|
HC LIPID PANEL LMPP
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100767
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$9.63
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$42.77
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$9.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$9.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicaid |
$9.17
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$9.17
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC LIPID PANEL LMPP
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100767
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.21 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.96
|
| Rate for Payer: BCN Commercial |
$42.96
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC LIPOPROTEIN A
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 83695
|
| Hospital Charge Code |
30100280
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC LIPOPROTEIN A
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 83695
|
| Hospital Charge Code |
30100280
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC LIQUID PLASMA IRRADIATED
|
Facility
|
OP
|
$372.35
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000096
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$65.65 |
| Max. Negotiated Rate |
$335.12 |
| Rate for Payer: Aetna Commercial |
$316.50
|
| Rate for Payer: Aetna Medicare |
$96.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$116.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$116.36
|
| Rate for Payer: BCBS Complete |
$68.92
|
| Rate for Payer: BCBS MAPPO |
$93.09
|
| Rate for Payer: BCBS Trust/PPO |
$306.11
|
| Rate for Payer: BCN Commercial |
$306.11
|
| Rate for Payer: BCN Medicare Advantage |
$93.09
|
| Rate for Payer: Cash Price |
$297.88
|
| Rate for Payer: Cofinity Commercial |
$320.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.09
|
| Rate for Payer: Healthscope Commercial |
$335.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.26
|
| Rate for Payer: Mclaren Medicaid |
$65.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.74
|
| Rate for Payer: Meridian Medicaid |
$68.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.50
|
| Rate for Payer: Nomi Health Commercial |
$305.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.26
|
| Rate for Payer: PACE Senior Care Partners |
$88.43
|
| Rate for Payer: PACE SWMI |
$93.09
|
| Rate for Payer: PHP Commercial |
$316.50
|
| Rate for Payer: PHP Medicare Advantage |
$93.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$323.94
|
| Rate for Payer: Priority Health Medicare |
$94.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$259.16
|
| Rate for Payer: Railroad Medicare Medicare |
$93.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.67
|
| Rate for Payer: UHC Core |
$310.91
|
| Rate for Payer: UHC Exchange |
$93.09
|
| Rate for Payer: UHC Medicaid |
$65.65
|
| Rate for Payer: UHC Medicare Advantage |
$93.09
|
| Rate for Payer: UHCCP Medicaid |
$65.65
|
| Rate for Payer: VA VA |
$93.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.26
|
|
|
HC LIQUID PLASMA IRRADIATED
|
Facility
|
IP
|
$372.35
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000096
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$259.16 |
| Max. Negotiated Rate |
$335.12 |
| Rate for Payer: Aetna Commercial |
$316.50
|
| Rate for Payer: BCBS Trust/PPO |
$307.52
|
| Rate for Payer: BCN Commercial |
$307.52
|
| Rate for Payer: Cash Price |
$297.88
|
| Rate for Payer: Cofinity Commercial |
$320.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.88
|
| Rate for Payer: Healthscope Commercial |
$335.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.50
|
| Rate for Payer: Nomi Health Commercial |
$305.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.26
|
| Rate for Payer: PHP Commercial |
$316.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$323.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$259.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.67
|
| Rate for Payer: UHC Core |
$310.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.26
|
|
|
HC LISTERIA MONOCYTOGENES
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600274
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC LISTERIA MONOCYTOGENES
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600274
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC LITHIUM LEVEL
|
Facility
|
IP
|
$56.04
|
|
|
Service Code
|
CPT 80178
|
| Hospital Charge Code |
30100034
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.00 |
| Max. Negotiated Rate |
$50.44 |
| Rate for Payer: Aetna Commercial |
$47.63
|
| Rate for Payer: BCBS Trust/PPO |
$46.28
|
| Rate for Payer: BCN Commercial |
$46.28
|
| Rate for Payer: Cash Price |
$44.83
|
| Rate for Payer: Cofinity Commercial |
$48.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.83
|
| Rate for Payer: Healthscope Commercial |
$50.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.63
|
| Rate for Payer: Nomi Health Commercial |
$45.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.03
|
| Rate for Payer: PHP Commercial |
$47.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.32
|
| Rate for Payer: UHC Core |
$46.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.03
|
|
|
HC LITHIUM LEVEL
|
Facility
|
OP
|
$56.04
|
|
|
Service Code
|
CPT 80178
|
| Hospital Charge Code |
30100034
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.88 |
| Max. Negotiated Rate |
$50.44 |
| Rate for Payer: Aetna Commercial |
$47.63
|
| Rate for Payer: Aetna Medicare |
$14.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.51
|
| Rate for Payer: BCBS Complete |
$10.37
|
| Rate for Payer: BCBS MAPPO |
$14.01
|
| Rate for Payer: BCBS Trust/PPO |
$46.07
|
| Rate for Payer: BCN Commercial |
$46.07
|
| Rate for Payer: BCN Medicare Advantage |
$14.01
|
| Rate for Payer: Cash Price |
$44.83
|
| Rate for Payer: Cofinity Commercial |
$48.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.01
|
| Rate for Payer: Healthscope Commercial |
$50.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.03
|
| Rate for Payer: Mclaren Medicaid |
$9.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.71
|
| Rate for Payer: Meridian Medicaid |
$10.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.63
|
| Rate for Payer: Nomi Health Commercial |
$45.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.03
|
| Rate for Payer: PACE Senior Care Partners |
$13.31
|
| Rate for Payer: PACE SWMI |
$14.01
|
| Rate for Payer: PHP Commercial |
$47.63
|
| Rate for Payer: PHP Medicare Advantage |
$14.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.75
|
| Rate for Payer: Priority Health Medicare |
$14.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.00
|
| Rate for Payer: Railroad Medicare Medicare |
$14.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.32
|
| Rate for Payer: UHC Core |
$46.79
|
| Rate for Payer: UHC Exchange |
$14.01
|
| Rate for Payer: UHC Medicaid |
$9.88
|
| Rate for Payer: UHC Medicare Advantage |
$14.01
|
| Rate for Payer: UHCCP Medicaid |
$9.88
|
| Rate for Payer: VA VA |
$14.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.03
|
|
|
HC LITHOTRIPSY
|
Facility
|
IP
|
$2,909.09
|
|
| Hospital Charge Code |
36000072
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,024.73 |
| Max. Negotiated Rate |
$2,618.18 |
| Rate for Payer: Aetna Commercial |
$2,472.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,402.62
|
| Rate for Payer: BCN Commercial |
$2,402.62
|
| Rate for Payer: Cash Price |
$2,327.27
|
| Rate for Payer: Cofinity Commercial |
$2,501.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,327.27
|
| Rate for Payer: Healthscope Commercial |
$2,618.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,181.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,472.73
|
| Rate for Payer: Nomi Health Commercial |
$2,385.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,181.82
|
| Rate for Payer: PHP Commercial |
$2,472.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,530.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,024.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,560.00
|
| Rate for Payer: UHC Core |
$2,429.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,181.82
|
|
|
HC LITHOTRIPSY
|
Facility
|
OP
|
$2,909.09
|
|
| Hospital Charge Code |
36000072
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$512.87 |
| Max. Negotiated Rate |
$2,618.18 |
| Rate for Payer: Aetna Commercial |
$2,472.73
|
| Rate for Payer: Aetna Medicare |
$756.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$909.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$909.09
|
| Rate for Payer: BCBS Complete |
$538.47
|
| Rate for Payer: BCBS MAPPO |
$727.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,391.56
|
| Rate for Payer: BCN Commercial |
$2,391.56
|
| Rate for Payer: BCN Medicare Advantage |
$727.27
|
| Rate for Payer: Cash Price |
$2,327.27
|
| Rate for Payer: Cofinity Commercial |
$2,501.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,327.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$727.27
|
| Rate for Payer: Healthscope Commercial |
$2,618.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,181.82
|
| Rate for Payer: Mclaren Medicaid |
$512.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$763.64
|
| Rate for Payer: Meridian Medicaid |
$538.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$836.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$800.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,472.73
|
| Rate for Payer: Nomi Health Commercial |
$2,385.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,181.82
|
| Rate for Payer: PACE Senior Care Partners |
$690.91
|
| Rate for Payer: PACE SWMI |
$727.27
|
| Rate for Payer: PHP Commercial |
$2,472.73
|
| Rate for Payer: PHP Medicare Advantage |
$727.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$512.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,530.91
|
| Rate for Payer: Priority Health Medicare |
$734.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,024.73
|
| Rate for Payer: Railroad Medicare Medicare |
$727.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,560.00
|
| Rate for Payer: UHC Core |
$2,429.09
|
| Rate for Payer: UHC Exchange |
$727.27
|
| Rate for Payer: UHC Medicaid |
$512.87
|
| Rate for Payer: UHC Medicare Advantage |
$727.27
|
| Rate for Payer: UHCCP Medicaid |
$512.87
|
| Rate for Payer: VA VA |
$727.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,181.82
|
|
|
HC LIVER BIOPSY
|
Facility
|
OP
|
$1,508.57
|
|
| Hospital Charge Code |
36000073
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$265.96 |
| Max. Negotiated Rate |
$1,357.71 |
| Rate for Payer: Aetna Commercial |
$1,282.28
|
| Rate for Payer: Aetna Medicare |
$392.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$471.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$471.43
|
| Rate for Payer: BCBS Complete |
$279.24
|
| Rate for Payer: BCBS MAPPO |
$377.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,240.20
|
| Rate for Payer: BCN Commercial |
$1,240.20
|
| Rate for Payer: BCN Medicare Advantage |
$377.14
|
| Rate for Payer: Cash Price |
$1,206.86
|
| Rate for Payer: Cofinity Commercial |
$1,297.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,206.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$377.14
|
| Rate for Payer: Healthscope Commercial |
$1,357.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,131.43
|
| Rate for Payer: Mclaren Medicaid |
$265.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$396.00
|
| Rate for Payer: Meridian Medicaid |
$279.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$433.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$414.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,282.28
|
| Rate for Payer: Nomi Health Commercial |
$1,237.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,131.43
|
| Rate for Payer: PACE Senior Care Partners |
$358.29
|
| Rate for Payer: PACE SWMI |
$377.14
|
| Rate for Payer: PHP Commercial |
$1,282.28
|
| Rate for Payer: PHP Medicare Advantage |
$377.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,312.46
|
| Rate for Payer: Priority Health Medicare |
$380.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,049.96
|
| Rate for Payer: Railroad Medicare Medicare |
$377.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,327.54
|
| Rate for Payer: UHC Core |
$1,259.66
|
| Rate for Payer: UHC Exchange |
$377.14
|
| Rate for Payer: UHC Medicaid |
$265.96
|
| Rate for Payer: UHC Medicare Advantage |
$377.14
|
| Rate for Payer: UHCCP Medicaid |
$265.96
|
| Rate for Payer: VA VA |
$377.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,131.43
|
|
|
HC LIVER BIOPSY
|
Facility
|
IP
|
$1,508.57
|
|
| Hospital Charge Code |
36000073
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,049.96 |
| Max. Negotiated Rate |
$1,357.71 |
| Rate for Payer: Aetna Commercial |
$1,282.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,245.93
|
| Rate for Payer: BCN Commercial |
$1,245.93
|
| Rate for Payer: Cash Price |
$1,206.86
|
| Rate for Payer: Cofinity Commercial |
$1,297.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,206.86
|
| Rate for Payer: Healthscope Commercial |
$1,357.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,131.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,282.28
|
| Rate for Payer: Nomi Health Commercial |
$1,237.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,131.43
|
| Rate for Payer: PHP Commercial |
$1,282.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,312.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,049.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,327.54
|
| Rate for Payer: UHC Core |
$1,259.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,131.43
|
|
|
HC LIVER KIDNEY MICROSOME ANTIBODY
|
Facility
|
OP
|
$57.73
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200208
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.18 |
| Max. Negotiated Rate |
$51.96 |
| Rate for Payer: Aetna Commercial |
$49.07
|
| Rate for Payer: Aetna Medicare |
$15.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.04
|
| Rate for Payer: BCBS Complete |
$10.69
|
| Rate for Payer: BCBS MAPPO |
$14.43
|
| Rate for Payer: BCBS Trust/PPO |
$47.46
|
| Rate for Payer: BCN Commercial |
$47.46
|
| Rate for Payer: BCN Medicare Advantage |
$14.43
|
| Rate for Payer: Cash Price |
$46.18
|
| Rate for Payer: Cofinity Commercial |
$49.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.43
|
| Rate for Payer: Healthscope Commercial |
$51.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.30
|
| Rate for Payer: Mclaren Medicaid |
$10.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.15
|
| Rate for Payer: Meridian Medicaid |
$10.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.07
|
| Rate for Payer: Nomi Health Commercial |
$47.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.30
|
| Rate for Payer: PACE Senior Care Partners |
$13.71
|
| Rate for Payer: PACE SWMI |
$14.43
|
| Rate for Payer: PHP Commercial |
$49.07
|
| Rate for Payer: PHP Medicare Advantage |
$14.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.23
|
| Rate for Payer: Priority Health Medicare |
$14.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.18
|
| Rate for Payer: Railroad Medicare Medicare |
$14.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.80
|
| Rate for Payer: UHC Core |
$48.20
|
| Rate for Payer: UHC Exchange |
$14.43
|
| Rate for Payer: UHC Medicaid |
$10.18
|
| Rate for Payer: UHC Medicare Advantage |
$14.43
|
| Rate for Payer: UHCCP Medicaid |
$10.18
|
| Rate for Payer: VA VA |
$14.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.30
|
|
|
HC LIVER KIDNEY MICROSOME ANTIBODY
|
Facility
|
IP
|
$57.73
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200208
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.18 |
| Max. Negotiated Rate |
$51.96 |
| Rate for Payer: Aetna Commercial |
$49.07
|
| Rate for Payer: BCBS Trust/PPO |
$47.68
|
| Rate for Payer: BCN Commercial |
$47.68
|
| Rate for Payer: Cash Price |
$46.18
|
| Rate for Payer: Cofinity Commercial |
$49.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.18
|
| Rate for Payer: Healthscope Commercial |
$51.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.07
|
| Rate for Payer: Nomi Health Commercial |
$47.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.30
|
| Rate for Payer: PHP Commercial |
$49.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.80
|
| Rate for Payer: UHC Core |
$48.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.30
|
|
|
HC LOBSTER IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200045
|
|
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 LOBSTER IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200045
|
|
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 LOCAL ANES ADDL 15 MIN
|
Facility
|
OP
|
$98.30
|
|
| Hospital Charge Code |
37000009
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$17.33 |
| Max. Negotiated Rate |
$88.47 |
| Rate for Payer: Aetna Commercial |
$83.56
|
| Rate for Payer: Aetna Medicare |
$25.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.72
|
| Rate for Payer: BCBS Complete |
$18.20
|
| Rate for Payer: BCBS MAPPO |
$24.57
|
| Rate for Payer: BCBS Trust/PPO |
$80.81
|
| Rate for Payer: BCN Commercial |
$80.81
|
| Rate for Payer: BCN Medicare Advantage |
$24.57
|
| Rate for Payer: Cash Price |
$78.64
|
| Rate for Payer: Cofinity Commercial |
$84.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.57
|
| Rate for Payer: Healthscope Commercial |
$88.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.72
|
| Rate for Payer: Mclaren Medicaid |
$17.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.80
|
| Rate for Payer: Meridian Medicaid |
$18.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.56
|
| Rate for Payer: Nomi Health Commercial |
$80.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.72
|
| Rate for Payer: PACE Senior Care Partners |
$23.35
|
| Rate for Payer: PACE SWMI |
$24.57
|
| Rate for Payer: PHP Commercial |
$83.56
|
| Rate for Payer: PHP Medicare Advantage |
$24.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.52
|
| Rate for Payer: Priority Health Medicare |
$24.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.42
|
| Rate for Payer: Railroad Medicare Medicare |
$24.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.50
|
| Rate for Payer: UHC Core |
$82.08
|
| Rate for Payer: UHC Exchange |
$24.57
|
| Rate for Payer: UHC Medicaid |
$17.33
|
| Rate for Payer: UHC Medicare Advantage |
$24.57
|
| Rate for Payer: UHCCP Medicaid |
$17.33
|
| Rate for Payer: VA VA |
$24.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.72
|
|
|
HC LOCAL ANES ADDL 15 MIN
|
Facility
|
IP
|
$98.30
|
|
| Hospital Charge Code |
37000009
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$68.42 |
| Max. Negotiated Rate |
$88.47 |
| Rate for Payer: Aetna Commercial |
$83.56
|
| Rate for Payer: BCBS Trust/PPO |
$81.19
|
| Rate for Payer: BCN Commercial |
$81.19
|
| Rate for Payer: Cash Price |
$78.64
|
| Rate for Payer: Cofinity Commercial |
$84.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.64
|
| Rate for Payer: Healthscope Commercial |
$88.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.56
|
| Rate for Payer: Nomi Health Commercial |
$80.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.72
|
| Rate for Payer: PHP Commercial |
$83.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.50
|
| Rate for Payer: UHC Core |
$82.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.72
|
|
|
HC LOCAL ANES INIT 30 MIN
|
Facility
|
IP
|
$356.63
|
|
| Hospital Charge Code |
37000010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$248.21 |
| Max. Negotiated Rate |
$320.97 |
| Rate for Payer: Aetna Commercial |
$303.14
|
| Rate for Payer: BCBS Trust/PPO |
$294.54
|
| Rate for Payer: BCN Commercial |
$294.54
|
| Rate for Payer: Cash Price |
$285.30
|
| Rate for Payer: Cofinity Commercial |
$306.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.30
|
| Rate for Payer: Healthscope Commercial |
$320.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.14
|
| Rate for Payer: Nomi Health Commercial |
$292.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.47
|
| Rate for Payer: PHP Commercial |
$303.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$310.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$248.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.83
|
| Rate for Payer: UHC Core |
$297.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.47
|
|
|
HC LOCAL ANES INIT 30 MIN
|
Facility
|
OP
|
$356.63
|
|
| Hospital Charge Code |
37000010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$62.87 |
| Max. Negotiated Rate |
$320.97 |
| Rate for Payer: Aetna Commercial |
$303.14
|
| Rate for Payer: Aetna Medicare |
$92.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.45
|
| Rate for Payer: BCBS Complete |
$66.01
|
| Rate for Payer: BCBS MAPPO |
$89.16
|
| Rate for Payer: BCBS Trust/PPO |
$293.19
|
| Rate for Payer: BCN Commercial |
$293.19
|
| Rate for Payer: BCN Medicare Advantage |
$89.16
|
| Rate for Payer: Cash Price |
$285.30
|
| Rate for Payer: Cofinity Commercial |
$306.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.16
|
| Rate for Payer: Healthscope Commercial |
$320.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.47
|
| Rate for Payer: Mclaren Medicaid |
$62.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.62
|
| Rate for Payer: Meridian Medicaid |
$66.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.14
|
| Rate for Payer: Nomi Health Commercial |
$292.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.47
|
| Rate for Payer: PACE Senior Care Partners |
$84.70
|
| Rate for Payer: PACE SWMI |
$89.16
|
| Rate for Payer: PHP Commercial |
$303.14
|
| Rate for Payer: PHP Medicare Advantage |
$89.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$310.27
|
| Rate for Payer: Priority Health Medicare |
$90.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$248.21
|
| Rate for Payer: Railroad Medicare Medicare |
$89.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.83
|
| Rate for Payer: UHC Core |
$297.79
|
| Rate for Payer: UHC Exchange |
$89.16
|
| Rate for Payer: UHC Medicaid |
$62.87
|
| Rate for Payer: UHC Medicare Advantage |
$89.16
|
| Rate for Payer: UHCCP Medicaid |
$62.87
|
| Rate for Payer: VA VA |
$89.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.47
|
|
|
HC LOCALIZATION CLIP
|
Facility
|
OP
|
$210.97
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800040
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$37.19 |
| Max. Negotiated Rate |
$189.87 |
| Rate for Payer: Aetna Commercial |
$179.32
|
| Rate for Payer: Aetna Medicare |
$54.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.93
|
| Rate for Payer: BCBS Complete |
$39.05
|
| Rate for Payer: BCBS MAPPO |
$52.74
|
| Rate for Payer: BCBS Trust/PPO |
$173.44
|
| Rate for Payer: BCN Commercial |
$173.44
|
| Rate for Payer: BCN Medicare Advantage |
$52.74
|
| Rate for Payer: Cash Price |
$168.78
|
| Rate for Payer: Cofinity Commercial |
$181.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.74
|
| Rate for Payer: Healthscope Commercial |
$189.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.23
|
| Rate for Payer: Mclaren Medicaid |
$37.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.38
|
| Rate for Payer: Meridian Medicaid |
$39.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.32
|
| Rate for Payer: Nomi Health Commercial |
$173.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.23
|
| Rate for Payer: PACE Senior Care Partners |
$50.11
|
| Rate for Payer: PACE SWMI |
$52.74
|
| Rate for Payer: PHP Commercial |
$179.32
|
| Rate for Payer: PHP Medicare Advantage |
$52.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$183.54
|
| Rate for Payer: Priority Health Medicare |
$53.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.84
|
| Rate for Payer: Railroad Medicare Medicare |
$52.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.65
|
| Rate for Payer: UHC Core |
$176.16
|
| Rate for Payer: UHC Exchange |
$52.74
|
| Rate for Payer: UHC Medicaid |
$37.19
|
| Rate for Payer: UHC Medicare Advantage |
$52.74
|
| Rate for Payer: UHCCP Medicaid |
$37.19
|
| Rate for Payer: VA VA |
$52.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.23
|
|
|
HC LOCALIZATION CLIP
|
Facility
|
IP
|
$210.97
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800040
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.84 |
| Max. Negotiated Rate |
$189.87 |
| Rate for Payer: Aetna Commercial |
$179.32
|
| Rate for Payer: BCBS Trust/PPO |
$174.24
|
| Rate for Payer: BCN Commercial |
$174.24
|
| Rate for Payer: Cash Price |
$168.78
|
| Rate for Payer: Cofinity Commercial |
$181.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.78
|
| Rate for Payer: Healthscope Commercial |
$189.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.32
|
| Rate for Payer: Nomi Health Commercial |
$173.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.23
|
| Rate for Payer: PHP Commercial |
$179.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$183.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.65
|
| Rate for Payer: UHC Core |
$176.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.23
|
|
|
HC LOCALIZATION DEVICE LEVEL 1
|
Facility
|
OP
|
$146.88
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$25.89 |
| Max. Negotiated Rate |
$132.19 |
| Rate for Payer: Aetna Commercial |
$124.85
|
| Rate for Payer: Aetna Medicare |
$38.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.90
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$36.72
|
| Rate for Payer: BCBS Trust/PPO |
$120.75
|
| Rate for Payer: BCN Commercial |
$120.75
|
| Rate for Payer: BCN Medicare Advantage |
$36.72
|
| Rate for Payer: Cash Price |
$117.50
|
| Rate for Payer: Cofinity Commercial |
$126.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$132.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.16
|
| Rate for Payer: Mclaren Medicaid |
$25.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.56
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.85
|
| Rate for Payer: Nomi Health Commercial |
$120.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.16
|
| Rate for Payer: PACE Senior Care Partners |
$34.88
|
| Rate for Payer: PACE SWMI |
$36.72
|
| Rate for Payer: PHP Commercial |
$124.85
|
| Rate for Payer: PHP Medicare Advantage |
$36.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$127.79
|
| Rate for Payer: Priority Health Medicare |
$37.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.23
|
| Rate for Payer: Railroad Medicare Medicare |
$36.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.25
|
| Rate for Payer: UHC Core |
$122.64
|
| Rate for Payer: UHC Exchange |
$36.72
|
| Rate for Payer: UHC Medicaid |
$25.89
|
| Rate for Payer: UHC Medicare Advantage |
$36.72
|
| Rate for Payer: UHCCP Medicaid |
$25.89
|
| Rate for Payer: VA VA |
$36.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.16
|
|
