|
HC LD RECOVERY 8-10 HRS
|
Facility
|
IP
|
$1,455.67
|
|
| Hospital Charge Code |
71000017
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$946.19 |
| Max. Negotiated Rate |
$1,310.10 |
| Rate for Payer: Aetna Commercial |
$1,237.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,188.26
|
| Rate for Payer: BCN Commercial |
$1,124.94
|
| Rate for Payer: Cash Price |
$1,164.54
|
| Rate for Payer: Cofinity Commercial |
$1,251.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,164.54
|
| Rate for Payer: Healthscope Commercial |
$1,310.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,091.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,237.32
|
| Rate for Payer: Nomi Health Commercial |
$1,193.65
|
| Rate for Payer: PHP Commercial |
$1,237.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$946.19
|
| Rate for Payer: Priority Health HMO/PPO |
$1,266.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$975.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,280.99
|
| Rate for Payer: UHC Core |
$1,215.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,091.75
|
|
|
HC LD RECOVERY 8-10 HRS
|
Facility
|
OP
|
$1,455.67
|
|
| Hospital Charge Code |
71000017
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$345.72 |
| Max. Negotiated Rate |
$1,310.10 |
| Rate for Payer: Aetna Commercial |
$1,237.32
|
| Rate for Payer: Aetna Medicare |
$378.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$454.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$454.90
|
| Rate for Payer: BCBS Complete |
$582.27
|
| Rate for Payer: BCBS MAPPO |
$363.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,196.71
|
| Rate for Payer: BCN Commercial |
$1,131.78
|
| Rate for Payer: BCN Medicare Advantage |
$363.92
|
| Rate for Payer: Cash Price |
$1,164.54
|
| Rate for Payer: Cofinity Commercial |
$1,251.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,164.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$363.92
|
| Rate for Payer: Healthscope Commercial |
$1,310.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,091.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$382.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$418.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,237.32
|
| Rate for Payer: Nomi Health Commercial |
$1,193.65
|
| Rate for Payer: PACE Senior Care Partners |
$345.72
|
| Rate for Payer: PACE SWMI |
$363.92
|
| Rate for Payer: PHP Commercial |
$1,237.32
|
| Rate for Payer: PHP Medicare Advantage |
$363.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$946.19
|
| Rate for Payer: Priority Health HMO/PPO |
$1,266.43
|
| Rate for Payer: Priority Health Medicare |
$367.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$975.30
|
| Rate for Payer: Railroad Medicare Medicare |
$363.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,280.99
|
| Rate for Payer: UHC Core |
$1,215.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$363.92
|
| Rate for Payer: UHC Exchange |
$363.92
|
| Rate for Payer: UHC Medicare Advantage |
$363.92
|
| Rate for Payer: VA VA |
$363.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,091.75
|
|
|
HC LEAD
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100275
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.17 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: BCBS Trust/PPO |
$36.64
|
| Rate for Payer: BCN Commercial |
$34.68
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.15
|
| Rate for Payer: Nomi Health Commercial |
$36.80
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.17
|
| Rate for Payer: Priority Health HMO/PPO |
$39.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC LEAD
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100275
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.76 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna Medicare |
$11.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.03
|
| Rate for Payer: BCBS Complete |
$9.19
|
| Rate for Payer: BCBS MAPPO |
$11.22
|
| Rate for Payer: BCBS Trust/PPO |
$36.90
|
| Rate for Payer: BCN Commercial |
$34.89
|
| Rate for Payer: BCN Medicare Advantage |
$11.22
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.22
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Mclaren Medicaid |
$8.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.78
|
| Rate for Payer: Meridian Medicaid |
$9.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.15
|
| Rate for Payer: Nomi Health Commercial |
$36.80
|
| Rate for Payer: PACE Senior Care Partners |
$10.66
|
| Rate for Payer: PACE SWMI |
$11.22
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.17
|
| Rate for Payer: Priority Health HMO/PPO |
$39.05
|
| Rate for Payer: Priority Health Medicare |
$11.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.07
|
| Rate for Payer: Railroad Medicare Medicare |
$11.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.22
|
| Rate for Payer: UHC Exchange |
$11.22
|
| Rate for Payer: UHC Medicare Advantage |
$11.22
|
| Rate for Payer: UHCCP Medicaid |
$8.76
|
| Rate for Payer: VA VA |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC LEAD CARDIOVERTER DEFIB ENDOCARDIAL SINGLE COIL
|
Facility
|
OP
|
$14,739.00
|
|
|
Service Code
|
HCPCS C1777
|
| Hospital Charge Code |
27800088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,500.51 |
| Max. Negotiated Rate |
$13,265.10 |
| Rate for Payer: Aetna Commercial |
$12,528.15
|
| Rate for Payer: Aetna Medicare |
$3,832.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,605.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,605.94
|
| Rate for Payer: BCBS Complete |
$5,895.60
|
| Rate for Payer: BCBS MAPPO |
$3,684.75
|
| Rate for Payer: BCBS Trust/PPO |
$12,116.93
|
| Rate for Payer: BCN Commercial |
$11,459.57
|
| Rate for Payer: BCN Medicare Advantage |
$3,684.75
|
| Rate for Payer: Cash Price |
$11,791.20
|
| Rate for Payer: Cofinity Commercial |
$12,675.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,791.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,684.75
|
| Rate for Payer: Healthscope Commercial |
$13,265.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,054.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,868.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,237.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,528.15
|
| Rate for Payer: Nomi Health Commercial |
$12,085.98
|
| Rate for Payer: PACE Senior Care Partners |
$3,500.51
|
| Rate for Payer: PACE SWMI |
$3,684.75
|
| Rate for Payer: PHP Commercial |
$12,528.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,684.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,580.35
|
| Rate for Payer: Priority Health HMO/PPO |
$12,822.93
|
| Rate for Payer: Priority Health Medicare |
$3,721.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,875.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3,684.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,970.32
|
| Rate for Payer: UHC Core |
$12,307.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,684.75
|
| Rate for Payer: UHC Exchange |
$3,684.75
|
| Rate for Payer: UHC Medicare Advantage |
$3,684.75
|
| Rate for Payer: VA VA |
$3,684.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,054.25
|
|
|
HC LEAD CARDIOVERTER DEFIB ENDOCARDIAL SINGLE COIL
|
Facility
|
IP
|
$14,739.00
|
|
|
Service Code
|
HCPCS C1777
|
| Hospital Charge Code |
27800088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,580.35 |
| Max. Negotiated Rate |
$13,265.10 |
| Rate for Payer: Aetna Commercial |
$12,528.15
|
| Rate for Payer: BCBS Trust/PPO |
$12,031.45
|
| Rate for Payer: BCN Commercial |
$11,390.30
|
| Rate for Payer: Cash Price |
$11,791.20
|
| Rate for Payer: Cofinity Commercial |
$12,675.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,791.20
|
| Rate for Payer: Healthscope Commercial |
$13,265.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,054.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,528.15
|
| Rate for Payer: Nomi Health Commercial |
$12,085.98
|
| Rate for Payer: PHP Commercial |
$12,528.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,580.35
|
| Rate for Payer: Priority Health HMO/PPO |
$12,822.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,875.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,970.32
|
| Rate for Payer: UHC Core |
$12,307.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,054.25
|
|
|
HC LEAD NEUROSTIM TEST KIT LEVEL 20
|
Facility
|
OP
|
$2,080.80
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27800134
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$494.19 |
| Max. Negotiated Rate |
$1,872.72 |
| Rate for Payer: Aetna Commercial |
$1,768.68
|
| Rate for Payer: Aetna Medicare |
$541.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$650.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$650.25
|
| Rate for Payer: BCBS Complete |
$832.32
|
| Rate for Payer: BCBS MAPPO |
$520.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,710.63
|
| Rate for Payer: BCN Commercial |
$1,617.82
|
| Rate for Payer: BCN Medicare Advantage |
$520.20
|
| Rate for Payer: Cash Price |
$1,664.64
|
| Rate for Payer: Cofinity Commercial |
$1,789.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$520.20
|
| Rate for Payer: Healthscope Commercial |
$1,872.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$546.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$598.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,768.68
|
| Rate for Payer: Nomi Health Commercial |
$1,706.26
|
| Rate for Payer: PACE Senior Care Partners |
$494.19
|
| Rate for Payer: PACE SWMI |
$520.20
|
| Rate for Payer: PHP Commercial |
$1,768.68
|
| Rate for Payer: PHP Medicare Advantage |
$520.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,352.52
|
| Rate for Payer: Priority Health HMO/PPO |
$1,810.30
|
| Rate for Payer: Priority Health Medicare |
$525.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,394.14
|
| Rate for Payer: Railroad Medicare Medicare |
$520.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,831.10
|
| Rate for Payer: UHC Core |
$1,737.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$520.20
|
| Rate for Payer: UHC Exchange |
$520.20
|
| Rate for Payer: UHC Medicare Advantage |
$520.20
|
| Rate for Payer: VA VA |
$520.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.60
|
|
|
HC LEAD NEUROSTIM TEST KIT LEVEL 20
|
Facility
|
IP
|
$2,080.80
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27800134
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,352.52 |
| Max. Negotiated Rate |
$1,872.72 |
| Rate for Payer: Aetna Commercial |
$1,768.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,698.56
|
| Rate for Payer: BCN Commercial |
$1,608.04
|
| Rate for Payer: Cash Price |
$1,664.64
|
| Rate for Payer: Cofinity Commercial |
$1,789.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.64
|
| Rate for Payer: Healthscope Commercial |
$1,872.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,768.68
|
| Rate for Payer: Nomi Health Commercial |
$1,706.26
|
| Rate for Payer: PHP Commercial |
$1,768.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,352.52
|
| Rate for Payer: Priority Health HMO/PPO |
$1,810.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,394.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,831.10
|
| Rate for Payer: UHC Core |
$1,737.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.60
|
|
|
HC LEAD NEUROSTIMULATOR
|
Facility
|
OP
|
$7,809.12
|
|
|
Service Code
|
HCPCS C1778
|
| Hospital Charge Code |
27800017
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,854.67 |
| Max. Negotiated Rate |
$7,028.21 |
| Rate for Payer: Aetna Commercial |
$6,637.75
|
| Rate for Payer: Aetna Medicare |
$2,030.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,440.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,440.35
|
| Rate for Payer: BCBS Complete |
$3,123.65
|
| Rate for Payer: BCBS MAPPO |
$1,952.28
|
| Rate for Payer: BCBS Trust/PPO |
$6,419.88
|
| Rate for Payer: BCN Commercial |
$6,071.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,952.28
|
| Rate for Payer: Cash Price |
$6,247.30
|
| Rate for Payer: Cofinity Commercial |
$6,715.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,247.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,952.28
|
| Rate for Payer: Healthscope Commercial |
$7,028.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,856.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,049.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,245.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,637.75
|
| Rate for Payer: Nomi Health Commercial |
$6,403.48
|
| Rate for Payer: PACE Senior Care Partners |
$1,854.67
|
| Rate for Payer: PACE SWMI |
$1,952.28
|
| Rate for Payer: PHP Commercial |
$6,637.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,952.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,075.93
|
| Rate for Payer: Priority Health HMO/PPO |
$6,793.93
|
| Rate for Payer: Priority Health Medicare |
$1,971.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,232.11
|
| Rate for Payer: Railroad Medicare Medicare |
$1,952.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,872.03
|
| Rate for Payer: UHC Core |
$6,520.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,952.28
|
| Rate for Payer: UHC Exchange |
$1,952.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,952.28
|
| Rate for Payer: VA VA |
$1,952.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,856.84
|
|
|
HC LEAD NEUROSTIMULATOR
|
Facility
|
IP
|
$7,809.12
|
|
|
Service Code
|
HCPCS C1778
|
| Hospital Charge Code |
27800017
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,075.93 |
| Max. Negotiated Rate |
$7,028.21 |
| Rate for Payer: Aetna Commercial |
$6,637.75
|
| Rate for Payer: BCBS Trust/PPO |
$6,374.58
|
| Rate for Payer: BCN Commercial |
$6,034.89
|
| Rate for Payer: Cash Price |
$6,247.30
|
| Rate for Payer: Cofinity Commercial |
$6,715.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,247.30
|
| Rate for Payer: Healthscope Commercial |
$7,028.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,856.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,637.75
|
| Rate for Payer: Nomi Health Commercial |
$6,403.48
|
| Rate for Payer: PHP Commercial |
$6,637.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,075.93
|
| Rate for Payer: Priority Health HMO/PPO |
$6,793.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,232.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,872.03
|
| Rate for Payer: UHC Core |
$6,520.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,856.84
|
|
|
HC LEAD NOS LVL 1
|
Facility
|
IP
|
$198.90
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.28 |
| Max. Negotiated Rate |
$179.01 |
| Rate for Payer: Aetna Commercial |
$169.06
|
| Rate for Payer: BCBS Trust/PPO |
$162.36
|
| Rate for Payer: BCN Commercial |
$153.71
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Commercial |
$171.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Healthscope Commercial |
$179.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.06
|
| Rate for Payer: Nomi Health Commercial |
$163.10
|
| Rate for Payer: PHP Commercial |
$169.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.28
|
| Rate for Payer: Priority Health HMO/PPO |
$173.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.03
|
| Rate for Payer: UHC Core |
$166.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.18
|
|
|
HC LEAD NOS LVL 1
|
Facility
|
OP
|
$198.90
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$47.24 |
| Max. Negotiated Rate |
$179.01 |
| Rate for Payer: Aetna Commercial |
$169.06
|
| Rate for Payer: Aetna Medicare |
$51.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.16
|
| Rate for Payer: BCBS Complete |
$79.56
|
| Rate for Payer: BCBS MAPPO |
$49.73
|
| Rate for Payer: BCBS Trust/PPO |
$163.52
|
| Rate for Payer: BCN Commercial |
$154.64
|
| Rate for Payer: BCN Medicare Advantage |
$49.73
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Commercial |
$171.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.73
|
| Rate for Payer: Healthscope Commercial |
$179.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.06
|
| Rate for Payer: Nomi Health Commercial |
$163.10
|
| Rate for Payer: PACE Senior Care Partners |
$47.24
|
| Rate for Payer: PACE SWMI |
$49.73
|
| Rate for Payer: PHP Commercial |
$169.06
|
| Rate for Payer: PHP Medicare Advantage |
$49.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.28
|
| Rate for Payer: Priority Health HMO/PPO |
$173.04
|
| Rate for Payer: Priority Health Medicare |
$50.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.26
|
| Rate for Payer: Railroad Medicare Medicare |
$49.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.03
|
| Rate for Payer: UHC Core |
$166.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.73
|
| Rate for Payer: UHC Exchange |
$49.73
|
| Rate for Payer: UHC Medicare Advantage |
$49.73
|
| Rate for Payer: VA VA |
$49.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.18
|
|
|
HC LEAD REMOVAL DUAL
|
Facility
|
IP
|
$2,925.53
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
36100074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,901.59 |
| Max. Negotiated Rate |
$2,632.98 |
| Rate for Payer: Aetna Commercial |
$2,486.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,388.11
|
| Rate for Payer: BCN Commercial |
$2,260.85
|
| Rate for Payer: Cash Price |
$2,340.42
|
| Rate for Payer: Cofinity Commercial |
$2,515.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,340.42
|
| Rate for Payer: Healthscope Commercial |
$2,632.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,194.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,486.70
|
| Rate for Payer: Nomi Health Commercial |
$2,398.93
|
| Rate for Payer: PHP Commercial |
$2,486.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,901.59
|
| Rate for Payer: Priority Health HMO/PPO |
$2,545.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,960.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,574.47
|
| Rate for Payer: UHC Core |
$2,442.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,194.15
|
|
|
HC LEAD REMOVAL DUAL
|
Facility
|
OP
|
$2,925.53
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
36100074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$694.81 |
| Max. Negotiated Rate |
$2,762.96 |
| Rate for Payer: Aetna Commercial |
$2,486.70
|
| Rate for Payer: Aetna Medicare |
$760.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$914.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$914.23
|
| Rate for Payer: BCBS Complete |
$2,762.96
|
| Rate for Payer: BCBS MAPPO |
$731.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,405.08
|
| Rate for Payer: BCN Commercial |
$2,274.60
|
| Rate for Payer: BCN Medicare Advantage |
$731.38
|
| Rate for Payer: Cash Price |
$2,340.42
|
| Rate for Payer: Cash Price |
$2,340.42
|
| Rate for Payer: Cofinity Commercial |
$2,515.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,340.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$731.38
|
| Rate for Payer: Healthscope Commercial |
$2,632.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,194.15
|
| Rate for Payer: Mclaren Medicaid |
$2,631.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$767.95
|
| Rate for Payer: Meridian Medicaid |
$2,762.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$841.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,486.70
|
| Rate for Payer: Nomi Health Commercial |
$2,398.93
|
| Rate for Payer: PACE Senior Care Partners |
$694.81
|
| Rate for Payer: PACE SWMI |
$731.38
|
| Rate for Payer: PHP Commercial |
$2,486.70
|
| Rate for Payer: PHP Medicare Advantage |
$731.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,631.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,901.59
|
| Rate for Payer: Priority Health HMO/PPO |
$2,545.21
|
| Rate for Payer: Priority Health Medicare |
$738.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,960.11
|
| Rate for Payer: Railroad Medicare Medicare |
$731.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,574.47
|
| Rate for Payer: UHC Core |
$2,442.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$731.38
|
| Rate for Payer: UHC Exchange |
$731.38
|
| Rate for Payer: UHC Medicare Advantage |
$731.38
|
| Rate for Payer: UHCCP Medicaid |
$2,631.21
|
| Rate for Payer: VA VA |
$731.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,194.15
|
|
|
HC LEAD REMOVAL SINGLE
|
Facility
|
IP
|
$3,704.87
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
36100073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,408.17 |
| Max. Negotiated Rate |
$3,334.38 |
| Rate for Payer: Aetna Commercial |
$3,149.14
|
| Rate for Payer: BCBS Trust/PPO |
$3,024.29
|
| Rate for Payer: BCN Commercial |
$2,863.12
|
| Rate for Payer: Cash Price |
$2,963.90
|
| Rate for Payer: Cofinity Commercial |
$3,186.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,963.90
|
| Rate for Payer: Healthscope Commercial |
$3,334.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,778.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,149.14
|
| Rate for Payer: Nomi Health Commercial |
$3,037.99
|
| Rate for Payer: PHP Commercial |
$3,149.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,408.17
|
| Rate for Payer: Priority Health HMO/PPO |
$3,223.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,482.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,260.29
|
| Rate for Payer: UHC Core |
$3,093.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,778.65
|
|
|
HC LEAD REMOVAL SINGLE
|
Facility
|
OP
|
$3,704.87
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
36100073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$879.91 |
| Max. Negotiated Rate |
$3,334.38 |
| Rate for Payer: Aetna Commercial |
$3,149.14
|
| Rate for Payer: Aetna Medicare |
$963.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,157.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,157.77
|
| Rate for Payer: BCBS Complete |
$2,762.96
|
| Rate for Payer: BCBS MAPPO |
$926.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,045.77
|
| Rate for Payer: BCN Commercial |
$2,880.54
|
| Rate for Payer: BCN Medicare Advantage |
$926.22
|
| Rate for Payer: Cash Price |
$2,963.90
|
| Rate for Payer: Cash Price |
$2,963.90
|
| Rate for Payer: Cofinity Commercial |
$3,186.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,963.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$926.22
|
| Rate for Payer: Healthscope Commercial |
$3,334.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,778.65
|
| Rate for Payer: Mclaren Medicaid |
$2,631.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.53
|
| Rate for Payer: Meridian Medicaid |
$2,762.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,065.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,149.14
|
| Rate for Payer: Nomi Health Commercial |
$3,037.99
|
| Rate for Payer: PACE Senior Care Partners |
$879.91
|
| Rate for Payer: PACE SWMI |
$926.22
|
| Rate for Payer: PHP Commercial |
$3,149.14
|
| Rate for Payer: PHP Medicare Advantage |
$926.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,631.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,408.17
|
| Rate for Payer: Priority Health HMO/PPO |
$3,223.24
|
| Rate for Payer: Priority Health Medicare |
$935.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,482.26
|
| Rate for Payer: Railroad Medicare Medicare |
$926.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,260.29
|
| Rate for Payer: UHC Core |
$3,093.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$926.22
|
| Rate for Payer: UHC Exchange |
$926.22
|
| Rate for Payer: UHC Medicare Advantage |
$926.22
|
| Rate for Payer: UHCCP Medicaid |
$2,631.21
|
| Rate for Payer: VA VA |
$926.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,778.65
|
|
|
HC LECITHIN-SPHINGOMYELIN
|
Facility
|
IP
|
$96.90
|
|
|
Service Code
|
CPT 83661
|
| Hospital Charge Code |
30100634
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.98 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: BCBS Trust/PPO |
$79.10
|
| Rate for Payer: BCN Commercial |
$74.88
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.36
|
| Rate for Payer: Nomi Health Commercial |
$79.46
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.98
|
| Rate for Payer: Priority Health HMO/PPO |
$84.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.27
|
| Rate for Payer: UHC Core |
$80.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.67
|
|
|
HC LECITHIN-SPHINGOMYELIN
|
Facility
|
OP
|
$96.90
|
|
|
Service Code
|
CPT 83661
|
| Hospital Charge Code |
30100634
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.90 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: Aetna Medicare |
$25.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.28
|
| Rate for Payer: BCBS Complete |
$16.69
|
| Rate for Payer: BCBS MAPPO |
$24.23
|
| Rate for Payer: BCBS Trust/PPO |
$79.66
|
| Rate for Payer: BCN Commercial |
$75.34
|
| Rate for Payer: BCN Medicare Advantage |
$24.23
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.23
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.67
|
| Rate for Payer: Mclaren Medicaid |
$15.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.44
|
| Rate for Payer: Meridian Medicaid |
$16.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.36
|
| Rate for Payer: Nomi Health Commercial |
$79.46
|
| Rate for Payer: PACE Senior Care Partners |
$23.01
|
| Rate for Payer: PACE SWMI |
$24.23
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: PHP Medicare Advantage |
$24.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.98
|
| Rate for Payer: Priority Health HMO/PPO |
$84.30
|
| Rate for Payer: Priority Health Medicare |
$24.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.92
|
| Rate for Payer: Railroad Medicare Medicare |
$24.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.27
|
| Rate for Payer: UHC Core |
$80.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.23
|
| Rate for Payer: UHC Exchange |
$24.23
|
| Rate for Payer: UHC Medicare Advantage |
$24.23
|
| Rate for Payer: UHCCP Medicaid |
$15.90
|
| Rate for Payer: VA VA |
$24.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.67
|
|
|
HC LEFT ATRIAL APPENDAGE CLOS WITH ENDOCARDIAL IMPLANT
|
Facility
|
IP
|
$29,495.34
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
48100112
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$19,171.97 |
| Max. Negotiated Rate |
$26,545.81 |
| Rate for Payer: Aetna Commercial |
$25,071.04
|
| Rate for Payer: BCBS Trust/PPO |
$24,077.05
|
| Rate for Payer: BCN Commercial |
$22,794.00
|
| Rate for Payer: Cash Price |
$23,596.27
|
| Rate for Payer: Cofinity Commercial |
$25,365.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,596.27
|
| Rate for Payer: Healthscope Commercial |
$26,545.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,121.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,071.04
|
| Rate for Payer: Nomi Health Commercial |
$24,186.18
|
| Rate for Payer: PHP Commercial |
$25,071.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,171.97
|
| Rate for Payer: Priority Health HMO/PPO |
$25,660.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,761.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,955.90
|
| Rate for Payer: UHC Core |
$24,628.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,121.51
|
|
|
HC LEFT ATRIAL APPENDAGE CLOS WITH ENDOCARDIAL IMPLANT
|
Facility
|
OP
|
$29,495.34
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
48100112
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,005.14 |
| Max. Negotiated Rate |
$26,545.81 |
| Rate for Payer: Aetna Commercial |
$25,071.04
|
| Rate for Payer: Aetna Medicare |
$7,668.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,217.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,217.29
|
| Rate for Payer: BCBS Complete |
$11,798.14
|
| Rate for Payer: BCBS MAPPO |
$7,373.84
|
| Rate for Payer: BCBS Trust/PPO |
$24,248.12
|
| Rate for Payer: BCN Commercial |
$22,932.63
|
| Rate for Payer: BCN Medicare Advantage |
$7,373.84
|
| Rate for Payer: Cash Price |
$23,596.27
|
| Rate for Payer: Cofinity Commercial |
$25,365.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,596.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,373.84
|
| Rate for Payer: Healthscope Commercial |
$26,545.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,121.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,742.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,479.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,071.04
|
| Rate for Payer: Nomi Health Commercial |
$24,186.18
|
| Rate for Payer: PACE Senior Care Partners |
$7,005.14
|
| Rate for Payer: PACE SWMI |
$7,373.84
|
| Rate for Payer: PHP Commercial |
$25,071.04
|
| Rate for Payer: PHP Medicare Advantage |
$7,373.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,171.97
|
| Rate for Payer: Priority Health HMO/PPO |
$25,660.95
|
| Rate for Payer: Priority Health Medicare |
$7,447.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,761.88
|
| Rate for Payer: Railroad Medicare Medicare |
$7,373.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,955.90
|
| Rate for Payer: UHC Core |
$24,628.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,373.84
|
| Rate for Payer: UHC Exchange |
$7,373.84
|
| Rate for Payer: UHC Medicare Advantage |
$7,373.84
|
| Rate for Payer: VA VA |
$7,373.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,121.51
|
|
|
HC LEFT CATH W INTERVENTION
|
Facility
|
IP
|
$9,854.02
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100049
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,405.11 |
| Max. Negotiated Rate |
$8,868.62 |
| Rate for Payer: Aetna Commercial |
$8,375.92
|
| Rate for Payer: BCBS Trust/PPO |
$8,043.84
|
| Rate for Payer: BCN Commercial |
$7,615.19
|
| Rate for Payer: Cash Price |
$7,883.22
|
| Rate for Payer: Cofinity Commercial |
$8,474.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,883.22
|
| Rate for Payer: Healthscope Commercial |
$8,868.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,390.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,375.92
|
| Rate for Payer: Nomi Health Commercial |
$8,080.30
|
| Rate for Payer: PHP Commercial |
$8,375.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,405.11
|
| Rate for Payer: Priority Health HMO/PPO |
$8,573.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,602.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,671.54
|
| Rate for Payer: UHC Core |
$8,228.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,390.52
|
|
|
HC LEFT CATH W INTERVENTION
|
Facility
|
OP
|
$9,854.02
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100049
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,325.46 |
| Max. Negotiated Rate |
$8,868.62 |
| Rate for Payer: Aetna Commercial |
$8,375.92
|
| Rate for Payer: Aetna Medicare |
$2,562.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,079.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,079.38
|
| Rate for Payer: BCBS Complete |
$2,441.90
|
| Rate for Payer: BCBS MAPPO |
$2,463.51
|
| Rate for Payer: BCBS Trust/PPO |
$8,100.99
|
| Rate for Payer: BCN Commercial |
$7,661.50
|
| Rate for Payer: BCN Medicare Advantage |
$2,463.51
|
| Rate for Payer: Cash Price |
$7,883.22
|
| Rate for Payer: Cash Price |
$7,883.22
|
| Rate for Payer: Cofinity Commercial |
$8,474.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,883.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,463.51
|
| Rate for Payer: Healthscope Commercial |
$8,868.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,390.52
|
| Rate for Payer: Mclaren Medicaid |
$2,325.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,586.68
|
| Rate for Payer: Meridian Medicaid |
$2,441.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,833.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,375.92
|
| Rate for Payer: Nomi Health Commercial |
$8,080.30
|
| Rate for Payer: PACE Senior Care Partners |
$2,340.33
|
| Rate for Payer: PACE SWMI |
$2,463.51
|
| Rate for Payer: PHP Commercial |
$8,375.92
|
| Rate for Payer: PHP Medicare Advantage |
$2,463.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,325.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,405.11
|
| Rate for Payer: Priority Health HMO/PPO |
$8,573.00
|
| Rate for Payer: Priority Health Medicare |
$2,488.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,602.19
|
| Rate for Payer: Railroad Medicare Medicare |
$2,463.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,671.54
|
| Rate for Payer: UHC Core |
$8,228.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,463.51
|
| Rate for Payer: UHC Exchange |
$2,463.51
|
| Rate for Payer: UHC Medicare Advantage |
$2,463.51
|
| Rate for Payer: UHCCP Medicaid |
$2,325.46
|
| Rate for Payer: VA VA |
$2,463.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,390.52
|
|
|
HC LEGAL BLOOD DRAW KZO CO/STATE/OTHER
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000049
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: BCBS Trust/PPO |
$81.63
|
| Rate for Payer: BCN Commercial |
$77.28
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$82.00
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.00
|
| Rate for Payer: Priority Health HMO/PPO |
$87.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.00
|
| Rate for Payer: UHC Core |
$83.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC LEGAL BLOOD DRAW KZO CO/STATE/OTHER
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000049
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: Aetna Medicare |
$26.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.25
|
| Rate for Payer: BCBS Complete |
$6.90
|
| Rate for Payer: BCBS MAPPO |
$25.00
|
| Rate for Payer: BCBS Trust/PPO |
$82.21
|
| Rate for Payer: BCN Commercial |
$77.75
|
| Rate for Payer: BCN Medicare Advantage |
$25.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: City of Battle Creek Police Dept Commercial |
$50.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: Mclaren Medicaid |
$6.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.25
|
| Rate for Payer: Meridian Medicaid |
$6.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.75
|
| Rate for Payer: Michigan State Police Michigan State Police |
$50.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$82.00
|
| Rate for Payer: PACE Senior Care Partners |
$23.75
|
| Rate for Payer: PACE SWMI |
$25.00
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: PHP Medicare Advantage |
$25.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.00
|
| Rate for Payer: Priority Health HMO/PPO |
$87.00
|
| Rate for Payer: Priority Health Medicare |
$25.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.00
|
| Rate for Payer: Railroad Medicare Medicare |
$25.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.00
|
| Rate for Payer: UHC Core |
$83.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.00
|
| Rate for Payer: UHC Exchange |
$25.00
|
| Rate for Payer: UHC Medicare Advantage |
$25.00
|
| Rate for Payer: UHCCP Medicaid |
$6.57
|
| Rate for Payer: VA VA |
$25.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC LEGIONELLA
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600300
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.14 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: BCBS Trust/PPO |
$41.61
|
| Rate for Payer: BCN Commercial |
$39.40
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$43.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health HMO/PPO |
$44.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.86
|
| Rate for Payer: UHC Core |
$42.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.23
|
|
