|
HC SURG SUPPLY MISC
|
Facility
|
IP
|
$84.74
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
62300132
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$51.68 |
| Max. Negotiated Rate |
$76.27 |
| Rate for Payer: Aetna Commercial |
$72.03
|
| Rate for Payer: BCBS Trust/PPO |
$65.49
|
| Rate for Payer: BCN Commercial |
$65.49
|
| Rate for Payer: Cash Price |
$67.79
|
| Rate for Payer: Cofinity Commercial |
$72.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.79
|
| Rate for Payer: Healthscope Commercial |
$76.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.03
|
| Rate for Payer: PHP Commercial |
$72.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.57
|
| Rate for Payer: UHC Core |
$70.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.56
|
|
|
HC SURG SUPPLY MISC
|
Facility
|
OP
|
$84.74
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
62300132
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$20.13 |
| Max. Negotiated Rate |
$76.27 |
| Rate for Payer: Aetna Commercial |
$72.03
|
| Rate for Payer: Aetna Medicare |
$22.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.48
|
| Rate for Payer: BCBS Complete |
$33.90
|
| Rate for Payer: BCBS MAPPO |
$21.18
|
| Rate for Payer: BCBS Trust/PPO |
$65.89
|
| Rate for Payer: BCN Commercial |
$65.89
|
| Rate for Payer: BCN Medicare Advantage |
$21.18
|
| Rate for Payer: Cash Price |
$67.79
|
| Rate for Payer: Cofinity Commercial |
$72.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.18
|
| Rate for Payer: Healthscope Commercial |
$76.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.03
|
| Rate for Payer: PACE Senior Care Partners |
$20.13
|
| Rate for Payer: PACE SWMI |
$21.18
|
| Rate for Payer: PHP Commercial |
$72.03
|
| Rate for Payer: PHP Medicare Advantage |
$21.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.72
|
| Rate for Payer: Priority Health Medicare |
$21.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.68
|
| Rate for Payer: Railroad Medicare Medicare |
$21.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.57
|
| Rate for Payer: UHC Core |
$70.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.18
|
| Rate for Payer: UHC Medicare Advantage |
$21.82
|
| Rate for Payer: VA VA |
$21.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.56
|
|
|
HC SUSCEPTIBILITY DISK
|
Facility
|
IP
|
$57.50
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
30600098
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.07 |
| Max. Negotiated Rate |
$51.75 |
| Rate for Payer: Aetna Commercial |
$48.88
|
| Rate for Payer: BCBS Trust/PPO |
$44.44
|
| Rate for Payer: BCN Commercial |
$44.44
|
| Rate for Payer: Cash Price |
$46.00
|
| Rate for Payer: Cofinity Commercial |
$49.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.00
|
| Rate for Payer: Healthscope Commercial |
$51.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.88
|
| Rate for Payer: PHP Commercial |
$48.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.60
|
| Rate for Payer: UHC Core |
$48.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.12
|
|
|
HC SUSCEPTIBILITY DISK
|
Facility
|
OP
|
$57.50
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
30600098
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$51.75 |
| Rate for Payer: Aetna Commercial |
$48.88
|
| Rate for Payer: Aetna Medicare |
$14.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.97
|
| Rate for Payer: BCBS Complete |
$5.80
|
| Rate for Payer: BCBS MAPPO |
$14.38
|
| Rate for Payer: BCBS Trust/PPO |
$44.71
|
| Rate for Payer: BCN Commercial |
$44.71
|
| Rate for Payer: BCN Medicare Advantage |
$14.38
|
| Rate for Payer: Cash Price |
$46.00
|
| Rate for Payer: Cash Price |
$46.00
|
| Rate for Payer: Cofinity Commercial |
$49.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.38
|
| Rate for Payer: Healthscope Commercial |
$51.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.12
|
| Rate for Payer: Mclaren Medicaid |
$5.52
|
| Rate for Payer: Meridian Medicaid |
$5.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.88
|
| Rate for Payer: PACE Senior Care Partners |
$13.66
|
| Rate for Payer: PACE SWMI |
$14.38
|
| Rate for Payer: PHP Commercial |
$48.88
|
| Rate for Payer: PHP Medicare Advantage |
$14.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.02
|
| Rate for Payer: Priority Health Medicare |
$14.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.07
|
| Rate for Payer: Railroad Medicare Medicare |
$14.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.60
|
| Rate for Payer: UHC Core |
$48.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.38
|
| Rate for Payer: UHC Medicare Advantage |
$14.81
|
| Rate for Payer: VA VA |
$14.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.12
|
|
|
HC SUSCEPTIBILITY E TEST
|
Facility
|
IP
|
$32.13
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
30600097
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$28.92 |
| Rate for Payer: Aetna Commercial |
$27.31
|
| Rate for Payer: BCBS Trust/PPO |
$24.83
|
| Rate for Payer: BCN Commercial |
$24.83
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$27.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.70
|
| Rate for Payer: Healthscope Commercial |
$28.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.31
|
| Rate for Payer: PHP Commercial |
$27.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.27
|
| Rate for Payer: UHC Core |
$26.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.10
|
|
|
HC SUSCEPTIBILITY E TEST
|
Facility
|
OP
|
$32.13
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
30600097
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.51 |
| Max. Negotiated Rate |
$28.92 |
| Rate for Payer: Aetna Commercial |
$27.31
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.04
|
| Rate for Payer: BCBS Complete |
$3.68
|
| Rate for Payer: BCBS MAPPO |
$8.03
|
| Rate for Payer: BCBS Trust/PPO |
$24.98
|
| Rate for Payer: BCN Commercial |
$24.98
|
| Rate for Payer: BCN Medicare Advantage |
$8.03
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$27.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.03
|
| Rate for Payer: Healthscope Commercial |
$28.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.10
|
| Rate for Payer: Mclaren Medicaid |
$3.51
|
| Rate for Payer: Meridian Medicaid |
$3.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.31
|
| Rate for Payer: PACE Senior Care Partners |
$7.63
|
| Rate for Payer: PACE SWMI |
$8.03
|
| Rate for Payer: PHP Commercial |
$27.31
|
| Rate for Payer: PHP Medicare Advantage |
$8.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$8.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.60
|
| Rate for Payer: Railroad Medicare Medicare |
$8.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.27
|
| Rate for Payer: UHC Core |
$26.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.03
|
| Rate for Payer: UHC Medicare Advantage |
$8.27
|
| Rate for Payer: VA VA |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.10
|
|
|
HC SUSCEPTIBILITY, MIC
|
Facility
|
OP
|
$79.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600100
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.38 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$67.15
|
| Rate for Payer: Aetna Medicare |
$20.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.69
|
| Rate for Payer: BCBS Complete |
$6.70
|
| Rate for Payer: BCBS MAPPO |
$19.75
|
| Rate for Payer: BCBS Trust/PPO |
$61.42
|
| Rate for Payer: BCN Commercial |
$61.42
|
| Rate for Payer: BCN Medicare Advantage |
$19.75
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$67.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.75
|
| Rate for Payer: Healthscope Commercial |
$71.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.25
|
| Rate for Payer: Mclaren Medicaid |
$6.38
|
| Rate for Payer: Meridian Medicaid |
$6.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PACE Senior Care Partners |
$18.76
|
| Rate for Payer: PACE SWMI |
$19.75
|
| Rate for Payer: PHP Commercial |
$67.15
|
| Rate for Payer: PHP Medicare Advantage |
$19.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.73
|
| Rate for Payer: Priority Health Medicare |
$19.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.18
|
| Rate for Payer: Railroad Medicare Medicare |
$19.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.52
|
| Rate for Payer: UHC Core |
$65.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.75
|
| Rate for Payer: UHC Medicare Advantage |
$20.34
|
| Rate for Payer: VA VA |
$19.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.25
|
|
|
HC SUSCEPTIBILITY, MIC
|
Facility
|
IP
|
$79.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600100
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$48.18 |
| Max. Negotiated Rate |
$71.10 |
| Rate for Payer: Aetna Commercial |
$67.15
|
| Rate for Payer: BCBS Trust/PPO |
$61.05
|
| Rate for Payer: BCN Commercial |
$61.05
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$67.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.20
|
| Rate for Payer: Healthscope Commercial |
$71.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$67.15
|
| Rate for Payer: PHP Commercial |
$67.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.52
|
| Rate for Payer: UHC Core |
$65.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.25
|
|
|
HC SUTURE REMOVAL UNDER ANESTHESIA
|
Facility
|
IP
|
$768.07
|
|
| Hospital Charge Code |
36100544
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$468.45 |
| Max. Negotiated Rate |
$691.26 |
| Rate for Payer: Aetna Commercial |
$652.86
|
| Rate for Payer: BCBS Trust/PPO |
$593.56
|
| Rate for Payer: BCN Commercial |
$593.56
|
| Rate for Payer: Cash Price |
$614.46
|
| Rate for Payer: Cofinity Commercial |
$660.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.46
|
| Rate for Payer: Healthscope Commercial |
$691.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$576.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$652.86
|
| Rate for Payer: PHP Commercial |
$652.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$668.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$468.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$675.90
|
| Rate for Payer: UHC Core |
$641.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$576.05
|
|
|
HC SUTURE REMOVAL UNDER ANESTHESIA
|
Facility
|
OP
|
$768.07
|
|
| Hospital Charge Code |
36100544
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$182.42 |
| Max. Negotiated Rate |
$691.26 |
| Rate for Payer: Aetna Commercial |
$652.86
|
| Rate for Payer: Aetna Medicare |
$199.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$240.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$240.02
|
| Rate for Payer: BCBS Complete |
$307.23
|
| Rate for Payer: BCBS MAPPO |
$192.02
|
| Rate for Payer: BCBS Trust/PPO |
$597.17
|
| Rate for Payer: BCN Commercial |
$597.17
|
| Rate for Payer: BCN Medicare Advantage |
$192.02
|
| Rate for Payer: Cash Price |
$614.46
|
| Rate for Payer: Cofinity Commercial |
$660.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.02
|
| Rate for Payer: Healthscope Commercial |
$691.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$576.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$201.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$220.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$652.86
|
| Rate for Payer: PACE Senior Care Partners |
$182.42
|
| Rate for Payer: PACE SWMI |
$192.02
|
| Rate for Payer: PHP Commercial |
$652.86
|
| Rate for Payer: PHP Medicare Advantage |
$192.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$668.22
|
| Rate for Payer: Priority Health Medicare |
$192.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$468.45
|
| Rate for Payer: Railroad Medicare Medicare |
$192.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$675.90
|
| Rate for Payer: UHC Core |
$641.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.02
|
| Rate for Payer: UHC Medicare Advantage |
$197.78
|
| Rate for Payer: VA VA |
$192.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$576.05
|
|
|
HC SWALLOW EVALUATION
|
Facility
|
OP
|
$326.81
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
44400004
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$77.62 |
| Max. Negotiated Rate |
$294.13 |
| Rate for Payer: Aetna Commercial |
$277.79
|
| Rate for Payer: Aetna Medicare |
$84.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.13
|
| Rate for Payer: BCBS Complete |
$130.72
|
| Rate for Payer: BCBS MAPPO |
$81.70
|
| Rate for Payer: BCBS Trust/PPO |
$254.09
|
| Rate for Payer: BCN Commercial |
$254.09
|
| Rate for Payer: BCN Medicare Advantage |
$81.70
|
| Rate for Payer: Cash Price |
$261.45
|
| Rate for Payer: Cofinity Commercial |
$281.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.70
|
| Rate for Payer: Healthscope Commercial |
$294.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$245.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$85.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$277.79
|
| Rate for Payer: PACE Senior Care Partners |
$77.62
|
| Rate for Payer: PACE SWMI |
$81.70
|
| Rate for Payer: PHP Commercial |
$277.79
|
| Rate for Payer: PHP Medicare Advantage |
$81.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$284.32
|
| Rate for Payer: Priority Health Medicare |
$81.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.32
|
| Rate for Payer: Railroad Medicare Medicare |
$81.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.59
|
| Rate for Payer: UHC Core |
$272.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.70
|
| Rate for Payer: UHC Medicare Advantage |
$84.15
|
| Rate for Payer: VA VA |
$81.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$245.11
|
|
|
HC SWALLOW EVALUATION
|
Facility
|
IP
|
$326.81
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
44400004
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$199.32 |
| Max. Negotiated Rate |
$294.13 |
| Rate for Payer: Aetna Commercial |
$277.79
|
| Rate for Payer: BCBS Trust/PPO |
$252.56
|
| Rate for Payer: BCN Commercial |
$252.56
|
| Rate for Payer: Cash Price |
$261.45
|
| Rate for Payer: Cofinity Commercial |
$281.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.45
|
| Rate for Payer: Healthscope Commercial |
$294.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$245.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$277.79
|
| Rate for Payer: PHP Commercial |
$277.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$284.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.59
|
| Rate for Payer: UHC Core |
$272.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$245.11
|
|
|
HC SWALLOWING THERAPY
|
Facility
|
IP
|
$214.20
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
43000020
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$130.64 |
| Max. Negotiated Rate |
$192.78 |
| Rate for Payer: Aetna Commercial |
$182.07
|
| Rate for Payer: BCBS Trust/PPO |
$165.53
|
| Rate for Payer: BCN Commercial |
$165.53
|
| Rate for Payer: Cash Price |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$184.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.36
|
| Rate for Payer: Healthscope Commercial |
$192.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.07
|
| Rate for Payer: PHP Commercial |
$182.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.50
|
| Rate for Payer: UHC Core |
$178.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.65
|
|
|
HC SWALLOWING THERAPY
|
Facility
|
OP
|
$214.20
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
43000020
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$50.87 |
| Max. Negotiated Rate |
$192.78 |
| Rate for Payer: Aetna Commercial |
$182.07
|
| Rate for Payer: Aetna Medicare |
$55.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.94
|
| Rate for Payer: BCBS Complete |
$85.68
|
| Rate for Payer: BCBS MAPPO |
$53.55
|
| Rate for Payer: BCBS Trust/PPO |
$166.54
|
| Rate for Payer: BCN Commercial |
$166.54
|
| Rate for Payer: BCN Medicare Advantage |
$53.55
|
| Rate for Payer: Cash Price |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$184.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.55
|
| Rate for Payer: Healthscope Commercial |
$192.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$56.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$182.07
|
| Rate for Payer: PACE Senior Care Partners |
$50.87
|
| Rate for Payer: PACE SWMI |
$53.55
|
| Rate for Payer: PHP Commercial |
$182.07
|
| Rate for Payer: PHP Medicare Advantage |
$53.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.35
|
| Rate for Payer: Priority Health Medicare |
$53.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.64
|
| Rate for Payer: Railroad Medicare Medicare |
$53.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.50
|
| Rate for Payer: UHC Core |
$178.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.55
|
| Rate for Payer: UHC Medicare Advantage |
$55.16
|
| Rate for Payer: VA VA |
$53.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.65
|
|
|
HC SWAN GANZ CATHETER
|
Facility
|
OP
|
$230.85
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200073
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.83 |
| Max. Negotiated Rate |
$207.76 |
| Rate for Payer: Aetna Commercial |
$196.22
|
| Rate for Payer: Aetna Medicare |
$60.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.14
|
| Rate for Payer: BCBS Complete |
$92.34
|
| Rate for Payer: BCBS MAPPO |
$57.71
|
| Rate for Payer: BCBS Trust/PPO |
$179.49
|
| Rate for Payer: BCN Commercial |
$179.49
|
| Rate for Payer: BCN Medicare Advantage |
$57.71
|
| Rate for Payer: Cash Price |
$184.68
|
| Rate for Payer: Cofinity Commercial |
$198.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.71
|
| Rate for Payer: Healthscope Commercial |
$207.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$60.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$196.22
|
| Rate for Payer: PACE Senior Care Partners |
$54.83
|
| Rate for Payer: PACE SWMI |
$57.71
|
| Rate for Payer: PHP Commercial |
$196.22
|
| Rate for Payer: PHP Medicare Advantage |
$57.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.84
|
| Rate for Payer: Priority Health Medicare |
$57.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.80
|
| Rate for Payer: Railroad Medicare Medicare |
$57.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.15
|
| Rate for Payer: UHC Core |
$192.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.71
|
| Rate for Payer: UHC Medicare Advantage |
$59.44
|
| Rate for Payer: VA VA |
$57.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.14
|
|
|
HC SWAN GANZ CATHETER
|
Facility
|
IP
|
$230.85
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200073
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$140.80 |
| Max. Negotiated Rate |
$207.76 |
| Rate for Payer: Aetna Commercial |
$196.22
|
| Rate for Payer: BCBS Trust/PPO |
$178.40
|
| Rate for Payer: BCN Commercial |
$178.40
|
| Rate for Payer: Cash Price |
$184.68
|
| Rate for Payer: Cofinity Commercial |
$198.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.68
|
| Rate for Payer: Healthscope Commercial |
$207.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$196.22
|
| Rate for Payer: PHP Commercial |
$196.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.15
|
| Rate for Payer: UHC Core |
$192.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.14
|
|
|
HC SWAN GANZ PLACEMENT
|
Facility
|
OP
|
$1,612.62
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
48100024
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$383.00 |
| Max. Negotiated Rate |
$1,451.36 |
| Rate for Payer: Aetna Commercial |
$1,370.73
|
| Rate for Payer: Aetna Medicare |
$419.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$503.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$503.94
|
| Rate for Payer: BCBS Complete |
$1,103.12
|
| Rate for Payer: BCBS MAPPO |
$403.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,253.81
|
| Rate for Payer: BCN Commercial |
$1,253.81
|
| Rate for Payer: BCN Medicare Advantage |
$403.16
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cofinity Commercial |
$1,386.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,290.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.16
|
| Rate for Payer: Healthscope Commercial |
$1,451.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,209.46
|
| Rate for Payer: Mclaren Medicaid |
$1,050.59
|
| Rate for Payer: Meridian Medicaid |
$1,103.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$423.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$463.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,370.73
|
| Rate for Payer: PACE Senior Care Partners |
$383.00
|
| Rate for Payer: PACE SWMI |
$403.16
|
| Rate for Payer: PHP Commercial |
$1,370.73
|
| Rate for Payer: PHP Medicare Advantage |
$403.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,050.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,128.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,402.98
|
| Rate for Payer: Priority Health Medicare |
$403.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$983.54
|
| Rate for Payer: Railroad Medicare Medicare |
$403.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,419.11
|
| Rate for Payer: UHC Core |
$1,346.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$403.16
|
| Rate for Payer: UHC Medicare Advantage |
$415.25
|
| Rate for Payer: VA VA |
$403.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,209.46
|
|
|
HC SWAN GANZ PLACEMENT
|
Facility
|
IP
|
$1,612.62
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
48100024
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$983.54 |
| Max. Negotiated Rate |
$1,451.36 |
| Rate for Payer: Aetna Commercial |
$1,370.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,246.23
|
| Rate for Payer: BCN Commercial |
$1,246.23
|
| Rate for Payer: Cash Price |
$1,290.10
|
| Rate for Payer: Cofinity Commercial |
$1,386.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,290.10
|
| Rate for Payer: Healthscope Commercial |
$1,451.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,209.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,370.73
|
| Rate for Payer: PHP Commercial |
$1,370.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,128.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,402.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$983.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,419.11
|
| Rate for Payer: UHC Core |
$1,346.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,209.46
|
|
|
HC SWEAT CHLORIDE
|
Facility
|
OP
|
$77.70
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100154
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.69 |
| Max. Negotiated Rate |
$69.93 |
| Rate for Payer: Aetna Commercial |
$66.04
|
| Rate for Payer: Aetna Medicare |
$20.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.28
|
| Rate for Payer: BCBS Complete |
$3.87
|
| Rate for Payer: BCBS MAPPO |
$19.42
|
| Rate for Payer: BCBS Trust/PPO |
$60.41
|
| Rate for Payer: BCN Commercial |
$60.41
|
| Rate for Payer: BCN Medicare Advantage |
$19.42
|
| Rate for Payer: Cash Price |
$62.16
|
| Rate for Payer: Cash Price |
$62.16
|
| Rate for Payer: Cofinity Commercial |
$66.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.42
|
| Rate for Payer: Healthscope Commercial |
$69.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.28
|
| Rate for Payer: Mclaren Medicaid |
$3.69
|
| Rate for Payer: Meridian Medicaid |
$3.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$66.04
|
| Rate for Payer: PACE Senior Care Partners |
$18.45
|
| Rate for Payer: PACE SWMI |
$19.42
|
| Rate for Payer: PHP Commercial |
$66.04
|
| Rate for Payer: PHP Medicare Advantage |
$19.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.60
|
| Rate for Payer: Priority Health Medicare |
$19.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.39
|
| Rate for Payer: Railroad Medicare Medicare |
$19.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.38
|
| Rate for Payer: UHC Core |
$64.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.42
|
| Rate for Payer: UHC Medicare Advantage |
$20.01
|
| Rate for Payer: VA VA |
$19.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.28
|
|
|
HC SWEAT CHLORIDE
|
Facility
|
IP
|
$77.70
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100154
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.39 |
| Max. Negotiated Rate |
$69.93 |
| Rate for Payer: Aetna Commercial |
$66.04
|
| Rate for Payer: BCBS Trust/PPO |
$60.05
|
| Rate for Payer: BCN Commercial |
$60.05
|
| Rate for Payer: Cash Price |
$62.16
|
| Rate for Payer: Cofinity Commercial |
$66.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.16
|
| Rate for Payer: Healthscope Commercial |
$69.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$66.04
|
| Rate for Payer: PHP Commercial |
$66.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.38
|
| Rate for Payer: UHC Core |
$64.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.28
|
|
|
HC SWEAT COLLECTION
|
Facility
|
IP
|
$97.20
|
|
|
Service Code
|
CPT 89230
|
| Hospital Charge Code |
30000004
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$59.28 |
| Max. Negotiated Rate |
$87.48 |
| Rate for Payer: Aetna Commercial |
$82.62
|
| Rate for Payer: BCBS Trust/PPO |
$75.12
|
| Rate for Payer: BCN Commercial |
$75.12
|
| Rate for Payer: Cash Price |
$77.76
|
| Rate for Payer: Cofinity Commercial |
$83.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.76
|
| Rate for Payer: Healthscope Commercial |
$87.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.62
|
| Rate for Payer: PHP Commercial |
$82.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.54
|
| Rate for Payer: UHC Core |
$81.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.90
|
|
|
HC SWEAT COLLECTION
|
Facility
|
OP
|
$97.20
|
|
|
Service Code
|
CPT 89230
|
| Hospital Charge Code |
30000004
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.08 |
| Max. Negotiated Rate |
$87.48 |
| Rate for Payer: Aetna Commercial |
$82.62
|
| Rate for Payer: Aetna Medicare |
$25.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.38
|
| Rate for Payer: BCBS Complete |
$37.33
|
| Rate for Payer: BCBS MAPPO |
$24.30
|
| Rate for Payer: BCBS Trust/PPO |
$75.57
|
| Rate for Payer: BCN Commercial |
$75.57
|
| Rate for Payer: BCN Medicare Advantage |
$24.30
|
| Rate for Payer: Cash Price |
$77.76
|
| Rate for Payer: Cash Price |
$77.76
|
| Rate for Payer: Cofinity Commercial |
$83.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.30
|
| Rate for Payer: Healthscope Commercial |
$87.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.90
|
| Rate for Payer: Mclaren Medicaid |
$35.55
|
| Rate for Payer: Meridian Medicaid |
$37.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.62
|
| Rate for Payer: PACE Senior Care Partners |
$23.08
|
| Rate for Payer: PACE SWMI |
$24.30
|
| Rate for Payer: PHP Commercial |
$82.62
|
| Rate for Payer: PHP Medicare Advantage |
$24.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.56
|
| Rate for Payer: Priority Health Medicare |
$24.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.28
|
| Rate for Payer: Railroad Medicare Medicare |
$24.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.54
|
| Rate for Payer: UHC Core |
$81.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.30
|
| Rate for Payer: UHC Medicare Advantage |
$25.03
|
| Rate for Payer: VA VA |
$24.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.90
|
|
|
HC SWEET VERNAL IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200103
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC SWEET VERNAL IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200103
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC SYCAMORE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200104
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
