|
HC MECONIUM BUPRENORPHINE CONFIRMATION
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30000100
|
|
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 DRUG SCRN EA
|
Facility
|
OP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000144
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$85.08 |
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: Aetna Medicare |
$24.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.54
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$23.63
|
| Rate for Payer: BCBS Trust/PPO |
$77.71
|
| Rate for Payer: BCN Commercial |
$73.50
|
| Rate for Payer: BCN Medicare Advantage |
$23.63
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.63
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.90
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.81
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: PACE Senior Care Partners |
$22.45
|
| Rate for Payer: PACE SWMI |
$23.63
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: PHP Medicare Advantage |
$23.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO |
$82.24
|
| Rate for Payer: Priority Health Medicare |
$23.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.34
|
| Rate for Payer: Railroad Medicare Medicare |
$23.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.19
|
| Rate for Payer: UHC Core |
$78.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.63
|
| Rate for Payer: UHC Exchange |
$23.63
|
| Rate for Payer: UHC Medicare Advantage |
$23.63
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$23.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.90
|
|
|
HC MECONIUM DRUG SCRN EA
|
Facility
|
IP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000144
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$61.44 |
| Max. Negotiated Rate |
$85.08 |
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: BCBS Trust/PPO |
$77.16
|
| Rate for Payer: BCN Commercial |
$73.05
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO |
$82.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.19
|
| Rate for Payer: UHC Core |
$78.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.90
|
|
|
HC MECONIUM DRUG SCRN MULTI DRUGS.
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100653
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.63 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: BCBS Trust/PPO |
$84.93
|
| Rate for Payer: BCN Commercial |
$80.40
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC MECONIUM DRUG SCRN MULTI DRUGS.
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100653
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna Medicare |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.51
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$85.53
|
| Rate for Payer: BCN Commercial |
$80.89
|
| Rate for Payer: BCN Medicare Advantage |
$26.01
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.01
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.31
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PACE Senior Care Partners |
$24.71
|
| Rate for Payer: PACE SWMI |
$26.01
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: PHP Medicare Advantage |
$26.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Medicare |
$26.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.71
|
| Rate for Payer: Railroad Medicare Medicare |
$26.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.01
|
| Rate for Payer: UHC Exchange |
$26.01
|
| Rate for Payer: UHC Medicare Advantage |
$26.01
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$26.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC MECONIUM OPIATES CONFIRMATION
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100577
|
|
Hospital Revenue Code
|
301
|
| 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 OPIATES CONFIRMATION
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100577
|
|
Hospital Revenue Code
|
301
|
| 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 OXYCODONE CONFIRMATION
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80365
|
| Hospital Charge Code |
30000104
|
|
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 OXYCODONE CONFIRMATION
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80365
|
| Hospital Charge Code |
30000104
|
|
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 THC CONFIRMATION
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80349
|
| Hospital Charge Code |
30100567
|
|
Hospital Revenue Code
|
301
|
| 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 THC CONFIRMATION
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80349
|
| Hospital Charge Code |
30100567
|
|
Hospital Revenue Code
|
301
|
| 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 TRAMADOL CONFIRMATION
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80373
|
| Hospital Charge Code |
30000101
|
|
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 TRAMADOL CONFIRMATION
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80373
|
| Hospital Charge Code |
30000101
|
|
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 MEDICAL NUTRITION TX EACH 15"
|
Facility
|
OP
|
$65.14
|
|
|
Service Code
|
HCPCS G0270
|
| Hospital Charge Code |
94200008
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$15.47 |
| Max. Negotiated Rate |
$58.63 |
| Rate for Payer: Aetna Commercial |
$55.37
|
| Rate for Payer: Aetna Medicare |
$16.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.36
|
| Rate for Payer: BCBS Complete |
$26.06
|
| Rate for Payer: BCBS MAPPO |
$16.29
|
| Rate for Payer: BCBS Trust/PPO |
$53.55
|
| Rate for Payer: BCN Commercial |
$50.65
|
| Rate for Payer: BCN Medicare Advantage |
$16.29
|
| Rate for Payer: Cash Price |
$52.11
|
| Rate for Payer: Cofinity Commercial |
$56.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.29
|
| Rate for Payer: Healthscope Commercial |
$58.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.37
|
| Rate for Payer: Nomi Health Commercial |
$53.41
|
| Rate for Payer: PACE Senior Care Partners |
$15.47
|
| Rate for Payer: PACE SWMI |
$16.29
|
| Rate for Payer: PHP Commercial |
$55.37
|
| Rate for Payer: PHP Medicare Advantage |
$16.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.34
|
| Rate for Payer: Priority Health HMO/PPO |
$56.67
|
| Rate for Payer: Priority Health Medicare |
$16.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.64
|
| Rate for Payer: Railroad Medicare Medicare |
$16.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.32
|
| Rate for Payer: UHC Core |
$54.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.29
|
| Rate for Payer: UHC Exchange |
$16.29
|
| Rate for Payer: UHC Medicare Advantage |
$16.29
|
| Rate for Payer: VA VA |
$16.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.85
|
|
|
HC MEDICAL NUTRITION TX EACH 15"
|
Facility
|
IP
|
$65.14
|
|
|
Service Code
|
HCPCS G0270
|
| Hospital Charge Code |
94200008
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$42.34 |
| Max. Negotiated Rate |
$58.63 |
| Rate for Payer: Aetna Commercial |
$55.37
|
| Rate for Payer: BCBS Trust/PPO |
$53.17
|
| Rate for Payer: BCN Commercial |
$50.34
|
| Rate for Payer: Cash Price |
$52.11
|
| Rate for Payer: Cofinity Commercial |
$56.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$58.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.37
|
| Rate for Payer: Nomi Health Commercial |
$53.41
|
| Rate for Payer: PHP Commercial |
$55.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.34
|
| Rate for Payer: Priority Health HMO/PPO |
$56.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.32
|
| Rate for Payer: UHC Core |
$54.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.85
|
|
|
HC MED PHYSIC DOS EVAL RAD EXPS
|
Facility
|
OP
|
$263.99
|
|
|
Service Code
|
CPT 76145
|
| Hospital Charge Code |
32000333
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.70 |
| Max. Negotiated Rate |
$402.83 |
| Rate for Payer: Aetna Commercial |
$224.39
|
| Rate for Payer: Aetna Medicare |
$68.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.50
|
| Rate for Payer: BCBS Complete |
$402.83
|
| Rate for Payer: BCBS MAPPO |
$66.00
|
| Rate for Payer: BCBS Trust/PPO |
$217.03
|
| Rate for Payer: BCN Commercial |
$205.25
|
| Rate for Payer: BCN Medicare Advantage |
$66.00
|
| Rate for Payer: Cash Price |
$211.19
|
| Rate for Payer: Cash Price |
$211.19
|
| Rate for Payer: Cofinity Commercial |
$227.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.00
|
| Rate for Payer: Healthscope Commercial |
$237.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.99
|
| Rate for Payer: Mclaren Medicaid |
$383.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.30
|
| Rate for Payer: Meridian Medicaid |
$402.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.39
|
| Rate for Payer: Nomi Health Commercial |
$216.47
|
| Rate for Payer: PACE Senior Care Partners |
$62.70
|
| Rate for Payer: PACE SWMI |
$66.00
|
| Rate for Payer: PHP Commercial |
$224.39
|
| Rate for Payer: PHP Medicare Advantage |
$66.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.59
|
| Rate for Payer: Priority Health HMO/PPO |
$229.67
|
| Rate for Payer: Priority Health Medicare |
$66.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.87
|
| Rate for Payer: Railroad Medicare Medicare |
$66.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.31
|
| Rate for Payer: UHC Core |
$220.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.00
|
| Rate for Payer: UHC Exchange |
$66.00
|
| Rate for Payer: UHC Medicare Advantage |
$66.00
|
| Rate for Payer: UHCCP Medicaid |
$383.62
|
| Rate for Payer: VA VA |
$66.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.99
|
|
|
HC MED PHYSIC DOS EVAL RAD EXPS
|
Facility
|
IP
|
$263.99
|
|
|
Service Code
|
CPT 76145
|
| Hospital Charge Code |
32000333
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$171.59 |
| Max. Negotiated Rate |
$237.59 |
| Rate for Payer: Aetna Commercial |
$224.39
|
| Rate for Payer: BCBS Trust/PPO |
$215.50
|
| Rate for Payer: BCN Commercial |
$204.01
|
| Rate for Payer: Cash Price |
$211.19
|
| Rate for Payer: Cofinity Commercial |
$227.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.19
|
| Rate for Payer: Healthscope Commercial |
$237.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.39
|
| Rate for Payer: Nomi Health Commercial |
$216.47
|
| Rate for Payer: PHP Commercial |
$224.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.59
|
| Rate for Payer: Priority Health HMO/PPO |
$229.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.31
|
| Rate for Payer: UHC Core |
$220.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.99
|
|
|
HC MED SURG ROOM & BOARD
|
Facility
|
IP
|
$3,356.84
|
|
| Hospital Charge Code |
11000001
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$2,181.95 |
| Max. Negotiated Rate |
$3,021.16 |
| Rate for Payer: Aetna Commercial |
$2,853.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,740.19
|
| Rate for Payer: BCN Commercial |
$2,594.17
|
| Rate for Payer: Cash Price |
$2,685.47
|
| Rate for Payer: Cofinity Commercial |
$2,886.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,685.47
|
| Rate for Payer: Healthscope Commercial |
$3,021.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,517.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,853.31
|
| Rate for Payer: Nomi Health Commercial |
$2,752.61
|
| Rate for Payer: PHP Commercial |
$2,853.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,181.95
|
| Rate for Payer: Priority Health HMO/PPO |
$2,920.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,249.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,954.02
|
| Rate for Payer: UHC Core |
$2,802.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,517.63
|
|
|
HC MED SURVEILLANCE SH
|
Facility
|
IP
|
$48.96
|
|
|
Service Code
|
HCPCS G0435
|
| Hospital Charge Code |
30200415
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.82 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$41.62
|
| Rate for Payer: BCBS Trust/PPO |
$39.97
|
| Rate for Payer: BCN Commercial |
$37.84
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.62
|
| Rate for Payer: Nomi Health Commercial |
$40.15
|
| Rate for Payer: PHP Commercial |
$41.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.82
|
| Rate for Payer: Priority Health HMO/PPO |
$42.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.08
|
| Rate for Payer: UHC Core |
$40.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.72
|
|
|
HC MED SURVEILLANCE SH
|
Facility
|
OP
|
$48.96
|
|
|
Service Code
|
HCPCS G0435
|
| Hospital Charge Code |
30200415
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.66 |
| Max. Negotiated Rate |
$44.06 |
| Rate for Payer: Aetna Commercial |
$41.62
|
| Rate for Payer: Aetna Medicare |
$12.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.30
|
| Rate for Payer: BCBS Complete |
$9.10
|
| Rate for Payer: BCBS MAPPO |
$12.24
|
| Rate for Payer: BCBS Trust/PPO |
$40.25
|
| Rate for Payer: BCN Commercial |
$38.07
|
| Rate for Payer: BCN Medicare Advantage |
$12.24
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cash Price |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.72
|
| Rate for Payer: Mclaren Medicaid |
$8.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.85
|
| Rate for Payer: Meridian Medicaid |
$9.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.62
|
| Rate for Payer: Nomi Health Commercial |
$40.15
|
| Rate for Payer: PACE Senior Care Partners |
$11.63
|
| Rate for Payer: PACE SWMI |
$12.24
|
| Rate for Payer: PHP Commercial |
$41.62
|
| Rate for Payer: PHP Medicare Advantage |
$12.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.82
|
| Rate for Payer: Priority Health HMO/PPO |
$42.60
|
| Rate for Payer: Priority Health Medicare |
$12.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.80
|
| Rate for Payer: Railroad Medicare Medicare |
$12.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.08
|
| Rate for Payer: UHC Core |
$40.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.24
|
| Rate for Payer: UHC Exchange |
$12.24
|
| Rate for Payer: UHC Medicare Advantage |
$12.24
|
| Rate for Payer: UHCCP Medicaid |
$8.66
|
| Rate for Payer: VA VA |
$12.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.72
|
|
|
HC MEDTRONIC CRT ICD
|
Facility
|
OP
|
$29,963.52
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500006
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$7,116.34 |
| Max. Negotiated Rate |
$26,967.17 |
| Rate for Payer: Aetna Commercial |
$25,468.99
|
| Rate for Payer: Aetna Medicare |
$7,790.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,363.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,363.60
|
| Rate for Payer: BCBS Complete |
$11,985.41
|
| Rate for Payer: BCBS MAPPO |
$7,490.88
|
| Rate for Payer: BCBS Trust/PPO |
$24,633.01
|
| Rate for Payer: BCN Commercial |
$23,296.64
|
| Rate for Payer: BCN Medicare Advantage |
$7,490.88
|
| Rate for Payer: Cash Price |
$23,970.82
|
| Rate for Payer: Cofinity Commercial |
$25,768.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,970.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,490.88
|
| Rate for Payer: Healthscope Commercial |
$26,967.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,472.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,865.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,614.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,468.99
|
| Rate for Payer: Nomi Health Commercial |
$24,570.09
|
| Rate for Payer: PACE Senior Care Partners |
$7,116.34
|
| Rate for Payer: PACE SWMI |
$7,490.88
|
| Rate for Payer: PHP Commercial |
$25,468.99
|
| Rate for Payer: PHP Medicare Advantage |
$7,490.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,476.29
|
| Rate for Payer: Priority Health HMO/PPO |
$26,068.26
|
| Rate for Payer: Priority Health Medicare |
$7,565.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20,075.56
|
| Rate for Payer: Railroad Medicare Medicare |
$7,490.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,367.90
|
| Rate for Payer: UHC Core |
$25,019.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,490.88
|
| Rate for Payer: UHC Exchange |
$7,490.88
|
| Rate for Payer: UHC Medicare Advantage |
$7,490.88
|
| Rate for Payer: VA VA |
$7,490.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,472.64
|
|
|
HC MEDTRONIC CRT ICD
|
Facility
|
IP
|
$29,963.52
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500006
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$19,476.29 |
| Max. Negotiated Rate |
$26,967.17 |
| Rate for Payer: Aetna Commercial |
$25,468.99
|
| Rate for Payer: BCBS Trust/PPO |
$24,459.22
|
| Rate for Payer: BCN Commercial |
$23,155.81
|
| Rate for Payer: Cash Price |
$23,970.82
|
| Rate for Payer: Cofinity Commercial |
$25,768.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,970.82
|
| Rate for Payer: Healthscope Commercial |
$26,967.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,472.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,468.99
|
| Rate for Payer: Nomi Health Commercial |
$24,570.09
|
| Rate for Payer: PHP Commercial |
$25,468.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,476.29
|
| Rate for Payer: Priority Health HMO/PPO |
$26,068.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20,075.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,367.90
|
| Rate for Payer: UHC Core |
$25,019.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,472.64
|
|
|
HC MEDTRONIC CRT LEAD
|
Facility
|
IP
|
$6,207.54
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,034.90 |
| Max. Negotiated Rate |
$5,586.79 |
| Rate for Payer: Aetna Commercial |
$5,276.41
|
| Rate for Payer: BCBS Trust/PPO |
$5,067.21
|
| Rate for Payer: BCN Commercial |
$4,797.19
|
| Rate for Payer: Cash Price |
$4,966.03
|
| Rate for Payer: Cofinity Commercial |
$5,338.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,966.03
|
| Rate for Payer: Healthscope Commercial |
$5,586.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,655.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,276.41
|
| Rate for Payer: Nomi Health Commercial |
$5,090.18
|
| Rate for Payer: PHP Commercial |
$5,276.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,034.90
|
| Rate for Payer: Priority Health HMO/PPO |
$5,400.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,159.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,462.64
|
| Rate for Payer: UHC Core |
$5,183.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,655.65
|
|
|
HC MEDTRONIC CRT LEAD
|
Facility
|
OP
|
$6,207.54
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,474.29 |
| Max. Negotiated Rate |
$5,586.79 |
| Rate for Payer: Aetna Commercial |
$5,276.41
|
| Rate for Payer: Aetna Medicare |
$1,613.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,939.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,939.86
|
| Rate for Payer: BCBS Complete |
$2,483.02
|
| Rate for Payer: BCBS MAPPO |
$1,551.88
|
| Rate for Payer: BCBS Trust/PPO |
$5,103.22
|
| Rate for Payer: BCN Commercial |
$4,826.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,551.88
|
| Rate for Payer: Cash Price |
$4,966.03
|
| Rate for Payer: Cofinity Commercial |
$5,338.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,966.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,551.88
|
| Rate for Payer: Healthscope Commercial |
$5,586.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,655.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,629.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,784.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,276.41
|
| Rate for Payer: Nomi Health Commercial |
$5,090.18
|
| Rate for Payer: PACE Senior Care Partners |
$1,474.29
|
| Rate for Payer: PACE SWMI |
$1,551.88
|
| Rate for Payer: PHP Commercial |
$5,276.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,551.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,034.90
|
| Rate for Payer: Priority Health HMO/PPO |
$5,400.56
|
| Rate for Payer: Priority Health Medicare |
$1,567.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,159.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,551.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,462.64
|
| Rate for Payer: UHC Core |
$5,183.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,551.88
|
| Rate for Payer: UHC Exchange |
$1,551.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,551.88
|
| Rate for Payer: VA VA |
$1,551.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,655.65
|
|
|
HC MEDTRONIC DUAL PACEMAKER
|
Facility
|
IP
|
$8,843.40
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500007
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,748.21 |
| Max. Negotiated Rate |
$7,959.06 |
| Rate for Payer: Aetna Commercial |
$7,516.89
|
| Rate for Payer: BCBS Trust/PPO |
$7,218.87
|
| Rate for Payer: BCN Commercial |
$6,834.18
|
| Rate for Payer: Cash Price |
$7,074.72
|
| Rate for Payer: Cofinity Commercial |
$7,605.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,074.72
|
| Rate for Payer: Healthscope Commercial |
$7,959.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,632.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,516.89
|
| Rate for Payer: Nomi Health Commercial |
$7,251.59
|
| Rate for Payer: PHP Commercial |
$7,516.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,748.21
|
| Rate for Payer: Priority Health HMO/PPO |
$7,693.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,925.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,782.19
|
| Rate for Payer: UHC Core |
$7,384.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,632.55
|
|
