|
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: BCN Commercial |
$206.12
|
| Rate for Payer: BCN Medicare Advantage |
$66.28
|
| 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 |
$172.31
|
| 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 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 |
$172.31 |
| 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 |
$172.31
|
| 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 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 |
$123.89 |
| 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 |
$130.10
|
| Rate for Payer: BCBS MAPPO |
$163.86
|
| Rate for Payer: BCBS Trust/PPO |
$538.85
|
| 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 |
$123.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.06
|
| Rate for Payer: Meridian Medicaid |
$130.10
|
| 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 |
$123.89
|
| 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 |
$123.89
|
| Rate for Payer: VA VA |
$163.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$491.59
|
|
|
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 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 |
$506.74
|
| 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 |
$482.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.96
|
| Rate for Payer: Meridian Medicaid |
$506.74
|
| 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 |
$482.58
|
| 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 |
$482.58
|
| 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
|
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 |
$566.87
|
| 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 |
$184.65
|
| 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 |
$175.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.06
|
| Rate for Payer: Meridian Medicaid |
$184.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$191.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$566.87
|
| 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 |
$566.87
|
| Rate for Payer: PHP Medicare Advantage |
$166.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.49
|
| 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 |
$175.84
|
| Rate for Payer: VA VA |
$166.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$500.18
|
|
|
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 |
$433.49 |
| Max. Negotiated Rate |
$600.21 |
| Rate for Payer: Aetna Commercial |
$566.87
|
| 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 |
$566.87
|
| Rate for Payer: Nomi Health Commercial |
$546.86
|
| Rate for Payer: PHP Commercial |
$566.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$433.49
|
| 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 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
|
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 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 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 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 |
$37.45
|
| 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 |
$37.45
|
|
|
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 |
$37.45
|
| 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 |
$37.45
|
|
|
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
|
|
|
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 |
$47.45
|
| Rate for Payer: BCBS Trust/PPO |
$156.02
|
| Rate for Payer: BCN Commercial |
$147.55
|
| Rate for Payer: BCN Medicare Advantage |
$47.45
|
| 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 |
$47.45
|
| 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 |
$47.45
|
| Rate for Payer: PHP Commercial |
$161.31
|
| Rate for Payer: PHP Medicare Advantage |
$47.45
|
| 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 |
$47.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.01
|
| Rate for Payer: UHC Core |
$158.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.45
|
| Rate for Payer: UHC Exchange |
$47.45
|
| Rate for Payer: UHC Medicare Advantage |
$47.45
|
| Rate for Payer: VA VA |
$47.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.34
|
|
|
HC INTERCEDE ANTIADHESIVE
|
Facility
|
IP
|
$1,185.64
|
|
| Hospital Charge Code |
27200134
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$770.67 |
| Max. Negotiated Rate |
$1,067.08 |
| Rate for Payer: Aetna Commercial |
$1,007.79
|
| Rate for Payer: BCBS Trust/PPO |
$967.84
|
| Rate for Payer: BCN Commercial |
$916.26
|
| Rate for Payer: Cash Price |
$948.51
|
| Rate for Payer: Cofinity Commercial |
$1,019.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.51
|
| Rate for Payer: Healthscope Commercial |
$1,067.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$889.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.79
|
| Rate for Payer: Nomi Health Commercial |
$972.22
|
| Rate for Payer: PHP Commercial |
$1,007.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.67
|
| Rate for Payer: Priority Health HMO/PPO |
$1,031.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$794.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,043.36
|
| Rate for Payer: UHC Core |
$990.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$889.23
|
|
|
HC INTERCEDE ANTIADHESIVE
|
Facility
|
OP
|
$1,185.64
|
|
| Hospital Charge Code |
27200134
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$281.59 |
| Max. Negotiated Rate |
$1,067.08 |
| Rate for Payer: Aetna Commercial |
$1,007.79
|
| Rate for Payer: Aetna Medicare |
$308.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$370.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$370.51
|
| Rate for Payer: BCBS Complete |
$474.26
|
| Rate for Payer: BCBS MAPPO |
$296.41
|
| Rate for Payer: BCBS Trust/PPO |
$974.71
|
| Rate for Payer: BCN Commercial |
$921.84
|
| Rate for Payer: BCN Medicare Advantage |
$296.41
|
| Rate for Payer: Cash Price |
$948.51
|
| Rate for Payer: Cofinity Commercial |
$1,019.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.41
|
| Rate for Payer: Healthscope Commercial |
$1,067.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$889.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$340.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.79
|
| Rate for Payer: Nomi Health Commercial |
$972.22
|
| Rate for Payer: PACE Senior Care Partners |
$281.59
|
| Rate for Payer: PACE SWMI |
$296.41
|
| Rate for Payer: PHP Commercial |
$1,007.79
|
| Rate for Payer: PHP Medicare Advantage |
$296.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.67
|
| Rate for Payer: Priority Health HMO/PPO |
$1,031.51
|
| Rate for Payer: Priority Health Medicare |
$299.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$794.38
|
| Rate for Payer: Railroad Medicare Medicare |
$296.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,043.36
|
| Rate for Payer: UHC Core |
$990.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$296.41
|
| Rate for Payer: UHC Exchange |
$296.41
|
| Rate for Payer: UHC Medicare Advantage |
$296.41
|
| Rate for Payer: VA VA |
$296.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$889.23
|
|
|
HC INTERLEUKIN 6, PLASMA
|
Facility
|
OP
|
$131.58
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100710
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$118.42 |
| Rate for Payer: Aetna Commercial |
$111.84
|
| Rate for Payer: Aetna Medicare |
$34.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.12
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$32.90
|
| Rate for Payer: BCBS Trust/PPO |
$108.17
|
| Rate for Payer: BCN Commercial |
$102.30
|
| Rate for Payer: BCN Medicare Advantage |
$32.90
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cofinity Commercial |
$113.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.90
|
| Rate for Payer: Healthscope Commercial |
$118.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.69
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.54
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.84
|
| Rate for Payer: Nomi Health Commercial |
$107.90
|
| Rate for Payer: PACE Senior Care Partners |
$31.25
|
| Rate for Payer: PACE SWMI |
$32.90
|
| Rate for Payer: PHP Commercial |
$111.84
|
| Rate for Payer: PHP Medicare Advantage |
$32.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.53
|
| Rate for Payer: Priority Health HMO/PPO |
$114.47
|
| Rate for Payer: Priority Health Medicare |
$33.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.16
|
| Rate for Payer: Railroad Medicare Medicare |
$32.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.79
|
| Rate for Payer: UHC Core |
$109.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.90
|
| Rate for Payer: UHC Exchange |
$32.90
|
| Rate for Payer: UHC Medicare Advantage |
$32.90
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$32.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.69
|
|
|
HC INTERLEUKIN 6, PLASMA
|
Facility
|
IP
|
$131.58
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100710
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$85.53 |
| Max. Negotiated Rate |
$118.42 |
| Rate for Payer: Aetna Commercial |
$111.84
|
| Rate for Payer: BCBS Trust/PPO |
$107.41
|
| Rate for Payer: BCN Commercial |
$101.69
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cofinity Commercial |
$113.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.26
|
| Rate for Payer: Healthscope Commercial |
$118.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.84
|
| Rate for Payer: Nomi Health Commercial |
$107.90
|
| Rate for Payer: PHP Commercial |
$111.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.53
|
| Rate for Payer: Priority Health HMO/PPO |
$114.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.79
|
| Rate for Payer: UHC Core |
$109.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.69
|
|
|
HC INTERMEDIATE CARE R & B
|
Facility
|
IP
|
$4,896.09
|
|
| Hospital Charge Code |
20600001
|
|
Hospital Revenue Code
|
206
|
| Min. Negotiated Rate |
$3,182.46 |
| Max. Negotiated Rate |
$4,406.48 |
| Rate for Payer: Aetna Commercial |
$4,161.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,996.68
|
| Rate for Payer: BCN Commercial |
$3,783.70
|
| Rate for Payer: Cash Price |
$3,916.87
|
| Rate for Payer: Cofinity Commercial |
$4,210.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,916.87
|
| Rate for Payer: Healthscope Commercial |
$4,406.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,672.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,161.68
|
| Rate for Payer: Nomi Health Commercial |
$4,014.79
|
| Rate for Payer: PHP Commercial |
$4,161.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,182.46
|
| Rate for Payer: Priority Health HMO/PPO |
$4,259.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,280.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,308.56
|
| Rate for Payer: UHC Core |
$4,088.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,672.07
|
|
|
HC INTERMEDIATE NURSERY CARE
|
Facility
|
IP
|
$2,965.64
|
|
| Hospital Charge Code |
17100001
|
|
Hospital Revenue Code
|
171
|
| Min. Negotiated Rate |
$1,927.67 |
| Max. Negotiated Rate |
$2,669.08 |
| Rate for Payer: Aetna Commercial |
$2,520.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,420.85
|
| Rate for Payer: BCN Commercial |
$2,291.85
|
| Rate for Payer: Cash Price |
$2,372.51
|
| Rate for Payer: Cofinity Commercial |
$2,550.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,372.51
|
| Rate for Payer: Healthscope Commercial |
$2,669.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,224.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,520.79
|
| Rate for Payer: Nomi Health Commercial |
$2,431.82
|
| Rate for Payer: PHP Commercial |
$2,520.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,927.67
|
| Rate for Payer: Priority Health HMO/PPO |
$2,580.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,986.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,609.76
|
| Rate for Payer: UHC Core |
$2,476.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,224.23
|
|
|
HC INTERMEDIATE REPAIR WOUND NECK, HANDS, FEET, GENITALIA 2.6 TO 7.5 CM
|
Facility
|
IP
|
$536.85
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
76100117
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$348.95 |
| Max. Negotiated Rate |
$483.17 |
| Rate for Payer: Aetna Commercial |
$456.32
|
| Rate for Payer: BCBS Trust/PPO |
$438.23
|
| Rate for Payer: BCN Commercial |
$414.88
|
| Rate for Payer: Cash Price |
$429.48
|
| Rate for Payer: Cofinity Commercial |
$461.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.48
|
| Rate for Payer: Healthscope Commercial |
$483.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$402.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.32
|
| Rate for Payer: Nomi Health Commercial |
$440.22
|
| Rate for Payer: PHP Commercial |
$456.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.95
|
| Rate for Payer: Priority Health HMO/PPO |
$467.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$359.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$472.43
|
| Rate for Payer: UHC Core |
$448.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$402.64
|
|
|
HC INTERMEDIATE REPAIR WOUND NECK, HANDS, FEET, GENITALIA 2.6 TO 7.5 CM
|
Facility
|
OP
|
$536.85
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
76100117
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$127.50 |
| Max. Negotiated Rate |
$483.17 |
| Rate for Payer: Aetna Commercial |
$456.32
|
| Rate for Payer: Aetna Medicare |
$139.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$167.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$167.77
|
| Rate for Payer: BCBS Complete |
$303.32
|
| Rate for Payer: BCBS MAPPO |
$134.21
|
| Rate for Payer: BCBS Trust/PPO |
$441.34
|
| Rate for Payer: BCN Commercial |
$417.40
|
| Rate for Payer: BCN Medicare Advantage |
$134.21
|
| Rate for Payer: Cash Price |
$429.48
|
| Rate for Payer: Cash Price |
$429.48
|
| Rate for Payer: Cofinity Commercial |
$461.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.21
|
| Rate for Payer: Healthscope Commercial |
$483.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$402.64
|
| Rate for Payer: Mclaren Medicaid |
$288.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.92
|
| Rate for Payer: Meridian Medicaid |
$303.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$154.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.32
|
| Rate for Payer: Nomi Health Commercial |
$440.22
|
| Rate for Payer: PACE Senior Care Partners |
$127.50
|
| Rate for Payer: PACE SWMI |
$134.21
|
| Rate for Payer: PHP Commercial |
$456.32
|
| Rate for Payer: PHP Medicare Advantage |
$134.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.95
|
| Rate for Payer: Priority Health HMO/PPO |
$467.06
|
| Rate for Payer: Priority Health Medicare |
$135.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$359.69
|
| Rate for Payer: Railroad Medicare Medicare |
$134.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$472.43
|
| Rate for Payer: UHC Core |
$448.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.21
|
| Rate for Payer: UHC Exchange |
$134.21
|
| Rate for Payer: UHC Medicare Advantage |
$134.21
|
| Rate for Payer: UHCCP Medicaid |
$288.86
|
| Rate for Payer: VA VA |
$134.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$402.64
|
|
|
HC INTERP REN/VISC PTRA ADD VESS
|
Facility
|
OP
|
$1,888.39
|
|
| Hospital Charge Code |
32000266
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$448.49 |
| Max. Negotiated Rate |
$1,699.55 |
| Rate for Payer: Aetna Commercial |
$1,605.13
|
| Rate for Payer: Aetna Medicare |
$490.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$590.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$590.12
|
| Rate for Payer: BCBS Complete |
$755.36
|
| Rate for Payer: BCBS MAPPO |
$472.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,552.45
|
| Rate for Payer: BCN Commercial |
$1,468.22
|
| Rate for Payer: BCN Medicare Advantage |
$472.10
|
| Rate for Payer: Cash Price |
$1,510.71
|
| Rate for Payer: Cofinity Commercial |
$1,624.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,510.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$472.10
|
| Rate for Payer: Healthscope Commercial |
$1,699.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,416.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$495.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$542.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,605.13
|
| Rate for Payer: Nomi Health Commercial |
$1,548.48
|
| Rate for Payer: PACE Senior Care Partners |
$448.49
|
| Rate for Payer: PACE SWMI |
$472.10
|
| Rate for Payer: PHP Commercial |
$1,605.13
|
| Rate for Payer: PHP Medicare Advantage |
$472.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,642.90
|
| Rate for Payer: Priority Health Medicare |
$476.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,265.22
|
| Rate for Payer: Railroad Medicare Medicare |
$472.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,661.78
|
| Rate for Payer: UHC Core |
$1,576.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$472.10
|
| Rate for Payer: UHC Exchange |
$472.10
|
| Rate for Payer: UHC Medicare Advantage |
$472.10
|
| Rate for Payer: VA VA |
$472.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,416.29
|
|
