|
HC STRAPPING TOES
|
Facility
|
IP
|
$184.92
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
45000001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$112.78 |
| Max. Negotiated Rate |
$166.43 |
| Rate for Payer: Aetna Commercial |
$157.18
|
| Rate for Payer: BCBS Trust/PPO |
$142.91
|
| Rate for Payer: BCN Commercial |
$142.91
|
| Rate for Payer: Cash Price |
$147.94
|
| Rate for Payer: Cofinity Commercial |
$159.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.94
|
| Rate for Payer: Healthscope Commercial |
$166.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$157.18
|
| Rate for Payer: PHP Commercial |
$157.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.73
|
| Rate for Payer: UHC Core |
$154.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.69
|
|
|
HC STRAPPING TOES
|
Facility
|
OP
|
$184.92
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
45000001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$40.13 |
| Max. Negotiated Rate |
$166.43 |
| Rate for Payer: Aetna Commercial |
$157.18
|
| Rate for Payer: Aetna Medicare |
$48.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.79
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$46.23
|
| Rate for Payer: BCBS Trust/PPO |
$143.78
|
| Rate for Payer: BCN Commercial |
$143.78
|
| Rate for Payer: BCN Medicare Advantage |
$46.23
|
| Rate for Payer: Cash Price |
$147.94
|
| Rate for Payer: Cash Price |
$147.94
|
| Rate for Payer: Cofinity Commercial |
$159.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.23
|
| Rate for Payer: Healthscope Commercial |
$166.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.69
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$48.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$157.18
|
| Rate for Payer: PACE Senior Care Partners |
$43.92
|
| Rate for Payer: PACE SWMI |
$46.23
|
| Rate for Payer: PHP Commercial |
$157.18
|
| Rate for Payer: PHP Medicare Advantage |
$46.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.88
|
| Rate for Payer: Priority Health Medicare |
$46.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.78
|
| Rate for Payer: Railroad Medicare Medicare |
$46.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.73
|
| Rate for Payer: UHC Core |
$154.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.23
|
| Rate for Payer: UHC Medicare Advantage |
$47.62
|
| Rate for Payer: VA VA |
$46.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.69
|
|
|
HC STRAWBERRY ALLERGEN
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200124
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC STRAWBERRY ALLERGEN
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200124
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC STREP A PCR
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 87651
|
| Hospital Charge Code |
30600288
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$46.66 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: BCBS Trust/PPO |
$59.12
|
| Rate for Payer: BCN Commercial |
$59.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC STREP A PCR
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 87651
|
| Hospital Charge Code |
30600288
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.17 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$59.48
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.66
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.70
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC STREP PNEUMONIAE ANTIGEN
|
Facility
|
IP
|
$78.95
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600147
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$48.15 |
| Max. Negotiated Rate |
$71.06 |
| Rate for Payer: Aetna Commercial |
$67.11
|
| Rate for Payer: BCBS Trust/PPO |
$61.01
|
| Rate for Payer: BCN Commercial |
$61.01
|
| Rate for Payer: Cash Price |
$63.16
|
| Rate for Payer: Cofinity Commercial |
$67.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.16
|
| Rate for Payer: Healthscope Commercial |
$71.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.11
|
| Rate for Payer: PHP Commercial |
$67.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.48
|
| Rate for Payer: UHC Core |
$65.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.21
|
|
|
HC STREP PNEUMONIAE ANTIGEN
|
Facility
|
OP
|
$78.95
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600147
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.84 |
| Max. Negotiated Rate |
$71.06 |
| Rate for Payer: Aetna Commercial |
$67.11
|
| Rate for Payer: Aetna Medicare |
$20.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.67
|
| Rate for Payer: BCBS Complete |
$9.28
|
| Rate for Payer: BCBS MAPPO |
$19.74
|
| Rate for Payer: BCBS Trust/PPO |
$61.38
|
| Rate for Payer: BCN Commercial |
$61.38
|
| Rate for Payer: BCN Medicare Advantage |
$19.74
|
| Rate for Payer: Cash Price |
$63.16
|
| Rate for Payer: Cash Price |
$63.16
|
| Rate for Payer: Cofinity Commercial |
$67.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.74
|
| Rate for Payer: Healthscope Commercial |
$71.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.21
|
| Rate for Payer: Mclaren Medicaid |
$8.84
|
| Rate for Payer: Meridian Medicaid |
$9.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.11
|
| Rate for Payer: PACE Senior Care Partners |
$18.75
|
| Rate for Payer: PACE SWMI |
$19.74
|
| Rate for Payer: PHP Commercial |
$67.11
|
| Rate for Payer: PHP Medicare Advantage |
$19.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.69
|
| Rate for Payer: Priority Health Medicare |
$19.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.15
|
| Rate for Payer: Railroad Medicare Medicare |
$19.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.48
|
| Rate for Payer: UHC Core |
$65.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.74
|
| Rate for Payer: UHC Medicare Advantage |
$20.33
|
| Rate for Payer: VA VA |
$19.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.21
|
|
|
HC STREP PNEUMONIAE IGG 7 CMPTS
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200361
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC STREP PNEUMONIAE IGG 7 CMPTS
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200361
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$11.62
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$11.06
|
| Rate for Payer: Meridian Medicaid |
$11.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC STREP PNEUMONIAE IGG 7 SEROTYP
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200188
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.38
|
| Rate for Payer: BCBS Complete |
$11.62
|
| Rate for Payer: BCBS MAPPO |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.10
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.10
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$11.06
|
| Rate for Payer: Meridian Medicaid |
$11.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Senior Care Partners |
$4.84
|
| Rate for Payer: PACE SWMI |
$5.10
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Medicare |
$5.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.10
|
| Rate for Payer: UHC Medicare Advantage |
$5.25
|
| Rate for Payer: VA VA |
$5.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC STREP PNEUMONIAE IGG 7 SEROTYP
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200188
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$15.77
|
| Rate for Payer: BCN Commercial |
$15.77
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.95
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC STREPTOCOCCUS AGALACTIAE
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 87653
|
| Hospital Charge Code |
30600276
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC STREPTOCOCCUS AGALACTIAE
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 87653
|
| Hospital Charge Code |
30600276
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC STREPTOCOCCUS PNEUMONIA
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600277
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC STREPTOCOCCUS PNEUMONIA
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600277
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC STRESS COMPLETE PHYSIOLOGY ARTERIES
|
Facility
|
OP
|
$348.76
|
|
|
Service Code
|
CPT 93924
|
| Hospital Charge Code |
92100021
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$82.83 |
| Max. Negotiated Rate |
$313.88 |
| Rate for Payer: Aetna Commercial |
$296.45
|
| Rate for Payer: Aetna Medicare |
$90.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.99
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$87.19
|
| Rate for Payer: BCBS Trust/PPO |
$271.16
|
| Rate for Payer: BCN Commercial |
$271.16
|
| Rate for Payer: BCN Medicare Advantage |
$87.19
|
| Rate for Payer: Cash Price |
$279.01
|
| Rate for Payer: Cash Price |
$279.01
|
| Rate for Payer: Cofinity Commercial |
$299.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.19
|
| Rate for Payer: Healthscope Commercial |
$313.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$261.57
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$296.45
|
| Rate for Payer: PACE Senior Care Partners |
$82.83
|
| Rate for Payer: PACE SWMI |
$87.19
|
| Rate for Payer: PHP Commercial |
$296.45
|
| Rate for Payer: PHP Medicare Advantage |
$87.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$303.42
|
| Rate for Payer: Priority Health Medicare |
$87.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.71
|
| Rate for Payer: Railroad Medicare Medicare |
$87.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.91
|
| Rate for Payer: UHC Core |
$291.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.19
|
| Rate for Payer: UHC Medicare Advantage |
$89.81
|
| Rate for Payer: VA VA |
$87.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$261.57
|
|
|
HC STRESS COMPLETE PHYSIOLOGY ARTERIES
|
Facility
|
IP
|
$348.76
|
|
|
Service Code
|
CPT 93924
|
| Hospital Charge Code |
92100021
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$212.71 |
| Max. Negotiated Rate |
$313.88 |
| Rate for Payer: Aetna Commercial |
$296.45
|
| Rate for Payer: BCBS Trust/PPO |
$269.52
|
| Rate for Payer: BCN Commercial |
$269.52
|
| Rate for Payer: Cash Price |
$279.01
|
| Rate for Payer: Cofinity Commercial |
$299.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.01
|
| Rate for Payer: Healthscope Commercial |
$313.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$261.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$296.45
|
| Rate for Payer: PHP Commercial |
$296.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$303.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.91
|
| Rate for Payer: UHC Core |
$291.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$261.57
|
|
|
HC STRESS ECHO
|
Facility
|
OP
|
$1,485.66
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
48000008
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$352.84 |
| Max. Negotiated Rate |
$1,337.09 |
| Rate for Payer: Aetna Commercial |
$1,262.81
|
| Rate for Payer: Aetna Medicare |
$386.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.27
|
| Rate for Payer: BCBS Complete |
$379.99
|
| Rate for Payer: BCBS MAPPO |
$371.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,155.10
|
| Rate for Payer: BCN Commercial |
$1,155.10
|
| Rate for Payer: BCN Medicare Advantage |
$371.42
|
| Rate for Payer: Cash Price |
$1,188.53
|
| Rate for Payer: Cash Price |
$1,188.53
|
| Rate for Payer: Cofinity Commercial |
$1,277.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,188.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.42
|
| Rate for Payer: Healthscope Commercial |
$1,337.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,114.24
|
| Rate for Payer: Mclaren Medicaid |
$361.89
|
| Rate for Payer: Meridian Medicaid |
$379.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$389.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,262.81
|
| Rate for Payer: PACE Senior Care Partners |
$352.84
|
| Rate for Payer: PACE SWMI |
$371.42
|
| Rate for Payer: PHP Commercial |
$1,262.81
|
| Rate for Payer: PHP Medicare Advantage |
$371.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$361.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,039.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,292.52
|
| Rate for Payer: Priority Health Medicare |
$371.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$906.10
|
| Rate for Payer: Railroad Medicare Medicare |
$371.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,307.38
|
| Rate for Payer: UHC Core |
$1,240.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$371.42
|
| Rate for Payer: UHC Medicare Advantage |
$382.56
|
| Rate for Payer: VA VA |
$371.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,114.24
|
|
|
HC STRESS ECHO
|
Facility
|
IP
|
$1,485.66
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
48000008
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$906.10 |
| Max. Negotiated Rate |
$1,337.09 |
| Rate for Payer: Aetna Commercial |
$1,262.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,148.12
|
| Rate for Payer: BCN Commercial |
$1,148.12
|
| Rate for Payer: Cash Price |
$1,188.53
|
| Rate for Payer: Cofinity Commercial |
$1,277.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,188.53
|
| Rate for Payer: Healthscope Commercial |
$1,337.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,114.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,262.81
|
| Rate for Payer: PHP Commercial |
$1,262.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,039.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,292.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$906.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,307.38
|
| Rate for Payer: UHC Core |
$1,240.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,114.24
|
|
|
HC STRESS TEST
|
Facility
|
IP
|
$884.25
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200001
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$539.30 |
| Max. Negotiated Rate |
$795.82 |
| Rate for Payer: Aetna Commercial |
$751.61
|
| Rate for Payer: BCBS Trust/PPO |
$683.35
|
| Rate for Payer: BCN Commercial |
$683.35
|
| Rate for Payer: Cash Price |
$707.40
|
| Rate for Payer: Cofinity Commercial |
$760.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.40
|
| Rate for Payer: Healthscope Commercial |
$795.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$663.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$751.61
|
| Rate for Payer: PHP Commercial |
$751.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$769.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$539.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.14
|
| Rate for Payer: UHC Core |
$738.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$663.19
|
|
|
HC STRESS TEST
|
Facility
|
OP
|
$884.25
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200001
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$205.90 |
| Max. Negotiated Rate |
$795.82 |
| Rate for Payer: Aetna Commercial |
$751.61
|
| Rate for Payer: Aetna Medicare |
$229.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$276.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$276.33
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$221.06
|
| Rate for Payer: BCBS Trust/PPO |
$687.50
|
| Rate for Payer: BCN Commercial |
$687.50
|
| Rate for Payer: BCN Medicare Advantage |
$221.06
|
| Rate for Payer: Cash Price |
$707.40
|
| Rate for Payer: Cash Price |
$707.40
|
| Rate for Payer: Cofinity Commercial |
$760.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.06
|
| Rate for Payer: Healthscope Commercial |
$795.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$663.19
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$232.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$751.61
|
| Rate for Payer: PACE Senior Care Partners |
$210.01
|
| Rate for Payer: PACE SWMI |
$221.06
|
| Rate for Payer: PHP Commercial |
$751.61
|
| Rate for Payer: PHP Medicare Advantage |
$221.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$769.30
|
| Rate for Payer: Priority Health Medicare |
$221.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$539.30
|
| Rate for Payer: Railroad Medicare Medicare |
$221.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.14
|
| Rate for Payer: UHC Core |
$738.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$221.06
|
| Rate for Payer: UHC Medicare Advantage |
$227.69
|
| Rate for Payer: VA VA |
$221.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$663.19
|
|
|
HC STRIP PASTE
|
Facility
|
OP
|
$4.41
|
|
| Hospital Charge Code |
27000109
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$3.97 |
| Rate for Payer: Aetna Commercial |
$3.75
|
| Rate for Payer: Aetna Medicare |
$1.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.38
|
| Rate for Payer: BCBS Complete |
$1.76
|
| Rate for Payer: BCBS MAPPO |
$1.10
|
| Rate for Payer: BCBS Trust/PPO |
$3.43
|
| Rate for Payer: BCN Commercial |
$3.43
|
| Rate for Payer: BCN Medicare Advantage |
$1.10
|
| Rate for Payer: Cash Price |
$3.53
|
| Rate for Payer: Cofinity Commercial |
$3.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.10
|
| Rate for Payer: Healthscope Commercial |
$3.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.75
|
| Rate for Payer: PACE Senior Care Partners |
$1.05
|
| Rate for Payer: PACE SWMI |
$1.10
|
| Rate for Payer: PHP Commercial |
$3.75
|
| Rate for Payer: PHP Medicare Advantage |
$1.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.84
|
| Rate for Payer: Priority Health Medicare |
$1.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.69
|
| Rate for Payer: Railroad Medicare Medicare |
$1.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.88
|
| Rate for Payer: UHC Core |
$3.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.10
|
| Rate for Payer: UHC Medicare Advantage |
$1.14
|
| Rate for Payer: VA VA |
$1.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.31
|
|
|
HC STRIP PASTE
|
Facility
|
IP
|
$4.41
|
|
| Hospital Charge Code |
27000109
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$3.97 |
| Rate for Payer: Aetna Commercial |
$3.75
|
| Rate for Payer: BCBS Trust/PPO |
$3.41
|
| Rate for Payer: BCN Commercial |
$3.41
|
| Rate for Payer: Cash Price |
$3.53
|
| Rate for Payer: Cofinity Commercial |
$3.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.53
|
| Rate for Payer: Healthscope Commercial |
$3.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.75
|
| Rate for Payer: PHP Commercial |
$3.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.88
|
| Rate for Payer: UHC Core |
$3.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.31
|
|
|
HC STRONGYLOIDES ANTIBODY, IGG, SERUM
|
Facility
|
OP
|
$85.60
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200490
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$77.04 |
| Rate for Payer: Aetna Commercial |
$72.76
|
| Rate for Payer: Aetna Medicare |
$22.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.75
|
| Rate for Payer: BCBS Complete |
$10.08
|
| Rate for Payer: BCBS MAPPO |
$21.40
|
| Rate for Payer: BCBS Trust/PPO |
$66.55
|
| Rate for Payer: BCN Commercial |
$66.55
|
| Rate for Payer: BCN Medicare Advantage |
$21.40
|
| Rate for Payer: Cash Price |
$68.48
|
| Rate for Payer: Cash Price |
$68.48
|
| Rate for Payer: Cofinity Commercial |
$73.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.40
|
| Rate for Payer: Healthscope Commercial |
$77.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.20
|
| Rate for Payer: Mclaren Medicaid |
$9.60
|
| Rate for Payer: Meridian Medicaid |
$10.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.76
|
| Rate for Payer: PACE Senior Care Partners |
$20.33
|
| Rate for Payer: PACE SWMI |
$21.40
|
| Rate for Payer: PHP Commercial |
$72.76
|
| Rate for Payer: PHP Medicare Advantage |
$21.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.47
|
| Rate for Payer: Priority Health Medicare |
$21.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.21
|
| Rate for Payer: Railroad Medicare Medicare |
$21.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.33
|
| Rate for Payer: UHC Core |
$71.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.40
|
| Rate for Payer: UHC Medicare Advantage |
$22.04
|
| Rate for Payer: VA VA |
$21.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.20
|
|
