|
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
|
|
|
HC STUDY INSERT NON TUNNELED CENTRAL LINE > 5 YRS
|
Facility
|
IP
|
$39.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100588
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$23.79 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Aetna Commercial |
$33.15
|
| Rate for Payer: BCBS Trust/PPO |
$30.14
|
| Rate for Payer: BCN Commercial |
$30.14
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$33.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.20
|
| Rate for Payer: Healthscope Commercial |
$35.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.15
|
| Rate for Payer: PHP Commercial |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.32
|
| Rate for Payer: UHC Core |
$32.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.25
|
|
|
HC STUDY INSERT NON TUNNELED CENTRAL LINE > 5 YRS
|
Facility
|
OP
|
$39.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100588
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$2,195.52 |
| Rate for Payer: Aetna Commercial |
$33.15
|
| Rate for Payer: Aetna Medicare |
$10.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.19
|
| Rate for Payer: BCBS Complete |
$2,195.52
|
| Rate for Payer: BCBS MAPPO |
$9.75
|
| Rate for Payer: BCBS Trust/PPO |
$30.32
|
| Rate for Payer: BCN Commercial |
$30.32
|
| Rate for Payer: BCN Medicare Advantage |
$9.75
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$33.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.75
|
| Rate for Payer: Healthscope Commercial |
$35.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.25
|
| Rate for Payer: Mclaren Medicaid |
$2,090.97
|
| Rate for Payer: Meridian Medicaid |
$2,195.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.15
|
| Rate for Payer: PACE Senior Care Partners |
$9.26
|
| Rate for Payer: PACE SWMI |
$9.75
|
| Rate for Payer: PHP Commercial |
$33.15
|
| Rate for Payer: PHP Medicare Advantage |
$9.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,090.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.93
|
| Rate for Payer: Priority Health Medicare |
$9.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.79
|
| Rate for Payer: Railroad Medicare Medicare |
$9.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.32
|
| Rate for Payer: UHC Core |
$32.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.75
|
| Rate for Payer: UHC Medicare Advantage |
$10.04
|
| Rate for Payer: VA VA |
$9.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.25
|
|
|
HC SUBCLASS IGG4, SERUM
|
Facility
|
OP
|
$130.00
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100720
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.92 |
| Max. Negotiated Rate |
$117.00 |
| Rate for Payer: Aetna Commercial |
$110.50
|
| Rate for Payer: Aetna Medicare |
$33.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.62
|
| Rate for Payer: BCBS Complete |
$6.21
|
| Rate for Payer: BCBS MAPPO |
$32.50
|
| Rate for Payer: BCBS Trust/PPO |
$101.08
|
| Rate for Payer: BCN Commercial |
$101.08
|
| Rate for Payer: BCN Medicare Advantage |
$32.50
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$111.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.50
|
| Rate for Payer: Healthscope Commercial |
$117.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.50
|
| Rate for Payer: Mclaren Medicaid |
$5.92
|
| Rate for Payer: Meridian Medicaid |
$6.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.50
|
| Rate for Payer: PACE Senior Care Partners |
$30.88
|
| Rate for Payer: PACE SWMI |
$32.50
|
| Rate for Payer: PHP Commercial |
$110.50
|
| Rate for Payer: PHP Medicare Advantage |
$32.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.10
|
| Rate for Payer: Priority Health Medicare |
$32.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.29
|
| Rate for Payer: Railroad Medicare Medicare |
$32.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.40
|
| Rate for Payer: UHC Core |
$108.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.50
|
| Rate for Payer: UHC Medicare Advantage |
$33.48
|
| Rate for Payer: VA VA |
$32.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.50
|
|
|
HC SUBCLASS IGG4, SERUM
|
Facility
|
IP
|
$130.00
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100720
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$79.29 |
| Max. Negotiated Rate |
$117.00 |
| Rate for Payer: Aetna Commercial |
$110.50
|
| Rate for Payer: BCBS Trust/PPO |
$100.46
|
| Rate for Payer: BCN Commercial |
$100.46
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$111.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.00
|
| Rate for Payer: Healthscope Commercial |
$117.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.50
|
| Rate for Payer: PHP Commercial |
$110.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.40
|
| Rate for Payer: UHC Core |
$108.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.50
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL
|
Facility
|
OP
|
$7,950.00
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100377
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,888.12 |
| Max. Negotiated Rate |
$7,155.00 |
| Rate for Payer: Aetna Commercial |
$6,757.50
|
| Rate for Payer: Aetna Medicare |
$2,067.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,484.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,484.38
|
| Rate for Payer: BCBS Complete |
$2,217.64
|
| Rate for Payer: BCBS MAPPO |
$1,987.50
|
| Rate for Payer: BCBS Trust/PPO |
$6,181.12
|
| Rate for Payer: BCN Commercial |
$6,181.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,987.50
|
| Rate for Payer: Cash Price |
$6,360.00
|
| Rate for Payer: Cash Price |
$6,360.00
|
| Rate for Payer: Cofinity Commercial |
$6,837.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,360.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,987.50
|
| Rate for Payer: Healthscope Commercial |
$7,155.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,962.50
|
| Rate for Payer: Mclaren Medicaid |
$2,112.04
|
| Rate for Payer: Meridian Medicaid |
$2,217.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,086.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,285.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,757.50
|
| Rate for Payer: PACE Senior Care Partners |
$1,888.12
|
| Rate for Payer: PACE SWMI |
$1,987.50
|
| Rate for Payer: PHP Commercial |
$6,757.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,987.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,565.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,916.50
|
| Rate for Payer: Priority Health Medicare |
$1,987.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,848.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,987.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,996.00
|
| Rate for Payer: UHC Core |
$6,638.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,987.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,047.12
|
| Rate for Payer: VA VA |
$1,987.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,962.50
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL
|
Facility
|
IP
|
$7,950.00
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100377
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,848.70 |
| Max. Negotiated Rate |
$7,155.00 |
| Rate for Payer: Aetna Commercial |
$6,757.50
|
| Rate for Payer: BCBS Trust/PPO |
$6,143.76
|
| Rate for Payer: BCN Commercial |
$6,143.76
|
| Rate for Payer: Cash Price |
$6,360.00
|
| Rate for Payer: Cofinity Commercial |
$6,837.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,360.00
|
| Rate for Payer: Healthscope Commercial |
$7,155.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,962.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,757.50
|
| Rate for Payer: PHP Commercial |
$6,757.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,565.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,916.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,848.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,996.00
|
| Rate for Payer: UHC Core |
$6,638.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,962.50
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL BILAT
|
Facility
|
IP
|
$11,925.00
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100378
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7,273.06 |
| Max. Negotiated Rate |
$10,732.50 |
| Rate for Payer: Aetna Commercial |
$10,136.25
|
| Rate for Payer: BCBS Trust/PPO |
$9,215.64
|
| Rate for Payer: BCN Commercial |
$9,215.64
|
| Rate for Payer: Cash Price |
$9,540.00
|
| Rate for Payer: Cofinity Commercial |
$10,255.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,540.00
|
| Rate for Payer: Healthscope Commercial |
$10,732.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,943.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,136.25
|
| Rate for Payer: PHP Commercial |
$10,136.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,347.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,374.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,273.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,494.00
|
| Rate for Payer: UHC Core |
$9,957.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,943.75
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL BILAT
|
Facility
|
OP
|
$11,925.00
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100378
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,112.04 |
| Max. Negotiated Rate |
$10,732.50 |
| Rate for Payer: Aetna Commercial |
$10,136.25
|
| Rate for Payer: Aetna Medicare |
$3,100.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,726.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,726.56
|
| Rate for Payer: BCBS Complete |
$2,217.64
|
| Rate for Payer: BCBS MAPPO |
$2,981.25
|
| Rate for Payer: BCBS Trust/PPO |
$9,271.69
|
| Rate for Payer: BCN Commercial |
$9,271.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,981.25
|
| Rate for Payer: Cash Price |
$9,540.00
|
| Rate for Payer: Cash Price |
$9,540.00
|
| Rate for Payer: Cofinity Commercial |
$10,255.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,540.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,981.25
|
| Rate for Payer: Healthscope Commercial |
$10,732.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,943.75
|
| Rate for Payer: Mclaren Medicaid |
$2,112.04
|
| Rate for Payer: Meridian Medicaid |
$2,217.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,130.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,428.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,136.25
|
| Rate for Payer: PACE Senior Care Partners |
$2,832.19
|
| Rate for Payer: PACE SWMI |
$2,981.25
|
| Rate for Payer: PHP Commercial |
$10,136.25
|
| Rate for Payer: PHP Medicare Advantage |
$2,981.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,347.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,374.75
|
| Rate for Payer: Priority Health Medicare |
$2,981.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,273.06
|
| Rate for Payer: Railroad Medicare Medicare |
$2,981.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,494.00
|
| Rate for Payer: UHC Core |
$9,957.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,981.25
|
| Rate for Payer: UHC Medicare Advantage |
$3,070.69
|
| Rate for Payer: VA VA |
$2,981.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,943.75
|
|
|
HC SUCTION A&A LINE
|
Facility
|
OP
|
$31.50
|
|
| Hospital Charge Code |
27000110
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$28.35 |
| Rate for Payer: Aetna Commercial |
$26.78
|
| Rate for Payer: Aetna Medicare |
$8.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.84
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$7.88
|
| Rate for Payer: BCBS Trust/PPO |
$24.49
|
| Rate for Payer: BCN Commercial |
$24.49
|
| Rate for Payer: BCN Medicare Advantage |
$7.88
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cofinity Commercial |
$27.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.88
|
| Rate for Payer: Healthscope Commercial |
$28.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.78
|
| Rate for Payer: PACE Senior Care Partners |
$7.48
|
| Rate for Payer: PACE SWMI |
$7.88
|
| Rate for Payer: PHP Commercial |
$26.78
|
| Rate for Payer: PHP Medicare Advantage |
$7.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.40
|
| Rate for Payer: Priority Health Medicare |
$7.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.21
|
| Rate for Payer: Railroad Medicare Medicare |
$7.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.72
|
| Rate for Payer: UHC Core |
$26.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.88
|
| Rate for Payer: UHC Medicare Advantage |
$8.11
|
| Rate for Payer: VA VA |
$7.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
HC SUCTION A&A LINE
|
Facility
|
IP
|
$31.50
|
|
| Hospital Charge Code |
27000110
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.21 |
| Max. Negotiated Rate |
$28.35 |
| Rate for Payer: Aetna Commercial |
$26.78
|
| Rate for Payer: BCBS Trust/PPO |
$24.34
|
| Rate for Payer: BCN Commercial |
$24.34
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cofinity Commercial |
$27.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.20
|
| Rate for Payer: Healthscope Commercial |
$28.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.78
|
| Rate for Payer: PHP Commercial |
$26.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.72
|
| Rate for Payer: UHC Core |
$26.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
HC SUMP VENTRICULAR LIVANOVA
|
Facility
|
IP
|
$43.50
|
|
| Hospital Charge Code |
27000659
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.53 |
| Max. Negotiated Rate |
$39.15 |
| Rate for Payer: Aetna Commercial |
$36.98
|
| Rate for Payer: BCBS Trust/PPO |
$33.62
|
| Rate for Payer: BCN Commercial |
$33.62
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cofinity Commercial |
$37.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.80
|
| Rate for Payer: Healthscope Commercial |
$39.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.98
|
| Rate for Payer: PHP Commercial |
$36.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.28
|
| Rate for Payer: UHC Core |
$36.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.62
|
|
|
HC SUMP VENTRICULAR LIVANOVA
|
Facility
|
OP
|
$43.50
|
|
| Hospital Charge Code |
27000659
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.33 |
| Max. Negotiated Rate |
$39.15 |
| Rate for Payer: Aetna Commercial |
$36.98
|
| Rate for Payer: Aetna Medicare |
$11.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.59
|
| Rate for Payer: BCBS Complete |
$17.40
|
| Rate for Payer: BCBS MAPPO |
$10.88
|
| Rate for Payer: BCBS Trust/PPO |
$33.82
|
| Rate for Payer: BCN Commercial |
$33.82
|
| Rate for Payer: BCN Medicare Advantage |
$10.88
|
| Rate for Payer: Cash Price |
$34.80
|
| Rate for Payer: Cofinity Commercial |
$37.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.88
|
| Rate for Payer: Healthscope Commercial |
$39.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.98
|
| Rate for Payer: PACE Senior Care Partners |
$10.33
|
| Rate for Payer: PACE SWMI |
$10.88
|
| Rate for Payer: PHP Commercial |
$36.98
|
| Rate for Payer: PHP Medicare Advantage |
$10.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.84
|
| Rate for Payer: Priority Health Medicare |
$10.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.53
|
| Rate for Payer: Railroad Medicare Medicare |
$10.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.28
|
| Rate for Payer: UHC Core |
$36.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.88
|
| Rate for Payer: UHC Medicare Advantage |
$11.20
|
| Rate for Payer: VA VA |
$10.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.62
|
|
|
HC SUMP VENTRICULAR MEDTRONIC
|
Facility
|
OP
|
$42.00
|
|
| Hospital Charge Code |
27000122
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.98 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Aetna Commercial |
$35.70
|
| Rate for Payer: Aetna Medicare |
$10.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.12
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS MAPPO |
$10.50
|
| Rate for Payer: BCBS Trust/PPO |
$32.66
|
| Rate for Payer: BCN Commercial |
$32.66
|
| Rate for Payer: BCN Medicare Advantage |
$10.50
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$36.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.50
|
| Rate for Payer: Healthscope Commercial |
$37.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.70
|
| Rate for Payer: PACE Senior Care Partners |
$9.98
|
| Rate for Payer: PACE SWMI |
$10.50
|
| Rate for Payer: PHP Commercial |
$35.70
|
| Rate for Payer: PHP Medicare Advantage |
$10.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.54
|
| Rate for Payer: Priority Health Medicare |
$10.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.62
|
| Rate for Payer: Railroad Medicare Medicare |
$10.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.96
|
| Rate for Payer: UHC Core |
$35.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.50
|
| Rate for Payer: UHC Medicare Advantage |
$10.82
|
| Rate for Payer: VA VA |
$10.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.50
|
|
|
HC SUMP VENTRICULAR MEDTRONIC
|
Facility
|
IP
|
$42.00
|
|
| Hospital Charge Code |
27000122
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$25.62 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Aetna Commercial |
$35.70
|
| Rate for Payer: BCBS Trust/PPO |
$32.46
|
| Rate for Payer: BCN Commercial |
$32.46
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$36.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.60
|
| Rate for Payer: Healthscope Commercial |
$37.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.70
|
| Rate for Payer: PHP Commercial |
$35.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.96
|
| Rate for Payer: UHC Core |
$35.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.50
|
|
|
HC SUPERVISION & HANDLING
|
Facility
|
IP
|
$154.02
|
|
|
Service Code
|
CPT 77790
|
| Hospital Charge Code |
33300029
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$93.94 |
| Max. Negotiated Rate |
$138.62 |
| Rate for Payer: Aetna Commercial |
$130.92
|
| Rate for Payer: Aetna Commercial |
$142.80
|
| Rate for Payer: BCBS Trust/PPO |
$119.03
|
| Rate for Payer: BCBS Trust/PPO |
$129.83
|
| Rate for Payer: BCN Commercial |
$129.83
|
| Rate for Payer: BCN Commercial |
$119.03
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$123.22
|
| Rate for Payer: Cofinity Commercial |
$132.46
|
| Rate for Payer: Cofinity Commercial |
$144.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.22
|
| Rate for Payer: Healthscope Commercial |
$138.62
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$130.92
|
| Rate for Payer: PHP Commercial |
$142.80
|
| Rate for Payer: PHP Commercial |
$130.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.54
|
| Rate for Payer: UHC Core |
$128.61
|
| Rate for Payer: UHC Core |
$140.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.00
|
|
|
HC SUPERVISION & HANDLING
|
Facility
|
OP
|
$154.02
|
|
|
Service Code
|
CPT 77790
|
| Hospital Charge Code |
33300029
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$36.58 |
| Max. Negotiated Rate |
$138.62 |
| Rate for Payer: Aetna Commercial |
$130.92
|
| Rate for Payer: Aetna Commercial |
$142.80
|
| Rate for Payer: Aetna Medicare |
$40.05
|
| Rate for Payer: Aetna Medicare |
$43.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.13
|
| Rate for Payer: BCBS Complete |
$61.61
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: BCBS MAPPO |
$38.50
|
| Rate for Payer: BCBS MAPPO |
$42.00
|
| Rate for Payer: BCBS Trust/PPO |
$130.62
|
| Rate for Payer: BCBS Trust/PPO |
$119.75
|
| Rate for Payer: BCN Commercial |
$130.62
|
| Rate for Payer: BCN Commercial |
$119.75
|
| Rate for Payer: BCN Medicare Advantage |
$38.50
|
| Rate for Payer: BCN Medicare Advantage |
$42.00
|
| Rate for Payer: Cash Price |
$123.22
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$144.48
|
| Rate for Payer: Cofinity Commercial |
$132.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.50
|
| Rate for Payer: Healthscope Commercial |
$138.62
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$130.92
|
| Rate for Payer: PACE Senior Care Partners |
$36.58
|
| Rate for Payer: PACE Senior Care Partners |
$39.90
|
| Rate for Payer: PACE SWMI |
$42.00
|
| Rate for Payer: PACE SWMI |
$38.50
|
| Rate for Payer: PHP Commercial |
$142.80
|
| Rate for Payer: PHP Commercial |
$130.92
|
| Rate for Payer: PHP Medicare Advantage |
$42.00
|
| Rate for Payer: PHP Medicare Advantage |
$38.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.00
|
| Rate for Payer: Priority Health Medicare |
$38.50
|
| Rate for Payer: Priority Health Medicare |
$42.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.46
|
| Rate for Payer: Railroad Medicare Medicare |
$38.50
|
| Rate for Payer: Railroad Medicare Medicare |
$42.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.54
|
| Rate for Payer: UHC Core |
$140.28
|
| Rate for Payer: UHC Core |
$128.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.00
|
| Rate for Payer: UHC Medicare Advantage |
$39.66
|
| Rate for Payer: UHC Medicare Advantage |
$43.26
|
| Rate for Payer: VA VA |
$38.50
|
| Rate for Payer: VA VA |
$42.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.52
|
|
|
HC SUPPLEMENTAL NEWBORN SCRN
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
30100686
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.84 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$72.25
|
| Rate for Payer: BCBS Trust/PPO |
$65.69
|
| Rate for Payer: BCN Commercial |
$65.69
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$73.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.00
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.25
|
| Rate for Payer: PHP Commercial |
$72.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.80
|
| Rate for Payer: UHC Core |
$70.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.75
|
|
|
HC SUPPLEMENTAL NEWBORN SCRN
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
30100686
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.79 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna Commercial |
$72.25
|
| Rate for Payer: Aetna Medicare |
$22.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.56
|
| Rate for Payer: BCBS Complete |
$18.68
|
| Rate for Payer: BCBS MAPPO |
$21.25
|
| Rate for Payer: BCBS Trust/PPO |
$66.09
|
| Rate for Payer: BCN Commercial |
$66.09
|
| Rate for Payer: BCN Medicare Advantage |
$21.25
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$73.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.25
|
| Rate for Payer: Healthscope Commercial |
$76.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.75
|
| Rate for Payer: Mclaren Medicaid |
$17.79
|
| Rate for Payer: Meridian Medicaid |
$18.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.25
|
| Rate for Payer: PACE Senior Care Partners |
$20.19
|
| Rate for Payer: PACE SWMI |
$21.25
|
| Rate for Payer: PHP Commercial |
$72.25
|
| Rate for Payer: PHP Medicare Advantage |
$21.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.95
|
| Rate for Payer: Priority Health Medicare |
$21.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.84
|
| Rate for Payer: Railroad Medicare Medicare |
$21.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.80
|
| Rate for Payer: UHC Core |
$70.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.25
|
| Rate for Payer: UHC Medicare Advantage |
$21.89
|
| Rate for Payer: VA VA |
$21.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.75
|
|
|
HC SUPRAPUBIC CATHETER
|
Facility
|
IP
|
$116.64
|
|
|
Service Code
|
HCPCS C2627
|
| Hospital Charge Code |
27200072
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$71.14 |
| Max. Negotiated Rate |
$104.98 |
| Rate for Payer: Aetna Commercial |
$99.14
|
| Rate for Payer: BCBS Trust/PPO |
$90.14
|
| Rate for Payer: BCN Commercial |
$90.14
|
| Rate for Payer: Cash Price |
$93.31
|
| Rate for Payer: Cofinity Commercial |
$100.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.31
|
| Rate for Payer: Healthscope Commercial |
$104.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.14
|
| Rate for Payer: PHP Commercial |
$99.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.64
|
| Rate for Payer: UHC Core |
$97.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.48
|
|
|
HC SUPRAPUBIC CATHETER
|
Facility
|
OP
|
$116.64
|
|
|
Service Code
|
HCPCS C2627
|
| Hospital Charge Code |
27200072
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.70 |
| Max. Negotiated Rate |
$104.98 |
| Rate for Payer: Aetna Commercial |
$99.14
|
| Rate for Payer: Aetna Medicare |
$30.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.45
|
| Rate for Payer: BCBS Complete |
$46.66
|
| Rate for Payer: BCBS MAPPO |
$29.16
|
| Rate for Payer: BCBS Trust/PPO |
$90.69
|
| Rate for Payer: BCN Commercial |
$90.69
|
| Rate for Payer: BCN Medicare Advantage |
$29.16
|
| Rate for Payer: Cash Price |
$93.31
|
| Rate for Payer: Cofinity Commercial |
$100.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.16
|
| Rate for Payer: Healthscope Commercial |
$104.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.14
|
| Rate for Payer: PACE Senior Care Partners |
$27.70
|
| Rate for Payer: PACE SWMI |
$29.16
|
| Rate for Payer: PHP Commercial |
$99.14
|
| Rate for Payer: PHP Medicare Advantage |
$29.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.48
|
| Rate for Payer: Priority Health Medicare |
$29.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.14
|
| Rate for Payer: Railroad Medicare Medicare |
$29.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.64
|
| Rate for Payer: UHC Core |
$97.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.16
|
| Rate for Payer: UHC Medicare Advantage |
$30.03
|
| Rate for Payer: VA VA |
$29.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.48
|
|
|
HC SURGERY FROZEN EA ADDL
|
Facility
|
OP
|
$73.24
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
31000057
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.39 |
| Max. Negotiated Rate |
$65.92 |
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: Aetna Medicare |
$19.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.89
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCBS MAPPO |
$18.31
|
| Rate for Payer: BCBS Trust/PPO |
$56.94
|
| Rate for Payer: BCCCP Commercial |
$55.41
|
| Rate for Payer: BCN Commercial |
$56.94
|
| Rate for Payer: BCN Medicare Advantage |
$18.31
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cofinity Commercial |
$62.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$65.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.25
|
| Rate for Payer: PACE Senior Care Partners |
$17.39
|
| Rate for Payer: PACE SWMI |
$18.31
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: PHP Medicare Advantage |
$18.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.72
|
| Rate for Payer: Priority Health Medicare |
$18.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.67
|
| Rate for Payer: Railroad Medicare Medicare |
$18.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.45
|
| Rate for Payer: UHC Core |
$61.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.31
|
| Rate for Payer: UHC Medicare Advantage |
$18.86
|
| Rate for Payer: VA VA |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.93
|
|
|
HC SURGERY FROZEN EA ADDL
|
Facility
|
IP
|
$73.24
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
31000057
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$44.67 |
| Max. Negotiated Rate |
$65.92 |
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: BCBS Trust/PPO |
$56.60
|
| Rate for Payer: BCN Commercial |
$56.60
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cofinity Commercial |
$62.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.59
|
| Rate for Payer: Healthscope Commercial |
$65.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.25
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.45
|
| Rate for Payer: UHC Core |
$61.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.93
|
|
|
HC SURGICAL HAND
|
Facility
|
OP
|
$690.61
|
|
| Hospital Charge Code |
45000053
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$164.02 |
| Max. Negotiated Rate |
$621.55 |
| Rate for Payer: Aetna Commercial |
$587.02
|
| Rate for Payer: Aetna Medicare |
$179.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$215.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$215.82
|
| Rate for Payer: BCBS Complete |
$276.24
|
| Rate for Payer: BCBS MAPPO |
$172.65
|
| Rate for Payer: BCBS Trust/PPO |
$536.95
|
| Rate for Payer: BCN Commercial |
$536.95
|
| Rate for Payer: BCN Medicare Advantage |
$172.65
|
| Rate for Payer: Cash Price |
$552.49
|
| Rate for Payer: Cofinity Commercial |
$593.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.65
|
| Rate for Payer: Healthscope Commercial |
$621.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$517.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$181.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.02
|
| Rate for Payer: PACE Senior Care Partners |
$164.02
|
| Rate for Payer: PACE SWMI |
$172.65
|
| Rate for Payer: PHP Commercial |
$587.02
|
| Rate for Payer: PHP Medicare Advantage |
$172.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$600.83
|
| Rate for Payer: Priority Health Medicare |
$172.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$421.20
|
| Rate for Payer: Railroad Medicare Medicare |
$172.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.74
|
| Rate for Payer: UHC Core |
$576.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.65
|
| Rate for Payer: UHC Medicare Advantage |
$177.83
|
| Rate for Payer: VA VA |
$172.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$517.96
|
|
|
HC SURGICAL HAND
|
Facility
|
IP
|
$690.61
|
|
| Hospital Charge Code |
45000053
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$421.20 |
| Max. Negotiated Rate |
$621.55 |
| Rate for Payer: Aetna Commercial |
$587.02
|
| Rate for Payer: BCBS Trust/PPO |
$533.70
|
| Rate for Payer: BCN Commercial |
$533.70
|
| Rate for Payer: Cash Price |
$552.49
|
| Rate for Payer: Cofinity Commercial |
$593.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.49
|
| Rate for Payer: Healthscope Commercial |
$621.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$517.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.02
|
| Rate for Payer: PHP Commercial |
$587.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$600.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$421.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$607.74
|
| Rate for Payer: UHC Core |
$576.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$517.96
|
|
