|
HC NG/CT DETECT BY NUCLEIC ACID CEPHEID
|
Facility
|
OP
|
$135.26
|
|
|
Service Code
|
CPT 87494
|
| Hospital Charge Code |
30600357
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.85 |
| Max. Negotiated Rate |
$121.73 |
| Rate for Payer: Aetna Commercial |
$114.97
|
| Rate for Payer: Aetna Medicare |
$35.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.27
|
| Rate for Payer: BCBS Complete |
$25.04
|
| Rate for Payer: BCBS MAPPO |
$33.81
|
| Rate for Payer: BCBS Trust/PPO |
$111.20
|
| Rate for Payer: BCN Commercial |
$111.20
|
| Rate for Payer: BCN Medicare Advantage |
$33.81
|
| Rate for Payer: Cash Price |
$108.21
|
| Rate for Payer: Cofinity Commercial |
$116.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.81
|
| Rate for Payer: Healthscope Commercial |
$121.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.44
|
| Rate for Payer: Mclaren Medicaid |
$23.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.51
|
| Rate for Payer: Meridian Medicaid |
$25.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.97
|
| Rate for Payer: Nomi Health Commercial |
$110.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.44
|
| Rate for Payer: PACE Senior Care Partners |
$32.12
|
| Rate for Payer: PACE SWMI |
$33.81
|
| Rate for Payer: PHP Commercial |
$114.97
|
| Rate for Payer: PHP Medicare Advantage |
$33.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$117.68
|
| Rate for Payer: Priority Health Medicare |
$34.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.14
|
| Rate for Payer: Railroad Medicare Medicare |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.03
|
| Rate for Payer: UHC Core |
$112.94
|
| Rate for Payer: UHC Exchange |
$33.81
|
| Rate for Payer: UHC Medicaid |
$23.85
|
| Rate for Payer: UHC Medicare Advantage |
$33.81
|
| Rate for Payer: UHCCP Medicaid |
$23.85
|
| Rate for Payer: VA VA |
$33.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.44
|
|
|
HC NG/CT DETECT BY NUCLEIC ACID HOLOGIC
|
Facility
|
OP
|
$135.26
|
|
|
Service Code
|
CPT 87494
|
| Hospital Charge Code |
30600358
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.85 |
| Max. Negotiated Rate |
$121.73 |
| Rate for Payer: Aetna Commercial |
$114.97
|
| Rate for Payer: Aetna Medicare |
$35.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.27
|
| Rate for Payer: BCBS Complete |
$25.04
|
| Rate for Payer: BCBS MAPPO |
$33.81
|
| Rate for Payer: BCBS Trust/PPO |
$111.20
|
| Rate for Payer: BCN Commercial |
$111.20
|
| Rate for Payer: BCN Medicare Advantage |
$33.81
|
| Rate for Payer: Cash Price |
$108.21
|
| Rate for Payer: Cofinity Commercial |
$116.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.81
|
| Rate for Payer: Healthscope Commercial |
$121.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.44
|
| Rate for Payer: Mclaren Medicaid |
$23.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.51
|
| Rate for Payer: Meridian Medicaid |
$25.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.97
|
| Rate for Payer: Nomi Health Commercial |
$110.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.44
|
| Rate for Payer: PACE Senior Care Partners |
$32.12
|
| Rate for Payer: PACE SWMI |
$33.81
|
| Rate for Payer: PHP Commercial |
$114.97
|
| Rate for Payer: PHP Medicare Advantage |
$33.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$117.68
|
| Rate for Payer: Priority Health Medicare |
$34.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.14
|
| Rate for Payer: Railroad Medicare Medicare |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.03
|
| Rate for Payer: UHC Core |
$112.94
|
| Rate for Payer: UHC Exchange |
$33.81
|
| Rate for Payer: UHC Medicaid |
$23.85
|
| Rate for Payer: UHC Medicare Advantage |
$33.81
|
| Rate for Payer: UHCCP Medicaid |
$23.85
|
| Rate for Payer: VA VA |
$33.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.44
|
|
|
HC NG/CT DETECT BY NUCLEIC ACID HOLOGIC
|
Facility
|
IP
|
$135.26
|
|
|
Service Code
|
CPT 87494
|
| Hospital Charge Code |
30600358
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$94.14 |
| Max. Negotiated Rate |
$121.73 |
| Rate for Payer: Aetna Commercial |
$114.97
|
| Rate for Payer: BCBS Trust/PPO |
$111.71
|
| Rate for Payer: BCN Commercial |
$111.71
|
| Rate for Payer: Cash Price |
$108.21
|
| Rate for Payer: Cofinity Commercial |
$116.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.21
|
| Rate for Payer: Healthscope Commercial |
$121.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.97
|
| Rate for Payer: Nomi Health Commercial |
$110.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.44
|
| Rate for Payer: PHP Commercial |
$114.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$117.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.03
|
| Rate for Payer: UHC Core |
$112.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.44
|
|
|
HC NG/CT DETECT BY PCR CEPHEID
|
Facility
|
OP
|
$135.26
|
|
|
Service Code
|
CPT 87801
|
| Hospital Charge Code |
30600355
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.85 |
| Max. Negotiated Rate |
$121.73 |
| Rate for Payer: Aetna Commercial |
$114.97
|
| Rate for Payer: Aetna Medicare |
$35.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.27
|
| Rate for Payer: BCBS Complete |
$25.04
|
| Rate for Payer: BCBS MAPPO |
$33.81
|
| Rate for Payer: BCBS Trust/PPO |
$111.20
|
| Rate for Payer: BCN Commercial |
$111.20
|
| Rate for Payer: BCN Medicare Advantage |
$33.81
|
| Rate for Payer: Cash Price |
$108.21
|
| Rate for Payer: Cofinity Commercial |
$116.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.81
|
| Rate for Payer: Healthscope Commercial |
$121.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.44
|
| Rate for Payer: Mclaren Medicaid |
$23.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.51
|
| Rate for Payer: Meridian Medicaid |
$25.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.97
|
| Rate for Payer: Nomi Health Commercial |
$110.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.44
|
| Rate for Payer: PACE Senior Care Partners |
$32.12
|
| Rate for Payer: PACE SWMI |
$33.81
|
| Rate for Payer: PHP Commercial |
$114.97
|
| Rate for Payer: PHP Medicare Advantage |
$33.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$117.68
|
| Rate for Payer: Priority Health Medicare |
$34.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.14
|
| Rate for Payer: Railroad Medicare Medicare |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.03
|
| Rate for Payer: UHC Core |
$112.94
|
| Rate for Payer: UHC Exchange |
$33.81
|
| Rate for Payer: UHC Medicaid |
$23.85
|
| Rate for Payer: UHC Medicare Advantage |
$33.81
|
| Rate for Payer: UHCCP Medicaid |
$23.85
|
| Rate for Payer: VA VA |
$33.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.44
|
|
|
HC NG/CT DETECT BY PCR CEPHEID
|
Facility
|
IP
|
$135.26
|
|
|
Service Code
|
CPT 87801
|
| Hospital Charge Code |
30600355
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$94.14 |
| Max. Negotiated Rate |
$121.73 |
| Rate for Payer: Aetna Commercial |
$114.97
|
| Rate for Payer: BCBS Trust/PPO |
$111.71
|
| Rate for Payer: BCN Commercial |
$111.71
|
| Rate for Payer: Cash Price |
$108.21
|
| Rate for Payer: Cofinity Commercial |
$116.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.21
|
| Rate for Payer: Healthscope Commercial |
$121.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.97
|
| Rate for Payer: Nomi Health Commercial |
$110.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.44
|
| Rate for Payer: PHP Commercial |
$114.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$117.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.03
|
| Rate for Payer: UHC Core |
$112.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.44
|
|
|
HC NG/CT DETECTION BY NUCLEIC ACID AMP
|
Facility
|
OP
|
$137.97
|
|
|
Service Code
|
CPT 87801
|
| Hospital Charge Code |
30600348
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.32 |
| Max. Negotiated Rate |
$124.17 |
| Rate for Payer: Aetna Commercial |
$117.27
|
| Rate for Payer: Aetna Medicare |
$35.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.12
|
| Rate for Payer: BCBS Complete |
$25.54
|
| Rate for Payer: BCBS MAPPO |
$34.49
|
| Rate for Payer: BCBS Trust/PPO |
$113.43
|
| Rate for Payer: BCN Commercial |
$113.43
|
| Rate for Payer: BCN Medicare Advantage |
$34.49
|
| Rate for Payer: Cash Price |
$110.38
|
| Rate for Payer: Cofinity Commercial |
$118.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.49
|
| Rate for Payer: Healthscope Commercial |
$124.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.48
|
| Rate for Payer: Mclaren Medicaid |
$24.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.22
|
| Rate for Payer: Meridian Medicaid |
$25.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.27
|
| Rate for Payer: Nomi Health Commercial |
$113.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.48
|
| Rate for Payer: PACE Senior Care Partners |
$32.77
|
| Rate for Payer: PACE SWMI |
$34.49
|
| Rate for Payer: PHP Commercial |
$117.27
|
| Rate for Payer: PHP Medicare Advantage |
$34.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$120.03
|
| Rate for Payer: Priority Health Medicare |
$34.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.03
|
| Rate for Payer: Railroad Medicare Medicare |
$34.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.41
|
| Rate for Payer: UHC Core |
$115.20
|
| Rate for Payer: UHC Exchange |
$34.49
|
| Rate for Payer: UHC Medicaid |
$24.32
|
| Rate for Payer: UHC Medicare Advantage |
$34.49
|
| Rate for Payer: UHCCP Medicaid |
$24.32
|
| Rate for Payer: VA VA |
$34.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.48
|
|
|
HC NG/CT DETECTION BY NUCLEIC ACID AMP
|
Facility
|
IP
|
$137.97
|
|
|
Service Code
|
CPT 87801
|
| Hospital Charge Code |
30600348
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$96.03 |
| Max. Negotiated Rate |
$124.17 |
| Rate for Payer: Aetna Commercial |
$117.27
|
| Rate for Payer: BCBS Trust/PPO |
$113.95
|
| Rate for Payer: BCN Commercial |
$113.95
|
| Rate for Payer: Cash Price |
$110.38
|
| Rate for Payer: Cofinity Commercial |
$118.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.38
|
| Rate for Payer: Healthscope Commercial |
$124.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.27
|
| Rate for Payer: Nomi Health Commercial |
$113.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.48
|
| Rate for Payer: PHP Commercial |
$117.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$120.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.41
|
| Rate for Payer: UHC Core |
$115.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.48
|
|
|
HC NICOTINE AND METABOLITES BLD
|
Facility
|
IP
|
$63.46
|
|
|
Service Code
|
CPT 80323
|
| Hospital Charge Code |
30100599
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.17 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: BCBS Trust/PPO |
$52.41
|
| Rate for Payer: BCN Commercial |
$52.41
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.84
|
| Rate for Payer: UHC Core |
$52.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC NICOTINE AND METABOLITES BLD
|
Facility
|
OP
|
$63.46
|
|
|
Service Code
|
CPT 80323
|
| Hospital Charge Code |
30100599
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.19 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.83
|
| Rate for Payer: BCBS Complete |
$11.75
|
| Rate for Payer: BCBS MAPPO |
$15.87
|
| Rate for Payer: BCBS Trust/PPO |
$52.17
|
| Rate for Payer: BCN Commercial |
$52.17
|
| Rate for Payer: BCN Medicare Advantage |
$15.87
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.87
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| Rate for Payer: Mclaren Medicaid |
$11.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.66
|
| Rate for Payer: Meridian Medicaid |
$11.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PACE Senior Care Partners |
$15.07
|
| Rate for Payer: PACE SWMI |
$15.87
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: PHP Medicare Advantage |
$15.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.21
|
| Rate for Payer: Priority Health Medicare |
$16.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.17
|
| Rate for Payer: Railroad Medicare Medicare |
$15.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.84
|
| Rate for Payer: UHC Core |
$52.99
|
| Rate for Payer: UHC Exchange |
$15.87
|
| Rate for Payer: UHC Medicaid |
$11.19
|
| Rate for Payer: UHC Medicare Advantage |
$15.87
|
| Rate for Payer: UHCCP Medicaid |
$11.19
|
| Rate for Payer: VA VA |
$15.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC NICOTINE AND METABOLITES URN
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 80323
|
| Hospital Charge Code |
30100613
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$9.63
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$42.77
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$9.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$9.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicaid |
$9.17
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$9.17
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC NICOTINE AND METABOLITES URN
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 80323
|
| Hospital Charge Code |
30100613
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.21 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.96
|
| Rate for Payer: BCN Commercial |
$42.96
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC NICU LEVEL 2 R&B
|
Facility
|
IP
|
$3,499.11
|
|
| Hospital Charge Code |
17200001
|
|
Hospital Revenue Code
|
172
|
| Min. Negotiated Rate |
$1,819.25 |
| Max. Negotiated Rate |
$3,149.20 |
| Rate for Payer: Aetna Commercial |
$2,974.24
|
| Rate for Payer: Aetna Medicare |
$1,991.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,393.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,393.75
|
| Rate for Payer: BCBS MAPPO |
$1,915.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,889.91
|
| Rate for Payer: BCN Commercial |
$2,889.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,915.00
|
| Rate for Payer: Cash Price |
$2,799.29
|
| Rate for Payer: Cash Price |
$2,799.29
|
| Rate for Payer: Cofinity Commercial |
$3,009.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,799.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,915.00
|
| Rate for Payer: Healthscope Commercial |
$3,149.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,624.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,010.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,202.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,106.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,974.24
|
| Rate for Payer: Nomi Health Commercial |
$2,869.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,624.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,819.25
|
| Rate for Payer: PACE SWMI |
$1,915.00
|
| Rate for Payer: PHP Commercial |
$2,974.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,915.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,044.23
|
| Rate for Payer: Priority Health Medicare |
$1,934.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,435.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,915.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,079.22
|
| Rate for Payer: UHC Core |
$2,921.76
|
| Rate for Payer: VA VA |
$1,915.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,624.33
|
|
|
HC NICU LEVEL 3 R&B
|
Facility
|
IP
|
$5,187.47
|
|
| Hospital Charge Code |
17300001
|
|
Hospital Revenue Code
|
173
|
| Min. Negotiated Rate |
$1,819.25 |
| Max. Negotiated Rate |
$4,668.72 |
| Rate for Payer: Aetna Commercial |
$4,409.35
|
| Rate for Payer: Aetna Medicare |
$1,991.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,393.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,393.75
|
| Rate for Payer: BCBS MAPPO |
$1,915.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,284.33
|
| Rate for Payer: BCN Commercial |
$4,284.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,915.00
|
| Rate for Payer: Cash Price |
$4,149.98
|
| Rate for Payer: Cash Price |
$4,149.98
|
| Rate for Payer: Cofinity Commercial |
$4,461.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,149.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,915.00
|
| Rate for Payer: Healthscope Commercial |
$4,668.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,890.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,010.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,202.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,106.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,409.35
|
| Rate for Payer: Nomi Health Commercial |
$4,253.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,890.60
|
| Rate for Payer: PACE Senior Care Partners |
$1,819.25
|
| Rate for Payer: PACE SWMI |
$1,915.00
|
| Rate for Payer: PHP Commercial |
$4,409.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,915.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,513.10
|
| Rate for Payer: Priority Health Medicare |
$1,934.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,610.48
|
| Rate for Payer: Railroad Medicare Medicare |
$1,915.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,564.97
|
| Rate for Payer: UHC Core |
$4,331.54
|
| Rate for Payer: VA VA |
$1,915.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,890.60
|
|
|
HC NICU LEVEL 4 R&B
|
Facility
|
IP
|
$5,432.11
|
|
| Hospital Charge Code |
17400001
|
|
Hospital Revenue Code
|
174
|
| Min. Negotiated Rate |
$1,819.25 |
| Max. Negotiated Rate |
$4,888.90 |
| Rate for Payer: Aetna Commercial |
$4,617.29
|
| Rate for Payer: Aetna Medicare |
$1,991.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,393.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,393.75
|
| Rate for Payer: BCBS MAPPO |
$1,915.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,486.38
|
| Rate for Payer: BCN Commercial |
$4,486.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,915.00
|
| Rate for Payer: Cash Price |
$4,345.69
|
| Rate for Payer: Cash Price |
$4,345.69
|
| Rate for Payer: Cofinity Commercial |
$4,671.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,345.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,915.00
|
| Rate for Payer: Healthscope Commercial |
$4,888.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,074.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,010.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,202.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,106.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,617.29
|
| Rate for Payer: Nomi Health Commercial |
$4,454.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,074.08
|
| Rate for Payer: PACE Senior Care Partners |
$1,819.25
|
| Rate for Payer: PACE SWMI |
$1,915.00
|
| Rate for Payer: PHP Commercial |
$4,617.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,915.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,725.94
|
| Rate for Payer: Priority Health Medicare |
$1,934.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,780.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,915.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,780.26
|
| Rate for Payer: UHC Core |
$4,535.81
|
| Rate for Payer: VA VA |
$1,915.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,074.08
|
|
|
HC NICU OBSERVATION PER HOUR
|
Facility
|
IP
|
$204.96
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200013
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$142.65 |
| Max. Negotiated Rate |
$184.46 |
| Rate for Payer: Aetna Commercial |
$174.22
|
| Rate for Payer: BCBS Trust/PPO |
$169.28
|
| Rate for Payer: BCN Commercial |
$169.28
|
| Rate for Payer: Cash Price |
$163.97
|
| Rate for Payer: Cofinity Commercial |
$176.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.97
|
| Rate for Payer: Healthscope Commercial |
$184.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.22
|
| Rate for Payer: Nomi Health Commercial |
$168.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.72
|
| Rate for Payer: PHP Commercial |
$174.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$178.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.36
|
| Rate for Payer: UHC Core |
$171.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.72
|
|
|
HC NICU OBSERVATION PER HOUR
|
Facility
|
OP
|
$204.96
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200013
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$36.13 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$174.22
|
| Rate for Payer: Aetna Medicare |
$53.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.05
|
| Rate for Payer: BCBS Complete |
$37.94
|
| Rate for Payer: BCBS MAPPO |
$51.24
|
| Rate for Payer: BCBS Trust/PPO |
$168.50
|
| Rate for Payer: BCN Commercial |
$168.50
|
| Rate for Payer: BCN Medicare Advantage |
$51.24
|
| Rate for Payer: Cash Price |
$163.97
|
| Rate for Payer: Cash Price |
$163.97
|
| Rate for Payer: Cofinity Commercial |
$176.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.24
|
| Rate for Payer: Healthscope Commercial |
$184.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.72
|
| Rate for Payer: Mclaren Medicaid |
$36.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.80
|
| Rate for Payer: Meridian Medicaid |
$37.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.22
|
| Rate for Payer: Nomi Health Commercial |
$168.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.72
|
| Rate for Payer: PACE Senior Care Partners |
$48.68
|
| Rate for Payer: PACE SWMI |
$51.24
|
| Rate for Payer: PHP Commercial |
$174.22
|
| Rate for Payer: PHP Medicare Advantage |
$51.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$178.32
|
| Rate for Payer: Priority Health Medicare |
$51.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.65
|
| Rate for Payer: Railroad Medicare Medicare |
$51.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.36
|
| Rate for Payer: UHC Core |
$171.14
|
| Rate for Payer: UHC Exchange |
$51.24
|
| Rate for Payer: UHC Medicaid |
$36.13
|
| Rate for Payer: UHC Medicare Advantage |
$51.24
|
| Rate for Payer: UHCCP Medicaid |
$850.00
|
| Rate for Payer: VA VA |
$51.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.72
|
|
|
HC NICU OR OB NURSERY R&B
|
Facility
|
IP
|
$2,409.92
|
|
| Hospital Charge Code |
17000001
|
|
Hospital Revenue Code
|
170
|
| Min. Negotiated Rate |
$1,677.30 |
| Max. Negotiated Rate |
$2,393.75 |
| Rate for Payer: Aetna Commercial |
$2,048.43
|
| Rate for Payer: Aetna Medicare |
$1,991.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,393.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,393.75
|
| Rate for Payer: BCBS MAPPO |
$1,915.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,990.35
|
| Rate for Payer: BCN Commercial |
$1,990.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,915.00
|
| Rate for Payer: Cash Price |
$1,927.94
|
| Rate for Payer: Cash Price |
$1,927.94
|
| Rate for Payer: Cofinity Commercial |
$2,072.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,927.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,915.00
|
| Rate for Payer: Healthscope Commercial |
$2,168.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,807.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,010.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,202.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,106.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,048.43
|
| Rate for Payer: Nomi Health Commercial |
$1,976.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,807.44
|
| Rate for Payer: PACE Senior Care Partners |
$1,819.25
|
| Rate for Payer: PACE SWMI |
$1,915.00
|
| Rate for Payer: PHP Commercial |
$2,048.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,915.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,096.63
|
| Rate for Payer: Priority Health Medicare |
$1,934.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,677.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,915.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,120.73
|
| Rate for Payer: UHC Core |
$2,012.28
|
| Rate for Payer: VA VA |
$1,915.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,807.44
|
|
|
HC NIFOMETER
|
Facility
|
IP
|
$85.81
|
|
| Hospital Charge Code |
27000125
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$59.72 |
| Max. Negotiated Rate |
$77.23 |
| Rate for Payer: Aetna Commercial |
$72.94
|
| Rate for Payer: BCBS Trust/PPO |
$70.87
|
| Rate for Payer: BCN Commercial |
$70.87
|
| Rate for Payer: Cash Price |
$68.65
|
| Rate for Payer: Cofinity Commercial |
$73.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.65
|
| Rate for Payer: Healthscope Commercial |
$77.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.94
|
| Rate for Payer: Nomi Health Commercial |
$70.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.36
|
| Rate for Payer: PHP Commercial |
$72.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.51
|
| Rate for Payer: UHC Core |
$71.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.36
|
|
|
HC NIFOMETER
|
Facility
|
OP
|
$85.81
|
|
| Hospital Charge Code |
27000125
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.13 |
| Max. Negotiated Rate |
$77.23 |
| Rate for Payer: Aetna Commercial |
$72.94
|
| Rate for Payer: Aetna Medicare |
$22.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.82
|
| Rate for Payer: BCBS Complete |
$15.88
|
| Rate for Payer: BCBS MAPPO |
$21.45
|
| Rate for Payer: BCBS Trust/PPO |
$70.54
|
| Rate for Payer: BCN Commercial |
$70.54
|
| Rate for Payer: BCN Medicare Advantage |
$21.45
|
| Rate for Payer: Cash Price |
$68.65
|
| Rate for Payer: Cofinity Commercial |
$73.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.45
|
| Rate for Payer: Healthscope Commercial |
$77.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.36
|
| Rate for Payer: Mclaren Medicaid |
$15.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.53
|
| Rate for Payer: Meridian Medicaid |
$15.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.94
|
| Rate for Payer: Nomi Health Commercial |
$70.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.36
|
| Rate for Payer: PACE Senior Care Partners |
$20.38
|
| Rate for Payer: PACE SWMI |
$21.45
|
| Rate for Payer: PHP Commercial |
$72.94
|
| Rate for Payer: PHP Medicare Advantage |
$21.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$74.65
|
| Rate for Payer: Priority Health Medicare |
$21.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.72
|
| Rate for Payer: Railroad Medicare Medicare |
$21.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.51
|
| Rate for Payer: UHC Core |
$71.65
|
| Rate for Payer: UHC Exchange |
$21.45
|
| Rate for Payer: UHC Medicaid |
$15.13
|
| Rate for Payer: UHC Medicare Advantage |
$21.45
|
| Rate for Payer: UHCCP Medicaid |
$15.13
|
| Rate for Payer: VA VA |
$21.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.36
|
|
|
HC NITRIC OXIDE EXPIRED GAS DETERMINATION
|
Facility
|
IP
|
$51.12
|
|
|
Service Code
|
CPT 95012
|
| Hospital Charge Code |
46000031
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$35.58 |
| Max. Negotiated Rate |
$46.01 |
| Rate for Payer: Aetna Commercial |
$43.45
|
| Rate for Payer: BCBS Trust/PPO |
$42.22
|
| Rate for Payer: BCN Commercial |
$42.22
|
| Rate for Payer: Cash Price |
$40.90
|
| Rate for Payer: Cofinity Commercial |
$43.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.90
|
| Rate for Payer: Healthscope Commercial |
$46.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.45
|
| Rate for Payer: Nomi Health Commercial |
$41.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.34
|
| Rate for Payer: PHP Commercial |
$43.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.99
|
| Rate for Payer: UHC Core |
$42.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.34
|
|
|
HC NITRIC OXIDE EXPIRED GAS DETERMINATION
|
Facility
|
OP
|
$51.12
|
|
|
Service Code
|
CPT 95012
|
| Hospital Charge Code |
46000031
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$9.01 |
| Max. Negotiated Rate |
$46.01 |
| Rate for Payer: Aetna Commercial |
$43.45
|
| Rate for Payer: Aetna Medicare |
$13.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.97
|
| Rate for Payer: BCBS Complete |
$9.46
|
| Rate for Payer: BCBS MAPPO |
$12.78
|
| Rate for Payer: BCBS Trust/PPO |
$42.03
|
| Rate for Payer: BCN Commercial |
$42.03
|
| Rate for Payer: BCN Medicare Advantage |
$12.78
|
| Rate for Payer: Cash Price |
$40.90
|
| Rate for Payer: Cofinity Commercial |
$43.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.78
|
| Rate for Payer: Healthscope Commercial |
$46.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.34
|
| Rate for Payer: Mclaren Medicaid |
$9.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.42
|
| Rate for Payer: Meridian Medicaid |
$9.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.45
|
| Rate for Payer: Nomi Health Commercial |
$41.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.34
|
| Rate for Payer: PACE Senior Care Partners |
$12.14
|
| Rate for Payer: PACE SWMI |
$12.78
|
| Rate for Payer: PHP Commercial |
$43.45
|
| Rate for Payer: PHP Medicare Advantage |
$12.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.47
|
| Rate for Payer: Priority Health Medicare |
$12.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.58
|
| Rate for Payer: Railroad Medicare Medicare |
$12.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.99
|
| Rate for Payer: UHC Core |
$42.69
|
| Rate for Payer: UHC Exchange |
$12.78
|
| Rate for Payer: UHC Medicaid |
$9.01
|
| Rate for Payer: UHC Medicare Advantage |
$12.78
|
| Rate for Payer: UHCCP Medicaid |
$9.01
|
| Rate for Payer: VA VA |
$12.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.34
|
|
|
HC NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS
|
Facility
|
IP
|
$4,993.92
|
|
|
Service Code
|
CPT 36466
|
| Hospital Charge Code |
76100402
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,475.77 |
| Max. Negotiated Rate |
$4,494.53 |
| Rate for Payer: Aetna Commercial |
$4,244.83
|
| Rate for Payer: BCBS Trust/PPO |
$4,124.48
|
| Rate for Payer: BCN Commercial |
$4,124.48
|
| Rate for Payer: Cash Price |
$3,995.14
|
| Rate for Payer: Cofinity Commercial |
$4,294.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,995.14
|
| Rate for Payer: Healthscope Commercial |
$4,494.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,745.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,244.83
|
| Rate for Payer: Nomi Health Commercial |
$4,095.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,745.44
|
| Rate for Payer: PHP Commercial |
$4,244.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,344.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,475.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,394.65
|
| Rate for Payer: UHC Core |
$4,169.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,745.44
|
|
|
HC NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS
|
Facility
|
OP
|
$4,993.92
|
|
|
Service Code
|
CPT 36466
|
| Hospital Charge Code |
76100402
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$880.43 |
| Max. Negotiated Rate |
$4,494.53 |
| Rate for Payer: Aetna Commercial |
$4,244.83
|
| Rate for Payer: Aetna Medicare |
$1,298.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,560.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,560.60
|
| Rate for Payer: BCBS Complete |
$924.37
|
| Rate for Payer: BCBS MAPPO |
$1,248.48
|
| Rate for Payer: BCBS Trust/PPO |
$4,105.50
|
| Rate for Payer: BCN Commercial |
$4,105.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,248.48
|
| Rate for Payer: Cash Price |
$3,995.14
|
| Rate for Payer: Cofinity Commercial |
$4,294.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,995.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,248.48
|
| Rate for Payer: Healthscope Commercial |
$4,494.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,745.44
|
| Rate for Payer: Mclaren Medicaid |
$880.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,310.90
|
| Rate for Payer: Meridian Medicaid |
$924.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,435.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,373.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,244.83
|
| Rate for Payer: Nomi Health Commercial |
$4,095.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,745.44
|
| Rate for Payer: PACE Senior Care Partners |
$1,186.06
|
| Rate for Payer: PACE SWMI |
$1,248.48
|
| Rate for Payer: PHP Commercial |
$4,244.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,248.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$880.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,344.71
|
| Rate for Payer: Priority Health Medicare |
$1,260.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,475.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,248.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,394.65
|
| Rate for Payer: UHC Core |
$4,169.92
|
| Rate for Payer: UHC Exchange |
$1,248.48
|
| Rate for Payer: UHC Medicaid |
$880.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,248.48
|
| Rate for Payer: UHCCP Medicaid |
$880.43
|
| Rate for Payer: VA VA |
$1,248.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,745.44
|
|
|
HC NM BONE MARROW LIMITED AREA
|
Facility
|
OP
|
$919.70
|
|
|
Service Code
|
CPT 78102
|
| Hospital Charge Code |
34100009
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$162.14 |
| Max. Negotiated Rate |
$827.73 |
| Rate for Payer: Aetna Commercial |
$781.75
|
| Rate for Payer: Aetna Medicare |
$239.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$287.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$287.41
|
| Rate for Payer: BCBS Complete |
$170.24
|
| Rate for Payer: BCBS MAPPO |
$229.93
|
| Rate for Payer: BCBS Trust/PPO |
$756.09
|
| Rate for Payer: BCN Commercial |
$756.09
|
| Rate for Payer: BCN Medicare Advantage |
$229.93
|
| Rate for Payer: Cash Price |
$735.76
|
| Rate for Payer: Cofinity Commercial |
$790.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.93
|
| Rate for Payer: Healthscope Commercial |
$827.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.77
|
| Rate for Payer: Mclaren Medicaid |
$162.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.42
|
| Rate for Payer: Meridian Medicaid |
$170.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$264.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$252.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.75
|
| Rate for Payer: Nomi Health Commercial |
$754.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$689.77
|
| Rate for Payer: PACE Senior Care Partners |
$218.43
|
| Rate for Payer: PACE SWMI |
$229.93
|
| Rate for Payer: PHP Commercial |
$781.75
|
| Rate for Payer: PHP Medicare Advantage |
$229.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$800.14
|
| Rate for Payer: Priority Health Medicare |
$232.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$640.11
|
| Rate for Payer: Railroad Medicare Medicare |
$229.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$809.34
|
| Rate for Payer: UHC Core |
$767.95
|
| Rate for Payer: UHC Exchange |
$229.93
|
| Rate for Payer: UHC Medicaid |
$162.14
|
| Rate for Payer: UHC Medicare Advantage |
$229.93
|
| Rate for Payer: UHCCP Medicaid |
$162.14
|
| Rate for Payer: VA VA |
$229.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.77
|
|
|
HC NM BONE MARROW LIMITED AREA
|
Facility
|
IP
|
$919.70
|
|
|
Service Code
|
CPT 78102
|
| Hospital Charge Code |
34100009
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$640.11 |
| Max. Negotiated Rate |
$827.73 |
| Rate for Payer: Aetna Commercial |
$781.75
|
| Rate for Payer: BCBS Trust/PPO |
$759.58
|
| Rate for Payer: BCN Commercial |
$759.58
|
| Rate for Payer: Cash Price |
$735.76
|
| Rate for Payer: Cofinity Commercial |
$790.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.76
|
| Rate for Payer: Healthscope Commercial |
$827.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.75
|
| Rate for Payer: Nomi Health Commercial |
$754.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$689.77
|
| Rate for Payer: PHP Commercial |
$781.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$800.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$640.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$809.34
|
| Rate for Payer: UHC Core |
$767.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.77
|
|
