| Rate for Payer: UHCCP Medicaid |
$6.32
|
| Rate for Payer: VA VA |
$8.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC LA RO SSB SJOGRENS AB
|
Facility
|
IP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200160
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.97 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: BCBS Trust/PPO |
$29.63
|
| Rate for Payer: BCN Commercial |
$29.63
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.57
|
| Rate for Payer: UHC Core |
$29.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC LARYNGOSCOPY
|
Facility
|
OP
|
$2,616.10
|
|
| Hospital Charge Code |
36000113
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$461.22 |
| Max. Negotiated Rate |
$2,354.49 |
| Rate for Payer: Aetna Commercial |
$2,223.68
|
| Rate for Payer: Aetna Medicare |
$680.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$817.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$817.53
|
| Rate for Payer: BCBS Complete |
$484.24
|
| Rate for Payer: BCBS MAPPO |
$654.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,150.70
|
| Rate for Payer: BCN Commercial |
$2,150.70
|
| Rate for Payer: BCN Medicare Advantage |
$654.02
|
| Rate for Payer: Cash Price |
$2,092.88
|
| Rate for Payer: Cofinity Commercial |
$2,249.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,092.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$654.02
|
| Rate for Payer: Healthscope Commercial |
$2,354.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,962.08
|
| Rate for Payer: Mclaren Medicaid |
$461.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$686.73
|
| Rate for Payer: Meridian Medicaid |
$484.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$752.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$719.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,223.68
|
| Rate for Payer: Nomi Health Commercial |
$2,145.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,962.08
|
| Rate for Payer: PACE Senior Care Partners |
$621.32
|
| Rate for Payer: PACE SWMI |
$654.02
|
| Rate for Payer: PHP Commercial |
$2,223.68
|
| Rate for Payer: PHP Medicare Advantage |
$654.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$461.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,276.01
|
| Rate for Payer: Priority Health Medicare |
$660.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,820.81
|
| Rate for Payer: Railroad Medicare Medicare |
$654.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,302.17
|
| Rate for Payer: UHC Core |
$2,184.44
|
| Rate for Payer: UHC Exchange |
$654.02
|
| Rate for Payer: UHC Medicaid |
$461.22
|
| Rate for Payer: UHC Medicare Advantage |
$654.02
|
| Rate for Payer: UHCCP Medicaid |
$461.22
|
| Rate for Payer: VA VA |
$654.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,962.08
|
|
|
HC LARYNGOSCOPY
|
Facility
|
IP
|
$2,616.10
|
|
| Hospital Charge Code |
36000113
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,820.81 |
| Max. Negotiated Rate |
$2,354.49 |
| Rate for Payer: Aetna Commercial |
$2,223.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,160.64
|
| Rate for Payer: BCN Commercial |
$2,160.64
|
| Rate for Payer: Cash Price |
$2,092.88
|
| Rate for Payer: Cofinity Commercial |
$2,249.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,092.88
|
| Rate for Payer: Healthscope Commercial |
$2,354.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,962.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,223.68
|
| Rate for Payer: Nomi Health Commercial |
$2,145.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,962.08
|
| Rate for Payer: PHP Commercial |
$2,223.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,276.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,820.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,302.17
|
| Rate for Payer: UHC Core |
$2,184.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,962.08
|
|
|
HC LARYNGOSCOPY DIRECT OPERATIVE W BIOPSY
|
Facility
|
OP
|
$4,890.90
|
|
|
Service Code
|
CPT 31235
|
| Hospital Charge Code |
76100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$862.27 |
| Max. Negotiated Rate |
$4,401.81 |
| Rate for Payer: Aetna Commercial |
$4,157.27
|
| Rate for Payer: Aetna Medicare |
$1,271.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,528.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,528.41
|
| Rate for Payer: BCBS Complete |
$905.31
|
| Rate for Payer: BCBS MAPPO |
$1,222.72
|
| Rate for Payer: BCBS Trust/PPO |
$4,020.81
|
| Rate for Payer: BCN Commercial |
$4,020.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,222.72
|
| Rate for Payer: Cash Price |
$3,912.72
|
| Rate for Payer: Cofinity Commercial |
$4,206.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,912.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,222.72
|
| Rate for Payer: Healthscope Commercial |
$4,401.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,668.18
|
| Rate for Payer: Mclaren Medicaid |
$862.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,283.86
|
| Rate for Payer: Meridian Medicaid |
$905.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,406.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,345.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,157.27
|
| Rate for Payer: Nomi Health Commercial |
$4,010.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,668.18
|
| Rate for Payer: PACE Senior Care Partners |
$1,161.59
|
| Rate for Payer: PACE SWMI |
$1,222.72
|
| Rate for Payer: PHP Commercial |
$4,157.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,222.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$862.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,255.08
|
| Rate for Payer: Priority Health Medicare |
$1,234.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,404.07
|
| Rate for Payer: Railroad Medicare Medicare |
$1,222.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,303.99
|
| Rate for Payer: UHC Core |
$4,083.90
|
| Rate for Payer: UHC Exchange |
$1,222.72
|
| Rate for Payer: UHC Medicaid |
$862.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,222.72
|
| Rate for Payer: UHCCP Medicaid |
$862.27
|
| Rate for Payer: VA VA |
$1,222.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,668.18
|
|
|
HC LARYNGOSCOPY DIRECT OPERATIVE W BIOPSY
|
Facility
|
IP
|
$4,890.90
|
|
|
Service Code
|
CPT 31235
|
| Hospital Charge Code |
76100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,404.07 |
| Max. Negotiated Rate |
$4,401.81 |
| Rate for Payer: Aetna Commercial |
$4,157.27
|
| Rate for Payer: BCBS Trust/PPO |
$4,039.39
|
| Rate for Payer: BCN Commercial |
$4,039.39
|
| Rate for Payer: Cash Price |
$3,912.72
|
| Rate for Payer: Cofinity Commercial |
$4,206.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,912.72
|
| Rate for Payer: Healthscope Commercial |
$4,401.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,668.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,157.27
|
| Rate for Payer: Nomi Health Commercial |
$4,010.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,668.18
|
| Rate for Payer: PHP Commercial |
$4,157.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,255.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,404.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,303.99
|
| Rate for Payer: UHC Core |
$4,083.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,668.18
|
|
|
HC LARYNGOSCOPY FIBEROPTIC
|
Facility
|
OP
|
$379.73
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
36100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.95 |
| Max. Negotiated Rate |
$341.76 |
| Rate for Payer: Aetna Commercial |
$322.77
|
| Rate for Payer: Aetna Medicare |
$98.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.67
|
| Rate for Payer: BCBS Complete |
$70.29
|
| Rate for Payer: BCBS MAPPO |
$94.93
|
| Rate for Payer: BCBS Trust/PPO |
$312.18
|
| Rate for Payer: BCN Commercial |
$312.18
|
| Rate for Payer: BCN Medicare Advantage |
$94.93
|
| Rate for Payer: Cash Price |
$303.78
|
| Rate for Payer: Cofinity Commercial |
$326.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.93
|
| Rate for Payer: Healthscope Commercial |
$341.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.80
|
| Rate for Payer: Mclaren Medicaid |
$66.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.68
|
| Rate for Payer: Meridian Medicaid |
$70.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.77
|
| Rate for Payer: Nomi Health Commercial |
$311.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.80
|
| Rate for Payer: PACE Senior Care Partners |
$90.19
|
| Rate for Payer: PACE SWMI |
$94.93
|
| Rate for Payer: PHP Commercial |
$322.77
|
| Rate for Payer: PHP Medicare Advantage |
$94.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$330.37
|
| Rate for Payer: Priority Health Medicare |
$95.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$264.29
|
| Rate for Payer: Railroad Medicare Medicare |
$94.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.16
|
| Rate for Payer: UHC Core |
$317.07
|
| Rate for Payer: UHC Exchange |
$94.93
|
| Rate for Payer: UHC Medicaid |
$66.95
|
| Rate for Payer: UHC Medicare Advantage |
$94.93
|
| Rate for Payer: UHCCP Medicaid |
$66.95
|
| Rate for Payer: VA VA |
$94.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.80
|
|
|
HC LARYNGOSCOPY FIBEROPTIC
|
Facility
|
IP
|
$379.73
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
36100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$264.29 |
| Max. Negotiated Rate |
$341.76 |
| Rate for Payer: Aetna Commercial |
$322.77
|
| Rate for Payer: BCBS Trust/PPO |
$313.62
|
| Rate for Payer: BCN Commercial |
$313.62
|
| Rate for Payer: Cash Price |
$303.78
|
| Rate for Payer: Cofinity Commercial |
$326.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.78
|
| Rate for Payer: Healthscope Commercial |
$341.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.77
|
| Rate for Payer: Nomi Health Commercial |
$311.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.80
|
| Rate for Payer: PHP Commercial |
$322.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$330.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$264.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.16
|
| Rate for Payer: UHC Core |
$317.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.80
|
|
|
HC LARYNGOSCOPY FLX/RGD TELESCOP W/STROBOSCOP
|
Facility
|
IP
|
$1,144.44
|
|
|
Service Code
|
CPT 31579
|
| Hospital Charge Code |
76100455
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$796.53 |
| Max. Negotiated Rate |
$1,030.00 |
| Rate for Payer: Aetna Commercial |
$972.77
|
| Rate for Payer: BCBS Trust/PPO |
$945.19
|
| Rate for Payer: BCN Commercial |
$945.19
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Commercial |
$984.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Healthscope Commercial |
$1,030.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$938.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.33
|
| Rate for Payer: PHP Commercial |
$972.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$995.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$796.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.11
|
| Rate for Payer: UHC Core |
$955.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.33
|
|
|
HC LARYNGOSCOPY FLX/RGD TELESCOP W/STROBOSCOP
|
Facility
|
OP
|
$1,144.44
|
|
|
Service Code
|
CPT 31579
|
| Hospital Charge Code |
76100455
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.76 |
| Max. Negotiated Rate |
$1,030.00 |
| Rate for Payer: Aetna Commercial |
$972.77
|
| Rate for Payer: Aetna Medicare |
$297.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$357.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$357.64
|
| Rate for Payer: BCBS Complete |
$211.84
|
| Rate for Payer: BCBS MAPPO |
$286.11
|
| Rate for Payer: BCBS Trust/PPO |
$940.84
|
| Rate for Payer: BCN Commercial |
$940.84
|
| Rate for Payer: BCN Medicare Advantage |
$286.11
|
| Rate for Payer: Cash Price |
$915.55
|
| Rate for Payer: Cofinity Commercial |
$984.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$915.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.11
|
| Rate for Payer: Healthscope Commercial |
$1,030.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.33
|
| Rate for Payer: Mclaren Medicaid |
$201.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.42
|
| Rate for Payer: Meridian Medicaid |
$211.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$329.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$314.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$972.77
|
| Rate for Payer: Nomi Health Commercial |
$938.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.33
|
| Rate for Payer: PACE Senior Care Partners |
$271.80
|
| Rate for Payer: PACE SWMI |
$286.11
|
| Rate for Payer: PHP Commercial |
$972.77
|
| Rate for Payer: PHP Medicare Advantage |
$286.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$995.66
|
| Rate for Payer: Priority Health Medicare |
$288.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$796.53
|
| Rate for Payer: Railroad Medicare Medicare |
$286.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.11
|
| Rate for Payer: UHC Core |
$955.61
|
| Rate for Payer: UHC Exchange |
$286.11
|
| Rate for Payer: UHC Medicaid |
$201.76
|
| Rate for Payer: UHC Medicare Advantage |
$286.11
|
| Rate for Payer: UHCCP Medicaid |
$201.76
|
| Rate for Payer: VA VA |
$286.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.33
|
|
|
HC LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX
|
Facility
|
IP
|
$577.42
|
|
|
Service Code
|
CPT 31505
|
| Hospital Charge Code |
76100411
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$401.88 |
| Max. Negotiated Rate |
$519.68 |
| Rate for Payer: Aetna Commercial |
$490.81
|
| Rate for Payer: BCBS Trust/PPO |
$476.89
|
| Rate for Payer: BCN Commercial |
$476.89
|
| Rate for Payer: Cash Price |
$461.94
|
| Rate for Payer: Cofinity Commercial |
$496.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.94
|
| Rate for Payer: Healthscope Commercial |
$519.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$433.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.81
|
| Rate for Payer: Nomi Health Commercial |
$473.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$433.06
|
| Rate for Payer: PHP Commercial |
$490.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$502.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$401.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$508.13
|
| Rate for Payer: UHC Core |
$482.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$433.06
|
|
|
HC LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX
|
Facility
|
OP
|
$577.42
|
|
|
Service Code
|
CPT 31505
|
| Hospital Charge Code |
76100411
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$101.80 |
| Max. Negotiated Rate |
$519.68 |
| Rate for Payer: Aetna Commercial |
$490.81
|
| Rate for Payer: Aetna Medicare |
$150.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$180.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$180.44
|
| Rate for Payer: BCBS Complete |
$106.88
|
| Rate for Payer: BCBS MAPPO |
$144.35
|
| Rate for Payer: BCBS Trust/PPO |
$474.70
|
| Rate for Payer: BCN Commercial |
$474.70
|
| Rate for Payer: BCN Medicare Advantage |
$144.35
|
| Rate for Payer: Cash Price |
$461.94
|
| Rate for Payer: Cofinity Commercial |
$496.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.35
|
| Rate for Payer: Healthscope Commercial |
$519.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$433.06
|
| Rate for Payer: Mclaren Medicaid |
$101.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.57
|
| Rate for Payer: Meridian Medicaid |
$106.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$166.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$158.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.81
|
| Rate for Payer: Nomi Health Commercial |
$473.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$433.06
|
| Rate for Payer: PACE Senior Care Partners |
$137.14
|
| Rate for Payer: PACE SWMI |
$144.35
|
| Rate for Payer: PHP Commercial |
$490.81
|
| Rate for Payer: PHP Medicare Advantage |
$144.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$502.36
|
| Rate for Payer: Priority Health Medicare |
$145.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$401.88
|
| Rate for Payer: Railroad Medicare Medicare |
$144.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$508.13
|
| Rate for Payer: UHC Core |
$482.15
|
| Rate for Payer: UHC Exchange |
$144.35
|
| Rate for Payer: UHC Medicaid |
$101.80
|
| Rate for Payer: UHC Medicare Advantage |
$144.35
|
| Rate for Payer: UHCCP Medicaid |
$101.80
|
| Rate for Payer: VA VA |
$144.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$433.06
|
|
|
HC LASER CATHETER
|
Facility
|
OP
|
$5,038.11
|
|
|
Service Code
|
HCPCS C1885
|
| Hospital Charge Code |
27200054
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$888.22 |
| Max. Negotiated Rate |
$4,534.30 |
| Rate for Payer: Aetna Commercial |
$4,282.39
|
| Rate for Payer: Aetna Medicare |
$1,309.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,574.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,574.41
|
| Rate for Payer: BCBS Complete |
$932.55
|
| Rate for Payer: BCBS MAPPO |
$1,259.53
|
| Rate for Payer: BCBS Trust/PPO |
$4,141.83
|
| Rate for Payer: BCN Commercial |
$4,141.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,259.53
|
| Rate for Payer: Cash Price |
$4,030.49
|
| Rate for Payer: Cofinity Commercial |
$4,332.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,030.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,259.53
|
| Rate for Payer: Healthscope Commercial |
$4,534.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,778.58
|
| Rate for Payer: Mclaren Medicaid |
$888.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,322.50
|
| Rate for Payer: Meridian Medicaid |
$932.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,448.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,385.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,282.39
|
| Rate for Payer: Nomi Health Commercial |
$4,131.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,778.58
|
| Rate for Payer: PACE Senior Care Partners |
$1,196.55
|
| Rate for Payer: PACE SWMI |
$1,259.53
|
| Rate for Payer: PHP Commercial |
$4,282.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,259.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$888.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,383.16
|
| Rate for Payer: Priority Health Medicare |
$1,272.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,506.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,259.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,433.54
|
| Rate for Payer: UHC Core |
$4,206.82
|
| Rate for Payer: UHC Exchange |
$1,259.53
|
| Rate for Payer: UHC Medicaid |
$888.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,259.53
|
| Rate for Payer: UHCCP Medicaid |
$888.22
|
| Rate for Payer: VA VA |
$1,259.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,778.58
|
|
|
HC LASER CATHETER
|
Facility
|
IP
|
$5,038.11
|
|
|
Service Code
|
HCPCS C1885
|
| Hospital Charge Code |
27200054
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,506.52 |
| Max. Negotiated Rate |
$4,534.30 |
| Rate for Payer: Aetna Commercial |
$4,282.39
|
| Rate for Payer: BCBS Trust/PPO |
$4,160.98
|
| Rate for Payer: BCN Commercial |
$4,160.98
|
| Rate for Payer: Cash Price |
$4,030.49
|
| Rate for Payer: Cofinity Commercial |
$4,332.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,030.49
|
| Rate for Payer: Healthscope Commercial |
$4,534.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,778.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,282.39
|
| Rate for Payer: Nomi Health Commercial |
$4,131.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,778.58
|
| Rate for Payer: PHP Commercial |
$4,282.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,383.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,506.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,433.54
|
| Rate for Payer: UHC Core |
$4,206.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,778.58
|
|
|
HC LATEX IGE
|
Facility
|
IP
|
$36.51
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200044
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.41 |
| Max. Negotiated Rate |
$32.86 |
| Rate for Payer: Aetna Commercial |
$31.03
|
| Rate for Payer: BCBS Trust/PPO |
$30.15
|
| Rate for Payer: BCN Commercial |
$30.15
|
| Rate for Payer: Cash Price |
$29.21
|
| Rate for Payer: Cofinity Commercial |
$31.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.21
|
| Rate for Payer: Healthscope Commercial |
$32.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.03
|
| Rate for Payer: Nomi Health Commercial |
$29.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.38
|
| Rate for Payer: PHP Commercial |
$31.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.13
|
| Rate for Payer: UHC Core |
$30.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.38
|
|
|
HC LATEX IGE
|
Facility
|
OP
|
$36.51
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200044
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.44 |
| Max. Negotiated Rate |
$32.86 |
| Rate for Payer: Aetna Commercial |
$31.03
|
| Rate for Payer: Aetna Medicare |
$9.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.41
|
| Rate for Payer: BCBS Complete |
$6.76
|
| Rate for Payer: BCBS MAPPO |
$9.13
|
| Rate for Payer: BCBS Trust/PPO |
$30.01
|
| Rate for Payer: BCN Commercial |
$30.01
|
| Rate for Payer: BCN Medicare Advantage |
$9.13
|
| Rate for Payer: Cash Price |
$29.21
|
| Rate for Payer: Cofinity Commercial |
$31.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.13
|
| Rate for Payer: Healthscope Commercial |
$32.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.38
|
| Rate for Payer: Mclaren Medicaid |
$6.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.58
|
| Rate for Payer: Meridian Medicaid |
$6.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.03
|
| Rate for Payer: Nomi Health Commercial |
$29.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.38
|
| Rate for Payer: PACE Senior Care Partners |
$8.67
|
| Rate for Payer: PACE SWMI |
$9.13
|
| Rate for Payer: PHP Commercial |
$31.03
|
| Rate for Payer: PHP Medicare Advantage |
$9.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.76
|
| Rate for Payer: Priority Health Medicare |
$9.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.41
|
| Rate for Payer: Railroad Medicare Medicare |
$9.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.13
|
| Rate for Payer: UHC Core |
$30.49
|
| Rate for Payer: UHC Exchange |
$9.13
|
| Rate for Payer: UHC Medicaid |
$6.44
|
| Rate for Payer: UHC Medicare Advantage |
$9.13
|
| Rate for Payer: UHCCP Medicaid |
$6.44
|
| Rate for Payer: VA VA |
$9.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.38
|
|
|
HC LAYR CLOS WND REST BODY <2.5 CM
|
Facility
|
OP
|
$508.61
|
|
|
Service Code
|
CPT 12041
|
| Hospital Charge Code |
76100228
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$457.75 |
| Rate for Payer: Aetna Commercial |
$432.32
|
| Rate for Payer: Aetna Medicare |
$132.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$158.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$158.94
|
| Rate for Payer: BCBS Complete |
$94.14
|
| Rate for Payer: BCBS MAPPO |
$127.15
|
| Rate for Payer: BCBS Trust/PPO |
$418.13
|
| Rate for Payer: BCN Commercial |
$418.13
|
| Rate for Payer: BCN Medicare Advantage |
$127.15
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cofinity Commercial |
$437.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.15
|
| Rate for Payer: Healthscope Commercial |
$457.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.46
|
| Rate for Payer: Mclaren Medicaid |
$89.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.51
|
| Rate for Payer: Meridian Medicaid |
$94.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.32
|
| Rate for Payer: Nomi Health Commercial |
$417.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.46
|
| Rate for Payer: PACE Senior Care Partners |
$120.79
|
| Rate for Payer: PACE SWMI |
$127.15
|
| Rate for Payer: PHP Commercial |
$432.32
|
| Rate for Payer: PHP Medicare Advantage |
$127.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$442.49
|
| Rate for Payer: Priority Health Medicare |
$128.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$353.99
|
| Rate for Payer: Railroad Medicare Medicare |
$127.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.58
|
| Rate for Payer: UHC Core |
$424.69
|
| Rate for Payer: UHC Exchange |
$127.15
|
| Rate for Payer: UHC Medicaid |
$89.67
|
| Rate for Payer: UHC Medicare Advantage |
$127.15
|
| Rate for Payer: UHCCP Medicaid |
$89.67
|
| Rate for Payer: VA VA |
$127.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.46
|
|
