|
HC POWDER OSTOMY
|
Facility
|
IP
|
$26.19
|
|
| Hospital Charge Code |
27000139
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.23 |
| Max. Negotiated Rate |
$23.57 |
| Rate for Payer: Aetna Commercial |
$22.26
|
| Rate for Payer: BCBS Trust/PPO |
$21.63
|
| Rate for Payer: BCN Commercial |
$21.63
|
| Rate for Payer: Cash Price |
$20.95
|
| Rate for Payer: Cofinity Commercial |
$22.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.95
|
| Rate for Payer: Healthscope Commercial |
$23.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.26
|
| Rate for Payer: Nomi Health Commercial |
$21.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.64
|
| Rate for Payer: PHP Commercial |
$22.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.05
|
| Rate for Payer: UHC Core |
$21.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.64
|
|
|
HC POWER CVC
|
Facility
|
OP
|
$563.75
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200235
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$99.39 |
| Max. Negotiated Rate |
$507.38 |
| Rate for Payer: Aetna Commercial |
$479.19
|
| Rate for Payer: Aetna Medicare |
$146.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$176.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$176.17
|
| Rate for Payer: BCBS Complete |
$104.35
|
| Rate for Payer: BCBS MAPPO |
$140.94
|
| Rate for Payer: BCBS Trust/PPO |
$463.46
|
| Rate for Payer: BCN Commercial |
$463.46
|
| Rate for Payer: BCN Medicare Advantage |
$140.94
|
| Rate for Payer: Cash Price |
$451.00
|
| Rate for Payer: Cofinity Commercial |
$484.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$451.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.94
|
| Rate for Payer: Healthscope Commercial |
$507.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.81
|
| Rate for Payer: Mclaren Medicaid |
$99.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.98
|
| Rate for Payer: Meridian Medicaid |
$104.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$155.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$479.19
|
| Rate for Payer: Nomi Health Commercial |
$462.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$422.81
|
| Rate for Payer: PACE Senior Care Partners |
$133.89
|
| Rate for Payer: PACE SWMI |
$140.94
|
| Rate for Payer: PHP Commercial |
$479.19
|
| Rate for Payer: PHP Medicare Advantage |
$140.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$490.46
|
| Rate for Payer: Priority Health Medicare |
$142.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$392.37
|
| Rate for Payer: Railroad Medicare Medicare |
$140.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$496.10
|
| Rate for Payer: UHC Core |
$470.73
|
| Rate for Payer: UHC Exchange |
$140.94
|
| Rate for Payer: UHC Medicaid |
$99.39
|
| Rate for Payer: UHC Medicare Advantage |
$140.94
|
| Rate for Payer: UHCCP Medicaid |
$99.39
|
| Rate for Payer: VA VA |
$140.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.81
|
|
|
HC POWER CVC
|
Facility
|
IP
|
$563.75
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200235
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$392.37 |
| Max. Negotiated Rate |
$507.38 |
| Rate for Payer: Aetna Commercial |
$479.19
|
| Rate for Payer: BCBS Trust/PPO |
$465.60
|
| Rate for Payer: BCN Commercial |
$465.60
|
| Rate for Payer: Cash Price |
$451.00
|
| Rate for Payer: Cofinity Commercial |
$484.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$451.00
|
| Rate for Payer: Healthscope Commercial |
$507.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$479.19
|
| Rate for Payer: Nomi Health Commercial |
$462.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$422.81
|
| Rate for Payer: PHP Commercial |
$479.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$490.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$392.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$496.10
|
| Rate for Payer: UHC Core |
$470.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.81
|
|
|
HC POWER CVC SPRINGWIRE GUIDE
|
Facility
|
IP
|
$39.48
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.48 |
| Max. Negotiated Rate |
$35.53 |
| Rate for Payer: Aetna Commercial |
$33.56
|
| Rate for Payer: BCBS Trust/PPO |
$32.61
|
| Rate for Payer: BCN Commercial |
$32.61
|
| Rate for Payer: Cash Price |
$31.58
|
| Rate for Payer: Cofinity Commercial |
$33.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.58
|
| Rate for Payer: Healthscope Commercial |
$35.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.56
|
| Rate for Payer: Nomi Health Commercial |
$32.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.61
|
| Rate for Payer: PHP Commercial |
$33.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.74
|
| Rate for Payer: UHC Core |
$32.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.61
|
|
|
HC POWER CVC SPRINGWIRE GUIDE
|
Facility
|
OP
|
$39.48
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.96 |
| Max. Negotiated Rate |
$35.53 |
| Rate for Payer: Aetna Commercial |
$33.56
|
| Rate for Payer: Aetna Medicare |
$10.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.34
|
| Rate for Payer: BCBS Complete |
$7.31
|
| Rate for Payer: BCBS MAPPO |
$9.87
|
| Rate for Payer: BCBS Trust/PPO |
$32.46
|
| Rate for Payer: BCN Commercial |
$32.46
|
| Rate for Payer: BCN Medicare Advantage |
$9.87
|
| Rate for Payer: Cash Price |
$31.58
|
| Rate for Payer: Cofinity Commercial |
$33.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.87
|
| Rate for Payer: Healthscope Commercial |
$35.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.61
|
| Rate for Payer: Mclaren Medicaid |
$6.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.36
|
| Rate for Payer: Meridian Medicaid |
$7.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.56
|
| Rate for Payer: Nomi Health Commercial |
$32.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.61
|
| Rate for Payer: PACE Senior Care Partners |
$9.38
|
| Rate for Payer: PACE SWMI |
$9.87
|
| Rate for Payer: PHP Commercial |
$33.56
|
| Rate for Payer: PHP Medicare Advantage |
$9.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.35
|
| Rate for Payer: Priority Health Medicare |
$9.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.48
|
| Rate for Payer: Railroad Medicare Medicare |
$9.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.74
|
| Rate for Payer: UHC Core |
$32.97
|
| Rate for Payer: UHC Exchange |
$9.87
|
| Rate for Payer: UHC Medicaid |
$6.96
|
| Rate for Payer: UHC Medicare Advantage |
$9.87
|
| Rate for Payer: UHCCP Medicaid |
$6.96
|
| Rate for Payer: VA VA |
$9.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.61
|
|
|
HC POWERWAND CATHETER
|
Facility
|
OP
|
$548.74
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200241
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$96.74 |
| Max. Negotiated Rate |
$493.87 |
| Rate for Payer: Aetna Commercial |
$466.43
|
| Rate for Payer: Aetna Medicare |
$142.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$171.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$171.48
|
| Rate for Payer: BCBS Complete |
$101.57
|
| Rate for Payer: BCBS MAPPO |
$137.19
|
| Rate for Payer: BCBS Trust/PPO |
$451.12
|
| Rate for Payer: BCN Commercial |
$451.12
|
| Rate for Payer: BCN Medicare Advantage |
$137.19
|
| Rate for Payer: Cash Price |
$438.99
|
| Rate for Payer: Cofinity Commercial |
$471.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$438.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.19
|
| Rate for Payer: Healthscope Commercial |
$493.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$411.56
|
| Rate for Payer: Mclaren Medicaid |
$96.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.04
|
| Rate for Payer: Meridian Medicaid |
$101.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$157.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$466.43
|
| Rate for Payer: Nomi Health Commercial |
$449.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$411.56
|
| Rate for Payer: PACE Senior Care Partners |
$130.33
|
| Rate for Payer: PACE SWMI |
$137.19
|
| Rate for Payer: PHP Commercial |
$466.43
|
| Rate for Payer: PHP Medicare Advantage |
$137.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$477.40
|
| Rate for Payer: Priority Health Medicare |
$138.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$381.92
|
| Rate for Payer: Railroad Medicare Medicare |
$137.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$482.89
|
| Rate for Payer: UHC Core |
$458.20
|
| Rate for Payer: UHC Exchange |
$137.19
|
| Rate for Payer: UHC Medicaid |
$96.74
|
| Rate for Payer: UHC Medicare Advantage |
$137.19
|
| Rate for Payer: UHCCP Medicaid |
$96.74
|
| Rate for Payer: VA VA |
$137.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$411.56
|
|
|
HC POWERWAND CATHETER
|
Facility
|
IP
|
$548.74
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200241
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$381.92 |
| Max. Negotiated Rate |
$493.87 |
| Rate for Payer: Aetna Commercial |
$466.43
|
| Rate for Payer: BCBS Trust/PPO |
$453.20
|
| Rate for Payer: BCN Commercial |
$453.20
|
| Rate for Payer: Cash Price |
$438.99
|
| Rate for Payer: Cofinity Commercial |
$471.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$438.99
|
| Rate for Payer: Healthscope Commercial |
$493.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$411.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$466.43
|
| Rate for Payer: Nomi Health Commercial |
$449.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$411.56
|
| Rate for Payer: PHP Commercial |
$466.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$477.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$381.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$482.89
|
| Rate for Payer: UHC Core |
$458.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$411.56
|
|
|
HC PPM SINGLE/A LEAD
|
Facility
|
OP
|
$12,110.55
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
36100057
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,135.09 |
| Max. Negotiated Rate |
$10,899.50 |
| Rate for Payer: Aetna Commercial |
$10,293.97
|
| Rate for Payer: Aetna Medicare |
$3,148.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,784.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,784.55
|
| Rate for Payer: BCBS Complete |
$2,241.66
|
| Rate for Payer: BCBS MAPPO |
$3,027.64
|
| Rate for Payer: BCBS Trust/PPO |
$9,956.08
|
| Rate for Payer: BCN Commercial |
$9,956.08
|
| Rate for Payer: BCN Medicare Advantage |
$3,027.64
|
| Rate for Payer: Cash Price |
$9,688.44
|
| Rate for Payer: Cofinity Commercial |
$10,415.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,688.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,027.64
|
| Rate for Payer: Healthscope Commercial |
$10,899.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,082.91
|
| Rate for Payer: Mclaren Medicaid |
$2,135.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,179.02
|
| Rate for Payer: Meridian Medicaid |
$2,241.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,481.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,330.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,293.97
|
| Rate for Payer: Nomi Health Commercial |
$9,930.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,082.91
|
| Rate for Payer: PACE Senior Care Partners |
$2,876.26
|
| Rate for Payer: PACE SWMI |
$3,027.64
|
| Rate for Payer: PHP Commercial |
$10,293.97
|
| Rate for Payer: PHP Medicare Advantage |
$3,027.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,135.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,536.18
|
| Rate for Payer: Priority Health Medicare |
$3,057.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,428.94
|
| Rate for Payer: Railroad Medicare Medicare |
$3,027.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,657.28
|
| Rate for Payer: UHC Core |
$10,112.31
|
| Rate for Payer: UHC Exchange |
$3,027.64
|
| Rate for Payer: UHC Medicaid |
$2,135.09
|
| Rate for Payer: UHC Medicare Advantage |
$3,027.64
|
| Rate for Payer: UHCCP Medicaid |
$2,135.09
|
| Rate for Payer: VA VA |
$3,027.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,082.91
|
|
|
HC PPM SINGLE/A LEAD
|
Facility
|
IP
|
$12,110.55
|
|
|
Service Code
|
CPT 33206
|
| Hospital Charge Code |
36100057
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,428.94 |
| Max. Negotiated Rate |
$10,899.50 |
| Rate for Payer: Aetna Commercial |
$10,293.97
|
| Rate for Payer: BCBS Trust/PPO |
$10,002.10
|
| Rate for Payer: BCN Commercial |
$10,002.10
|
| Rate for Payer: Cash Price |
$9,688.44
|
| Rate for Payer: Cofinity Commercial |
$10,415.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,688.44
|
| Rate for Payer: Healthscope Commercial |
$10,899.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,082.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,293.97
|
| Rate for Payer: Nomi Health Commercial |
$9,930.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,082.91
|
| Rate for Payer: PHP Commercial |
$10,293.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,536.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,428.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,657.28
|
| Rate for Payer: UHC Core |
$10,112.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,082.91
|
|
|
HC PPM SINGLE/V LEAD
|
Facility
|
OP
|
$13,713.41
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
36100058
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,417.67 |
| Max. Negotiated Rate |
$12,342.07 |
| Rate for Payer: Aetna Commercial |
$11,656.40
|
| Rate for Payer: Aetna Medicare |
$3,565.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,285.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,285.44
|
| Rate for Payer: BCBS Complete |
$2,538.35
|
| Rate for Payer: BCBS MAPPO |
$3,428.35
|
| Rate for Payer: BCBS Trust/PPO |
$11,273.79
|
| Rate for Payer: BCN Commercial |
$11,273.79
|
| Rate for Payer: BCN Medicare Advantage |
$3,428.35
|
| Rate for Payer: Cash Price |
$10,970.73
|
| Rate for Payer: Cofinity Commercial |
$11,793.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,970.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,428.35
|
| Rate for Payer: Healthscope Commercial |
$12,342.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,285.06
|
| Rate for Payer: Mclaren Medicaid |
$2,417.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,599.77
|
| Rate for Payer: Meridian Medicaid |
$2,538.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,942.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,771.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,656.40
|
| Rate for Payer: Nomi Health Commercial |
$11,245.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,285.06
|
| Rate for Payer: PACE Senior Care Partners |
$3,256.93
|
| Rate for Payer: PACE SWMI |
$3,428.35
|
| Rate for Payer: PHP Commercial |
$11,656.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,428.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,417.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,930.67
|
| Rate for Payer: Priority Health Medicare |
$3,462.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,544.53
|
| Rate for Payer: Railroad Medicare Medicare |
$3,428.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,067.80
|
| Rate for Payer: UHC Core |
$11,450.70
|
| Rate for Payer: UHC Exchange |
$3,428.35
|
| Rate for Payer: UHC Medicaid |
$2,417.67
|
| Rate for Payer: UHC Medicare Advantage |
$3,428.35
|
| Rate for Payer: UHCCP Medicaid |
$2,417.67
|
| Rate for Payer: VA VA |
$3,428.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,285.06
|
|
|
HC PPM SINGLE/V LEAD
|
Facility
|
IP
|
$13,713.41
|
|
|
Service Code
|
CPT 33207
|
| Hospital Charge Code |
36100058
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,544.53 |
| Max. Negotiated Rate |
$12,342.07 |
| Rate for Payer: Aetna Commercial |
$11,656.40
|
| Rate for Payer: BCBS Trust/PPO |
$11,325.91
|
| Rate for Payer: BCN Commercial |
$11,325.91
|
| Rate for Payer: Cash Price |
$10,970.73
|
| Rate for Payer: Cofinity Commercial |
$11,793.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,970.73
|
| Rate for Payer: Healthscope Commercial |
$12,342.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,285.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,656.40
|
| Rate for Payer: Nomi Health Commercial |
$11,245.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,285.06
|
| Rate for Payer: PHP Commercial |
$11,656.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,930.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,544.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,067.80
|
| Rate for Payer: UHC Core |
$11,450.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,285.06
|
|
|
HC PPU OBSERVATION PER HOUR
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200007
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna Medicare |
$41.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.00
|
| Rate for Payer: BCBS Complete |
$29.62
|
| Rate for Payer: BCBS MAPPO |
$40.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.54
|
| Rate for Payer: BCN Commercial |
$131.54
|
| Rate for Payer: BCN Medicare Advantage |
$40.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Mclaren Medicaid |
$28.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.00
|
| Rate for Payer: Meridian Medicaid |
$29.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PACE Senior Care Partners |
$38.00
|
| Rate for Payer: PACE SWMI |
$40.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: PHP Medicare Advantage |
$40.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: Railroad Medicare Medicare |
$40.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: UHC Exchange |
$40.00
|
| Rate for Payer: UHC Medicaid |
$28.21
|
| Rate for Payer: UHC Medicare Advantage |
$40.00
|
| Rate for Payer: UHCCP Medicaid |
$850.00
|
| Rate for Payer: VA VA |
$40.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC PPU OBSERVATION PER HOUR
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200007
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$111.36 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: BCBS Trust/PPO |
$132.14
|
| Rate for Payer: BCN Commercial |
$132.14
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC PRADER WILLI MOL ANALYSIS
|
Facility
|
IP
|
$447.37
|
|
|
Service Code
|
CPT 81331
|
| Hospital Charge Code |
31000103
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$311.37 |
| Max. Negotiated Rate |
$402.63 |
| Rate for Payer: Aetna Commercial |
$380.26
|
| Rate for Payer: BCBS Trust/PPO |
$369.48
|
| Rate for Payer: BCN Commercial |
$369.48
|
| Rate for Payer: Cash Price |
$357.90
|
| Rate for Payer: Cofinity Commercial |
$384.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.90
|
| Rate for Payer: Healthscope Commercial |
$402.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.26
|
| Rate for Payer: Nomi Health Commercial |
$366.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.53
|
| Rate for Payer: PHP Commercial |
$380.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$389.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.69
|
| Rate for Payer: UHC Core |
$373.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.53
|
|
|
HC PRADER WILLI MOL ANALYSIS
|
Facility
|
OP
|
$447.37
|
|
|
Service Code
|
CPT 81331
|
| Hospital Charge Code |
31000103
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$78.87 |
| Max. Negotiated Rate |
$402.63 |
| Rate for Payer: Aetna Commercial |
$380.26
|
| Rate for Payer: Aetna Medicare |
$116.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.80
|
| Rate for Payer: BCBS Complete |
$82.81
|
| Rate for Payer: BCBS MAPPO |
$111.84
|
| Rate for Payer: BCBS Trust/PPO |
$367.78
|
| Rate for Payer: BCN Commercial |
$367.78
|
| Rate for Payer: BCN Medicare Advantage |
$111.84
|
| Rate for Payer: Cash Price |
$357.90
|
| Rate for Payer: Cofinity Commercial |
$384.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.84
|
| Rate for Payer: Healthscope Commercial |
$402.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.53
|
| Rate for Payer: Mclaren Medicaid |
$78.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.43
|
| Rate for Payer: Meridian Medicaid |
$82.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.26
|
| Rate for Payer: Nomi Health Commercial |
$366.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.53
|
| Rate for Payer: PACE Senior Care Partners |
$106.25
|
| Rate for Payer: PACE SWMI |
$111.84
|
| Rate for Payer: PHP Commercial |
$380.26
|
| Rate for Payer: PHP Medicare Advantage |
$111.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$389.21
|
| Rate for Payer: Priority Health Medicare |
$112.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.37
|
| Rate for Payer: Railroad Medicare Medicare |
$111.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.69
|
| Rate for Payer: UHC Core |
$373.55
|
| Rate for Payer: UHC Exchange |
$111.84
|
| Rate for Payer: UHC Medicaid |
$78.87
|
| Rate for Payer: UHC Medicare Advantage |
$111.84
|
| Rate for Payer: UHCCP Medicaid |
$78.87
|
| Rate for Payer: VA VA |
$111.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.53
|
|
|
HC PREALBUMIN
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 84134
|
| Hospital Charge Code |
30100398
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.47 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$18.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.11
|
| Rate for Payer: BCBS Complete |
$13.10
|
| Rate for Payer: BCBS MAPPO |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$58.16
|
| Rate for Payer: BCN Commercial |
$58.16
|
| Rate for Payer: BCN Medicare Advantage |
$17.69
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.69
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Mclaren Medicaid |
$12.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.57
|
| Rate for Payer: Meridian Medicaid |
$13.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PACE Senior Care Partners |
$16.80
|
| Rate for Payer: PACE SWMI |
$17.69
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: PHP Medicare Advantage |
$17.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Medicare |
$17.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.24
|
| Rate for Payer: Railroad Medicare Medicare |
$17.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: UHC Exchange |
$17.69
|
| Rate for Payer: UHC Medicaid |
$12.47
|
| Rate for Payer: UHC Medicare Advantage |
$17.69
|
| Rate for Payer: UHCCP Medicaid |
$12.47
|
| Rate for Payer: VA VA |
$17.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC PREALBUMIN
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 84134
|
| Hospital Charge Code |
30100398
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.24 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: BCBS Trust/PPO |
$58.43
|
| Rate for Payer: BCN Commercial |
$58.43
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC PREGNANCY TEST SERUM
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 84703
|
| Hospital Charge Code |
30100467
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.15 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: BCBS Trust/PPO |
$26.29
|
| Rate for Payer: BCN Commercial |
$26.29
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.01
|
| Rate for Payer: UHC Core |
$26.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC PREGNANCY TEST SERUM
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 84703
|
| Hospital Charge Code |
30100467
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Medicare |
$8.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.95
|
| Rate for Payer: BCBS Complete |
$5.89
|
| Rate for Payer: BCBS MAPPO |
$7.96
|
| Rate for Payer: BCBS Trust/PPO |
$26.17
|
| Rate for Payer: BCN Commercial |
$26.17
|
| Rate for Payer: BCN Medicare Advantage |
$7.96
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.96
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Mclaren Medicaid |
$5.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.36
|
| Rate for Payer: Meridian Medicaid |
$5.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PACE Senior Care Partners |
$7.56
|
| Rate for Payer: PACE SWMI |
$7.96
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: PHP Medicare Advantage |
$7.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.69
|
| Rate for Payer: Priority Health Medicare |
$8.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.15
|
| Rate for Payer: Railroad Medicare Medicare |
$7.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.01
|
| Rate for Payer: UHC Core |
$26.58
|
| Rate for Payer: UHC Exchange |
$7.96
|
| Rate for Payer: UHC Medicaid |
$5.61
|
| Rate for Payer: UHC Medicare Advantage |
$7.96
|
| Rate for Payer: UHCCP Medicaid |
$5.61
|
| Rate for Payer: VA VA |
$7.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC PREGNENOLONE
|
Facility
|
IP
|
$93.64
|
|
|
Service Code
|
CPT 84140
|
| Hospital Charge Code |
30100561
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$65.17 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: BCBS Trust/PPO |
$77.34
|
| Rate for Payer: BCN Commercial |
$77.34
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.40
|
| Rate for Payer: UHC Core |
$78.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC PREGNENOLONE
|
Facility
|
OP
|
$93.64
|
|
|
Service Code
|
CPT 84140
|
| Hospital Charge Code |
30100561
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.51 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna Medicare |
$24.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.26
|
| Rate for Payer: BCBS Complete |
$17.33
|
| Rate for Payer: BCBS MAPPO |
$23.41
|
| Rate for Payer: BCBS Trust/PPO |
$76.98
|
| Rate for Payer: BCN Commercial |
$76.98
|
| Rate for Payer: BCN Medicare Advantage |
$23.41
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.41
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$16.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.58
|
| Rate for Payer: Meridian Medicaid |
$17.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PACE Senior Care Partners |
$22.24
|
| Rate for Payer: PACE SWMI |
$23.41
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: PHP Medicare Advantage |
$23.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.47
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.17
|
| Rate for Payer: Railroad Medicare Medicare |
$23.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.40
|
| Rate for Payer: UHC Core |
$78.19
|
| Rate for Payer: UHC Exchange |
$23.41
|
| Rate for Payer: UHC Medicaid |
$16.51
|
| Rate for Payer: UHC Medicare Advantage |
$23.41
|
| Rate for Payer: UHCCP Medicaid |
$16.51
|
| Rate for Payer: VA VA |
$23.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC PRENATAL ANEUPLOIDY DETECTION, FISH
|
Facility
|
IP
|
$98.70
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000130
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.70 |
| Max. Negotiated Rate |
$88.83 |
| Rate for Payer: Aetna Commercial |
$83.89
|
| Rate for Payer: BCBS Trust/PPO |
$81.52
|
| Rate for Payer: BCN Commercial |
$81.52
|
| Rate for Payer: Cash Price |
$78.96
|
| Rate for Payer: Cofinity Commercial |
$84.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.96
|
| Rate for Payer: Healthscope Commercial |
$88.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.89
|
| Rate for Payer: Nomi Health Commercial |
$80.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.03
|
| Rate for Payer: PHP Commercial |
$83.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.86
|
| Rate for Payer: UHC Core |
$82.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.03
|
|
|
HC PRENATAL ANEUPLOIDY DETECTION, FISH
|
Facility
|
OP
|
$98.70
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000130
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.40 |
| Max. Negotiated Rate |
$88.83 |
| Rate for Payer: Aetna Commercial |
$83.89
|
| Rate for Payer: Aetna Medicare |
$25.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.84
|
| Rate for Payer: BCBS Complete |
$18.27
|
| Rate for Payer: BCBS MAPPO |
$24.68
|
| Rate for Payer: BCBS Trust/PPO |
$81.14
|
| Rate for Payer: BCN Commercial |
$81.14
|
| Rate for Payer: BCN Medicare Advantage |
$24.68
|
| Rate for Payer: Cash Price |
$78.96
|
| Rate for Payer: Cofinity Commercial |
$84.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.68
|
| Rate for Payer: Healthscope Commercial |
$88.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.03
|
| Rate for Payer: Mclaren Medicaid |
$17.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.91
|
| Rate for Payer: Meridian Medicaid |
$18.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.89
|
| Rate for Payer: Nomi Health Commercial |
$80.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.03
|
| Rate for Payer: PACE Senior Care Partners |
$23.44
|
| Rate for Payer: PACE SWMI |
$24.68
|
| Rate for Payer: PHP Commercial |
$83.89
|
| Rate for Payer: PHP Medicare Advantage |
$24.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.87
|
| Rate for Payer: Priority Health Medicare |
$24.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.70
|
| Rate for Payer: Railroad Medicare Medicare |
$24.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.86
|
| Rate for Payer: UHC Core |
$82.41
|
| Rate for Payer: UHC Exchange |
$24.68
|
| Rate for Payer: UHC Medicaid |
$17.40
|
| Rate for Payer: UHC Medicare Advantage |
$24.68
|
| Rate for Payer: UHCCP Medicaid |
$17.40
|
| Rate for Payer: VA VA |
$24.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.03
|
|
|
HC PRENATAL ZIKA VIRUS MAC ELISA IGM
|
Facility
|
OP
|
$191.43
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000149
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$172.29 |
| Rate for Payer: Aetna Commercial |
$162.72
|
| Rate for Payer: Aetna Medicare |
$49.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.82
|
| Rate for Payer: BCBS Complete |
$35.43
|
| Rate for Payer: BCBS MAPPO |
$47.86
|
| Rate for Payer: BCBS Trust/PPO |
$157.37
|
| Rate for Payer: BCN Commercial |
$157.37
|
| Rate for Payer: BCN Medicare Advantage |
$47.86
|
| Rate for Payer: Cash Price |
$153.14
|
| Rate for Payer: Cofinity Commercial |
$164.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.86
|
| Rate for Payer: Healthscope Commercial |
$172.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.57
|
| Rate for Payer: Mclaren Medicaid |
$33.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.25
|
| Rate for Payer: Meridian Medicaid |
$35.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.72
|
| Rate for Payer: Nomi Health Commercial |
$156.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.57
|
| Rate for Payer: PACE Senior Care Partners |
$45.46
|
| Rate for Payer: PACE SWMI |
$47.86
|
| Rate for Payer: PHP Commercial |
$162.72
|
| Rate for Payer: PHP Medicare Advantage |
$47.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$166.54
|
| Rate for Payer: Priority Health Medicare |
$48.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.24
|
| Rate for Payer: Railroad Medicare Medicare |
$47.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.46
|
| Rate for Payer: UHC Core |
$159.84
|
| Rate for Payer: UHC Exchange |
$47.86
|
| Rate for Payer: UHC Medicaid |
$33.75
|
| Rate for Payer: UHC Medicare Advantage |
$47.86
|
| Rate for Payer: UHCCP Medicaid |
$33.75
|
| Rate for Payer: VA VA |
$47.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.57
|
|
|
HC PRENATAL ZIKA VIRUS MAC ELISA IGM
|
Facility
|
IP
|
$191.43
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000149
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$133.24 |
| Max. Negotiated Rate |
$172.29 |
| Rate for Payer: Aetna Commercial |
$162.72
|
| Rate for Payer: BCBS Trust/PPO |
$158.10
|
| Rate for Payer: BCN Commercial |
$158.10
|
| Rate for Payer: Cash Price |
$153.14
|
| Rate for Payer: Cofinity Commercial |
$164.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.14
|
| Rate for Payer: Healthscope Commercial |
$172.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.72
|
| Rate for Payer: Nomi Health Commercial |
$156.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.57
|
| Rate for Payer: PHP Commercial |
$162.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$166.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.46
|
| Rate for Payer: UHC Core |
$159.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.57
|
|
