|
HC THYROGLOBULIN CMPT
|
Facility
|
OP
|
$59.06
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.74 |
| Max. Negotiated Rate |
$53.15 |
| Rate for Payer: Aetna Commercial |
$50.20
|
| Rate for Payer: Aetna Medicare |
$15.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.46
|
| Rate for Payer: BCBS Complete |
$12.33
|
| Rate for Payer: BCBS MAPPO |
$14.76
|
| Rate for Payer: BCBS Trust/PPO |
$45.92
|
| Rate for Payer: BCN Commercial |
$45.92
|
| Rate for Payer: BCN Medicare Advantage |
$14.76
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cofinity Commercial |
$50.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.76
|
| Rate for Payer: Healthscope Commercial |
$53.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.30
|
| Rate for Payer: Mclaren Medicaid |
$11.74
|
| Rate for Payer: Meridian Medicaid |
$12.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.20
|
| Rate for Payer: PACE Senior Care Partners |
$14.03
|
| Rate for Payer: PACE SWMI |
$14.76
|
| Rate for Payer: PHP Commercial |
$50.20
|
| Rate for Payer: PHP Medicare Advantage |
$14.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.38
|
| Rate for Payer: Priority Health Medicare |
$14.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.02
|
| Rate for Payer: Railroad Medicare Medicare |
$14.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.97
|
| Rate for Payer: UHC Core |
$49.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.76
|
| Rate for Payer: UHC Medicare Advantage |
$15.21
|
| Rate for Payer: VA VA |
$14.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.30
|
|
|
HC THYROID IMAGING W VASC FLOW
|
Facility
|
IP
|
$571.97
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
34100075
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$348.84 |
| Max. Negotiated Rate |
$514.77 |
| Rate for Payer: Aetna Commercial |
$486.17
|
| Rate for Payer: BCBS Trust/PPO |
$442.02
|
| Rate for Payer: BCN Commercial |
$442.02
|
| Rate for Payer: Cash Price |
$457.58
|
| Rate for Payer: Cofinity Commercial |
$491.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.58
|
| Rate for Payer: Healthscope Commercial |
$514.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.17
|
| Rate for Payer: PHP Commercial |
$486.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$497.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$503.33
|
| Rate for Payer: UHC Core |
$477.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.98
|
|
|
HC THYROID IMAGING W VASC FLOW
|
Facility
|
OP
|
$571.97
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
34100075
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$135.84 |
| Max. Negotiated Rate |
$514.77 |
| Rate for Payer: Aetna Commercial |
$486.17
|
| Rate for Payer: Aetna Medicare |
$148.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.74
|
| Rate for Payer: BCBS Complete |
$284.09
|
| Rate for Payer: BCBS MAPPO |
$142.99
|
| Rate for Payer: BCBS Trust/PPO |
$444.71
|
| Rate for Payer: BCN Commercial |
$444.71
|
| Rate for Payer: BCN Medicare Advantage |
$142.99
|
| Rate for Payer: Cash Price |
$457.58
|
| Rate for Payer: Cash Price |
$457.58
|
| Rate for Payer: Cofinity Commercial |
$491.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.99
|
| Rate for Payer: Healthscope Commercial |
$514.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.98
|
| Rate for Payer: Mclaren Medicaid |
$270.56
|
| Rate for Payer: Meridian Medicaid |
$284.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.17
|
| Rate for Payer: PACE Senior Care Partners |
$135.84
|
| Rate for Payer: PACE SWMI |
$142.99
|
| Rate for Payer: PHP Commercial |
$486.17
|
| Rate for Payer: PHP Medicare Advantage |
$142.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$497.61
|
| Rate for Payer: Priority Health Medicare |
$142.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$348.84
|
| Rate for Payer: Railroad Medicare Medicare |
$142.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$503.33
|
| Rate for Payer: UHC Core |
$477.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.99
|
| Rate for Payer: UHC Medicare Advantage |
$147.28
|
| Rate for Payer: VA VA |
$142.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.98
|
|
|
HC THYROID IMAG W VASC FLOW SNGL OR MULTI
|
Facility
|
OP
|
$1,201.61
|
|
|
Service Code
|
CPT 78014
|
| Hospital Charge Code |
34100076
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$270.56 |
| Max. Negotiated Rate |
$1,081.45 |
| Rate for Payer: Aetna Commercial |
$1,021.37
|
| Rate for Payer: Aetna Medicare |
$312.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$375.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$375.50
|
| Rate for Payer: BCBS Complete |
$284.09
|
| Rate for Payer: BCBS MAPPO |
$300.40
|
| Rate for Payer: BCBS Trust/PPO |
$934.25
|
| Rate for Payer: BCN Commercial |
$934.25
|
| Rate for Payer: BCN Medicare Advantage |
$300.40
|
| Rate for Payer: Cash Price |
$961.29
|
| Rate for Payer: Cash Price |
$961.29
|
| Rate for Payer: Cofinity Commercial |
$1,033.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$961.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.40
|
| Rate for Payer: Healthscope Commercial |
$1,081.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$901.21
|
| Rate for Payer: Mclaren Medicaid |
$270.56
|
| Rate for Payer: Meridian Medicaid |
$284.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$315.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$345.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,021.37
|
| Rate for Payer: PACE Senior Care Partners |
$285.38
|
| Rate for Payer: PACE SWMI |
$300.40
|
| Rate for Payer: PHP Commercial |
$1,021.37
|
| Rate for Payer: PHP Medicare Advantage |
$300.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$841.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,045.40
|
| Rate for Payer: Priority Health Medicare |
$300.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$732.86
|
| Rate for Payer: Railroad Medicare Medicare |
$300.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,057.42
|
| Rate for Payer: UHC Core |
$1,003.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$300.40
|
| Rate for Payer: UHC Medicare Advantage |
$309.41
|
| Rate for Payer: VA VA |
$300.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$901.21
|
|
|
HC THYROID IMAG W VASC FLOW SNGL OR MULTI
|
Facility
|
IP
|
$1,201.61
|
|
|
Service Code
|
CPT 78014
|
| Hospital Charge Code |
34100076
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$732.86 |
| Max. Negotiated Rate |
$1,081.45 |
| Rate for Payer: Aetna Commercial |
$1,021.37
|
| Rate for Payer: BCBS Trust/PPO |
$928.60
|
| Rate for Payer: BCN Commercial |
$928.60
|
| Rate for Payer: Cash Price |
$961.29
|
| Rate for Payer: Cofinity Commercial |
$1,033.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$961.29
|
| Rate for Payer: Healthscope Commercial |
$1,081.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$901.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,021.37
|
| Rate for Payer: PHP Commercial |
$1,021.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$841.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,045.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$732.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,057.42
|
| Rate for Payer: UHC Core |
$1,003.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$901.21
|
|
|
HC THYROID PEROXIDASE ANTIBODY
|
Facility
|
IP
|
$83.90
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200209
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$51.17 |
| Max. Negotiated Rate |
$75.51 |
| Rate for Payer: Aetna Commercial |
$71.32
|
| Rate for Payer: BCBS Trust/PPO |
$64.84
|
| Rate for Payer: BCN Commercial |
$64.84
|
| Rate for Payer: Cash Price |
$67.12
|
| Rate for Payer: Cofinity Commercial |
$72.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.12
|
| Rate for Payer: Healthscope Commercial |
$75.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.32
|
| Rate for Payer: PHP Commercial |
$71.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.83
|
| Rate for Payer: UHC Core |
$70.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.92
|
|
|
HC THYROID PEROXIDASE ANTIBODY
|
Facility
|
OP
|
$83.90
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200209
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.74 |
| Max. Negotiated Rate |
$75.51 |
| Rate for Payer: Aetna Commercial |
$71.32
|
| Rate for Payer: Aetna Medicare |
$21.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.22
|
| Rate for Payer: BCBS Complete |
$11.27
|
| Rate for Payer: BCBS MAPPO |
$20.98
|
| Rate for Payer: BCBS Trust/PPO |
$65.23
|
| Rate for Payer: BCN Commercial |
$65.23
|
| Rate for Payer: BCN Medicare Advantage |
$20.98
|
| Rate for Payer: Cash Price |
$67.12
|
| Rate for Payer: Cash Price |
$67.12
|
| Rate for Payer: Cofinity Commercial |
$72.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.98
|
| Rate for Payer: Healthscope Commercial |
$75.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.92
|
| Rate for Payer: Mclaren Medicaid |
$10.74
|
| Rate for Payer: Meridian Medicaid |
$11.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.32
|
| Rate for Payer: PACE Senior Care Partners |
$19.93
|
| Rate for Payer: PACE SWMI |
$20.98
|
| Rate for Payer: PHP Commercial |
$71.32
|
| Rate for Payer: PHP Medicare Advantage |
$20.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.99
|
| Rate for Payer: Priority Health Medicare |
$20.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.17
|
| Rate for Payer: Railroad Medicare Medicare |
$20.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.83
|
| Rate for Payer: UHC Core |
$70.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.98
|
| Rate for Payer: UHC Medicare Advantage |
$21.60
|
| Rate for Payer: VA VA |
$20.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.92
|
|
|
HC THYROID STIMULATING IMMUNOGLOB
|
Facility
|
IP
|
$83.95
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
30100439
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.20 |
| Max. Negotiated Rate |
$75.56 |
| Rate for Payer: Aetna Commercial |
$71.36
|
| Rate for Payer: BCBS Trust/PPO |
$64.88
|
| Rate for Payer: BCN Commercial |
$64.88
|
| Rate for Payer: Cash Price |
$67.16
|
| Rate for Payer: Cofinity Commercial |
$72.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.16
|
| Rate for Payer: Healthscope Commercial |
$75.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.36
|
| Rate for Payer: PHP Commercial |
$71.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.88
|
| Rate for Payer: UHC Core |
$70.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.96
|
|
|
HC THYROID STIMULATING IMMUNOGLOB
|
Facility
|
OP
|
$83.95
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
30100439
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.94 |
| Max. Negotiated Rate |
$75.56 |
| Rate for Payer: Aetna Commercial |
$71.36
|
| Rate for Payer: Aetna Medicare |
$21.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.23
|
| Rate for Payer: BCBS Complete |
$39.41
|
| Rate for Payer: BCBS MAPPO |
$20.99
|
| Rate for Payer: BCBS Trust/PPO |
$65.27
|
| Rate for Payer: BCN Commercial |
$65.27
|
| Rate for Payer: BCN Medicare Advantage |
$20.99
|
| Rate for Payer: Cash Price |
$67.16
|
| Rate for Payer: Cash Price |
$67.16
|
| Rate for Payer: Cofinity Commercial |
$72.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.99
|
| Rate for Payer: Healthscope Commercial |
$75.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.96
|
| Rate for Payer: Mclaren Medicaid |
$37.53
|
| Rate for Payer: Meridian Medicaid |
$39.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.36
|
| Rate for Payer: PACE Senior Care Partners |
$19.94
|
| Rate for Payer: PACE SWMI |
$20.99
|
| Rate for Payer: PHP Commercial |
$71.36
|
| Rate for Payer: PHP Medicare Advantage |
$20.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.04
|
| Rate for Payer: Priority Health Medicare |
$20.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.20
|
| Rate for Payer: Railroad Medicare Medicare |
$20.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.88
|
| Rate for Payer: UHC Core |
$70.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.99
|
| Rate for Payer: UHC Medicare Advantage |
$21.62
|
| Rate for Payer: VA VA |
$20.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.96
|
|
|
HC THYROID TC 99M PER STUDY
|
Facility
|
IP
|
$140.39
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300021
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$85.62 |
| Max. Negotiated Rate |
$126.35 |
| Rate for Payer: Aetna Commercial |
$119.33
|
| Rate for Payer: BCBS Trust/PPO |
$108.49
|
| Rate for Payer: BCN Commercial |
$108.49
|
| Rate for Payer: Cash Price |
$112.31
|
| Rate for Payer: Cofinity Commercial |
$120.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.31
|
| Rate for Payer: Healthscope Commercial |
$126.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.33
|
| Rate for Payer: PHP Commercial |
$119.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.54
|
| Rate for Payer: UHC Core |
$117.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.29
|
|
|
HC THYROID TC 99M PER STUDY
|
Facility
|
OP
|
$140.39
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300021
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$33.34 |
| Max. Negotiated Rate |
$126.35 |
| Rate for Payer: Aetna Commercial |
$119.33
|
| Rate for Payer: Aetna Medicare |
$36.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.87
|
| Rate for Payer: BCBS Complete |
$56.16
|
| Rate for Payer: BCBS MAPPO |
$35.10
|
| Rate for Payer: BCBS Trust/PPO |
$109.15
|
| Rate for Payer: BCN Commercial |
$109.15
|
| Rate for Payer: BCN Medicare Advantage |
$35.10
|
| Rate for Payer: Cash Price |
$112.31
|
| Rate for Payer: Cofinity Commercial |
$120.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.10
|
| Rate for Payer: Healthscope Commercial |
$126.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.33
|
| Rate for Payer: PACE Senior Care Partners |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.10
|
| Rate for Payer: PHP Commercial |
$119.33
|
| Rate for Payer: PHP Medicare Advantage |
$35.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.14
|
| Rate for Payer: Priority Health Medicare |
$35.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.62
|
| Rate for Payer: Railroad Medicare Medicare |
$35.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.54
|
| Rate for Payer: UHC Core |
$117.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.10
|
| Rate for Payer: UHC Medicare Advantage |
$36.15
|
| Rate for Payer: VA VA |
$35.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.29
|
|
|
HC THYROID UPTK SNGL OR MULTI DETER
|
Facility
|
OP
|
$1,035.91
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
34100074
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$246.03 |
| Max. Negotiated Rate |
$932.32 |
| Rate for Payer: Aetna Commercial |
$880.52
|
| Rate for Payer: Aetna Medicare |
$269.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.72
|
| Rate for Payer: BCBS Complete |
$284.09
|
| Rate for Payer: BCBS MAPPO |
$258.98
|
| Rate for Payer: BCBS Trust/PPO |
$805.42
|
| Rate for Payer: BCN Commercial |
$805.42
|
| Rate for Payer: BCN Medicare Advantage |
$258.98
|
| Rate for Payer: Cash Price |
$828.73
|
| Rate for Payer: Cash Price |
$828.73
|
| Rate for Payer: Cofinity Commercial |
$890.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$828.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.98
|
| Rate for Payer: Healthscope Commercial |
$932.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$776.93
|
| Rate for Payer: Mclaren Medicaid |
$270.56
|
| Rate for Payer: Meridian Medicaid |
$284.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$271.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$880.52
|
| Rate for Payer: PACE Senior Care Partners |
$246.03
|
| Rate for Payer: PACE SWMI |
$258.98
|
| Rate for Payer: PHP Commercial |
$880.52
|
| Rate for Payer: PHP Medicare Advantage |
$258.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$725.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$901.24
|
| Rate for Payer: Priority Health Medicare |
$258.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$631.80
|
| Rate for Payer: Railroad Medicare Medicare |
$258.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$911.60
|
| Rate for Payer: UHC Core |
$864.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$258.98
|
| Rate for Payer: UHC Medicare Advantage |
$266.75
|
| Rate for Payer: VA VA |
$258.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$776.93
|
|
|
HC THYROID UPTK SNGL OR MULTI DETER
|
Facility
|
IP
|
$1,035.91
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
34100074
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$631.80 |
| Max. Negotiated Rate |
$932.32 |
| Rate for Payer: Aetna Commercial |
$880.52
|
| Rate for Payer: BCBS Trust/PPO |
$800.55
|
| Rate for Payer: BCN Commercial |
$800.55
|
| Rate for Payer: Cash Price |
$828.73
|
| Rate for Payer: Cofinity Commercial |
$890.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$828.73
|
| Rate for Payer: Healthscope Commercial |
$932.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$776.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$880.52
|
| Rate for Payer: PHP Commercial |
$880.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$725.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$901.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$631.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$911.60
|
| Rate for Payer: UHC Core |
$864.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$776.93
|
|
|
HC THYROXINE BINDING GLOBULIN
|
Facility
|
IP
|
$65.10
|
|
|
Service Code
|
CPT 84442
|
| Hospital Charge Code |
30100437
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.70 |
| Max. Negotiated Rate |
$58.59 |
| Rate for Payer: Aetna Commercial |
$55.34
|
| Rate for Payer: BCBS Trust/PPO |
$50.31
|
| Rate for Payer: BCN Commercial |
$50.31
|
| Rate for Payer: Cash Price |
$52.08
|
| Rate for Payer: Cofinity Commercial |
$55.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.08
|
| Rate for Payer: Healthscope Commercial |
$58.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.34
|
| Rate for Payer: PHP Commercial |
$55.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.29
|
| Rate for Payer: UHC Core |
$54.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.82
|
|
|
HC THYROXINE BINDING GLOBULIN
|
Facility
|
OP
|
$65.10
|
|
|
Service Code
|
CPT 84442
|
| Hospital Charge Code |
30100437
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.91 |
| Max. Negotiated Rate |
$58.59 |
| Rate for Payer: Aetna Commercial |
$55.34
|
| Rate for Payer: Aetna Medicare |
$16.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.34
|
| Rate for Payer: BCBS Complete |
$11.45
|
| Rate for Payer: BCBS MAPPO |
$16.28
|
| Rate for Payer: BCBS Trust/PPO |
$50.62
|
| Rate for Payer: BCN Commercial |
$50.62
|
| Rate for Payer: BCN Medicare Advantage |
$16.28
|
| Rate for Payer: Cash Price |
$52.08
|
| Rate for Payer: Cash Price |
$52.08
|
| Rate for Payer: Cofinity Commercial |
$55.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.28
|
| Rate for Payer: Healthscope Commercial |
$58.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.82
|
| Rate for Payer: Mclaren Medicaid |
$10.91
|
| Rate for Payer: Meridian Medicaid |
$11.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.34
|
| Rate for Payer: PACE Senior Care Partners |
$15.46
|
| Rate for Payer: PACE SWMI |
$16.28
|
| Rate for Payer: PHP Commercial |
$55.34
|
| Rate for Payer: PHP Medicare Advantage |
$16.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.64
|
| Rate for Payer: Priority Health Medicare |
$16.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.70
|
| Rate for Payer: Railroad Medicare Medicare |
$16.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.29
|
| Rate for Payer: UHC Core |
$54.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.28
|
| Rate for Payer: UHC Medicare Advantage |
$16.76
|
| Rate for Payer: VA VA |
$16.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.82
|
|
|
HC THYROXINE FREE T4
|
Facility
|
IP
|
$113.00
|
|
|
Service Code
|
CPT 84439
|
| Hospital Charge Code |
30100436
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.92 |
| Max. Negotiated Rate |
$101.70 |
| Rate for Payer: Aetna Commercial |
$96.05
|
| Rate for Payer: BCBS Trust/PPO |
$87.33
|
| Rate for Payer: BCN Commercial |
$87.33
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cofinity Commercial |
$97.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.40
|
| Rate for Payer: Healthscope Commercial |
$101.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.05
|
| Rate for Payer: PHP Commercial |
$96.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.44
|
| Rate for Payer: UHC Core |
$94.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.75
|
|
|
HC THYROXINE FREE T4
|
Facility
|
OP
|
$113.00
|
|
|
Service Code
|
CPT 84439
|
| Hospital Charge Code |
30100436
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$101.70 |
| Rate for Payer: Aetna Commercial |
$96.05
|
| Rate for Payer: Aetna Medicare |
$29.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.31
|
| Rate for Payer: BCBS Complete |
$6.99
|
| Rate for Payer: BCBS MAPPO |
$28.25
|
| Rate for Payer: BCBS Trust/PPO |
$87.86
|
| Rate for Payer: BCN Commercial |
$87.86
|
| Rate for Payer: BCN Medicare Advantage |
$28.25
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cofinity Commercial |
$97.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.25
|
| Rate for Payer: Healthscope Commercial |
$101.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.75
|
| Rate for Payer: Mclaren Medicaid |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$6.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.05
|
| Rate for Payer: PACE Senior Care Partners |
$26.84
|
| Rate for Payer: PACE SWMI |
$28.25
|
| Rate for Payer: PHP Commercial |
$96.05
|
| Rate for Payer: PHP Medicare Advantage |
$28.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.31
|
| Rate for Payer: Priority Health Medicare |
$28.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.92
|
| Rate for Payer: Railroad Medicare Medicare |
$28.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.44
|
| Rate for Payer: UHC Core |
$94.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.25
|
| Rate for Payer: UHC Medicare Advantage |
$29.10
|
| Rate for Payer: VA VA |
$28.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.75
|
|
|
HC TIAGABINE LEVEL
|
Facility
|
IP
|
$113.66
|
|
|
Service Code
|
CPT 80199
|
| Hospital Charge Code |
30100058
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$69.32 |
| Max. Negotiated Rate |
$102.29 |
| Rate for Payer: Aetna Commercial |
$96.61
|
| Rate for Payer: BCBS Trust/PPO |
$87.84
|
| Rate for Payer: BCN Commercial |
$87.84
|
| Rate for Payer: Cash Price |
$90.93
|
| Rate for Payer: Cofinity Commercial |
$97.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.93
|
| Rate for Payer: Healthscope Commercial |
$102.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.61
|
| Rate for Payer: PHP Commercial |
$96.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.02
|
| Rate for Payer: UHC Core |
$94.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.24
|
|
|
HC TIAGABINE LEVEL
|
Facility
|
OP
|
$113.66
|
|
|
Service Code
|
CPT 80199
|
| Hospital Charge Code |
30100058
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.01 |
| Max. Negotiated Rate |
$102.29 |
| Rate for Payer: Aetna Commercial |
$96.61
|
| Rate for Payer: Aetna Medicare |
$29.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.52
|
| Rate for Payer: BCBS Complete |
$21.01
|
| Rate for Payer: BCBS MAPPO |
$28.42
|
| Rate for Payer: BCBS Trust/PPO |
$88.37
|
| Rate for Payer: BCN Commercial |
$88.37
|
| Rate for Payer: BCN Medicare Advantage |
$28.42
|
| Rate for Payer: Cash Price |
$90.93
|
| Rate for Payer: Cash Price |
$90.93
|
| Rate for Payer: Cofinity Commercial |
$97.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.42
|
| Rate for Payer: Healthscope Commercial |
$102.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.24
|
| Rate for Payer: Mclaren Medicaid |
$20.01
|
| Rate for Payer: Meridian Medicaid |
$21.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.61
|
| Rate for Payer: PACE Senior Care Partners |
$26.99
|
| Rate for Payer: PACE SWMI |
$28.42
|
| Rate for Payer: PHP Commercial |
$96.61
|
| Rate for Payer: PHP Medicare Advantage |
$28.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.88
|
| Rate for Payer: Priority Health Medicare |
$28.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.32
|
| Rate for Payer: Railroad Medicare Medicare |
$28.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.02
|
| Rate for Payer: UHC Core |
$94.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.42
|
| Rate for Payer: UHC Medicare Advantage |
$29.27
|
| Rate for Payer: VA VA |
$28.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.24
|
|
|
HC TIER 1 MAJOR TRAUMA RESUSCITATION
|
Facility
|
OP
|
$5,903.93
|
|
| Hospital Charge Code |
68100001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$1,402.18 |
| Max. Negotiated Rate |
$5,313.54 |
| Rate for Payer: Aetna Commercial |
$5,018.34
|
| Rate for Payer: Aetna Medicare |
$1,535.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,844.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,844.98
|
| Rate for Payer: BCBS Complete |
$2,361.57
|
| Rate for Payer: BCBS MAPPO |
$1,475.98
|
| Rate for Payer: BCBS Trust/PPO |
$4,590.31
|
| Rate for Payer: BCN Commercial |
$4,590.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,475.98
|
| Rate for Payer: Cash Price |
$4,723.14
|
| Rate for Payer: Cofinity Commercial |
$5,077.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,723.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,475.98
|
| Rate for Payer: Healthscope Commercial |
$5,313.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,427.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,549.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,697.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,018.34
|
| Rate for Payer: PACE Senior Care Partners |
$1,402.18
|
| Rate for Payer: PACE SWMI |
$1,475.98
|
| Rate for Payer: PHP Commercial |
$5,018.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,475.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,132.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,136.42
|
| Rate for Payer: Priority Health Medicare |
$1,475.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,600.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,475.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,195.46
|
| Rate for Payer: UHC Core |
$4,929.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,475.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,520.26
|
| Rate for Payer: VA VA |
$1,475.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,427.95
|
|
|
HC TIER 1 MAJOR TRAUMA RESUSCITATION
|
Facility
|
IP
|
$5,903.93
|
|
| Hospital Charge Code |
68100001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$3,600.81 |
| Max. Negotiated Rate |
$5,313.54 |
| Rate for Payer: Aetna Commercial |
$5,018.34
|
| Rate for Payer: BCBS Trust/PPO |
$4,562.56
|
| Rate for Payer: BCN Commercial |
$4,562.56
|
| Rate for Payer: Cash Price |
$4,723.14
|
| Rate for Payer: Cofinity Commercial |
$5,077.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,723.14
|
| Rate for Payer: Healthscope Commercial |
$5,313.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,427.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,018.34
|
| Rate for Payer: PHP Commercial |
$5,018.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,132.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,136.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,600.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,195.46
|
| Rate for Payer: UHC Core |
$4,929.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,427.95
|
|
|
HC TIER 2 TRAUMA RESUSCITATION
|
Facility
|
OP
|
$4,502.61
|
|
| Hospital Charge Code |
68200001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$1,069.37 |
| Max. Negotiated Rate |
$4,052.35 |
| Rate for Payer: Aetna Commercial |
$3,827.22
|
| Rate for Payer: Aetna Medicare |
$1,170.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,407.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,407.07
|
| Rate for Payer: BCBS Complete |
$1,801.04
|
| Rate for Payer: BCBS MAPPO |
$1,125.65
|
| Rate for Payer: BCBS Trust/PPO |
$3,500.78
|
| Rate for Payer: BCN Commercial |
$3,500.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,125.65
|
| Rate for Payer: Cash Price |
$3,602.09
|
| Rate for Payer: Cofinity Commercial |
$3,872.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,602.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,125.65
|
| Rate for Payer: Healthscope Commercial |
$4,052.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,376.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,181.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,294.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,827.22
|
| Rate for Payer: PACE Senior Care Partners |
$1,069.37
|
| Rate for Payer: PACE SWMI |
$1,125.65
|
| Rate for Payer: PHP Commercial |
$3,827.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,125.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,151.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,917.27
|
| Rate for Payer: Priority Health Medicare |
$1,125.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,746.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,125.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,962.30
|
| Rate for Payer: UHC Core |
$3,759.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,125.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,159.42
|
| Rate for Payer: VA VA |
$1,125.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,376.96
|
|
|
HC TIER 2 TRAUMA RESUSCITATION
|
Facility
|
IP
|
$4,502.61
|
|
| Hospital Charge Code |
68200001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$2,746.14 |
| Max. Negotiated Rate |
$4,052.35 |
| Rate for Payer: Aetna Commercial |
$3,827.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,479.62
|
| Rate for Payer: BCN Commercial |
$3,479.62
|
| Rate for Payer: Cash Price |
$3,602.09
|
| Rate for Payer: Cofinity Commercial |
$3,872.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,602.09
|
| Rate for Payer: Healthscope Commercial |
$4,052.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,376.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,827.22
|
| Rate for Payer: PHP Commercial |
$3,827.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,151.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,917.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,746.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,962.30
|
| Rate for Payer: UHC Core |
$3,759.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,376.96
|
|
|
HC TIER 3 TRAUMA CONSULT
|
Facility
|
IP
|
$3,434.34
|
|
| Hospital Charge Code |
68100002
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$2,094.60 |
| Max. Negotiated Rate |
$3,090.91 |
| Rate for Payer: Aetna Commercial |
$2,919.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,654.06
|
| Rate for Payer: BCN Commercial |
$2,654.06
|
| Rate for Payer: Cash Price |
$2,747.47
|
| Rate for Payer: Cofinity Commercial |
$2,953.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,747.47
|
| Rate for Payer: Healthscope Commercial |
$3,090.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,575.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,919.19
|
| Rate for Payer: PHP Commercial |
$2,919.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,404.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,987.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,094.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,022.22
|
| Rate for Payer: UHC Core |
$2,867.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,575.76
|
|
|
HC TIER 3 TRAUMA CONSULT
|
Facility
|
OP
|
$3,434.34
|
|
| Hospital Charge Code |
68100002
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$815.66 |
| Max. Negotiated Rate |
$3,090.91 |
| Rate for Payer: Aetna Commercial |
$2,919.19
|
| Rate for Payer: Aetna Medicare |
$892.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,073.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,073.23
|
| Rate for Payer: BCBS Complete |
$1,373.74
|
| Rate for Payer: BCBS MAPPO |
$858.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,670.20
|
| Rate for Payer: BCN Commercial |
$2,670.20
|
| Rate for Payer: BCN Medicare Advantage |
$858.58
|
| Rate for Payer: Cash Price |
$2,747.47
|
| Rate for Payer: Cofinity Commercial |
$2,953.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,747.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$858.58
|
| Rate for Payer: Healthscope Commercial |
$3,090.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,575.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$901.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$987.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,919.19
|
| Rate for Payer: PACE Senior Care Partners |
$815.66
|
| Rate for Payer: PACE SWMI |
$858.58
|
| Rate for Payer: PHP Commercial |
$2,919.19
|
| Rate for Payer: PHP Medicare Advantage |
$858.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,404.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,987.88
|
| Rate for Payer: Priority Health Medicare |
$858.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,094.60
|
| Rate for Payer: Railroad Medicare Medicare |
$858.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,022.22
|
| Rate for Payer: UHC Core |
$2,867.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$858.58
|
| Rate for Payer: UHC Medicare Advantage |
$884.34
|
| Rate for Payer: VA VA |
$858.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,575.76
|
|
