|
HC NCS 5-6 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$1,128.89
|
|
|
Service Code
|
CPT 95909
|
| Hospital Charge Code |
92200029
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$220.59 |
| Max. Negotiated Rate |
$1,016.00 |
| Rate for Payer: Aetna Commercial |
$959.56
|
| Rate for Payer: Aetna Medicare |
$293.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$352.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$352.78
|
| Rate for Payer: BCBS Complete |
$231.63
|
| Rate for Payer: BCBS MAPPO |
$282.22
|
| Rate for Payer: BCBS Trust/PPO |
$928.06
|
| Rate for Payer: BCN Commercial |
$877.71
|
| Rate for Payer: BCN Medicare Advantage |
$282.22
|
| Rate for Payer: Cash Price |
$903.11
|
| Rate for Payer: Cash Price |
$903.11
|
| Rate for Payer: Cofinity Commercial |
$970.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$903.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.22
|
| Rate for Payer: Healthscope Commercial |
$1,016.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$846.67
|
| Rate for Payer: Mclaren Medicaid |
$220.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.33
|
| Rate for Payer: Meridian Medicaid |
$231.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$324.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.56
|
| Rate for Payer: Nomi Health Commercial |
$925.69
|
| Rate for Payer: PACE Senior Care Partners |
$268.11
|
| Rate for Payer: PACE SWMI |
$282.22
|
| Rate for Payer: PHP Commercial |
$959.56
|
| Rate for Payer: PHP Medicare Advantage |
$282.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.78
|
| Rate for Payer: Priority Health HMO/PPO |
$982.13
|
| Rate for Payer: Priority Health Medicare |
$285.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$756.36
|
| Rate for Payer: Railroad Medicare Medicare |
$282.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$993.42
|
| Rate for Payer: UHC Core |
$942.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$282.22
|
| Rate for Payer: UHC Exchange |
$282.22
|
| Rate for Payer: UHC Medicare Advantage |
$282.22
|
| Rate for Payer: UHCCP Medicaid |
$220.59
|
| Rate for Payer: VA VA |
$282.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$846.67
|
|
|
HC NCS 7-8 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$1,457.88
|
|
|
Service Code
|
CPT 95910
|
| Hospital Charge Code |
92200030
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$220.59 |
| Max. Negotiated Rate |
$1,312.09 |
| Rate for Payer: Aetna Commercial |
$1,239.20
|
| Rate for Payer: Aetna Medicare |
$379.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$455.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$455.59
|
| Rate for Payer: BCBS Complete |
$231.63
|
| Rate for Payer: BCBS MAPPO |
$364.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,198.52
|
| Rate for Payer: BCN Commercial |
$1,133.50
|
| Rate for Payer: BCN Medicare Advantage |
$364.47
|
| Rate for Payer: Cash Price |
$1,166.30
|
| Rate for Payer: Cash Price |
$1,166.30
|
| Rate for Payer: Cofinity Commercial |
$1,253.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,166.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$364.47
|
| Rate for Payer: Healthscope Commercial |
$1,312.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,093.41
|
| Rate for Payer: Mclaren Medicaid |
$220.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$382.69
|
| Rate for Payer: Meridian Medicaid |
$231.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$419.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,239.20
|
| Rate for Payer: Nomi Health Commercial |
$1,195.46
|
| Rate for Payer: PACE Senior Care Partners |
$346.25
|
| Rate for Payer: PACE SWMI |
$364.47
|
| Rate for Payer: PHP Commercial |
$1,239.20
|
| Rate for Payer: PHP Medicare Advantage |
$364.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.62
|
| Rate for Payer: Priority Health HMO/PPO |
$1,268.36
|
| Rate for Payer: Priority Health Medicare |
$368.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$976.78
|
| Rate for Payer: Railroad Medicare Medicare |
$364.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,282.93
|
| Rate for Payer: UHC Core |
$1,217.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$364.47
|
| Rate for Payer: UHC Exchange |
$364.47
|
| Rate for Payer: UHC Medicare Advantage |
$364.47
|
| Rate for Payer: UHCCP Medicaid |
$220.59
|
| Rate for Payer: VA VA |
$364.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,093.41
|
|
|
HC NCS 7-8 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$1,457.88
|
|
|
Service Code
|
CPT 95910
|
| Hospital Charge Code |
92200030
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$947.62 |
| Max. Negotiated Rate |
$1,312.09 |
| Rate for Payer: Aetna Commercial |
$1,239.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,190.07
|
| Rate for Payer: BCN Commercial |
$1,126.65
|
| Rate for Payer: Cash Price |
$1,166.30
|
| Rate for Payer: Cofinity Commercial |
$1,253.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,166.30
|
| Rate for Payer: Healthscope Commercial |
$1,312.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,093.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,239.20
|
| Rate for Payer: Nomi Health Commercial |
$1,195.46
|
| Rate for Payer: PHP Commercial |
$1,239.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.62
|
| Rate for Payer: Priority Health HMO/PPO |
$1,268.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$976.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,282.93
|
| Rate for Payer: UHC Core |
$1,217.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,093.41
|
|
|
HC NCS 9-10 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$1,806.20
|
|
|
Service Code
|
CPT 95911
|
| Hospital Charge Code |
92200031
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$375.87 |
| Max. Negotiated Rate |
$1,625.58 |
| Rate for Payer: Aetna Commercial |
$1,535.27
|
| Rate for Payer: Aetna Medicare |
$469.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$564.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$564.44
|
| Rate for Payer: BCBS Complete |
$394.69
|
| Rate for Payer: BCBS MAPPO |
$451.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,484.88
|
| Rate for Payer: BCN Commercial |
$1,404.32
|
| Rate for Payer: BCN Medicare Advantage |
$451.55
|
| Rate for Payer: Cash Price |
$1,444.96
|
| Rate for Payer: Cash Price |
$1,444.96
|
| Rate for Payer: Cofinity Commercial |
$1,553.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$451.55
|
| Rate for Payer: Healthscope Commercial |
$1,625.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,354.65
|
| Rate for Payer: Mclaren Medicaid |
$375.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$474.13
|
| Rate for Payer: Meridian Medicaid |
$394.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$519.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,535.27
|
| Rate for Payer: Nomi Health Commercial |
$1,481.08
|
| Rate for Payer: PACE Senior Care Partners |
$428.97
|
| Rate for Payer: PACE SWMI |
$451.55
|
| Rate for Payer: PHP Commercial |
$1,535.27
|
| Rate for Payer: PHP Medicare Advantage |
$451.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,174.03
|
| Rate for Payer: Priority Health HMO/PPO |
$1,571.39
|
| Rate for Payer: Priority Health Medicare |
$456.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,210.15
|
| Rate for Payer: Railroad Medicare Medicare |
$451.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,589.46
|
| Rate for Payer: UHC Core |
$1,508.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$451.55
|
| Rate for Payer: UHC Exchange |
$451.55
|
| Rate for Payer: UHC Medicare Advantage |
$451.55
|
| Rate for Payer: UHCCP Medicaid |
$375.87
|
| Rate for Payer: VA VA |
$451.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,354.65
|
|
|
HC NCS 9-10 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$1,806.20
|
|
|
Service Code
|
CPT 95911
|
| Hospital Charge Code |
92200031
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$1,174.03 |
| Max. Negotiated Rate |
$1,625.58 |
| Rate for Payer: Aetna Commercial |
$1,535.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,474.40
|
| Rate for Payer: BCN Commercial |
$1,395.83
|
| Rate for Payer: Cash Price |
$1,444.96
|
| Rate for Payer: Cofinity Commercial |
$1,553.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.96
|
| Rate for Payer: Healthscope Commercial |
$1,625.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,354.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,535.27
|
| Rate for Payer: Nomi Health Commercial |
$1,481.08
|
| Rate for Payer: PHP Commercial |
$1,535.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,174.03
|
| Rate for Payer: Priority Health HMO/PPO |
$1,571.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,210.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,589.46
|
| Rate for Payer: UHC Core |
$1,508.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,354.65
|
|
|
HC NEEDLE 14 GAUGE LONG
|
Facility
|
IP
|
$110.16
|
|
| Hospital Charge Code |
27000674
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$71.60 |
| Max. Negotiated Rate |
$99.14 |
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: BCBS Trust/PPO |
$89.92
|
| Rate for Payer: BCN Commercial |
$85.13
|
| Rate for Payer: Cash Price |
$88.13
|
| Rate for Payer: Cofinity Commercial |
$94.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.13
|
| Rate for Payer: Healthscope Commercial |
$99.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.64
|
| Rate for Payer: Nomi Health Commercial |
$90.33
|
| Rate for Payer: PHP Commercial |
$93.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.60
|
| Rate for Payer: Priority Health HMO/PPO |
$95.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.94
|
| Rate for Payer: UHC Core |
$91.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.62
|
|
|
HC NEEDLE 14 GAUGE LONG
|
Facility
|
OP
|
$110.16
|
|
| Hospital Charge Code |
27000674
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.16 |
| Max. Negotiated Rate |
$99.14 |
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: Aetna Medicare |
$28.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.42
|
| Rate for Payer: BCBS Complete |
$44.06
|
| Rate for Payer: BCBS MAPPO |
$27.54
|
| Rate for Payer: BCBS Trust/PPO |
$90.56
|
| Rate for Payer: BCN Commercial |
$85.65
|
| Rate for Payer: BCN Medicare Advantage |
$27.54
|
| Rate for Payer: Cash Price |
$88.13
|
| Rate for Payer: Cofinity Commercial |
$94.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.54
|
| Rate for Payer: Healthscope Commercial |
$99.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.64
|
| Rate for Payer: Nomi Health Commercial |
$90.33
|
| Rate for Payer: PACE Senior Care Partners |
$26.16
|
| Rate for Payer: PACE SWMI |
$27.54
|
| Rate for Payer: PHP Commercial |
$93.64
|
| Rate for Payer: PHP Medicare Advantage |
$27.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.60
|
| Rate for Payer: Priority Health HMO/PPO |
$95.84
|
| Rate for Payer: Priority Health Medicare |
$27.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.81
|
| Rate for Payer: Railroad Medicare Medicare |
$27.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.94
|
| Rate for Payer: UHC Core |
$91.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.54
|
| Rate for Payer: UHC Exchange |
$27.54
|
| Rate for Payer: UHC Medicare Advantage |
$27.54
|
| Rate for Payer: VA VA |
$27.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.62
|
|
|
HC NEEDLE 1 EXTREMITY NON PARASPINAL
|
Facility
|
IP
|
$252.61
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
92200009
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$164.20 |
| Max. Negotiated Rate |
$227.35 |
| Rate for Payer: Aetna Commercial |
$214.72
|
| Rate for Payer: BCBS Trust/PPO |
$206.21
|
| Rate for Payer: BCN Commercial |
$195.22
|
| Rate for Payer: Cash Price |
$202.09
|
| Rate for Payer: Cofinity Commercial |
$217.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.09
|
| Rate for Payer: Healthscope Commercial |
$227.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.72
|
| Rate for Payer: Nomi Health Commercial |
$207.14
|
| Rate for Payer: PHP Commercial |
$214.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.20
|
| Rate for Payer: Priority Health HMO/PPO |
$219.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.30
|
| Rate for Payer: UHC Core |
$210.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.46
|
|
|
HC NEEDLE 1 EXTREMITY NON PARASPINAL
|
Facility
|
OP
|
$252.61
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
92200009
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$59.99 |
| Max. Negotiated Rate |
$227.35 |
| Rate for Payer: Aetna Commercial |
$214.72
|
| Rate for Payer: Aetna Medicare |
$65.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.94
|
| Rate for Payer: BCBS Complete |
$95.88
|
| Rate for Payer: BCBS MAPPO |
$63.15
|
| Rate for Payer: BCBS Trust/PPO |
$207.67
|
| Rate for Payer: BCN Commercial |
$196.40
|
| Rate for Payer: BCN Medicare Advantage |
$63.15
|
| Rate for Payer: Cash Price |
$202.09
|
| Rate for Payer: Cash Price |
$202.09
|
| Rate for Payer: Cofinity Commercial |
$217.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.15
|
| Rate for Payer: Healthscope Commercial |
$227.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.46
|
| Rate for Payer: Mclaren Medicaid |
$91.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.31
|
| Rate for Payer: Meridian Medicaid |
$95.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.72
|
| Rate for Payer: Nomi Health Commercial |
$207.14
|
| Rate for Payer: PACE Senior Care Partners |
$59.99
|
| Rate for Payer: PACE SWMI |
$63.15
|
| Rate for Payer: PHP Commercial |
$214.72
|
| Rate for Payer: PHP Medicare Advantage |
$63.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.20
|
| Rate for Payer: Priority Health HMO/PPO |
$219.77
|
| Rate for Payer: Priority Health Medicare |
$63.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.25
|
| Rate for Payer: Railroad Medicare Medicare |
$63.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.30
|
| Rate for Payer: UHC Core |
$210.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.15
|
| Rate for Payer: UHC Exchange |
$63.15
|
| Rate for Payer: UHC Medicare Advantage |
$63.15
|
| Rate for Payer: UHCCP Medicaid |
$91.31
|
| Rate for Payer: VA VA |
$63.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.46
|
|
|
HC NEEDLE BRACHYTHERAPY EACH
|
Facility
|
OP
|
$73.90
|
|
|
Service Code
|
HCPCS C1715
|
| Hospital Charge Code |
27200247
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.55 |
| Max. Negotiated Rate |
$66.51 |
| Rate for Payer: Aetna Commercial |
$62.82
|
| Rate for Payer: Aetna Medicare |
$19.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.09
|
| Rate for Payer: BCBS Complete |
$29.56
|
| Rate for Payer: BCBS MAPPO |
$18.48
|
| Rate for Payer: BCBS Trust/PPO |
$60.75
|
| Rate for Payer: BCN Commercial |
$57.46
|
| Rate for Payer: BCN Medicare Advantage |
$18.48
|
| Rate for Payer: Cash Price |
$59.12
|
| Rate for Payer: Cofinity Commercial |
$63.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.48
|
| Rate for Payer: Healthscope Commercial |
$66.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.82
|
| Rate for Payer: Nomi Health Commercial |
$60.60
|
| Rate for Payer: PACE Senior Care Partners |
$17.55
|
| Rate for Payer: PACE SWMI |
$18.48
|
| Rate for Payer: PHP Commercial |
$62.82
|
| Rate for Payer: PHP Medicare Advantage |
$18.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.04
|
| Rate for Payer: Priority Health HMO/PPO |
$64.29
|
| Rate for Payer: Priority Health Medicare |
$18.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.51
|
| Rate for Payer: Railroad Medicare Medicare |
$18.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.03
|
| Rate for Payer: UHC Core |
$61.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.48
|
| Rate for Payer: UHC Exchange |
$18.48
|
| Rate for Payer: UHC Medicare Advantage |
$18.48
|
| Rate for Payer: VA VA |
$18.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.42
|
|
|
HC NEEDLE BRACHYTHERAPY EACH
|
Facility
|
IP
|
$73.90
|
|
|
Service Code
|
HCPCS C1715
|
| Hospital Charge Code |
27200247
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.04 |
| Max. Negotiated Rate |
$66.51 |
| Rate for Payer: Aetna Commercial |
$62.82
|
| Rate for Payer: BCBS Trust/PPO |
$60.32
|
| Rate for Payer: BCN Commercial |
$57.11
|
| Rate for Payer: Cash Price |
$59.12
|
| Rate for Payer: Cofinity Commercial |
$63.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.12
|
| Rate for Payer: Healthscope Commercial |
$66.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.82
|
| Rate for Payer: Nomi Health Commercial |
$60.60
|
| Rate for Payer: PHP Commercial |
$62.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.04
|
| Rate for Payer: Priority Health HMO/PPO |
$64.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.03
|
| Rate for Payer: UHC Core |
$61.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.42
|
|
|
HC NEEDLE INSERT W/O INJECT 1 OR 2 MUSCLES
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
76100364
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$18.21
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$17.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$18.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.00
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UHC Medicare Advantage |
$13.00
|
| Rate for Payer: UHCCP Medicaid |
$17.34
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC NEEDLE INSERT W/O INJECT 1 OR 2 MUSCLES
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
76100364
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC NEEDLE INSERT W/O INJECTION, 1 OR 2 MUSCLES
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
42000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$24.98
|
| Rate for Payer: BCN Commercial |
$23.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO |
$26.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC NEEDLE INSERT W/O INJECTION, 1 OR 2 MUSCLES
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
42000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7.27 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.56
|
| Rate for Payer: BCBS Complete |
$18.21
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$25.16
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.65
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$17.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: Meridian Medicaid |
$18.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PACE Senior Care Partners |
$7.27
|
| Rate for Payer: PACE SWMI |
$7.65
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO |
$26.62
|
| Rate for Payer: Priority Health Medicare |
$7.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.50
|
| Rate for Payer: Railroad Medicare Medicare |
$7.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.65
|
| Rate for Payer: UHC Exchange |
$7.65
|
| Rate for Payer: UHC Medicare Advantage |
$7.65
|
| Rate for Payer: UHCCP Medicaid |
$17.34
|
| Rate for Payer: VA VA |
$7.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC NEEDLE INSERT W/O INJECTION, 3 OR MORE MUSCLES
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 20561
|
| Hospital Charge Code |
42000061
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$18.21
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$41.93
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$17.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: Meridian Medicaid |
$18.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.17
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Exchange |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$12.75
|
| Rate for Payer: UHCCP Medicaid |
$17.34
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC NEEDLE INSERT W/O INJECTION, 3 OR MORE MUSCLES
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 20561
|
| Hospital Charge Code |
42000061
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.15 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$41.63
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC NEEDLE LOC WIRE
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
HCPCS C1819
|
| Hospital Charge Code |
27200323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$21.22
|
| Rate for Payer: BCBS MAPPO |
$13.26
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$41.25
|
| Rate for Payer: BCN Medicare Advantage |
$13.26
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.26
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.26
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.55
|
| Rate for Payer: Railroad Medicare Medicare |
$13.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.26
|
| Rate for Payer: UHC Exchange |
$13.26
|
| Rate for Payer: UHC Medicare Advantage |
$13.26
|
| Rate for Payer: VA VA |
$13.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC NEEDLE LOC WIRE
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
HCPCS C1819
|
| Hospital Charge Code |
27200323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.49 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.31
|
| Rate for Payer: BCN Commercial |
$41.00
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC NEG PRES CANIST 1000CC
|
Facility
|
IP
|
$233.19
|
|
| Hospital Charge Code |
27200232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$151.57 |
| Max. Negotiated Rate |
$209.87 |
| Rate for Payer: Aetna Commercial |
$198.21
|
| Rate for Payer: BCBS Trust/PPO |
$190.35
|
| Rate for Payer: BCN Commercial |
$180.21
|
| Rate for Payer: Cash Price |
$186.55
|
| Rate for Payer: Cofinity Commercial |
$200.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.55
|
| Rate for Payer: Healthscope Commercial |
$209.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.21
|
| Rate for Payer: Nomi Health Commercial |
$191.22
|
| Rate for Payer: PHP Commercial |
$198.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.57
|
| Rate for Payer: Priority Health HMO/PPO |
$202.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.21
|
| Rate for Payer: UHC Core |
$194.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.89
|
|
|
HC NEG PRES CANIST 1000CC
|
Facility
|
OP
|
$233.19
|
|
| Hospital Charge Code |
27200232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$209.87 |
| Rate for Payer: Aetna Commercial |
$198.21
|
| Rate for Payer: Aetna Medicare |
$60.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.87
|
| Rate for Payer: BCBS Complete |
$93.28
|
| Rate for Payer: BCBS MAPPO |
$58.30
|
| Rate for Payer: BCBS Trust/PPO |
$191.71
|
| Rate for Payer: BCN Commercial |
$181.31
|
| Rate for Payer: BCN Medicare Advantage |
$58.30
|
| Rate for Payer: Cash Price |
$186.55
|
| Rate for Payer: Cofinity Commercial |
$200.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.30
|
| Rate for Payer: Healthscope Commercial |
$209.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.21
|
| Rate for Payer: Nomi Health Commercial |
$191.22
|
| Rate for Payer: PACE Senior Care Partners |
$55.38
|
| Rate for Payer: PACE SWMI |
$58.30
|
| Rate for Payer: PHP Commercial |
$198.21
|
| Rate for Payer: PHP Medicare Advantage |
$58.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.57
|
| Rate for Payer: Priority Health HMO/PPO |
$202.88
|
| Rate for Payer: Priority Health Medicare |
$58.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.24
|
| Rate for Payer: Railroad Medicare Medicare |
$58.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.21
|
| Rate for Payer: UHC Core |
$194.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.30
|
| Rate for Payer: UHC Exchange |
$58.30
|
| Rate for Payer: UHC Medicare Advantage |
$58.30
|
| Rate for Payer: VA VA |
$58.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.89
|
|
|
HC NEG PRES CANIST 500CC
|
Facility
|
IP
|
$151.46
|
|
| Hospital Charge Code |
27200136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$98.45 |
| Max. Negotiated Rate |
$136.31 |
| Rate for Payer: Aetna Commercial |
$128.74
|
| Rate for Payer: BCBS Trust/PPO |
$123.64
|
| Rate for Payer: BCN Commercial |
$117.05
|
| Rate for Payer: Cash Price |
$121.17
|
| Rate for Payer: Cofinity Commercial |
$130.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.17
|
| Rate for Payer: Healthscope Commercial |
$136.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.74
|
| Rate for Payer: Nomi Health Commercial |
$124.20
|
| Rate for Payer: PHP Commercial |
$128.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.45
|
| Rate for Payer: Priority Health HMO/PPO |
$131.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.28
|
| Rate for Payer: UHC Core |
$126.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.60
|
|
|
HC NEG PRES CANIST 500CC
|
Facility
|
OP
|
$151.46
|
|
| Hospital Charge Code |
27200136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.97 |
| Max. Negotiated Rate |
$136.31 |
| Rate for Payer: Aetna Commercial |
$128.74
|
| Rate for Payer: Aetna Medicare |
$39.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.33
|
| Rate for Payer: BCBS Complete |
$60.58
|
| Rate for Payer: BCBS MAPPO |
$37.86
|
| Rate for Payer: BCBS Trust/PPO |
$124.52
|
| Rate for Payer: BCN Commercial |
$117.76
|
| Rate for Payer: BCN Medicare Advantage |
$37.86
|
| Rate for Payer: Cash Price |
$121.17
|
| Rate for Payer: Cofinity Commercial |
$130.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.86
|
| Rate for Payer: Healthscope Commercial |
$136.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.74
|
| Rate for Payer: Nomi Health Commercial |
$124.20
|
| Rate for Payer: PACE Senior Care Partners |
$35.97
|
| Rate for Payer: PACE SWMI |
$37.86
|
| Rate for Payer: PHP Commercial |
$128.74
|
| Rate for Payer: PHP Medicare Advantage |
$37.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.45
|
| Rate for Payer: Priority Health HMO/PPO |
$131.77
|
| Rate for Payer: Priority Health Medicare |
$38.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.48
|
| Rate for Payer: Railroad Medicare Medicare |
$37.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.28
|
| Rate for Payer: UHC Core |
$126.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.86
|
| Rate for Payer: UHC Exchange |
$37.86
|
| Rate for Payer: UHC Medicare Advantage |
$37.86
|
| Rate for Payer: VA VA |
$37.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.60
|
|
|
HC NEG PRES CLEANSE DRSG MED
|
Facility
|
OP
|
$510.90
|
|
| Hospital Charge Code |
27200229
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.34 |
| Max. Negotiated Rate |
$459.81 |
| Rate for Payer: Aetna Commercial |
$434.26
|
| Rate for Payer: Aetna Medicare |
$132.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$159.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$159.66
|
| Rate for Payer: BCBS Complete |
$204.36
|
| Rate for Payer: BCBS MAPPO |
$127.72
|
| Rate for Payer: BCBS Trust/PPO |
$420.01
|
| Rate for Payer: BCN Commercial |
$397.22
|
| Rate for Payer: BCN Medicare Advantage |
$127.72
|
| Rate for Payer: Cash Price |
$408.72
|
| Rate for Payer: Cofinity Commercial |
$439.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.72
|
| Rate for Payer: Healthscope Commercial |
$459.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$383.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$434.26
|
| Rate for Payer: Nomi Health Commercial |
$418.94
|
| Rate for Payer: PACE Senior Care Partners |
$121.34
|
| Rate for Payer: PACE SWMI |
$127.72
|
| Rate for Payer: PHP Commercial |
$434.26
|
| Rate for Payer: PHP Medicare Advantage |
$127.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.08
|
| Rate for Payer: Priority Health HMO/PPO |
$444.48
|
| Rate for Payer: Priority Health Medicare |
$129.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$342.30
|
| Rate for Payer: Railroad Medicare Medicare |
$127.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.59
|
| Rate for Payer: UHC Core |
$426.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.72
|
| Rate for Payer: UHC Exchange |
$127.72
|
| Rate for Payer: UHC Medicare Advantage |
$127.72
|
| Rate for Payer: VA VA |
$127.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$383.18
|
|
|
HC NEG PRES CLEANSE DRSG MED
|
Facility
|
IP
|
$510.90
|
|
| Hospital Charge Code |
27200229
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$332.08 |
| Max. Negotiated Rate |
$459.81 |
| Rate for Payer: Aetna Commercial |
$434.26
|
| Rate for Payer: BCBS Trust/PPO |
$417.05
|
| Rate for Payer: BCN Commercial |
$394.82
|
| Rate for Payer: Cash Price |
$408.72
|
| Rate for Payer: Cofinity Commercial |
$439.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.72
|
| Rate for Payer: Healthscope Commercial |
$459.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$383.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$434.26
|
| Rate for Payer: Nomi Health Commercial |
$418.94
|
| Rate for Payer: PHP Commercial |
$434.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.08
|
| Rate for Payer: Priority Health HMO/PPO |
$444.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$342.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.59
|
| Rate for Payer: UHC Core |
$426.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$383.18
|
|
