|
HC MICU OBSERVATION PER HOUR
|
Facility
|
OP
|
$204.96
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200005
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$36.13 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$174.22
|
| Rate for Payer: Aetna Medicare |
$53.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.05
|
| Rate for Payer: BCBS Complete |
$37.94
|
| Rate for Payer: BCBS MAPPO |
$51.24
|
| Rate for Payer: BCBS Trust/PPO |
$168.50
|
| Rate for Payer: BCN Commercial |
$168.50
|
| Rate for Payer: BCN Medicare Advantage |
$51.24
|
| Rate for Payer: Cash Price |
$163.97
|
| Rate for Payer: Cash Price |
$163.97
|
| Rate for Payer: Cofinity Commercial |
$176.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.24
|
| Rate for Payer: Healthscope Commercial |
$184.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.72
|
| Rate for Payer: Mclaren Medicaid |
$36.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.80
|
| Rate for Payer: Meridian Medicaid |
$37.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.22
|
| Rate for Payer: Nomi Health Commercial |
$168.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.72
|
| Rate for Payer: PACE Senior Care Partners |
$48.68
|
| Rate for Payer: PACE SWMI |
$51.24
|
| Rate for Payer: PHP Commercial |
$174.22
|
| Rate for Payer: PHP Medicare Advantage |
$51.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$178.32
|
| Rate for Payer: Priority Health Medicare |
$51.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.65
|
| Rate for Payer: Railroad Medicare Medicare |
$51.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.36
|
| Rate for Payer: UHC Core |
$171.14
|
| Rate for Payer: UHC Exchange |
$51.24
|
| Rate for Payer: UHC Medicaid |
$36.13
|
| Rate for Payer: UHC Medicare Advantage |
$51.24
|
| Rate for Payer: UHCCP Medicaid |
$850.00
|
| Rate for Payer: VA VA |
$51.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.72
|
|
|
HC MICU OBSERVATION PER HOUR
|
Facility
|
IP
|
$204.96
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200005
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$142.65 |
| Max. Negotiated Rate |
$184.46 |
| Rate for Payer: Aetna Commercial |
$174.22
|
| Rate for Payer: BCBS Trust/PPO |
$169.28
|
| Rate for Payer: BCN Commercial |
$169.28
|
| Rate for Payer: Cash Price |
$163.97
|
| Rate for Payer: Cofinity Commercial |
$176.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.97
|
| Rate for Payer: Healthscope Commercial |
$184.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.22
|
| Rate for Payer: Nomi Health Commercial |
$168.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.72
|
| Rate for Payer: PHP Commercial |
$174.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$178.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.36
|
| Rate for Payer: UHC Core |
$171.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.72
|
|
|
HC MILK IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200047
|
|
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 MILK IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200047
|
|
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 MINI BAL PROCEDURE
|
Facility
|
OP
|
$315.45
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
41000014
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$55.61 |
| Max. Negotiated Rate |
$283.90 |
| Rate for Payer: Aetna Commercial |
$268.13
|
| Rate for Payer: Aetna Medicare |
$82.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.58
|
| Rate for Payer: BCBS Complete |
$58.39
|
| Rate for Payer: BCBS MAPPO |
$78.86
|
| Rate for Payer: BCBS Trust/PPO |
$259.33
|
| Rate for Payer: BCN Commercial |
$259.33
|
| Rate for Payer: BCN Medicare Advantage |
$78.86
|
| Rate for Payer: Cash Price |
$252.36
|
| Rate for Payer: Cofinity Commercial |
$271.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.86
|
| Rate for Payer: Healthscope Commercial |
$283.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.59
|
| Rate for Payer: Mclaren Medicaid |
$55.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.81
|
| Rate for Payer: Meridian Medicaid |
$58.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.13
|
| Rate for Payer: Nomi Health Commercial |
$258.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.59
|
| Rate for Payer: PACE Senior Care Partners |
$74.92
|
| Rate for Payer: PACE SWMI |
$78.86
|
| Rate for Payer: PHP Commercial |
$268.13
|
| Rate for Payer: PHP Medicare Advantage |
$78.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.44
|
| Rate for Payer: Priority Health Medicare |
$79.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.55
|
| Rate for Payer: Railroad Medicare Medicare |
$78.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.60
|
| Rate for Payer: UHC Core |
$263.40
|
| Rate for Payer: UHC Exchange |
$78.86
|
| Rate for Payer: UHC Medicaid |
$55.61
|
| Rate for Payer: UHC Medicare Advantage |
$78.86
|
| Rate for Payer: UHCCP Medicaid |
$55.61
|
| Rate for Payer: VA VA |
$78.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.59
|
|
|
HC MINI BAL PROCEDURE
|
Facility
|
IP
|
$315.45
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
41000014
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$219.55 |
| Max. Negotiated Rate |
$283.90 |
| Rate for Payer: Aetna Commercial |
$268.13
|
| Rate for Payer: BCBS Trust/PPO |
$260.53
|
| Rate for Payer: BCN Commercial |
$260.53
|
| Rate for Payer: Cash Price |
$252.36
|
| Rate for Payer: Cofinity Commercial |
$271.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.36
|
| Rate for Payer: Healthscope Commercial |
$283.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.13
|
| Rate for Payer: Nomi Health Commercial |
$258.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.59
|
| Rate for Payer: PHP Commercial |
$268.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$274.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.60
|
| Rate for Payer: UHC Core |
$263.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.59
|
|
|
HC MINIMUM BACTERICIDAL CONCENTRA
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
30600103
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.50 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$8.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.75
|
| Rate for Payer: BCBS Complete |
$5.78
|
| Rate for Payer: BCBS MAPPO |
$7.80
|
| Rate for Payer: BCBS Trust/PPO |
$25.66
|
| Rate for Payer: BCN Commercial |
$25.66
|
| Rate for Payer: BCN Medicare Advantage |
$7.80
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.80
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$5.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.19
|
| Rate for Payer: Meridian Medicaid |
$5.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PACE Senior Care Partners |
$7.41
|
| Rate for Payer: PACE SWMI |
$7.80
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$7.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Medicare |
$7.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.72
|
| Rate for Payer: Railroad Medicare Medicare |
$7.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: UHC Exchange |
$7.80
|
| Rate for Payer: UHC Medicaid |
$5.50
|
| Rate for Payer: UHC Medicare Advantage |
$7.80
|
| Rate for Payer: UHCCP Medicaid |
$5.50
|
| Rate for Payer: VA VA |
$7.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC MINIMUM BACTERICIDAL CONCENTRA
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
30600103
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.72 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$25.78
|
| Rate for Payer: BCN Commercial |
$25.78
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC MINIMUM LETHAL CONCENTRATION (MLC)
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 87187
|
| Hospital Charge Code |
30600102
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.24 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: BCBS Trust/PPO |
$39.44
|
| Rate for Payer: BCN Commercial |
$39.44
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC MINIMUM LETHAL CONCENTRATION (MLC)
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 87187
|
| Hospital Charge Code |
30600102
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.42 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$12.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.93
|
| Rate for Payer: BCBS Complete |
$8.84
|
| Rate for Payer: BCBS MAPPO |
$11.94
|
| Rate for Payer: BCBS Trust/PPO |
$39.26
|
| Rate for Payer: BCN Commercial |
$39.26
|
| Rate for Payer: BCN Medicare Advantage |
$11.94
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Mclaren Medicaid |
$8.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.54
|
| Rate for Payer: Meridian Medicaid |
$8.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Senior Care Partners |
$11.34
|
| Rate for Payer: PACE SWMI |
$11.94
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$11.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Medicare |
$12.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.24
|
| Rate for Payer: Railroad Medicare Medicare |
$11.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: UHC Exchange |
$11.94
|
| Rate for Payer: UHC Medicaid |
$8.42
|
| Rate for Payer: UHC Medicare Advantage |
$11.94
|
| Rate for Payer: UHCCP Medicaid |
$8.42
|
| Rate for Payer: VA VA |
$11.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC MINOR PROCEDURE WO SEDATION
|
Facility
|
IP
|
$542.17
|
|
| Hospital Charge Code |
36000076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$377.35 |
| Max. Negotiated Rate |
$487.95 |
| Rate for Payer: Aetna Commercial |
$460.84
|
| Rate for Payer: BCBS Trust/PPO |
$447.78
|
| Rate for Payer: BCN Commercial |
$447.78
|
| Rate for Payer: Cash Price |
$433.74
|
| Rate for Payer: Cofinity Commercial |
$466.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.74
|
| Rate for Payer: Healthscope Commercial |
$487.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.84
|
| Rate for Payer: Nomi Health Commercial |
$444.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$406.63
|
| Rate for Payer: PHP Commercial |
$460.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$471.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.11
|
| Rate for Payer: UHC Core |
$452.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.63
|
|
|
HC MINOR PROCEDURE WO SEDATION
|
Facility
|
OP
|
$542.17
|
|
| Hospital Charge Code |
36000076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$95.58 |
| Max. Negotiated Rate |
$487.95 |
| Rate for Payer: Aetna Commercial |
$460.84
|
| Rate for Payer: Aetna Medicare |
$140.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.43
|
| Rate for Payer: BCBS Complete |
$100.36
|
| Rate for Payer: BCBS MAPPO |
$135.54
|
| Rate for Payer: BCBS Trust/PPO |
$445.72
|
| Rate for Payer: BCN Commercial |
$445.72
|
| Rate for Payer: BCN Medicare Advantage |
$135.54
|
| Rate for Payer: Cash Price |
$433.74
|
| Rate for Payer: Cofinity Commercial |
$466.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.54
|
| Rate for Payer: Healthscope Commercial |
$487.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.63
|
| Rate for Payer: Mclaren Medicaid |
$95.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.32
|
| Rate for Payer: Meridian Medicaid |
$100.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$155.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$149.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.84
|
| Rate for Payer: Nomi Health Commercial |
$444.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$406.63
|
| Rate for Payer: PACE Senior Care Partners |
$128.77
|
| Rate for Payer: PACE SWMI |
$135.54
|
| Rate for Payer: PHP Commercial |
$460.84
|
| Rate for Payer: PHP Medicare Advantage |
$135.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$471.69
|
| Rate for Payer: Priority Health Medicare |
$136.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$377.35
|
| Rate for Payer: Railroad Medicare Medicare |
$135.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.11
|
| Rate for Payer: UHC Core |
$452.71
|
| Rate for Payer: UHC Exchange |
$135.54
|
| Rate for Payer: UHC Medicaid |
$95.58
|
| Rate for Payer: UHC Medicare Advantage |
$135.54
|
| Rate for Payer: UHCCP Medicaid |
$95.58
|
| Rate for Payer: VA VA |
$135.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.63
|
|
|
HC MINOR PROCEDURE W SEDATION
|
Facility
|
OP
|
$628.24
|
|
| Hospital Charge Code |
36000075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$110.76 |
| Max. Negotiated Rate |
$565.42 |
| Rate for Payer: Aetna Commercial |
$534.00
|
| Rate for Payer: Aetna Medicare |
$163.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$196.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$196.32
|
| Rate for Payer: BCBS Complete |
$116.29
|
| Rate for Payer: BCBS MAPPO |
$157.06
|
| Rate for Payer: BCBS Trust/PPO |
$516.48
|
| Rate for Payer: BCN Commercial |
$516.48
|
| Rate for Payer: BCN Medicare Advantage |
$157.06
|
| Rate for Payer: Cash Price |
$502.59
|
| Rate for Payer: Cofinity Commercial |
$540.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.06
|
| Rate for Payer: Healthscope Commercial |
$565.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$471.18
|
| Rate for Payer: Mclaren Medicaid |
$110.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.91
|
| Rate for Payer: Meridian Medicaid |
$116.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$172.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.00
|
| Rate for Payer: Nomi Health Commercial |
$515.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$471.18
|
| Rate for Payer: PACE Senior Care Partners |
$149.21
|
| Rate for Payer: PACE SWMI |
$157.06
|
| Rate for Payer: PHP Commercial |
$534.00
|
| Rate for Payer: PHP Medicare Advantage |
$157.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$546.57
|
| Rate for Payer: Priority Health Medicare |
$158.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$437.26
|
| Rate for Payer: Railroad Medicare Medicare |
$157.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.85
|
| Rate for Payer: UHC Core |
$524.58
|
| Rate for Payer: UHC Exchange |
$157.06
|
| Rate for Payer: UHC Medicaid |
$110.76
|
| Rate for Payer: UHC Medicare Advantage |
$157.06
|
| Rate for Payer: UHCCP Medicaid |
$110.76
|
| Rate for Payer: VA VA |
$157.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.18
|
|
|
HC MINOR PROCEDURE W SEDATION
|
Facility
|
IP
|
$628.24
|
|
| Hospital Charge Code |
36000075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$437.26 |
| Max. Negotiated Rate |
$565.42 |
| Rate for Payer: Aetna Commercial |
$534.00
|
| Rate for Payer: BCBS Trust/PPO |
$518.86
|
| Rate for Payer: BCN Commercial |
$518.86
|
| Rate for Payer: Cash Price |
$502.59
|
| Rate for Payer: Cofinity Commercial |
$540.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.59
|
| Rate for Payer: Healthscope Commercial |
$565.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$471.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.00
|
| Rate for Payer: Nomi Health Commercial |
$515.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$471.18
|
| Rate for Payer: PHP Commercial |
$534.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$546.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$437.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.85
|
| Rate for Payer: UHC Core |
$524.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.18
|
|
|
HC MITOTANE (LYSODREN)
|
Facility
|
IP
|
$119.87
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100731
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$83.43 |
| Max. Negotiated Rate |
$107.88 |
| Rate for Payer: Aetna Commercial |
$101.89
|
| Rate for Payer: BCBS Trust/PPO |
$99.00
|
| Rate for Payer: BCN Commercial |
$99.00
|
| Rate for Payer: Cash Price |
$95.90
|
| Rate for Payer: Cofinity Commercial |
$103.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.90
|
| Rate for Payer: Healthscope Commercial |
$107.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.89
|
| Rate for Payer: Nomi Health Commercial |
$98.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.90
|
| Rate for Payer: PHP Commercial |
$101.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.49
|
| Rate for Payer: UHC Core |
$100.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.90
|
|
|
HC MITOTANE (LYSODREN)
|
Facility
|
OP
|
$119.87
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100731
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.13 |
| Max. Negotiated Rate |
$107.88 |
| Rate for Payer: Aetna Commercial |
$101.89
|
| Rate for Payer: Aetna Medicare |
$31.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.46
|
| Rate for Payer: BCBS Complete |
$22.19
|
| Rate for Payer: BCBS MAPPO |
$29.97
|
| Rate for Payer: BCBS Trust/PPO |
$98.55
|
| Rate for Payer: BCN Commercial |
$98.55
|
| Rate for Payer: BCN Medicare Advantage |
$29.97
|
| Rate for Payer: Cash Price |
$95.90
|
| Rate for Payer: Cofinity Commercial |
$103.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.97
|
| Rate for Payer: Healthscope Commercial |
$107.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.90
|
| Rate for Payer: Mclaren Medicaid |
$21.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.47
|
| Rate for Payer: Meridian Medicaid |
$22.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.89
|
| Rate for Payer: Nomi Health Commercial |
$98.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.90
|
| Rate for Payer: PACE Senior Care Partners |
$28.47
|
| Rate for Payer: PACE SWMI |
$29.97
|
| Rate for Payer: PHP Commercial |
$101.89
|
| Rate for Payer: PHP Medicare Advantage |
$29.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.29
|
| Rate for Payer: Priority Health Medicare |
$30.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.43
|
| Rate for Payer: Railroad Medicare Medicare |
$29.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.49
|
| Rate for Payer: UHC Core |
$100.09
|
| Rate for Payer: UHC Exchange |
$29.97
|
| Rate for Payer: UHC Medicaid |
$21.13
|
| Rate for Payer: UHC Medicare Advantage |
$29.97
|
| Rate for Payer: UHCCP Medicaid |
$21.13
|
| Rate for Payer: VA VA |
$29.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.90
|
|
|
HC MMR VACCINE
|
Facility
|
OP
|
$111.42
|
|
|
Service Code
|
CPT 90707
|
| Hospital Charge Code |
63600027
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.64 |
| Max. Negotiated Rate |
$100.28 |
| Rate for Payer: Aetna Commercial |
$94.71
|
| Rate for Payer: Aetna Medicare |
$28.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.82
|
| Rate for Payer: BCBS Complete |
$20.62
|
| Rate for Payer: BCBS MAPPO |
$27.86
|
| Rate for Payer: BCBS Trust/PPO |
$91.60
|
| Rate for Payer: BCN Commercial |
$91.60
|
| Rate for Payer: BCN Medicare Advantage |
$27.86
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$95.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.86
|
| Rate for Payer: Healthscope Commercial |
$100.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.56
|
| Rate for Payer: Mclaren Medicaid |
$19.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.25
|
| Rate for Payer: Meridian Medicaid |
$20.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.71
|
| Rate for Payer: Nomi Health Commercial |
$91.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.56
|
| Rate for Payer: PACE Senior Care Partners |
$26.46
|
| Rate for Payer: PACE SWMI |
$27.86
|
| Rate for Payer: PHP Commercial |
$94.71
|
| Rate for Payer: PHP Medicare Advantage |
$27.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.94
|
| Rate for Payer: Priority Health Medicare |
$28.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.55
|
| Rate for Payer: Railroad Medicare Medicare |
$27.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.05
|
| Rate for Payer: UHC Core |
$93.04
|
| Rate for Payer: UHC Exchange |
$27.86
|
| Rate for Payer: UHC Medicaid |
$19.64
|
| Rate for Payer: UHC Medicare Advantage |
$27.86
|
| Rate for Payer: UHCCP Medicaid |
$19.64
|
| Rate for Payer: VA VA |
$27.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.56
|
|
|
HC MMR VACCINE
|
Facility
|
IP
|
$111.42
|
|
|
Service Code
|
CPT 90707
|
| Hospital Charge Code |
63600027
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$77.55 |
| Max. Negotiated Rate |
$100.28 |
| Rate for Payer: Aetna Commercial |
$94.71
|
| Rate for Payer: BCBS Trust/PPO |
$92.02
|
| Rate for Payer: BCN Commercial |
$92.02
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$95.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.14
|
| Rate for Payer: Healthscope Commercial |
$100.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.71
|
| Rate for Payer: Nomi Health Commercial |
$91.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.56
|
| Rate for Payer: PHP Commercial |
$94.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.05
|
| Rate for Payer: UHC Core |
$93.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.56
|
|
|
HC MNT GROUP 2ND REFERRAL 30 MIN
|
Facility
|
OP
|
$52.63
|
|
|
Service Code
|
HCPCS G0271
|
| Hospital Charge Code |
94200009
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$47.37 |
| Rate for Payer: Aetna Commercial |
$44.74
|
| Rate for Payer: Aetna Medicare |
$13.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.45
|
| Rate for Payer: BCBS Complete |
$9.74
|
| Rate for Payer: BCBS MAPPO |
$13.16
|
| Rate for Payer: BCBS Trust/PPO |
$43.27
|
| Rate for Payer: BCN Commercial |
$43.27
|
| Rate for Payer: BCN Medicare Advantage |
$13.16
|
| Rate for Payer: Cash Price |
$42.10
|
| Rate for Payer: Cofinity Commercial |
$45.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.16
|
| Rate for Payer: Healthscope Commercial |
$47.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.47
|
| Rate for Payer: Mclaren Medicaid |
$9.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.82
|
| Rate for Payer: Meridian Medicaid |
$9.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.74
|
| Rate for Payer: Nomi Health Commercial |
$43.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.47
|
| Rate for Payer: PACE Senior Care Partners |
$12.50
|
| Rate for Payer: PACE SWMI |
$13.16
|
| Rate for Payer: PHP Commercial |
$44.74
|
| Rate for Payer: PHP Medicare Advantage |
$13.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.79
|
| Rate for Payer: Priority Health Medicare |
$13.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.63
|
| Rate for Payer: Railroad Medicare Medicare |
$13.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.31
|
| Rate for Payer: UHC Core |
$43.95
|
| Rate for Payer: UHC Exchange |
$13.16
|
| Rate for Payer: UHC Medicaid |
$9.28
|
| Rate for Payer: UHC Medicare Advantage |
$13.16
|
| Rate for Payer: UHCCP Medicaid |
$9.28
|
| Rate for Payer: VA VA |
$13.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.47
|
|
|
HC MNT GROUP 2ND REFERRAL 30 MIN
|
Facility
|
IP
|
$52.63
|
|
|
Service Code
|
HCPCS G0271
|
| Hospital Charge Code |
94200009
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$36.63 |
| Max. Negotiated Rate |
$47.37 |
| Rate for Payer: Aetna Commercial |
$44.74
|
| Rate for Payer: BCBS Trust/PPO |
$43.47
|
| Rate for Payer: BCN Commercial |
$43.47
|
| Rate for Payer: Cash Price |
$42.10
|
| Rate for Payer: Cofinity Commercial |
$45.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.10
|
| Rate for Payer: Healthscope Commercial |
$47.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.74
|
| Rate for Payer: Nomi Health Commercial |
$43.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.47
|
| Rate for Payer: PHP Commercial |
$44.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.31
|
| Rate for Payer: UHC Core |
$43.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.47
|
|
|
HC MNT GROUP 30 MIN
|
Facility
|
OP
|
$61.74
|
|
|
Service Code
|
CPT 97804
|
| Hospital Charge Code |
94200004
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$10.88 |
| Max. Negotiated Rate |
$55.57 |
| Rate for Payer: Aetna Commercial |
$52.48
|
| Rate for Payer: Aetna Medicare |
$16.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.29
|
| Rate for Payer: BCBS Complete |
$11.43
|
| Rate for Payer: BCBS MAPPO |
$15.44
|
| Rate for Payer: BCBS Trust/PPO |
$50.76
|
| Rate for Payer: BCN Commercial |
$50.76
|
| Rate for Payer: BCN Medicare Advantage |
$15.44
|
| Rate for Payer: Cash Price |
$49.39
|
| Rate for Payer: Cofinity Commercial |
$53.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.44
|
| Rate for Payer: Healthscope Commercial |
$55.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.30
|
| Rate for Payer: Mclaren Medicaid |
$10.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.21
|
| Rate for Payer: Meridian Medicaid |
$11.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.48
|
| Rate for Payer: Nomi Health Commercial |
$50.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.30
|
| Rate for Payer: PACE Senior Care Partners |
$14.66
|
| Rate for Payer: PACE SWMI |
$15.44
|
| Rate for Payer: PHP Commercial |
$52.48
|
| Rate for Payer: PHP Medicare Advantage |
$15.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.71
|
| Rate for Payer: Priority Health Medicare |
$15.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.97
|
| Rate for Payer: Railroad Medicare Medicare |
$15.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.33
|
| Rate for Payer: UHC Core |
$51.55
|
| Rate for Payer: UHC Exchange |
$15.44
|
| Rate for Payer: UHC Medicaid |
$10.88
|
| Rate for Payer: UHC Medicare Advantage |
$15.44
|
| Rate for Payer: UHCCP Medicaid |
$10.88
|
| Rate for Payer: VA VA |
$15.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.30
|
|
|
HC MNT GROUP 30 MIN
|
Facility
|
IP
|
$61.74
|
|
|
Service Code
|
CPT 97804
|
| Hospital Charge Code |
94200004
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$42.97 |
| Max. Negotiated Rate |
$55.57 |
| Rate for Payer: Aetna Commercial |
$52.48
|
| Rate for Payer: BCBS Trust/PPO |
$50.99
|
| Rate for Payer: BCN Commercial |
$50.99
|
| Rate for Payer: Cash Price |
$49.39
|
| Rate for Payer: Cofinity Commercial |
$53.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.39
|
| Rate for Payer: Healthscope Commercial |
$55.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.48
|
| Rate for Payer: Nomi Health Commercial |
$50.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.30
|
| Rate for Payer: PHP Commercial |
$52.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.33
|
| Rate for Payer: UHC Core |
$51.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.30
|
|
|
HC MNT INITIAL 15 MIN
|
Facility
|
IP
|
$141.43
|
|
|
Service Code
|
CPT 97802
|
| Hospital Charge Code |
94200002
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$98.44 |
| Max. Negotiated Rate |
$127.29 |
| Rate for Payer: Aetna Commercial |
$120.22
|
| Rate for Payer: BCBS Trust/PPO |
$116.81
|
| Rate for Payer: BCN Commercial |
$116.81
|
| Rate for Payer: Cash Price |
$113.14
|
| Rate for Payer: Cofinity Commercial |
$121.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.14
|
| Rate for Payer: Healthscope Commercial |
$127.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.22
|
| Rate for Payer: Nomi Health Commercial |
$115.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.07
|
| Rate for Payer: PHP Commercial |
$120.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$123.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.46
|
| Rate for Payer: UHC Core |
$118.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.07
|
|
|
HC MNT INITIAL 15 MIN
|
Facility
|
OP
|
$141.43
|
|
|
Service Code
|
CPT 97802
|
| Hospital Charge Code |
94200002
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$24.93 |
| Max. Negotiated Rate |
$127.29 |
| Rate for Payer: Aetna Commercial |
$120.22
|
| Rate for Payer: Aetna Medicare |
$36.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.20
|
| Rate for Payer: BCBS Complete |
$26.18
|
| Rate for Payer: BCBS MAPPO |
$35.36
|
| Rate for Payer: BCBS Trust/PPO |
$116.27
|
| Rate for Payer: BCN Commercial |
$116.27
|
| Rate for Payer: BCN Medicare Advantage |
$35.36
|
| Rate for Payer: Cash Price |
$113.14
|
| Rate for Payer: Cofinity Commercial |
$121.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.36
|
| Rate for Payer: Healthscope Commercial |
$127.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.07
|
| Rate for Payer: Mclaren Medicaid |
$24.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.13
|
| Rate for Payer: Meridian Medicaid |
$26.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.22
|
| Rate for Payer: Nomi Health Commercial |
$115.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.07
|
| Rate for Payer: PACE Senior Care Partners |
$33.59
|
| Rate for Payer: PACE SWMI |
$35.36
|
| Rate for Payer: PHP Commercial |
$120.22
|
| Rate for Payer: PHP Medicare Advantage |
$35.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$123.04
|
| Rate for Payer: Priority Health Medicare |
$35.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.44
|
| Rate for Payer: Railroad Medicare Medicare |
$35.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.46
|
| Rate for Payer: UHC Core |
$118.09
|
| Rate for Payer: UHC Exchange |
$35.36
|
| Rate for Payer: UHC Medicaid |
$24.93
|
| Rate for Payer: UHC Medicare Advantage |
$35.36
|
| Rate for Payer: UHCCP Medicaid |
$24.93
|
| Rate for Payer: VA VA |
$35.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.07
|
|
|
HC MNT REASSESS & INTERVENT 15 MIN
|
Facility
|
OP
|
$125.01
|
|
|
Service Code
|
CPT 97803
|
| Hospital Charge Code |
94200003
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$22.04 |
| Max. Negotiated Rate |
$112.51 |
| Rate for Payer: Aetna Commercial |
$106.26
|
| Rate for Payer: Aetna Medicare |
$32.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.07
|
| Rate for Payer: BCBS Complete |
$23.14
|
| Rate for Payer: BCBS MAPPO |
$31.25
|
| Rate for Payer: BCBS Trust/PPO |
$102.77
|
| Rate for Payer: BCN Commercial |
$102.77
|
| Rate for Payer: BCN Medicare Advantage |
$31.25
|
| Rate for Payer: Cash Price |
$100.01
|
| Rate for Payer: Cofinity Commercial |
$107.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.25
|
| Rate for Payer: Healthscope Commercial |
$112.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.76
|
| Rate for Payer: Mclaren Medicaid |
$22.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.82
|
| Rate for Payer: Meridian Medicaid |
$23.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.26
|
| Rate for Payer: Nomi Health Commercial |
$102.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.76
|
| Rate for Payer: PACE Senior Care Partners |
$29.69
|
| Rate for Payer: PACE SWMI |
$31.25
|
| Rate for Payer: PHP Commercial |
$106.26
|
| Rate for Payer: PHP Medicare Advantage |
$31.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$108.76
|
| Rate for Payer: Priority Health Medicare |
$31.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.01
|
| Rate for Payer: Railroad Medicare Medicare |
$31.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.01
|
| Rate for Payer: UHC Core |
$104.38
|
| Rate for Payer: UHC Exchange |
$31.25
|
| Rate for Payer: UHC Medicaid |
$22.04
|
| Rate for Payer: UHC Medicare Advantage |
$31.25
|
| Rate for Payer: UHCCP Medicaid |
$22.04
|
| Rate for Payer: VA VA |
$31.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.76
|
|
