|
HC MAYO CREATININE, URINE CMPT
|
Facility
|
OP
|
$11.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100734
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$9.90 |
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: Aetna Medicare |
$2.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.44
|
| Rate for Payer: BCBS Complete |
$2.04
|
| Rate for Payer: BCBS MAPPO |
$2.75
|
| Rate for Payer: BCBS Trust/PPO |
$9.04
|
| Rate for Payer: BCN Commercial |
$9.04
|
| Rate for Payer: BCN Medicare Advantage |
$2.75
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.75
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.25
|
| Rate for Payer: Mclaren Medicaid |
$1.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.89
|
| Rate for Payer: Meridian Medicaid |
$2.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Nomi Health Commercial |
$9.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: PACE Senior Care Partners |
$2.61
|
| Rate for Payer: PACE SWMI |
$2.75
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: PHP Medicare Advantage |
$2.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.57
|
| Rate for Payer: Priority Health Medicare |
$2.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.68
|
| Rate for Payer: UHC Core |
$9.19
|
| Rate for Payer: UHC Exchange |
$2.75
|
| Rate for Payer: UHC Medicaid |
$1.94
|
| Rate for Payer: UHC Medicare Advantage |
$2.75
|
| Rate for Payer: UHCCP Medicaid |
$1.94
|
| Rate for Payer: VA VA |
$2.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.25
|
|
|
HC MAYO CREATININE, URINE CMPT
|
Facility
|
IP
|
$11.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100734
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$9.90 |
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: BCBS Trust/PPO |
$9.08
|
| Rate for Payer: BCN Commercial |
$9.08
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$9.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.80
|
| Rate for Payer: Healthscope Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Nomi Health Commercial |
$9.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: PHP Commercial |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.68
|
| Rate for Payer: UHC Core |
$9.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.25
|
|
|
HC MDI TREATMENT
|
Facility
|
OP
|
$152.66
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000004
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$26.91 |
| Max. Negotiated Rate |
$137.39 |
| Rate for Payer: Aetna Commercial |
$129.76
|
| Rate for Payer: Aetna Medicare |
$39.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.71
|
| Rate for Payer: BCBS Complete |
$28.26
|
| Rate for Payer: BCBS MAPPO |
$38.16
|
| Rate for Payer: BCBS Trust/PPO |
$125.50
|
| Rate for Payer: BCN Commercial |
$125.50
|
| Rate for Payer: BCN Medicare Advantage |
$38.16
|
| Rate for Payer: Cash Price |
$122.13
|
| Rate for Payer: Cofinity Commercial |
$131.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.16
|
| Rate for Payer: Healthscope Commercial |
$137.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.50
|
| Rate for Payer: Mclaren Medicaid |
$26.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.07
|
| Rate for Payer: Meridian Medicaid |
$28.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.76
|
| Rate for Payer: Nomi Health Commercial |
$125.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.50
|
| Rate for Payer: PACE Senior Care Partners |
$36.26
|
| Rate for Payer: PACE SWMI |
$38.16
|
| Rate for Payer: PHP Commercial |
$129.76
|
| Rate for Payer: PHP Medicare Advantage |
$38.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.81
|
| Rate for Payer: Priority Health Medicare |
$38.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.25
|
| Rate for Payer: Railroad Medicare Medicare |
$38.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.34
|
| Rate for Payer: UHC Core |
$127.47
|
| Rate for Payer: UHC Exchange |
$38.16
|
| Rate for Payer: UHC Medicaid |
$26.91
|
| Rate for Payer: UHC Medicare Advantage |
$38.16
|
| Rate for Payer: UHCCP Medicaid |
$26.91
|
| Rate for Payer: VA VA |
$38.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.50
|
|
|
HC MDI TREATMENT
|
Facility
|
IP
|
$152.66
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000004
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$106.25 |
| Max. Negotiated Rate |
$137.39 |
| Rate for Payer: Aetna Commercial |
$129.76
|
| Rate for Payer: BCBS Trust/PPO |
$126.08
|
| Rate for Payer: BCN Commercial |
$126.08
|
| Rate for Payer: Cash Price |
$122.13
|
| Rate for Payer: Cofinity Commercial |
$131.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.13
|
| Rate for Payer: Healthscope Commercial |
$137.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.76
|
| Rate for Payer: Nomi Health Commercial |
$125.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.50
|
| Rate for Payer: PHP Commercial |
$129.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.34
|
| Rate for Payer: UHC Core |
$127.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.50
|
|
|
HC MEADOW FESCUE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200092
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC MEADOW FESCUE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200092
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC MEASLES PCR THROAT
|
Facility
|
OP
|
$500.92
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600347
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$88.31 |
| Max. Negotiated Rate |
$450.83 |
| Rate for Payer: Aetna Commercial |
$425.78
|
| Rate for Payer: Aetna Medicare |
$130.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.54
|
| Rate for Payer: BCBS Complete |
$92.72
|
| Rate for Payer: BCBS MAPPO |
$125.23
|
| Rate for Payer: BCBS Trust/PPO |
$411.81
|
| Rate for Payer: BCN Commercial |
$411.81
|
| Rate for Payer: BCN Medicare Advantage |
$125.23
|
| Rate for Payer: Cash Price |
$400.74
|
| Rate for Payer: Cofinity Commercial |
$430.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.23
|
| Rate for Payer: Healthscope Commercial |
$450.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.69
|
| Rate for Payer: Mclaren Medicaid |
$88.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.49
|
| Rate for Payer: Meridian Medicaid |
$92.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.78
|
| Rate for Payer: Nomi Health Commercial |
$410.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.69
|
| Rate for Payer: PACE Senior Care Partners |
$118.97
|
| Rate for Payer: PACE SWMI |
$125.23
|
| Rate for Payer: PHP Commercial |
$425.78
|
| Rate for Payer: PHP Medicare Advantage |
$125.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$435.80
|
| Rate for Payer: Priority Health Medicare |
$126.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.64
|
| Rate for Payer: Railroad Medicare Medicare |
$125.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.81
|
| Rate for Payer: UHC Core |
$418.27
|
| Rate for Payer: UHC Exchange |
$125.23
|
| Rate for Payer: UHC Medicaid |
$88.31
|
| Rate for Payer: UHC Medicare Advantage |
$125.23
|
| Rate for Payer: UHCCP Medicaid |
$88.31
|
| Rate for Payer: VA VA |
$125.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.69
|
|
|
HC MEASLES PCR THROAT
|
Facility
|
IP
|
$500.92
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600347
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$348.64 |
| Max. Negotiated Rate |
$450.83 |
| Rate for Payer: Aetna Commercial |
$425.78
|
| Rate for Payer: BCBS Trust/PPO |
$413.71
|
| Rate for Payer: BCN Commercial |
$413.71
|
| Rate for Payer: Cash Price |
$400.74
|
| Rate for Payer: Cofinity Commercial |
$430.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.74
|
| Rate for Payer: Healthscope Commercial |
$450.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.78
|
| Rate for Payer: Nomi Health Commercial |
$410.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.69
|
| Rate for Payer: PHP Commercial |
$425.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$435.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$440.81
|
| Rate for Payer: UHC Core |
$418.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.69
|
|
|
HC MEASLES (RUBEOLA) IGM
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200398
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.19 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: BCBS Trust/PPO |
$42.95
|
| Rate for Payer: BCN Commercial |
$42.95
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$42.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.76
|
| Rate for Payer: UHC Core |
$43.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC MEASLES (RUBEOLA) IGM
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200398
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna Medicare |
$13.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.25
|
| Rate for Payer: BCBS Complete |
$9.63
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$42.75
|
| Rate for Payer: BCN Commercial |
$42.75
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Mclaren Medicaid |
$9.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.65
|
| Rate for Payer: Meridian Medicaid |
$9.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$42.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.24
|
| Rate for Payer: Priority Health Medicare |
$13.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.19
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.76
|
| Rate for Payer: UHC Core |
$43.42
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UHC Medicaid |
$9.17
|
| Rate for Payer: UHC Medicare Advantage |
$13.00
|
| Rate for Payer: UHCCP Medicaid |
$9.17
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC MECHANICAL REMOVAL OBSTRC CVD
|
Facility
|
IP
|
$1,599.40
|
|
|
Service Code
|
CPT 36596
|
| Hospital Charge Code |
36100143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,113.18 |
| Max. Negotiated Rate |
$1,439.46 |
| Rate for Payer: Aetna Commercial |
$1,359.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,320.94
|
| Rate for Payer: BCN Commercial |
$1,320.94
|
| Rate for Payer: Cash Price |
$1,279.52
|
| Rate for Payer: Cofinity Commercial |
$1,375.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,279.52
|
| Rate for Payer: Healthscope Commercial |
$1,439.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,199.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,359.49
|
| Rate for Payer: Nomi Health Commercial |
$1,311.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,199.55
|
| Rate for Payer: PHP Commercial |
$1,359.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,391.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,113.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,407.47
|
| Rate for Payer: UHC Core |
$1,335.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,199.55
|
|
|
HC MECHANICAL REMOVAL OBSTRC CVD
|
Facility
|
OP
|
$1,599.40
|
|
|
Service Code
|
CPT 36596
|
| Hospital Charge Code |
36100143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$281.97 |
| Max. Negotiated Rate |
$1,439.46 |
| Rate for Payer: Aetna Commercial |
$1,359.49
|
| Rate for Payer: Aetna Medicare |
$415.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$499.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$499.81
|
| Rate for Payer: BCBS Complete |
$296.05
|
| Rate for Payer: BCBS MAPPO |
$399.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,314.87
|
| Rate for Payer: BCN Commercial |
$1,314.87
|
| Rate for Payer: BCN Medicare Advantage |
$399.85
|
| Rate for Payer: Cash Price |
$1,279.52
|
| Rate for Payer: Cofinity Commercial |
$1,375.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,279.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$399.85
|
| Rate for Payer: Healthscope Commercial |
$1,439.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,199.55
|
| Rate for Payer: Mclaren Medicaid |
$281.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$419.84
|
| Rate for Payer: Meridian Medicaid |
$296.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$459.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$439.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,359.49
|
| Rate for Payer: Nomi Health Commercial |
$1,311.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,199.55
|
| Rate for Payer: PACE Senior Care Partners |
$379.86
|
| Rate for Payer: PACE SWMI |
$399.85
|
| Rate for Payer: PHP Commercial |
$1,359.49
|
| Rate for Payer: PHP Medicare Advantage |
$399.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,391.48
|
| Rate for Payer: Priority Health Medicare |
$403.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,113.18
|
| Rate for Payer: Railroad Medicare Medicare |
$399.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,407.47
|
| Rate for Payer: UHC Core |
$1,335.50
|
| Rate for Payer: UHC Exchange |
$399.85
|
| Rate for Payer: UHC Medicaid |
$281.97
|
| Rate for Payer: UHC Medicare Advantage |
$399.85
|
| Rate for Payer: UHCCP Medicaid |
$281.97
|
| Rate for Payer: VA VA |
$399.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,199.55
|
|
|
HC MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTION
|
Facility
|
IP
|
$3,021.82
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
36100142
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,103.19 |
| Max. Negotiated Rate |
$2,719.64 |
| Rate for Payer: Aetna Commercial |
$2,568.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,495.72
|
| Rate for Payer: BCN Commercial |
$2,495.72
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cofinity Commercial |
$2,598.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.46
|
| Rate for Payer: Healthscope Commercial |
$2,719.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,266.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.55
|
| Rate for Payer: Nomi Health Commercial |
$2,477.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.36
|
| Rate for Payer: PHP Commercial |
$2,568.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,628.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,103.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,659.20
|
| Rate for Payer: UHC Core |
$2,523.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,266.36
|
|
|
HC MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTION
|
Facility
|
OP
|
$3,021.82
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
36100142
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$532.75 |
| Max. Negotiated Rate |
$2,719.64 |
| Rate for Payer: Aetna Commercial |
$2,568.55
|
| Rate for Payer: Aetna Medicare |
$785.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$944.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$944.32
|
| Rate for Payer: BCBS Complete |
$559.34
|
| Rate for Payer: BCBS MAPPO |
$755.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,484.24
|
| Rate for Payer: BCN Commercial |
$2,484.24
|
| Rate for Payer: BCN Medicare Advantage |
$755.46
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cofinity Commercial |
$2,598.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$755.46
|
| Rate for Payer: Healthscope Commercial |
$2,719.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,266.36
|
| Rate for Payer: Mclaren Medicaid |
$532.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$793.23
|
| Rate for Payer: Meridian Medicaid |
$559.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$868.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$831.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.55
|
| Rate for Payer: Nomi Health Commercial |
$2,477.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.36
|
| Rate for Payer: PACE Senior Care Partners |
$717.68
|
| Rate for Payer: PACE SWMI |
$755.46
|
| Rate for Payer: PHP Commercial |
$2,568.55
|
| Rate for Payer: PHP Medicare Advantage |
$755.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$532.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,628.98
|
| Rate for Payer: Priority Health Medicare |
$763.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,103.19
|
| Rate for Payer: Railroad Medicare Medicare |
$755.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,659.20
|
| Rate for Payer: UHC Core |
$2,523.22
|
| Rate for Payer: UHC Exchange |
$755.46
|
| Rate for Payer: UHC Medicaid |
$532.75
|
| Rate for Payer: UHC Medicare Advantage |
$755.46
|
| Rate for Payer: UHCCP Medicaid |
$532.75
|
| Rate for Payer: VA VA |
$755.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,266.36
|
|
|
HC MECH CHEST WALL OSCILLATION
|
Facility
|
OP
|
$327.02
|
|
|
Service Code
|
CPT 94669
|
| Hospital Charge Code |
41000043
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$57.65 |
| Max. Negotiated Rate |
$294.32 |
| Rate for Payer: Aetna Commercial |
$277.97
|
| Rate for Payer: Aetna Medicare |
$85.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.19
|
| Rate for Payer: BCBS Complete |
$60.53
|
| Rate for Payer: BCBS MAPPO |
$81.75
|
| Rate for Payer: BCBS Trust/PPO |
$268.84
|
| Rate for Payer: BCN Commercial |
$268.84
|
| Rate for Payer: BCN Medicare Advantage |
$81.75
|
| Rate for Payer: Cash Price |
$261.62
|
| Rate for Payer: Cofinity Commercial |
$281.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.75
|
| Rate for Payer: Healthscope Commercial |
$294.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$245.26
|
| Rate for Payer: Mclaren Medicaid |
$57.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.84
|
| Rate for Payer: Meridian Medicaid |
$60.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$89.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.97
|
| Rate for Payer: Nomi Health Commercial |
$268.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.26
|
| Rate for Payer: PACE Senior Care Partners |
$77.67
|
| Rate for Payer: PACE SWMI |
$81.75
|
| Rate for Payer: PHP Commercial |
$277.97
|
| Rate for Payer: PHP Medicare Advantage |
$81.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$284.51
|
| Rate for Payer: Priority Health Medicare |
$82.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.61
|
| Rate for Payer: Railroad Medicare Medicare |
$81.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.78
|
| Rate for Payer: UHC Core |
$273.06
|
| Rate for Payer: UHC Exchange |
$81.75
|
| Rate for Payer: UHC Medicaid |
$57.65
|
| Rate for Payer: UHC Medicare Advantage |
$81.75
|
| Rate for Payer: UHCCP Medicaid |
$57.65
|
| Rate for Payer: VA VA |
$81.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$245.26
|
|
|
HC MECH CHEST WALL OSCILLATION
|
Facility
|
IP
|
$327.02
|
|
|
Service Code
|
CPT 94669
|
| Hospital Charge Code |
41000043
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$227.61 |
| Max. Negotiated Rate |
$294.32 |
| Rate for Payer: Aetna Commercial |
$277.97
|
| Rate for Payer: BCBS Trust/PPO |
$270.09
|
| Rate for Payer: BCN Commercial |
$270.09
|
| Rate for Payer: Cash Price |
$261.62
|
| Rate for Payer: Cofinity Commercial |
$281.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.62
|
| Rate for Payer: Healthscope Commercial |
$294.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$245.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.97
|
| Rate for Payer: Nomi Health Commercial |
$268.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.26
|
| Rate for Payer: PHP Commercial |
$277.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$284.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.78
|
| Rate for Payer: UHC Core |
$273.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$245.26
|
|
|
HC MECH VENT INITIAL DAY
|
Facility
|
OP
|
$1,536.90
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000002
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$270.96 |
| Max. Negotiated Rate |
$1,383.21 |
| Rate for Payer: Aetna Commercial |
$1,306.37
|
| Rate for Payer: Aetna Medicare |
$399.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$480.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$480.28
|
| Rate for Payer: BCBS Complete |
$284.48
|
| Rate for Payer: BCBS MAPPO |
$384.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,263.49
|
| Rate for Payer: BCN Commercial |
$1,263.49
|
| Rate for Payer: BCN Medicare Advantage |
$384.23
|
| Rate for Payer: Cash Price |
$1,229.52
|
| Rate for Payer: Cofinity Commercial |
$1,321.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$384.23
|
| Rate for Payer: Healthscope Commercial |
$1,383.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.67
|
| Rate for Payer: Mclaren Medicaid |
$270.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$403.44
|
| Rate for Payer: Meridian Medicaid |
$284.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$441.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$422.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.37
|
| Rate for Payer: Nomi Health Commercial |
$1,260.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,152.67
|
| Rate for Payer: PACE Senior Care Partners |
$365.01
|
| Rate for Payer: PACE SWMI |
$384.23
|
| Rate for Payer: PHP Commercial |
$1,306.37
|
| Rate for Payer: PHP Medicare Advantage |
$384.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,337.10
|
| Rate for Payer: Priority Health Medicare |
$388.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,069.68
|
| Rate for Payer: Railroad Medicare Medicare |
$384.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.47
|
| Rate for Payer: UHC Core |
$1,283.31
|
| Rate for Payer: UHC Exchange |
$384.23
|
| Rate for Payer: UHC Medicaid |
$270.96
|
| Rate for Payer: UHC Medicare Advantage |
$384.23
|
| Rate for Payer: UHCCP Medicaid |
$270.96
|
| Rate for Payer: VA VA |
$384.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.67
|
|
|
HC MECH VENT INITIAL DAY
|
Facility
|
IP
|
$1,536.90
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000002
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,069.68 |
| Max. Negotiated Rate |
$1,383.21 |
| Rate for Payer: Aetna Commercial |
$1,306.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,269.33
|
| Rate for Payer: BCN Commercial |
$1,269.33
|
| Rate for Payer: Cash Price |
$1,229.52
|
| Rate for Payer: Cofinity Commercial |
$1,321.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.52
|
| Rate for Payer: Healthscope Commercial |
$1,383.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.37
|
| Rate for Payer: Nomi Health Commercial |
$1,260.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,152.67
|
| Rate for Payer: PHP Commercial |
$1,306.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,337.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,069.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.47
|
| Rate for Payer: UHC Core |
$1,283.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.67
|
|
|
HC MECH VENT SUBS DAYS
|
Facility
|
OP
|
$1,338.85
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000003
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$236.04 |
| Max. Negotiated Rate |
$1,204.96 |
| Rate for Payer: Aetna Commercial |
$1,138.02
|
| Rate for Payer: Aetna Medicare |
$348.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$418.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$418.39
|
| Rate for Payer: BCBS Complete |
$247.82
|
| Rate for Payer: BCBS MAPPO |
$334.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.67
|
| Rate for Payer: BCN Commercial |
$1,100.67
|
| Rate for Payer: BCN Medicare Advantage |
$334.71
|
| Rate for Payer: Cash Price |
$1,071.08
|
| Rate for Payer: Cofinity Commercial |
$1,151.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,071.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$334.71
|
| Rate for Payer: Healthscope Commercial |
$1,204.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,004.14
|
| Rate for Payer: Mclaren Medicaid |
$236.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$351.45
|
| Rate for Payer: Meridian Medicaid |
$247.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$384.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$368.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,138.02
|
| Rate for Payer: Nomi Health Commercial |
$1,097.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,004.14
|
| Rate for Payer: PACE Senior Care Partners |
$317.98
|
| Rate for Payer: PACE SWMI |
$334.71
|
| Rate for Payer: PHP Commercial |
$1,138.02
|
| Rate for Payer: PHP Medicare Advantage |
$334.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$236.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,164.80
|
| Rate for Payer: Priority Health Medicare |
$338.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$931.84
|
| Rate for Payer: Railroad Medicare Medicare |
$334.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,178.19
|
| Rate for Payer: UHC Core |
$1,117.94
|
| Rate for Payer: UHC Exchange |
$334.71
|
| Rate for Payer: UHC Medicaid |
$236.04
|
| Rate for Payer: UHC Medicare Advantage |
$334.71
|
| Rate for Payer: UHCCP Medicaid |
$236.04
|
| Rate for Payer: VA VA |
$334.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,004.14
|
|
|
HC MECH VENT SUBS DAYS
|
Facility
|
IP
|
$1,338.85
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000003
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$931.84 |
| Max. Negotiated Rate |
$1,204.96 |
| Rate for Payer: Aetna Commercial |
$1,138.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,105.76
|
| Rate for Payer: BCN Commercial |
$1,105.76
|
| Rate for Payer: Cash Price |
$1,071.08
|
| Rate for Payer: Cofinity Commercial |
$1,151.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,071.08
|
| Rate for Payer: Healthscope Commercial |
$1,204.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,004.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,138.02
|
| Rate for Payer: Nomi Health Commercial |
$1,097.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,004.14
|
| Rate for Payer: PHP Commercial |
$1,138.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,164.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$931.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,178.19
|
| Rate for Payer: UHC Core |
$1,117.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,004.14
|
|
|
HC MECONIUM AMPHETAMINE CONFIRM
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30000099
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: BCBS Trust/PPO |
$98.82
|
| Rate for Payer: BCN Commercial |
$98.82
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.74
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.29
|
| Rate for Payer: UHC Core |
$99.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC MECONIUM AMPHETAMINE CONFIRM
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30000099
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna Medicare |
$31.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.39
|
| Rate for Payer: BCBS Complete |
$22.15
|
| Rate for Payer: BCBS MAPPO |
$29.91
|
| Rate for Payer: BCBS Trust/PPO |
$98.36
|
| Rate for Payer: BCN Commercial |
$98.36
|
| Rate for Payer: BCN Medicare Advantage |
$29.91
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.91
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Mclaren Medicaid |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.41
|
| Rate for Payer: Meridian Medicaid |
$22.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.74
|
| Rate for Payer: PACE Senior Care Partners |
$28.42
|
| Rate for Payer: PACE SWMI |
$29.91
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.10
|
| Rate for Payer: Priority Health Medicare |
$30.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.28
|
| Rate for Payer: Railroad Medicare Medicare |
$29.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.29
|
| Rate for Payer: UHC Core |
$99.91
|
| Rate for Payer: UHC Exchange |
$29.91
|
| Rate for Payer: UHC Medicaid |
$21.09
|
| Rate for Payer: UHC Medicare Advantage |
$29.91
|
| Rate for Payer: UHCCP Medicaid |
$21.09
|
| Rate for Payer: VA VA |
$29.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC MECONIUM BENZODIAZAPINE CONFIRMATION
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30000102
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: BCBS Trust/PPO |
$98.82
|
| Rate for Payer: BCN Commercial |
$98.82
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.74
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.29
|
| Rate for Payer: UHC Core |
$99.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC MECONIUM BENZODIAZAPINE CONFIRMATION
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30000102
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna Medicare |
$31.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.39
|
| Rate for Payer: BCBS Complete |
$22.15
|
| Rate for Payer: BCBS MAPPO |
$29.91
|
| Rate for Payer: BCBS Trust/PPO |
$98.36
|
| Rate for Payer: BCN Commercial |
$98.36
|
| Rate for Payer: BCN Medicare Advantage |
$29.91
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.91
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Mclaren Medicaid |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.41
|
| Rate for Payer: Meridian Medicaid |
$22.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.74
|
| Rate for Payer: PACE Senior Care Partners |
$28.42
|
| Rate for Payer: PACE SWMI |
$29.91
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.10
|
| Rate for Payer: Priority Health Medicare |
$30.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.28
|
| Rate for Payer: Railroad Medicare Medicare |
$29.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.29
|
| Rate for Payer: UHC Core |
$99.91
|
| Rate for Payer: UHC Exchange |
$29.91
|
| Rate for Payer: UHC Medicaid |
$21.09
|
| Rate for Payer: UHC Medicare Advantage |
$29.91
|
| Rate for Payer: UHCCP Medicaid |
$21.09
|
| Rate for Payer: VA VA |
$29.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC MECONIUM BUPRENORPHINE CONFIRMATION
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30000100
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: BCBS Trust/PPO |
$98.82
|
| Rate for Payer: BCN Commercial |
$98.82
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.74
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.29
|
| Rate for Payer: UHC Core |
$99.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
