|
HC SCALLOP IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200060
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC SCALLOP IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200060
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC SCALP ELECTRODE
|
Facility
|
OP
|
$131.15
|
|
| Hospital Charge Code |
72000005
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$31.15 |
| Max. Negotiated Rate |
$118.04 |
| Rate for Payer: Aetna Commercial |
$111.48
|
| Rate for Payer: Aetna Medicare |
$34.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.98
|
| Rate for Payer: BCBS Complete |
$52.46
|
| Rate for Payer: BCBS MAPPO |
$32.79
|
| Rate for Payer: BCBS Trust/PPO |
$101.97
|
| Rate for Payer: BCN Commercial |
$101.97
|
| Rate for Payer: BCN Medicare Advantage |
$32.79
|
| Rate for Payer: Cash Price |
$104.92
|
| Rate for Payer: Cofinity Commercial |
$112.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.79
|
| Rate for Payer: Healthscope Commercial |
$118.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$111.48
|
| Rate for Payer: PACE Senior Care Partners |
$31.15
|
| Rate for Payer: PACE SWMI |
$32.79
|
| Rate for Payer: PHP Commercial |
$111.48
|
| Rate for Payer: PHP Medicare Advantage |
$32.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.10
|
| Rate for Payer: Priority Health Medicare |
$32.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.99
|
| Rate for Payer: Railroad Medicare Medicare |
$32.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.41
|
| Rate for Payer: UHC Core |
$109.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.79
|
| Rate for Payer: UHC Medicare Advantage |
$33.77
|
| Rate for Payer: VA VA |
$32.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.36
|
|
|
HC SCALP ELECTRODE
|
Facility
|
IP
|
$131.15
|
|
| Hospital Charge Code |
72000005
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$79.99 |
| Max. Negotiated Rate |
$118.04 |
| Rate for Payer: Aetna Commercial |
$111.48
|
| Rate for Payer: BCBS Trust/PPO |
$101.35
|
| Rate for Payer: BCN Commercial |
$101.35
|
| Rate for Payer: Cash Price |
$104.92
|
| Rate for Payer: Cofinity Commercial |
$112.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.92
|
| Rate for Payer: Healthscope Commercial |
$118.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$111.48
|
| Rate for Payer: PHP Commercial |
$111.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.41
|
| Rate for Payer: UHC Core |
$109.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.36
|
|
|
HC SCHISTOSOMA SPECIES ANTIBODY, IGG, SERUM
|
Facility
|
OP
|
$97.80
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200489
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$88.02 |
| Rate for Payer: Aetna Commercial |
$83.13
|
| Rate for Payer: Aetna Medicare |
$25.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.56
|
| Rate for Payer: BCBS Complete |
$10.08
|
| Rate for Payer: BCBS MAPPO |
$24.45
|
| Rate for Payer: BCBS Trust/PPO |
$76.04
|
| Rate for Payer: BCN Commercial |
$76.04
|
| Rate for Payer: BCN Medicare Advantage |
$24.45
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cofinity Commercial |
$84.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.45
|
| Rate for Payer: Healthscope Commercial |
$88.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.35
|
| Rate for Payer: Mclaren Medicaid |
$9.60
|
| Rate for Payer: Meridian Medicaid |
$10.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$83.13
|
| Rate for Payer: PACE Senior Care Partners |
$23.23
|
| Rate for Payer: PACE SWMI |
$24.45
|
| Rate for Payer: PHP Commercial |
$83.13
|
| Rate for Payer: PHP Medicare Advantage |
$24.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.09
|
| Rate for Payer: Priority Health Medicare |
$24.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.65
|
| Rate for Payer: Railroad Medicare Medicare |
$24.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.06
|
| Rate for Payer: UHC Core |
$81.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.45
|
| Rate for Payer: UHC Medicare Advantage |
$25.18
|
| Rate for Payer: VA VA |
$24.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.35
|
|
|
HC SCHISTOSOMA SPECIES ANTIBODY, IGG, SERUM
|
Facility
|
IP
|
$97.80
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200489
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$59.65 |
| Max. Negotiated Rate |
$88.02 |
| Rate for Payer: Aetna Commercial |
$83.13
|
| Rate for Payer: BCBS Trust/PPO |
$75.58
|
| Rate for Payer: BCN Commercial |
$75.58
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cofinity Commercial |
$84.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.24
|
| Rate for Payer: Healthscope Commercial |
$88.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$83.13
|
| Rate for Payer: PHP Commercial |
$83.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.06
|
| Rate for Payer: UHC Core |
$81.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.35
|
|
|
HC SCISSORS
|
Facility
|
IP
|
$17.32
|
|
| Hospital Charge Code |
27000143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.56 |
| Max. Negotiated Rate |
$15.59 |
| Rate for Payer: Aetna Commercial |
$14.72
|
| Rate for Payer: BCBS Trust/PPO |
$13.38
|
| Rate for Payer: BCN Commercial |
$13.38
|
| Rate for Payer: Cash Price |
$13.86
|
| Rate for Payer: Cofinity Commercial |
$14.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.86
|
| Rate for Payer: Healthscope Commercial |
$15.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.72
|
| Rate for Payer: PHP Commercial |
$14.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.24
|
| Rate for Payer: UHC Core |
$14.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.99
|
|
|
HC SCISSORS
|
Facility
|
OP
|
$17.32
|
|
| Hospital Charge Code |
27000143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.11 |
| Max. Negotiated Rate |
$15.59 |
| Rate for Payer: Aetna Commercial |
$14.72
|
| Rate for Payer: Aetna Medicare |
$4.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.41
|
| Rate for Payer: BCBS Complete |
$6.93
|
| Rate for Payer: BCBS MAPPO |
$4.33
|
| Rate for Payer: BCBS Trust/PPO |
$13.47
|
| Rate for Payer: BCN Commercial |
$13.47
|
| Rate for Payer: BCN Medicare Advantage |
$4.33
|
| Rate for Payer: Cash Price |
$13.86
|
| Rate for Payer: Cofinity Commercial |
$14.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.33
|
| Rate for Payer: Healthscope Commercial |
$15.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.72
|
| Rate for Payer: PACE Senior Care Partners |
$4.11
|
| Rate for Payer: PACE SWMI |
$4.33
|
| Rate for Payer: PHP Commercial |
$14.72
|
| Rate for Payer: PHP Medicare Advantage |
$4.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.07
|
| Rate for Payer: Priority Health Medicare |
$4.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.56
|
| Rate for Payer: Railroad Medicare Medicare |
$4.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.24
|
| Rate for Payer: UHC Core |
$14.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.33
|
| Rate for Payer: UHC Medicare Advantage |
$4.46
|
| Rate for Payer: VA VA |
$4.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.99
|
|
|
HC SCL70 SCLERODERMA AB
|
Facility
|
IP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200161
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.03 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: BCBS Trust/PPO |
$26.65
|
| Rate for Payer: BCN Commercial |
$26.65
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
| Rate for Payer: UHC Core |
$28.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC SCL70 SCLERODERMA AB
|
Facility
|
OP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200161
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$26.81
|
| Rate for Payer: BCN Commercial |
$26.81
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PACE Senior Care Partners |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
| Rate for Payer: UHC Core |
$28.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$8.88
|
| Rate for Payer: VA VA |
$8.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC SCLEROTHERAPY OF FLUID COLLECTION
|
Facility
|
OP
|
$2,125.40
|
|
|
Service Code
|
CPT 49185
|
| Hospital Charge Code |
36100501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$504.78 |
| Max. Negotiated Rate |
$1,912.86 |
| Rate for Payer: Aetna Commercial |
$1,806.59
|
| Rate for Payer: Aetna Medicare |
$552.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$664.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$664.19
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$531.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,652.50
|
| Rate for Payer: BCN Commercial |
$1,652.50
|
| Rate for Payer: BCN Medicare Advantage |
$531.35
|
| Rate for Payer: Cash Price |
$1,700.32
|
| Rate for Payer: Cash Price |
$1,700.32
|
| Rate for Payer: Cofinity Commercial |
$1,827.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,700.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$531.35
|
| Rate for Payer: Healthscope Commercial |
$1,912.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,594.05
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$557.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$611.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,806.59
|
| Rate for Payer: PACE Senior Care Partners |
$504.78
|
| Rate for Payer: PACE SWMI |
$531.35
|
| Rate for Payer: PHP Commercial |
$1,806.59
|
| Rate for Payer: PHP Medicare Advantage |
$531.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,849.10
|
| Rate for Payer: Priority Health Medicare |
$531.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,296.28
|
| Rate for Payer: Railroad Medicare Medicare |
$531.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,870.35
|
| Rate for Payer: UHC Core |
$1,774.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$531.35
|
| Rate for Payer: UHC Medicare Advantage |
$547.29
|
| Rate for Payer: VA VA |
$531.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,594.05
|
|
|
HC SCLEROTHERAPY OF FLUID COLLECTION
|
Facility
|
IP
|
$2,125.40
|
|
|
Service Code
|
CPT 49185
|
| Hospital Charge Code |
36100501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,296.28 |
| Max. Negotiated Rate |
$1,912.86 |
| Rate for Payer: Aetna Commercial |
$1,806.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,642.51
|
| Rate for Payer: BCN Commercial |
$1,642.51
|
| Rate for Payer: Cash Price |
$1,700.32
|
| Rate for Payer: Cofinity Commercial |
$1,827.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,700.32
|
| Rate for Payer: Healthscope Commercial |
$1,912.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,594.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,806.59
|
| Rate for Payer: PHP Commercial |
$1,806.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,849.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,296.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,870.35
|
| Rate for Payer: UHC Core |
$1,774.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,594.05
|
|
|
HC SCREENING PAP SMEAR, OBTAIN PREP TO LAB
|
Facility
|
OP
|
$77.05
|
|
|
Service Code
|
CPT Q0091
|
| Hospital Charge Code |
31100043
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$15.88 |
| Max. Negotiated Rate |
$69.34 |
| Rate for Payer: Aetna Commercial |
$65.49
|
| Rate for Payer: Aetna Medicare |
$20.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.08
|
| Rate for Payer: BCBS Complete |
$20.51
|
| Rate for Payer: BCBS MAPPO |
$19.26
|
| Rate for Payer: BCBS Trust/PPO |
$59.91
|
| Rate for Payer: BCCCP Commercial |
$15.88
|
| Rate for Payer: BCN Commercial |
$59.91
|
| Rate for Payer: BCN Medicare Advantage |
$19.26
|
| Rate for Payer: Cash Price |
$61.64
|
| Rate for Payer: Cash Price |
$61.64
|
| Rate for Payer: Cofinity Commercial |
$66.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.26
|
| Rate for Payer: Healthscope Commercial |
$69.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.79
|
| Rate for Payer: Mclaren Medicaid |
$19.53
|
| Rate for Payer: Meridian Medicaid |
$20.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.49
|
| Rate for Payer: PACE Senior Care Partners |
$18.30
|
| Rate for Payer: PACE SWMI |
$19.26
|
| Rate for Payer: PHP Commercial |
$65.49
|
| Rate for Payer: PHP Medicare Advantage |
$19.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.03
|
| Rate for Payer: Priority Health Medicare |
$19.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.99
|
| Rate for Payer: Railroad Medicare Medicare |
$19.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.80
|
| Rate for Payer: UHC Core |
$64.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.26
|
| Rate for Payer: UHC Medicare Advantage |
$19.84
|
| Rate for Payer: VA VA |
$19.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.79
|
|
|
HC SCREENING PAP SMEAR, OBTAIN PREP TO LAB
|
Facility
|
IP
|
$77.05
|
|
|
Service Code
|
CPT Q0091
|
| Hospital Charge Code |
31100043
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$46.99 |
| Max. Negotiated Rate |
$69.34 |
| Rate for Payer: Aetna Commercial |
$65.49
|
| Rate for Payer: BCBS Trust/PPO |
$59.54
|
| Rate for Payer: BCN Commercial |
$59.54
|
| Rate for Payer: Cash Price |
$61.64
|
| Rate for Payer: Cofinity Commercial |
$66.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.64
|
| Rate for Payer: Healthscope Commercial |
$69.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.49
|
| Rate for Payer: PHP Commercial |
$65.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.80
|
| Rate for Payer: UHC Core |
$64.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.79
|
|
|
HC SCREENING TOMOSYNTHESIS
|
Facility
|
OP
|
$101.19
|
|
|
Service Code
|
CPT 77063
|
| Hospital Charge Code |
32000301
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$24.03 |
| Max. Negotiated Rate |
$91.07 |
| Rate for Payer: Aetna Commercial |
$86.01
|
| Rate for Payer: Aetna Medicare |
$26.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.62
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS MAPPO |
$25.30
|
| Rate for Payer: BCBS Trust/PPO |
$78.68
|
| Rate for Payer: BCCCP Commercial |
$54.20
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Medicare Advantage |
$25.30
|
| Rate for Payer: Cash Price |
$80.95
|
| Rate for Payer: Cash Price |
$80.95
|
| Rate for Payer: Cofinity Commercial |
$87.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$91.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.01
|
| Rate for Payer: PACE Senior Care Partners |
$24.03
|
| Rate for Payer: PACE SWMI |
$25.30
|
| Rate for Payer: PHP Commercial |
$86.01
|
| Rate for Payer: PHP Medicare Advantage |
$25.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.04
|
| Rate for Payer: Priority Health Medicare |
$25.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.72
|
| Rate for Payer: Railroad Medicare Medicare |
$25.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.05
|
| Rate for Payer: UHC Core |
$84.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.30
|
| Rate for Payer: UHC Medicare Advantage |
$26.06
|
| Rate for Payer: VA VA |
$25.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.89
|
|
|
HC SCREENING TOMOSYNTHESIS
|
Facility
|
IP
|
$101.19
|
|
|
Service Code
|
CPT 77063
|
| Hospital Charge Code |
32000301
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$61.72 |
| Max. Negotiated Rate |
$91.07 |
| Rate for Payer: Aetna Commercial |
$86.01
|
| Rate for Payer: BCBS Trust/PPO |
$78.20
|
| Rate for Payer: BCN Commercial |
$78.20
|
| Rate for Payer: Cash Price |
$80.95
|
| Rate for Payer: Cofinity Commercial |
$87.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.95
|
| Rate for Payer: Healthscope Commercial |
$91.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.01
|
| Rate for Payer: PHP Commercial |
$86.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.05
|
| Rate for Payer: UHC Core |
$84.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.89
|
|
|
HC SDL MSLT/MWT
|
Facility
|
OP
|
$2,521.75
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
92000005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$351.60 |
| Max. Negotiated Rate |
$2,269.58 |
| Rate for Payer: Aetna Commercial |
$2,143.49
|
| Rate for Payer: Aetna Medicare |
$655.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$788.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$788.05
|
| Rate for Payer: BCBS Complete |
$369.18
|
| Rate for Payer: BCBS MAPPO |
$630.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,960.66
|
| Rate for Payer: BCN Commercial |
$1,960.66
|
| Rate for Payer: BCN Medicare Advantage |
$630.44
|
| Rate for Payer: Cash Price |
$2,017.40
|
| Rate for Payer: Cash Price |
$2,017.40
|
| Rate for Payer: Cofinity Commercial |
$2,168.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,017.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$630.44
|
| Rate for Payer: Healthscope Commercial |
$2,269.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,891.31
|
| Rate for Payer: Mclaren Medicaid |
$351.60
|
| Rate for Payer: Meridian Medicaid |
$369.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$661.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$725.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,143.49
|
| Rate for Payer: PACE Senior Care Partners |
$598.92
|
| Rate for Payer: PACE SWMI |
$630.44
|
| Rate for Payer: PHP Commercial |
$2,143.49
|
| Rate for Payer: PHP Medicare Advantage |
$630.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,765.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,193.92
|
| Rate for Payer: Priority Health Medicare |
$630.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,538.02
|
| Rate for Payer: Railroad Medicare Medicare |
$630.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,219.14
|
| Rate for Payer: UHC Core |
$2,105.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$630.44
|
| Rate for Payer: UHC Medicare Advantage |
$649.35
|
| Rate for Payer: VA VA |
$630.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,891.31
|
|
|
HC SDL MSLT/MWT
|
Facility
|
IP
|
$2,521.75
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
92000005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,538.02 |
| Max. Negotiated Rate |
$2,269.58 |
| Rate for Payer: Aetna Commercial |
$2,143.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,948.81
|
| Rate for Payer: BCN Commercial |
$1,948.81
|
| Rate for Payer: Cash Price |
$2,017.40
|
| Rate for Payer: Cofinity Commercial |
$2,168.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,017.40
|
| Rate for Payer: Healthscope Commercial |
$2,269.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,891.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,143.49
|
| Rate for Payer: PHP Commercial |
$2,143.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,765.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,193.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,538.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,219.14
|
| Rate for Payer: UHC Core |
$2,105.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,891.31
|
|
|
HC SDL POLYSOMNOGRAPHY
|
Facility
|
OP
|
$3,490.58
|
|
|
Service Code
|
CPT 95810
|
| Hospital Charge Code |
74000001
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$685.87 |
| Max. Negotiated Rate |
$3,141.52 |
| Rate for Payer: Aetna Commercial |
$2,966.99
|
| Rate for Payer: Aetna Medicare |
$907.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,090.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,090.81
|
| Rate for Payer: BCBS Complete |
$720.16
|
| Rate for Payer: BCBS MAPPO |
$872.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,713.93
|
| Rate for Payer: BCN Commercial |
$2,713.93
|
| Rate for Payer: BCN Medicare Advantage |
$872.64
|
| Rate for Payer: Cash Price |
$2,792.46
|
| Rate for Payer: Cash Price |
$2,792.46
|
| Rate for Payer: Cofinity Commercial |
$3,001.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,792.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$872.64
|
| Rate for Payer: Healthscope Commercial |
$3,141.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,617.94
|
| Rate for Payer: Mclaren Medicaid |
$685.87
|
| Rate for Payer: Meridian Medicaid |
$720.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$916.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,003.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,966.99
|
| Rate for Payer: PACE Senior Care Partners |
$829.01
|
| Rate for Payer: PACE SWMI |
$872.64
|
| Rate for Payer: PHP Commercial |
$2,966.99
|
| Rate for Payer: PHP Medicare Advantage |
$872.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$685.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,443.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,036.80
|
| Rate for Payer: Priority Health Medicare |
$872.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,128.90
|
| Rate for Payer: Railroad Medicare Medicare |
$872.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,071.71
|
| Rate for Payer: UHC Core |
$2,914.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$872.64
|
| Rate for Payer: UHC Medicare Advantage |
$898.82
|
| Rate for Payer: VA VA |
$872.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,617.94
|
|
|
HC SDL POLYSOMNOGRAPHY
|
Facility
|
IP
|
$3,490.58
|
|
|
Service Code
|
CPT 95810
|
| Hospital Charge Code |
74000001
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$2,128.90 |
| Max. Negotiated Rate |
$3,141.52 |
| Rate for Payer: Aetna Commercial |
$2,966.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,697.52
|
| Rate for Payer: BCN Commercial |
$2,697.52
|
| Rate for Payer: Cash Price |
$2,792.46
|
| Rate for Payer: Cofinity Commercial |
$3,001.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,792.46
|
| Rate for Payer: Healthscope Commercial |
$3,141.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,617.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,966.99
|
| Rate for Payer: PHP Commercial |
$2,966.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,443.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,036.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,128.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,071.71
|
| Rate for Payer: UHC Core |
$2,914.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,617.94
|
|
|
HC SDL PSG WITH CPAP/BIPAP
|
Facility
|
OP
|
$3,859.04
|
|
|
Service Code
|
CPT 95811
|
| Hospital Charge Code |
74000002
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$685.87 |
| Max. Negotiated Rate |
$3,473.14 |
| Rate for Payer: Aetna Commercial |
$3,280.18
|
| Rate for Payer: Aetna Medicare |
$1,003.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,205.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,205.95
|
| Rate for Payer: BCBS Complete |
$720.16
|
| Rate for Payer: BCBS MAPPO |
$964.76
|
| Rate for Payer: BCBS Trust/PPO |
$3,000.40
|
| Rate for Payer: BCN Commercial |
$3,000.40
|
| Rate for Payer: BCN Medicare Advantage |
$964.76
|
| Rate for Payer: Cash Price |
$3,087.23
|
| Rate for Payer: Cash Price |
$3,087.23
|
| Rate for Payer: Cofinity Commercial |
$3,318.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,087.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$964.76
|
| Rate for Payer: Healthscope Commercial |
$3,473.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,894.28
|
| Rate for Payer: Mclaren Medicaid |
$685.87
|
| Rate for Payer: Meridian Medicaid |
$720.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,013.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,109.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,280.18
|
| Rate for Payer: PACE Senior Care Partners |
$916.52
|
| Rate for Payer: PACE SWMI |
$964.76
|
| Rate for Payer: PHP Commercial |
$3,280.18
|
| Rate for Payer: PHP Medicare Advantage |
$964.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$685.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,701.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,357.36
|
| Rate for Payer: Priority Health Medicare |
$964.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,353.63
|
| Rate for Payer: Railroad Medicare Medicare |
$964.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,395.96
|
| Rate for Payer: UHC Core |
$3,222.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$964.76
|
| Rate for Payer: UHC Medicare Advantage |
$993.70
|
| Rate for Payer: VA VA |
$964.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,894.28
|
|
|
HC SDL PSG WITH CPAP/BIPAP
|
Facility
|
IP
|
$3,859.04
|
|
|
Service Code
|
CPT 95811
|
| Hospital Charge Code |
74000002
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$2,353.63 |
| Max. Negotiated Rate |
$3,473.14 |
| Rate for Payer: Aetna Commercial |
$3,280.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,982.27
|
| Rate for Payer: BCN Commercial |
$2,982.27
|
| Rate for Payer: Cash Price |
$3,087.23
|
| Rate for Payer: Cofinity Commercial |
$3,318.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,087.23
|
| Rate for Payer: Healthscope Commercial |
$3,473.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,894.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,280.18
|
| Rate for Payer: PHP Commercial |
$3,280.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,701.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,357.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,353.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,395.96
|
| Rate for Payer: UHC Core |
$3,222.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,894.28
|
|
|
HC SEDATION IV / IM OR INHALANT
|
Facility
|
OP
|
$720.47
|
|
| Hospital Charge Code |
37000005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$171.11 |
| Max. Negotiated Rate |
$648.42 |
| Rate for Payer: Aetna Commercial |
$612.40
|
| Rate for Payer: Aetna Medicare |
$187.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$225.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$225.15
|
| Rate for Payer: BCBS Complete |
$288.19
|
| Rate for Payer: BCBS MAPPO |
$180.12
|
| Rate for Payer: BCBS Trust/PPO |
$560.17
|
| Rate for Payer: BCN Commercial |
$560.17
|
| Rate for Payer: BCN Medicare Advantage |
$180.12
|
| Rate for Payer: Cash Price |
$576.38
|
| Rate for Payer: Cofinity Commercial |
$619.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.12
|
| Rate for Payer: Healthscope Commercial |
$648.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$189.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$612.40
|
| Rate for Payer: PACE Senior Care Partners |
$171.11
|
| Rate for Payer: PACE SWMI |
$180.12
|
| Rate for Payer: PHP Commercial |
$612.40
|
| Rate for Payer: PHP Medicare Advantage |
$180.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$626.81
|
| Rate for Payer: Priority Health Medicare |
$180.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$439.41
|
| Rate for Payer: Railroad Medicare Medicare |
$180.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$634.01
|
| Rate for Payer: UHC Core |
$601.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.12
|
| Rate for Payer: UHC Medicare Advantage |
$185.52
|
| Rate for Payer: VA VA |
$180.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.35
|
|
|
HC SEDATION IV / IM OR INHALANT
|
Facility
|
IP
|
$720.47
|
|
| Hospital Charge Code |
37000005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$439.41 |
| Max. Negotiated Rate |
$648.42 |
| Rate for Payer: Aetna Commercial |
$612.40
|
| Rate for Payer: BCBS Trust/PPO |
$556.78
|
| Rate for Payer: BCN Commercial |
$556.78
|
| Rate for Payer: Cash Price |
$576.38
|
| Rate for Payer: Cofinity Commercial |
$619.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.38
|
| Rate for Payer: Healthscope Commercial |
$648.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$612.40
|
| Rate for Payer: PHP Commercial |
$612.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$626.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$439.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$634.01
|
| Rate for Payer: UHC Core |
$601.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.35
|
|
|
HC SED RATE WESTERGREN
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
30500060
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.99 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna Medicare |
$3.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.78
|
| Rate for Payer: BCBS Complete |
$2.09
|
| Rate for Payer: BCBS MAPPO |
$3.82
|
| Rate for Payer: BCBS Trust/PPO |
$11.90
|
| Rate for Payer: BCN Commercial |
$11.90
|
| Rate for Payer: BCN Medicare Advantage |
$3.82
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.82
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Mclaren Medicaid |
$1.99
|
| Rate for Payer: Meridian Medicaid |
$2.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PACE Senior Care Partners |
$3.63
|
| Rate for Payer: PACE SWMI |
$3.82
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Medicare Advantage |
$3.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.31
|
| Rate for Payer: Priority Health Medicare |
$3.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.33
|
| Rate for Payer: Railroad Medicare Medicare |
$3.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.46
|
| Rate for Payer: UHC Core |
$12.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.82
|
| Rate for Payer: UHC Medicare Advantage |
$3.94
|
| Rate for Payer: VA VA |
$3.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
