|
HC PPM SINGLE/V LEAD
|
Facility
|
OP
|
$12,804.30
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
36100058
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,041.02 |
| Max. Negotiated Rate |
$11,523.87 |
| Rate for Payer: Aetna Commercial |
$10,883.66
|
| Rate for Payer: Aetna Medicare |
$3,329.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,001.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,001.34
|
| Rate for Payer: BCBS Complete |
$7,355.10
|
| Rate for Payer: BCBS MAPPO |
$3,201.08
|
| Rate for Payer: BCBS Trust/PPO |
$9,955.34
|
| Rate for Payer: BCN Commercial |
$9,955.34
|
| Rate for Payer: BCN Medicare Advantage |
$3,201.08
|
| Rate for Payer: Cash Price |
$10,243.44
|
| Rate for Payer: Cash Price |
$10,243.44
|
| Rate for Payer: Cofinity Commercial |
$11,011.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,243.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,201.08
|
| Rate for Payer: Healthscope Commercial |
$11,523.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,603.22
|
| Rate for Payer: Mclaren Medicaid |
$7,004.86
|
| Rate for Payer: Meridian Medicaid |
$7,355.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,361.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,681.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,883.66
|
| Rate for Payer: PACE Senior Care Partners |
$3,041.02
|
| Rate for Payer: PACE SWMI |
$3,201.08
|
| Rate for Payer: PHP Commercial |
$10,883.66
|
| Rate for Payer: PHP Medicare Advantage |
$3,201.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,004.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,963.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,139.74
|
| Rate for Payer: Priority Health Medicare |
$3,201.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,809.34
|
| Rate for Payer: Railroad Medicare Medicare |
$3,201.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,267.78
|
| Rate for Payer: UHC Core |
$10,691.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,201.08
|
| Rate for Payer: UHC Medicare Advantage |
$3,297.11
|
| Rate for Payer: VA VA |
$3,201.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,603.22
|
|
|
HC PPM SINGLE/V LEAD
|
Facility
|
IP
|
$12,804.30
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
36100058
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,809.34 |
| Max. Negotiated Rate |
$11,523.87 |
| Rate for Payer: Aetna Commercial |
$10,883.66
|
| Rate for Payer: BCBS Trust/PPO |
$9,895.16
|
| Rate for Payer: BCN Commercial |
$9,895.16
|
| Rate for Payer: Cash Price |
$10,243.44
|
| Rate for Payer: Cofinity Commercial |
$11,011.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,243.44
|
| Rate for Payer: Healthscope Commercial |
$11,523.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,603.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,883.66
|
| Rate for Payer: PHP Commercial |
$10,883.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,963.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,139.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,809.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,267.78
|
| Rate for Payer: UHC Core |
$10,691.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,603.22
|
|
|
HC PPU OBSERVATION PER HOUR
|
Facility
|
OP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200007
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$31.90 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna Medicare |
$34.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.98
|
| Rate for Payer: BCBS Complete |
$53.73
|
| Rate for Payer: BCBS MAPPO |
$33.58
|
| Rate for Payer: BCBS Trust/PPO |
$104.44
|
| Rate for Payer: BCN Commercial |
$104.44
|
| Rate for Payer: BCN Medicare Advantage |
$33.58
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.58
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PACE Senior Care Partners |
$31.90
|
| Rate for Payer: PACE SWMI |
$33.58
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: PHP Medicare Advantage |
$33.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.87
|
| Rate for Payer: Priority Health Medicare |
$33.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.93
|
| Rate for Payer: Railroad Medicare Medicare |
$33.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.21
|
| Rate for Payer: UHC Core |
$112.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.58
|
| Rate for Payer: UHC Medicare Advantage |
$34.59
|
| Rate for Payer: VA VA |
$33.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC PPU OBSERVATION PER HOUR
|
Facility
|
IP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200007
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$81.93 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: BCBS Trust/PPO |
$103.81
|
| Rate for Payer: BCN Commercial |
$103.81
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.21
|
| Rate for Payer: UHC Core |
$112.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC PRADER WILLI MOL ANALYSIS
|
Facility
|
OP
|
$430.00
|
|
|
Service Code
|
CPT 81331
|
| Hospital Charge Code |
31000103
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.69 |
| Max. Negotiated Rate |
$387.00 |
| Rate for Payer: Aetna Commercial |
$365.50
|
| Rate for Payer: Aetna Medicare |
$111.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.38
|
| Rate for Payer: BCBS Complete |
$39.57
|
| Rate for Payer: BCBS MAPPO |
$107.50
|
| Rate for Payer: BCBS Trust/PPO |
$334.32
|
| Rate for Payer: BCN Commercial |
$334.32
|
| Rate for Payer: BCN Medicare Advantage |
$107.50
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cofinity Commercial |
$369.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.50
|
| Rate for Payer: Healthscope Commercial |
$387.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.50
|
| Rate for Payer: Mclaren Medicaid |
$37.69
|
| Rate for Payer: Meridian Medicaid |
$39.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.50
|
| Rate for Payer: PACE Senior Care Partners |
$102.12
|
| Rate for Payer: PACE SWMI |
$107.50
|
| Rate for Payer: PHP Commercial |
$365.50
|
| Rate for Payer: PHP Medicare Advantage |
$107.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$374.10
|
| Rate for Payer: Priority Health Medicare |
$107.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.26
|
| Rate for Payer: Railroad Medicare Medicare |
$107.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.40
|
| Rate for Payer: UHC Core |
$359.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.50
|
| Rate for Payer: UHC Medicare Advantage |
$110.72
|
| Rate for Payer: VA VA |
$107.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.50
|
|
|
HC PRADER WILLI MOL ANALYSIS
|
Facility
|
IP
|
$430.00
|
|
|
Service Code
|
CPT 81331
|
| Hospital Charge Code |
31000103
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$262.26 |
| Max. Negotiated Rate |
$387.00 |
| Rate for Payer: Aetna Commercial |
$365.50
|
| Rate for Payer: BCBS Trust/PPO |
$332.30
|
| Rate for Payer: BCN Commercial |
$332.30
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cofinity Commercial |
$369.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.00
|
| Rate for Payer: Healthscope Commercial |
$387.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.50
|
| Rate for Payer: PHP Commercial |
$365.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$374.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.40
|
| Rate for Payer: UHC Core |
$359.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.50
|
|
|
HC PREALBUMIN
|
Facility
|
OP
|
$68.00
|
|
|
Service Code
|
CPT 84134
|
| Hospital Charge Code |
30100398
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.77 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$57.80
|
| Rate for Payer: Aetna Medicare |
$17.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.25
|
| Rate for Payer: BCBS Complete |
$11.31
|
| Rate for Payer: BCBS MAPPO |
$17.00
|
| Rate for Payer: BCBS Trust/PPO |
$52.87
|
| Rate for Payer: BCN Commercial |
$52.87
|
| Rate for Payer: BCN Medicare Advantage |
$17.00
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$58.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.00
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.00
|
| Rate for Payer: Mclaren Medicaid |
$10.77
|
| Rate for Payer: Meridian Medicaid |
$11.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.80
|
| Rate for Payer: PACE Senior Care Partners |
$16.15
|
| Rate for Payer: PACE SWMI |
$17.00
|
| Rate for Payer: PHP Commercial |
$57.80
|
| Rate for Payer: PHP Medicare Advantage |
$17.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.16
|
| Rate for Payer: Priority Health Medicare |
$17.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.47
|
| Rate for Payer: Railroad Medicare Medicare |
$17.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.84
|
| Rate for Payer: UHC Core |
$56.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.00
|
| Rate for Payer: UHC Medicare Advantage |
$17.51
|
| Rate for Payer: VA VA |
$17.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.00
|
|
|
HC PREALBUMIN
|
Facility
|
IP
|
$68.00
|
|
|
Service Code
|
CPT 84134
|
| Hospital Charge Code |
30100398
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.47 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Aetna Commercial |
$57.80
|
| Rate for Payer: BCBS Trust/PPO |
$52.55
|
| Rate for Payer: BCN Commercial |
$52.55
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$58.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.40
|
| Rate for Payer: Healthscope Commercial |
$61.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$57.80
|
| Rate for Payer: PHP Commercial |
$57.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.84
|
| Rate for Payer: UHC Core |
$56.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.00
|
|
|
HC PREGNANCY TEST SERUM
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 84703
|
| Hospital Charge Code |
30100467
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.66 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$23.65
|
| Rate for Payer: BCN Commercial |
$23.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC PREGNANCY TEST SERUM
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 84703
|
| Hospital Charge Code |
30100467
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.55 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.56
|
| Rate for Payer: BCBS Complete |
$5.83
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$23.79
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.65
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$5.55
|
| Rate for Payer: Meridian Medicaid |
$5.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PACE Senior Care Partners |
$7.27
|
| Rate for Payer: PACE SWMI |
$7.65
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.62
|
| Rate for Payer: Priority Health Medicare |
$7.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.66
|
| Rate for Payer: Railroad Medicare Medicare |
$7.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.65
|
| Rate for Payer: UHC Medicare Advantage |
$7.88
|
| Rate for Payer: VA VA |
$7.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC PREGNENOLONE
|
Facility
|
IP
|
$90.00
|
|
|
Service Code
|
CPT 84140
|
| Hospital Charge Code |
30100561
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.89 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: BCBS Trust/PPO |
$69.55
|
| Rate for Payer: BCN Commercial |
$69.55
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$77.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Healthscope Commercial |
$81.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: PHP Commercial |
$76.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.20
|
| Rate for Payer: UHC Core |
$75.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.50
|
|
|
HC PREGNENOLONE
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT 84140
|
| Hospital Charge Code |
30100561
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.25 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: Aetna Medicare |
$23.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.12
|
| Rate for Payer: BCBS Complete |
$16.02
|
| Rate for Payer: BCBS MAPPO |
$22.50
|
| Rate for Payer: BCBS Trust/PPO |
$69.98
|
| Rate for Payer: BCN Commercial |
$69.98
|
| Rate for Payer: BCN Medicare Advantage |
$22.50
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$77.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.50
|
| Rate for Payer: Healthscope Commercial |
$81.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.50
|
| Rate for Payer: Mclaren Medicaid |
$15.25
|
| Rate for Payer: Meridian Medicaid |
$16.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: PACE Senior Care Partners |
$21.38
|
| Rate for Payer: PACE SWMI |
$22.50
|
| Rate for Payer: PHP Commercial |
$76.50
|
| Rate for Payer: PHP Medicare Advantage |
$22.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.30
|
| Rate for Payer: Priority Health Medicare |
$22.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.89
|
| Rate for Payer: Railroad Medicare Medicare |
$22.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.20
|
| Rate for Payer: UHC Core |
$75.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.50
|
| Rate for Payer: UHC Medicare Advantage |
$23.18
|
| Rate for Payer: VA VA |
$22.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.50
|
|
|
HC PRENATAL ANEUPLOIDY DETECTION, FISH
|
Facility
|
IP
|
$94.86
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000130
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$57.86 |
| Max. Negotiated Rate |
$85.37 |
| Rate for Payer: Aetna Commercial |
$80.63
|
| Rate for Payer: BCBS Trust/PPO |
$73.31
|
| Rate for Payer: BCN Commercial |
$73.31
|
| Rate for Payer: Cash Price |
$75.89
|
| Rate for Payer: Cofinity Commercial |
$81.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.89
|
| Rate for Payer: Healthscope Commercial |
$85.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.63
|
| Rate for Payer: PHP Commercial |
$80.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.48
|
| Rate for Payer: UHC Core |
$79.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.14
|
|
|
HC PRENATAL ANEUPLOIDY DETECTION, FISH
|
Facility
|
OP
|
$94.86
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000130
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$85.37 |
| Rate for Payer: Aetna Commercial |
$80.63
|
| Rate for Payer: Aetna Medicare |
$24.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.64
|
| Rate for Payer: BCBS Complete |
$16.60
|
| Rate for Payer: BCBS MAPPO |
$23.72
|
| Rate for Payer: BCBS Trust/PPO |
$73.75
|
| Rate for Payer: BCN Commercial |
$73.75
|
| Rate for Payer: BCN Medicare Advantage |
$23.72
|
| Rate for Payer: Cash Price |
$75.89
|
| Rate for Payer: Cash Price |
$75.89
|
| Rate for Payer: Cofinity Commercial |
$81.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.72
|
| Rate for Payer: Healthscope Commercial |
$85.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.14
|
| Rate for Payer: Mclaren Medicaid |
$15.81
|
| Rate for Payer: Meridian Medicaid |
$16.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.63
|
| Rate for Payer: PACE Senior Care Partners |
$22.53
|
| Rate for Payer: PACE SWMI |
$23.72
|
| Rate for Payer: PHP Commercial |
$80.63
|
| Rate for Payer: PHP Medicare Advantage |
$23.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.53
|
| Rate for Payer: Priority Health Medicare |
$23.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.86
|
| Rate for Payer: Railroad Medicare Medicare |
$23.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.48
|
| Rate for Payer: UHC Core |
$79.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.72
|
| Rate for Payer: UHC Medicare Advantage |
$24.43
|
| Rate for Payer: VA VA |
$23.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.14
|
|
|
HC PRENATAL ZIKA VIRUS MAC ELISA IGM
|
Facility
|
OP
|
$184.00
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000149
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$165.60 |
| Rate for Payer: Aetna Commercial |
$156.40
|
| Rate for Payer: Aetna Medicare |
$47.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.50
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: BCBS MAPPO |
$46.00
|
| Rate for Payer: BCBS Trust/PPO |
$143.06
|
| Rate for Payer: BCN Commercial |
$143.06
|
| Rate for Payer: BCN Medicare Advantage |
$46.00
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$158.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.00
|
| Rate for Payer: Healthscope Commercial |
$165.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.00
|
| Rate for Payer: Mclaren Medicaid |
$12.44
|
| Rate for Payer: Meridian Medicaid |
$13.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$48.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.40
|
| Rate for Payer: PACE Senior Care Partners |
$43.70
|
| Rate for Payer: PACE SWMI |
$46.00
|
| Rate for Payer: PHP Commercial |
$156.40
|
| Rate for Payer: PHP Medicare Advantage |
$46.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.08
|
| Rate for Payer: Priority Health Medicare |
$46.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.22
|
| Rate for Payer: Railroad Medicare Medicare |
$46.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.92
|
| Rate for Payer: UHC Core |
$153.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.00
|
| Rate for Payer: UHC Medicare Advantage |
$47.38
|
| Rate for Payer: VA VA |
$46.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.00
|
|
|
HC PRENATAL ZIKA VIRUS MAC ELISA IGM
|
Facility
|
IP
|
$184.00
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000149
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$112.22 |
| Max. Negotiated Rate |
$165.60 |
| Rate for Payer: Aetna Commercial |
$156.40
|
| Rate for Payer: BCBS Trust/PPO |
$142.20
|
| Rate for Payer: BCN Commercial |
$142.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$158.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
| Rate for Payer: Healthscope Commercial |
$165.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.40
|
| Rate for Payer: PHP Commercial |
$156.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.92
|
| Rate for Payer: UHC Core |
$153.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.00
|
|
|
HC PRENATLA ANEUPLOIDY DETECTION, FISH CMPT
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000131
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$42.30 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: BCBS Trust/PPO |
$53.60
|
| Rate for Payer: BCN Commercial |
$53.60
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.96
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.04
|
| Rate for Payer: UHC Core |
$57.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC PRENATLA ANEUPLOIDY DETECTION, FISH CMPT
|
Facility
|
OP
|
$69.36
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000131
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna Medicare |
$18.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.68
|
| Rate for Payer: BCBS Complete |
$16.60
|
| Rate for Payer: BCBS MAPPO |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$53.93
|
| Rate for Payer: BCN Commercial |
$53.93
|
| Rate for Payer: BCN Medicare Advantage |
$17.34
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.34
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Mclaren Medicaid |
$15.81
|
| Rate for Payer: Meridian Medicaid |
$16.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.96
|
| Rate for Payer: PACE Senior Care Partners |
$16.47
|
| Rate for Payer: PACE SWMI |
$17.34
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: PHP Medicare Advantage |
$17.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.34
|
| Rate for Payer: Priority Health Medicare |
$17.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.30
|
| Rate for Payer: Railroad Medicare Medicare |
$17.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.04
|
| Rate for Payer: UHC Core |
$57.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.34
|
| Rate for Payer: UHC Medicare Advantage |
$17.86
|
| Rate for Payer: VA VA |
$17.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS BIL
|
Facility
|
IP
|
$1,467.38
|
|
|
Service Code
|
CPT 93985
|
| Hospital Charge Code |
92100036
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$894.96 |
| Max. Negotiated Rate |
$1,320.64 |
| Rate for Payer: Aetna Commercial |
$1,247.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,133.99
|
| Rate for Payer: BCN Commercial |
$1,133.99
|
| Rate for Payer: Cash Price |
$1,173.90
|
| Rate for Payer: Cofinity Commercial |
$1,261.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,173.90
|
| Rate for Payer: Healthscope Commercial |
$1,320.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,100.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,247.27
|
| Rate for Payer: PHP Commercial |
$1,247.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,276.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$894.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,291.29
|
| Rate for Payer: UHC Core |
$1,225.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,100.54
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS BIL
|
Facility
|
OP
|
$1,467.38
|
|
|
Service Code
|
CPT 93985
|
| Hospital Charge Code |
92100036
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,320.64 |
| Rate for Payer: Aetna Commercial |
$1,247.27
|
| Rate for Payer: Aetna Medicare |
$381.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.56
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$366.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,140.89
|
| Rate for Payer: BCN Commercial |
$1,140.89
|
| Rate for Payer: BCN Medicare Advantage |
$366.84
|
| Rate for Payer: Cash Price |
$1,173.90
|
| Rate for Payer: Cash Price |
$1,173.90
|
| Rate for Payer: Cofinity Commercial |
$1,261.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,173.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.84
|
| Rate for Payer: Healthscope Commercial |
$1,320.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,100.54
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$385.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,247.27
|
| Rate for Payer: PACE Senior Care Partners |
$348.50
|
| Rate for Payer: PACE SWMI |
$366.84
|
| Rate for Payer: PHP Commercial |
$1,247.27
|
| Rate for Payer: PHP Medicare Advantage |
$366.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,276.62
|
| Rate for Payer: Priority Health Medicare |
$366.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$894.96
|
| Rate for Payer: Railroad Medicare Medicare |
$366.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,291.29
|
| Rate for Payer: UHC Core |
$1,225.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.84
|
| Rate for Payer: UHC Medicare Advantage |
$377.85
|
| Rate for Payer: VA VA |
$366.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,100.54
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS UNI.
|
Facility
|
OP
|
$850.62
|
|
|
Service Code
|
CPT 93986
|
| Hospital Charge Code |
92100037
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$72.12 |
| Max. Negotiated Rate |
$765.56 |
| Rate for Payer: Aetna Commercial |
$723.03
|
| Rate for Payer: Aetna Medicare |
$221.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$265.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$265.82
|
| Rate for Payer: BCBS Complete |
$75.72
|
| Rate for Payer: BCBS MAPPO |
$212.66
|
| Rate for Payer: BCBS Trust/PPO |
$661.36
|
| Rate for Payer: BCN Commercial |
$661.36
|
| Rate for Payer: BCN Medicare Advantage |
$212.66
|
| Rate for Payer: Cash Price |
$680.50
|
| Rate for Payer: Cash Price |
$680.50
|
| Rate for Payer: Cofinity Commercial |
$731.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.66
|
| Rate for Payer: Healthscope Commercial |
$765.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$637.96
|
| Rate for Payer: Mclaren Medicaid |
$72.12
|
| Rate for Payer: Meridian Medicaid |
$75.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$223.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$244.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$723.03
|
| Rate for Payer: PACE Senior Care Partners |
$202.02
|
| Rate for Payer: PACE SWMI |
$212.66
|
| Rate for Payer: PHP Commercial |
$723.03
|
| Rate for Payer: PHP Medicare Advantage |
$212.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$740.04
|
| Rate for Payer: Priority Health Medicare |
$212.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$518.79
|
| Rate for Payer: Railroad Medicare Medicare |
$212.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$748.55
|
| Rate for Payer: UHC Core |
$710.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$212.66
|
| Rate for Payer: UHC Medicare Advantage |
$219.03
|
| Rate for Payer: VA VA |
$212.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$637.96
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS UNI.
|
Facility
|
IP
|
$850.62
|
|
|
Service Code
|
CPT 93986
|
| Hospital Charge Code |
92100037
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$518.79 |
| Max. Negotiated Rate |
$765.56 |
| Rate for Payer: Aetna Commercial |
$723.03
|
| Rate for Payer: BCBS Trust/PPO |
$657.36
|
| Rate for Payer: BCN Commercial |
$657.36
|
| Rate for Payer: Cash Price |
$680.50
|
| Rate for Payer: Cofinity Commercial |
$731.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.50
|
| Rate for Payer: Healthscope Commercial |
$765.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$637.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$723.03
|
| Rate for Payer: PHP Commercial |
$723.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$740.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$518.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$748.55
|
| Rate for Payer: UHC Core |
$710.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$637.96
|
|
|
HC PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT
|
Facility
|
OP
|
$1,000.00
|
|
|
Service Code
|
CPT 15004
|
| Hospital Charge Code |
76100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$237.50 |
| Max. Negotiated Rate |
$900.00 |
| Rate for Payer: Aetna Commercial |
$850.00
|
| Rate for Payer: Aetna Medicare |
$260.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$312.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$312.50
|
| Rate for Payer: BCBS Complete |
$432.60
|
| Rate for Payer: BCBS MAPPO |
$250.00
|
| Rate for Payer: BCBS Trust/PPO |
$777.50
|
| Rate for Payer: BCN Commercial |
$777.50
|
| Rate for Payer: BCN Medicare Advantage |
$250.00
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cofinity Commercial |
$860.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.00
|
| Rate for Payer: Healthscope Commercial |
$900.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.00
|
| Rate for Payer: Mclaren Medicaid |
$412.00
|
| Rate for Payer: Meridian Medicaid |
$432.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$262.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$287.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$850.00
|
| Rate for Payer: PACE Senior Care Partners |
$237.50
|
| Rate for Payer: PACE SWMI |
$250.00
|
| Rate for Payer: PHP Commercial |
$850.00
|
| Rate for Payer: PHP Medicare Advantage |
$250.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$870.00
|
| Rate for Payer: Priority Health Medicare |
$250.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$609.90
|
| Rate for Payer: Railroad Medicare Medicare |
$250.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$880.00
|
| Rate for Payer: UHC Core |
$835.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$250.00
|
| Rate for Payer: UHC Medicare Advantage |
$257.50
|
| Rate for Payer: VA VA |
$250.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.00
|
|
|
HC PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT
|
Facility
|
IP
|
$1,000.00
|
|
|
Service Code
|
CPT 15004
|
| Hospital Charge Code |
76100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$609.90 |
| Max. Negotiated Rate |
$900.00 |
| Rate for Payer: Aetna Commercial |
$850.00
|
| Rate for Payer: BCBS Trust/PPO |
$772.80
|
| Rate for Payer: BCN Commercial |
$772.80
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cofinity Commercial |
$860.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.00
|
| Rate for Payer: Healthscope Commercial |
$900.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$850.00
|
| Rate for Payer: PHP Commercial |
$850.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$870.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$609.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$880.00
|
| Rate for Payer: UHC Core |
$835.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.00
|
|
|
HC PRESBYOPIA LENS
|
Facility
|
OP
|
$3,586.48
|
|
|
Service Code
|
HCPCS C1780
|
| Hospital Charge Code |
27600001
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$851.79 |
| Max. Negotiated Rate |
$3,227.83 |
| Rate for Payer: Aetna Commercial |
$3,048.51
|
| Rate for Payer: Aetna Medicare |
$932.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,120.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,120.78
|
| Rate for Payer: BCBS Complete |
$1,434.59
|
| Rate for Payer: BCBS MAPPO |
$896.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,788.49
|
| Rate for Payer: BCN Commercial |
$2,788.49
|
| Rate for Payer: BCN Medicare Advantage |
$896.62
|
| Rate for Payer: Cash Price |
$2,869.18
|
| Rate for Payer: Cofinity Commercial |
$3,084.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,869.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$896.62
|
| Rate for Payer: Healthscope Commercial |
$3,227.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,689.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$941.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,031.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,048.51
|
| Rate for Payer: PACE Senior Care Partners |
$851.79
|
| Rate for Payer: PACE SWMI |
$896.62
|
| Rate for Payer: PHP Commercial |
$3,048.51
|
| Rate for Payer: PHP Medicare Advantage |
$896.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,510.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,120.24
|
| Rate for Payer: Priority Health Medicare |
$896.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,187.39
|
| Rate for Payer: Railroad Medicare Medicare |
$896.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,156.10
|
| Rate for Payer: UHC Core |
$2,994.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$896.62
|
| Rate for Payer: UHC Medicare Advantage |
$923.52
|
| Rate for Payer: VA VA |
$896.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,689.86
|
|
