|
HC PHOSPHO-TAU 217,P
|
Facility
|
OP
|
$375.00
|
|
|
Service Code
|
CPT 84393
|
| Hospital Charge Code |
30000176
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$66.11 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna Commercial |
$318.75
|
| Rate for Payer: Aetna Medicare |
$97.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$117.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$117.19
|
| Rate for Payer: BCBS Complete |
$69.41
|
| Rate for Payer: BCBS MAPPO |
$93.75
|
| Rate for Payer: BCBS Trust/PPO |
$308.29
|
| Rate for Payer: BCN Commercial |
$308.29
|
| Rate for Payer: BCN Medicare Advantage |
$93.75
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$322.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.75
|
| Rate for Payer: Healthscope Commercial |
$337.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.25
|
| Rate for Payer: Mclaren Medicaid |
$66.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.44
|
| Rate for Payer: Meridian Medicaid |
$69.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.75
|
| Rate for Payer: Nomi Health Commercial |
$307.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.25
|
| Rate for Payer: PACE Senior Care Partners |
$89.06
|
| Rate for Payer: PACE SWMI |
$93.75
|
| Rate for Payer: PHP Commercial |
$318.75
|
| Rate for Payer: PHP Medicare Advantage |
$93.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$326.25
|
| Rate for Payer: Priority Health Medicare |
$94.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.00
|
| Rate for Payer: Railroad Medicare Medicare |
$93.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.00
|
| Rate for Payer: UHC Core |
$313.12
|
| Rate for Payer: UHC Exchange |
$93.75
|
| Rate for Payer: UHC Medicaid |
$66.11
|
| Rate for Payer: UHC Medicare Advantage |
$93.75
|
| Rate for Payer: UHCCP Medicaid |
$66.11
|
| Rate for Payer: VA VA |
$93.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.25
|
|
|
HC PHOSPHO-TAU 217,P
|
Facility
|
IP
|
$375.00
|
|
|
Service Code
|
CPT 84393
|
| Hospital Charge Code |
30000176
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$261.00 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna Commercial |
$318.75
|
| Rate for Payer: BCBS Trust/PPO |
$309.71
|
| Rate for Payer: BCN Commercial |
$309.71
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$322.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.00
|
| Rate for Payer: Healthscope Commercial |
$337.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.75
|
| Rate for Payer: Nomi Health Commercial |
$307.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$281.25
|
| Rate for Payer: PHP Commercial |
$318.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$326.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.00
|
| Rate for Payer: UHC Core |
$313.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.25
|
|
|
HC PHYSICAL PERF TEST EA 15 MIN
|
Facility
|
IP
|
$95.51
|
|
|
Service Code
|
CPT 97750
|
| Hospital Charge Code |
42000038
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$66.47 |
| Max. Negotiated Rate |
$85.96 |
| Rate for Payer: Aetna Commercial |
$81.18
|
| Rate for Payer: BCBS Trust/PPO |
$78.88
|
| Rate for Payer: BCN Commercial |
$78.88
|
| Rate for Payer: Cash Price |
$76.41
|
| Rate for Payer: Cofinity Commercial |
$82.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.41
|
| Rate for Payer: Healthscope Commercial |
$85.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.18
|
| Rate for Payer: Nomi Health Commercial |
$78.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.63
|
| Rate for Payer: PHP Commercial |
$81.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.05
|
| Rate for Payer: UHC Core |
$79.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.63
|
|
|
HC PHYSICAL PERF TEST EA 15 MIN
|
Facility
|
OP
|
$95.51
|
|
|
Service Code
|
CPT 97750
|
| Hospital Charge Code |
42000038
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$16.84 |
| Max. Negotiated Rate |
$85.96 |
| Rate for Payer: Aetna Commercial |
$81.18
|
| Rate for Payer: Aetna Medicare |
$24.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.85
|
| Rate for Payer: BCBS Complete |
$17.68
|
| Rate for Payer: BCBS MAPPO |
$23.88
|
| Rate for Payer: BCBS Trust/PPO |
$78.52
|
| Rate for Payer: BCN Commercial |
$78.52
|
| Rate for Payer: BCN Medicare Advantage |
$23.88
|
| Rate for Payer: Cash Price |
$76.41
|
| Rate for Payer: Cofinity Commercial |
$82.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.88
|
| Rate for Payer: Healthscope Commercial |
$85.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.63
|
| Rate for Payer: Mclaren Medicaid |
$16.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.07
|
| Rate for Payer: Meridian Medicaid |
$17.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.18
|
| Rate for Payer: Nomi Health Commercial |
$78.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.63
|
| Rate for Payer: PACE Senior Care Partners |
$22.68
|
| Rate for Payer: PACE SWMI |
$23.88
|
| Rate for Payer: PHP Commercial |
$81.18
|
| Rate for Payer: PHP Medicare Advantage |
$23.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.09
|
| Rate for Payer: Priority Health Medicare |
$24.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.47
|
| Rate for Payer: Railroad Medicare Medicare |
$23.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.05
|
| Rate for Payer: UHC Core |
$79.75
|
| Rate for Payer: UHC Exchange |
$23.88
|
| Rate for Payer: UHC Medicaid |
$16.84
|
| Rate for Payer: UHC Medicare Advantage |
$23.88
|
| Rate for Payer: UHCCP Medicaid |
$16.84
|
| Rate for Payer: VA VA |
$23.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.63
|
|
|
HC PICC INTRODUCER
|
Facility
|
OP
|
$100.29
|
|
| Hospital Charge Code |
27200147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.68 |
| Max. Negotiated Rate |
$90.26 |
| Rate for Payer: Aetna Commercial |
$85.25
|
| Rate for Payer: Aetna Medicare |
$26.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.34
|
| Rate for Payer: BCBS Complete |
$18.56
|
| Rate for Payer: BCBS MAPPO |
$25.07
|
| Rate for Payer: BCBS Trust/PPO |
$82.45
|
| Rate for Payer: BCN Commercial |
$82.45
|
| Rate for Payer: BCN Medicare Advantage |
$25.07
|
| Rate for Payer: Cash Price |
$80.23
|
| Rate for Payer: Cofinity Commercial |
$86.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.07
|
| Rate for Payer: Healthscope Commercial |
$90.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.22
|
| Rate for Payer: Mclaren Medicaid |
$17.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.33
|
| Rate for Payer: Meridian Medicaid |
$18.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.25
|
| Rate for Payer: Nomi Health Commercial |
$82.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.22
|
| Rate for Payer: PACE Senior Care Partners |
$23.82
|
| Rate for Payer: PACE SWMI |
$25.07
|
| Rate for Payer: PHP Commercial |
$85.25
|
| Rate for Payer: PHP Medicare Advantage |
$25.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.25
|
| Rate for Payer: Priority Health Medicare |
$25.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.80
|
| Rate for Payer: Railroad Medicare Medicare |
$25.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.26
|
| Rate for Payer: UHC Core |
$83.74
|
| Rate for Payer: UHC Exchange |
$25.07
|
| Rate for Payer: UHC Medicaid |
$17.68
|
| Rate for Payer: UHC Medicare Advantage |
$25.07
|
| Rate for Payer: UHCCP Medicaid |
$17.68
|
| Rate for Payer: VA VA |
$25.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.22
|
|
|
HC PICC INTRODUCER
|
Facility
|
IP
|
$100.29
|
|
| Hospital Charge Code |
27200147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$69.80 |
| Max. Negotiated Rate |
$90.26 |
| Rate for Payer: Aetna Commercial |
$85.25
|
| Rate for Payer: BCBS Trust/PPO |
$82.83
|
| Rate for Payer: BCN Commercial |
$82.83
|
| Rate for Payer: Cash Price |
$80.23
|
| Rate for Payer: Cofinity Commercial |
$86.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.23
|
| Rate for Payer: Healthscope Commercial |
$90.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.25
|
| Rate for Payer: Nomi Health Commercial |
$82.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.22
|
| Rate for Payer: PHP Commercial |
$85.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.26
|
| Rate for Payer: UHC Core |
$83.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.22
|
|
|
HC PICU 30" NITROUS OXIDE SED RECOVERY
|
Facility
|
IP
|
$114.84
|
|
| Hospital Charge Code |
37000019
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$79.93 |
| Max. Negotiated Rate |
$103.36 |
| Rate for Payer: Aetna Commercial |
$97.61
|
| Rate for Payer: BCBS Trust/PPO |
$94.85
|
| Rate for Payer: BCN Commercial |
$94.85
|
| Rate for Payer: Cash Price |
$91.87
|
| Rate for Payer: Cofinity Commercial |
$98.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.87
|
| Rate for Payer: Healthscope Commercial |
$103.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.61
|
| Rate for Payer: Nomi Health Commercial |
$94.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.13
|
| Rate for Payer: PHP Commercial |
$97.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.06
|
| Rate for Payer: UHC Core |
$95.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.13
|
|
|
HC PICU 30" NITROUS OXIDE SED RECOVERY
|
Facility
|
OP
|
$114.84
|
|
| Hospital Charge Code |
37000019
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$103.36 |
| Rate for Payer: Aetna Commercial |
$97.61
|
| Rate for Payer: Aetna Medicare |
$29.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.89
|
| Rate for Payer: BCBS Complete |
$21.26
|
| Rate for Payer: BCBS MAPPO |
$28.71
|
| Rate for Payer: BCBS Trust/PPO |
$94.41
|
| Rate for Payer: BCN Commercial |
$94.41
|
| Rate for Payer: BCN Medicare Advantage |
$28.71
|
| Rate for Payer: Cash Price |
$91.87
|
| Rate for Payer: Cofinity Commercial |
$98.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.71
|
| Rate for Payer: Healthscope Commercial |
$103.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.13
|
| Rate for Payer: Mclaren Medicaid |
$20.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.15
|
| Rate for Payer: Meridian Medicaid |
$21.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.61
|
| Rate for Payer: Nomi Health Commercial |
$94.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.13
|
| Rate for Payer: PACE Senior Care Partners |
$27.27
|
| Rate for Payer: PACE SWMI |
$28.71
|
| Rate for Payer: PHP Commercial |
$97.61
|
| Rate for Payer: PHP Medicare Advantage |
$28.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.91
|
| Rate for Payer: Priority Health Medicare |
$29.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.93
|
| Rate for Payer: Railroad Medicare Medicare |
$28.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.06
|
| Rate for Payer: UHC Core |
$95.89
|
| Rate for Payer: UHC Exchange |
$28.71
|
| Rate for Payer: UHC Medicaid |
$20.25
|
| Rate for Payer: UHC Medicare Advantage |
$28.71
|
| Rate for Payer: UHCCP Medicaid |
$20.25
|
| Rate for Payer: VA VA |
$28.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.13
|
|
|
HC PICU OBSERVATION PER HOUR
|
Facility
|
OP
|
$204.96
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200017
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$36.13 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$174.22
|
| Rate for Payer: Aetna Medicare |
$53.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.05
|
| Rate for Payer: BCBS Complete |
$37.94
|
| Rate for Payer: BCBS MAPPO |
$51.24
|
| Rate for Payer: BCBS Trust/PPO |
$168.50
|
| Rate for Payer: BCN Commercial |
$168.50
|
| Rate for Payer: BCN Medicare Advantage |
$51.24
|
| Rate for Payer: Cash Price |
$163.97
|
| Rate for Payer: Cash Price |
$163.97
|
| Rate for Payer: Cofinity Commercial |
$176.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.24
|
| Rate for Payer: Healthscope Commercial |
$184.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.72
|
| Rate for Payer: Mclaren Medicaid |
$36.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.80
|
| Rate for Payer: Meridian Medicaid |
$37.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.22
|
| Rate for Payer: Nomi Health Commercial |
$168.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.72
|
| Rate for Payer: PACE Senior Care Partners |
$48.68
|
| Rate for Payer: PACE SWMI |
$51.24
|
| Rate for Payer: PHP Commercial |
$174.22
|
| Rate for Payer: PHP Medicare Advantage |
$51.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$178.32
|
| Rate for Payer: Priority Health Medicare |
$51.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.65
|
| Rate for Payer: Railroad Medicare Medicare |
$51.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.36
|
| Rate for Payer: UHC Core |
$171.14
|
| Rate for Payer: UHC Exchange |
$51.24
|
| Rate for Payer: UHC Medicaid |
$36.13
|
| Rate for Payer: UHC Medicare Advantage |
$51.24
|
| Rate for Payer: UHCCP Medicaid |
$850.00
|
| Rate for Payer: VA VA |
$51.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.72
|
|
|
HC PICU OBSERVATION PER HOUR
|
Facility
|
IP
|
$204.96
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200017
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$142.65 |
| Max. Negotiated Rate |
$184.46 |
| Rate for Payer: Aetna Commercial |
$174.22
|
| Rate for Payer: BCBS Trust/PPO |
$169.28
|
| Rate for Payer: BCN Commercial |
$169.28
|
| Rate for Payer: Cash Price |
$163.97
|
| Rate for Payer: Cofinity Commercial |
$176.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.97
|
| Rate for Payer: Healthscope Commercial |
$184.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.22
|
| Rate for Payer: Nomi Health Commercial |
$168.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.72
|
| Rate for Payer: PHP Commercial |
$174.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$178.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.36
|
| Rate for Payer: UHC Core |
$171.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.72
|
|
|
HC PICU OR PED CRITICAL CARE R&B
|
Facility
|
IP
|
$7,957.94
|
|
| Hospital Charge Code |
20300001
|
|
Hospital Revenue Code
|
203
|
| Min. Negotiated Rate |
$1,819.25 |
| Max. Negotiated Rate |
$7,162.15 |
| Rate for Payer: Aetna Commercial |
$6,764.25
|
| Rate for Payer: Aetna Medicare |
$1,991.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,393.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,393.75
|
| Rate for Payer: BCBS MAPPO |
$1,915.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,572.46
|
| Rate for Payer: BCN Commercial |
$6,572.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,915.00
|
| Rate for Payer: Cash Price |
$6,366.35
|
| Rate for Payer: Cash Price |
$6,366.35
|
| Rate for Payer: Cofinity Commercial |
$6,843.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,366.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,915.00
|
| Rate for Payer: Healthscope Commercial |
$7,162.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,968.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,010.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,202.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,106.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,764.25
|
| Rate for Payer: Nomi Health Commercial |
$6,525.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,968.45
|
| Rate for Payer: PACE Senior Care Partners |
$1,819.25
|
| Rate for Payer: PACE SWMI |
$1,915.00
|
| Rate for Payer: PHP Commercial |
$6,764.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,915.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,923.41
|
| Rate for Payer: Priority Health Medicare |
$1,934.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,538.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,915.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,002.99
|
| Rate for Payer: UHC Core |
$6,644.88
|
| Rate for Payer: UHC Exchange |
$1,915.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,915.00
|
| Rate for Payer: VA VA |
$1,915.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,968.45
|
|
|
HC PICU OR PED INTERMEDIATE CARE R&B
|
Facility
|
IP
|
$6,640.46
|
|
| Hospital Charge Code |
20600002
|
|
Hospital Revenue Code
|
206
|
| Min. Negotiated Rate |
$1,819.25 |
| Max. Negotiated Rate |
$5,976.41 |
| Rate for Payer: Aetna Commercial |
$5,644.39
|
| Rate for Payer: Aetna Medicare |
$1,991.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,393.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,393.75
|
| Rate for Payer: BCBS MAPPO |
$1,915.00
|
| Rate for Payer: BCBS Trust/PPO |
$5,484.36
|
| Rate for Payer: BCN Commercial |
$5,484.36
|
| Rate for Payer: BCN Medicare Advantage |
$1,915.00
|
| Rate for Payer: Cash Price |
$5,312.37
|
| Rate for Payer: Cash Price |
$5,312.37
|
| Rate for Payer: Cofinity Commercial |
$5,710.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,312.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,915.00
|
| Rate for Payer: Healthscope Commercial |
$5,976.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,980.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,010.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,202.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,106.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,644.39
|
| Rate for Payer: Nomi Health Commercial |
$5,445.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,980.35
|
| Rate for Payer: PACE Senior Care Partners |
$1,819.25
|
| Rate for Payer: PACE SWMI |
$1,915.00
|
| Rate for Payer: PHP Commercial |
$5,644.39
|
| Rate for Payer: PHP Medicare Advantage |
$1,915.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,777.20
|
| Rate for Payer: Priority Health Medicare |
$1,934.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,621.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,915.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,843.60
|
| Rate for Payer: UHC Core |
$5,544.78
|
| Rate for Payer: UHC Exchange |
$1,915.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,915.00
|
| Rate for Payer: VA VA |
$1,915.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,980.35
|
|
|
HC PICU/PEDS 30" SEDATION RECOVERY
|
Facility
|
IP
|
$321.36
|
|
| Hospital Charge Code |
71000009
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$223.67 |
| Max. Negotiated Rate |
$289.22 |
| Rate for Payer: Aetna Commercial |
$273.16
|
| Rate for Payer: BCBS Trust/PPO |
$265.41
|
| Rate for Payer: BCN Commercial |
$265.41
|
| Rate for Payer: Cash Price |
$257.09
|
| Rate for Payer: Cofinity Commercial |
$276.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.09
|
| Rate for Payer: Healthscope Commercial |
$289.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.16
|
| Rate for Payer: Nomi Health Commercial |
$263.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$241.02
|
| Rate for Payer: PHP Commercial |
$273.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$279.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$223.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.80
|
| Rate for Payer: UHC Core |
$268.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.02
|
|
|
HC PICU/PEDS 30" SEDATION RECOVERY
|
Facility
|
OP
|
$321.36
|
|
| Hospital Charge Code |
71000009
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$56.66 |
| Max. Negotiated Rate |
$289.22 |
| Rate for Payer: Aetna Commercial |
$273.16
|
| Rate for Payer: Aetna Medicare |
$83.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.42
|
| Rate for Payer: BCBS Complete |
$59.48
|
| Rate for Payer: BCBS MAPPO |
$80.34
|
| Rate for Payer: BCBS Trust/PPO |
$264.19
|
| Rate for Payer: BCN Commercial |
$264.19
|
| Rate for Payer: BCN Medicare Advantage |
$80.34
|
| Rate for Payer: Cash Price |
$257.09
|
| Rate for Payer: Cofinity Commercial |
$276.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.34
|
| Rate for Payer: Healthscope Commercial |
$289.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.02
|
| Rate for Payer: Mclaren Medicaid |
$56.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.36
|
| Rate for Payer: Meridian Medicaid |
$59.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.16
|
| Rate for Payer: Nomi Health Commercial |
$263.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$241.02
|
| Rate for Payer: PACE Senior Care Partners |
$76.32
|
| Rate for Payer: PACE SWMI |
$80.34
|
| Rate for Payer: PHP Commercial |
$273.16
|
| Rate for Payer: PHP Medicare Advantage |
$80.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$279.58
|
| Rate for Payer: Priority Health Medicare |
$81.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$223.67
|
| Rate for Payer: Railroad Medicare Medicare |
$80.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$282.80
|
| Rate for Payer: UHC Core |
$268.34
|
| Rate for Payer: UHC Exchange |
$80.34
|
| Rate for Payer: UHC Medicaid |
$56.66
|
| Rate for Payer: UHC Medicare Advantage |
$80.34
|
| Rate for Payer: UHCCP Medicaid |
$56.66
|
| Rate for Payer: VA VA |
$80.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.02
|
|
|
HC PIFLUFOLASTAT PER MILLICURIE
|
Facility
|
OP
|
$1,591.81
|
|
|
Service Code
|
CPT A9595
|
| Hospital Charge Code |
34300369
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$280.64 |
| Max. Negotiated Rate |
$1,432.63 |
| Rate for Payer: Aetna Commercial |
$1,353.04
|
| Rate for Payer: Aetna Medicare |
$413.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.44
|
| Rate for Payer: BCBS Complete |
$294.64
|
| Rate for Payer: BCBS MAPPO |
$397.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,308.63
|
| Rate for Payer: BCN Commercial |
$1,308.63
|
| Rate for Payer: BCN Medicare Advantage |
$397.95
|
| Rate for Payer: Cash Price |
$1,273.45
|
| Rate for Payer: Cofinity Commercial |
$1,368.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,273.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.95
|
| Rate for Payer: Healthscope Commercial |
$1,432.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,193.86
|
| Rate for Payer: Mclaren Medicaid |
$280.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.85
|
| Rate for Payer: Meridian Medicaid |
$294.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$457.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$437.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,353.04
|
| Rate for Payer: Nomi Health Commercial |
$1,305.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,193.86
|
| Rate for Payer: PACE Senior Care Partners |
$378.05
|
| Rate for Payer: PACE SWMI |
$397.95
|
| Rate for Payer: PHP Commercial |
$1,353.04
|
| Rate for Payer: PHP Medicare Advantage |
$397.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$280.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,384.87
|
| Rate for Payer: Priority Health Medicare |
$401.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,107.90
|
| Rate for Payer: Railroad Medicare Medicare |
$397.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,400.79
|
| Rate for Payer: UHC Core |
$1,329.16
|
| Rate for Payer: UHC Exchange |
$397.95
|
| Rate for Payer: UHC Medicaid |
$280.64
|
| Rate for Payer: UHC Medicare Advantage |
$397.95
|
| Rate for Payer: UHCCP Medicaid |
$280.64
|
| Rate for Payer: VA VA |
$397.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,193.86
|
|
|
HC PIFLUFOLASTAT PER MILLICURIE
|
Facility
|
IP
|
$1,591.81
|
|
|
Service Code
|
CPT A9595
|
| Hospital Charge Code |
34300369
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,107.90 |
| Max. Negotiated Rate |
$1,432.63 |
| Rate for Payer: Aetna Commercial |
$1,353.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,314.68
|
| Rate for Payer: BCN Commercial |
$1,314.68
|
| Rate for Payer: Cash Price |
$1,273.45
|
| Rate for Payer: Cofinity Commercial |
$1,368.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,273.45
|
| Rate for Payer: Healthscope Commercial |
$1,432.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,193.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,353.04
|
| Rate for Payer: Nomi Health Commercial |
$1,305.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,193.86
|
| Rate for Payer: PHP Commercial |
$1,353.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,384.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,107.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,400.79
|
| Rate for Payer: UHC Core |
$1,329.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,193.86
|
|
|
HC PIGWEED IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200098
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC PIGWEED IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200098
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC PI LINKED ANTIGEN
|
Facility
|
OP
|
$204.94
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000004
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$36.13 |
| Max. Negotiated Rate |
$184.45 |
| Rate for Payer: Aetna Commercial |
$174.20
|
| Rate for Payer: Aetna Medicare |
$53.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.04
|
| Rate for Payer: BCBS Complete |
$37.93
|
| Rate for Payer: BCBS MAPPO |
$51.23
|
| Rate for Payer: BCBS Trust/PPO |
$168.48
|
| Rate for Payer: BCN Commercial |
$168.48
|
| Rate for Payer: BCN Medicare Advantage |
$51.23
|
| Rate for Payer: Cash Price |
$163.95
|
| Rate for Payer: Cofinity Commercial |
$176.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.23
|
| Rate for Payer: Healthscope Commercial |
$184.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.71
|
| Rate for Payer: Mclaren Medicaid |
$36.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.80
|
| Rate for Payer: Meridian Medicaid |
$37.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.20
|
| Rate for Payer: Nomi Health Commercial |
$168.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.71
|
| Rate for Payer: PACE Senior Care Partners |
$48.67
|
| Rate for Payer: PACE SWMI |
$51.23
|
| Rate for Payer: PHP Commercial |
$174.20
|
| Rate for Payer: PHP Medicare Advantage |
$51.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$178.30
|
| Rate for Payer: Priority Health Medicare |
$51.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.64
|
| Rate for Payer: Railroad Medicare Medicare |
$51.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.35
|
| Rate for Payer: UHC Core |
$171.12
|
| Rate for Payer: UHC Exchange |
$51.23
|
| Rate for Payer: UHC Medicaid |
$36.13
|
| Rate for Payer: UHC Medicare Advantage |
$51.23
|
| Rate for Payer: UHCCP Medicaid |
$36.13
|
| Rate for Payer: VA VA |
$51.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.71
|
|
|
HC PI LINKED ANTIGEN
|
Facility
|
IP
|
$204.94
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000004
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$142.64 |
| Max. Negotiated Rate |
$184.45 |
| Rate for Payer: Aetna Commercial |
$174.20
|
| Rate for Payer: BCBS Trust/PPO |
$169.26
|
| Rate for Payer: BCN Commercial |
$169.26
|
| Rate for Payer: Cash Price |
$163.95
|
| Rate for Payer: Cofinity Commercial |
$176.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.95
|
| Rate for Payer: Healthscope Commercial |
$184.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.20
|
| Rate for Payer: Nomi Health Commercial |
$168.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.71
|
| Rate for Payer: PHP Commercial |
$174.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$178.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.35
|
| Rate for Payer: UHC Core |
$171.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.71
|
|
|
HC PI LINKED ANTIGEN CMPT
|
Facility
|
IP
|
$204.94
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000005
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$142.64 |
| Max. Negotiated Rate |
$184.45 |
| Rate for Payer: Aetna Commercial |
$174.20
|
| Rate for Payer: BCBS Trust/PPO |
$169.26
|
| Rate for Payer: BCN Commercial |
$169.26
|
| Rate for Payer: Cash Price |
$163.95
|
| Rate for Payer: Cofinity Commercial |
$176.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.95
|
| Rate for Payer: Healthscope Commercial |
$184.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.20
|
| Rate for Payer: Nomi Health Commercial |
$168.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.71
|
| Rate for Payer: PHP Commercial |
$174.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$178.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.35
|
| Rate for Payer: UHC Core |
$171.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.71
|
|
|
HC PI LINKED ANTIGEN CMPT
|
Facility
|
OP
|
$204.94
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000005
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$36.13 |
| Max. Negotiated Rate |
$184.45 |
| Rate for Payer: Aetna Commercial |
$174.20
|
| Rate for Payer: Aetna Medicare |
$53.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.04
|
| Rate for Payer: BCBS Complete |
$37.93
|
| Rate for Payer: BCBS MAPPO |
$51.23
|
| Rate for Payer: BCBS Trust/PPO |
$168.48
|
| Rate for Payer: BCN Commercial |
$168.48
|
| Rate for Payer: BCN Medicare Advantage |
$51.23
|
| Rate for Payer: Cash Price |
$163.95
|
| Rate for Payer: Cofinity Commercial |
$176.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.23
|
| Rate for Payer: Healthscope Commercial |
$184.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.71
|
| Rate for Payer: Mclaren Medicaid |
$36.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.80
|
| Rate for Payer: Meridian Medicaid |
$37.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.20
|
| Rate for Payer: Nomi Health Commercial |
$168.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.71
|
| Rate for Payer: PACE Senior Care Partners |
$48.67
|
| Rate for Payer: PACE SWMI |
$51.23
|
| Rate for Payer: PHP Commercial |
$174.20
|
| Rate for Payer: PHP Medicare Advantage |
$51.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$178.30
|
| Rate for Payer: Priority Health Medicare |
$51.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.64
|
| Rate for Payer: Railroad Medicare Medicare |
$51.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.35
|
| Rate for Payer: UHC Core |
$171.12
|
| Rate for Payer: UHC Exchange |
$51.23
|
| Rate for Payer: UHC Medicaid |
$36.13
|
| Rate for Payer: UHC Medicare Advantage |
$51.23
|
| Rate for Payer: UHCCP Medicaid |
$36.13
|
| Rate for Payer: VA VA |
$51.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.71
|
|
|
HC PI LINKED ANTIGEN CMPT2
|
Facility
|
OP
|
$64.85
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.43 |
| Max. Negotiated Rate |
$58.37 |
| Rate for Payer: Aetna Commercial |
$55.12
|
| Rate for Payer: Aetna Medicare |
$16.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.27
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$16.21
|
| Rate for Payer: BCBS Trust/PPO |
$53.31
|
| Rate for Payer: BCN Commercial |
$53.31
|
| Rate for Payer: BCN Medicare Advantage |
$16.21
|
| Rate for Payer: Cash Price |
$51.88
|
| Rate for Payer: Cofinity Commercial |
$55.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.21
|
| Rate for Payer: Healthscope Commercial |
$58.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.64
|
| Rate for Payer: Mclaren Medicaid |
$11.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.02
|
| Rate for Payer: Meridian Medicaid |
$12.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.12
|
| Rate for Payer: Nomi Health Commercial |
$53.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.64
|
| Rate for Payer: PACE Senior Care Partners |
$15.40
|
| Rate for Payer: PACE SWMI |
$16.21
|
| Rate for Payer: PHP Commercial |
$55.12
|
| Rate for Payer: PHP Medicare Advantage |
$16.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.42
|
| Rate for Payer: Priority Health Medicare |
$16.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.14
|
| Rate for Payer: Railroad Medicare Medicare |
$16.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.07
|
| Rate for Payer: UHC Core |
$54.15
|
| Rate for Payer: UHC Exchange |
$16.21
|
| Rate for Payer: UHC Medicaid |
$11.43
|
| Rate for Payer: UHC Medicare Advantage |
$16.21
|
| Rate for Payer: UHCCP Medicaid |
$11.43
|
| Rate for Payer: VA VA |
$16.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.64
|
|
|
HC PI LINKED ANTIGEN CMPT2
|
Facility
|
IP
|
$64.85
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$45.14 |
| Max. Negotiated Rate |
$58.37 |
| Rate for Payer: Aetna Commercial |
$55.12
|
| Rate for Payer: BCBS Trust/PPO |
$53.56
|
| Rate for Payer: BCN Commercial |
$53.56
|
| Rate for Payer: Cash Price |
$51.88
|
| Rate for Payer: Cofinity Commercial |
$55.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.88
|
| Rate for Payer: Healthscope Commercial |
$58.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.12
|
| Rate for Payer: Nomi Health Commercial |
$53.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.64
|
| Rate for Payer: PHP Commercial |
$55.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.07
|
| Rate for Payer: UHC Core |
$54.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.64
|
|
|
HC PINWORM EXAM
|
Facility
|
OP
|
$56.60
|
|
|
Service Code
|
CPT 87172
|
| Hospital Charge Code |
30600094
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.98 |
| Max. Negotiated Rate |
$50.94 |
| Rate for Payer: Aetna Commercial |
$48.11
|
| Rate for Payer: Aetna Medicare |
$14.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.69
|
| Rate for Payer: BCBS Complete |
$10.48
|
| Rate for Payer: BCBS MAPPO |
$14.15
|
| Rate for Payer: BCBS Trust/PPO |
$46.53
|
| Rate for Payer: BCN Commercial |
$46.53
|
| Rate for Payer: BCN Medicare Advantage |
$14.15
|
| Rate for Payer: Cash Price |
$45.28
|
| Rate for Payer: Cofinity Commercial |
$48.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.15
|
| Rate for Payer: Healthscope Commercial |
$50.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.45
|
| Rate for Payer: Mclaren Medicaid |
$9.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.86
|
| Rate for Payer: Meridian Medicaid |
$10.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.11
|
| Rate for Payer: Nomi Health Commercial |
$46.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.45
|
| Rate for Payer: PACE Senior Care Partners |
$13.44
|
| Rate for Payer: PACE SWMI |
$14.15
|
| Rate for Payer: PHP Commercial |
$48.11
|
| Rate for Payer: PHP Medicare Advantage |
$14.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.24
|
| Rate for Payer: Priority Health Medicare |
$14.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.39
|
| Rate for Payer: Railroad Medicare Medicare |
$14.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.81
|
| Rate for Payer: UHC Core |
$47.26
|
| Rate for Payer: UHC Exchange |
$14.15
|
| Rate for Payer: UHC Medicaid |
$9.98
|
| Rate for Payer: UHC Medicare Advantage |
$14.15
|
| Rate for Payer: UHCCP Medicaid |
$9.98
|
| Rate for Payer: VA VA |
$14.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.45
|
|
