|
HC MICRA VV LEADLESS PACEMAKER
|
Facility
|
OP
|
$17,615.28
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500012
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,183.63 |
| Max. Negotiated Rate |
$15,853.75 |
| Rate for Payer: Aetna Commercial |
$14,972.99
|
| Rate for Payer: Aetna Medicare |
$4,579.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,504.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,504.78
|
| Rate for Payer: BCBS Complete |
$7,046.11
|
| Rate for Payer: BCBS MAPPO |
$4,403.82
|
| Rate for Payer: BCBS Trust/PPO |
$14,481.52
|
| Rate for Payer: BCN Commercial |
$13,695.88
|
| Rate for Payer: BCN Medicare Advantage |
$4,403.82
|
| Rate for Payer: Cash Price |
$14,092.22
|
| Rate for Payer: Cofinity Commercial |
$15,149.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,092.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,403.82
|
| Rate for Payer: Healthscope Commercial |
$15,853.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,211.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,624.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,064.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,972.99
|
| Rate for Payer: Nomi Health Commercial |
$14,444.53
|
| Rate for Payer: PACE Senior Care Partners |
$4,183.63
|
| Rate for Payer: PACE SWMI |
$4,403.82
|
| Rate for Payer: PHP Commercial |
$14,972.99
|
| Rate for Payer: PHP Medicare Advantage |
$4,403.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,449.93
|
| Rate for Payer: Priority Health HMO/PPO |
$15,325.29
|
| Rate for Payer: Priority Health Medicare |
$4,447.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,802.24
|
| Rate for Payer: Railroad Medicare Medicare |
$4,403.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,501.45
|
| Rate for Payer: UHC Core |
$14,708.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,403.82
|
| Rate for Payer: UHC Exchange |
$4,403.82
|
| Rate for Payer: UHC Medicare Advantage |
$4,403.82
|
| Rate for Payer: VA VA |
$4,403.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,211.46
|
|
|
HC MICRO ALBUMIN URINE
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 82043
|
| Hospital Charge Code |
30100075
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: BCBS Trust/PPO |
$62.78
|
| Rate for Payer: BCN Commercial |
$59.44
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC MICRO ALBUMIN URINE
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 82043
|
| Hospital Charge Code |
30100075
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.03
|
| Rate for Payer: BCBS Complete |
$4.39
|
| Rate for Payer: BCBS MAPPO |
$19.23
|
| Rate for Payer: BCBS Trust/PPO |
$63.23
|
| Rate for Payer: BCN Commercial |
$59.80
|
| Rate for Payer: BCN Medicare Advantage |
$19.23
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.23
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$4.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.19
|
| Rate for Payer: Meridian Medicaid |
$4.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PACE Senior Care Partners |
$18.27
|
| Rate for Payer: PACE SWMI |
$19.23
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Medicare |
$19.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: Railroad Medicare Medicare |
$19.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.23
|
| Rate for Payer: UHC Exchange |
$19.23
|
| Rate for Payer: UHC Medicare Advantage |
$19.23
|
| Rate for Payer: UHCCP Medicaid |
$4.18
|
| Rate for Payer: VA VA |
$19.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC MICROSPORIDIA DETECTION
|
Facility
|
IP
|
$22.89
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600070
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: BCBS Trust/PPO |
$18.69
|
| Rate for Payer: BCN Commercial |
$17.69
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO |
$19.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.14
|
| Rate for Payer: UHC Core |
$19.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.17
|
|
|
HC MICROSPORIDIA DETECTION
|
Facility
|
OP
|
$22.89
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600070
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.83 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: Aetna Medicare |
$5.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.15
|
| Rate for Payer: BCBS Complete |
$5.07
|
| Rate for Payer: BCBS MAPPO |
$5.72
|
| Rate for Payer: BCBS Trust/PPO |
$18.82
|
| Rate for Payer: BCN Commercial |
$17.80
|
| Rate for Payer: BCN Medicare Advantage |
$5.72
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.72
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.17
|
| Rate for Payer: Mclaren Medicaid |
$4.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.01
|
| Rate for Payer: Meridian Medicaid |
$5.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: PACE Senior Care Partners |
$5.44
|
| Rate for Payer: PACE SWMI |
$5.72
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: PHP Medicare Advantage |
$5.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO |
$19.91
|
| Rate for Payer: Priority Health Medicare |
$5.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.34
|
| Rate for Payer: Railroad Medicare Medicare |
$5.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.14
|
| Rate for Payer: UHC Core |
$19.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.72
|
| Rate for Payer: UHC Exchange |
$5.72
|
| Rate for Payer: UHC Medicare Advantage |
$5.72
|
| Rate for Payer: UHCCP Medicaid |
$4.83
|
| Rate for Payer: VA VA |
$5.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.17
|
|
|
HC MICROSPORIDIA DETECTION CMPT
|
Facility
|
IP
|
$32.64
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600107
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.22 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Aetna Commercial |
$27.74
|
| Rate for Payer: BCBS Trust/PPO |
$26.64
|
| Rate for Payer: BCN Commercial |
$25.22
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$29.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.74
|
| Rate for Payer: Nomi Health Commercial |
$26.76
|
| Rate for Payer: PHP Commercial |
$27.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.22
|
| Rate for Payer: Priority Health HMO/PPO |
$28.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.72
|
| Rate for Payer: UHC Core |
$27.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.48
|
|
|
HC MICROSPORIDIA DETECTION CMPT
|
Facility
|
OP
|
$32.64
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600107
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.33 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Aetna Commercial |
$27.74
|
| Rate for Payer: Aetna Medicare |
$8.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.20
|
| Rate for Payer: BCBS Complete |
$4.55
|
| Rate for Payer: BCBS MAPPO |
$8.16
|
| Rate for Payer: BCBS Trust/PPO |
$26.83
|
| Rate for Payer: BCN Commercial |
$25.38
|
| Rate for Payer: BCN Medicare Advantage |
$8.16
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.16
|
| Rate for Payer: Healthscope Commercial |
$29.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.48
|
| Rate for Payer: Mclaren Medicaid |
$4.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.57
|
| Rate for Payer: Meridian Medicaid |
$4.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.74
|
| Rate for Payer: Nomi Health Commercial |
$26.76
|
| Rate for Payer: PACE Senior Care Partners |
$7.75
|
| Rate for Payer: PACE SWMI |
$8.16
|
| Rate for Payer: PHP Commercial |
$27.74
|
| Rate for Payer: PHP Medicare Advantage |
$8.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.22
|
| Rate for Payer: Priority Health HMO/PPO |
$28.40
|
| Rate for Payer: Priority Health Medicare |
$8.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.87
|
| Rate for Payer: Railroad Medicare Medicare |
$8.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.72
|
| Rate for Payer: UHC Core |
$27.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.16
|
| Rate for Payer: UHC Exchange |
$8.16
|
| Rate for Payer: UHC Medicare Advantage |
$8.16
|
| Rate for Payer: UHCCP Medicaid |
$4.33
|
| Rate for Payer: VA VA |
$8.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.48
|
|
|
HC MICROSPORIDIA PCR
|
Facility
|
OP
|
$375.36
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600285
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.37 |
| Max. Negotiated Rate |
$337.82 |
| Rate for Payer: Aetna Commercial |
$319.06
|
| Rate for Payer: Aetna Medicare |
$97.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$117.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$117.30
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$93.84
|
| Rate for Payer: BCBS Trust/PPO |
$308.58
|
| Rate for Payer: BCN Commercial |
$291.84
|
| Rate for Payer: BCN Medicare Advantage |
$93.84
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$322.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$337.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.52
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.53
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.06
|
| Rate for Payer: Nomi Health Commercial |
$307.80
|
| Rate for Payer: PACE Senior Care Partners |
$89.15
|
| Rate for Payer: PACE SWMI |
$93.84
|
| Rate for Payer: PHP Commercial |
$319.06
|
| Rate for Payer: PHP Medicare Advantage |
$93.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.98
|
| Rate for Payer: Priority Health HMO/PPO |
$326.56
|
| Rate for Payer: Priority Health Medicare |
$94.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$251.49
|
| Rate for Payer: Railroad Medicare Medicare |
$93.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.32
|
| Rate for Payer: UHC Core |
$313.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.84
|
| Rate for Payer: UHC Exchange |
$93.84
|
| Rate for Payer: UHC Medicare Advantage |
$93.84
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$93.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.52
|
|
|
HC MICROSPORIDIA PCR
|
Facility
|
IP
|
$375.36
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600285
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$243.98 |
| Max. Negotiated Rate |
$337.82 |
| Rate for Payer: Aetna Commercial |
$319.06
|
| Rate for Payer: BCBS Trust/PPO |
$306.41
|
| Rate for Payer: BCN Commercial |
$290.08
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$322.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Healthscope Commercial |
$337.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.06
|
| Rate for Payer: Nomi Health Commercial |
$307.80
|
| Rate for Payer: PHP Commercial |
$319.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.98
|
| Rate for Payer: Priority Health HMO/PPO |
$326.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$251.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.32
|
| Rate for Payer: UHC Core |
$313.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.52
|
|
|
HC MICU OBSERVATION PER HOUR
|
Facility
|
IP
|
$200.94
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200005
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$130.61 |
| Max. Negotiated Rate |
$180.85 |
| Rate for Payer: Aetna Commercial |
$170.80
|
| Rate for Payer: BCBS Trust/PPO |
$164.03
|
| Rate for Payer: BCN Commercial |
$155.29
|
| Rate for Payer: Cash Price |
$160.75
|
| Rate for Payer: Cofinity Commercial |
$172.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.75
|
| Rate for Payer: Healthscope Commercial |
$180.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.80
|
| Rate for Payer: Nomi Health Commercial |
$164.77
|
| Rate for Payer: PHP Commercial |
$170.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.61
|
| Rate for Payer: Priority Health HMO/PPO |
$174.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.83
|
| Rate for Payer: UHC Core |
$167.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.70
|
|
|
HC MICU OBSERVATION PER HOUR
|
Facility
|
OP
|
$200.94
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200005
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$47.72 |
| Max. Negotiated Rate |
$180.85 |
| Rate for Payer: Aetna Commercial |
$170.80
|
| Rate for Payer: Aetna Medicare |
$52.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.79
|
| Rate for Payer: BCBS Complete |
$80.38
|
| Rate for Payer: BCBS MAPPO |
$50.24
|
| Rate for Payer: BCBS Trust/PPO |
$165.19
|
| Rate for Payer: BCN Commercial |
$156.23
|
| Rate for Payer: BCN Medicare Advantage |
$50.24
|
| Rate for Payer: Cash Price |
$160.75
|
| Rate for Payer: Cofinity Commercial |
$172.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.24
|
| Rate for Payer: Healthscope Commercial |
$180.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.80
|
| Rate for Payer: Nomi Health Commercial |
$164.77
|
| Rate for Payer: PACE Senior Care Partners |
$47.72
|
| Rate for Payer: PACE SWMI |
$50.24
|
| Rate for Payer: PHP Commercial |
$170.80
|
| Rate for Payer: PHP Medicare Advantage |
$50.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.61
|
| Rate for Payer: Priority Health HMO/PPO |
$174.82
|
| Rate for Payer: Priority Health Medicare |
$50.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$134.63
|
| Rate for Payer: Railroad Medicare Medicare |
$50.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.83
|
| Rate for Payer: UHC Core |
$167.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.24
|
| Rate for Payer: UHC Exchange |
$50.24
|
| Rate for Payer: UHC Medicare Advantage |
$50.24
|
| Rate for Payer: VA VA |
$50.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.70
|
|
|
HC MILK IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200047
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC MILK IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200047
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC MINI BAL PROCEDURE
|
Facility
|
OP
|
$309.26
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
41000014
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$73.45 |
| Max. Negotiated Rate |
$278.33 |
| Rate for Payer: Aetna Commercial |
$262.87
|
| Rate for Payer: Aetna Medicare |
$80.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$96.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$96.64
|
| Rate for Payer: BCBS Complete |
$116.39
|
| Rate for Payer: BCBS MAPPO |
$77.32
|
| Rate for Payer: BCBS Trust/PPO |
$254.24
|
| Rate for Payer: BCN Commercial |
$240.45
|
| Rate for Payer: BCN Medicare Advantage |
$77.32
|
| Rate for Payer: Cash Price |
$247.41
|
| Rate for Payer: Cash Price |
$247.41
|
| Rate for Payer: Cofinity Commercial |
$265.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.32
|
| Rate for Payer: Healthscope Commercial |
$278.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.94
|
| Rate for Payer: Mclaren Medicaid |
$110.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.18
|
| Rate for Payer: Meridian Medicaid |
$116.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.87
|
| Rate for Payer: Nomi Health Commercial |
$253.59
|
| Rate for Payer: PACE Senior Care Partners |
$73.45
|
| Rate for Payer: PACE SWMI |
$77.32
|
| Rate for Payer: PHP Commercial |
$262.87
|
| Rate for Payer: PHP Medicare Advantage |
$77.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.02
|
| Rate for Payer: Priority Health HMO/PPO |
$269.06
|
| Rate for Payer: Priority Health Medicare |
$78.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.20
|
| Rate for Payer: Railroad Medicare Medicare |
$77.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.15
|
| Rate for Payer: UHC Core |
$258.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.32
|
| Rate for Payer: UHC Exchange |
$77.32
|
| Rate for Payer: UHC Medicare Advantage |
$77.32
|
| Rate for Payer: UHCCP Medicaid |
$110.84
|
| Rate for Payer: VA VA |
$77.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.94
|
|
|
HC MINI BAL PROCEDURE
|
Facility
|
IP
|
$309.26
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
41000014
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$201.02 |
| Max. Negotiated Rate |
$278.33 |
| Rate for Payer: Aetna Commercial |
$262.87
|
| Rate for Payer: BCBS Trust/PPO |
$252.45
|
| Rate for Payer: BCN Commercial |
$239.00
|
| Rate for Payer: Cash Price |
$247.41
|
| Rate for Payer: Cofinity Commercial |
$265.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.41
|
| Rate for Payer: Healthscope Commercial |
$278.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.87
|
| Rate for Payer: Nomi Health Commercial |
$253.59
|
| Rate for Payer: PHP Commercial |
$262.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.02
|
| Rate for Payer: Priority Health HMO/PPO |
$269.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.15
|
| Rate for Payer: UHC Core |
$258.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.94
|
|
|
HC MINIMUM BACTERICIDAL CONCENTRA
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
30600103
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$24.98
|
| Rate for Payer: BCN Commercial |
$23.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO |
$26.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC MINIMUM BACTERICIDAL CONCENTRA
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
30600103
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.56
|
| Rate for Payer: BCBS Complete |
$5.04
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$25.16
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.65
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$4.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: Meridian Medicaid |
$5.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PACE Senior Care Partners |
$7.27
|
| Rate for Payer: PACE SWMI |
$7.65
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO |
$26.62
|
| Rate for Payer: Priority Health Medicare |
$7.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.50
|
| Rate for Payer: Railroad Medicare Medicare |
$7.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.65
|
| Rate for Payer: UHC Exchange |
$7.65
|
| Rate for Payer: UHC Medicare Advantage |
$7.65
|
| Rate for Payer: UHCCP Medicaid |
$4.80
|
| Rate for Payer: VA VA |
$7.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC MINIMUM LETHAL CONCENTRATION (MLC)
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 87187
|
| Hospital Charge Code |
30600102
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: BCBS Trust/PPO |
$38.22
|
| Rate for Payer: BCN Commercial |
$36.18
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC MINIMUM LETHAL CONCENTRATION (MLC)
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 87187
|
| Hospital Charge Code |
30600102
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.63
|
| Rate for Payer: BCBS Complete |
$30.50
|
| Rate for Payer: BCBS MAPPO |
$11.70
|
| Rate for Payer: BCBS Trust/PPO |
$38.49
|
| Rate for Payer: BCN Commercial |
$36.40
|
| Rate for Payer: BCN Medicare Advantage |
$11.70
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.70
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$29.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.29
|
| Rate for Payer: Meridian Medicaid |
$30.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PACE Senior Care Partners |
$11.12
|
| Rate for Payer: PACE SWMI |
$11.70
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.37
|
| Rate for Payer: Railroad Medicare Medicare |
$11.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.70
|
| Rate for Payer: UHC Exchange |
$11.70
|
| Rate for Payer: UHC Medicare Advantage |
$11.70
|
| Rate for Payer: UHCCP Medicaid |
$29.04
|
| Rate for Payer: VA VA |
$11.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC MINOR PROCEDURE WO SEDATION
|
Facility
|
OP
|
$531.54
|
|
| Hospital Charge Code |
36000076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$126.24 |
| Max. Negotiated Rate |
$478.39 |
| Rate for Payer: Aetna Commercial |
$451.81
|
| Rate for Payer: Aetna Medicare |
$138.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$166.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$166.11
|
| Rate for Payer: BCBS Complete |
$212.62
|
| Rate for Payer: BCBS MAPPO |
$132.88
|
| Rate for Payer: BCBS Trust/PPO |
$436.98
|
| Rate for Payer: BCN Commercial |
$413.27
|
| Rate for Payer: BCN Medicare Advantage |
$132.88
|
| Rate for Payer: Cash Price |
$425.23
|
| Rate for Payer: Cofinity Commercial |
$457.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.88
|
| Rate for Payer: Healthscope Commercial |
$478.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.81
|
| Rate for Payer: Nomi Health Commercial |
$435.86
|
| Rate for Payer: PACE Senior Care Partners |
$126.24
|
| Rate for Payer: PACE SWMI |
$132.88
|
| Rate for Payer: PHP Commercial |
$451.81
|
| Rate for Payer: PHP Medicare Advantage |
$132.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.50
|
| Rate for Payer: Priority Health HMO/PPO |
$462.44
|
| Rate for Payer: Priority Health Medicare |
$134.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$356.13
|
| Rate for Payer: Railroad Medicare Medicare |
$132.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.76
|
| Rate for Payer: UHC Core |
$443.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$132.88
|
| Rate for Payer: UHC Exchange |
$132.88
|
| Rate for Payer: UHC Medicare Advantage |
$132.88
|
| Rate for Payer: VA VA |
$132.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.66
|
|
|
HC MINOR PROCEDURE WO SEDATION
|
Facility
|
IP
|
$531.54
|
|
| Hospital Charge Code |
36000076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$345.50 |
| Max. Negotiated Rate |
$478.39 |
| Rate for Payer: Aetna Commercial |
$451.81
|
| Rate for Payer: BCBS Trust/PPO |
$433.90
|
| Rate for Payer: BCN Commercial |
$410.77
|
| Rate for Payer: Cash Price |
$425.23
|
| Rate for Payer: Cofinity Commercial |
$457.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.23
|
| Rate for Payer: Healthscope Commercial |
$478.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.81
|
| Rate for Payer: Nomi Health Commercial |
$435.86
|
| Rate for Payer: PHP Commercial |
$451.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.50
|
| Rate for Payer: Priority Health HMO/PPO |
$462.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$356.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.76
|
| Rate for Payer: UHC Core |
$443.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.66
|
|
|
HC MINOR PROCEDURE W SEDATION
|
Facility
|
OP
|
$615.92
|
|
| Hospital Charge Code |
36000075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$146.28 |
| Max. Negotiated Rate |
$554.33 |
| Rate for Payer: Aetna Commercial |
$523.53
|
| Rate for Payer: Aetna Medicare |
$160.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$192.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$192.48
|
| Rate for Payer: BCBS Complete |
$246.37
|
| Rate for Payer: BCBS MAPPO |
$153.98
|
| Rate for Payer: BCBS Trust/PPO |
$506.35
|
| Rate for Payer: BCN Commercial |
$478.88
|
| Rate for Payer: BCN Medicare Advantage |
$153.98
|
| Rate for Payer: Cash Price |
$492.74
|
| Rate for Payer: Cofinity Commercial |
$529.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.98
|
| Rate for Payer: Healthscope Commercial |
$554.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$461.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$523.53
|
| Rate for Payer: Nomi Health Commercial |
$505.05
|
| Rate for Payer: PACE Senior Care Partners |
$146.28
|
| Rate for Payer: PACE SWMI |
$153.98
|
| Rate for Payer: PHP Commercial |
$523.53
|
| Rate for Payer: PHP Medicare Advantage |
$153.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.35
|
| Rate for Payer: Priority Health HMO/PPO |
$535.85
|
| Rate for Payer: Priority Health Medicare |
$155.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$412.67
|
| Rate for Payer: Railroad Medicare Medicare |
$153.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.01
|
| Rate for Payer: UHC Core |
$514.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.98
|
| Rate for Payer: UHC Exchange |
$153.98
|
| Rate for Payer: UHC Medicare Advantage |
$153.98
|
| Rate for Payer: VA VA |
$153.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$461.94
|
|
|
HC MINOR PROCEDURE W SEDATION
|
Facility
|
IP
|
$615.92
|
|
| Hospital Charge Code |
36000075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$400.35 |
| Max. Negotiated Rate |
$554.33 |
| Rate for Payer: Aetna Commercial |
$523.53
|
| Rate for Payer: BCBS Trust/PPO |
$502.78
|
| Rate for Payer: BCN Commercial |
$475.98
|
| Rate for Payer: Cash Price |
$492.74
|
| Rate for Payer: Cofinity Commercial |
$529.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.74
|
| Rate for Payer: Healthscope Commercial |
$554.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$461.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$523.53
|
| Rate for Payer: Nomi Health Commercial |
$505.05
|
| Rate for Payer: PHP Commercial |
$523.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.35
|
| Rate for Payer: Priority Health HMO/PPO |
$535.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$412.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$542.01
|
| Rate for Payer: UHC Core |
$514.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$461.94
|
|
|
HC MITOTANE (LYSODREN)
|
Facility
|
OP
|
$117.52
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100731
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.48 |
| Max. Negotiated Rate |
$105.77 |
| Rate for Payer: Aetna Commercial |
$99.89
|
| Rate for Payer: Aetna Medicare |
$30.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.72
|
| Rate for Payer: BCBS Complete |
$14.15
|
| Rate for Payer: BCBS MAPPO |
$29.38
|
| Rate for Payer: BCBS Trust/PPO |
$96.61
|
| Rate for Payer: BCN Commercial |
$91.37
|
| Rate for Payer: BCN Medicare Advantage |
$29.38
|
| Rate for Payer: Cash Price |
$94.02
|
| Rate for Payer: Cash Price |
$94.02
|
| Rate for Payer: Cofinity Commercial |
$101.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.38
|
| Rate for Payer: Healthscope Commercial |
$105.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.14
|
| Rate for Payer: Mclaren Medicaid |
$13.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.85
|
| Rate for Payer: Meridian Medicaid |
$14.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.89
|
| Rate for Payer: Nomi Health Commercial |
$96.37
|
| Rate for Payer: PACE Senior Care Partners |
$27.91
|
| Rate for Payer: PACE SWMI |
$29.38
|
| Rate for Payer: PHP Commercial |
$99.89
|
| Rate for Payer: PHP Medicare Advantage |
$29.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.39
|
| Rate for Payer: Priority Health HMO/PPO |
$102.24
|
| Rate for Payer: Priority Health Medicare |
$29.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.74
|
| Rate for Payer: Railroad Medicare Medicare |
$29.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.42
|
| Rate for Payer: UHC Core |
$98.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.38
|
| Rate for Payer: UHC Exchange |
$29.38
|
| Rate for Payer: UHC Medicare Advantage |
$29.38
|
| Rate for Payer: UHCCP Medicaid |
$13.48
|
| Rate for Payer: VA VA |
$29.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.14
|
|
|
HC MITOTANE (LYSODREN)
|
Facility
|
IP
|
$117.52
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100731
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$76.39 |
| Max. Negotiated Rate |
$105.77 |
| Rate for Payer: Aetna Commercial |
$99.89
|
| Rate for Payer: BCBS Trust/PPO |
$95.93
|
| Rate for Payer: BCN Commercial |
$90.82
|
| Rate for Payer: Cash Price |
$94.02
|
| Rate for Payer: Cofinity Commercial |
$101.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.02
|
| Rate for Payer: Healthscope Commercial |
$105.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.89
|
| Rate for Payer: Nomi Health Commercial |
$96.37
|
| Rate for Payer: PHP Commercial |
$99.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.39
|
| Rate for Payer: Priority Health HMO/PPO |
$102.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.42
|
| Rate for Payer: UHC Core |
$98.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.14
|
|
