|
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 |
$8.09
|
| 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 |
$8.09
|
|
|
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 |
$2.69
|
| Rate for Payer: BCBS Trust/PPO |
$8.86
|
| Rate for Payer: BCN Commercial |
$8.38
|
| Rate for Payer: BCN Medicare Advantage |
$2.69
|
| 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 |
$2.69
|
| Rate for Payer: Healthscope Commercial |
$9.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.09
|
| 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 |
$2.69
|
| Rate for Payer: PHP Commercial |
$9.16
|
| Rate for Payer: PHP Medicare Advantage |
$2.69
|
| 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 |
$2.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.49
|
| Rate for Payer: UHC Core |
$9.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.69
|
| Rate for Payer: UHC Exchange |
$2.69
|
| Rate for Payer: UHC Medicare Advantage |
$2.69
|
| Rate for Payer: UHCCP Medicaid |
$3.75
|
| Rate for Payer: VA VA |
$2.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.09
|
|
|
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 |
$154.41 |
| 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 |
$154.41
|
| 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 |
$147.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.29
|
| Rate for Payer: Meridian Medicaid |
$154.41
|
| 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 |
$147.05
|
| 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 |
$147.05
|
| Rate for Payer: VA VA |
$37.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.25
|
|
|
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 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
|
IP
|
$491.10
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600347
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$319.21 |
| 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 |
$319.21
|
| 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 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 |
$319.21
|
| 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 (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 |
$38.23
|
| 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 |
$38.23
|
|
|
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 |
$38.23
|
| 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 |
$38.23
|
|
|
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 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 |
$1,179.37
|
| 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 |
$1,123.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.61
|
| Rate for Payer: Meridian Medicaid |
$1,179.37
|
| 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 |
$1,123.14
|
| 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 |
$1,123.14
|
| Rate for Payer: VA VA |
$392.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.03
|
|
|
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 |
$2,389.58
|
| 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 |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$777.67
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| 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 |
$2,275.64
|
| 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 |
$2,275.64
|
| Rate for Payer: VA VA |
$740.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,221.93
|
|
|
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 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 |
$154.41
|
| 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 |
$147.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.16
|
| Rate for Payer: Meridian Medicaid |
$154.41
|
| 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 |
$147.05
|
| 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 |
$147.05
|
| Rate for Payer: VA VA |
$80.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.46
|
|
|
HC MECH VENT INITIAL DAY
|
Facility
|
OP
|
$1,506.76
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000002
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$357.86 |
| Max. Negotiated Rate |
$1,356.08 |
| Rate for Payer: Aetna Commercial |
$1,280.75
|
| Rate for Payer: Aetna Medicare |
$391.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$470.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$470.86
|
| Rate for Payer: BCBS Complete |
$501.91
|
| Rate for Payer: BCBS MAPPO |
$376.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,238.71
|
| Rate for Payer: BCN Commercial |
$1,171.51
|
| Rate for Payer: BCN Medicare Advantage |
$376.69
|
| Rate for Payer: Cash Price |
$1,205.41
|
| Rate for Payer: Cash Price |
$1,205.41
|
| Rate for Payer: Cofinity Commercial |
$1,295.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,205.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.69
|
| Rate for Payer: Healthscope Commercial |
$1,356.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,130.07
|
| Rate for Payer: Mclaren Medicaid |
$477.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.52
|
| Rate for Payer: Meridian Medicaid |
$501.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$433.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,280.75
|
| Rate for Payer: Nomi Health Commercial |
$1,235.54
|
| Rate for Payer: PACE Senior Care Partners |
$357.86
|
| Rate for Payer: PACE SWMI |
$376.69
|
| Rate for Payer: PHP Commercial |
$1,280.75
|
| Rate for Payer: PHP Medicare Advantage |
$376.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$979.39
|
| Rate for Payer: Priority Health HMO/PPO |
$1,310.88
|
| Rate for Payer: Priority Health Medicare |
$380.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,009.53
|
| Rate for Payer: Railroad Medicare Medicare |
$376.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,325.95
|
| Rate for Payer: UHC Core |
$1,258.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$376.69
|
| Rate for Payer: UHC Exchange |
$376.69
|
| Rate for Payer: UHC Medicare Advantage |
$376.69
|
| Rate for Payer: UHCCP Medicaid |
$477.98
|
| Rate for Payer: VA VA |
$376.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,130.07
|
|
|
HC MECH VENT INITIAL DAY
|
Facility
|
IP
|
$1,506.76
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000002
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$979.39 |
| Max. Negotiated Rate |
$1,356.08 |
| Rate for Payer: Aetna Commercial |
$1,280.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,229.97
|
| Rate for Payer: BCN Commercial |
$1,164.42
|
| Rate for Payer: Cash Price |
$1,205.41
|
| Rate for Payer: Cofinity Commercial |
$1,295.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,205.41
|
| Rate for Payer: Healthscope Commercial |
$1,356.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,130.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,280.75
|
| Rate for Payer: Nomi Health Commercial |
$1,235.54
|
| Rate for Payer: PHP Commercial |
$1,280.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$979.39
|
| Rate for Payer: Priority Health HMO/PPO |
$1,310.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,009.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,325.95
|
| Rate for Payer: UHC Core |
$1,258.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,130.07
|
|
|
HC MECH VENT SUBS DAYS
|
Facility
|
OP
|
$1,312.60
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000003
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$311.74 |
| Max. Negotiated Rate |
$1,181.34 |
| Rate for Payer: Aetna Commercial |
$1,115.71
|
| Rate for Payer: Aetna Medicare |
$341.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.19
|
| Rate for Payer: BCBS Complete |
$501.91
|
| Rate for Payer: BCBS MAPPO |
$328.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,079.09
|
| Rate for Payer: BCN Commercial |
$1,020.55
|
| Rate for Payer: BCN Medicare Advantage |
$328.15
|
| Rate for Payer: Cash Price |
$1,050.08
|
| Rate for Payer: Cash Price |
$1,050.08
|
| Rate for Payer: Cofinity Commercial |
$1,128.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,050.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.15
|
| Rate for Payer: Healthscope Commercial |
$1,181.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$984.45
|
| Rate for Payer: Mclaren Medicaid |
$477.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$344.56
|
| Rate for Payer: Meridian Medicaid |
$501.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,115.71
|
| Rate for Payer: Nomi Health Commercial |
$1,076.33
|
| Rate for Payer: PACE Senior Care Partners |
$311.74
|
| Rate for Payer: PACE SWMI |
$328.15
|
| Rate for Payer: PHP Commercial |
$1,115.71
|
| Rate for Payer: PHP Medicare Advantage |
$328.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$477.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$853.19
|
| Rate for Payer: Priority Health HMO/PPO |
$1,141.96
|
| Rate for Payer: Priority Health Medicare |
$331.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$879.44
|
| Rate for Payer: Railroad Medicare Medicare |
$328.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,155.09
|
| Rate for Payer: UHC Core |
$1,096.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.15
|
| Rate for Payer: UHC Exchange |
$328.15
|
| Rate for Payer: UHC Medicare Advantage |
$328.15
|
| Rate for Payer: UHCCP Medicaid |
$477.98
|
| Rate for Payer: VA VA |
$328.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$984.45
|
|
|
HC MECH VENT SUBS DAYS
|
Facility
|
IP
|
$1,312.60
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000003
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$853.19 |
| Max. Negotiated Rate |
$1,181.34 |
| Rate for Payer: Aetna Commercial |
$1,115.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,071.48
|
| Rate for Payer: BCN Commercial |
$1,014.38
|
| Rate for Payer: Cash Price |
$1,050.08
|
| Rate for Payer: Cofinity Commercial |
$1,128.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,050.08
|
| Rate for Payer: Healthscope Commercial |
$1,181.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$984.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,115.71
|
| Rate for Payer: Nomi Health Commercial |
$1,076.33
|
| Rate for Payer: PHP Commercial |
$1,115.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$853.19
|
| Rate for Payer: Priority Health HMO/PPO |
$1,141.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$879.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,155.09
|
| Rate for Payer: UHC Core |
$1,096.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$984.45
|
|
|
HC MECONIUM AMPHETAMINE CONFIRM
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30000099
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.86 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.66
|
| Rate for Payer: BCBS Complete |
$46.92
|
| Rate for Payer: BCBS MAPPO |
$29.32
|
| Rate for Payer: BCBS Trust/PPO |
$96.43
|
| Rate for Payer: BCN Commercial |
$91.20
|
| Rate for Payer: BCN Medicare Advantage |
$29.32
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.32
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: PACE Senior Care Partners |
$27.86
|
| Rate for Payer: PACE SWMI |
$29.32
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.25
|
| Rate for Payer: Priority Health HMO/PPO |
$102.05
|
| Rate for Payer: Priority Health Medicare |
$29.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.59
|
| Rate for Payer: Railroad Medicare Medicare |
$29.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.22
|
| Rate for Payer: UHC Core |
$97.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.32
|
| Rate for Payer: UHC Exchange |
$29.32
|
| Rate for Payer: UHC Medicare Advantage |
$29.32
|
| Rate for Payer: VA VA |
$29.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.97
|
|
|
HC MECONIUM AMPHETAMINE CONFIRM
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30000099
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$76.25 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: BCBS Trust/PPO |
$95.75
|
| Rate for Payer: BCN Commercial |
$90.65
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.25
|
| Rate for Payer: Priority Health HMO/PPO |
$102.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.22
|
| Rate for Payer: UHC Core |
$97.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.97
|
|
|
HC MECONIUM BENZODIAZAPINE CONFIRMATION
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30000102
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$76.25 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: BCBS Trust/PPO |
$95.75
|
| Rate for Payer: BCN Commercial |
$90.65
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.25
|
| Rate for Payer: Priority Health HMO/PPO |
$102.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.22
|
| Rate for Payer: UHC Core |
$97.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.97
|
|
|
HC MECONIUM BENZODIAZAPINE CONFIRMATION
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30000102
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.86 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.66
|
| Rate for Payer: BCBS Complete |
$46.92
|
| Rate for Payer: BCBS MAPPO |
$29.32
|
| Rate for Payer: BCBS Trust/PPO |
$96.43
|
| Rate for Payer: BCN Commercial |
$91.20
|
| Rate for Payer: BCN Medicare Advantage |
$29.32
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.32
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: PACE Senior Care Partners |
$27.86
|
| Rate for Payer: PACE SWMI |
$29.32
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.25
|
| Rate for Payer: Priority Health HMO/PPO |
$102.05
|
| Rate for Payer: Priority Health Medicare |
$29.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.59
|
| Rate for Payer: Railroad Medicare Medicare |
$29.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.22
|
| Rate for Payer: UHC Core |
$97.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.32
|
| Rate for Payer: UHC Exchange |
$29.32
|
| Rate for Payer: UHC Medicare Advantage |
$29.32
|
| Rate for Payer: VA VA |
$29.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.97
|
|
|
HC MECONIUM BUPRENORPHINE CONFIRMATION
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30000100
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.86 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.66
|
| Rate for Payer: BCBS Complete |
$46.92
|
| Rate for Payer: BCBS MAPPO |
$29.32
|
| Rate for Payer: BCBS Trust/PPO |
$96.43
|
| Rate for Payer: BCN Commercial |
$91.20
|
| Rate for Payer: BCN Medicare Advantage |
$29.32
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.32
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: PACE Senior Care Partners |
$27.86
|
| Rate for Payer: PACE SWMI |
$29.32
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.25
|
| Rate for Payer: Priority Health HMO/PPO |
$102.05
|
| Rate for Payer: Priority Health Medicare |
$29.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.59
|
| Rate for Payer: Railroad Medicare Medicare |
$29.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.22
|
| Rate for Payer: UHC Core |
$97.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.32
|
| Rate for Payer: UHC Exchange |
$29.32
|
| Rate for Payer: UHC Medicare Advantage |
$29.32
|
| Rate for Payer: VA VA |
$29.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.97
|
|
