|
HC MATERNAL SCRN INTEGRATED SERUM 2
|
Facility
|
IP
|
$242.35
|
|
|
Service Code
|
CPT 81511
|
| Hospital Charge Code |
30100654
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$157.53 |
| Max. Negotiated Rate |
$218.12 |
| Rate for Payer: Aetna Commercial |
$206.00
|
| Rate for Payer: BCBS Trust/PPO |
$197.83
|
| Rate for Payer: BCN Commercial |
$187.29
|
| Rate for Payer: Cash Price |
$193.88
|
| Rate for Payer: Cofinity Commercial |
$208.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.88
|
| Rate for Payer: Healthscope Commercial |
$218.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.00
|
| Rate for Payer: Nomi Health Commercial |
$198.73
|
| Rate for Payer: PHP Commercial |
$206.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.53
|
| Rate for Payer: Priority Health HMO/PPO |
$210.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.27
|
| Rate for Payer: UHC Core |
$202.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.76
|
|
|
HC MAXIMUM VOLUNTARY VENTILATION
|
Facility
|
OP
|
$122.63
|
|
|
Service Code
|
CPT 94200
|
| Hospital Charge Code |
46000022
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$29.12 |
| Max. Negotiated Rate |
$110.37 |
| Rate for Payer: Aetna Commercial |
$104.24
|
| Rate for Payer: Aetna Medicare |
$31.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.32
|
| Rate for Payer: BCBS Complete |
$44.19
|
| Rate for Payer: BCBS MAPPO |
$30.66
|
| Rate for Payer: BCBS Trust/PPO |
$100.81
|
| Rate for Payer: BCN Commercial |
$95.34
|
| Rate for Payer: BCN Medicare Advantage |
$30.66
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Cofinity Commercial |
$105.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.66
|
| Rate for Payer: Healthscope Commercial |
$110.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.97
|
| Rate for Payer: Mclaren Medicaid |
$42.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.19
|
| Rate for Payer: Meridian Medicaid |
$44.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.24
|
| Rate for Payer: Nomi Health Commercial |
$100.56
|
| Rate for Payer: PACE Senior Care Partners |
$29.12
|
| Rate for Payer: PACE SWMI |
$30.66
|
| Rate for Payer: PHP Commercial |
$104.24
|
| Rate for Payer: PHP Medicare Advantage |
$30.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.71
|
| Rate for Payer: Priority Health HMO/PPO |
$106.69
|
| Rate for Payer: Priority Health Medicare |
$30.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.16
|
| Rate for Payer: Railroad Medicare Medicare |
$30.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.91
|
| Rate for Payer: UHC Core |
$102.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.66
|
| Rate for Payer: UHC Exchange |
$30.66
|
| Rate for Payer: UHC Medicare Advantage |
$30.66
|
| Rate for Payer: UHCCP Medicaid |
$42.08
|
| Rate for Payer: VA VA |
$30.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.97
|
|
|
HC MAXIMUM VOLUNTARY VENTILATION
|
Facility
|
IP
|
$122.63
|
|
|
Service Code
|
CPT 94200
|
| Hospital Charge Code |
46000022
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$79.71 |
| Max. Negotiated Rate |
$110.37 |
| Rate for Payer: Aetna Commercial |
$104.24
|
| Rate for Payer: BCBS Trust/PPO |
$100.10
|
| Rate for Payer: BCN Commercial |
$94.77
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Cofinity Commercial |
$105.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.10
|
| Rate for Payer: Healthscope Commercial |
$110.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.24
|
| Rate for Payer: Nomi Health Commercial |
$100.56
|
| Rate for Payer: PHP Commercial |
$104.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.71
|
| Rate for Payer: Priority Health HMO/PPO |
$106.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.91
|
| Rate for Payer: UHC Core |
$102.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.97
|
|
|
HC MAYO CHROMOGENIC FACTOR 8
|
Facility
|
IP
|
$338.23
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500105
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$219.85 |
| Max. Negotiated Rate |
$304.41 |
| Rate for Payer: Aetna Commercial |
$287.50
|
| Rate for Payer: BCBS Trust/PPO |
$276.10
|
| Rate for Payer: BCN Commercial |
$261.38
|
| Rate for Payer: Cash Price |
$270.58
|
| Rate for Payer: Cofinity Commercial |
$290.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.58
|
| Rate for Payer: Healthscope Commercial |
$304.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.50
|
| Rate for Payer: Nomi Health Commercial |
$277.35
|
| Rate for Payer: PHP Commercial |
$287.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.85
|
| Rate for Payer: Priority Health HMO/PPO |
$294.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.64
|
| Rate for Payer: UHC Core |
$282.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.67
|
|
|
HC MAYO CHROMOGENIC FACTOR 8
|
Facility
|
OP
|
$338.23
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500105
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.60 |
| Max. Negotiated Rate |
$304.41 |
| Rate for Payer: Aetna Commercial |
$287.50
|
| Rate for Payer: Aetna Medicare |
$87.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$105.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$105.70
|
| Rate for Payer: BCBS Complete |
$9.03
|
| Rate for Payer: BCBS MAPPO |
$84.56
|
| Rate for Payer: BCBS Trust/PPO |
$278.06
|
| Rate for Payer: BCN Commercial |
$262.97
|
| Rate for Payer: BCN Medicare Advantage |
$84.56
|
| Rate for Payer: Cash Price |
$270.58
|
| Rate for Payer: Cash Price |
$270.58
|
| Rate for Payer: Cofinity Commercial |
$290.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.56
|
| Rate for Payer: Healthscope Commercial |
$304.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.67
|
| Rate for Payer: Mclaren Medicaid |
$8.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.79
|
| Rate for Payer: Meridian Medicaid |
$9.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.50
|
| Rate for Payer: Nomi Health Commercial |
$277.35
|
| Rate for Payer: PACE Senior Care Partners |
$80.33
|
| Rate for Payer: PACE SWMI |
$84.56
|
| Rate for Payer: PHP Commercial |
$287.50
|
| Rate for Payer: PHP Medicare Advantage |
$84.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.85
|
| Rate for Payer: Priority Health HMO/PPO |
$294.26
|
| Rate for Payer: Priority Health Medicare |
$85.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.61
|
| Rate for Payer: Railroad Medicare Medicare |
$84.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.64
|
| Rate for Payer: UHC Core |
$282.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$84.56
|
| Rate for Payer: UHC Exchange |
$84.56
|
| Rate for Payer: UHC Medicare Advantage |
$84.56
|
| Rate for Payer: UHCCP Medicaid |
$8.60
|
| Rate for Payer: VA VA |
$84.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.67
|
|
|
HC MAYO CHROMOGENIC FACTOR 9
|
Facility
|
OP
|
$358.56
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500104
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.60 |
| Max. Negotiated Rate |
$322.70 |
| Rate for Payer: Aetna Commercial |
$304.78
|
| Rate for Payer: Aetna Medicare |
$93.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.05
|
| Rate for Payer: BCBS Complete |
$9.03
|
| Rate for Payer: BCBS MAPPO |
$89.64
|
| Rate for Payer: BCBS Trust/PPO |
$294.77
|
| Rate for Payer: BCN Commercial |
$278.78
|
| Rate for Payer: BCN Medicare Advantage |
$89.64
|
| Rate for Payer: Cash Price |
$286.85
|
| Rate for Payer: Cash Price |
$286.85
|
| Rate for Payer: Cofinity Commercial |
$308.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.64
|
| Rate for Payer: Healthscope Commercial |
$322.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.92
|
| Rate for Payer: Mclaren Medicaid |
$8.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.12
|
| Rate for Payer: Meridian Medicaid |
$9.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.78
|
| Rate for Payer: Nomi Health Commercial |
$294.02
|
| Rate for Payer: PACE Senior Care Partners |
$85.16
|
| Rate for Payer: PACE SWMI |
$89.64
|
| Rate for Payer: PHP Commercial |
$304.78
|
| Rate for Payer: PHP Medicare Advantage |
$89.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.06
|
| Rate for Payer: Priority Health HMO/PPO |
$311.95
|
| Rate for Payer: Priority Health Medicare |
$90.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.24
|
| Rate for Payer: Railroad Medicare Medicare |
$89.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.53
|
| Rate for Payer: UHC Core |
$299.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.64
|
| Rate for Payer: UHC Exchange |
$89.64
|
| Rate for Payer: UHC Medicare Advantage |
$89.64
|
| Rate for Payer: UHCCP Medicaid |
$8.60
|
| Rate for Payer: VA VA |
$89.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.92
|
|
|
HC MAYO CHROMOGENIC FACTOR 9
|
Facility
|
IP
|
$358.56
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500104
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$233.06 |
| Max. Negotiated Rate |
$322.70 |
| Rate for Payer: Aetna Commercial |
$304.78
|
| Rate for Payer: BCBS Trust/PPO |
$292.69
|
| Rate for Payer: BCN Commercial |
$277.10
|
| Rate for Payer: Cash Price |
$286.85
|
| Rate for Payer: Cofinity Commercial |
$308.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.85
|
| Rate for Payer: Healthscope Commercial |
$322.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.78
|
| Rate for Payer: Nomi Health Commercial |
$294.02
|
| Rate for Payer: PHP Commercial |
$304.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.06
|
| Rate for Payer: Priority Health HMO/PPO |
$311.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.53
|
| Rate for Payer: UHC Core |
$299.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.92
|
|
|
HC MAYOCOMPLETE MYELOID NEOPLASMS, NGS
|
Facility
|
IP
|
$1,963.50
|
|
|
Service Code
|
CPT 81450
|
| Hospital Charge Code |
31000084
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,276.28 |
| Max. Negotiated Rate |
$1,767.15 |
| Rate for Payer: Aetna Commercial |
$1,668.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,602.81
|
| Rate for Payer: BCN Commercial |
$1,517.39
|
| Rate for Payer: Cash Price |
$1,570.80
|
| Rate for Payer: Cofinity Commercial |
$1,688.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,570.80
|
| Rate for Payer: Healthscope Commercial |
$1,767.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,472.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,668.98
|
| Rate for Payer: Nomi Health Commercial |
$1,610.07
|
| Rate for Payer: PHP Commercial |
$1,668.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,276.28
|
| Rate for Payer: Priority Health HMO/PPO |
$1,708.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,315.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,727.88
|
| Rate for Payer: UHC Core |
$1,639.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,472.62
|
|
|
HC MAYOCOMPLETE MYELOID NEOPLASMS, NGS
|
Facility
|
OP
|
$1,963.50
|
|
|
Service Code
|
CPT 81450
|
| Hospital Charge Code |
31000084
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$466.33 |
| Max. Negotiated Rate |
$1,767.15 |
| Rate for Payer: Aetna Commercial |
$1,668.98
|
| Rate for Payer: Aetna Medicare |
$510.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$613.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$613.59
|
| Rate for Payer: BCBS Complete |
$576.64
|
| Rate for Payer: BCBS MAPPO |
$490.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,614.19
|
| Rate for Payer: BCN Commercial |
$1,526.62
|
| Rate for Payer: BCN Medicare Advantage |
$490.88
|
| Rate for Payer: Cash Price |
$1,570.80
|
| Rate for Payer: Cash Price |
$1,570.80
|
| Rate for Payer: Cofinity Commercial |
$1,688.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,570.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.88
|
| Rate for Payer: Healthscope Commercial |
$1,767.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,472.62
|
| Rate for Payer: Mclaren Medicaid |
$549.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$515.42
|
| Rate for Payer: Meridian Medicaid |
$576.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$564.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,668.98
|
| Rate for Payer: Nomi Health Commercial |
$1,610.07
|
| Rate for Payer: PACE Senior Care Partners |
$466.33
|
| Rate for Payer: PACE SWMI |
$490.88
|
| Rate for Payer: PHP Commercial |
$1,668.98
|
| Rate for Payer: PHP Medicare Advantage |
$490.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$549.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,276.28
|
| Rate for Payer: Priority Health HMO/PPO |
$1,708.24
|
| Rate for Payer: Priority Health Medicare |
$495.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,315.54
|
| Rate for Payer: Railroad Medicare Medicare |
$490.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,727.88
|
| Rate for Payer: UHC Core |
$1,639.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$490.88
|
| Rate for Payer: UHC Exchange |
$490.88
|
| Rate for Payer: UHC Medicare Advantage |
$490.88
|
| Rate for Payer: UHCCP Medicaid |
$549.14
|
| Rate for Payer: VA VA |
$490.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,472.62
|
|
|
HC MAYO CREATININE, URINE CMPT
|
Facility
|
IP
|
$10.78
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100734
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.01 |
| Max. Negotiated Rate |
$9.70 |
| Rate for Payer: Aetna Commercial |
$9.16
|
| Rate for Payer: BCBS Trust/PPO |
$8.80
|
| Rate for Payer: BCN Commercial |
$8.33
|
| Rate for Payer: Cash Price |
$8.62
|
| Rate for Payer: Cofinity Commercial |
$9.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$9.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.16
|
| Rate for Payer: Nomi Health Commercial |
$8.84
|
| Rate for Payer: PHP Commercial |
$9.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.01
|
| Rate for Payer: Priority Health HMO/PPO |
$9.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.49
|
| Rate for Payer: UHC Core |
$9.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.08
|
|
|
HC MAYO CREATININE, URINE CMPT
|
Facility
|
OP
|
$10.78
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100734
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.56 |
| Max. Negotiated Rate |
$9.70 |
| Rate for Payer: Aetna Commercial |
$9.16
|
| Rate for Payer: Aetna Medicare |
$2.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.37
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$2.70
|
| Rate for Payer: BCBS Trust/PPO |
$8.86
|
| Rate for Payer: BCN Commercial |
$8.38
|
| Rate for Payer: BCN Medicare Advantage |
$2.70
|
| Rate for Payer: Cash Price |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| Rate for Payer: Cofinity Commercial |
$9.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.70
|
| Rate for Payer: Healthscope Commercial |
$9.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.08
|
| Rate for Payer: Mclaren Medicaid |
$3.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.83
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.16
|
| Rate for Payer: Nomi Health Commercial |
$8.84
|
| Rate for Payer: PACE Senior Care Partners |
$2.56
|
| Rate for Payer: PACE SWMI |
$2.70
|
| Rate for Payer: PHP Commercial |
$9.16
|
| Rate for Payer: PHP Medicare Advantage |
$2.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.01
|
| Rate for Payer: Priority Health HMO/PPO |
$9.38
|
| Rate for Payer: Priority Health Medicare |
$2.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.22
|
| Rate for Payer: Railroad Medicare Medicare |
$2.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.49
|
| Rate for Payer: UHC Core |
$9.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.70
|
| Rate for Payer: UHC Exchange |
$2.70
|
| Rate for Payer: UHC Medicare Advantage |
$2.70
|
| Rate for Payer: UHCCP Medicaid |
$3.75
|
| Rate for Payer: VA VA |
$2.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.08
|
|
|
HC MDI TREATMENT
|
Facility
|
IP
|
$149.67
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000004
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$97.29 |
| Max. Negotiated Rate |
$134.70 |
| Rate for Payer: Aetna Commercial |
$127.22
|
| Rate for Payer: BCBS Trust/PPO |
$122.18
|
| Rate for Payer: BCN Commercial |
$115.66
|
| Rate for Payer: Cash Price |
$119.74
|
| Rate for Payer: Cofinity Commercial |
$128.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.74
|
| Rate for Payer: Healthscope Commercial |
$134.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.22
|
| Rate for Payer: Nomi Health Commercial |
$122.73
|
| Rate for Payer: PHP Commercial |
$127.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.29
|
| Rate for Payer: Priority Health HMO/PPO |
$130.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.71
|
| Rate for Payer: UHC Core |
$124.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.25
|
|
|
HC MDI TREATMENT
|
Facility
|
OP
|
$149.67
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000004
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$35.55 |
| Max. Negotiated Rate |
$151.29 |
| Rate for Payer: Aetna Commercial |
$127.22
|
| Rate for Payer: Aetna Medicare |
$38.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.77
|
| Rate for Payer: BCBS Complete |
$151.29
|
| Rate for Payer: BCBS MAPPO |
$37.42
|
| Rate for Payer: BCBS Trust/PPO |
$123.04
|
| Rate for Payer: BCN Commercial |
$116.37
|
| Rate for Payer: BCN Medicare Advantage |
$37.42
|
| Rate for Payer: Cash Price |
$119.74
|
| Rate for Payer: Cash Price |
$119.74
|
| Rate for Payer: Cofinity Commercial |
$128.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.42
|
| Rate for Payer: Healthscope Commercial |
$134.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.25
|
| Rate for Payer: Mclaren Medicaid |
$144.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.29
|
| Rate for Payer: Meridian Medicaid |
$151.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.22
|
| Rate for Payer: Nomi Health Commercial |
$122.73
|
| Rate for Payer: PACE Senior Care Partners |
$35.55
|
| Rate for Payer: PACE SWMI |
$37.42
|
| Rate for Payer: PHP Commercial |
$127.22
|
| Rate for Payer: PHP Medicare Advantage |
$37.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.29
|
| Rate for Payer: Priority Health HMO/PPO |
$130.21
|
| Rate for Payer: Priority Health Medicare |
$37.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.28
|
| Rate for Payer: Railroad Medicare Medicare |
$37.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.71
|
| Rate for Payer: UHC Core |
$124.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.42
|
| Rate for Payer: UHC Exchange |
$37.42
|
| Rate for Payer: UHC Medicare Advantage |
$37.42
|
| Rate for Payer: UHCCP Medicaid |
$144.08
|
| Rate for Payer: VA VA |
$37.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.25
|
|
|
HC MEADOW FESCUE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200092
|
|
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 MEADOW FESCUE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200092
|
|
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 MEASLES PCR THROAT
|
Facility
|
OP
|
$491.10
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600347
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.37 |
| Max. Negotiated Rate |
$441.99 |
| Rate for Payer: Aetna Commercial |
$417.44
|
| Rate for Payer: Aetna Medicare |
$127.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.47
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$122.78
|
| Rate for Payer: BCBS Trust/PPO |
$403.73
|
| Rate for Payer: BCN Commercial |
$381.83
|
| Rate for Payer: BCN Medicare Advantage |
$122.78
|
| Rate for Payer: Cash Price |
$392.88
|
| Rate for Payer: Cash Price |
$392.88
|
| Rate for Payer: Cofinity Commercial |
$422.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.78
|
| Rate for Payer: Healthscope Commercial |
$441.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$368.32
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.91
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$417.44
|
| Rate for Payer: Nomi Health Commercial |
$402.70
|
| Rate for Payer: PACE Senior Care Partners |
$116.64
|
| Rate for Payer: PACE SWMI |
$122.78
|
| Rate for Payer: PHP Commercial |
$417.44
|
| Rate for Payer: PHP Medicare Advantage |
$122.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$319.22
|
| Rate for Payer: Priority Health HMO/PPO |
$427.26
|
| Rate for Payer: Priority Health Medicare |
$124.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.04
|
| Rate for Payer: Railroad Medicare Medicare |
$122.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$432.17
|
| Rate for Payer: UHC Core |
$410.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.78
|
| Rate for Payer: UHC Exchange |
$122.78
|
| Rate for Payer: UHC Medicare Advantage |
$122.78
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$122.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$368.32
|
|
|
HC MEASLES PCR THROAT
|
Facility
|
IP
|
$491.10
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600347
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$319.22 |
| Max. Negotiated Rate |
$441.99 |
| Rate for Payer: Aetna Commercial |
$417.44
|
| Rate for Payer: BCBS Trust/PPO |
$400.88
|
| Rate for Payer: BCN Commercial |
$379.52
|
| Rate for Payer: Cash Price |
$392.88
|
| Rate for Payer: Cofinity Commercial |
$422.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.88
|
| Rate for Payer: Healthscope Commercial |
$441.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$368.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$417.44
|
| Rate for Payer: Nomi Health Commercial |
$402.70
|
| Rate for Payer: PHP Commercial |
$417.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$319.22
|
| Rate for Payer: Priority Health HMO/PPO |
$427.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$432.17
|
| Rate for Payer: UHC Core |
$410.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$368.32
|
|
|
HC MEASLES (RUBEOLA) IGM
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200398
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.14 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: BCBS Trust/PPO |
$41.61
|
| Rate for Payer: BCN Commercial |
$39.40
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$43.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health HMO/PPO |
$44.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.86
|
| Rate for Payer: UHC Core |
$42.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.24
|
|
|
HC MEASLES (RUBEOLA) IGM
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200398
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.31 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: Aetna Medicare |
$13.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.93
|
| Rate for Payer: BCBS Complete |
$9.78
|
| Rate for Payer: BCBS MAPPO |
$12.74
|
| Rate for Payer: BCBS Trust/PPO |
$41.91
|
| Rate for Payer: BCN Commercial |
$39.64
|
| Rate for Payer: BCN Medicare Advantage |
$12.74
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$43.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.24
|
| Rate for Payer: Mclaren Medicaid |
$9.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.38
|
| Rate for Payer: Meridian Medicaid |
$9.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.74
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: PHP Medicare Advantage |
$12.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health HMO/PPO |
$44.35
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.16
|
| Rate for Payer: Railroad Medicare Medicare |
$12.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.86
|
| Rate for Payer: UHC Core |
$42.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.74
|
| Rate for Payer: UHC Exchange |
$12.74
|
| Rate for Payer: UHC Medicare Advantage |
$12.74
|
| Rate for Payer: UHCCP Medicaid |
$9.31
|
| Rate for Payer: VA VA |
$12.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.24
|
|
|
HC MECHANICAL REMOVAL OBSTRC CVD
|
Facility
|
OP
|
$1,568.04
|
|
|
Service Code
|
CPT 36596
|
| Hospital Charge Code |
36100143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$372.41 |
| Max. Negotiated Rate |
$1,411.24 |
| Rate for Payer: Aetna Commercial |
$1,332.83
|
| Rate for Payer: Aetna Medicare |
$407.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$490.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$490.01
|
| Rate for Payer: BCBS Complete |
$1,155.53
|
| Rate for Payer: BCBS MAPPO |
$392.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,289.09
|
| Rate for Payer: BCN Commercial |
$1,219.15
|
| Rate for Payer: BCN Medicare Advantage |
$392.01
|
| Rate for Payer: Cash Price |
$1,254.43
|
| Rate for Payer: Cash Price |
$1,254.43
|
| Rate for Payer: Cofinity Commercial |
$1,348.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,254.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.01
|
| Rate for Payer: Healthscope Commercial |
$1,411.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.03
|
| Rate for Payer: Mclaren Medicaid |
$1,100.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.61
|
| Rate for Payer: Meridian Medicaid |
$1,155.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.83
|
| Rate for Payer: Nomi Health Commercial |
$1,285.79
|
| Rate for Payer: PACE Senior Care Partners |
$372.41
|
| Rate for Payer: PACE SWMI |
$392.01
|
| Rate for Payer: PHP Commercial |
$1,332.83
|
| Rate for Payer: PHP Medicare Advantage |
$392.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,100.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.23
|
| Rate for Payer: Priority Health HMO/PPO |
$1,364.19
|
| Rate for Payer: Priority Health Medicare |
$395.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,050.59
|
| Rate for Payer: Railroad Medicare Medicare |
$392.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,379.88
|
| Rate for Payer: UHC Core |
$1,309.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.01
|
| Rate for Payer: UHC Exchange |
$392.01
|
| Rate for Payer: UHC Medicare Advantage |
$392.01
|
| Rate for Payer: UHCCP Medicaid |
$1,100.43
|
| Rate for Payer: VA VA |
$392.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.03
|
|
|
HC MECHANICAL REMOVAL OBSTRC CVD
|
Facility
|
IP
|
$1,568.04
|
|
|
Service Code
|
CPT 36596
|
| Hospital Charge Code |
36100143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,019.23 |
| Max. Negotiated Rate |
$1,411.24 |
| Rate for Payer: Aetna Commercial |
$1,332.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,279.99
|
| Rate for Payer: BCN Commercial |
$1,211.78
|
| Rate for Payer: Cash Price |
$1,254.43
|
| Rate for Payer: Cofinity Commercial |
$1,348.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,254.43
|
| Rate for Payer: Healthscope Commercial |
$1,411.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.83
|
| Rate for Payer: Nomi Health Commercial |
$1,285.79
|
| Rate for Payer: PHP Commercial |
$1,332.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.23
|
| Rate for Payer: Priority Health HMO/PPO |
$1,364.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,050.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,379.88
|
| Rate for Payer: UHC Core |
$1,309.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.03
|
|
|
HC MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTION
|
Facility
|
IP
|
$2,962.57
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
36100142
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,925.67 |
| Max. Negotiated Rate |
$2,666.31 |
| Rate for Payer: Aetna Commercial |
$2,518.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,418.35
|
| Rate for Payer: BCN Commercial |
$2,289.47
|
| Rate for Payer: Cash Price |
$2,370.06
|
| Rate for Payer: Cofinity Commercial |
$2,547.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,370.06
|
| Rate for Payer: Healthscope Commercial |
$2,666.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,221.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,518.18
|
| Rate for Payer: Nomi Health Commercial |
$2,429.31
|
| Rate for Payer: PHP Commercial |
$2,518.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,925.67
|
| Rate for Payer: Priority Health HMO/PPO |
$2,577.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,984.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,607.06
|
| Rate for Payer: UHC Core |
$2,473.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,221.93
|
|
|
HC MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTION
|
Facility
|
OP
|
$2,962.57
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
36100142
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$703.61 |
| Max. Negotiated Rate |
$2,666.31 |
| Rate for Payer: Aetna Commercial |
$2,518.18
|
| Rate for Payer: Aetna Medicare |
$770.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$925.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$925.80
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$740.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,435.53
|
| Rate for Payer: BCN Commercial |
$2,303.40
|
| Rate for Payer: BCN Medicare Advantage |
$740.64
|
| Rate for Payer: Cash Price |
$2,370.06
|
| Rate for Payer: Cash Price |
$2,370.06
|
| Rate for Payer: Cofinity Commercial |
$2,547.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,370.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$740.64
|
| Rate for Payer: Healthscope Commercial |
$2,666.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,221.93
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.67
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$851.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,518.18
|
| Rate for Payer: Nomi Health Commercial |
$2,429.31
|
| Rate for Payer: PACE Senior Care Partners |
$703.61
|
| Rate for Payer: PACE SWMI |
$740.64
|
| Rate for Payer: PHP Commercial |
$2,518.18
|
| Rate for Payer: PHP Medicare Advantage |
$740.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,925.67
|
| Rate for Payer: Priority Health HMO/PPO |
$2,577.44
|
| Rate for Payer: Priority Health Medicare |
$748.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,984.92
|
| Rate for Payer: Railroad Medicare Medicare |
$740.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,607.06
|
| Rate for Payer: UHC Core |
$2,473.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$740.64
|
| Rate for Payer: UHC Exchange |
$740.64
|
| Rate for Payer: UHC Medicare Advantage |
$740.64
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$740.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,221.93
|
|
|
HC MECH CHEST WALL OSCILLATION
|
Facility
|
IP
|
$320.61
|
|
|
Service Code
|
CPT 94669
|
| Hospital Charge Code |
41000043
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$208.40 |
| Max. Negotiated Rate |
$288.55 |
| Rate for Payer: Aetna Commercial |
$272.52
|
| Rate for Payer: BCBS Trust/PPO |
$261.71
|
| Rate for Payer: BCN Commercial |
$247.77
|
| Rate for Payer: Cash Price |
$256.49
|
| Rate for Payer: Cofinity Commercial |
$275.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.49
|
| Rate for Payer: Healthscope Commercial |
$288.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.52
|
| Rate for Payer: Nomi Health Commercial |
$262.90
|
| Rate for Payer: PHP Commercial |
$272.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.40
|
| Rate for Payer: Priority Health HMO/PPO |
$278.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.14
|
| Rate for Payer: UHC Core |
$267.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.46
|
|
|
HC MECH CHEST WALL OSCILLATION
|
Facility
|
OP
|
$320.61
|
|
|
Service Code
|
CPT 94669
|
| Hospital Charge Code |
41000043
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$76.14 |
| Max. Negotiated Rate |
$288.55 |
| Rate for Payer: Aetna Commercial |
$272.52
|
| Rate for Payer: Aetna Medicare |
$83.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.19
|
| Rate for Payer: BCBS Complete |
$151.29
|
| Rate for Payer: BCBS MAPPO |
$80.15
|
| Rate for Payer: BCBS Trust/PPO |
$263.57
|
| Rate for Payer: BCN Commercial |
$249.27
|
| Rate for Payer: BCN Medicare Advantage |
$80.15
|
| Rate for Payer: Cash Price |
$256.49
|
| Rate for Payer: Cash Price |
$256.49
|
| Rate for Payer: Cofinity Commercial |
$275.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.15
|
| Rate for Payer: Healthscope Commercial |
$288.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.46
|
| Rate for Payer: Mclaren Medicaid |
$144.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.16
|
| Rate for Payer: Meridian Medicaid |
$151.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.52
|
| Rate for Payer: Nomi Health Commercial |
$262.90
|
| Rate for Payer: PACE Senior Care Partners |
$76.14
|
| Rate for Payer: PACE SWMI |
$80.15
|
| Rate for Payer: PHP Commercial |
$272.52
|
| Rate for Payer: PHP Medicare Advantage |
$80.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.40
|
| Rate for Payer: Priority Health HMO/PPO |
$278.93
|
| Rate for Payer: Priority Health Medicare |
$80.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$214.81
|
| Rate for Payer: Railroad Medicare Medicare |
$80.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.14
|
| Rate for Payer: UHC Core |
$267.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.15
|
| Rate for Payer: UHC Exchange |
$80.15
|
| Rate for Payer: UHC Medicare Advantage |
$80.15
|
| Rate for Payer: UHCCP Medicaid |
$144.08
|
| Rate for Payer: VA VA |
$80.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.46
|
|
