|
HC ORPHENADRINE INJECTION, PER 60MG
|
Facility
|
OP
|
$30.77
|
|
|
Service Code
|
HCPCS J2360
|
| Hospital Charge Code |
63600143
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.42 |
| Max. Negotiated Rate |
$27.69 |
| Rate for Payer: Aetna Commercial |
$26.15
|
| Rate for Payer: Aetna Medicare |
$8.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.62
|
| Rate for Payer: BCBS Complete |
$5.70
|
| Rate for Payer: BCBS MAPPO |
$7.69
|
| Rate for Payer: BCBS Trust/PPO |
$25.30
|
| Rate for Payer: BCN Commercial |
$25.30
|
| Rate for Payer: BCN Medicare Advantage |
$7.69
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.69
|
| Rate for Payer: Healthscope Commercial |
$27.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.08
|
| Rate for Payer: Mclaren Medicaid |
$5.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.08
|
| Rate for Payer: Meridian Medicaid |
$5.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Nomi Health Commercial |
$25.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PACE Senior Care Partners |
$7.31
|
| Rate for Payer: PACE SWMI |
$7.69
|
| Rate for Payer: PHP Commercial |
$26.15
|
| Rate for Payer: PHP Medicare Advantage |
$7.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.77
|
| Rate for Payer: Priority Health Medicare |
$7.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.42
|
| Rate for Payer: Railroad Medicare Medicare |
$7.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.08
|
| Rate for Payer: UHC Core |
$25.69
|
| Rate for Payer: UHC Exchange |
$7.69
|
| Rate for Payer: UHC Medicaid |
$5.42
|
| Rate for Payer: UHC Medicare Advantage |
$7.69
|
| Rate for Payer: UHCCP Medicaid |
$5.42
|
| Rate for Payer: VA VA |
$7.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.08
|
|
|
HC OR SEDATION PER MINUTE
|
Facility
|
OP
|
$14.28
|
|
| Hospital Charge Code |
37000026
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$2.52 |
| Max. Negotiated Rate |
$12.85 |
| Rate for Payer: Aetna Commercial |
$12.14
|
| Rate for Payer: Aetna Medicare |
$3.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.46
|
| Rate for Payer: BCBS Complete |
$2.64
|
| Rate for Payer: BCBS MAPPO |
$3.57
|
| Rate for Payer: BCBS Trust/PPO |
$11.74
|
| Rate for Payer: BCN Commercial |
$11.74
|
| Rate for Payer: BCN Medicare Advantage |
$3.57
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cofinity Commercial |
$12.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.57
|
| Rate for Payer: Healthscope Commercial |
$12.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.71
|
| Rate for Payer: Mclaren Medicaid |
$2.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.75
|
| Rate for Payer: Meridian Medicaid |
$2.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.14
|
| Rate for Payer: Nomi Health Commercial |
$11.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.71
|
| Rate for Payer: PACE Senior Care Partners |
$3.39
|
| Rate for Payer: PACE SWMI |
$3.57
|
| Rate for Payer: PHP Commercial |
$12.14
|
| Rate for Payer: PHP Medicare Advantage |
$3.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.42
|
| Rate for Payer: Priority Health Medicare |
$3.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.94
|
| Rate for Payer: Railroad Medicare Medicare |
$3.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.57
|
| Rate for Payer: UHC Core |
$11.92
|
| Rate for Payer: UHC Exchange |
$3.57
|
| Rate for Payer: UHC Medicaid |
$2.52
|
| Rate for Payer: UHC Medicare Advantage |
$3.57
|
| Rate for Payer: UHCCP Medicaid |
$2.52
|
| Rate for Payer: VA VA |
$3.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.71
|
|
|
HC OR SEDATION PER MINUTE
|
Facility
|
IP
|
$14.28
|
|
| Hospital Charge Code |
37000026
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$12.85 |
| Rate for Payer: Aetna Commercial |
$12.14
|
| Rate for Payer: BCBS Trust/PPO |
$11.79
|
| Rate for Payer: BCN Commercial |
$11.79
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cofinity Commercial |
$12.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.42
|
| Rate for Payer: Healthscope Commercial |
$12.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.14
|
| Rate for Payer: Nomi Health Commercial |
$11.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.71
|
| Rate for Payer: PHP Commercial |
$12.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.57
|
| Rate for Payer: UHC Core |
$11.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.71
|
|
|
HC ORTHOPOX (AKA MONKEY)
|
Facility
|
OP
|
$125.74
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600334
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.17 |
| Max. Negotiated Rate |
$113.17 |
| Rate for Payer: Aetna Commercial |
$106.88
|
| Rate for Payer: Aetna Medicare |
$32.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.29
|
| Rate for Payer: BCBS Complete |
$23.27
|
| Rate for Payer: BCBS MAPPO |
$31.43
|
| Rate for Payer: BCBS Trust/PPO |
$103.37
|
| Rate for Payer: BCN Commercial |
$103.37
|
| Rate for Payer: BCN Medicare Advantage |
$31.43
|
| Rate for Payer: Cash Price |
$100.59
|
| Rate for Payer: Cofinity Commercial |
$108.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.43
|
| Rate for Payer: Healthscope Commercial |
$113.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.31
|
| Rate for Payer: Mclaren Medicaid |
$22.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.01
|
| Rate for Payer: Meridian Medicaid |
$23.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.88
|
| Rate for Payer: Nomi Health Commercial |
$103.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.31
|
| Rate for Payer: PACE Senior Care Partners |
$29.86
|
| Rate for Payer: PACE SWMI |
$31.43
|
| Rate for Payer: PHP Commercial |
$106.88
|
| Rate for Payer: PHP Medicare Advantage |
$31.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$109.39
|
| Rate for Payer: Priority Health Medicare |
$31.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.52
|
| Rate for Payer: Railroad Medicare Medicare |
$31.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.65
|
| Rate for Payer: UHC Core |
$104.99
|
| Rate for Payer: UHC Exchange |
$31.43
|
| Rate for Payer: UHC Medicaid |
$22.17
|
| Rate for Payer: UHC Medicare Advantage |
$31.43
|
| Rate for Payer: UHCCP Medicaid |
$22.17
|
| Rate for Payer: VA VA |
$31.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.31
|
|
|
HC ORTHOPOX (AKA MONKEY)
|
Facility
|
IP
|
$125.74
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600334
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$87.52 |
| Max. Negotiated Rate |
$113.17 |
| Rate for Payer: Aetna Commercial |
$106.88
|
| Rate for Payer: BCBS Trust/PPO |
$103.85
|
| Rate for Payer: BCN Commercial |
$103.85
|
| Rate for Payer: Cash Price |
$100.59
|
| Rate for Payer: Cofinity Commercial |
$108.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.59
|
| Rate for Payer: Healthscope Commercial |
$113.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.88
|
| Rate for Payer: Nomi Health Commercial |
$103.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.31
|
| Rate for Payer: PHP Commercial |
$106.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$109.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.65
|
| Rate for Payer: UHC Core |
$104.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.31
|
|
|
HC ORTHOPOX DNA, PCR
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600332
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$54.31 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$64.44
|
| Rate for Payer: BCN Commercial |
$64.44
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC ORTHOPOX DNA, PCR
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600332
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.76 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.38
|
| Rate for Payer: BCBS Complete |
$14.44
|
| Rate for Payer: BCBS MAPPO |
$19.51
|
| Rate for Payer: BCBS Trust/PPO |
$64.15
|
| Rate for Payer: BCN Commercial |
$64.15
|
| Rate for Payer: BCN Medicare Advantage |
$19.51
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.51
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$13.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.48
|
| Rate for Payer: Meridian Medicaid |
$14.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PACE Senior Care Partners |
$18.53
|
| Rate for Payer: PACE SWMI |
$19.51
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Medicare |
$19.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.31
|
| Rate for Payer: Railroad Medicare Medicare |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: UHC Exchange |
$19.51
|
| Rate for Payer: UHC Medicaid |
$13.76
|
| Rate for Payer: UHC Medicare Advantage |
$19.51
|
| Rate for Payer: UHCCP Medicaid |
$13.76
|
| Rate for Payer: VA VA |
$19.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC ORTHO/PROSTH MGMT SUBSEQ EA 15 MIN
|
Facility
|
OP
|
$149.64
|
|
|
Service Code
|
CPT 97763
|
| Hospital Charge Code |
42000056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$26.38 |
| Max. Negotiated Rate |
$134.68 |
| Rate for Payer: Aetna Commercial |
$127.19
|
| Rate for Payer: Aetna Medicare |
$38.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.76
|
| Rate for Payer: BCBS Complete |
$27.70
|
| Rate for Payer: BCBS MAPPO |
$37.41
|
| Rate for Payer: BCBS Trust/PPO |
$123.02
|
| Rate for Payer: BCN Commercial |
$123.02
|
| Rate for Payer: BCN Medicare Advantage |
$37.41
|
| Rate for Payer: Cash Price |
$119.71
|
| Rate for Payer: Cofinity Commercial |
$128.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.41
|
| Rate for Payer: Healthscope Commercial |
$134.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.23
|
| Rate for Payer: Mclaren Medicaid |
$26.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.28
|
| Rate for Payer: Meridian Medicaid |
$27.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.19
|
| Rate for Payer: Nomi Health Commercial |
$122.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$112.23
|
| Rate for Payer: PACE Senior Care Partners |
$35.54
|
| Rate for Payer: PACE SWMI |
$37.41
|
| Rate for Payer: PHP Commercial |
$127.19
|
| Rate for Payer: PHP Medicare Advantage |
$37.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$130.19
|
| Rate for Payer: Priority Health Medicare |
$37.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.15
|
| Rate for Payer: Railroad Medicare Medicare |
$37.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.68
|
| Rate for Payer: UHC Core |
$124.95
|
| Rate for Payer: UHC Exchange |
$37.41
|
| Rate for Payer: UHC Medicaid |
$26.38
|
| Rate for Payer: UHC Medicare Advantage |
$37.41
|
| Rate for Payer: UHCCP Medicaid |
$26.38
|
| Rate for Payer: VA VA |
$37.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.23
|
|
|
HC ORTHO/PROSTH MGMT SUBSEQ EA 15 MIN
|
Facility
|
IP
|
$149.64
|
|
|
Service Code
|
CPT 97763
|
| Hospital Charge Code |
42000056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$104.15 |
| Max. Negotiated Rate |
$134.68 |
| Rate for Payer: Aetna Commercial |
$127.19
|
| Rate for Payer: BCBS Trust/PPO |
$123.59
|
| Rate for Payer: BCN Commercial |
$123.59
|
| Rate for Payer: Cash Price |
$119.71
|
| Rate for Payer: Cofinity Commercial |
$128.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.71
|
| Rate for Payer: Healthscope Commercial |
$134.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.19
|
| Rate for Payer: Nomi Health Commercial |
$122.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$112.23
|
| Rate for Payer: PHP Commercial |
$127.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$130.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.68
|
| Rate for Payer: UHC Core |
$124.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.23
|
|
|
HC ORTHOTIC FIT/TRAIN INITIAL EA 15 MIN
|
Facility
|
IP
|
$137.09
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
42000039
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$95.41 |
| Max. Negotiated Rate |
$123.38 |
| Rate for Payer: Aetna Commercial |
$116.53
|
| Rate for Payer: BCBS Trust/PPO |
$113.22
|
| Rate for Payer: BCN Commercial |
$113.22
|
| Rate for Payer: Cash Price |
$109.67
|
| Rate for Payer: Cofinity Commercial |
$117.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.67
|
| Rate for Payer: Healthscope Commercial |
$123.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.53
|
| Rate for Payer: Nomi Health Commercial |
$112.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.82
|
| Rate for Payer: PHP Commercial |
$116.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$119.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.64
|
| Rate for Payer: UHC Core |
$114.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.82
|
|
|
HC ORTHOTIC FIT/TRAIN INITIAL EA 15 MIN
|
Facility
|
OP
|
$137.09
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
42000039
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$24.17 |
| Max. Negotiated Rate |
$123.38 |
| Rate for Payer: Aetna Commercial |
$116.53
|
| Rate for Payer: Aetna Medicare |
$35.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.84
|
| Rate for Payer: BCBS Complete |
$25.38
|
| Rate for Payer: BCBS MAPPO |
$34.27
|
| Rate for Payer: BCBS Trust/PPO |
$112.70
|
| Rate for Payer: BCN Commercial |
$112.70
|
| Rate for Payer: BCN Medicare Advantage |
$34.27
|
| Rate for Payer: Cash Price |
$109.67
|
| Rate for Payer: Cofinity Commercial |
$117.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$123.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.82
|
| Rate for Payer: Mclaren Medicaid |
$24.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.99
|
| Rate for Payer: Meridian Medicaid |
$25.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.53
|
| Rate for Payer: Nomi Health Commercial |
$112.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.82
|
| Rate for Payer: PACE Senior Care Partners |
$32.56
|
| Rate for Payer: PACE SWMI |
$34.27
|
| Rate for Payer: PHP Commercial |
$116.53
|
| Rate for Payer: PHP Medicare Advantage |
$34.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$119.27
|
| Rate for Payer: Priority Health Medicare |
$34.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.41
|
| Rate for Payer: Railroad Medicare Medicare |
$34.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.64
|
| Rate for Payer: UHC Core |
$114.47
|
| Rate for Payer: UHC Exchange |
$34.27
|
| Rate for Payer: UHC Medicaid |
$24.17
|
| Rate for Payer: UHC Medicare Advantage |
$34.27
|
| Rate for Payer: UHCCP Medicaid |
$24.17
|
| Rate for Payer: VA VA |
$34.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.82
|
|
|
HC OSCILLATOR INIT DAY
|
Facility
|
OP
|
$2,458.59
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000039
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$433.45 |
| Max. Negotiated Rate |
$2,212.73 |
| Rate for Payer: Aetna Commercial |
$2,089.80
|
| Rate for Payer: Aetna Medicare |
$639.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.31
|
| Rate for Payer: BCBS Complete |
$455.09
|
| Rate for Payer: BCBS MAPPO |
$614.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,021.21
|
| Rate for Payer: BCN Commercial |
$2,021.21
|
| Rate for Payer: BCN Medicare Advantage |
$614.65
|
| Rate for Payer: Cash Price |
$1,966.87
|
| Rate for Payer: Cofinity Commercial |
$2,114.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,966.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.65
|
| Rate for Payer: Healthscope Commercial |
$2,212.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,843.94
|
| Rate for Payer: Mclaren Medicaid |
$433.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$645.38
|
| Rate for Payer: Meridian Medicaid |
$455.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$676.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,089.80
|
| Rate for Payer: Nomi Health Commercial |
$2,016.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,843.94
|
| Rate for Payer: PACE Senior Care Partners |
$583.92
|
| Rate for Payer: PACE SWMI |
$614.65
|
| Rate for Payer: PHP Commercial |
$2,089.80
|
| Rate for Payer: PHP Medicare Advantage |
$614.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,138.97
|
| Rate for Payer: Priority Health Medicare |
$620.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,711.18
|
| Rate for Payer: Railroad Medicare Medicare |
$614.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,163.56
|
| Rate for Payer: UHC Core |
$2,052.92
|
| Rate for Payer: UHC Exchange |
$614.65
|
| Rate for Payer: UHC Medicaid |
$433.45
|
| Rate for Payer: UHC Medicare Advantage |
$614.65
|
| Rate for Payer: UHCCP Medicaid |
$433.45
|
| Rate for Payer: VA VA |
$614.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,843.94
|
|
|
HC OSCILLATOR INIT DAY
|
Facility
|
IP
|
$2,458.59
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000039
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,711.18 |
| Max. Negotiated Rate |
$2,212.73 |
| Rate for Payer: Aetna Commercial |
$2,089.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,030.55
|
| Rate for Payer: BCN Commercial |
$2,030.55
|
| Rate for Payer: Cash Price |
$1,966.87
|
| Rate for Payer: Cofinity Commercial |
$2,114.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,966.87
|
| Rate for Payer: Healthscope Commercial |
$2,212.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,843.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,089.80
|
| Rate for Payer: Nomi Health Commercial |
$2,016.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,843.94
|
| Rate for Payer: PHP Commercial |
$2,089.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,138.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,711.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,163.56
|
| Rate for Payer: UHC Core |
$2,052.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,843.94
|
|
|
HC OSCILLATOR SUB DAY
|
Facility
|
OP
|
$1,375.25
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000040
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$242.46 |
| Max. Negotiated Rate |
$1,237.72 |
| Rate for Payer: Aetna Commercial |
$1,168.96
|
| Rate for Payer: Aetna Medicare |
$357.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$429.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$429.77
|
| Rate for Payer: BCBS Complete |
$254.56
|
| Rate for Payer: BCBS MAPPO |
$343.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,130.59
|
| Rate for Payer: BCN Commercial |
$1,130.59
|
| Rate for Payer: BCN Medicare Advantage |
$343.81
|
| Rate for Payer: Cash Price |
$1,100.20
|
| Rate for Payer: Cofinity Commercial |
$1,182.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,100.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.81
|
| Rate for Payer: Healthscope Commercial |
$1,237.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,031.44
|
| Rate for Payer: Mclaren Medicaid |
$242.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$361.00
|
| Rate for Payer: Meridian Medicaid |
$254.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$395.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$378.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,168.96
|
| Rate for Payer: Nomi Health Commercial |
$1,127.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,031.44
|
| Rate for Payer: PACE Senior Care Partners |
$326.62
|
| Rate for Payer: PACE SWMI |
$343.81
|
| Rate for Payer: PHP Commercial |
$1,168.96
|
| Rate for Payer: PHP Medicare Advantage |
$343.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,196.47
|
| Rate for Payer: Priority Health Medicare |
$347.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$957.17
|
| Rate for Payer: Railroad Medicare Medicare |
$343.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,210.22
|
| Rate for Payer: UHC Core |
$1,148.33
|
| Rate for Payer: UHC Exchange |
$343.81
|
| Rate for Payer: UHC Medicaid |
$242.46
|
| Rate for Payer: UHC Medicare Advantage |
$343.81
|
| Rate for Payer: UHCCP Medicaid |
$242.46
|
| Rate for Payer: VA VA |
$343.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,031.44
|
|
|
HC OSCILLATOR SUB DAY
|
Facility
|
IP
|
$1,375.25
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000040
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$957.17 |
| Max. Negotiated Rate |
$1,237.72 |
| Rate for Payer: Aetna Commercial |
$1,168.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,135.82
|
| Rate for Payer: BCN Commercial |
$1,135.82
|
| Rate for Payer: Cash Price |
$1,100.20
|
| Rate for Payer: Cofinity Commercial |
$1,182.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,100.20
|
| Rate for Payer: Healthscope Commercial |
$1,237.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,031.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,168.96
|
| Rate for Payer: Nomi Health Commercial |
$1,127.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,031.44
|
| Rate for Payer: PHP Commercial |
$1,168.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,196.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$957.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,210.22
|
| Rate for Payer: UHC Core |
$1,148.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,031.44
|
|
|
HC OSMOLALITY SERUM
|
Facility
|
IP
|
$56.04
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
30100378
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.00 |
| Max. Negotiated Rate |
$50.44 |
| Rate for Payer: Aetna Commercial |
$47.63
|
| Rate for Payer: BCBS Trust/PPO |
$46.28
|
| Rate for Payer: BCN Commercial |
$46.28
|
| Rate for Payer: Cash Price |
$44.83
|
| Rate for Payer: Cofinity Commercial |
$48.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.83
|
| Rate for Payer: Healthscope Commercial |
$50.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.63
|
| Rate for Payer: Nomi Health Commercial |
$45.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.03
|
| Rate for Payer: PHP Commercial |
$47.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.32
|
| Rate for Payer: UHC Core |
$46.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.03
|
|
|
HC OSMOLALITY SERUM
|
Facility
|
OP
|
$56.04
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
30100378
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.88 |
| Max. Negotiated Rate |
$50.44 |
| Rate for Payer: Aetna Commercial |
$47.63
|
| Rate for Payer: Aetna Medicare |
$14.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.51
|
| Rate for Payer: BCBS Complete |
$10.37
|
| Rate for Payer: BCBS MAPPO |
$14.01
|
| Rate for Payer: BCBS Trust/PPO |
$46.07
|
| Rate for Payer: BCN Commercial |
$46.07
|
| Rate for Payer: BCN Medicare Advantage |
$14.01
|
| Rate for Payer: Cash Price |
$44.83
|
| Rate for Payer: Cofinity Commercial |
$48.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.01
|
| Rate for Payer: Healthscope Commercial |
$50.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.03
|
| Rate for Payer: Mclaren Medicaid |
$9.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.71
|
| Rate for Payer: Meridian Medicaid |
$10.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.63
|
| Rate for Payer: Nomi Health Commercial |
$45.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.03
|
| Rate for Payer: PACE Senior Care Partners |
$13.31
|
| Rate for Payer: PACE SWMI |
$14.01
|
| Rate for Payer: PHP Commercial |
$47.63
|
| Rate for Payer: PHP Medicare Advantage |
$14.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.75
|
| Rate for Payer: Priority Health Medicare |
$14.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.00
|
| Rate for Payer: Railroad Medicare Medicare |
$14.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.32
|
| Rate for Payer: UHC Core |
$46.79
|
| Rate for Payer: UHC Exchange |
$14.01
|
| Rate for Payer: UHC Medicaid |
$9.88
|
| Rate for Payer: UHC Medicare Advantage |
$14.01
|
| Rate for Payer: UHCCP Medicaid |
$9.88
|
| Rate for Payer: VA VA |
$14.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.03
|
|
|
HC OSMOLALITY URINE
|
Facility
|
OP
|
$54.94
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
30100379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.69 |
| Max. Negotiated Rate |
$49.45 |
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: Aetna Medicare |
$14.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.17
|
| Rate for Payer: BCBS Complete |
$10.17
|
| Rate for Payer: BCBS MAPPO |
$13.73
|
| Rate for Payer: BCBS Trust/PPO |
$45.17
|
| Rate for Payer: BCN Commercial |
$45.17
|
| Rate for Payer: BCN Medicare Advantage |
$13.73
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$47.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.73
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$9.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.42
|
| Rate for Payer: Meridian Medicaid |
$10.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Nomi Health Commercial |
$45.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.20
|
| Rate for Payer: PACE Senior Care Partners |
$13.05
|
| Rate for Payer: PACE SWMI |
$13.73
|
| Rate for Payer: PHP Commercial |
$46.70
|
| Rate for Payer: PHP Medicare Advantage |
$13.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.80
|
| Rate for Payer: Priority Health Medicare |
$13.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.24
|
| Rate for Payer: Railroad Medicare Medicare |
$13.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.35
|
| Rate for Payer: UHC Core |
$45.87
|
| Rate for Payer: UHC Exchange |
$13.73
|
| Rate for Payer: UHC Medicaid |
$9.69
|
| Rate for Payer: UHC Medicare Advantage |
$13.73
|
| Rate for Payer: UHCCP Medicaid |
$9.69
|
| Rate for Payer: VA VA |
$13.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.20
|
|
|
HC OSMOLALITY URINE
|
Facility
|
IP
|
$54.94
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
30100379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.24 |
| Max. Negotiated Rate |
$49.45 |
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: BCBS Trust/PPO |
$45.37
|
| Rate for Payer: BCN Commercial |
$45.37
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$47.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Nomi Health Commercial |
$45.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.20
|
| Rate for Payer: PHP Commercial |
$46.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.35
|
| Rate for Payer: UHC Core |
$45.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.20
|
|
|
HC OSMOTIC FRAGILITY RBC
|
Facility
|
OP
|
$134.05
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
30500052
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$23.63 |
| Max. Negotiated Rate |
$120.64 |
| Rate for Payer: Aetna Commercial |
$113.94
|
| Rate for Payer: Aetna Medicare |
$34.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.89
|
| Rate for Payer: BCBS Complete |
$24.81
|
| Rate for Payer: BCBS MAPPO |
$33.51
|
| Rate for Payer: BCBS Trust/PPO |
$110.20
|
| Rate for Payer: BCN Commercial |
$110.20
|
| Rate for Payer: BCN Medicare Advantage |
$33.51
|
| Rate for Payer: Cash Price |
$107.24
|
| Rate for Payer: Cofinity Commercial |
$115.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.51
|
| Rate for Payer: Healthscope Commercial |
$120.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.54
|
| Rate for Payer: Mclaren Medicaid |
$23.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.19
|
| Rate for Payer: Meridian Medicaid |
$24.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.94
|
| Rate for Payer: Nomi Health Commercial |
$109.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.54
|
| Rate for Payer: PACE Senior Care Partners |
$31.84
|
| Rate for Payer: PACE SWMI |
$33.51
|
| Rate for Payer: PHP Commercial |
$113.94
|
| Rate for Payer: PHP Medicare Advantage |
$33.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.62
|
| Rate for Payer: Priority Health Medicare |
$33.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.30
|
| Rate for Payer: Railroad Medicare Medicare |
$33.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.96
|
| Rate for Payer: UHC Core |
$111.93
|
| Rate for Payer: UHC Exchange |
$33.51
|
| Rate for Payer: UHC Medicaid |
$23.63
|
| Rate for Payer: UHC Medicare Advantage |
$33.51
|
| Rate for Payer: UHCCP Medicaid |
$23.63
|
| Rate for Payer: VA VA |
$33.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.54
|
|
|
HC OSMOTIC FRAGILITY RBC
|
Facility
|
IP
|
$134.05
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
30500052
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$93.30 |
| Max. Negotiated Rate |
$120.64 |
| Rate for Payer: Aetna Commercial |
$113.94
|
| Rate for Payer: BCBS Trust/PPO |
$110.71
|
| Rate for Payer: BCN Commercial |
$110.71
|
| Rate for Payer: Cash Price |
$107.24
|
| Rate for Payer: Cofinity Commercial |
$115.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.24
|
| Rate for Payer: Healthscope Commercial |
$120.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.94
|
| Rate for Payer: Nomi Health Commercial |
$109.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.54
|
| Rate for Payer: PHP Commercial |
$113.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.96
|
| Rate for Payer: UHC Core |
$111.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.54
|
|
|
HC OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Facility
|
OP
|
$8,531.28
|
|
|
Service Code
|
CPT 28111
|
| Hospital Charge Code |
76100365
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,504.06 |
| Max. Negotiated Rate |
$7,678.15 |
| Rate for Payer: Aetna Commercial |
$7,251.59
|
| Rate for Payer: Aetna Medicare |
$2,218.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,666.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,666.03
|
| Rate for Payer: BCBS Complete |
$1,579.14
|
| Rate for Payer: BCBS MAPPO |
$2,132.82
|
| Rate for Payer: BCBS Trust/PPO |
$7,013.57
|
| Rate for Payer: BCN Commercial |
$7,013.57
|
| Rate for Payer: BCN Medicare Advantage |
$2,132.82
|
| Rate for Payer: Cash Price |
$6,825.02
|
| Rate for Payer: Cofinity Commercial |
$7,336.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,825.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,132.82
|
| Rate for Payer: Healthscope Commercial |
$7,678.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,398.46
|
| Rate for Payer: Mclaren Medicaid |
$1,504.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,239.46
|
| Rate for Payer: Meridian Medicaid |
$1,579.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,452.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,346.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,251.59
|
| Rate for Payer: Nomi Health Commercial |
$6,995.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,398.46
|
| Rate for Payer: PACE Senior Care Partners |
$2,026.18
|
| Rate for Payer: PACE SWMI |
$2,132.82
|
| Rate for Payer: PHP Commercial |
$7,251.59
|
| Rate for Payer: PHP Medicare Advantage |
$2,132.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,504.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,422.21
|
| Rate for Payer: Priority Health Medicare |
$2,154.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,937.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,132.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,507.53
|
| Rate for Payer: UHC Core |
$7,123.62
|
| Rate for Payer: UHC Exchange |
$2,132.82
|
| Rate for Payer: UHC Medicaid |
$1,504.06
|
| Rate for Payer: UHC Medicare Advantage |
$2,132.82
|
| Rate for Payer: UHCCP Medicaid |
$1,504.06
|
| Rate for Payer: VA VA |
$2,132.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,398.46
|
|
|
HC OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Facility
|
IP
|
$8,531.28
|
|
|
Service Code
|
CPT 28111
|
| Hospital Charge Code |
76100365
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,937.77 |
| Max. Negotiated Rate |
$7,678.15 |
| Rate for Payer: Aetna Commercial |
$7,251.59
|
| Rate for Payer: BCBS Trust/PPO |
$7,045.98
|
| Rate for Payer: BCN Commercial |
$7,045.98
|
| Rate for Payer: Cash Price |
$6,825.02
|
| Rate for Payer: Cofinity Commercial |
$7,336.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,825.02
|
| Rate for Payer: Healthscope Commercial |
$7,678.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,398.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,251.59
|
| Rate for Payer: Nomi Health Commercial |
$6,995.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,398.46
|
| Rate for Payer: PHP Commercial |
$7,251.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,422.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,937.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,507.53
|
| Rate for Payer: UHC Core |
$7,123.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,398.46
|
|
|
HC OSTECTOMY COMPLETE 2,3 OR 4TH METATARSAL HEAD
|
Facility
|
OP
|
$8,531.28
|
|
|
Service Code
|
CPT 28112
|
| Hospital Charge Code |
76100366
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,504.06 |
| Max. Negotiated Rate |
$7,678.15 |
| Rate for Payer: Aetna Commercial |
$7,251.59
|
| Rate for Payer: Aetna Medicare |
$2,218.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,666.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,666.03
|
| Rate for Payer: BCBS Complete |
$1,579.14
|
| Rate for Payer: BCBS MAPPO |
$2,132.82
|
| Rate for Payer: BCBS Trust/PPO |
$7,013.57
|
| Rate for Payer: BCN Commercial |
$7,013.57
|
| Rate for Payer: BCN Medicare Advantage |
$2,132.82
|
| Rate for Payer: Cash Price |
$6,825.02
|
| Rate for Payer: Cofinity Commercial |
$7,336.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,825.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,132.82
|
| Rate for Payer: Healthscope Commercial |
$7,678.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,398.46
|
| Rate for Payer: Mclaren Medicaid |
$1,504.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,239.46
|
| Rate for Payer: Meridian Medicaid |
$1,579.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,452.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,346.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,251.59
|
| Rate for Payer: Nomi Health Commercial |
$6,995.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,398.46
|
| Rate for Payer: PACE Senior Care Partners |
$2,026.18
|
| Rate for Payer: PACE SWMI |
$2,132.82
|
| Rate for Payer: PHP Commercial |
$7,251.59
|
| Rate for Payer: PHP Medicare Advantage |
$2,132.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,504.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,422.21
|
| Rate for Payer: Priority Health Medicare |
$2,154.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,937.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,132.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,507.53
|
| Rate for Payer: UHC Core |
$7,123.62
|
| Rate for Payer: UHC Exchange |
$2,132.82
|
| Rate for Payer: UHC Medicaid |
$1,504.06
|
| Rate for Payer: UHC Medicare Advantage |
$2,132.82
|
| Rate for Payer: UHCCP Medicaid |
$1,504.06
|
| Rate for Payer: VA VA |
$2,132.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,398.46
|
|
|
HC OSTECTOMY COMPLETE 2,3 OR 4TH METATARSAL HEAD
|
Facility
|
IP
|
$8,531.28
|
|
|
Service Code
|
CPT 28112
|
| Hospital Charge Code |
76100366
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,937.77 |
| Max. Negotiated Rate |
$7,678.15 |
| Rate for Payer: Aetna Commercial |
$7,251.59
|
| Rate for Payer: BCBS Trust/PPO |
$7,045.98
|
| Rate for Payer: BCN Commercial |
$7,045.98
|
| Rate for Payer: Cash Price |
$6,825.02
|
| Rate for Payer: Cofinity Commercial |
$7,336.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,825.02
|
| Rate for Payer: Healthscope Commercial |
$7,678.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,398.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,251.59
|
| Rate for Payer: Nomi Health Commercial |
$6,995.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,398.46
|
| Rate for Payer: PHP Commercial |
$7,251.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,422.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,937.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,507.53
|
| Rate for Payer: UHC Core |
$7,123.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,398.46
|
|
