|
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
|
|
|
HC MECONIUM DRUG SCRN EA
|
Facility
|
OP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000144
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$86.78 |
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: Aetna Medicare |
$25.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.13
|
| Rate for Payer: BCBS Complete |
$17.85
|
| Rate for Payer: BCBS MAPPO |
$24.11
|
| Rate for Payer: BCBS Trust/PPO |
$79.27
|
| Rate for Payer: BCN Commercial |
$79.27
|
| Rate for Payer: BCN Medicare Advantage |
$24.11
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.11
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Mclaren Medicaid |
$17.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.31
|
| Rate for Payer: Meridian Medicaid |
$17.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$79.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PACE Senior Care Partners |
$22.90
|
| Rate for Payer: PACE SWMI |
$24.11
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: PHP Medicare Advantage |
$24.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.89
|
| Rate for Payer: Priority Health Medicare |
$24.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.11
|
| Rate for Payer: Railroad Medicare Medicare |
$24.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.85
|
| Rate for Payer: UHC Core |
$80.51
|
| Rate for Payer: UHC Exchange |
$24.11
|
| Rate for Payer: UHC Medicaid |
$17.00
|
| Rate for Payer: UHC Medicare Advantage |
$24.11
|
| Rate for Payer: UHCCP Medicaid |
$17.00
|
| Rate for Payer: VA VA |
$24.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC MECONIUM DRUG SCRN EA
|
Facility
|
IP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000144
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.11 |
| Max. Negotiated Rate |
$86.78 |
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: BCBS Trust/PPO |
$79.63
|
| Rate for Payer: BCN Commercial |
$79.63
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$79.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.85
|
| Rate for Payer: UHC Core |
$80.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC MECONIUM DRUG SCRN MULTI DRUGS.
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100653
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.71 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna Medicare |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.16
|
| Rate for Payer: BCBS Complete |
$19.64
|
| Rate for Payer: BCBS MAPPO |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$87.24
|
| Rate for Payer: BCN Commercial |
$87.24
|
| Rate for Payer: BCN Medicare Advantage |
$26.53
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.53
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Mclaren Medicaid |
$18.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.86
|
| Rate for Payer: Meridian Medicaid |
$19.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$87.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.59
|
| Rate for Payer: PACE Senior Care Partners |
$25.20
|
| Rate for Payer: PACE SWMI |
$26.53
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: PHP Medicare Advantage |
$26.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$92.32
|
| Rate for Payer: Priority Health Medicare |
$26.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.86
|
| Rate for Payer: Railroad Medicare Medicare |
$26.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.39
|
| Rate for Payer: UHC Core |
$88.61
|
| Rate for Payer: UHC Exchange |
$26.53
|
| Rate for Payer: UHC Medicaid |
$18.71
|
| Rate for Payer: UHC Medicare Advantage |
$26.53
|
| Rate for Payer: UHCCP Medicaid |
$18.71
|
| Rate for Payer: VA VA |
$26.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC MECONIUM DRUG SCRN MULTI DRUGS.
|
Facility
|
IP
|
$106.12
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100653
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$73.86 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: BCBS Trust/PPO |
$87.64
|
| Rate for Payer: BCN Commercial |
$87.64
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$87.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.59
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$92.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.39
|
| Rate for Payer: UHC Core |
$88.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC MECONIUM OPIATES CONFIRMATION
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100577
|
|
Hospital Revenue Code
|
301
|
| 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 OPIATES CONFIRMATION
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100577
|
|
Hospital Revenue Code
|
301
|
| 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 OXYCODONE CONFIRMATION
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 80365
|
| Hospital Charge Code |
30000104
|
|
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 OXYCODONE CONFIRMATION
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 80365
|
| Hospital Charge Code |
30000104
|
|
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 THC CONFIRMATION
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 80349
|
| Hospital Charge Code |
30100567
|
|
Hospital Revenue Code
|
301
|
| 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 THC CONFIRMATION
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 80349
|
| Hospital Charge Code |
30100567
|
|
Hospital Revenue Code
|
301
|
| 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 TRAMADOL CONFIRMATION
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 80373
|
| Hospital Charge Code |
30000101
|
|
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 TRAMADOL CONFIRMATION
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 80373
|
| Hospital Charge Code |
30000101
|
|
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 MEDICAL NUTRITION TX EACH 15"
|
Facility
|
OP
|
$66.44
|
|
|
Service Code
|
HCPCS G0270
|
| Hospital Charge Code |
94200008
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$11.71 |
| Max. Negotiated Rate |
$59.80 |
| Rate for Payer: Aetna Commercial |
$56.47
|
| Rate for Payer: Aetna Medicare |
$17.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.76
|
| Rate for Payer: BCBS Complete |
$12.30
|
| Rate for Payer: BCBS MAPPO |
$16.61
|
| Rate for Payer: BCBS Trust/PPO |
$54.62
|
| Rate for Payer: BCN Commercial |
$54.62
|
| Rate for Payer: BCN Medicare Advantage |
$16.61
|
| Rate for Payer: Cash Price |
$53.15
|
| Rate for Payer: Cofinity Commercial |
$57.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.61
|
| Rate for Payer: Healthscope Commercial |
$59.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.83
|
| Rate for Payer: Mclaren Medicaid |
$11.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.44
|
| Rate for Payer: Meridian Medicaid |
$12.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.47
|
| Rate for Payer: Nomi Health Commercial |
$54.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.83
|
| Rate for Payer: PACE Senior Care Partners |
$15.78
|
| Rate for Payer: PACE SWMI |
$16.61
|
| Rate for Payer: PHP Commercial |
$56.47
|
| Rate for Payer: PHP Medicare Advantage |
$16.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.80
|
| Rate for Payer: Priority Health Medicare |
$16.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.24
|
| Rate for Payer: Railroad Medicare Medicare |
$16.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.47
|
| Rate for Payer: UHC Core |
$55.48
|
| Rate for Payer: UHC Exchange |
$16.61
|
| Rate for Payer: UHC Medicaid |
$11.71
|
| Rate for Payer: UHC Medicare Advantage |
$16.61
|
| Rate for Payer: UHCCP Medicaid |
$11.71
|
| Rate for Payer: VA VA |
$16.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.83
|
|
|
HC MEDICAL NUTRITION TX EACH 15"
|
Facility
|
IP
|
$66.44
|
|
|
Service Code
|
HCPCS G0270
|
| Hospital Charge Code |
94200008
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$59.80 |
| Rate for Payer: Aetna Commercial |
$56.47
|
| Rate for Payer: BCBS Trust/PPO |
$54.87
|
| Rate for Payer: BCN Commercial |
$54.87
|
| Rate for Payer: Cash Price |
$53.15
|
| Rate for Payer: Cofinity Commercial |
$57.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.15
|
| Rate for Payer: Healthscope Commercial |
$59.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.47
|
| Rate for Payer: Nomi Health Commercial |
$54.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.83
|
| Rate for Payer: PHP Commercial |
$56.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.47
|
| Rate for Payer: UHC Core |
$55.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.83
|
|
|
HC MED PHYSIC DOS EVAL RAD EXPS
|
Facility
|
IP
|
$269.27
|
|
|
Service Code
|
CPT 76145
|
| Hospital Charge Code |
32000333
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$187.41 |
| Max. Negotiated Rate |
$242.34 |
| Rate for Payer: Aetna Commercial |
$228.88
|
| Rate for Payer: BCBS Trust/PPO |
$222.39
|
| Rate for Payer: BCN Commercial |
$222.39
|
| Rate for Payer: Cash Price |
$215.42
|
| Rate for Payer: Cofinity Commercial |
$231.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.42
|
| Rate for Payer: Healthscope Commercial |
$242.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.88
|
| Rate for Payer: Nomi Health Commercial |
$220.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.95
|
| Rate for Payer: PHP Commercial |
$228.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$234.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.96
|
| Rate for Payer: UHC Core |
$224.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.95
|
|
|
HC MED PHYSIC DOS EVAL RAD EXPS
|
Facility
|
OP
|
$269.27
|
|
|
Service Code
|
CPT 76145
|
| Hospital Charge Code |
32000333
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$47.47 |
| Max. Negotiated Rate |
$242.34 |
| Rate for Payer: Aetna Commercial |
$228.88
|
| Rate for Payer: Aetna Medicare |
$70.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.15
|
| Rate for Payer: BCBS Complete |
$49.84
|
| Rate for Payer: BCBS MAPPO |
$67.32
|
| Rate for Payer: BCBS Trust/PPO |
$221.37
|
| Rate for Payer: BCN Commercial |
$221.37
|
| Rate for Payer: BCN Medicare Advantage |
$67.32
|
| Rate for Payer: Cash Price |
$215.42
|
| Rate for Payer: Cofinity Commercial |
$231.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.32
|
| Rate for Payer: Healthscope Commercial |
$242.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.95
|
| Rate for Payer: Mclaren Medicaid |
$47.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.68
|
| Rate for Payer: Meridian Medicaid |
$49.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.88
|
| Rate for Payer: Nomi Health Commercial |
$220.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.95
|
| Rate for Payer: PACE Senior Care Partners |
$63.95
|
| Rate for Payer: PACE SWMI |
$67.32
|
| Rate for Payer: PHP Commercial |
$228.88
|
| Rate for Payer: PHP Medicare Advantage |
$67.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$234.26
|
| Rate for Payer: Priority Health Medicare |
$67.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.41
|
| Rate for Payer: Railroad Medicare Medicare |
$67.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.96
|
| Rate for Payer: UHC Core |
$224.84
|
| Rate for Payer: UHC Exchange |
$67.32
|
| Rate for Payer: UHC Medicaid |
$47.47
|
| Rate for Payer: UHC Medicare Advantage |
$67.32
|
| Rate for Payer: UHCCP Medicaid |
$47.47
|
| Rate for Payer: VA VA |
$67.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.95
|
|
|
HC MED SURG ROOM & BOARD
|
Facility
|
IP
|
$3,423.98
|
|
| Hospital Charge Code |
11000001
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$1,819.25 |
| Max. Negotiated Rate |
$3,081.58 |
| Rate for Payer: Aetna Commercial |
$2,910.38
|
| Rate for Payer: Aetna Medicare |
$1,991.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,393.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,393.75
|
| Rate for Payer: BCBS MAPPO |
$1,915.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,827.87
|
| Rate for Payer: BCN Commercial |
$2,827.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,915.00
|
| Rate for Payer: Cash Price |
$2,739.18
|
| Rate for Payer: Cash Price |
$2,739.18
|
| Rate for Payer: Cofinity Commercial |
$2,944.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,739.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,915.00
|
| Rate for Payer: Healthscope Commercial |
$3,081.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,567.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,010.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,202.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,106.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,910.38
|
| Rate for Payer: Nomi Health Commercial |
$2,807.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,567.99
|
| Rate for Payer: PACE Senior Care Partners |
$1,819.25
|
| Rate for Payer: PACE SWMI |
$1,915.00
|
| Rate for Payer: PHP Commercial |
$2,910.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,915.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,978.86
|
| Rate for Payer: Priority Health Medicare |
$1,934.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,383.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,915.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,013.10
|
| Rate for Payer: UHC Core |
$2,859.02
|
| Rate for Payer: UHC Exchange |
$1,915.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,915.00
|
| Rate for Payer: VA VA |
$1,915.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,567.99
|
|
|
HC MED SURVEILLANCE SH
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
HCPCS G0435
|
| Hospital Charge Code |
30200415
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.80 |
| 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 |
$9.24
|
| Rate for Payer: BCBS MAPPO |
$12.48
|
| Rate for Payer: BCBS Trust/PPO |
$41.06
|
| Rate for Payer: BCN Commercial |
$41.06
|
| Rate for Payer: BCN Medicare Advantage |
$12.48
|
| 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 |
$8.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.11
|
| Rate for Payer: Meridian Medicaid |
$9.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| 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 |
$8.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.45
|
| Rate for Payer: Priority Health Medicare |
$12.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.76
|
| 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 Exchange |
$12.48
|
| Rate for Payer: UHC Medicaid |
$8.80
|
| Rate for Payer: UHC Medicare Advantage |
$12.48
|
| Rate for Payer: UHCCP Medicaid |
$8.80
|
| Rate for Payer: VA VA |
$12.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.45
|
|
|
HC MED SURVEILLANCE SH
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
HCPCS G0435
|
| Hospital Charge Code |
30200415
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.76 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.25
|
| Rate for Payer: BCN Commercial |
$41.25
|
| 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: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.76
|
| 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 MEDTRONIC CRT ICD
|
Facility
|
IP
|
$30,562.79
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500006
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$21,271.70 |
| Max. Negotiated Rate |
$27,506.51 |
| Rate for Payer: Aetna Commercial |
$25,978.37
|
| Rate for Payer: BCBS Trust/PPO |
$25,241.81
|
| Rate for Payer: BCN Commercial |
$25,241.81
|
| Rate for Payer: Cash Price |
$24,450.23
|
| Rate for Payer: Cofinity Commercial |
$26,284.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,450.23
|
| Rate for Payer: Healthscope Commercial |
$27,506.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,922.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,978.37
|
| Rate for Payer: Nomi Health Commercial |
$25,061.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,922.09
|
| Rate for Payer: PHP Commercial |
$25,978.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26,589.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21,271.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,895.26
|
| Rate for Payer: UHC Core |
$25,519.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,922.09
|
|
|
HC MEDTRONIC CRT ICD
|
Facility
|
OP
|
$30,562.79
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500006
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,388.22 |
| Max. Negotiated Rate |
$27,506.51 |
| Rate for Payer: Aetna Commercial |
$25,978.37
|
| Rate for Payer: Aetna Medicare |
$7,946.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,550.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,550.87
|
| Rate for Payer: BCBS Complete |
$5,657.17
|
| Rate for Payer: BCBS MAPPO |
$7,640.70
|
| Rate for Payer: BCBS Trust/PPO |
$25,125.67
|
| Rate for Payer: BCN Commercial |
$25,125.67
|
| Rate for Payer: BCN Medicare Advantage |
$7,640.70
|
| Rate for Payer: Cash Price |
$24,450.23
|
| Rate for Payer: Cofinity Commercial |
$26,284.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,450.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,640.70
|
| Rate for Payer: Healthscope Commercial |
$27,506.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,922.09
|
| Rate for Payer: Mclaren Medicaid |
$5,388.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,022.73
|
| Rate for Payer: Meridian Medicaid |
$5,657.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,786.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,404.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,978.37
|
| Rate for Payer: Nomi Health Commercial |
$25,061.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,922.09
|
| Rate for Payer: PACE Senior Care Partners |
$7,258.66
|
| Rate for Payer: PACE SWMI |
$7,640.70
|
| Rate for Payer: PHP Commercial |
$25,978.37
|
| Rate for Payer: PHP Medicare Advantage |
$7,640.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,388.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26,589.63
|
| Rate for Payer: Priority Health Medicare |
$7,717.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21,271.70
|
| Rate for Payer: Railroad Medicare Medicare |
$7,640.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,895.26
|
| Rate for Payer: UHC Core |
$25,519.93
|
| Rate for Payer: UHC Exchange |
$7,640.70
|
| Rate for Payer: UHC Medicaid |
$5,388.22
|
| Rate for Payer: UHC Medicare Advantage |
$7,640.70
|
| Rate for Payer: UHCCP Medicaid |
$5,388.22
|
| Rate for Payer: VA VA |
$7,640.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,922.09
|
|
|
HC MEDTRONIC CRT LEAD
|
Facility
|
IP
|
$6,331.69
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,406.86 |
| Max. Negotiated Rate |
$5,698.52 |
| Rate for Payer: Aetna Commercial |
$5,381.94
|
| Rate for Payer: BCBS Trust/PPO |
$5,229.34
|
| Rate for Payer: BCN Commercial |
$5,229.34
|
| Rate for Payer: Cash Price |
$5,065.35
|
| Rate for Payer: Cofinity Commercial |
$5,445.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,065.35
|
| Rate for Payer: Healthscope Commercial |
$5,698.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,748.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,381.94
|
| Rate for Payer: Nomi Health Commercial |
$5,191.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,748.77
|
| Rate for Payer: PHP Commercial |
$5,381.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,508.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,406.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,571.89
|
| Rate for Payer: UHC Core |
$5,286.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,748.77
|
|
|
HC MEDTRONIC CRT LEAD
|
Facility
|
OP
|
$6,331.69
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,116.28 |
| Max. Negotiated Rate |
$5,698.52 |
| Rate for Payer: Aetna Commercial |
$5,381.94
|
| Rate for Payer: Aetna Medicare |
$1,646.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,978.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,978.65
|
| Rate for Payer: BCBS Complete |
$1,172.00
|
| Rate for Payer: BCBS MAPPO |
$1,582.92
|
| Rate for Payer: BCBS Trust/PPO |
$5,205.28
|
| Rate for Payer: BCN Commercial |
$5,205.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,582.92
|
| Rate for Payer: Cash Price |
$5,065.35
|
| Rate for Payer: Cofinity Commercial |
$5,445.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,065.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,582.92
|
| Rate for Payer: Healthscope Commercial |
$5,698.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,748.77
|
| Rate for Payer: Mclaren Medicaid |
$1,116.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,662.07
|
| Rate for Payer: Meridian Medicaid |
$1,172.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,820.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,741.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,381.94
|
| Rate for Payer: Nomi Health Commercial |
$5,191.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,748.77
|
| Rate for Payer: PACE Senior Care Partners |
$1,503.78
|
| Rate for Payer: PACE SWMI |
$1,582.92
|
| Rate for Payer: PHP Commercial |
$5,381.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,582.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,116.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,508.57
|
| Rate for Payer: Priority Health Medicare |
$1,598.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,406.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,582.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,571.89
|
| Rate for Payer: UHC Core |
$5,286.96
|
| Rate for Payer: UHC Exchange |
$1,582.92
|
| Rate for Payer: UHC Medicaid |
$1,116.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,582.92
|
| Rate for Payer: UHCCP Medicaid |
$1,116.28
|
| Rate for Payer: VA VA |
$1,582.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,748.77
|
|
|
HC MEDTRONIC DUAL PACEMAKER
|
Facility
|
OP
|
$9,020.27
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500007
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,590.27 |
| Max. Negotiated Rate |
$8,118.24 |
| Rate for Payer: Aetna Commercial |
$7,667.23
|
| Rate for Payer: Aetna Medicare |
$2,345.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,818.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,818.83
|
| Rate for Payer: BCBS Complete |
$1,669.65
|
| Rate for Payer: BCBS MAPPO |
$2,255.07
|
| Rate for Payer: BCBS Trust/PPO |
$7,415.56
|
| Rate for Payer: BCN Commercial |
$7,415.56
|
| Rate for Payer: BCN Medicare Advantage |
$2,255.07
|
| Rate for Payer: Cash Price |
$7,216.22
|
| Rate for Payer: Cofinity Commercial |
$7,757.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,216.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,255.07
|
| Rate for Payer: Healthscope Commercial |
$8,118.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,765.20
|
| Rate for Payer: Mclaren Medicaid |
$1,590.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,367.82
|
| Rate for Payer: Meridian Medicaid |
$1,669.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,593.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,480.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,667.23
|
| Rate for Payer: Nomi Health Commercial |
$7,396.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,765.20
|
| Rate for Payer: PACE Senior Care Partners |
$2,142.31
|
| Rate for Payer: PACE SWMI |
$2,255.07
|
| Rate for Payer: PHP Commercial |
$7,667.23
|
| Rate for Payer: PHP Medicare Advantage |
$2,255.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,590.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,847.63
|
| Rate for Payer: Priority Health Medicare |
$2,277.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,278.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,255.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,937.84
|
| Rate for Payer: UHC Core |
$7,531.93
|
| Rate for Payer: UHC Exchange |
$2,255.07
|
| Rate for Payer: UHC Medicaid |
$1,590.27
|
| Rate for Payer: UHC Medicare Advantage |
$2,255.07
|
| Rate for Payer: UHCCP Medicaid |
$1,590.27
|
| Rate for Payer: VA VA |
$2,255.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,765.20
|
|
