|
HC LIVER KIDNEY MICROSOME ANTIBODY
|
Facility
|
IP
|
$56.60
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200208
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.79 |
| Max. Negotiated Rate |
$50.94 |
| Rate for Payer: Aetna Commercial |
$48.11
|
| Rate for Payer: BCBS Trust/PPO |
$46.20
|
| Rate for Payer: BCN Commercial |
$43.74
|
| Rate for Payer: Cash Price |
$45.28
|
| Rate for Payer: Cofinity Commercial |
$48.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.28
|
| Rate for Payer: Healthscope Commercial |
$50.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.11
|
| Rate for Payer: Nomi Health Commercial |
$46.41
|
| Rate for Payer: PHP Commercial |
$48.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.79
|
| Rate for Payer: Priority Health HMO/PPO |
$49.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.81
|
| Rate for Payer: UHC Core |
$47.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.45
|
|
|
HC LOBSTER IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200045
|
|
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 LOBSTER IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200045
|
|
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 LOCAL ANES ADDL 15 MIN
|
Facility
|
IP
|
$96.37
|
|
| Hospital Charge Code |
37000009
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$62.64 |
| Max. Negotiated Rate |
$86.73 |
| Rate for Payer: Aetna Commercial |
$81.91
|
| Rate for Payer: BCBS Trust/PPO |
$78.67
|
| Rate for Payer: BCN Commercial |
$74.47
|
| Rate for Payer: Cash Price |
$77.10
|
| Rate for Payer: Cofinity Commercial |
$82.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.10
|
| Rate for Payer: Healthscope Commercial |
$86.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.91
|
| Rate for Payer: Nomi Health Commercial |
$79.02
|
| Rate for Payer: PHP Commercial |
$81.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.64
|
| Rate for Payer: Priority Health HMO/PPO |
$83.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.81
|
| Rate for Payer: UHC Core |
$80.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.28
|
|
|
HC LOCAL ANES ADDL 15 MIN
|
Facility
|
OP
|
$96.37
|
|
| Hospital Charge Code |
37000009
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$86.73 |
| Rate for Payer: Aetna Commercial |
$81.91
|
| Rate for Payer: Aetna Medicare |
$25.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.12
|
| Rate for Payer: BCBS Complete |
$38.55
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$79.23
|
| Rate for Payer: BCN Commercial |
$74.93
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$77.10
|
| Rate for Payer: Cofinity Commercial |
$82.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$86.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.91
|
| Rate for Payer: Nomi Health Commercial |
$79.02
|
| Rate for Payer: PACE Senior Care Partners |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$81.91
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.64
|
| Rate for Payer: Priority Health HMO/PPO |
$83.84
|
| Rate for Payer: Priority Health Medicare |
$24.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.57
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.81
|
| Rate for Payer: UHC Core |
$80.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.09
|
| Rate for Payer: UHC Exchange |
$24.09
|
| Rate for Payer: UHC Medicare Advantage |
$24.09
|
| Rate for Payer: VA VA |
$24.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.28
|
|
|
HC LOCAL ANES INIT 30 MIN
|
Facility
|
IP
|
$349.64
|
|
| Hospital Charge Code |
37000010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$227.27 |
| Max. Negotiated Rate |
$314.68 |
| Rate for Payer: Aetna Commercial |
$297.19
|
| Rate for Payer: BCBS Trust/PPO |
$285.41
|
| Rate for Payer: BCN Commercial |
$270.20
|
| Rate for Payer: Cash Price |
$279.71
|
| Rate for Payer: Cofinity Commercial |
$300.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.71
|
| Rate for Payer: Healthscope Commercial |
$314.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297.19
|
| Rate for Payer: Nomi Health Commercial |
$286.70
|
| Rate for Payer: PHP Commercial |
$297.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.27
|
| Rate for Payer: Priority Health HMO/PPO |
$304.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$234.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.68
|
| Rate for Payer: UHC Core |
$291.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.23
|
|
|
HC LOCAL ANES INIT 30 MIN
|
Facility
|
OP
|
$349.64
|
|
| Hospital Charge Code |
37000010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$83.04 |
| Max. Negotiated Rate |
$314.68 |
| Rate for Payer: Aetna Commercial |
$297.19
|
| Rate for Payer: Aetna Medicare |
$90.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.26
|
| Rate for Payer: BCBS Complete |
$139.86
|
| Rate for Payer: BCBS MAPPO |
$87.41
|
| Rate for Payer: BCBS Trust/PPO |
$287.44
|
| Rate for Payer: BCN Commercial |
$271.85
|
| Rate for Payer: BCN Medicare Advantage |
$87.41
|
| Rate for Payer: Cash Price |
$279.71
|
| Rate for Payer: Cofinity Commercial |
$300.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.41
|
| Rate for Payer: Healthscope Commercial |
$314.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297.19
|
| Rate for Payer: Nomi Health Commercial |
$286.70
|
| Rate for Payer: PACE Senior Care Partners |
$83.04
|
| Rate for Payer: PACE SWMI |
$87.41
|
| Rate for Payer: PHP Commercial |
$297.19
|
| Rate for Payer: PHP Medicare Advantage |
$87.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.27
|
| Rate for Payer: Priority Health HMO/PPO |
$304.19
|
| Rate for Payer: Priority Health Medicare |
$88.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$234.26
|
| Rate for Payer: Railroad Medicare Medicare |
$87.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.68
|
| Rate for Payer: UHC Core |
$291.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.41
|
| Rate for Payer: UHC Exchange |
$87.41
|
| Rate for Payer: UHC Medicare Advantage |
$87.41
|
| Rate for Payer: VA VA |
$87.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.23
|
|
|
HC LOCALIZATION CLIP
|
Facility
|
OP
|
$206.83
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800040
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$49.12 |
| Max. Negotiated Rate |
$186.15 |
| Rate for Payer: Aetna Commercial |
$175.81
|
| Rate for Payer: Aetna Medicare |
$53.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.63
|
| Rate for Payer: BCBS Complete |
$82.73
|
| Rate for Payer: BCBS MAPPO |
$51.71
|
| Rate for Payer: BCBS Trust/PPO |
$170.03
|
| Rate for Payer: BCN Commercial |
$160.81
|
| Rate for Payer: BCN Medicare Advantage |
$51.71
|
| Rate for Payer: Cash Price |
$165.46
|
| Rate for Payer: Cofinity Commercial |
$177.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.71
|
| Rate for Payer: Healthscope Commercial |
$186.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.81
|
| Rate for Payer: Nomi Health Commercial |
$169.60
|
| Rate for Payer: PACE Senior Care Partners |
$49.12
|
| Rate for Payer: PACE SWMI |
$51.71
|
| Rate for Payer: PHP Commercial |
$175.81
|
| Rate for Payer: PHP Medicare Advantage |
$51.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.44
|
| Rate for Payer: Priority Health HMO/PPO |
$179.94
|
| Rate for Payer: Priority Health Medicare |
$52.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.58
|
| Rate for Payer: Railroad Medicare Medicare |
$51.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.01
|
| Rate for Payer: UHC Core |
$172.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.71
|
| Rate for Payer: UHC Exchange |
$51.71
|
| Rate for Payer: UHC Medicare Advantage |
$51.71
|
| Rate for Payer: VA VA |
$51.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.12
|
|
|
HC LOCALIZATION CLIP
|
Facility
|
IP
|
$206.83
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800040
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.44 |
| Max. Negotiated Rate |
$186.15 |
| Rate for Payer: Aetna Commercial |
$175.81
|
| Rate for Payer: BCBS Trust/PPO |
$168.84
|
| Rate for Payer: BCN Commercial |
$159.84
|
| Rate for Payer: Cash Price |
$165.46
|
| Rate for Payer: Cofinity Commercial |
$177.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.46
|
| Rate for Payer: Healthscope Commercial |
$186.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.81
|
| Rate for Payer: Nomi Health Commercial |
$169.60
|
| Rate for Payer: PHP Commercial |
$175.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.44
|
| Rate for Payer: Priority Health HMO/PPO |
$179.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.01
|
| Rate for Payer: UHC Core |
$172.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.12
|
|
|
HC LOCALIZATION DEVICE LEVEL 1
|
Facility
|
IP
|
$146.88
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$95.47 |
| Max. Negotiated Rate |
$132.19 |
| Rate for Payer: Aetna Commercial |
$124.85
|
| Rate for Payer: BCBS Trust/PPO |
$119.90
|
| Rate for Payer: BCN Commercial |
$113.51
|
| Rate for Payer: Cash Price |
$117.50
|
| Rate for Payer: Cofinity Commercial |
$126.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.50
|
| Rate for Payer: Healthscope Commercial |
$132.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.85
|
| Rate for Payer: Nomi Health Commercial |
$120.44
|
| Rate for Payer: PHP Commercial |
$124.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.47
|
| Rate for Payer: Priority Health HMO/PPO |
$127.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.25
|
| Rate for Payer: UHC Core |
$122.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.16
|
|
|
HC LOCALIZATION DEVICE LEVEL 1
|
Facility
|
OP
|
$146.88
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.88 |
| Max. Negotiated Rate |
$132.19 |
| Rate for Payer: Aetna Commercial |
$124.85
|
| Rate for Payer: Aetna Medicare |
$38.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.90
|
| Rate for Payer: BCBS Complete |
$58.75
|
| Rate for Payer: BCBS MAPPO |
$36.72
|
| Rate for Payer: BCBS Trust/PPO |
$120.75
|
| Rate for Payer: BCN Commercial |
$114.20
|
| Rate for Payer: BCN Medicare Advantage |
$36.72
|
| Rate for Payer: Cash Price |
$117.50
|
| Rate for Payer: Cofinity Commercial |
$126.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$132.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.85
|
| Rate for Payer: Nomi Health Commercial |
$120.44
|
| Rate for Payer: PACE Senior Care Partners |
$34.88
|
| Rate for Payer: PACE SWMI |
$36.72
|
| Rate for Payer: PHP Commercial |
$124.85
|
| Rate for Payer: PHP Medicare Advantage |
$36.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.47
|
| Rate for Payer: Priority Health HMO/PPO |
$127.79
|
| Rate for Payer: Priority Health Medicare |
$37.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.41
|
| Rate for Payer: Railroad Medicare Medicare |
$36.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.25
|
| Rate for Payer: UHC Core |
$122.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.72
|
| Rate for Payer: UHC Exchange |
$36.72
|
| Rate for Payer: UHC Medicare Advantage |
$36.72
|
| Rate for Payer: VA VA |
$36.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.16
|
|
|
HC LOC INFIL W/CS 15 MIN
|
Facility
|
IP
|
$144.37
|
|
| Hospital Charge Code |
37000007
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$93.84 |
| Max. Negotiated Rate |
$129.93 |
| Rate for Payer: Aetna Commercial |
$122.71
|
| Rate for Payer: BCBS Trust/PPO |
$117.85
|
| Rate for Payer: BCN Commercial |
$111.57
|
| Rate for Payer: Cash Price |
$115.50
|
| Rate for Payer: Cofinity Commercial |
$124.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$115.50
|
| Rate for Payer: Healthscope Commercial |
$129.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.71
|
| Rate for Payer: Nomi Health Commercial |
$118.38
|
| Rate for Payer: PHP Commercial |
$122.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.84
|
| Rate for Payer: Priority Health HMO/PPO |
$125.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.05
|
| Rate for Payer: UHC Core |
$120.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.28
|
|
|
HC LOC INFIL W/CS 15 MIN
|
Facility
|
OP
|
$144.37
|
|
| Hospital Charge Code |
37000007
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$34.29 |
| Max. Negotiated Rate |
$129.93 |
| Rate for Payer: Aetna Commercial |
$122.71
|
| Rate for Payer: Aetna Medicare |
$37.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.12
|
| Rate for Payer: BCBS Complete |
$57.75
|
| Rate for Payer: BCBS MAPPO |
$36.09
|
| Rate for Payer: BCBS Trust/PPO |
$118.69
|
| Rate for Payer: BCN Commercial |
$112.25
|
| Rate for Payer: BCN Medicare Advantage |
$36.09
|
| Rate for Payer: Cash Price |
$115.50
|
| Rate for Payer: Cofinity Commercial |
$124.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$115.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.09
|
| Rate for Payer: Healthscope Commercial |
$129.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.71
|
| Rate for Payer: Nomi Health Commercial |
$118.38
|
| Rate for Payer: PACE Senior Care Partners |
$34.29
|
| Rate for Payer: PACE SWMI |
$36.09
|
| Rate for Payer: PHP Commercial |
$122.71
|
| Rate for Payer: PHP Medicare Advantage |
$36.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.84
|
| Rate for Payer: Priority Health HMO/PPO |
$125.60
|
| Rate for Payer: Priority Health Medicare |
$36.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.73
|
| Rate for Payer: Railroad Medicare Medicare |
$36.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.05
|
| Rate for Payer: UHC Core |
$120.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.09
|
| Rate for Payer: UHC Exchange |
$36.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.09
|
| Rate for Payer: VA VA |
$36.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.28
|
|
|
HC LOC INFIL W/CS 30 MIN
|
Facility
|
OP
|
$721.58
|
|
| Hospital Charge Code |
37000008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$171.38 |
| Max. Negotiated Rate |
$649.42 |
| Rate for Payer: Aetna Commercial |
$613.34
|
| Rate for Payer: Aetna Medicare |
$187.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$225.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$225.49
|
| Rate for Payer: BCBS Complete |
$288.63
|
| Rate for Payer: BCBS MAPPO |
$180.40
|
| Rate for Payer: BCBS Trust/PPO |
$593.21
|
| Rate for Payer: BCN Commercial |
$561.03
|
| Rate for Payer: BCN Medicare Advantage |
$180.40
|
| Rate for Payer: Cash Price |
$577.26
|
| Rate for Payer: Cofinity Commercial |
$620.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$577.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.40
|
| Rate for Payer: Healthscope Commercial |
$649.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$541.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$207.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$613.34
|
| Rate for Payer: Nomi Health Commercial |
$591.70
|
| Rate for Payer: PACE Senior Care Partners |
$171.38
|
| Rate for Payer: PACE SWMI |
$180.40
|
| Rate for Payer: PHP Commercial |
$613.34
|
| Rate for Payer: PHP Medicare Advantage |
$180.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.03
|
| Rate for Payer: Priority Health HMO/PPO |
$627.77
|
| Rate for Payer: Priority Health Medicare |
$182.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$483.46
|
| Rate for Payer: Railroad Medicare Medicare |
$180.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$634.99
|
| Rate for Payer: UHC Core |
$602.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.40
|
| Rate for Payer: UHC Exchange |
$180.40
|
| Rate for Payer: UHC Medicare Advantage |
$180.40
|
| Rate for Payer: VA VA |
$180.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$541.18
|
|
|
HC LOC INFIL W/CS 30 MIN
|
Facility
|
IP
|
$721.58
|
|
| Hospital Charge Code |
37000008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$469.03 |
| Max. Negotiated Rate |
$649.42 |
| Rate for Payer: Aetna Commercial |
$613.34
|
| Rate for Payer: BCBS Trust/PPO |
$589.03
|
| Rate for Payer: BCN Commercial |
$557.64
|
| Rate for Payer: Cash Price |
$577.26
|
| Rate for Payer: Cofinity Commercial |
$620.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$577.26
|
| Rate for Payer: Healthscope Commercial |
$649.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$541.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$613.34
|
| Rate for Payer: Nomi Health Commercial |
$591.70
|
| Rate for Payer: PHP Commercial |
$613.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.03
|
| Rate for Payer: Priority Health HMO/PPO |
$627.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$483.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$634.99
|
| Rate for Payer: UHC Core |
$602.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$541.18
|
|
|
HC LOCM 100-199 MG/ML IODINE/ML1
|
Facility
|
IP
|
$3.75
|
|
|
Service Code
|
HCPCS Q9965
|
| Hospital Charge Code |
25500002
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$3.38 |
| Rate for Payer: Aetna Commercial |
$3.19
|
| Rate for Payer: BCBS Trust/PPO |
$3.06
|
| Rate for Payer: BCN Commercial |
$2.90
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cofinity Commercial |
$3.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.00
|
| Rate for Payer: Healthscope Commercial |
$3.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.19
|
| Rate for Payer: Nomi Health Commercial |
$3.08
|
| Rate for Payer: PHP Commercial |
$3.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.44
|
| Rate for Payer: Priority Health HMO/PPO |
$3.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.30
|
| Rate for Payer: UHC Core |
$3.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.81
|
|
|
HC LOCM 100-199 MG/ML IODINE/ML1
|
Facility
|
OP
|
$3.75
|
|
|
Service Code
|
HCPCS Q9965
|
| Hospital Charge Code |
25500002
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$0.89 |
| Max. Negotiated Rate |
$3.38 |
| Rate for Payer: Aetna Commercial |
$3.19
|
| Rate for Payer: Aetna Medicare |
$0.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.17
|
| Rate for Payer: BCBS Complete |
$1.50
|
| Rate for Payer: BCBS MAPPO |
$0.94
|
| Rate for Payer: BCBS Trust/PPO |
$3.08
|
| Rate for Payer: BCN Commercial |
$2.92
|
| Rate for Payer: BCN Medicare Advantage |
$0.94
|
| Rate for Payer: Cash Price |
$3.00
|
| Rate for Payer: Cofinity Commercial |
$3.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.94
|
| Rate for Payer: Healthscope Commercial |
$3.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.19
|
| Rate for Payer: Nomi Health Commercial |
$3.08
|
| Rate for Payer: PACE Senior Care Partners |
$0.89
|
| Rate for Payer: PACE SWMI |
$0.94
|
| Rate for Payer: PHP Commercial |
$3.19
|
| Rate for Payer: PHP Medicare Advantage |
$0.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.44
|
| Rate for Payer: Priority Health HMO/PPO |
$3.26
|
| Rate for Payer: Priority Health Medicare |
$0.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.51
|
| Rate for Payer: Railroad Medicare Medicare |
$0.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.30
|
| Rate for Payer: UHC Core |
$3.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.94
|
| Rate for Payer: UHC Exchange |
$0.94
|
| Rate for Payer: UHC Medicare Advantage |
$0.94
|
| Rate for Payer: VA VA |
$0.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.81
|
|
|
HC LOOP AV 3/8 INCH OR 1/2 INCH
|
Facility
|
OP
|
$216.04
|
|
| Hospital Charge Code |
27000444
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.31 |
| Max. Negotiated Rate |
$194.44 |
| Rate for Payer: Aetna Commercial |
$183.63
|
| Rate for Payer: Aetna Medicare |
$56.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.51
|
| Rate for Payer: BCBS Complete |
$86.42
|
| Rate for Payer: BCBS MAPPO |
$54.01
|
| Rate for Payer: BCBS Trust/PPO |
$177.61
|
| Rate for Payer: BCN Commercial |
$167.97
|
| Rate for Payer: BCN Medicare Advantage |
$54.01
|
| Rate for Payer: Cash Price |
$172.83
|
| Rate for Payer: Cofinity Commercial |
$185.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.01
|
| Rate for Payer: Healthscope Commercial |
$194.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.63
|
| Rate for Payer: Nomi Health Commercial |
$177.15
|
| Rate for Payer: PACE Senior Care Partners |
$51.31
|
| Rate for Payer: PACE SWMI |
$54.01
|
| Rate for Payer: PHP Commercial |
$183.63
|
| Rate for Payer: PHP Medicare Advantage |
$54.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.43
|
| Rate for Payer: Priority Health HMO/PPO |
$187.95
|
| Rate for Payer: Priority Health Medicare |
$54.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.75
|
| Rate for Payer: Railroad Medicare Medicare |
$54.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.12
|
| Rate for Payer: UHC Core |
$180.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.01
|
| Rate for Payer: UHC Exchange |
$54.01
|
| Rate for Payer: UHC Medicare Advantage |
$54.01
|
| Rate for Payer: VA VA |
$54.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.03
|
|
|
HC LOOP AV 3/8 INCH OR 1/2 INCH
|
Facility
|
IP
|
$216.04
|
|
| Hospital Charge Code |
27000444
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$140.43 |
| Max. Negotiated Rate |
$194.44 |
| Rate for Payer: Aetna Commercial |
$183.63
|
| Rate for Payer: BCBS Trust/PPO |
$176.35
|
| Rate for Payer: BCN Commercial |
$166.96
|
| Rate for Payer: Cash Price |
$172.83
|
| Rate for Payer: Cofinity Commercial |
$185.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.83
|
| Rate for Payer: Healthscope Commercial |
$194.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.63
|
| Rate for Payer: Nomi Health Commercial |
$177.15
|
| Rate for Payer: PHP Commercial |
$183.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.43
|
| Rate for Payer: Priority Health HMO/PPO |
$187.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.12
|
| Rate for Payer: UHC Core |
$180.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.03
|
|
|
HC LOW-LEVEL LASER THERAPY
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 0552T
|
| Hospital Charge Code |
43000024
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.69
|
| Rate for Payer: BCBS Complete |
$36.72
|
| Rate for Payer: BCBS MAPPO |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$75.47
|
| Rate for Payer: BCN Commercial |
$71.37
|
| Rate for Payer: BCN Medicare Advantage |
$22.95
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.95
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PACE Senior Care Partners |
$21.80
|
| Rate for Payer: PACE SWMI |
$22.95
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Medicare Advantage |
$22.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Medicare |
$23.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: Railroad Medicare Medicare |
$22.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.95
|
| Rate for Payer: UHC Exchange |
$22.95
|
| Rate for Payer: UHC Medicare Advantage |
$22.95
|
| Rate for Payer: VA VA |
$22.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC LOW-LEVEL LASER THERAPY
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 0552T
|
| Hospital Charge Code |
43000024
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: BCBS Trust/PPO |
$74.94
|
| Rate for Payer: BCN Commercial |
$70.94
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC LP (A) CHOLESTEROL LMPP
|
Facility
|
OP
|
$23.93
|
|
|
Service Code
|
CPT 83700
|
| Hospital Charge Code |
30100636
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.68 |
| Max. Negotiated Rate |
$21.54 |
| Rate for Payer: Aetna Commercial |
$20.34
|
| Rate for Payer: Aetna Medicare |
$6.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.48
|
| Rate for Payer: BCBS Complete |
$8.55
|
| Rate for Payer: BCBS MAPPO |
$5.98
|
| Rate for Payer: BCBS Trust/PPO |
$19.67
|
| Rate for Payer: BCN Commercial |
$18.61
|
| Rate for Payer: BCN Medicare Advantage |
$5.98
|
| Rate for Payer: Cash Price |
$19.14
|
| Rate for Payer: Cash Price |
$19.14
|
| Rate for Payer: Cofinity Commercial |
$20.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.98
|
| Rate for Payer: Healthscope Commercial |
$21.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.95
|
| Rate for Payer: Mclaren Medicaid |
$8.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.28
|
| Rate for Payer: Meridian Medicaid |
$8.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.34
|
| Rate for Payer: Nomi Health Commercial |
$19.62
|
| Rate for Payer: PACE Senior Care Partners |
$5.68
|
| Rate for Payer: PACE SWMI |
$5.98
|
| Rate for Payer: PHP Commercial |
$20.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.55
|
| Rate for Payer: Priority Health HMO/PPO |
$20.82
|
| Rate for Payer: Priority Health Medicare |
$6.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.03
|
| Rate for Payer: Railroad Medicare Medicare |
$5.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.06
|
| Rate for Payer: UHC Core |
$19.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.98
|
| Rate for Payer: UHC Exchange |
$5.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.98
|
| Rate for Payer: UHCCP Medicaid |
$8.14
|
| Rate for Payer: VA VA |
$5.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.95
|
|
|
HC LP (A) CHOLESTEROL LMPP
|
Facility
|
IP
|
$23.93
|
|
|
Service Code
|
CPT 83700
|
| Hospital Charge Code |
30100636
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$21.54 |
| Rate for Payer: Aetna Commercial |
$20.34
|
| Rate for Payer: BCBS Trust/PPO |
$19.53
|
| Rate for Payer: BCN Commercial |
$18.49
|
| Rate for Payer: Cash Price |
$19.14
|
| Rate for Payer: Cofinity Commercial |
$20.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.14
|
| Rate for Payer: Healthscope Commercial |
$21.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.34
|
| Rate for Payer: Nomi Health Commercial |
$19.62
|
| Rate for Payer: PHP Commercial |
$20.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.55
|
| Rate for Payer: Priority Health HMO/PPO |
$20.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.06
|
| Rate for Payer: UHC Core |
$19.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.95
|
|
|
HC LTC ROOM AND BOARD
|
Facility
|
IP
|
$377.40
|
|
| Hospital Charge Code |
11000003
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$245.31 |
| Max. Negotiated Rate |
$339.66 |
| Rate for Payer: Aetna Commercial |
$320.79
|
| Rate for Payer: BCBS Trust/PPO |
$308.07
|
| Rate for Payer: BCN Commercial |
$291.65
|
| Rate for Payer: Cash Price |
$301.92
|
| Rate for Payer: Cofinity Commercial |
$324.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.92
|
| Rate for Payer: Healthscope Commercial |
$339.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$320.79
|
| Rate for Payer: Nomi Health Commercial |
$309.47
|
| Rate for Payer: PHP Commercial |
$320.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.31
|
| Rate for Payer: Priority Health HMO/PPO |
$328.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.11
|
| Rate for Payer: UHC Core |
$315.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.05
|
|
|
HC LT/RT/C'S/CABG'S W INTERVENTION
|
Facility
|
IP
|
$12,357.92
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100051
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,032.65 |
| Max. Negotiated Rate |
$11,122.13 |
| Rate for Payer: Aetna Commercial |
$10,504.23
|
| Rate for Payer: BCBS Trust/PPO |
$10,087.77
|
| Rate for Payer: BCN Commercial |
$9,550.20
|
| Rate for Payer: Cash Price |
$9,886.34
|
| Rate for Payer: Cofinity Commercial |
$10,627.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,886.34
|
| Rate for Payer: Healthscope Commercial |
$11,122.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,268.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,504.23
|
| Rate for Payer: Nomi Health Commercial |
$10,133.49
|
| Rate for Payer: PHP Commercial |
$10,504.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,032.65
|
| Rate for Payer: Priority Health HMO/PPO |
$10,751.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,279.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,874.97
|
| Rate for Payer: UHC Core |
$10,318.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,268.44
|
|
