|
HC METHADONE CONFIRM MECON
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100574
|
|
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 METHADONE CONFIRM MECON
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100574
|
|
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 METHADONE SCRN URIN
|
Facility
|
IP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000118
|
|
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 METHADONE SCRN URIN
|
Facility
|
OP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000118
|
|
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 METHADONE SCRN URN
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000117
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.11 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$9.57
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$9.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$9.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$9.11
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC METHADONE SCRN URN
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000117
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC METHADONE SERUM LVL
|
Facility
|
IP
|
$79.56
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100575
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.71 |
| Max. Negotiated Rate |
$71.60 |
| Rate for Payer: Aetna Commercial |
$67.63
|
| Rate for Payer: BCBS Trust/PPO |
$64.94
|
| Rate for Payer: BCN Commercial |
$61.48
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cofinity Commercial |
$68.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.65
|
| Rate for Payer: Healthscope Commercial |
$71.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.63
|
| Rate for Payer: Nomi Health Commercial |
$65.24
|
| Rate for Payer: PHP Commercial |
$67.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.71
|
| Rate for Payer: Priority Health HMO/PPO |
$69.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.01
|
| Rate for Payer: UHC Core |
$66.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.67
|
|
|
HC METHADONE SERUM LVL
|
Facility
|
OP
|
$79.56
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100575
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$71.60 |
| Rate for Payer: Aetna Commercial |
$67.63
|
| Rate for Payer: Aetna Medicare |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.86
|
| Rate for Payer: BCBS Complete |
$31.82
|
| Rate for Payer: BCBS MAPPO |
$19.89
|
| Rate for Payer: BCBS Trust/PPO |
$65.41
|
| Rate for Payer: BCN Commercial |
$61.86
|
| Rate for Payer: BCN Medicare Advantage |
$19.89
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cofinity Commercial |
$68.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.89
|
| Rate for Payer: Healthscope Commercial |
$71.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.63
|
| Rate for Payer: Nomi Health Commercial |
$65.24
|
| Rate for Payer: PACE Senior Care Partners |
$18.90
|
| Rate for Payer: PACE SWMI |
$19.89
|
| Rate for Payer: PHP Commercial |
$67.63
|
| Rate for Payer: PHP Medicare Advantage |
$19.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.71
|
| Rate for Payer: Priority Health HMO/PPO |
$69.22
|
| Rate for Payer: Priority Health Medicare |
$20.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.31
|
| Rate for Payer: Railroad Medicare Medicare |
$19.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.01
|
| Rate for Payer: UHC Core |
$66.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.89
|
| Rate for Payer: UHC Exchange |
$19.89
|
| Rate for Payer: UHC Medicare Advantage |
$19.89
|
| Rate for Payer: VA VA |
$19.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.67
|
|
|
HC METHADONE URN
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100576
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.54 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$24.48
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$50.31
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health HMO/PPO |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.00
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Exchange |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.30
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC METHADONE URN
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100576
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.78 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$49.96
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$50.18
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health HMO/PPO |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC METHANOL LVL
|
Facility
|
OP
|
$159.12
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$143.21 |
| Rate for Payer: Aetna Commercial |
$135.25
|
| Rate for Payer: Aetna Medicare |
$41.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.73
|
| Rate for Payer: BCBS Complete |
$63.65
|
| Rate for Payer: BCBS MAPPO |
$39.78
|
| Rate for Payer: BCBS Trust/PPO |
$130.81
|
| Rate for Payer: BCN Commercial |
$123.72
|
| Rate for Payer: BCN Medicare Advantage |
$39.78
|
| Rate for Payer: Cash Price |
$127.30
|
| Rate for Payer: Cofinity Commercial |
$136.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.78
|
| Rate for Payer: Healthscope Commercial |
$143.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.25
|
| Rate for Payer: Nomi Health Commercial |
$130.48
|
| Rate for Payer: PACE Senior Care Partners |
$37.79
|
| Rate for Payer: PACE SWMI |
$39.78
|
| Rate for Payer: PHP Commercial |
$135.25
|
| Rate for Payer: PHP Medicare Advantage |
$39.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.43
|
| Rate for Payer: Priority Health HMO/PPO |
$138.43
|
| Rate for Payer: Priority Health Medicare |
$40.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.61
|
| Rate for Payer: Railroad Medicare Medicare |
$39.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.03
|
| Rate for Payer: UHC Core |
$132.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.78
|
| Rate for Payer: UHC Exchange |
$39.78
|
| Rate for Payer: UHC Medicare Advantage |
$39.78
|
| Rate for Payer: VA VA |
$39.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.34
|
|
|
HC METHANOL LVL
|
Facility
|
IP
|
$159.12
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$103.43 |
| Max. Negotiated Rate |
$143.21 |
| Rate for Payer: Aetna Commercial |
$135.25
|
| Rate for Payer: BCBS Trust/PPO |
$129.89
|
| Rate for Payer: BCN Commercial |
$122.97
|
| Rate for Payer: Cash Price |
$127.30
|
| Rate for Payer: Cofinity Commercial |
$136.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.30
|
| Rate for Payer: Healthscope Commercial |
$143.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.25
|
| Rate for Payer: Nomi Health Commercial |
$130.48
|
| Rate for Payer: PHP Commercial |
$135.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.43
|
| Rate for Payer: Priority Health HMO/PPO |
$138.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.03
|
| Rate for Payer: UHC Core |
$132.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.34
|
|
|
HC METHEMOGLOBIN
|
Facility
|
OP
|
$47.02
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
30100239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.93 |
| Max. Negotiated Rate |
$42.32 |
| Rate for Payer: Aetna Commercial |
$39.97
|
| Rate for Payer: Aetna Medicare |
$12.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.69
|
| Rate for Payer: BCBS Complete |
$6.23
|
| Rate for Payer: BCBS MAPPO |
$11.76
|
| Rate for Payer: BCBS Trust/PPO |
$38.66
|
| Rate for Payer: BCN Commercial |
$36.56
|
| Rate for Payer: BCN Medicare Advantage |
$11.76
|
| Rate for Payer: Cash Price |
$37.62
|
| Rate for Payer: Cash Price |
$37.62
|
| Rate for Payer: Cofinity Commercial |
$40.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.76
|
| Rate for Payer: Healthscope Commercial |
$42.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.27
|
| Rate for Payer: Mclaren Medicaid |
$5.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.34
|
| Rate for Payer: Meridian Medicaid |
$6.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.97
|
| Rate for Payer: Nomi Health Commercial |
$38.56
|
| Rate for Payer: PACE Senior Care Partners |
$11.17
|
| Rate for Payer: PACE SWMI |
$11.76
|
| Rate for Payer: PHP Commercial |
$39.97
|
| Rate for Payer: PHP Medicare Advantage |
$11.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.56
|
| Rate for Payer: Priority Health HMO/PPO |
$40.91
|
| Rate for Payer: Priority Health Medicare |
$11.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.50
|
| Rate for Payer: Railroad Medicare Medicare |
$11.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.38
|
| Rate for Payer: UHC Core |
$39.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.76
|
| Rate for Payer: UHC Exchange |
$11.76
|
| Rate for Payer: UHC Medicare Advantage |
$11.76
|
| Rate for Payer: UHCCP Medicaid |
$5.93
|
| Rate for Payer: VA VA |
$11.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.27
|
|
|
HC METHEMOGLOBIN
|
Facility
|
IP
|
$47.02
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
30100239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.56 |
| Max. Negotiated Rate |
$42.32 |
| Rate for Payer: Aetna Commercial |
$39.97
|
| Rate for Payer: BCBS Trust/PPO |
$38.38
|
| Rate for Payer: BCN Commercial |
$36.34
|
| Rate for Payer: Cash Price |
$37.62
|
| Rate for Payer: Cofinity Commercial |
$40.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.62
|
| Rate for Payer: Healthscope Commercial |
$42.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.97
|
| Rate for Payer: Nomi Health Commercial |
$38.56
|
| Rate for Payer: PHP Commercial |
$39.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.56
|
| Rate for Payer: Priority Health HMO/PPO |
$40.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.38
|
| Rate for Payer: UHC Core |
$39.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.27
|
|
|
HC METHOTREXATE LEVEL
|
Facility
|
IP
|
$176.97
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100064
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$115.03 |
| Max. Negotiated Rate |
$159.27 |
| Rate for Payer: Aetna Commercial |
$150.42
|
| Rate for Payer: BCBS Trust/PPO |
$144.46
|
| Rate for Payer: BCN Commercial |
$136.76
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cofinity Commercial |
$152.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.58
|
| Rate for Payer: Healthscope Commercial |
$159.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.42
|
| Rate for Payer: Nomi Health Commercial |
$145.12
|
| Rate for Payer: PHP Commercial |
$150.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.03
|
| Rate for Payer: Priority Health HMO/PPO |
$153.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.73
|
| Rate for Payer: UHC Core |
$147.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.73
|
|
|
HC METHOTREXATE LEVEL
|
Facility
|
OP
|
$176.97
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100064
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.48 |
| Max. Negotiated Rate |
$159.27 |
| Rate for Payer: Aetna Commercial |
$150.42
|
| Rate for Payer: Aetna Medicare |
$46.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.30
|
| Rate for Payer: BCBS Complete |
$14.15
|
| Rate for Payer: BCBS MAPPO |
$44.24
|
| Rate for Payer: BCBS Trust/PPO |
$145.49
|
| Rate for Payer: BCN Commercial |
$137.59
|
| Rate for Payer: BCN Medicare Advantage |
$44.24
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cofinity Commercial |
$152.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.24
|
| Rate for Payer: Healthscope Commercial |
$159.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.73
|
| Rate for Payer: Mclaren Medicaid |
$13.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.45
|
| Rate for Payer: Meridian Medicaid |
$14.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.42
|
| Rate for Payer: Nomi Health Commercial |
$145.12
|
| Rate for Payer: PACE Senior Care Partners |
$42.03
|
| Rate for Payer: PACE SWMI |
$44.24
|
| Rate for Payer: PHP Commercial |
$150.42
|
| Rate for Payer: PHP Medicare Advantage |
$44.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.03
|
| Rate for Payer: Priority Health HMO/PPO |
$153.96
|
| Rate for Payer: Priority Health Medicare |
$44.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.57
|
| Rate for Payer: Railroad Medicare Medicare |
$44.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.73
|
| Rate for Payer: UHC Core |
$147.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.24
|
| Rate for Payer: UHC Exchange |
$44.24
|
| Rate for Payer: UHC Medicare Advantage |
$44.24
|
| Rate for Payer: UHCCP Medicaid |
$13.48
|
| Rate for Payer: VA VA |
$44.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.73
|
|
|
HC METHYLMALONIC ACID
|
Facility
|
OP
|
$62.33
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
30100373
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Aetna Commercial |
$52.98
|
| Rate for Payer: Aetna Medicare |
$16.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.48
|
| Rate for Payer: BCBS Complete |
$16.10
|
| Rate for Payer: BCBS MAPPO |
$15.58
|
| Rate for Payer: BCBS Trust/PPO |
$51.24
|
| Rate for Payer: BCN Commercial |
$48.46
|
| Rate for Payer: BCN Medicare Advantage |
$15.58
|
| Rate for Payer: Cash Price |
$49.86
|
| Rate for Payer: Cash Price |
$49.86
|
| Rate for Payer: Cofinity Commercial |
$53.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.58
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.75
|
| Rate for Payer: Mclaren Medicaid |
$15.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.36
|
| Rate for Payer: Meridian Medicaid |
$16.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.98
|
| Rate for Payer: Nomi Health Commercial |
$51.11
|
| Rate for Payer: PACE Senior Care Partners |
$14.80
|
| Rate for Payer: PACE SWMI |
$15.58
|
| Rate for Payer: PHP Commercial |
$52.98
|
| Rate for Payer: PHP Medicare Advantage |
$15.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.51
|
| Rate for Payer: Priority Health HMO/PPO |
$54.23
|
| Rate for Payer: Priority Health Medicare |
$15.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.76
|
| Rate for Payer: Railroad Medicare Medicare |
$15.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.85
|
| Rate for Payer: UHC Core |
$52.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.58
|
| Rate for Payer: UHC Exchange |
$15.58
|
| Rate for Payer: UHC Medicare Advantage |
$15.58
|
| Rate for Payer: UHCCP Medicaid |
$15.33
|
| Rate for Payer: VA VA |
$15.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.75
|
|
|
HC METHYLMALONIC ACID
|
Facility
|
IP
|
$62.33
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
30100373
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.51 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Aetna Commercial |
$52.98
|
| Rate for Payer: BCBS Trust/PPO |
$50.88
|
| Rate for Payer: BCN Commercial |
$48.17
|
| Rate for Payer: Cash Price |
$49.86
|
| Rate for Payer: Cofinity Commercial |
$53.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.86
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.98
|
| Rate for Payer: Nomi Health Commercial |
$51.11
|
| Rate for Payer: PHP Commercial |
$52.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.51
|
| Rate for Payer: Priority Health HMO/PPO |
$54.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.85
|
| Rate for Payer: UHC Core |
$52.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.75
|
|
|
HC MFM CORDOCENTESIS
|
Facility
|
OP
|
$437.63
|
|
|
Service Code
|
CPT 59012
|
| Hospital Charge Code |
36100262
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$103.94 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna Medicare |
$113.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.76
|
| Rate for Payer: BCBS Complete |
$230.94
|
| Rate for Payer: BCBS MAPPO |
$109.41
|
| Rate for Payer: BCBS Trust/PPO |
$359.78
|
| Rate for Payer: BCN Commercial |
$340.26
|
| Rate for Payer: BCN Medicare Advantage |
$109.41
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.41
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Mclaren Medicaid |
$219.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.88
|
| Rate for Payer: Meridian Medicaid |
$230.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: PACE Senior Care Partners |
$103.94
|
| Rate for Payer: PACE SWMI |
$109.41
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: PHP Medicare Advantage |
$109.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO |
$380.74
|
| Rate for Payer: Priority Health Medicare |
$110.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.21
|
| Rate for Payer: Railroad Medicare Medicare |
$109.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.11
|
| Rate for Payer: UHC Core |
$365.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.41
|
| Rate for Payer: UHC Exchange |
$109.41
|
| Rate for Payer: UHC Medicare Advantage |
$109.41
|
| Rate for Payer: UHCCP Medicaid |
$219.93
|
| Rate for Payer: VA VA |
$109.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC MFM CORDOCENTESIS
|
Facility
|
IP
|
$437.63
|
|
|
Service Code
|
CPT 59012
|
| Hospital Charge Code |
36100262
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$284.46 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: BCBS Trust/PPO |
$357.24
|
| Rate for Payer: BCN Commercial |
$338.20
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$358.86
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO |
$380.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.11
|
| Rate for Payer: UHC Core |
$365.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC MG EVALUATION WITH MUSK REFLEX, S
|
Facility
|
IP
|
$83.47
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000160
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.26 |
| Max. Negotiated Rate |
$75.12 |
| Rate for Payer: Aetna Commercial |
$70.95
|
| Rate for Payer: BCBS Trust/PPO |
$68.14
|
| Rate for Payer: BCN Commercial |
$64.51
|
| Rate for Payer: Cash Price |
$66.78
|
| Rate for Payer: Cofinity Commercial |
$71.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.78
|
| Rate for Payer: Healthscope Commercial |
$75.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.95
|
| Rate for Payer: Nomi Health Commercial |
$68.45
|
| Rate for Payer: PHP Commercial |
$70.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.26
|
| Rate for Payer: Priority Health HMO/PPO |
$72.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.45
|
| Rate for Payer: UHC Core |
$69.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.60
|
|
|
HC MG EVALUATION WITH MUSK REFLEX, S
|
Facility
|
OP
|
$83.47
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000160
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$75.12 |
| Rate for Payer: Aetna Commercial |
$70.95
|
| Rate for Payer: Aetna Medicare |
$21.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.08
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$20.87
|
| Rate for Payer: BCBS Trust/PPO |
$68.62
|
| Rate for Payer: BCN Commercial |
$64.90
|
| Rate for Payer: BCN Medicare Advantage |
$20.87
|
| Rate for Payer: Cash Price |
$66.78
|
| Rate for Payer: Cash Price |
$66.78
|
| Rate for Payer: Cofinity Commercial |
$71.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.87
|
| Rate for Payer: Healthscope Commercial |
$75.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.60
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.91
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.95
|
| Rate for Payer: Nomi Health Commercial |
$68.45
|
| Rate for Payer: PACE Senior Care Partners |
$19.82
|
| Rate for Payer: PACE SWMI |
$20.87
|
| Rate for Payer: PHP Commercial |
$70.95
|
| Rate for Payer: PHP Medicare Advantage |
$20.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.26
|
| Rate for Payer: Priority Health HMO/PPO |
$72.62
|
| Rate for Payer: Priority Health Medicare |
$21.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.92
|
| Rate for Payer: Railroad Medicare Medicare |
$20.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.45
|
| Rate for Payer: UHC Core |
$69.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.87
|
| Rate for Payer: UHC Exchange |
$20.87
|
| Rate for Payer: UHC Medicare Advantage |
$20.87
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$20.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.60
|
|
|
HC MG EVALUATION W REFLEX
|
Facility
|
IP
|
$81.15
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100724
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$52.75 |
| Max. Negotiated Rate |
$73.03 |
| Rate for Payer: Aetna Commercial |
$68.98
|
| Rate for Payer: BCBS Trust/PPO |
$66.24
|
| Rate for Payer: BCN Commercial |
$62.71
|
| Rate for Payer: Cash Price |
$64.92
|
| Rate for Payer: Cofinity Commercial |
$69.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.92
|
| Rate for Payer: Healthscope Commercial |
$73.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.98
|
| Rate for Payer: Nomi Health Commercial |
$66.54
|
| Rate for Payer: PHP Commercial |
$68.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.75
|
| Rate for Payer: Priority Health HMO/PPO |
$70.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.41
|
| Rate for Payer: UHC Core |
$67.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.86
|
|
|
HC MG EVALUATION W REFLEX
|
Facility
|
OP
|
$81.15
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100724
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.30 |
| Max. Negotiated Rate |
$73.03 |
| Rate for Payer: Aetna Commercial |
$68.98
|
| Rate for Payer: Aetna Medicare |
$21.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.36
|
| Rate for Payer: BCBS Complete |
$13.97
|
| Rate for Payer: BCBS MAPPO |
$20.29
|
| Rate for Payer: BCBS Trust/PPO |
$66.71
|
| Rate for Payer: BCN Commercial |
$63.09
|
| Rate for Payer: BCN Medicare Advantage |
$20.29
|
| Rate for Payer: Cash Price |
$64.92
|
| Rate for Payer: Cash Price |
$64.92
|
| Rate for Payer: Cofinity Commercial |
$69.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.29
|
| Rate for Payer: Healthscope Commercial |
$73.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.86
|
| Rate for Payer: Mclaren Medicaid |
$13.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.30
|
| Rate for Payer: Meridian Medicaid |
$13.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.98
|
| Rate for Payer: Nomi Health Commercial |
$66.54
|
| Rate for Payer: PACE Senior Care Partners |
$19.27
|
| Rate for Payer: PACE SWMI |
$20.29
|
| Rate for Payer: PHP Commercial |
$68.98
|
| Rate for Payer: PHP Medicare Advantage |
$20.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.75
|
| Rate for Payer: Priority Health HMO/PPO |
$70.60
|
| Rate for Payer: Priority Health Medicare |
$20.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.37
|
| Rate for Payer: Railroad Medicare Medicare |
$20.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.41
|
| Rate for Payer: UHC Core |
$67.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.29
|
| Rate for Payer: UHC Exchange |
$20.29
|
| Rate for Payer: UHC Medicare Advantage |
$20.29
|
| Rate for Payer: UHCCP Medicaid |
$13.30
|
| Rate for Payer: VA VA |
$20.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.86
|
|
|
HC MGLUR1 AB CBA, S
|
Facility
|
IP
|
$255.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200464
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$165.75 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Aetna Commercial |
$216.75
|
| Rate for Payer: BCBS Trust/PPO |
$208.16
|
| Rate for Payer: BCN Commercial |
$197.06
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$219.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
| Rate for Payer: Healthscope Commercial |
$229.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.75
|
| Rate for Payer: Nomi Health Commercial |
$209.10
|
| Rate for Payer: PHP Commercial |
$216.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: Priority Health HMO/PPO |
$221.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.40
|
| Rate for Payer: UHC Core |
$212.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.25
|
|
