|
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 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 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 |
$38.55 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna Commercial |
$50.41
|
| 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 |
$50.41
|
| Rate for Payer: Nomi Health Commercial |
$48.63
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.55
|
| 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 |
$50.41
|
| 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 |
$50.41
|
| 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 |
$50.41
|
| 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 |
$38.55
|
| 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
|
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 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 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
|
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 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 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 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 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 |
$13.53
|
| Rate for Payer: BCBS Trust/PPO |
$44.48
|
| Rate for Payer: BCN Commercial |
$42.06
|
| Rate for Payer: BCN Medicare Advantage |
$13.53
|
| 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 |
$13.53
|
| 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 |
$13.53
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: PHP Medicare Advantage |
$13.53
|
| 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 |
$13.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.61
|
| Rate for Payer: UHC Core |
$45.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.53
|
| Rate for Payer: UHC Exchange |
$13.53
|
| Rate for Payer: UHC Medicare Advantage |
$13.53
|
| Rate for Payer: UHCCP Medicaid |
$9.58
|
| Rate for Payer: VA VA |
$13.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Facility
|
OP
|
$10,480.00
|
|
|
Service Code
|
CPT 31571
|
| Hospital Charge Code |
76100432
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,489.00 |
| Max. Negotiated Rate |
$9,432.00 |
| Rate for Payer: Aetna Commercial |
$8,908.00
|
| Rate for Payer: Aetna Medicare |
$2,724.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,275.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,275.00
|
| Rate for Payer: BCBS Complete |
$2,799.13
|
| Rate for Payer: BCBS MAPPO |
$2,620.00
|
| Rate for Payer: BCBS Trust/PPO |
$8,615.61
|
| Rate for Payer: BCN Commercial |
$8,148.20
|
| Rate for Payer: BCN Medicare Advantage |
$2,620.00
|
| Rate for Payer: Cash Price |
$8,384.00
|
| Rate for Payer: Cash Price |
$8,384.00
|
| Rate for Payer: Cofinity Commercial |
$9,012.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,384.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,620.00
|
| Rate for Payer: Healthscope Commercial |
$9,432.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,860.00
|
| Rate for Payer: Mclaren Medicaid |
$2,665.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,751.00
|
| Rate for Payer: Meridian Medicaid |
$2,799.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,013.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,908.00
|
| Rate for Payer: Nomi Health Commercial |
$8,593.60
|
| Rate for Payer: PACE Senior Care Partners |
$2,489.00
|
| Rate for Payer: PACE SWMI |
$2,620.00
|
| Rate for Payer: PHP Commercial |
$8,908.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,620.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,665.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,812.00
|
| Rate for Payer: Priority Health HMO/PPO |
$9,117.60
|
| Rate for Payer: Priority Health Medicare |
$2,646.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,021.60
|
| Rate for Payer: Railroad Medicare Medicare |
$2,620.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,222.40
|
| Rate for Payer: UHC Core |
$8,750.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,620.00
|
| Rate for Payer: UHC Exchange |
$2,620.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,620.00
|
| Rate for Payer: UHCCP Medicaid |
$2,665.66
|
| Rate for Payer: VA VA |
$2,620.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,860.00
|
|
|
HC LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Facility
|
IP
|
$10,480.00
|
|
|
Service Code
|
CPT 31571
|
| Hospital Charge Code |
76100432
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,812.00 |
| Max. Negotiated Rate |
$9,432.00 |
| Rate for Payer: Aetna Commercial |
$8,908.00
|
| Rate for Payer: BCBS Trust/PPO |
$8,554.82
|
| Rate for Payer: BCN Commercial |
$8,098.94
|
| Rate for Payer: Cash Price |
$8,384.00
|
| Rate for Payer: Cofinity Commercial |
$9,012.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,384.00
|
| Rate for Payer: Healthscope Commercial |
$9,432.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,860.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,908.00
|
| Rate for Payer: Nomi Health Commercial |
$8,593.60
|
| Rate for Payer: PHP Commercial |
$8,908.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,812.00
|
| Rate for Payer: Priority Health HMO/PPO |
$9,117.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,021.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,222.40
|
| Rate for Payer: UHC Core |
$8,750.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,860.00
|
|
|
HC LA RO SSB SJOGRENS AB
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200160
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.35 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$9.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.99
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$8.79
|
| Rate for Payer: BCBS Trust/PPO |
$28.91
|
| Rate for Payer: BCN Commercial |
$27.34
|
| Rate for Payer: BCN Medicare Advantage |
$8.79
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.79
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.23
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PACE Senior Care Partners |
$8.35
|
| Rate for Payer: PACE SWMI |
$8.79
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$8.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Medicare |
$8.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: Railroad Medicare Medicare |
$8.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.79
|
| Rate for Payer: UHC Exchange |
$8.79
|
| Rate for Payer: UHC Medicare Advantage |
$8.79
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$8.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC LA RO SSB SJOGRENS AB
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200160
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: BCBS Trust/PPO |
$28.71
|
| Rate for Payer: BCN Commercial |
$27.18
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC LARYNGOSCOPY
|
Facility
|
IP
|
$2,564.80
|
|
| Hospital Charge Code |
36000113
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,667.12 |
| Max. Negotiated Rate |
$2,308.32 |
| Rate for Payer: Aetna Commercial |
$2,180.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,093.65
|
| Rate for Payer: BCN Commercial |
$1,982.08
|
| Rate for Payer: Cash Price |
$2,051.84
|
| Rate for Payer: Cofinity Commercial |
$2,205.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,051.84
|
| Rate for Payer: Healthscope Commercial |
$2,308.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,923.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,180.08
|
| Rate for Payer: Nomi Health Commercial |
$2,103.14
|
| Rate for Payer: PHP Commercial |
$2,180.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,667.12
|
| Rate for Payer: Priority Health HMO/PPO |
$2,231.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,718.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,257.02
|
| Rate for Payer: UHC Core |
$2,141.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,923.60
|
|
|
HC LARYNGOSCOPY
|
Facility
|
OP
|
$2,564.80
|
|
| Hospital Charge Code |
36000113
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$609.14 |
| Max. Negotiated Rate |
$2,308.32 |
| Rate for Payer: Aetna Commercial |
$2,180.08
|
| Rate for Payer: Aetna Medicare |
$666.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$801.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$801.50
|
| Rate for Payer: BCBS Complete |
$1,025.92
|
| Rate for Payer: BCBS MAPPO |
$641.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,108.52
|
| Rate for Payer: BCN Commercial |
$1,994.13
|
| Rate for Payer: BCN Medicare Advantage |
$641.20
|
| Rate for Payer: Cash Price |
$2,051.84
|
| Rate for Payer: Cofinity Commercial |
$2,205.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,051.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.20
|
| Rate for Payer: Healthscope Commercial |
$2,308.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,923.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$737.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,180.08
|
| Rate for Payer: Nomi Health Commercial |
$2,103.14
|
| Rate for Payer: PACE Senior Care Partners |
$609.14
|
| Rate for Payer: PACE SWMI |
$641.20
|
| Rate for Payer: PHP Commercial |
$2,180.08
|
| Rate for Payer: PHP Medicare Advantage |
$641.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,667.12
|
| Rate for Payer: Priority Health HMO/PPO |
$2,231.38
|
| Rate for Payer: Priority Health Medicare |
$647.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,718.42
|
| Rate for Payer: Railroad Medicare Medicare |
$641.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,257.02
|
| Rate for Payer: UHC Core |
$2,141.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$641.20
|
| Rate for Payer: UHC Exchange |
$641.20
|
| Rate for Payer: UHC Medicare Advantage |
$641.20
|
| Rate for Payer: VA VA |
$641.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,923.60
|
|
|
HC LARYNGOSCOPY DIRECT OPERATIVE W BIOPSY
|
Facility
|
IP
|
$4,795.00
|
|
|
Service Code
|
CPT 31235
|
| Hospital Charge Code |
76100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,116.75 |
| Max. Negotiated Rate |
$4,315.50 |
| Rate for Payer: Aetna Commercial |
$4,075.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,914.16
|
| Rate for Payer: BCN Commercial |
$3,705.58
|
| Rate for Payer: Cash Price |
$3,836.00
|
| Rate for Payer: Cofinity Commercial |
$4,123.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,836.00
|
| Rate for Payer: Healthscope Commercial |
$4,315.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,596.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,075.75
|
| Rate for Payer: Nomi Health Commercial |
$3,931.90
|
| Rate for Payer: PHP Commercial |
$4,075.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,116.75
|
| Rate for Payer: Priority Health HMO/PPO |
$4,171.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,212.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,219.60
|
| Rate for Payer: UHC Core |
$4,003.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,596.25
|
|
|
HC LARYNGOSCOPY DIRECT OPERATIVE W BIOPSY
|
Facility
|
OP
|
$4,795.00
|
|
|
Service Code
|
CPT 31235
|
| Hospital Charge Code |
76100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,138.81 |
| Max. Negotiated Rate |
$4,315.50 |
| Rate for Payer: Aetna Commercial |
$4,075.75
|
| Rate for Payer: Aetna Medicare |
$1,246.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,498.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,498.44
|
| Rate for Payer: BCBS Complete |
$1,309.22
|
| Rate for Payer: BCBS MAPPO |
$1,198.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,941.97
|
| Rate for Payer: BCN Commercial |
$3,728.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,198.75
|
| Rate for Payer: Cash Price |
$3,836.00
|
| Rate for Payer: Cash Price |
$3,836.00
|
| Rate for Payer: Cofinity Commercial |
$4,123.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,836.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,198.75
|
| Rate for Payer: Healthscope Commercial |
$4,315.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,596.25
|
| Rate for Payer: Mclaren Medicaid |
$1,246.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,258.69
|
| Rate for Payer: Meridian Medicaid |
$1,309.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,378.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,075.75
|
| Rate for Payer: Nomi Health Commercial |
$3,931.90
|
| Rate for Payer: PACE Senior Care Partners |
$1,138.81
|
| Rate for Payer: PACE SWMI |
$1,198.75
|
| Rate for Payer: PHP Commercial |
$4,075.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,198.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,246.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,116.75
|
| Rate for Payer: Priority Health HMO/PPO |
$4,171.65
|
| Rate for Payer: Priority Health Medicare |
$1,210.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,212.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,198.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,219.60
|
| Rate for Payer: UHC Core |
$4,003.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,198.75
|
| Rate for Payer: UHC Exchange |
$1,198.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,198.75
|
| Rate for Payer: UHCCP Medicaid |
$1,246.79
|
| Rate for Payer: VA VA |
$1,198.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,596.25
|
|
|
HC LARYNGOSCOPY FIBEROPTIC
|
Facility
|
IP
|
$372.28
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
36100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$241.98 |
| Max. Negotiated Rate |
$335.05 |
| Rate for Payer: Aetna Commercial |
$316.44
|
| Rate for Payer: BCBS Trust/PPO |
$303.89
|
| Rate for Payer: BCN Commercial |
$287.70
|
| Rate for Payer: Cash Price |
$297.82
|
| Rate for Payer: Cofinity Commercial |
$320.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.82
|
| Rate for Payer: Healthscope Commercial |
$335.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.44
|
| Rate for Payer: Nomi Health Commercial |
$305.27
|
| Rate for Payer: PHP Commercial |
$316.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.98
|
| Rate for Payer: Priority Health HMO/PPO |
$323.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.61
|
| Rate for Payer: UHC Core |
$310.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.21
|
|
