|
HC INSERT PICC LESS THAN 5 YRS W IMAGING
|
Facility
|
OP
|
$1,986.12
|
|
|
Service Code
|
CPT 36572
|
| Hospital Charge Code |
36100552
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$437.96 |
| Max. Negotiated Rate |
$1,787.51 |
| Rate for Payer: Aetna Commercial |
$1,688.20
|
| Rate for Payer: Aetna Medicare |
$516.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$620.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$620.66
|
| Rate for Payer: BCBS Complete |
$459.89
|
| Rate for Payer: BCBS MAPPO |
$496.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,632.79
|
| Rate for Payer: BCN Commercial |
$1,544.21
|
| Rate for Payer: BCN Medicare Advantage |
$496.53
|
| Rate for Payer: Cash Price |
$1,588.90
|
| Rate for Payer: Cash Price |
$1,588.90
|
| Rate for Payer: Cofinity Commercial |
$1,708.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,588.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.53
|
| Rate for Payer: Healthscope Commercial |
$1,787.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,489.59
|
| Rate for Payer: Mclaren Medicaid |
$437.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.36
|
| Rate for Payer: Meridian Medicaid |
$459.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$571.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,688.20
|
| Rate for Payer: Nomi Health Commercial |
$1,628.62
|
| Rate for Payer: PACE Senior Care Partners |
$471.70
|
| Rate for Payer: PACE SWMI |
$496.53
|
| Rate for Payer: PHP Commercial |
$1,688.20
|
| Rate for Payer: PHP Medicare Advantage |
$496.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$437.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,290.98
|
| Rate for Payer: Priority Health HMO/PPO |
$1,727.92
|
| Rate for Payer: Priority Health Medicare |
$501.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,330.70
|
| Rate for Payer: Railroad Medicare Medicare |
$496.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,747.79
|
| Rate for Payer: UHC Core |
$1,658.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.53
|
| Rate for Payer: UHC Exchange |
$496.53
|
| Rate for Payer: UHC Medicare Advantage |
$496.53
|
| Rate for Payer: UHCCP Medicaid |
$437.96
|
| Rate for Payer: VA VA |
$496.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,489.59
|
|
|
HC INSERT/REPLACE SQ ICD W ELECTRODES
|
Facility
|
IP
|
$84,898.54
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
48100113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$55,184.05 |
| Max. Negotiated Rate |
$76,408.69 |
| Rate for Payer: Aetna Commercial |
$72,163.76
|
| Rate for Payer: BCBS Trust/PPO |
$69,302.68
|
| Rate for Payer: BCN Commercial |
$65,609.59
|
| Rate for Payer: Cash Price |
$67,918.83
|
| Rate for Payer: Cofinity Commercial |
$73,012.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67,918.83
|
| Rate for Payer: Healthscope Commercial |
$76,408.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63,673.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,163.76
|
| Rate for Payer: Nomi Health Commercial |
$69,616.80
|
| Rate for Payer: PHP Commercial |
$72,163.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55,184.05
|
| Rate for Payer: Priority Health HMO/PPO |
$73,861.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56,882.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74,710.72
|
| Rate for Payer: UHC Core |
$70,890.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63,673.90
|
|
|
HC INSERT/REPLACE SQ ICD W ELECTRODES
|
Facility
|
OP
|
$84,898.54
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
48100113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$20,163.40 |
| Max. Negotiated Rate |
$76,408.69 |
| Rate for Payer: Aetna Commercial |
$72,163.76
|
| Rate for Payer: Aetna Medicare |
$22,073.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,530.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,530.79
|
| Rate for Payer: BCBS Complete |
$23,848.97
|
| Rate for Payer: BCBS MAPPO |
$21,224.64
|
| Rate for Payer: BCBS Trust/PPO |
$69,795.09
|
| Rate for Payer: BCN Commercial |
$66,008.61
|
| Rate for Payer: BCN Medicare Advantage |
$21,224.64
|
| Rate for Payer: Cash Price |
$67,918.83
|
| Rate for Payer: Cash Price |
$67,918.83
|
| Rate for Payer: Cofinity Commercial |
$73,012.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67,918.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,224.64
|
| Rate for Payer: Healthscope Commercial |
$76,408.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63,673.90
|
| Rate for Payer: Mclaren Medicaid |
$22,711.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,285.87
|
| Rate for Payer: Meridian Medicaid |
$23,848.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,408.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72,163.76
|
| Rate for Payer: Nomi Health Commercial |
$69,616.80
|
| Rate for Payer: PACE Senior Care Partners |
$20,163.40
|
| Rate for Payer: PACE SWMI |
$21,224.64
|
| Rate for Payer: PHP Commercial |
$72,163.76
|
| Rate for Payer: PHP Medicare Advantage |
$21,224.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$22,711.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55,184.05
|
| Rate for Payer: Priority Health HMO/PPO |
$73,861.73
|
| Rate for Payer: Priority Health Medicare |
$21,436.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56,882.02
|
| Rate for Payer: Railroad Medicare Medicare |
$21,224.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74,710.72
|
| Rate for Payer: UHC Core |
$70,890.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,224.64
|
| Rate for Payer: UHC Exchange |
$21,224.64
|
| Rate for Payer: UHC Medicare Advantage |
$21,224.64
|
| Rate for Payer: UHCCP Medicaid |
$22,711.81
|
| Rate for Payer: VA VA |
$21,224.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63,673.90
|
|
|
HC INSERT STRAIGHT CATH
|
Facility
|
OP
|
$185.30
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
45000003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$44.01 |
| Max. Negotiated Rate |
$166.77 |
| Rate for Payer: Aetna Commercial |
$157.50
|
| Rate for Payer: Aetna Medicare |
$48.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.91
|
| Rate for Payer: BCBS Complete |
$95.88
|
| Rate for Payer: BCBS MAPPO |
$46.32
|
| Rate for Payer: BCBS Trust/PPO |
$152.34
|
| Rate for Payer: BCN Commercial |
$144.07
|
| Rate for Payer: BCN Medicare Advantage |
$46.32
|
| Rate for Payer: Cash Price |
$148.24
|
| Rate for Payer: Cash Price |
$148.24
|
| Rate for Payer: Cofinity Commercial |
$159.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.32
|
| Rate for Payer: Healthscope Commercial |
$166.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.98
|
| Rate for Payer: Mclaren Medicaid |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.64
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.50
|
| Rate for Payer: Nomi Health Commercial |
$151.95
|
| Rate for Payer: PACE Senior Care Partners |
$44.01
|
| Rate for Payer: PACE SWMI |
$46.32
|
| Rate for Payer: PHP Commercial |
$157.50
|
| Rate for Payer: PHP Medicare Advantage |
$46.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.44
|
| Rate for Payer: Priority Health HMO/PPO |
$161.21
|
| Rate for Payer: Priority Health Medicare |
$46.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.15
|
| Rate for Payer: Railroad Medicare Medicare |
$46.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.06
|
| Rate for Payer: UHC Core |
$154.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.32
|
| Rate for Payer: UHC Exchange |
$46.32
|
| Rate for Payer: UHC Medicare Advantage |
$46.32
|
| Rate for Payer: UHCCP Medicaid |
$91.31
|
| Rate for Payer: VA VA |
$46.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.98
|
|
|
HC INSERT STRAIGHT CATH
|
Facility
|
IP
|
$185.30
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
45000003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$120.44 |
| Max. Negotiated Rate |
$166.77 |
| Rate for Payer: Aetna Commercial |
$157.50
|
| Rate for Payer: BCBS Trust/PPO |
$151.26
|
| Rate for Payer: BCN Commercial |
$143.20
|
| Rate for Payer: Cash Price |
$148.24
|
| Rate for Payer: Cofinity Commercial |
$159.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.24
|
| Rate for Payer: Healthscope Commercial |
$166.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.50
|
| Rate for Payer: Nomi Health Commercial |
$151.95
|
| Rate for Payer: PHP Commercial |
$157.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.44
|
| Rate for Payer: Priority Health HMO/PPO |
$161.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.06
|
| Rate for Payer: UHC Core |
$154.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.98
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP ABOVE 5 YRS AGE
|
Facility
|
OP
|
$4,076.99
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
36100123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$968.29 |
| Max. Negotiated Rate |
$3,669.29 |
| Rate for Payer: Aetna Commercial |
$3,465.44
|
| Rate for Payer: Aetna Medicare |
$1,060.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,274.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,274.06
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$1,019.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,351.69
|
| Rate for Payer: BCN Commercial |
$3,169.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,019.25
|
| Rate for Payer: Cash Price |
$3,261.59
|
| Rate for Payer: Cash Price |
$3,261.59
|
| Rate for Payer: Cofinity Commercial |
$3,506.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,261.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,019.25
|
| Rate for Payer: Healthscope Commercial |
$3,669.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,057.74
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,070.21
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,172.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,465.44
|
| Rate for Payer: Nomi Health Commercial |
$3,343.13
|
| Rate for Payer: PACE Senior Care Partners |
$968.29
|
| Rate for Payer: PACE SWMI |
$1,019.25
|
| Rate for Payer: PHP Commercial |
$3,465.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,019.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.04
|
| Rate for Payer: Priority Health HMO/PPO |
$3,546.98
|
| Rate for Payer: Priority Health Medicare |
$1,029.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,731.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,019.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,587.75
|
| Rate for Payer: UHC Core |
$3,404.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,019.25
|
| Rate for Payer: UHC Exchange |
$1,019.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,019.25
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$1,019.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,057.74
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP ABOVE 5 YRS AGE
|
Facility
|
IP
|
$4,076.99
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
36100123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,650.04 |
| Max. Negotiated Rate |
$3,669.29 |
| Rate for Payer: Aetna Commercial |
$3,465.44
|
| Rate for Payer: BCBS Trust/PPO |
$3,328.05
|
| Rate for Payer: BCN Commercial |
$3,150.70
|
| Rate for Payer: Cash Price |
$3,261.59
|
| Rate for Payer: Cofinity Commercial |
$3,506.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,261.59
|
| Rate for Payer: Healthscope Commercial |
$3,669.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,057.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,465.44
|
| Rate for Payer: Nomi Health Commercial |
$3,343.13
|
| Rate for Payer: PHP Commercial |
$3,465.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,650.04
|
| Rate for Payer: Priority Health HMO/PPO |
$3,546.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,731.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,587.75
|
| Rate for Payer: UHC Core |
$3,404.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,057.74
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$4,139.56
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
36100122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,690.71 |
| Max. Negotiated Rate |
$3,725.60 |
| Rate for Payer: Aetna Commercial |
$3,518.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,379.12
|
| Rate for Payer: BCN Commercial |
$3,199.05
|
| Rate for Payer: Cash Price |
$3,311.65
|
| Rate for Payer: Cofinity Commercial |
$3,560.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,311.65
|
| Rate for Payer: Healthscope Commercial |
$3,725.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,104.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,518.63
|
| Rate for Payer: Nomi Health Commercial |
$3,394.44
|
| Rate for Payer: PHP Commercial |
$3,518.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,690.71
|
| Rate for Payer: Priority Health HMO/PPO |
$3,601.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,773.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,642.81
|
| Rate for Payer: UHC Core |
$3,456.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,104.67
|
|
|
HC INSERT TUNNELED CENTRAL LINE WO PORT OR PUMP LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$4,139.56
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
36100122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$983.15 |
| Max. Negotiated Rate |
$4,021.03 |
| Rate for Payer: Aetna Commercial |
$3,518.63
|
| Rate for Payer: Aetna Medicare |
$1,076.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,293.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,293.61
|
| Rate for Payer: BCBS Complete |
$4,021.03
|
| Rate for Payer: BCBS MAPPO |
$1,034.89
|
| Rate for Payer: BCBS Trust/PPO |
$3,403.13
|
| Rate for Payer: BCN Commercial |
$3,218.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,034.89
|
| Rate for Payer: Cash Price |
$3,311.65
|
| Rate for Payer: Cash Price |
$3,311.65
|
| Rate for Payer: Cofinity Commercial |
$3,560.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,311.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,034.89
|
| Rate for Payer: Healthscope Commercial |
$3,725.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,104.67
|
| Rate for Payer: Mclaren Medicaid |
$3,829.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,086.63
|
| Rate for Payer: Meridian Medicaid |
$4,021.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,190.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,518.63
|
| Rate for Payer: Nomi Health Commercial |
$3,394.44
|
| Rate for Payer: PACE Senior Care Partners |
$983.15
|
| Rate for Payer: PACE SWMI |
$1,034.89
|
| Rate for Payer: PHP Commercial |
$3,518.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,034.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,829.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,690.71
|
| Rate for Payer: Priority Health HMO/PPO |
$3,601.42
|
| Rate for Payer: Priority Health Medicare |
$1,045.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,773.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,034.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,642.81
|
| Rate for Payer: UHC Core |
$3,456.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,034.89
|
| Rate for Payer: UHC Exchange |
$1,034.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,034.89
|
| Rate for Payer: UHCCP Medicaid |
$3,829.30
|
| Rate for Payer: VA VA |
$1,034.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,104.67
|
|
|
HC IN SITU HYBRID EA ADDL PROBE STAIN PER SPECIMEN
|
Facility
|
IP
|
$265.10
|
|
|
Service Code
|
CPT 88364
|
| Hospital Charge Code |
31000120
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$172.32 |
| Max. Negotiated Rate |
$238.59 |
| Rate for Payer: Aetna Commercial |
$225.34
|
| Rate for Payer: BCBS Trust/PPO |
$216.40
|
| Rate for Payer: BCN Commercial |
$204.87
|
| Rate for Payer: Cash Price |
$212.08
|
| Rate for Payer: Cofinity Commercial |
$227.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.08
|
| Rate for Payer: Healthscope Commercial |
$238.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.34
|
| Rate for Payer: Nomi Health Commercial |
$217.38
|
| Rate for Payer: PHP Commercial |
$225.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.32
|
| Rate for Payer: Priority Health HMO/PPO |
$230.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.29
|
| Rate for Payer: UHC Core |
$221.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.82
|
|
|
HC IN SITU HYBRID EA ADDL PROBE STAIN PER SPECIMEN
|
Facility
|
OP
|
$265.10
|
|
|
Service Code
|
CPT 88364
|
| Hospital Charge Code |
31000120
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$62.96 |
| Max. Negotiated Rate |
$238.59 |
| Rate for Payer: Aetna Commercial |
$225.34
|
| Rate for Payer: Aetna Medicare |
$68.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.84
|
| Rate for Payer: BCBS Complete |
$106.04
|
| Rate for Payer: BCBS MAPPO |
$66.28
|
| Rate for Payer: BCBS Trust/PPO |
$217.94
|
| Rate for Payer: BCCCP Commercial |
$119.98
|
| Rate for Payer: BCN Commercial |
$206.12
|
| Rate for Payer: BCN Medicare Advantage |
$66.28
|
| Rate for Payer: Cash Price |
$212.08
|
| Rate for Payer: Cash Price |
$212.08
|
| Rate for Payer: Cofinity Commercial |
$227.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.28
|
| Rate for Payer: Healthscope Commercial |
$238.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.34
|
| Rate for Payer: Nomi Health Commercial |
$217.38
|
| Rate for Payer: PACE Senior Care Partners |
$62.96
|
| Rate for Payer: PACE SWMI |
$66.28
|
| Rate for Payer: PHP Commercial |
$225.34
|
| Rate for Payer: PHP Medicare Advantage |
$66.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.32
|
| Rate for Payer: Priority Health HMO/PPO |
$230.64
|
| Rate for Payer: Priority Health Medicare |
$66.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.62
|
| Rate for Payer: Railroad Medicare Medicare |
$66.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.29
|
| Rate for Payer: UHC Core |
$221.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.28
|
| Rate for Payer: UHC Exchange |
$66.28
|
| Rate for Payer: UHC Medicare Advantage |
$66.28
|
| Rate for Payer: VA VA |
$66.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.82
|
|
|
HC IN SITU HYBRID MULTIPLX MRPH QUANT OR SEMI-QUANT
|
Facility
|
IP
|
$655.45
|
|
|
Service Code
|
CPT 88377
|
| Hospital Charge Code |
31000119
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$426.04 |
| Max. Negotiated Rate |
$589.90 |
| Rate for Payer: Aetna Commercial |
$557.13
|
| Rate for Payer: BCBS Trust/PPO |
$535.04
|
| Rate for Payer: BCN Commercial |
$506.53
|
| Rate for Payer: Cash Price |
$524.36
|
| Rate for Payer: Cofinity Commercial |
$563.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.36
|
| Rate for Payer: Healthscope Commercial |
$589.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$491.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.13
|
| Rate for Payer: Nomi Health Commercial |
$537.47
|
| Rate for Payer: PHP Commercial |
$557.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$426.04
|
| Rate for Payer: Priority Health HMO/PPO |
$570.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$439.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$576.80
|
| Rate for Payer: UHC Core |
$547.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$491.59
|
|
|
HC IN SITU HYBRID MULTIPLX MRPH QUANT OR SEMI-QUANT
|
Facility
|
OP
|
$655.45
|
|
|
Service Code
|
CPT 88377
|
| Hospital Charge Code |
31000119
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$121.39 |
| Max. Negotiated Rate |
$589.90 |
| Rate for Payer: Aetna Commercial |
$557.13
|
| Rate for Payer: Aetna Medicare |
$170.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.83
|
| Rate for Payer: BCBS Complete |
$127.47
|
| Rate for Payer: BCBS MAPPO |
$163.86
|
| Rate for Payer: BCBS Trust/PPO |
$538.85
|
| Rate for Payer: BCCCP Commercial |
$359.30
|
| Rate for Payer: BCN Commercial |
$509.61
|
| Rate for Payer: BCN Medicare Advantage |
$163.86
|
| Rate for Payer: Cash Price |
$524.36
|
| Rate for Payer: Cash Price |
$524.36
|
| Rate for Payer: Cofinity Commercial |
$563.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.86
|
| Rate for Payer: Healthscope Commercial |
$589.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$491.59
|
| Rate for Payer: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.06
|
| Rate for Payer: Meridian Medicaid |
$127.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$557.13
|
| Rate for Payer: Nomi Health Commercial |
$537.47
|
| Rate for Payer: PACE Senior Care Partners |
$155.67
|
| Rate for Payer: PACE SWMI |
$163.86
|
| Rate for Payer: PHP Commercial |
$557.13
|
| Rate for Payer: PHP Medicare Advantage |
$163.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$426.04
|
| Rate for Payer: Priority Health HMO/PPO |
$570.24
|
| Rate for Payer: Priority Health Medicare |
$165.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$439.15
|
| Rate for Payer: Railroad Medicare Medicare |
$163.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$576.80
|
| Rate for Payer: UHC Core |
$547.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.86
|
| Rate for Payer: UHC Exchange |
$163.86
|
| Rate for Payer: UHC Medicare Advantage |
$163.86
|
| Rate for Payer: UHCCP Medicaid |
$121.39
|
| Rate for Payer: VA VA |
$163.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$491.59
|
|
|
HC INSTILL ANTICARCIN BLADDER
|
Facility
|
OP
|
$746.53
|
|
|
Service Code
|
CPT 51720
|
| Hospital Charge Code |
36100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$177.30 |
| Max. Negotiated Rate |
$671.88 |
| Rate for Payer: Aetna Commercial |
$634.55
|
| Rate for Payer: Aetna Medicare |
$194.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$233.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$233.29
|
| Rate for Payer: BCBS Complete |
$496.49
|
| Rate for Payer: BCBS MAPPO |
$186.63
|
| Rate for Payer: BCBS Trust/PPO |
$613.72
|
| Rate for Payer: BCN Commercial |
$580.43
|
| Rate for Payer: BCN Medicare Advantage |
$186.63
|
| Rate for Payer: Cash Price |
$597.22
|
| Rate for Payer: Cash Price |
$597.22
|
| Rate for Payer: Cofinity Commercial |
$642.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$597.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.63
|
| Rate for Payer: Healthscope Commercial |
$671.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$559.90
|
| Rate for Payer: Mclaren Medicaid |
$472.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.96
|
| Rate for Payer: Meridian Medicaid |
$496.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$214.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$634.55
|
| Rate for Payer: Nomi Health Commercial |
$612.15
|
| Rate for Payer: PACE Senior Care Partners |
$177.30
|
| Rate for Payer: PACE SWMI |
$186.63
|
| Rate for Payer: PHP Commercial |
$634.55
|
| Rate for Payer: PHP Medicare Advantage |
$186.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.24
|
| Rate for Payer: Priority Health HMO/PPO |
$649.48
|
| Rate for Payer: Priority Health Medicare |
$188.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.18
|
| Rate for Payer: Railroad Medicare Medicare |
$186.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.95
|
| Rate for Payer: UHC Core |
$623.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.63
|
| Rate for Payer: UHC Exchange |
$186.63
|
| Rate for Payer: UHC Medicare Advantage |
$186.63
|
| Rate for Payer: UHCCP Medicaid |
$472.82
|
| Rate for Payer: VA VA |
$186.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$559.90
|
|
|
HC INSTILL ANTICARCIN BLADDER
|
Facility
|
IP
|
$746.53
|
|
|
Service Code
|
CPT 51720
|
| Hospital Charge Code |
36100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$485.24 |
| Max. Negotiated Rate |
$671.88 |
| Rate for Payer: Aetna Commercial |
$634.55
|
| Rate for Payer: BCBS Trust/PPO |
$609.39
|
| Rate for Payer: BCN Commercial |
$576.92
|
| Rate for Payer: Cash Price |
$597.22
|
| Rate for Payer: Cofinity Commercial |
$642.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$597.22
|
| Rate for Payer: Healthscope Commercial |
$671.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$559.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$634.55
|
| Rate for Payer: Nomi Health Commercial |
$612.15
|
| Rate for Payer: PHP Commercial |
$634.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.24
|
| Rate for Payer: Priority Health HMO/PPO |
$649.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.95
|
| Rate for Payer: UHC Core |
$623.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$559.90
|
|
|
HC INST THER AGENT RENAL PELVIS/URETER VIA TUB
|
Facility
|
IP
|
$666.90
|
|
|
Service Code
|
CPT 50391
|
| Hospital Charge Code |
36100571
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$433.48 |
| Max. Negotiated Rate |
$600.21 |
| Rate for Payer: Aetna Commercial |
$566.86
|
| Rate for Payer: BCBS Trust/PPO |
$544.39
|
| Rate for Payer: BCN Commercial |
$515.38
|
| Rate for Payer: Cash Price |
$533.52
|
| Rate for Payer: Cofinity Commercial |
$573.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.52
|
| Rate for Payer: Healthscope Commercial |
$600.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$500.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$566.86
|
| Rate for Payer: Nomi Health Commercial |
$546.86
|
| Rate for Payer: PHP Commercial |
$566.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.48
|
| Rate for Payer: Priority Health HMO/PPO |
$580.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$446.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$586.87
|
| Rate for Payer: UHC Core |
$556.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$500.18
|
|
|
HC INST THER AGENT RENAL PELVIS/URETER VIA TUB
|
Facility
|
OP
|
$666.90
|
|
|
Service Code
|
CPT 50391
|
| Hospital Charge Code |
36100571
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$158.39 |
| Max. Negotiated Rate |
$600.21 |
| Rate for Payer: Aetna Commercial |
$566.86
|
| Rate for Payer: Aetna Medicare |
$173.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$208.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$208.41
|
| Rate for Payer: BCBS Complete |
$180.91
|
| Rate for Payer: BCBS MAPPO |
$166.72
|
| Rate for Payer: BCBS Trust/PPO |
$548.26
|
| Rate for Payer: BCN Commercial |
$518.51
|
| Rate for Payer: BCN Medicare Advantage |
$166.72
|
| Rate for Payer: Cash Price |
$533.52
|
| Rate for Payer: Cash Price |
$533.52
|
| Rate for Payer: Cofinity Commercial |
$573.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.72
|
| Rate for Payer: Healthscope Commercial |
$600.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$500.18
|
| Rate for Payer: Mclaren Medicaid |
$172.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.06
|
| Rate for Payer: Meridian Medicaid |
$180.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$191.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$566.86
|
| Rate for Payer: Nomi Health Commercial |
$546.86
|
| Rate for Payer: PACE Senior Care Partners |
$158.39
|
| Rate for Payer: PACE SWMI |
$166.72
|
| Rate for Payer: PHP Commercial |
$566.86
|
| Rate for Payer: PHP Medicare Advantage |
$166.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.48
|
| Rate for Payer: Priority Health HMO/PPO |
$580.20
|
| Rate for Payer: Priority Health Medicare |
$168.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$446.82
|
| Rate for Payer: Railroad Medicare Medicare |
$166.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$586.87
|
| Rate for Payer: UHC Core |
$556.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.72
|
| Rate for Payer: UHC Exchange |
$166.72
|
| Rate for Payer: UHC Medicare Advantage |
$166.72
|
| Rate for Payer: UHCCP Medicaid |
$172.28
|
| Rate for Payer: VA VA |
$166.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$500.18
|
|
|
HC INSULIN
|
Facility
|
OP
|
$99.96
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
30100266
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.26 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna Medicare |
$25.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.24
|
| Rate for Payer: BCBS Complete |
$8.68
|
| Rate for Payer: BCBS MAPPO |
$24.99
|
| Rate for Payer: BCBS Trust/PPO |
$82.18
|
| Rate for Payer: BCN Commercial |
$77.72
|
| Rate for Payer: BCN Medicare Advantage |
$24.99
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.99
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.97
|
| Rate for Payer: Mclaren Medicaid |
$8.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.24
|
| Rate for Payer: Meridian Medicaid |
$8.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.97
|
| Rate for Payer: Nomi Health Commercial |
$81.97
|
| Rate for Payer: PACE Senior Care Partners |
$23.74
|
| Rate for Payer: PACE SWMI |
$24.99
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: PHP Medicare Advantage |
$24.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health HMO/PPO |
$86.97
|
| Rate for Payer: Priority Health Medicare |
$25.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.97
|
| Rate for Payer: Railroad Medicare Medicare |
$24.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.96
|
| Rate for Payer: UHC Core |
$83.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.99
|
| Rate for Payer: UHC Exchange |
$24.99
|
| Rate for Payer: UHC Medicare Advantage |
$24.99
|
| Rate for Payer: UHCCP Medicaid |
$8.26
|
| Rate for Payer: VA VA |
$24.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.97
|
|
|
HC INSULIN
|
Facility
|
IP
|
$99.96
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
30100266
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: BCBS Trust/PPO |
$81.60
|
| Rate for Payer: BCN Commercial |
$77.25
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.97
|
| Rate for Payer: Nomi Health Commercial |
$81.97
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health HMO/PPO |
$86.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.96
|
| Rate for Payer: UHC Core |
$83.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.97
|
|
|
HC INSULIN ANTIBODIES
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
30200199
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.08 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: BCBS Trust/PPO |
$56.62
|
| 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 Commercial |
$58.96
|
| Rate for Payer: Nomi Health Commercial |
$56.88
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: Priority Health HMO/PPO |
$60.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.47
|
| 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 INSULIN ANTIBODIES
|
Facility
|
OP
|
$69.36
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
30200199
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.48 |
| 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 |
$16.25
|
| Rate for Payer: BCBS MAPPO |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$57.02
|
| 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 |
$15.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.21
|
| Rate for Payer: Meridian Medicaid |
$16.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.96
|
| Rate for Payer: Nomi Health Commercial |
$56.88
|
| 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 |
$15.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: Priority Health HMO/PPO |
$60.34
|
| Rate for Payer: Priority Health Medicare |
$17.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.47
|
| 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 Exchange |
$17.34
|
| Rate for Payer: UHC Medicare Advantage |
$17.34
|
| Rate for Payer: UHCCP Medicaid |
$15.48
|
| Rate for Payer: VA VA |
$17.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC INSULIN LIKE GROWTH FACTOR BP3
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100258
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.86 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna Medicare |
$12.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.61
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$12.48
|
| Rate for Payer: BCBS Trust/PPO |
$41.06
|
| Rate for Payer: BCN Commercial |
$38.83
|
| Rate for Payer: BCN Medicare Advantage |
$12.48
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.48
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.46
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.11
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: PACE Senior Care Partners |
$11.86
|
| Rate for Payer: PACE SWMI |
$12.48
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$12.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health HMO/PPO |
$43.45
|
| Rate for Payer: Priority Health Medicare |
$12.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.46
|
| Rate for Payer: Railroad Medicare Medicare |
$12.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.95
|
| Rate for Payer: UHC Core |
$41.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.48
|
| Rate for Payer: UHC Exchange |
$12.48
|
| Rate for Payer: UHC Medicare Advantage |
$12.48
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$12.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.46
|
|
|
HC INSULIN LIKE GROWTH FACTOR BP3
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100258
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.46 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: BCBS Trust/PPO |
$40.77
|
| Rate for Payer: BCN Commercial |
$38.59
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health HMO/PPO |
$43.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.95
|
| Rate for Payer: UHC Core |
$41.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.46
|
|
|
HC INTENSIVE CARE OBS OVERFLOW PER HR
|
Facility
|
OP
|
$189.78
|
|
| Hospital Charge Code |
76900004
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$45.07 |
| Max. Negotiated Rate |
$170.80 |
| Rate for Payer: Aetna Commercial |
$161.31
|
| Rate for Payer: Aetna Medicare |
$49.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.31
|
| Rate for Payer: BCBS Complete |
$75.91
|
| Rate for Payer: BCBS MAPPO |
$47.44
|
| Rate for Payer: BCBS Trust/PPO |
$156.02
|
| Rate for Payer: BCN Commercial |
$147.55
|
| Rate for Payer: BCN Medicare Advantage |
$47.44
|
| Rate for Payer: Cash Price |
$151.82
|
| Rate for Payer: Cofinity Commercial |
$163.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.44
|
| Rate for Payer: Healthscope Commercial |
$170.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.31
|
| Rate for Payer: Nomi Health Commercial |
$155.62
|
| Rate for Payer: PACE Senior Care Partners |
$45.07
|
| Rate for Payer: PACE SWMI |
$47.44
|
| Rate for Payer: PHP Commercial |
$161.31
|
| Rate for Payer: PHP Medicare Advantage |
$47.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.36
|
| Rate for Payer: Priority Health HMO/PPO |
$165.11
|
| Rate for Payer: Priority Health Medicare |
$47.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.15
|
| Rate for Payer: Railroad Medicare Medicare |
$47.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.01
|
| Rate for Payer: UHC Core |
$158.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.44
|
| Rate for Payer: UHC Exchange |
$47.44
|
| Rate for Payer: UHC Medicare Advantage |
$47.44
|
| Rate for Payer: VA VA |
$47.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.34
|
|
|
HC INTENSIVE CARE OBS OVERFLOW PER HR
|
Facility
|
IP
|
$189.78
|
|
| Hospital Charge Code |
76900004
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$123.36 |
| Max. Negotiated Rate |
$170.80 |
| Rate for Payer: Aetna Commercial |
$161.31
|
| Rate for Payer: BCBS Trust/PPO |
$154.92
|
| Rate for Payer: BCN Commercial |
$146.66
|
| Rate for Payer: Cash Price |
$151.82
|
| Rate for Payer: Cofinity Commercial |
$163.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$151.82
|
| Rate for Payer: Healthscope Commercial |
$170.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.31
|
| Rate for Payer: Nomi Health Commercial |
$155.62
|
| Rate for Payer: PHP Commercial |
$161.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.36
|
| Rate for Payer: Priority Health HMO/PPO |
$165.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.01
|
| Rate for Payer: UHC Core |
$158.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.34
|
|
