|
HC LABOR CAT (3) 5-8HRS
|
Facility
|
IP
|
$2,551.65
|
|
| Hospital Charge Code |
72000003
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,658.57 |
| Max. Negotiated Rate |
$2,296.48 |
| Rate for Payer: Aetna Commercial |
$2,168.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,082.91
|
| Rate for Payer: BCN Commercial |
$1,971.92
|
| Rate for Payer: Cash Price |
$2,041.32
|
| Rate for Payer: Cofinity Commercial |
$2,194.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,041.32
|
| Rate for Payer: Healthscope Commercial |
$2,296.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,913.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,168.90
|
| Rate for Payer: Nomi Health Commercial |
$2,092.35
|
| Rate for Payer: PHP Commercial |
$2,168.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,658.57
|
| Rate for Payer: Priority Health HMO/PPO |
$2,219.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,709.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,245.45
|
| Rate for Payer: UHC Core |
$2,130.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,913.74
|
|
|
HC LABOR CAT (4) 8-12HRS
|
Facility
|
IP
|
$3,062.03
|
|
| Hospital Charge Code |
72000004
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,990.32 |
| Max. Negotiated Rate |
$2,755.83 |
| Rate for Payer: Aetna Commercial |
$2,602.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,499.54
|
| Rate for Payer: BCN Commercial |
$2,366.34
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cofinity Commercial |
$2,633.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,449.62
|
| Rate for Payer: Healthscope Commercial |
$2,755.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,296.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,602.73
|
| Rate for Payer: Nomi Health Commercial |
$2,510.86
|
| Rate for Payer: PHP Commercial |
$2,602.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,990.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,663.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,051.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,694.59
|
| Rate for Payer: UHC Core |
$2,556.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,296.52
|
|
|
HC LABOR CAT (4) 8-12HRS
|
Facility
|
OP
|
$3,062.03
|
|
| Hospital Charge Code |
72000004
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$727.23 |
| Max. Negotiated Rate |
$2,755.83 |
| Rate for Payer: Aetna Commercial |
$2,602.73
|
| Rate for Payer: Aetna Medicare |
$796.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$956.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$956.88
|
| Rate for Payer: BCBS Complete |
$1,224.81
|
| Rate for Payer: BCBS MAPPO |
$765.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,517.29
|
| Rate for Payer: BCN Commercial |
$2,380.73
|
| Rate for Payer: BCN Medicare Advantage |
$765.51
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cofinity Commercial |
$2,633.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,449.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.51
|
| Rate for Payer: Healthscope Commercial |
$2,755.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,296.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$803.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$880.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,602.73
|
| Rate for Payer: Nomi Health Commercial |
$2,510.86
|
| Rate for Payer: PACE Senior Care Partners |
$727.23
|
| Rate for Payer: PACE SWMI |
$765.51
|
| Rate for Payer: PHP Commercial |
$2,602.73
|
| Rate for Payer: PHP Medicare Advantage |
$765.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,990.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,663.97
|
| Rate for Payer: Priority Health Medicare |
$773.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,051.56
|
| Rate for Payer: Railroad Medicare Medicare |
$765.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,694.59
|
| Rate for Payer: UHC Core |
$2,556.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$765.51
|
| Rate for Payer: UHC Exchange |
$765.51
|
| Rate for Payer: UHC Medicare Advantage |
$765.51
|
| Rate for Payer: VA VA |
$765.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,296.52
|
|
|
HC LABOR CAT (5) 12-17HRS
|
Facility
|
IP
|
$4,589.55
|
|
| Hospital Charge Code |
72000007
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$2,983.21 |
| Max. Negotiated Rate |
$4,130.60 |
| Rate for Payer: Aetna Commercial |
$3,901.12
|
| Rate for Payer: BCBS Trust/PPO |
$3,746.45
|
| Rate for Payer: BCN Commercial |
$3,546.80
|
| Rate for Payer: Cash Price |
$3,671.64
|
| Rate for Payer: Cofinity Commercial |
$3,947.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,671.64
|
| Rate for Payer: Healthscope Commercial |
$4,130.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,442.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,901.12
|
| Rate for Payer: Nomi Health Commercial |
$3,763.43
|
| Rate for Payer: PHP Commercial |
$3,901.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.21
|
| Rate for Payer: Priority Health HMO/PPO |
$3,992.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,075.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,038.80
|
| Rate for Payer: UHC Core |
$3,832.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,442.16
|
|
|
HC LABOR CAT (5) 12-17HRS
|
Facility
|
OP
|
$4,589.55
|
|
| Hospital Charge Code |
72000007
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,090.02 |
| Max. Negotiated Rate |
$4,130.60 |
| Rate for Payer: Aetna Commercial |
$3,901.12
|
| Rate for Payer: Aetna Medicare |
$1,193.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,434.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,434.23
|
| Rate for Payer: BCBS Complete |
$1,835.82
|
| Rate for Payer: BCBS MAPPO |
$1,147.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,773.07
|
| Rate for Payer: BCN Commercial |
$3,568.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,147.39
|
| Rate for Payer: Cash Price |
$3,671.64
|
| Rate for Payer: Cofinity Commercial |
$3,947.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,671.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,147.39
|
| Rate for Payer: Healthscope Commercial |
$4,130.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,442.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,204.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,319.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,901.12
|
| Rate for Payer: Nomi Health Commercial |
$3,763.43
|
| Rate for Payer: PACE Senior Care Partners |
$1,090.02
|
| Rate for Payer: PACE SWMI |
$1,147.39
|
| Rate for Payer: PHP Commercial |
$3,901.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,147.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.21
|
| Rate for Payer: Priority Health HMO/PPO |
$3,992.91
|
| Rate for Payer: Priority Health Medicare |
$1,158.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,075.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,147.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,038.80
|
| Rate for Payer: UHC Core |
$3,832.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,147.39
|
| Rate for Payer: UHC Exchange |
$1,147.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,147.39
|
| Rate for Payer: VA VA |
$1,147.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,442.16
|
|
|
HC LABOR CAT (6) 17 OR MORE HRS
|
Facility
|
OP
|
$6,790.05
|
|
| Hospital Charge Code |
72000008
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,612.64 |
| Max. Negotiated Rate |
$6,111.04 |
| Rate for Payer: Aetna Commercial |
$5,771.54
|
| Rate for Payer: Aetna Medicare |
$1,765.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,121.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,121.89
|
| Rate for Payer: BCBS Complete |
$2,716.02
|
| Rate for Payer: BCBS MAPPO |
$1,697.51
|
| Rate for Payer: BCBS Trust/PPO |
$5,582.10
|
| Rate for Payer: BCN Commercial |
$5,279.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,697.51
|
| Rate for Payer: Cash Price |
$5,432.04
|
| Rate for Payer: Cofinity Commercial |
$5,839.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,432.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,697.51
|
| Rate for Payer: Healthscope Commercial |
$6,111.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,092.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,782.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,952.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,771.54
|
| Rate for Payer: Nomi Health Commercial |
$5,567.84
|
| Rate for Payer: PACE Senior Care Partners |
$1,612.64
|
| Rate for Payer: PACE SWMI |
$1,697.51
|
| Rate for Payer: PHP Commercial |
$5,771.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,697.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,413.53
|
| Rate for Payer: Priority Health HMO/PPO |
$5,907.34
|
| Rate for Payer: Priority Health Medicare |
$1,714.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,549.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,697.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,975.24
|
| Rate for Payer: UHC Core |
$5,669.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,697.51
|
| Rate for Payer: UHC Exchange |
$1,697.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,697.51
|
| Rate for Payer: VA VA |
$1,697.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,092.54
|
|
|
HC LABOR CAT (6) 17 OR MORE HRS
|
Facility
|
IP
|
$6,790.05
|
|
| Hospital Charge Code |
72000008
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$4,413.53 |
| Max. Negotiated Rate |
$6,111.04 |
| Rate for Payer: Aetna Commercial |
$5,771.54
|
| Rate for Payer: BCBS Trust/PPO |
$5,542.72
|
| Rate for Payer: BCN Commercial |
$5,247.35
|
| Rate for Payer: Cash Price |
$5,432.04
|
| Rate for Payer: Cofinity Commercial |
$5,839.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,432.04
|
| Rate for Payer: Healthscope Commercial |
$6,111.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,092.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,771.54
|
| Rate for Payer: Nomi Health Commercial |
$5,567.84
|
| Rate for Payer: PHP Commercial |
$5,771.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,413.53
|
| Rate for Payer: Priority Health HMO/PPO |
$5,907.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,549.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,975.24
|
| Rate for Payer: UHC Core |
$5,669.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,092.54
|
|
|
HC LABYRINTHOTOMY TRANSCANAL
|
Facility
|
IP
|
$4,015.74
|
|
|
Service Code
|
CPT 69801
|
| Hospital Charge Code |
76100487
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,610.23 |
| Max. Negotiated Rate |
$3,614.17 |
| Rate for Payer: Aetna Commercial |
$3,413.38
|
| Rate for Payer: BCBS Trust/PPO |
$3,278.05
|
| Rate for Payer: BCN Commercial |
$3,103.36
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cofinity Commercial |
$3,453.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,212.59
|
| Rate for Payer: Healthscope Commercial |
$3,614.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,011.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,413.38
|
| Rate for Payer: Nomi Health Commercial |
$3,292.91
|
| Rate for Payer: PHP Commercial |
$3,413.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,610.23
|
| Rate for Payer: Priority Health HMO/PPO |
$3,493.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,690.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,533.85
|
| Rate for Payer: UHC Core |
$3,353.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,011.80
|
|
|
HC LABYRINTHOTOMY TRANSCANAL
|
Facility
|
OP
|
$4,015.74
|
|
|
Service Code
|
CPT 69801
|
| Hospital Charge Code |
76100487
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$953.74 |
| Max. Negotiated Rate |
$3,614.17 |
| Rate for Payer: Aetna Commercial |
$3,413.38
|
| Rate for Payer: Aetna Medicare |
$1,044.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,254.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,254.92
|
| Rate for Payer: BCBS Complete |
$1,101.85
|
| Rate for Payer: BCBS MAPPO |
$1,003.94
|
| Rate for Payer: BCBS Trust/PPO |
$3,301.34
|
| Rate for Payer: BCN Commercial |
$3,122.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,003.94
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cofinity Commercial |
$3,453.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,212.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,003.94
|
| Rate for Payer: Healthscope Commercial |
$3,614.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,011.80
|
| Rate for Payer: Mclaren Medicaid |
$1,049.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,054.13
|
| Rate for Payer: Meridian Medicaid |
$1,101.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,154.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,413.38
|
| Rate for Payer: Nomi Health Commercial |
$3,292.91
|
| Rate for Payer: PACE Senior Care Partners |
$953.74
|
| Rate for Payer: PACE SWMI |
$1,003.94
|
| Rate for Payer: PHP Commercial |
$3,413.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,003.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,049.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,610.23
|
| Rate for Payer: Priority Health HMO/PPO |
$3,493.69
|
| Rate for Payer: Priority Health Medicare |
$1,013.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,690.55
|
| Rate for Payer: Railroad Medicare Medicare |
$1,003.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,533.85
|
| Rate for Payer: UHC Core |
$3,353.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,003.94
|
| Rate for Payer: UHC Exchange |
$1,003.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,003.94
|
| Rate for Payer: UHCCP Medicaid |
$1,049.31
|
| Rate for Payer: VA VA |
$1,003.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,011.80
|
|
|
HC LA/CS PACING + RECORDING
|
Facility
|
OP
|
$1,555.91
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
48100038
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$369.53 |
| Max. Negotiated Rate |
$1,400.32 |
| Rate for Payer: Aetna Commercial |
$1,322.52
|
| Rate for Payer: Aetna Medicare |
$404.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$486.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$486.22
|
| Rate for Payer: BCBS Complete |
$622.36
|
| Rate for Payer: BCBS MAPPO |
$388.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,279.11
|
| Rate for Payer: BCN Commercial |
$1,209.72
|
| Rate for Payer: BCN Medicare Advantage |
$388.98
|
| Rate for Payer: Cash Price |
$1,244.73
|
| Rate for Payer: Cofinity Commercial |
$1,338.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,244.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$388.98
|
| Rate for Payer: Healthscope Commercial |
$1,400.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,166.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$408.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$447.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,322.52
|
| Rate for Payer: Nomi Health Commercial |
$1,275.85
|
| Rate for Payer: PACE Senior Care Partners |
$369.53
|
| Rate for Payer: PACE SWMI |
$388.98
|
| Rate for Payer: PHP Commercial |
$1,322.52
|
| Rate for Payer: PHP Medicare Advantage |
$388.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,011.34
|
| Rate for Payer: Priority Health HMO/PPO |
$1,353.64
|
| Rate for Payer: Priority Health Medicare |
$392.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,042.46
|
| Rate for Payer: Railroad Medicare Medicare |
$388.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,369.20
|
| Rate for Payer: UHC Core |
$1,299.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$388.98
|
| Rate for Payer: UHC Exchange |
$388.98
|
| Rate for Payer: UHC Medicare Advantage |
$388.98
|
| Rate for Payer: VA VA |
$388.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,166.93
|
|
|
HC LA/CS PACING + RECORDING
|
Facility
|
IP
|
$1,555.91
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
48100038
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,011.34 |
| Max. Negotiated Rate |
$1,400.32 |
| Rate for Payer: Aetna Commercial |
$1,322.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,270.09
|
| Rate for Payer: BCN Commercial |
$1,202.41
|
| Rate for Payer: Cash Price |
$1,244.73
|
| Rate for Payer: Cofinity Commercial |
$1,338.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,244.73
|
| Rate for Payer: Healthscope Commercial |
$1,400.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,166.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,322.52
|
| Rate for Payer: Nomi Health Commercial |
$1,275.85
|
| Rate for Payer: PHP Commercial |
$1,322.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,011.34
|
| Rate for Payer: Priority Health HMO/PPO |
$1,353.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,042.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,369.20
|
| Rate for Payer: UHC Core |
$1,299.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,166.93
|
|
|
HC LACTATE DEHYDROGENASE
|
Facility
|
IP
|
$22.20
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
30100272
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.43 |
| Max. Negotiated Rate |
$19.98 |
| Rate for Payer: Aetna Commercial |
$18.87
|
| Rate for Payer: BCBS Trust/PPO |
$18.12
|
| Rate for Payer: BCN Commercial |
$17.16
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$19.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.76
|
| Rate for Payer: Healthscope Commercial |
$19.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.87
|
| Rate for Payer: Nomi Health Commercial |
$18.20
|
| Rate for Payer: PHP Commercial |
$18.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.43
|
| Rate for Payer: Priority Health HMO/PPO |
$19.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.54
|
| Rate for Payer: UHC Core |
$18.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.65
|
|
|
HC LACTATE DEHYDROGENASE
|
Facility
|
OP
|
$22.20
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
30100272
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.37 |
| Max. Negotiated Rate |
$19.98 |
| Rate for Payer: Aetna Commercial |
$18.87
|
| Rate for Payer: Aetna Medicare |
$5.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.94
|
| Rate for Payer: BCBS Complete |
$4.59
|
| Rate for Payer: BCBS MAPPO |
$5.55
|
| Rate for Payer: BCBS Trust/PPO |
$18.25
|
| Rate for Payer: BCN Commercial |
$17.26
|
| Rate for Payer: BCN Medicare Advantage |
$5.55
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$19.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.55
|
| Rate for Payer: Healthscope Commercial |
$19.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.65
|
| Rate for Payer: Mclaren Medicaid |
$4.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.83
|
| Rate for Payer: Meridian Medicaid |
$4.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.87
|
| Rate for Payer: Nomi Health Commercial |
$18.20
|
| Rate for Payer: PACE Senior Care Partners |
$5.27
|
| Rate for Payer: PACE SWMI |
$5.55
|
| Rate for Payer: PHP Commercial |
$18.87
|
| Rate for Payer: PHP Medicare Advantage |
$5.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.43
|
| Rate for Payer: Priority Health HMO/PPO |
$19.31
|
| Rate for Payer: Priority Health Medicare |
$5.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.87
|
| Rate for Payer: Railroad Medicare Medicare |
$5.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.54
|
| Rate for Payer: UHC Core |
$18.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.55
|
| Rate for Payer: UHC Exchange |
$5.55
|
| Rate for Payer: UHC Medicare Advantage |
$5.55
|
| Rate for Payer: UHCCP Medicaid |
$4.37
|
| Rate for Payer: VA VA |
$5.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.65
|
|
|
HC LACTATE LACTIC ACID
|
Facility
|
IP
|
$59.30
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100270
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.54 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna Commercial |
$50.40
|
| Rate for Payer: BCBS Trust/PPO |
$48.41
|
| Rate for Payer: BCN Commercial |
$45.83
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.40
|
| Rate for Payer: Nomi Health Commercial |
$48.63
|
| Rate for Payer: PHP Commercial |
$50.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.54
|
| Rate for Payer: Priority Health HMO/PPO |
$51.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.18
|
| Rate for Payer: UHC Core |
$49.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC LACTATE LACTIC ACID
|
Facility
|
OP
|
$59.30
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100270
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.37 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna Commercial |
$50.40
|
| Rate for Payer: Aetna Medicare |
$15.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.53
|
| Rate for Payer: BCBS Complete |
$8.78
|
| Rate for Payer: BCBS MAPPO |
$14.82
|
| Rate for Payer: BCBS Trust/PPO |
$48.75
|
| Rate for Payer: BCN Commercial |
$46.11
|
| Rate for Payer: BCN Medicare Advantage |
$14.82
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.82
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Mclaren Medicaid |
$8.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.57
|
| Rate for Payer: Meridian Medicaid |
$8.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.40
|
| Rate for Payer: Nomi Health Commercial |
$48.63
|
| Rate for Payer: PACE Senior Care Partners |
$14.08
|
| Rate for Payer: PACE SWMI |
$14.82
|
| Rate for Payer: PHP Commercial |
$50.40
|
| Rate for Payer: PHP Medicare Advantage |
$14.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.54
|
| Rate for Payer: Priority Health HMO/PPO |
$51.59
|
| Rate for Payer: Priority Health Medicare |
$14.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.73
|
| Rate for Payer: Railroad Medicare Medicare |
$14.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.18
|
| Rate for Payer: UHC Core |
$49.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.82
|
| Rate for Payer: UHC Exchange |
$14.82
|
| Rate for Payer: UHC Medicare Advantage |
$14.82
|
| Rate for Payer: UHCCP Medicaid |
$8.37
|
| Rate for Payer: VA VA |
$14.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC LACTOSE TOLERANCE
|
Facility
|
IP
|
$94.05
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
30100226
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: BCBS Trust/PPO |
$76.77
|
| Rate for Payer: BCN Commercial |
$72.68
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Nomi Health Commercial |
$77.12
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.13
|
| Rate for Payer: Priority Health HMO/PPO |
$81.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.76
|
| Rate for Payer: UHC Core |
$78.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC LACTOSE TOLERANCE
|
Facility
|
OP
|
$94.05
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
30100226
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.31 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: Aetna Medicare |
$24.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.39
|
| Rate for Payer: BCBS Complete |
$9.77
|
| Rate for Payer: BCBS MAPPO |
$23.51
|
| Rate for Payer: BCBS Trust/PPO |
$77.32
|
| Rate for Payer: BCN Commercial |
$73.12
|
| Rate for Payer: BCN Medicare Advantage |
$23.51
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.51
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Mclaren Medicaid |
$9.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.69
|
| Rate for Payer: Meridian Medicaid |
$9.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Nomi Health Commercial |
$77.12
|
| Rate for Payer: PACE Senior Care Partners |
$22.34
|
| Rate for Payer: PACE SWMI |
$23.51
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: PHP Medicare Advantage |
$23.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.13
|
| Rate for Payer: Priority Health HMO/PPO |
$81.82
|
| Rate for Payer: Priority Health Medicare |
$23.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.01
|
| Rate for Payer: Railroad Medicare Medicare |
$23.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.76
|
| Rate for Payer: UHC Core |
$78.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.51
|
| Rate for Payer: UHC Exchange |
$23.51
|
| Rate for Payer: UHC Medicare Advantage |
$23.51
|
| Rate for Payer: UHCCP Medicaid |
$9.31
|
| Rate for Payer: VA VA |
$23.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC LAMBDA FREE LIGHT CHAIN SERUM
|
Facility
|
IP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100308
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$69.68 |
| Rate for Payer: Aetna Commercial |
$65.81
|
| Rate for Payer: BCBS Trust/PPO |
$63.20
|
| Rate for Payer: BCN Commercial |
$59.83
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Healthscope Commercial |
$69.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: Nomi Health Commercial |
$63.48
|
| Rate for Payer: PHP Commercial |
$65.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: Priority Health HMO/PPO |
$67.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.13
|
| Rate for Payer: UHC Core |
$64.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.06
|
|
|
HC LAMBDA FREE LIGHT CHAIN SERUM
|
Facility
|
OP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100308
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$69.68 |
| Rate for Payer: Aetna Commercial |
$65.81
|
| Rate for Payer: Aetna Medicare |
$20.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$19.36
|
| Rate for Payer: BCBS Trust/PPO |
$63.65
|
| Rate for Payer: BCN Commercial |
$60.19
|
| Rate for Payer: BCN Medicare Advantage |
$19.36
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.36
|
| Rate for Payer: Healthscope Commercial |
$69.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.06
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: Nomi Health Commercial |
$63.48
|
| Rate for Payer: PACE Senior Care Partners |
$18.39
|
| Rate for Payer: PACE SWMI |
$19.36
|
| Rate for Payer: PHP Commercial |
$65.81
|
| Rate for Payer: PHP Medicare Advantage |
$19.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: Priority Health HMO/PPO |
$67.36
|
| Rate for Payer: Priority Health Medicare |
$19.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.87
|
| Rate for Payer: Railroad Medicare Medicare |
$19.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.13
|
| Rate for Payer: UHC Core |
$64.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.36
|
| Rate for Payer: UHC Exchange |
$19.36
|
| Rate for Payer: UHC Medicare Advantage |
$19.36
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$19.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.06
|
|
|
HC LAMBS QUARTERS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200091
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC LAMBS QUARTERS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200091
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
30100278
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.97 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna Medicare |
$18.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.31
|
| Rate for Payer: BCBS Complete |
$14.67
|
| Rate for Payer: BCBS MAPPO |
$17.85
|
| Rate for Payer: BCBS Trust/PPO |
$58.70
|
| Rate for Payer: BCN Commercial |
$55.51
|
| Rate for Payer: BCN Medicare Advantage |
$17.85
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.85
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Mclaren Medicaid |
$13.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.74
|
| Rate for Payer: Meridian Medicaid |
$14.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: Nomi Health Commercial |
$58.55
|
| Rate for Payer: PACE Senior Care Partners |
$16.96
|
| Rate for Payer: PACE SWMI |
$17.85
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: PHP Medicare Advantage |
$17.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO |
$62.12
|
| Rate for Payer: Priority Health Medicare |
$18.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.84
|
| Rate for Payer: Railroad Medicare Medicare |
$17.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.83
|
| Rate for Payer: UHC Core |
$59.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.85
|
| Rate for Payer: UHC Exchange |
$17.85
|
| Rate for Payer: UHC Medicare Advantage |
$17.85
|
| Rate for Payer: UHCCP Medicaid |
$13.97
|
| Rate for Payer: VA VA |
$17.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
30100278
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.41 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: BCBS Trust/PPO |
$58.28
|
| Rate for Payer: BCN Commercial |
$55.18
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: Nomi Health Commercial |
$58.55
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO |
$62.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.83
|
| Rate for Payer: UHC Core |
$59.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
HC LAMICTAL LEVEL
|
Facility
|
IP
|
$54.10
|
|
|
Service Code
|
CPT 80175
|
| Hospital Charge Code |
30100054
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.16 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: BCBS Trust/PPO |
$44.16
|
| Rate for Payer: BCN Commercial |
$41.81
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health HMO/PPO |
$47.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.61
|
| Rate for Payer: UHC Core |
$45.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC LAMICTAL LEVEL
|
Facility
|
OP
|
$54.10
|
|
|
Service Code
|
CPT 80175
|
| Hospital Charge Code |
30100054
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna Medicare |
$14.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.91
|
| Rate for Payer: BCBS Complete |
$10.06
|
| Rate for Payer: BCBS MAPPO |
$13.52
|
| Rate for Payer: BCBS Trust/PPO |
$44.48
|
| Rate for Payer: BCN Commercial |
$42.06
|
| Rate for Payer: BCN Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.52
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Mclaren Medicaid |
$9.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.20
|
| Rate for Payer: Meridian Medicaid |
$10.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: PACE Senior Care Partners |
$12.85
|
| Rate for Payer: PACE SWMI |
$13.52
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: PHP Medicare Advantage |
$13.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health HMO/PPO |
$47.07
|
| Rate for Payer: Priority Health Medicare |
$13.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.25
|
| Rate for Payer: Railroad Medicare Medicare |
$13.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.61
|
| Rate for Payer: UHC Core |
$45.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.52
|
| Rate for Payer: UHC Exchange |
$13.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.52
|
| Rate for Payer: UHCCP Medicaid |
$9.58
|
| Rate for Payer: VA VA |
$13.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
