|
HC THIN PREP PAP SCREENING
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
HCPCS G0123
|
| Hospital Charge Code |
31100028
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$14.95 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$15.70
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$59.48
|
| Rate for Payer: BCCCP Commercial |
$20.26
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$14.95
|
| Rate for Payer: Meridian Medicaid |
$15.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.66
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.70
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC THIN PREP PAP SCREENING AUTO
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
HCPCS G0145
|
| Hospital Charge Code |
31100032
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$46.66 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: BCBS Trust/PPO |
$59.12
|
| Rate for Payer: BCN Commercial |
$59.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC THIN PREP PAP SCREENING AUTO
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
HCPCS G0145
|
| Hospital Charge Code |
31100032
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$18.17 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$20.53
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$59.48
|
| Rate for Payer: BCCCP Commercial |
$26.49
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$19.55
|
| Rate for Payer: Meridian Medicaid |
$20.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.66
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.70
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC THIOPURINE METABOLITES
|
Facility
|
OP
|
$290.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100719
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.76 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Aetna Commercial |
$246.50
|
| Rate for Payer: Aetna Medicare |
$75.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90.62
|
| Rate for Payer: BCBS Complete |
$14.44
|
| Rate for Payer: BCBS MAPPO |
$72.50
|
| Rate for Payer: BCBS Trust/PPO |
$225.48
|
| Rate for Payer: BCN Commercial |
$225.48
|
| Rate for Payer: BCN Medicare Advantage |
$72.50
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$249.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.50
|
| Rate for Payer: Healthscope Commercial |
$261.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.50
|
| Rate for Payer: Mclaren Medicaid |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$14.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$76.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$246.50
|
| Rate for Payer: PACE Senior Care Partners |
$68.88
|
| Rate for Payer: PACE SWMI |
$72.50
|
| Rate for Payer: PHP Commercial |
$246.50
|
| Rate for Payer: PHP Medicare Advantage |
$72.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$252.30
|
| Rate for Payer: Priority Health Medicare |
$72.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.87
|
| Rate for Payer: Railroad Medicare Medicare |
$72.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.20
|
| Rate for Payer: UHC Core |
$242.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.50
|
| Rate for Payer: UHC Medicare Advantage |
$74.68
|
| Rate for Payer: VA VA |
$72.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.50
|
|
|
HC THIOPURINE METABOLITES
|
Facility
|
IP
|
$290.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100719
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$176.87 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Aetna Commercial |
$246.50
|
| Rate for Payer: BCBS Trust/PPO |
$224.11
|
| Rate for Payer: BCN Commercial |
$224.11
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$249.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.00
|
| Rate for Payer: Healthscope Commercial |
$261.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$246.50
|
| Rate for Payer: PHP Commercial |
$246.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$252.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.20
|
| Rate for Payer: UHC Core |
$242.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.50
|
|
|
HC THIOPURINE METHYLTRANSFERASE RBC
|
Facility
|
IP
|
$324.00
|
|
|
Service Code
|
CPT 82657
|
| Hospital Charge Code |
30100621
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$197.61 |
| Max. Negotiated Rate |
$291.60 |
| Rate for Payer: Aetna Commercial |
$275.40
|
| Rate for Payer: BCBS Trust/PPO |
$250.39
|
| Rate for Payer: BCN Commercial |
$250.39
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cofinity Commercial |
$278.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.20
|
| Rate for Payer: Healthscope Commercial |
$291.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$275.40
|
| Rate for Payer: PHP Commercial |
$275.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$281.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.12
|
| Rate for Payer: UHC Core |
$270.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.00
|
|
|
HC THIOPURINE METHYLTRANSFERASE RBC
|
Facility
|
OP
|
$324.00
|
|
|
Service Code
|
CPT 82657
|
| Hospital Charge Code |
30100621
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.36 |
| Max. Negotiated Rate |
$291.60 |
| Rate for Payer: Aetna Commercial |
$275.40
|
| Rate for Payer: Aetna Medicare |
$84.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$101.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$101.25
|
| Rate for Payer: BCBS Complete |
$17.18
|
| Rate for Payer: BCBS MAPPO |
$81.00
|
| Rate for Payer: BCBS Trust/PPO |
$251.91
|
| Rate for Payer: BCN Commercial |
$251.91
|
| Rate for Payer: BCN Medicare Advantage |
$81.00
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cash Price |
$259.20
|
| Rate for Payer: Cofinity Commercial |
$278.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.00
|
| Rate for Payer: Healthscope Commercial |
$291.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.00
|
| Rate for Payer: Mclaren Medicaid |
$16.36
|
| Rate for Payer: Meridian Medicaid |
$17.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$85.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$275.40
|
| Rate for Payer: PACE Senior Care Partners |
$76.95
|
| Rate for Payer: PACE SWMI |
$81.00
|
| Rate for Payer: PHP Commercial |
$275.40
|
| Rate for Payer: PHP Medicare Advantage |
$81.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$281.88
|
| Rate for Payer: Priority Health Medicare |
$81.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.61
|
| Rate for Payer: Railroad Medicare Medicare |
$81.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.12
|
| Rate for Payer: UHC Core |
$270.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.00
|
| Rate for Payer: UHC Medicare Advantage |
$83.43
|
| Rate for Payer: VA VA |
$81.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.00
|
|
|
HC THIOPURINE METHYLTRANSFERASE T
|
Facility
|
OP
|
$140.00
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100290
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.78 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Aetna Commercial |
$119.00
|
| Rate for Payer: Aetna Medicare |
$36.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.75
|
| Rate for Payer: BCBS Complete |
$18.67
|
| Rate for Payer: BCBS MAPPO |
$35.00
|
| Rate for Payer: BCBS Trust/PPO |
$108.85
|
| Rate for Payer: BCN Commercial |
$108.85
|
| Rate for Payer: BCN Medicare Advantage |
$35.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$120.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.00
|
| Rate for Payer: Healthscope Commercial |
$126.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.00
|
| Rate for Payer: Mclaren Medicaid |
$17.78
|
| Rate for Payer: Meridian Medicaid |
$18.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.00
|
| Rate for Payer: PACE Senior Care Partners |
$33.25
|
| Rate for Payer: PACE SWMI |
$35.00
|
| Rate for Payer: PHP Commercial |
$119.00
|
| Rate for Payer: PHP Medicare Advantage |
$35.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.80
|
| Rate for Payer: Priority Health Medicare |
$35.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.39
|
| Rate for Payer: Railroad Medicare Medicare |
$35.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.20
|
| Rate for Payer: UHC Core |
$116.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.00
|
| Rate for Payer: UHC Medicare Advantage |
$36.05
|
| Rate for Payer: VA VA |
$35.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.00
|
|
|
HC THIOPURINE METHYLTRANSFERASE T
|
Facility
|
IP
|
$140.00
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100290
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$85.39 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Aetna Commercial |
$119.00
|
| Rate for Payer: BCBS Trust/PPO |
$108.19
|
| Rate for Payer: BCN Commercial |
$108.19
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$120.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.00
|
| Rate for Payer: Healthscope Commercial |
$126.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.00
|
| Rate for Payer: PHP Commercial |
$119.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.20
|
| Rate for Payer: UHC Core |
$116.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.00
|
|
|
HC THIRD STEP GEL 8 OZ
|
Facility
|
IP
|
$68.42
|
|
| Hospital Charge Code |
27100018
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$41.73 |
| Max. Negotiated Rate |
$61.58 |
| Rate for Payer: Aetna Commercial |
$58.16
|
| Rate for Payer: BCBS Trust/PPO |
$52.87
|
| Rate for Payer: BCN Commercial |
$52.87
|
| Rate for Payer: Cash Price |
$54.74
|
| Rate for Payer: Cofinity Commercial |
$58.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.74
|
| Rate for Payer: Healthscope Commercial |
$61.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.16
|
| Rate for Payer: PHP Commercial |
$58.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.21
|
| Rate for Payer: UHC Core |
$57.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.32
|
|
|
HC THIRD STEP GEL 8 OZ
|
Facility
|
OP
|
$68.42
|
|
| Hospital Charge Code |
27100018
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.25 |
| Max. Negotiated Rate |
$61.58 |
| Rate for Payer: Aetna Commercial |
$58.16
|
| Rate for Payer: Aetna Medicare |
$17.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.38
|
| Rate for Payer: BCBS Complete |
$27.37
|
| Rate for Payer: BCBS MAPPO |
$17.10
|
| Rate for Payer: BCBS Trust/PPO |
$53.20
|
| Rate for Payer: BCN Commercial |
$53.20
|
| Rate for Payer: BCN Medicare Advantage |
$17.10
|
| Rate for Payer: Cash Price |
$54.74
|
| Rate for Payer: Cofinity Commercial |
$58.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.10
|
| Rate for Payer: Healthscope Commercial |
$61.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.16
|
| Rate for Payer: PACE Senior Care Partners |
$16.25
|
| Rate for Payer: PACE SWMI |
$17.10
|
| Rate for Payer: PHP Commercial |
$58.16
|
| Rate for Payer: PHP Medicare Advantage |
$17.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.53
|
| Rate for Payer: Priority Health Medicare |
$17.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.73
|
| Rate for Payer: Railroad Medicare Medicare |
$17.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.21
|
| Rate for Payer: UHC Core |
$57.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.10
|
| Rate for Payer: UHC Medicare Advantage |
$17.62
|
| Rate for Payer: VA VA |
$17.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.32
|
|
|
HC THORACENTESIS/PARACENTESIS
|
Facility
|
OP
|
$831.27
|
|
| Hospital Charge Code |
45000054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$197.43 |
| Max. Negotiated Rate |
$748.14 |
| Rate for Payer: Aetna Commercial |
$706.58
|
| Rate for Payer: Aetna Medicare |
$216.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$259.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$259.77
|
| Rate for Payer: BCBS Complete |
$332.51
|
| Rate for Payer: BCBS MAPPO |
$207.82
|
| Rate for Payer: BCBS Trust/PPO |
$646.31
|
| Rate for Payer: BCN Commercial |
$646.31
|
| Rate for Payer: BCN Medicare Advantage |
$207.82
|
| Rate for Payer: Cash Price |
$665.02
|
| Rate for Payer: Cofinity Commercial |
$714.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$665.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.82
|
| Rate for Payer: Healthscope Commercial |
$748.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$623.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$218.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$238.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$706.58
|
| Rate for Payer: PACE Senior Care Partners |
$197.43
|
| Rate for Payer: PACE SWMI |
$207.82
|
| Rate for Payer: PHP Commercial |
$706.58
|
| Rate for Payer: PHP Medicare Advantage |
$207.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$581.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$723.20
|
| Rate for Payer: Priority Health Medicare |
$207.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$506.99
|
| Rate for Payer: Railroad Medicare Medicare |
$207.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$731.52
|
| Rate for Payer: UHC Core |
$694.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$207.82
|
| Rate for Payer: UHC Medicare Advantage |
$214.05
|
| Rate for Payer: VA VA |
$207.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$623.45
|
|
|
HC THORACENTESIS/PARACENTESIS
|
Facility
|
IP
|
$831.27
|
|
| Hospital Charge Code |
45000054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$506.99 |
| Max. Negotiated Rate |
$748.14 |
| Rate for Payer: Aetna Commercial |
$706.58
|
| Rate for Payer: BCBS Trust/PPO |
$642.41
|
| Rate for Payer: BCN Commercial |
$642.41
|
| Rate for Payer: Cash Price |
$665.02
|
| Rate for Payer: Cofinity Commercial |
$714.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$665.02
|
| Rate for Payer: Healthscope Commercial |
$748.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$623.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$706.58
|
| Rate for Payer: PHP Commercial |
$706.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$581.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$723.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$506.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$731.52
|
| Rate for Payer: UHC Core |
$694.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$623.45
|
|
|
HC THORACENT WO TUBE
|
Facility
|
OP
|
$1,088.19
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
36100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$258.45 |
| Max. Negotiated Rate |
$979.37 |
| Rate for Payer: Aetna Commercial |
$924.96
|
| Rate for Payer: Aetna Medicare |
$282.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$340.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$340.06
|
| Rate for Payer: BCBS Complete |
$432.70
|
| Rate for Payer: BCBS MAPPO |
$272.05
|
| Rate for Payer: BCBS Trust/PPO |
$846.07
|
| Rate for Payer: BCN Commercial |
$846.07
|
| Rate for Payer: BCN Medicare Advantage |
$272.05
|
| Rate for Payer: Cash Price |
$870.55
|
| Rate for Payer: Cash Price |
$870.55
|
| Rate for Payer: Cofinity Commercial |
$935.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$870.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$272.05
|
| Rate for Payer: Healthscope Commercial |
$979.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$816.14
|
| Rate for Payer: Mclaren Medicaid |
$412.10
|
| Rate for Payer: Meridian Medicaid |
$432.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$285.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$312.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$924.96
|
| Rate for Payer: PACE Senior Care Partners |
$258.45
|
| Rate for Payer: PACE SWMI |
$272.05
|
| Rate for Payer: PHP Commercial |
$924.96
|
| Rate for Payer: PHP Medicare Advantage |
$272.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$761.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$946.73
|
| Rate for Payer: Priority Health Medicare |
$272.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$663.69
|
| Rate for Payer: Railroad Medicare Medicare |
$272.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$957.61
|
| Rate for Payer: UHC Core |
$908.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$272.05
|
| Rate for Payer: UHC Medicare Advantage |
$280.21
|
| Rate for Payer: VA VA |
$272.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$816.14
|
|
|
HC THORACENT WO TUBE
|
Facility
|
IP
|
$1,088.19
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
36100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$663.69 |
| Max. Negotiated Rate |
$979.37 |
| Rate for Payer: Aetna Commercial |
$924.96
|
| Rate for Payer: BCBS Trust/PPO |
$840.95
|
| Rate for Payer: BCN Commercial |
$840.95
|
| Rate for Payer: Cash Price |
$870.55
|
| Rate for Payer: Cofinity Commercial |
$935.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$870.55
|
| Rate for Payer: Healthscope Commercial |
$979.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$816.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$924.96
|
| Rate for Payer: PHP Commercial |
$924.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$761.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$946.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$663.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$957.61
|
| Rate for Payer: UHC Core |
$908.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$816.14
|
|
|
HC THORACENT W TUBE
|
Facility
|
IP
|
$1,386.74
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
36100384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$845.77 |
| Max. Negotiated Rate |
$1,248.07 |
| Rate for Payer: Aetna Commercial |
$1,178.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,071.67
|
| Rate for Payer: BCN Commercial |
$1,071.67
|
| Rate for Payer: Cash Price |
$1,109.39
|
| Rate for Payer: Cofinity Commercial |
$1,192.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,109.39
|
| Rate for Payer: Healthscope Commercial |
$1,248.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,040.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,178.73
|
| Rate for Payer: PHP Commercial |
$1,178.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$970.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,206.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$845.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,220.33
|
| Rate for Payer: UHC Core |
$1,157.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,040.06
|
|
|
HC THORACENT W TUBE
|
Facility
|
OP
|
$1,386.74
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
36100384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$329.35 |
| Max. Negotiated Rate |
$1,248.07 |
| Rate for Payer: Aetna Commercial |
$1,178.73
|
| Rate for Payer: Aetna Medicare |
$360.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$433.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$433.36
|
| Rate for Payer: BCBS Complete |
$1,103.12
|
| Rate for Payer: BCBS MAPPO |
$346.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,078.19
|
| Rate for Payer: BCN Commercial |
$1,078.19
|
| Rate for Payer: BCN Medicare Advantage |
$346.68
|
| Rate for Payer: Cash Price |
$1,109.39
|
| Rate for Payer: Cash Price |
$1,109.39
|
| Rate for Payer: Cofinity Commercial |
$1,192.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,109.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.68
|
| Rate for Payer: Healthscope Commercial |
$1,248.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,040.06
|
| Rate for Payer: Mclaren Medicaid |
$1,050.59
|
| Rate for Payer: Meridian Medicaid |
$1,103.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$364.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$398.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,178.73
|
| Rate for Payer: PACE Senior Care Partners |
$329.35
|
| Rate for Payer: PACE SWMI |
$346.68
|
| Rate for Payer: PHP Commercial |
$1,178.73
|
| Rate for Payer: PHP Medicare Advantage |
$346.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,050.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$970.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,206.46
|
| Rate for Payer: Priority Health Medicare |
$346.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$845.77
|
| Rate for Payer: Railroad Medicare Medicare |
$346.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,220.33
|
| Rate for Payer: UHC Core |
$1,157.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.68
|
| Rate for Payer: UHC Medicare Advantage |
$357.09
|
| Rate for Payer: VA VA |
$346.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,040.06
|
|
|
HC THORACIC GAS/RAW
|
Facility
|
OP
|
$691.08
|
|
|
Service Code
|
CPT 94726
|
| Hospital Charge Code |
46000015
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$164.13 |
| Max. Negotiated Rate |
$621.97 |
| Rate for Payer: Aetna Commercial |
$587.42
|
| Rate for Payer: Aetna Medicare |
$179.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$215.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$215.96
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$172.77
|
| Rate for Payer: BCBS Trust/PPO |
$537.31
|
| Rate for Payer: BCN Commercial |
$537.31
|
| Rate for Payer: BCN Medicare Advantage |
$172.77
|
| Rate for Payer: Cash Price |
$552.86
|
| Rate for Payer: Cash Price |
$552.86
|
| Rate for Payer: Cofinity Commercial |
$594.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.77
|
| Rate for Payer: Healthscope Commercial |
$621.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.31
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$181.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.42
|
| Rate for Payer: PACE Senior Care Partners |
$164.13
|
| Rate for Payer: PACE SWMI |
$172.77
|
| Rate for Payer: PHP Commercial |
$587.42
|
| Rate for Payer: PHP Medicare Advantage |
$172.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$601.24
|
| Rate for Payer: Priority Health Medicare |
$172.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$421.49
|
| Rate for Payer: Railroad Medicare Medicare |
$172.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.15
|
| Rate for Payer: UHC Core |
$577.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.77
|
| Rate for Payer: UHC Medicare Advantage |
$177.95
|
| Rate for Payer: VA VA |
$172.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.31
|
|
|
HC THORACIC GAS/RAW
|
Facility
|
IP
|
$691.08
|
|
|
Service Code
|
CPT 94726
|
| Hospital Charge Code |
46000015
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$421.49 |
| Max. Negotiated Rate |
$621.97 |
| Rate for Payer: Aetna Commercial |
$587.42
|
| Rate for Payer: BCBS Trust/PPO |
$534.07
|
| Rate for Payer: BCN Commercial |
$534.07
|
| Rate for Payer: Cash Price |
$552.86
|
| Rate for Payer: Cofinity Commercial |
$594.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.86
|
| Rate for Payer: Healthscope Commercial |
$621.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.42
|
| Rate for Payer: PHP Commercial |
$587.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$601.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$421.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$608.15
|
| Rate for Payer: UHC Core |
$577.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.31
|
|
|
HC THORACOTOMY
|
Facility
|
IP
|
$2,050.86
|
|
| Hospital Charge Code |
27000156
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,250.82 |
| Max. Negotiated Rate |
$1,845.77 |
| Rate for Payer: Aetna Commercial |
$1,743.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,584.90
|
| Rate for Payer: BCN Commercial |
$1,584.90
|
| Rate for Payer: Cash Price |
$1,640.69
|
| Rate for Payer: Cofinity Commercial |
$1,763.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.69
|
| Rate for Payer: Healthscope Commercial |
$1,845.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,538.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,743.23
|
| Rate for Payer: PHP Commercial |
$1,743.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,435.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,784.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,250.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,804.76
|
| Rate for Payer: UHC Core |
$1,712.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,538.14
|
|
|
HC THORACOTOMY
|
Facility
|
OP
|
$2,050.86
|
|
| Hospital Charge Code |
27000156
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$487.08 |
| Max. Negotiated Rate |
$1,845.77 |
| Rate for Payer: Aetna Commercial |
$1,743.23
|
| Rate for Payer: Aetna Medicare |
$533.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$640.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$640.89
|
| Rate for Payer: BCBS Complete |
$820.34
|
| Rate for Payer: BCBS MAPPO |
$512.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,594.54
|
| Rate for Payer: BCN Commercial |
$1,594.54
|
| Rate for Payer: BCN Medicare Advantage |
$512.72
|
| Rate for Payer: Cash Price |
$1,640.69
|
| Rate for Payer: Cofinity Commercial |
$1,763.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$512.72
|
| Rate for Payer: Healthscope Commercial |
$1,845.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,538.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$538.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$589.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,743.23
|
| Rate for Payer: PACE Senior Care Partners |
$487.08
|
| Rate for Payer: PACE SWMI |
$512.72
|
| Rate for Payer: PHP Commercial |
$1,743.23
|
| Rate for Payer: PHP Medicare Advantage |
$512.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,435.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,784.25
|
| Rate for Payer: Priority Health Medicare |
$512.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,250.82
|
| Rate for Payer: Railroad Medicare Medicare |
$512.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,804.76
|
| Rate for Payer: UHC Core |
$1,712.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$512.72
|
| Rate for Payer: UHC Medicare Advantage |
$528.10
|
| Rate for Payer: VA VA |
$512.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,538.14
|
|
|
HC THROMBECTOMY MECH AND OR THROMBOLYSIS ARTERIAL INTRACRANIAL
|
Facility
|
OP
|
$4,870.71
|
|
|
Service Code
|
CPT 61645
|
| Hospital Charge Code |
36100513
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,156.79 |
| Max. Negotiated Rate |
$4,383.64 |
| Rate for Payer: Aetna Commercial |
$4,140.10
|
| Rate for Payer: Aetna Medicare |
$1,266.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,522.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,522.10
|
| Rate for Payer: BCBS Complete |
$1,948.28
|
| Rate for Payer: BCBS MAPPO |
$1,217.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,786.98
|
| Rate for Payer: BCN Commercial |
$3,786.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,217.68
|
| Rate for Payer: Cash Price |
$3,896.57
|
| Rate for Payer: Cofinity Commercial |
$4,188.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,896.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,217.68
|
| Rate for Payer: Healthscope Commercial |
$4,383.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,653.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,278.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,400.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,140.10
|
| Rate for Payer: PACE Senior Care Partners |
$1,156.79
|
| Rate for Payer: PACE SWMI |
$1,217.68
|
| Rate for Payer: PHP Commercial |
$4,140.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,217.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,409.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,237.52
|
| Rate for Payer: Priority Health Medicare |
$1,217.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,970.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,217.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,286.22
|
| Rate for Payer: UHC Core |
$4,067.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,217.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,254.21
|
| Rate for Payer: VA VA |
$1,217.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,653.03
|
|
|
HC THROMBECTOMY MECH AND OR THROMBOLYSIS ARTERIAL INTRACRANIAL
|
Facility
|
IP
|
$4,870.71
|
|
|
Service Code
|
CPT 61645
|
| Hospital Charge Code |
36100513
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,970.65 |
| Max. Negotiated Rate |
$4,383.64 |
| Rate for Payer: Aetna Commercial |
$4,140.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,764.08
|
| Rate for Payer: BCN Commercial |
$3,764.08
|
| Rate for Payer: Cash Price |
$3,896.57
|
| Rate for Payer: Cofinity Commercial |
$4,188.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,896.57
|
| Rate for Payer: Healthscope Commercial |
$4,383.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,653.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,140.10
|
| Rate for Payer: PHP Commercial |
$4,140.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,409.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,237.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,970.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,286.22
|
| Rate for Payer: UHC Core |
$4,067.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,653.03
|
|
|
HC THROMBIN TIME
|
Facility
|
OP
|
$74.46
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
30500062
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.26 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: Aetna Medicare |
$19.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.27
|
| Rate for Payer: BCBS Complete |
$4.47
|
| Rate for Payer: BCBS MAPPO |
$18.62
|
| Rate for Payer: BCBS Trust/PPO |
$57.89
|
| Rate for Payer: BCN Commercial |
$57.89
|
| Rate for Payer: BCN Medicare Advantage |
$18.62
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.62
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Mclaren Medicaid |
$4.26
|
| Rate for Payer: Meridian Medicaid |
$4.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.29
|
| Rate for Payer: PACE Senior Care Partners |
$17.68
|
| Rate for Payer: PACE SWMI |
$18.62
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: PHP Medicare Advantage |
$18.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.78
|
| Rate for Payer: Priority Health Medicare |
$18.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.41
|
| Rate for Payer: Railroad Medicare Medicare |
$18.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.52
|
| Rate for Payer: UHC Core |
$62.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.62
|
| Rate for Payer: UHC Medicare Advantage |
$19.17
|
| Rate for Payer: VA VA |
$18.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
HC THROMBIN TIME
|
Facility
|
IP
|
$74.46
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
30500062
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$45.41 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: BCBS Trust/PPO |
$57.54
|
| Rate for Payer: BCN Commercial |
$57.54
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.29
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.52
|
| Rate for Payer: UHC Core |
$62.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
