|
HC SODIUM BICARBONATE 4.2% SOL
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600214
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.99 |
| Max. Negotiated Rate |
$18.90 |
| Rate for Payer: Aetna Commercial |
$17.85
|
| Rate for Payer: Aetna Medicare |
$5.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.56
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS MAPPO |
$5.25
|
| Rate for Payer: BCBS Trust/PPO |
$16.33
|
| Rate for Payer: BCN Commercial |
$16.33
|
| Rate for Payer: BCN Medicare Advantage |
$5.25
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$18.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.25
|
| Rate for Payer: Healthscope Commercial |
$18.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.85
|
| Rate for Payer: PACE Senior Care Partners |
$4.99
|
| Rate for Payer: PACE SWMI |
$5.25
|
| Rate for Payer: PHP Commercial |
$17.85
|
| Rate for Payer: PHP Medicare Advantage |
$5.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.27
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.81
|
| Rate for Payer: Railroad Medicare Medicare |
$5.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.48
|
| Rate for Payer: UHC Core |
$17.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.25
|
| Rate for Payer: UHC Medicare Advantage |
$5.41
|
| Rate for Payer: VA VA |
$5.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.75
|
|
|
HC SODIUM BICARBONATE 4.2% SOL
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600214
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.81 |
| Max. Negotiated Rate |
$18.90 |
| Rate for Payer: Aetna Commercial |
$17.85
|
| Rate for Payer: BCBS Trust/PPO |
$16.23
|
| Rate for Payer: BCN Commercial |
$16.23
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$18.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.80
|
| Rate for Payer: Healthscope Commercial |
$18.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.85
|
| Rate for Payer: PHP Commercial |
$17.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.48
|
| Rate for Payer: UHC Core |
$17.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.75
|
|
|
HC SODIUM LEVEL
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
30100423
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC SODIUM LEVEL
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
30100423
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.55 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$3.73
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$3.55
|
| Rate for Payer: Meridian Medicaid |
$3.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC SODIUM OTHER SOURCE
|
Facility
|
OP
|
$21.22
|
|
|
Service Code
|
CPT 84302
|
| Hospital Charge Code |
30100555
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.59 |
| Max. Negotiated Rate |
$19.10 |
| Rate for Payer: Aetna Commercial |
$18.04
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.77
|
| Rate for Payer: BCBS MAPPO |
$5.30
|
| Rate for Payer: BCBS Trust/PPO |
$16.50
|
| Rate for Payer: BCN Commercial |
$16.50
|
| Rate for Payer: BCN Medicare Advantage |
$5.30
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.30
|
| Rate for Payer: Healthscope Commercial |
$19.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.59
|
| Rate for Payer: Meridian Medicaid |
$3.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.04
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.30
|
| Rate for Payer: PHP Commercial |
$18.04
|
| Rate for Payer: PHP Medicare Advantage |
$5.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.46
|
| Rate for Payer: Priority Health Medicare |
$5.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.67
|
| Rate for Payer: UHC Core |
$17.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.30
|
| Rate for Payer: UHC Medicare Advantage |
$5.46
|
| Rate for Payer: VA VA |
$5.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC SODIUM OTHER SOURCE
|
Facility
|
IP
|
$21.22
|
|
|
Service Code
|
CPT 84302
|
| Hospital Charge Code |
30100555
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.94 |
| Max. Negotiated Rate |
$19.10 |
| Rate for Payer: Aetna Commercial |
$18.04
|
| Rate for Payer: BCBS Trust/PPO |
$16.40
|
| Rate for Payer: BCN Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.04
|
| Rate for Payer: PHP Commercial |
$18.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.67
|
| Rate for Payer: UHC Core |
$17.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC SODIUM URINE
|
Facility
|
OP
|
$34.50
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
30100424
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.73 |
| Max. Negotiated Rate |
$31.05 |
| Rate for Payer: Aetna Commercial |
$29.32
|
| Rate for Payer: Aetna Medicare |
$8.97
|
| 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 |
$3.92
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$26.82
|
| Rate for Payer: BCN Commercial |
$26.82
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$29.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$31.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.88
|
| Rate for Payer: Mclaren Medicaid |
$3.73
|
| Rate for Payer: Meridian Medicaid |
$3.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.32
|
| Rate for Payer: PACE Senior Care Partners |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$29.32
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.02
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.04
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.36
|
| Rate for Payer: UHC Core |
$28.81
|
| 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 |
$25.88
|
|
|
HC SODIUM URINE
|
Facility
|
IP
|
$34.50
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
30100424
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.04 |
| Max. Negotiated Rate |
$31.05 |
| Rate for Payer: Aetna Commercial |
$29.32
|
| Rate for Payer: BCBS Trust/PPO |
$26.66
|
| Rate for Payer: BCN Commercial |
$26.66
|
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$29.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.60
|
| Rate for Payer: Healthscope Commercial |
$31.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.32
|
| Rate for Payer: PHP Commercial |
$29.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.36
|
| Rate for Payer: UHC Core |
$28.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.88
|
|
|
HC SOFTGOOD FOOT DROP PREVENT
|
Facility
|
IP
|
$191.36
|
|
| Hospital Charge Code |
27000148
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$116.71 |
| Max. Negotiated Rate |
$172.22 |
| Rate for Payer: Aetna Commercial |
$162.66
|
| Rate for Payer: BCBS Trust/PPO |
$147.88
|
| Rate for Payer: BCN Commercial |
$147.88
|
| Rate for Payer: Cash Price |
$153.09
|
| Rate for Payer: Cofinity Commercial |
$164.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.09
|
| Rate for Payer: Healthscope Commercial |
$172.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$162.66
|
| Rate for Payer: PHP Commercial |
$162.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.40
|
| Rate for Payer: UHC Core |
$159.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.52
|
|
|
HC SOFTGOOD FOOT DROP PREVENT
|
Facility
|
OP
|
$191.36
|
|
| Hospital Charge Code |
27000148
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.45 |
| Max. Negotiated Rate |
$172.22 |
| Rate for Payer: Aetna Commercial |
$162.66
|
| Rate for Payer: Aetna Medicare |
$49.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.80
|
| Rate for Payer: BCBS Complete |
$76.54
|
| Rate for Payer: BCBS MAPPO |
$47.84
|
| Rate for Payer: BCBS Trust/PPO |
$148.78
|
| Rate for Payer: BCN Commercial |
$148.78
|
| Rate for Payer: BCN Medicare Advantage |
$47.84
|
| Rate for Payer: Cash Price |
$153.09
|
| Rate for Payer: Cofinity Commercial |
$164.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.84
|
| Rate for Payer: Healthscope Commercial |
$172.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$162.66
|
| Rate for Payer: PACE Senior Care Partners |
$45.45
|
| Rate for Payer: PACE SWMI |
$47.84
|
| Rate for Payer: PHP Commercial |
$162.66
|
| Rate for Payer: PHP Medicare Advantage |
$47.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.48
|
| Rate for Payer: Priority Health Medicare |
$47.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.71
|
| Rate for Payer: Railroad Medicare Medicare |
$47.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.40
|
| Rate for Payer: UHC Core |
$159.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.84
|
| Rate for Payer: UHC Medicare Advantage |
$49.28
|
| Rate for Payer: VA VA |
$47.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.52
|
|
|
HC SOFTGOOD HIP PILLOW ABD
|
Facility
|
IP
|
$158.37
|
|
| Hospital Charge Code |
27000149
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$96.59 |
| Max. Negotiated Rate |
$142.53 |
| Rate for Payer: Aetna Commercial |
$134.61
|
| Rate for Payer: BCBS Trust/PPO |
$122.39
|
| Rate for Payer: BCN Commercial |
$122.39
|
| Rate for Payer: Cash Price |
$126.70
|
| Rate for Payer: Cofinity Commercial |
$136.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.70
|
| Rate for Payer: Healthscope Commercial |
$142.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.61
|
| Rate for Payer: PHP Commercial |
$134.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.37
|
| Rate for Payer: UHC Core |
$132.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.78
|
|
|
HC SOFTGOOD HIP PILLOW ABD
|
Facility
|
OP
|
$158.37
|
|
| Hospital Charge Code |
27000149
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.61 |
| Max. Negotiated Rate |
$142.53 |
| Rate for Payer: Aetna Commercial |
$134.61
|
| Rate for Payer: Aetna Medicare |
$41.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.49
|
| Rate for Payer: BCBS Complete |
$63.35
|
| Rate for Payer: BCBS MAPPO |
$39.59
|
| Rate for Payer: BCBS Trust/PPO |
$123.13
|
| Rate for Payer: BCN Commercial |
$123.13
|
| Rate for Payer: BCN Medicare Advantage |
$39.59
|
| Rate for Payer: Cash Price |
$126.70
|
| Rate for Payer: Cofinity Commercial |
$136.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.59
|
| Rate for Payer: Healthscope Commercial |
$142.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.61
|
| Rate for Payer: PACE Senior Care Partners |
$37.61
|
| Rate for Payer: PACE SWMI |
$39.59
|
| Rate for Payer: PHP Commercial |
$134.61
|
| Rate for Payer: PHP Medicare Advantage |
$39.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.78
|
| Rate for Payer: Priority Health Medicare |
$39.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.59
|
| Rate for Payer: Railroad Medicare Medicare |
$39.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.37
|
| Rate for Payer: UHC Core |
$132.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.59
|
| Rate for Payer: UHC Medicare Advantage |
$40.78
|
| Rate for Payer: VA VA |
$39.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.78
|
|
|
HC SOFTGOOD SHOULDER PILLOW ABD
|
Facility
|
OP
|
$234.51
|
|
| Hospital Charge Code |
27000150
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.70 |
| Max. Negotiated Rate |
$211.06 |
| Rate for Payer: Aetna Commercial |
$199.33
|
| Rate for Payer: Aetna Medicare |
$60.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.28
|
| Rate for Payer: BCBS Complete |
$93.80
|
| Rate for Payer: BCBS MAPPO |
$58.63
|
| Rate for Payer: BCBS Trust/PPO |
$182.33
|
| Rate for Payer: BCN Commercial |
$182.33
|
| Rate for Payer: BCN Medicare Advantage |
$58.63
|
| Rate for Payer: Cash Price |
$187.61
|
| Rate for Payer: Cofinity Commercial |
$201.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.63
|
| Rate for Payer: Healthscope Commercial |
$211.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$199.33
|
| Rate for Payer: PACE Senior Care Partners |
$55.70
|
| Rate for Payer: PACE SWMI |
$58.63
|
| Rate for Payer: PHP Commercial |
$199.33
|
| Rate for Payer: PHP Medicare Advantage |
$58.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.02
|
| Rate for Payer: Priority Health Medicare |
$58.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$143.03
|
| Rate for Payer: Railroad Medicare Medicare |
$58.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.37
|
| Rate for Payer: UHC Core |
$195.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.63
|
| Rate for Payer: UHC Medicare Advantage |
$60.39
|
| Rate for Payer: VA VA |
$58.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.88
|
|
|
HC SOFTGOOD SHOULDER PILLOW ABD
|
Facility
|
IP
|
$234.51
|
|
| Hospital Charge Code |
27000150
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$143.03 |
| Max. Negotiated Rate |
$211.06 |
| Rate for Payer: Aetna Commercial |
$199.33
|
| Rate for Payer: BCBS Trust/PPO |
$181.23
|
| Rate for Payer: BCN Commercial |
$181.23
|
| Rate for Payer: Cash Price |
$187.61
|
| Rate for Payer: Cofinity Commercial |
$201.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.61
|
| Rate for Payer: Healthscope Commercial |
$211.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$199.33
|
| Rate for Payer: PHP Commercial |
$199.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$143.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.37
|
| Rate for Payer: UHC Core |
$195.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.88
|
|
|
HC SOLUBLE TRANSFERRIN RECEPTOR
|
Facility
|
IP
|
$56.70
|
|
|
Service Code
|
CPT 84238
|
| Hospital Charge Code |
30100631
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.58 |
| Max. Negotiated Rate |
$51.03 |
| Rate for Payer: Aetna Commercial |
$48.20
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$45.36
|
| Rate for Payer: Cofinity Commercial |
$48.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.36
|
| Rate for Payer: Healthscope Commercial |
$51.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.20
|
| Rate for Payer: PHP Commercial |
$48.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.90
|
| Rate for Payer: UHC Core |
$47.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.52
|
|
|
HC SOLUBLE TRANSFERRIN RECEPTOR
|
Facility
|
OP
|
$56.70
|
|
|
Service Code
|
CPT 84238
|
| Hospital Charge Code |
30100631
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.47 |
| Max. Negotiated Rate |
$51.03 |
| Rate for Payer: Aetna Commercial |
$48.20
|
| Rate for Payer: Aetna Medicare |
$14.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.72
|
| Rate for Payer: BCBS Complete |
$28.34
|
| Rate for Payer: BCBS MAPPO |
$14.18
|
| Rate for Payer: BCBS Trust/PPO |
$44.08
|
| Rate for Payer: BCN Commercial |
$44.08
|
| Rate for Payer: BCN Medicare Advantage |
$14.18
|
| Rate for Payer: Cash Price |
$45.36
|
| Rate for Payer: Cash Price |
$45.36
|
| Rate for Payer: Cofinity Commercial |
$48.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$51.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.52
|
| Rate for Payer: Mclaren Medicaid |
$26.99
|
| Rate for Payer: Meridian Medicaid |
$28.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.20
|
| Rate for Payer: PACE Senior Care Partners |
$13.47
|
| Rate for Payer: PACE SWMI |
$14.18
|
| Rate for Payer: PHP Commercial |
$48.20
|
| Rate for Payer: PHP Medicare Advantage |
$14.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.33
|
| Rate for Payer: Priority Health Medicare |
$14.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.58
|
| Rate for Payer: Railroad Medicare Medicare |
$14.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.90
|
| Rate for Payer: UHC Core |
$47.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.18
|
| Rate for Payer: UHC Medicare Advantage |
$14.60
|
| Rate for Payer: VA VA |
$14.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.52
|
|
|
HC SOMATOMEDIN
|
Facility
|
IP
|
$54.06
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
30100425
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.97 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: BCBS Trust/PPO |
$41.78
|
| Rate for Payer: BCN Commercial |
$41.78
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.95
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.57
|
| Rate for Payer: UHC Core |
$45.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.54
|
|
|
HC SOMATOMEDIN
|
Facility
|
OP
|
$54.06
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
30100425
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.84 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna Medicare |
$14.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.89
|
| Rate for Payer: BCBS Complete |
$16.47
|
| Rate for Payer: BCBS MAPPO |
$13.52
|
| Rate for Payer: BCBS Trust/PPO |
$42.03
|
| Rate for Payer: BCN Commercial |
$42.03
|
| Rate for Payer: BCN Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.52
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.54
|
| Rate for Payer: Mclaren Medicaid |
$15.69
|
| Rate for Payer: Meridian Medicaid |
$16.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.95
|
| Rate for Payer: PACE Senior Care Partners |
$12.84
|
| Rate for Payer: PACE SWMI |
$13.52
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: PHP Medicare Advantage |
$13.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$47.03
|
| Rate for Payer: Priority Health Medicare |
$13.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.97
|
| Rate for Payer: Railroad Medicare Medicare |
$13.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.57
|
| Rate for Payer: UHC Core |
$45.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.92
|
| Rate for Payer: VA VA |
$13.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.54
|
|
|
HC SOYBEAN IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200062
|
|
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 SOYBEAN IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200062
|
|
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 SPACEOAR HYDROGEL
|
Facility
|
OP
|
$5,930.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,408.38 |
| Max. Negotiated Rate |
$5,337.00 |
| Rate for Payer: Aetna Commercial |
$5,040.50
|
| Rate for Payer: Aetna Medicare |
$1,541.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,853.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,853.12
|
| Rate for Payer: BCBS Complete |
$2,372.00
|
| Rate for Payer: BCBS MAPPO |
$1,482.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,610.58
|
| Rate for Payer: BCN Commercial |
$4,610.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,482.50
|
| Rate for Payer: Cash Price |
$4,744.00
|
| Rate for Payer: Cofinity Commercial |
$5,099.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,744.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,482.50
|
| Rate for Payer: Healthscope Commercial |
$5,337.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,447.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,556.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,704.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,040.50
|
| Rate for Payer: PACE Senior Care Partners |
$1,408.38
|
| Rate for Payer: PACE SWMI |
$1,482.50
|
| Rate for Payer: PHP Commercial |
$5,040.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,482.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,151.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,159.10
|
| Rate for Payer: Priority Health Medicare |
$1,482.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,616.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,482.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,218.40
|
| Rate for Payer: UHC Core |
$4,951.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,482.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,526.98
|
| Rate for Payer: VA VA |
$1,482.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,447.50
|
|
|
HC SPACEOAR HYDROGEL
|
Facility
|
IP
|
$5,930.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,616.71 |
| Max. Negotiated Rate |
$5,337.00 |
| Rate for Payer: Aetna Commercial |
$5,040.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,582.70
|
| Rate for Payer: BCN Commercial |
$4,582.70
|
| Rate for Payer: Cash Price |
$4,744.00
|
| Rate for Payer: Cofinity Commercial |
$5,099.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,744.00
|
| Rate for Payer: Healthscope Commercial |
$5,337.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,447.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,040.50
|
| Rate for Payer: PHP Commercial |
$5,040.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,151.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,159.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,616.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,218.40
|
| Rate for Payer: UHC Core |
$4,951.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,447.50
|
|
|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
OP
|
$3,774.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$896.32 |
| Max. Negotiated Rate |
$3,396.60 |
| Rate for Payer: Aetna Commercial |
$3,207.90
|
| Rate for Payer: Aetna Medicare |
$981.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,179.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,179.38
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$943.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,934.28
|
| Rate for Payer: BCN Commercial |
$2,934.28
|
| Rate for Payer: BCN Medicare Advantage |
$943.50
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cofinity Commercial |
$3,245.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,019.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$943.50
|
| Rate for Payer: Healthscope Commercial |
$3,396.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,830.50
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$990.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,085.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,207.90
|
| Rate for Payer: PACE Senior Care Partners |
$896.32
|
| Rate for Payer: PACE SWMI |
$943.50
|
| Rate for Payer: PHP Commercial |
$3,207.90
|
| Rate for Payer: PHP Medicare Advantage |
$943.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,283.38
|
| Rate for Payer: Priority Health Medicare |
$943.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,301.76
|
| Rate for Payer: Railroad Medicare Medicare |
$943.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,321.12
|
| Rate for Payer: UHC Core |
$3,151.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$943.50
|
| Rate for Payer: UHC Medicare Advantage |
$971.80
|
| Rate for Payer: VA VA |
$943.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,830.50
|
|
|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
IP
|
$3,774.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,301.76 |
| Max. Negotiated Rate |
$3,396.60 |
| Rate for Payer: Aetna Commercial |
$3,207.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,916.55
|
| Rate for Payer: BCN Commercial |
$2,916.55
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cofinity Commercial |
$3,245.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,019.20
|
| Rate for Payer: Healthscope Commercial |
$3,396.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,830.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,207.90
|
| Rate for Payer: PHP Commercial |
$3,207.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,283.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,301.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,321.12
|
| Rate for Payer: UHC Core |
$3,151.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,830.50
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
IP
|
$3,903.99
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,381.04 |
| Max. Negotiated Rate |
$3,513.59 |
| Rate for Payer: Aetna Commercial |
$3,318.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,017.00
|
| Rate for Payer: BCN Commercial |
$3,017.00
|
| Rate for Payer: Cash Price |
$3,123.19
|
| Rate for Payer: Cofinity Commercial |
$3,357.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,123.19
|
| Rate for Payer: Healthscope Commercial |
$3,513.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,927.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,318.39
|
| Rate for Payer: PHP Commercial |
$3,318.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,732.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,396.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,381.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,435.51
|
| Rate for Payer: UHC Core |
$3,259.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,927.99
|
|
