|
HC PRENATLA ANEUPLOIDY DETECTION, FISH CMPT
|
Facility
|
OP
|
$72.17
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000131
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.72 |
| Max. Negotiated Rate |
$64.95 |
| Rate for Payer: Aetna Commercial |
$61.34
|
| Rate for Payer: Aetna Medicare |
$18.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.55
|
| Rate for Payer: BCBS Complete |
$13.36
|
| Rate for Payer: BCBS MAPPO |
$18.04
|
| Rate for Payer: BCBS Trust/PPO |
$59.33
|
| Rate for Payer: BCN Commercial |
$59.33
|
| Rate for Payer: BCN Medicare Advantage |
$18.04
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$62.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.04
|
| Rate for Payer: Healthscope Commercial |
$64.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.13
|
| Rate for Payer: Mclaren Medicaid |
$12.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.94
|
| Rate for Payer: Meridian Medicaid |
$13.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PACE Senior Care Partners |
$17.14
|
| Rate for Payer: PACE SWMI |
$18.04
|
| Rate for Payer: PHP Commercial |
$61.34
|
| Rate for Payer: PHP Medicare Advantage |
$18.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.79
|
| Rate for Payer: Priority Health Medicare |
$18.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.23
|
| Rate for Payer: Railroad Medicare Medicare |
$18.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.51
|
| Rate for Payer: UHC Core |
$60.26
|
| Rate for Payer: UHC Exchange |
$18.04
|
| Rate for Payer: UHC Medicaid |
$12.72
|
| Rate for Payer: UHC Medicare Advantage |
$18.04
|
| Rate for Payer: UHCCP Medicaid |
$12.72
|
| Rate for Payer: VA VA |
$18.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.13
|
|
|
HC PRENATLA ANEUPLOIDY DETECTION, FISH CMPT
|
Facility
|
IP
|
$72.17
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000131
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$50.23 |
| Max. Negotiated Rate |
$64.95 |
| Rate for Payer: Aetna Commercial |
$61.34
|
| Rate for Payer: BCBS Trust/PPO |
$59.61
|
| Rate for Payer: BCN Commercial |
$59.61
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$62.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Healthscope Commercial |
$64.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PHP Commercial |
$61.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.51
|
| Rate for Payer: UHC Core |
$60.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.13
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS BIL
|
Facility
|
IP
|
$1,526.66
|
|
|
Service Code
|
CPT 93985
|
| Hospital Charge Code |
92100036
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,062.56 |
| Max. Negotiated Rate |
$1,373.99 |
| Rate for Payer: Aetna Commercial |
$1,297.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.87
|
| Rate for Payer: BCN Commercial |
$1,260.87
|
| Rate for Payer: Cash Price |
$1,221.33
|
| Rate for Payer: Cofinity Commercial |
$1,312.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,221.33
|
| Rate for Payer: Healthscope Commercial |
$1,373.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,144.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,297.66
|
| Rate for Payer: Nomi Health Commercial |
$1,251.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,144.99
|
| Rate for Payer: PHP Commercial |
$1,297.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,328.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,062.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,343.46
|
| Rate for Payer: UHC Core |
$1,274.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,144.99
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS BIL
|
Facility
|
OP
|
$1,526.66
|
|
|
Service Code
|
CPT 93985
|
| Hospital Charge Code |
92100036
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$269.15 |
| Max. Negotiated Rate |
$1,373.99 |
| Rate for Payer: Aetna Commercial |
$1,297.66
|
| Rate for Payer: Aetna Medicare |
$396.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$477.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$477.08
|
| Rate for Payer: BCBS Complete |
$282.58
|
| Rate for Payer: BCBS MAPPO |
$381.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,255.07
|
| Rate for Payer: BCN Commercial |
$1,255.07
|
| Rate for Payer: BCN Medicare Advantage |
$381.67
|
| Rate for Payer: Cash Price |
$1,221.33
|
| Rate for Payer: Cofinity Commercial |
$1,312.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,221.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$381.67
|
| Rate for Payer: Healthscope Commercial |
$1,373.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,144.99
|
| Rate for Payer: Mclaren Medicaid |
$269.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$400.75
|
| Rate for Payer: Meridian Medicaid |
$282.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$438.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$419.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,297.66
|
| Rate for Payer: Nomi Health Commercial |
$1,251.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,144.99
|
| Rate for Payer: PACE Senior Care Partners |
$362.58
|
| Rate for Payer: PACE SWMI |
$381.67
|
| Rate for Payer: PHP Commercial |
$1,297.66
|
| Rate for Payer: PHP Medicare Advantage |
$381.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,328.19
|
| Rate for Payer: Priority Health Medicare |
$385.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,062.56
|
| Rate for Payer: Railroad Medicare Medicare |
$381.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,343.46
|
| Rate for Payer: UHC Core |
$1,274.76
|
| Rate for Payer: UHC Exchange |
$381.67
|
| Rate for Payer: UHC Medicaid |
$269.15
|
| Rate for Payer: UHC Medicare Advantage |
$381.67
|
| Rate for Payer: UHCCP Medicaid |
$269.15
|
| Rate for Payer: VA VA |
$381.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,144.99
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS UNI.
|
Facility
|
IP
|
$884.98
|
|
|
Service Code
|
CPT 93986
|
| Hospital Charge Code |
92100037
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$615.95 |
| Max. Negotiated Rate |
$796.48 |
| Rate for Payer: Aetna Commercial |
$752.23
|
| Rate for Payer: BCBS Trust/PPO |
$730.90
|
| Rate for Payer: BCN Commercial |
$730.90
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Commercial |
$761.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Healthscope Commercial |
$796.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$663.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Nomi Health Commercial |
$725.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: PHP Commercial |
$752.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$769.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.78
|
| Rate for Payer: UHC Core |
$738.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$663.74
|
|
|
HC PREOP DUPLX HEMODIALYSIS ASSESS UNI.
|
Facility
|
OP
|
$884.98
|
|
|
Service Code
|
CPT 93986
|
| Hospital Charge Code |
92100037
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$156.02 |
| Max. Negotiated Rate |
$796.48 |
| Rate for Payer: Aetna Commercial |
$752.23
|
| Rate for Payer: Aetna Medicare |
$230.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$276.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$276.56
|
| Rate for Payer: BCBS Complete |
$163.81
|
| Rate for Payer: BCBS MAPPO |
$221.25
|
| Rate for Payer: BCBS Trust/PPO |
$727.54
|
| Rate for Payer: BCN Commercial |
$727.54
|
| Rate for Payer: BCN Medicare Advantage |
$221.25
|
| Rate for Payer: Cash Price |
$707.98
|
| Rate for Payer: Cofinity Commercial |
$761.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.25
|
| Rate for Payer: Healthscope Commercial |
$796.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$663.74
|
| Rate for Payer: Mclaren Medicaid |
$156.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$232.31
|
| Rate for Payer: Meridian Medicaid |
$163.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$243.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.23
|
| Rate for Payer: Nomi Health Commercial |
$725.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$663.74
|
| Rate for Payer: PACE Senior Care Partners |
$210.18
|
| Rate for Payer: PACE SWMI |
$221.25
|
| Rate for Payer: PHP Commercial |
$752.23
|
| Rate for Payer: PHP Medicare Advantage |
$221.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$156.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$769.93
|
| Rate for Payer: Priority Health Medicare |
$223.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$615.95
|
| Rate for Payer: Railroad Medicare Medicare |
$221.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.78
|
| Rate for Payer: UHC Core |
$738.96
|
| Rate for Payer: UHC Exchange |
$221.25
|
| Rate for Payer: UHC Medicaid |
$156.02
|
| Rate for Payer: UHC Medicare Advantage |
$221.25
|
| Rate for Payer: UHCCP Medicaid |
$156.02
|
| Rate for Payer: VA VA |
$221.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$663.74
|
|
|
HC PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT
|
Facility
|
OP
|
$1,040.40
|
|
|
Service Code
|
CPT 15004
|
| Hospital Charge Code |
76100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.42 |
| Max. Negotiated Rate |
$936.36 |
| Rate for Payer: Aetna Commercial |
$884.34
|
| Rate for Payer: Aetna Medicare |
$270.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.12
|
| Rate for Payer: BCBS Complete |
$192.58
|
| Rate for Payer: BCBS MAPPO |
$260.10
|
| Rate for Payer: BCBS Trust/PPO |
$855.31
|
| Rate for Payer: BCN Commercial |
$855.31
|
| Rate for Payer: BCN Medicare Advantage |
$260.10
|
| Rate for Payer: Cash Price |
$832.32
|
| Rate for Payer: Cofinity Commercial |
$894.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.10
|
| Rate for Payer: Healthscope Commercial |
$936.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$780.30
|
| Rate for Payer: Mclaren Medicaid |
$183.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.11
|
| Rate for Payer: Meridian Medicaid |
$192.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$286.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.34
|
| Rate for Payer: Nomi Health Commercial |
$853.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.30
|
| Rate for Payer: PACE Senior Care Partners |
$247.09
|
| Rate for Payer: PACE SWMI |
$260.10
|
| Rate for Payer: PHP Commercial |
$884.34
|
| Rate for Payer: PHP Medicare Advantage |
$260.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$905.15
|
| Rate for Payer: Priority Health Medicare |
$262.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$724.12
|
| Rate for Payer: Railroad Medicare Medicare |
$260.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$915.55
|
| Rate for Payer: UHC Core |
$868.73
|
| Rate for Payer: UHC Exchange |
$260.10
|
| Rate for Payer: UHC Medicaid |
$183.42
|
| Rate for Payer: UHC Medicare Advantage |
$260.10
|
| Rate for Payer: UHCCP Medicaid |
$183.42
|
| Rate for Payer: VA VA |
$260.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$780.30
|
|
|
HC PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT
|
Facility
|
IP
|
$1,040.40
|
|
|
Service Code
|
CPT 15004
|
| Hospital Charge Code |
76100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$724.12 |
| Max. Negotiated Rate |
$936.36 |
| Rate for Payer: Aetna Commercial |
$884.34
|
| Rate for Payer: BCBS Trust/PPO |
$859.27
|
| Rate for Payer: BCN Commercial |
$859.27
|
| Rate for Payer: Cash Price |
$832.32
|
| Rate for Payer: Cofinity Commercial |
$894.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$832.32
|
| Rate for Payer: Healthscope Commercial |
$936.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$780.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$884.34
|
| Rate for Payer: Nomi Health Commercial |
$853.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$780.30
|
| Rate for Payer: PHP Commercial |
$884.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$905.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$724.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$915.55
|
| Rate for Payer: UHC Core |
$868.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$780.30
|
|
|
HC PRESSURE WIRE
|
Facility
|
OP
|
$2,245.28
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$395.84 |
| Max. Negotiated Rate |
$2,020.75 |
| Rate for Payer: Aetna Commercial |
$1,908.49
|
| Rate for Payer: Aetna Medicare |
$583.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$701.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$701.65
|
| Rate for Payer: BCBS Complete |
$415.60
|
| Rate for Payer: BCBS MAPPO |
$561.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,845.84
|
| Rate for Payer: BCN Commercial |
$1,845.84
|
| Rate for Payer: BCN Medicare Advantage |
$561.32
|
| Rate for Payer: Cash Price |
$1,796.22
|
| Rate for Payer: Cofinity Commercial |
$1,930.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,796.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.32
|
| Rate for Payer: Healthscope Commercial |
$2,020.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,683.96
|
| Rate for Payer: Mclaren Medicaid |
$395.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.39
|
| Rate for Payer: Meridian Medicaid |
$415.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$645.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$617.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,908.49
|
| Rate for Payer: Nomi Health Commercial |
$1,841.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,683.96
|
| Rate for Payer: PACE Senior Care Partners |
$533.25
|
| Rate for Payer: PACE SWMI |
$561.32
|
| Rate for Payer: PHP Commercial |
$1,908.49
|
| Rate for Payer: PHP Medicare Advantage |
$561.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,953.39
|
| Rate for Payer: Priority Health Medicare |
$566.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,562.71
|
| Rate for Payer: Railroad Medicare Medicare |
$561.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,975.85
|
| Rate for Payer: UHC Core |
$1,874.81
|
| Rate for Payer: UHC Exchange |
$561.32
|
| Rate for Payer: UHC Medicaid |
$395.84
|
| Rate for Payer: UHC Medicare Advantage |
$561.32
|
| Rate for Payer: UHCCP Medicaid |
$395.84
|
| Rate for Payer: VA VA |
$561.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,683.96
|
|
|
HC PRESSURE WIRE
|
Facility
|
IP
|
$2,245.28
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200065
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,562.71 |
| Max. Negotiated Rate |
$2,020.75 |
| Rate for Payer: Aetna Commercial |
$1,908.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,854.38
|
| Rate for Payer: BCN Commercial |
$1,854.38
|
| Rate for Payer: Cash Price |
$1,796.22
|
| Rate for Payer: Cofinity Commercial |
$1,930.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,796.22
|
| Rate for Payer: Healthscope Commercial |
$2,020.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,683.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,908.49
|
| Rate for Payer: Nomi Health Commercial |
$1,841.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,683.96
|
| Rate for Payer: PHP Commercial |
$1,908.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,953.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,562.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,975.85
|
| Rate for Payer: UHC Core |
$1,874.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,683.96
|
|
|
HC PRESUMPTIVE DRUG TEST CHEM ANALYZER
|
Facility
|
IP
|
$106.12
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$73.86 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: BCBS Trust/PPO |
$87.64
|
| Rate for Payer: BCN Commercial |
$87.64
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$87.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.59
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$92.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.39
|
| Rate for Payer: UHC Core |
$88.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC PRESUMPTIVE DRUG TEST CHEM ANALYZER
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.71 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna Medicare |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.16
|
| Rate for Payer: BCBS Complete |
$19.64
|
| Rate for Payer: BCBS MAPPO |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$87.24
|
| Rate for Payer: BCN Commercial |
$87.24
|
| Rate for Payer: BCN Medicare Advantage |
$26.53
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.53
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Mclaren Medicaid |
$18.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.86
|
| Rate for Payer: Meridian Medicaid |
$19.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$87.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.59
|
| Rate for Payer: PACE Senior Care Partners |
$25.20
|
| Rate for Payer: PACE SWMI |
$26.53
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: PHP Medicare Advantage |
$26.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$92.32
|
| Rate for Payer: Priority Health Medicare |
$26.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.86
|
| Rate for Payer: Railroad Medicare Medicare |
$26.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.39
|
| Rate for Payer: UHC Core |
$88.61
|
| Rate for Payer: UHC Exchange |
$26.53
|
| Rate for Payer: UHC Medicaid |
$18.71
|
| Rate for Payer: UHC Medicare Advantage |
$26.53
|
| Rate for Payer: UHCCP Medicaid |
$18.71
|
| Rate for Payer: VA VA |
$26.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC PRESUMPTIVE DRUG TEST OPTICAL
|
Facility
|
OP
|
$52.53
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100728
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$47.28 |
| Rate for Payer: Aetna Commercial |
$44.65
|
| Rate for Payer: Aetna Medicare |
$13.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.42
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$13.13
|
| Rate for Payer: BCBS Trust/PPO |
$43.18
|
| Rate for Payer: BCN Commercial |
$43.18
|
| Rate for Payer: BCN Medicare Advantage |
$13.13
|
| Rate for Payer: Cash Price |
$42.02
|
| Rate for Payer: Cofinity Commercial |
$45.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.13
|
| Rate for Payer: Healthscope Commercial |
$47.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.40
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.79
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.65
|
| Rate for Payer: Nomi Health Commercial |
$43.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.40
|
| Rate for Payer: PACE Senior Care Partners |
$12.48
|
| Rate for Payer: PACE SWMI |
$13.13
|
| Rate for Payer: PHP Commercial |
$44.65
|
| Rate for Payer: PHP Medicare Advantage |
$13.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.70
|
| Rate for Payer: Priority Health Medicare |
$13.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.56
|
| Rate for Payer: Railroad Medicare Medicare |
$13.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.23
|
| Rate for Payer: UHC Core |
$43.86
|
| Rate for Payer: UHC Exchange |
$13.13
|
| Rate for Payer: UHC Medicaid |
$9.26
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: VA VA |
$13.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.40
|
|
|
HC PRESUMPTIVE DRUG TEST OPTICAL
|
Facility
|
IP
|
$52.53
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100728
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.56 |
| Max. Negotiated Rate |
$47.28 |
| Rate for Payer: Aetna Commercial |
$44.65
|
| Rate for Payer: BCBS Trust/PPO |
$43.38
|
| Rate for Payer: BCN Commercial |
$43.38
|
| Rate for Payer: Cash Price |
$42.02
|
| Rate for Payer: Cofinity Commercial |
$45.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.02
|
| Rate for Payer: Healthscope Commercial |
$47.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.65
|
| Rate for Payer: Nomi Health Commercial |
$43.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.40
|
| Rate for Payer: PHP Commercial |
$44.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.23
|
| Rate for Payer: UHC Core |
$43.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.40
|
|
|
HC PRIMARY MEMBRANOUS NEPH DX CASCADE S
|
Facility
|
IP
|
$215.36
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100757
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$149.89 |
| Max. Negotiated Rate |
$193.82 |
| Rate for Payer: Aetna Commercial |
$183.06
|
| Rate for Payer: BCBS Trust/PPO |
$177.87
|
| Rate for Payer: BCN Commercial |
$177.87
|
| Rate for Payer: Cash Price |
$172.29
|
| Rate for Payer: Cofinity Commercial |
$185.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.29
|
| Rate for Payer: Healthscope Commercial |
$193.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.06
|
| Rate for Payer: Nomi Health Commercial |
$176.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.52
|
| Rate for Payer: PHP Commercial |
$183.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$187.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.52
|
| Rate for Payer: UHC Core |
$179.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.52
|
|
|
HC PRIMARY MEMBRANOUS NEPH DX CASCADE S
|
Facility
|
OP
|
$215.36
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100757
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.97 |
| Max. Negotiated Rate |
$193.82 |
| Rate for Payer: Aetna Commercial |
$183.06
|
| Rate for Payer: Aetna Medicare |
$55.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.30
|
| Rate for Payer: BCBS Complete |
$39.86
|
| Rate for Payer: BCBS MAPPO |
$53.84
|
| Rate for Payer: BCBS Trust/PPO |
$177.05
|
| Rate for Payer: BCN Commercial |
$177.05
|
| Rate for Payer: BCN Medicare Advantage |
$53.84
|
| Rate for Payer: Cash Price |
$172.29
|
| Rate for Payer: Cofinity Commercial |
$185.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.84
|
| Rate for Payer: Healthscope Commercial |
$193.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.52
|
| Rate for Payer: Mclaren Medicaid |
$37.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.53
|
| Rate for Payer: Meridian Medicaid |
$39.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.06
|
| Rate for Payer: Nomi Health Commercial |
$176.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.52
|
| Rate for Payer: PACE Senior Care Partners |
$51.15
|
| Rate for Payer: PACE SWMI |
$53.84
|
| Rate for Payer: PHP Commercial |
$183.06
|
| Rate for Payer: PHP Medicare Advantage |
$53.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$187.36
|
| Rate for Payer: Priority Health Medicare |
$54.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.89
|
| Rate for Payer: Railroad Medicare Medicare |
$53.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.52
|
| Rate for Payer: UHC Core |
$179.83
|
| Rate for Payer: UHC Exchange |
$53.84
|
| Rate for Payer: UHC Medicaid |
$37.97
|
| Rate for Payer: UHC Medicare Advantage |
$53.84
|
| Rate for Payer: UHCCP Medicaid |
$37.97
|
| Rate for Payer: VA VA |
$53.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.52
|
|
|
HC PRIMIDONE MYSOLINE LEVEL
|
Facility
|
IP
|
$27.59
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$24.83 |
| Rate for Payer: Aetna Commercial |
$23.45
|
| Rate for Payer: BCBS Trust/PPO |
$22.79
|
| Rate for Payer: BCN Commercial |
$22.79
|
| Rate for Payer: Cash Price |
$22.07
|
| Rate for Payer: Cofinity Commercial |
$23.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.07
|
| Rate for Payer: Healthscope Commercial |
$24.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.45
|
| Rate for Payer: Nomi Health Commercial |
$22.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.69
|
| Rate for Payer: PHP Commercial |
$23.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.28
|
| Rate for Payer: UHC Core |
$23.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.69
|
|
|
HC PRIMIDONE MYSOLINE LEVEL
|
Facility
|
OP
|
$27.59
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.86 |
| Max. Negotiated Rate |
$24.83 |
| Rate for Payer: Aetna Commercial |
$23.45
|
| Rate for Payer: Aetna Medicare |
$7.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.62
|
| Rate for Payer: BCBS Complete |
$5.11
|
| Rate for Payer: BCBS MAPPO |
$6.90
|
| Rate for Payer: BCBS Trust/PPO |
$22.68
|
| Rate for Payer: BCN Commercial |
$22.68
|
| Rate for Payer: BCN Medicare Advantage |
$6.90
|
| Rate for Payer: Cash Price |
$22.07
|
| Rate for Payer: Cofinity Commercial |
$23.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.90
|
| Rate for Payer: Healthscope Commercial |
$24.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.69
|
| Rate for Payer: Mclaren Medicaid |
$4.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.24
|
| Rate for Payer: Meridian Medicaid |
$5.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.45
|
| Rate for Payer: Nomi Health Commercial |
$22.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.69
|
| Rate for Payer: PACE Senior Care Partners |
$6.55
|
| Rate for Payer: PACE SWMI |
$6.90
|
| Rate for Payer: PHP Commercial |
$23.45
|
| Rate for Payer: PHP Medicare Advantage |
$6.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.00
|
| Rate for Payer: Priority Health Medicare |
$6.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.20
|
| Rate for Payer: Railroad Medicare Medicare |
$6.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.28
|
| Rate for Payer: UHC Core |
$23.04
|
| Rate for Payer: UHC Exchange |
$6.90
|
| Rate for Payer: UHC Medicaid |
$4.86
|
| Rate for Payer: UHC Medicare Advantage |
$6.90
|
| Rate for Payer: UHCCP Medicaid |
$4.86
|
| Rate for Payer: VA VA |
$6.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.69
|
|
|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
IP
|
$39.26
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.32 |
| Max. Negotiated Rate |
$35.33 |
| Rate for Payer: Aetna Commercial |
$33.37
|
| Rate for Payer: BCBS Trust/PPO |
$32.42
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cofinity Commercial |
$33.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.41
|
| Rate for Payer: Healthscope Commercial |
$35.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.37
|
| Rate for Payer: Nomi Health Commercial |
$32.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.45
|
| Rate for Payer: PHP Commercial |
$33.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.55
|
| Rate for Payer: UHC Core |
$32.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.45
|
|
|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
OP
|
$39.26
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.92 |
| Max. Negotiated Rate |
$35.33 |
| Rate for Payer: Aetna Commercial |
$33.37
|
| Rate for Payer: Aetna Medicare |
$10.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.27
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$9.81
|
| Rate for Payer: BCBS Trust/PPO |
$32.28
|
| Rate for Payer: BCN Commercial |
$32.28
|
| Rate for Payer: BCN Medicare Advantage |
$9.81
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cofinity Commercial |
$33.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.81
|
| Rate for Payer: Healthscope Commercial |
$35.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.45
|
| Rate for Payer: Mclaren Medicaid |
$6.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.31
|
| Rate for Payer: Meridian Medicaid |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.37
|
| Rate for Payer: Nomi Health Commercial |
$32.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.45
|
| Rate for Payer: PACE Senior Care Partners |
$9.32
|
| Rate for Payer: PACE SWMI |
$9.81
|
| Rate for Payer: PHP Commercial |
$33.37
|
| Rate for Payer: PHP Medicare Advantage |
$9.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.16
|
| Rate for Payer: Priority Health Medicare |
$9.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.32
|
| Rate for Payer: Railroad Medicare Medicare |
$9.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.55
|
| Rate for Payer: UHC Core |
$32.78
|
| Rate for Payer: UHC Exchange |
$9.81
|
| Rate for Payer: UHC Medicaid |
$6.92
|
| Rate for Payer: UHC Medicare Advantage |
$9.81
|
| Rate for Payer: UHCCP Medicaid |
$6.92
|
| Rate for Payer: VA VA |
$9.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.45
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$258.02
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$45.49 |
| Max. Negotiated Rate |
$232.22 |
| Rate for Payer: Aetna Commercial |
$219.32
|
| Rate for Payer: Aetna Medicare |
$67.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.63
|
| Rate for Payer: BCBS Complete |
$47.76
|
| Rate for Payer: BCBS MAPPO |
$64.50
|
| Rate for Payer: BCBS Trust/PPO |
$212.12
|
| Rate for Payer: BCN Commercial |
$212.12
|
| Rate for Payer: BCN Medicare Advantage |
$64.50
|
| Rate for Payer: Cash Price |
$206.42
|
| Rate for Payer: Cofinity Commercial |
$221.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.50
|
| Rate for Payer: Healthscope Commercial |
$232.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.51
|
| Rate for Payer: Mclaren Medicaid |
$45.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.73
|
| Rate for Payer: Meridian Medicaid |
$47.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.32
|
| Rate for Payer: Nomi Health Commercial |
$211.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.51
|
| Rate for Payer: PACE Senior Care Partners |
$61.28
|
| Rate for Payer: PACE SWMI |
$64.50
|
| Rate for Payer: PHP Commercial |
$219.32
|
| Rate for Payer: PHP Medicare Advantage |
$64.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$224.48
|
| Rate for Payer: Priority Health Medicare |
$65.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.58
|
| Rate for Payer: Railroad Medicare Medicare |
$64.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.06
|
| Rate for Payer: UHC Core |
$215.45
|
| Rate for Payer: UHC Exchange |
$64.50
|
| Rate for Payer: UHC Medicaid |
$45.49
|
| Rate for Payer: UHC Medicare Advantage |
$64.50
|
| Rate for Payer: UHCCP Medicaid |
$45.49
|
| Rate for Payer: VA VA |
$64.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.51
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$258.02
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$179.58 |
| Max. Negotiated Rate |
$232.22 |
| Rate for Payer: Aetna Commercial |
$219.32
|
| Rate for Payer: BCBS Trust/PPO |
$213.10
|
| Rate for Payer: BCN Commercial |
$213.10
|
| Rate for Payer: Cash Price |
$206.42
|
| Rate for Payer: Cofinity Commercial |
$221.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.42
|
| Rate for Payer: Healthscope Commercial |
$232.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.32
|
| Rate for Payer: Nomi Health Commercial |
$211.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.51
|
| Rate for Payer: PHP Commercial |
$219.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$224.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.06
|
| Rate for Payer: UHC Core |
$215.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.51
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$197.68
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$137.59 |
| Max. Negotiated Rate |
$177.91 |
| Rate for Payer: Aetna Commercial |
$168.03
|
| Rate for Payer: BCBS Trust/PPO |
$163.26
|
| Rate for Payer: BCN Commercial |
$163.26
|
| Rate for Payer: Cash Price |
$158.14
|
| Rate for Payer: Cofinity Commercial |
$170.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.14
|
| Rate for Payer: Healthscope Commercial |
$177.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.03
|
| Rate for Payer: Nomi Health Commercial |
$162.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.26
|
| Rate for Payer: PHP Commercial |
$168.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$171.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.96
|
| Rate for Payer: UHC Core |
$165.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.26
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$197.68
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$34.85 |
| Max. Negotiated Rate |
$177.91 |
| Rate for Payer: Aetna Commercial |
$168.03
|
| Rate for Payer: Aetna Medicare |
$51.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.77
|
| Rate for Payer: BCBS Complete |
$36.59
|
| Rate for Payer: BCBS MAPPO |
$49.42
|
| Rate for Payer: BCBS Trust/PPO |
$162.51
|
| Rate for Payer: BCN Commercial |
$162.51
|
| Rate for Payer: BCN Medicare Advantage |
$49.42
|
| Rate for Payer: Cash Price |
$158.14
|
| Rate for Payer: Cofinity Commercial |
$170.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.42
|
| Rate for Payer: Healthscope Commercial |
$177.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.26
|
| Rate for Payer: Mclaren Medicaid |
$34.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.89
|
| Rate for Payer: Meridian Medicaid |
$36.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.03
|
| Rate for Payer: Nomi Health Commercial |
$162.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.26
|
| Rate for Payer: PACE Senior Care Partners |
$46.95
|
| Rate for Payer: PACE SWMI |
$49.42
|
| Rate for Payer: PHP Commercial |
$168.03
|
| Rate for Payer: PHP Medicare Advantage |
$49.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$171.98
|
| Rate for Payer: Priority Health Medicare |
$49.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.59
|
| Rate for Payer: Railroad Medicare Medicare |
$49.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.96
|
| Rate for Payer: UHC Core |
$165.06
|
| Rate for Payer: UHC Exchange |
$49.42
|
| Rate for Payer: UHC Medicaid |
$34.85
|
| Rate for Payer: UHC Medicare Advantage |
$49.42
|
| Rate for Payer: UHCCP Medicaid |
$34.85
|
| Rate for Payer: VA VA |
$49.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.26
|
|
|
HC PRO BNP
|
Facility
|
OP
|
$157.30
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
30100304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.73 |
| Max. Negotiated Rate |
$141.57 |
| Rate for Payer: Aetna Commercial |
$133.71
|
| Rate for Payer: Aetna Medicare |
$40.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.16
|
| Rate for Payer: BCBS Complete |
$29.12
|
| Rate for Payer: BCBS MAPPO |
$39.33
|
| Rate for Payer: BCBS Trust/PPO |
$129.32
|
| Rate for Payer: BCN Commercial |
$129.32
|
| Rate for Payer: BCN Medicare Advantage |
$39.33
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cofinity Commercial |
$135.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.33
|
| Rate for Payer: Healthscope Commercial |
$141.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.97
|
| Rate for Payer: Mclaren Medicaid |
$27.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.29
|
| Rate for Payer: Meridian Medicaid |
$29.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.71
|
| Rate for Payer: Nomi Health Commercial |
$128.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.97
|
| Rate for Payer: PACE Senior Care Partners |
$37.36
|
| Rate for Payer: PACE SWMI |
$39.33
|
| Rate for Payer: PHP Commercial |
$133.71
|
| Rate for Payer: PHP Medicare Advantage |
$39.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$136.85
|
| Rate for Payer: Priority Health Medicare |
$39.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.48
|
| Rate for Payer: Railroad Medicare Medicare |
$39.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.42
|
| Rate for Payer: UHC Core |
$131.35
|
| Rate for Payer: UHC Exchange |
$39.33
|
| Rate for Payer: UHC Medicaid |
$27.73
|
| Rate for Payer: UHC Medicare Advantage |
$39.33
|
| Rate for Payer: UHCCP Medicaid |
$27.73
|
| Rate for Payer: VA VA |
$39.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.97
|
|
