|
HC WALNUT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200065
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC WALNUT TREE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200116
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC WALNUT TREE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200116
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC WASHED RED BLOOD CELLS
|
Facility
|
OP
|
$813.45
|
|
|
Service Code
|
HCPCS P9022
|
| Hospital Charge Code |
39000073
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$193.19 |
| Max. Negotiated Rate |
$732.10 |
| Rate for Payer: Aetna Commercial |
$691.43
|
| Rate for Payer: Aetna Medicare |
$211.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$254.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$254.20
|
| Rate for Payer: BCBS Complete |
$287.08
|
| Rate for Payer: BCBS MAPPO |
$203.36
|
| Rate for Payer: BCBS Trust/PPO |
$632.46
|
| Rate for Payer: BCN Commercial |
$632.46
|
| Rate for Payer: BCN Medicare Advantage |
$203.36
|
| Rate for Payer: Cash Price |
$650.76
|
| Rate for Payer: Cash Price |
$650.76
|
| Rate for Payer: Cofinity Commercial |
$699.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.36
|
| Rate for Payer: Healthscope Commercial |
$732.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.09
|
| Rate for Payer: Mclaren Medicaid |
$273.41
|
| Rate for Payer: Meridian Medicaid |
$287.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$213.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$233.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$691.43
|
| Rate for Payer: PACE Senior Care Partners |
$193.19
|
| Rate for Payer: PACE SWMI |
$203.36
|
| Rate for Payer: PHP Commercial |
$691.43
|
| Rate for Payer: PHP Medicare Advantage |
$203.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$569.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$707.70
|
| Rate for Payer: Priority Health Medicare |
$203.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$496.12
|
| Rate for Payer: Railroad Medicare Medicare |
$203.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$715.84
|
| Rate for Payer: UHC Core |
$679.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$203.36
|
| Rate for Payer: UHC Medicare Advantage |
$209.46
|
| Rate for Payer: VA VA |
$203.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.09
|
|
|
HC WASHED RED BLOOD CELLS
|
Facility
|
IP
|
$813.45
|
|
|
Service Code
|
HCPCS P9022
|
| Hospital Charge Code |
39000073
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$496.12 |
| Max. Negotiated Rate |
$732.10 |
| Rate for Payer: Aetna Commercial |
$691.43
|
| Rate for Payer: BCBS Trust/PPO |
$628.63
|
| Rate for Payer: BCN Commercial |
$628.63
|
| Rate for Payer: Cash Price |
$650.76
|
| Rate for Payer: Cofinity Commercial |
$699.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.76
|
| Rate for Payer: Healthscope Commercial |
$732.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$691.43
|
| Rate for Payer: PHP Commercial |
$691.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$569.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$707.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$496.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$715.84
|
| Rate for Payer: UHC Core |
$679.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.09
|
|
|
HC WATCH PAT
|
Facility
|
IP
|
$667.46
|
|
|
Service Code
|
CPT 95800
|
| Hospital Charge Code |
92000015
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$407.08 |
| Max. Negotiated Rate |
$600.71 |
| Rate for Payer: Aetna Commercial |
$567.34
|
| Rate for Payer: BCBS Trust/PPO |
$515.81
|
| Rate for Payer: BCN Commercial |
$515.81
|
| Rate for Payer: Cash Price |
$533.97
|
| Rate for Payer: Cofinity Commercial |
$574.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.97
|
| Rate for Payer: Healthscope Commercial |
$600.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$500.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$567.34
|
| Rate for Payer: PHP Commercial |
$567.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$580.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$407.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$587.36
|
| Rate for Payer: UHC Core |
$557.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$500.60
|
|
|
HC WATCH PAT
|
Facility
|
OP
|
$667.46
|
|
|
Service Code
|
CPT 95800
|
| Hospital Charge Code |
92000015
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$102.47 |
| Max. Negotiated Rate |
$600.71 |
| Rate for Payer: Aetna Commercial |
$567.34
|
| Rate for Payer: Aetna Medicare |
$173.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$208.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$208.58
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$166.86
|
| Rate for Payer: BCBS Trust/PPO |
$518.95
|
| Rate for Payer: BCN Commercial |
$518.95
|
| Rate for Payer: BCN Medicare Advantage |
$166.86
|
| Rate for Payer: Cash Price |
$533.97
|
| Rate for Payer: Cash Price |
$533.97
|
| Rate for Payer: Cofinity Commercial |
$574.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$533.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.86
|
| Rate for Payer: Healthscope Commercial |
$600.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$500.60
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$175.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$191.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$567.34
|
| Rate for Payer: PACE Senior Care Partners |
$158.52
|
| Rate for Payer: PACE SWMI |
$166.86
|
| Rate for Payer: PHP Commercial |
$567.34
|
| Rate for Payer: PHP Medicare Advantage |
$166.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$580.69
|
| Rate for Payer: Priority Health Medicare |
$166.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$407.08
|
| Rate for Payer: Railroad Medicare Medicare |
$166.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$587.36
|
| Rate for Payer: UHC Core |
$557.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.86
|
| Rate for Payer: UHC Medicare Advantage |
$171.87
|
| Rate for Payer: VA VA |
$166.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$500.60
|
|
|
HC WBC BUFFY COAT
|
Facility
|
OP
|
$45.40
|
|
|
Service Code
|
CPT 85009
|
| Hospital Charge Code |
30500004
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$40.86 |
| Rate for Payer: Aetna Commercial |
$38.59
|
| Rate for Payer: Aetna Medicare |
$11.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.19
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$11.35
|
| Rate for Payer: BCBS Trust/PPO |
$35.30
|
| Rate for Payer: BCN Commercial |
$35.30
|
| Rate for Payer: BCN Medicare Advantage |
$11.35
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cofinity Commercial |
$39.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.35
|
| Rate for Payer: Healthscope Commercial |
$40.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.05
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.59
|
| Rate for Payer: PACE Senior Care Partners |
$10.78
|
| Rate for Payer: PACE SWMI |
$11.35
|
| Rate for Payer: PHP Commercial |
$38.59
|
| Rate for Payer: PHP Medicare Advantage |
$11.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.50
|
| Rate for Payer: Priority Health Medicare |
$11.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.69
|
| Rate for Payer: Railroad Medicare Medicare |
$11.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.95
|
| Rate for Payer: UHC Core |
$37.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.35
|
| Rate for Payer: UHC Medicare Advantage |
$11.69
|
| Rate for Payer: VA VA |
$11.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.05
|
|
|
HC WBC BUFFY COAT
|
Facility
|
IP
|
$45.40
|
|
|
Service Code
|
CPT 85009
|
| Hospital Charge Code |
30500004
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$27.69 |
| Max. Negotiated Rate |
$40.86 |
| Rate for Payer: Aetna Commercial |
$38.59
|
| Rate for Payer: BCBS Trust/PPO |
$35.09
|
| Rate for Payer: BCN Commercial |
$35.09
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cofinity Commercial |
$39.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.32
|
| Rate for Payer: Healthscope Commercial |
$40.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.59
|
| Rate for Payer: PHP Commercial |
$38.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.95
|
| Rate for Payer: UHC Core |
$37.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.05
|
|
|
HC WBC COUNT
|
Facility
|
OP
|
$26.52
|
|
|
Service Code
|
CPT 85048
|
| Hospital Charge Code |
30500011
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$23.87 |
| Rate for Payer: Aetna Commercial |
$22.54
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$1.97
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$20.62
|
| Rate for Payer: BCN Commercial |
$20.62
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.89
|
| Rate for Payer: Mclaren Medicaid |
$1.87
|
| Rate for Payer: Meridian Medicaid |
$1.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.54
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.54
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.07
|
| Rate for Payer: Priority Health Medicare |
$6.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.17
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.34
|
| Rate for Payer: UHC Core |
$22.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.63
|
| Rate for Payer: UHC Medicare Advantage |
$6.83
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.89
|
|
|
HC WBC COUNT
|
Facility
|
IP
|
$26.52
|
|
|
Service Code
|
CPT 85048
|
| Hospital Charge Code |
30500011
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.17 |
| Max. Negotiated Rate |
$23.87 |
| Rate for Payer: Aetna Commercial |
$22.54
|
| Rate for Payer: BCBS Trust/PPO |
$20.49
|
| Rate for Payer: BCN Commercial |
$20.49
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.54
|
| Rate for Payer: PHP Commercial |
$22.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.34
|
| Rate for Payer: UHC Core |
$22.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.89
|
|
|
HC WC EVAL JOB SITE ANALYSIS EACH 30 MIN
|
Facility
|
IP
|
$215.90
|
|
| Hospital Charge Code |
42000045
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$131.68 |
| Max. Negotiated Rate |
$194.31 |
| Rate for Payer: Aetna Commercial |
$183.52
|
| Rate for Payer: BCBS Trust/PPO |
$166.85
|
| Rate for Payer: BCN Commercial |
$166.85
|
| Rate for Payer: Cash Price |
$172.72
|
| Rate for Payer: Cofinity Commercial |
$185.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.72
|
| Rate for Payer: Healthscope Commercial |
$194.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$183.52
|
| Rate for Payer: PHP Commercial |
$183.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.99
|
| Rate for Payer: UHC Core |
$180.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.92
|
|
|
HC WC EVAL JOB SITE ANALYSIS EACH 30 MIN
|
Facility
|
OP
|
$215.90
|
|
| Hospital Charge Code |
42000045
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$51.28 |
| Max. Negotiated Rate |
$194.31 |
| Rate for Payer: Aetna Commercial |
$183.52
|
| Rate for Payer: Aetna Medicare |
$56.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.47
|
| Rate for Payer: BCBS Complete |
$86.36
|
| Rate for Payer: BCBS MAPPO |
$53.98
|
| Rate for Payer: BCBS Trust/PPO |
$167.86
|
| Rate for Payer: BCN Commercial |
$167.86
|
| Rate for Payer: BCN Medicare Advantage |
$53.98
|
| Rate for Payer: Cash Price |
$172.72
|
| Rate for Payer: Cofinity Commercial |
$185.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.98
|
| Rate for Payer: Healthscope Commercial |
$194.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$56.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$183.52
|
| Rate for Payer: PACE Senior Care Partners |
$51.28
|
| Rate for Payer: PACE SWMI |
$53.98
|
| Rate for Payer: PHP Commercial |
$183.52
|
| Rate for Payer: PHP Medicare Advantage |
$53.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.83
|
| Rate for Payer: Priority Health Medicare |
$53.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.68
|
| Rate for Payer: Railroad Medicare Medicare |
$53.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.99
|
| Rate for Payer: UHC Core |
$180.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.98
|
| Rate for Payer: UHC Medicare Advantage |
$55.59
|
| Rate for Payer: VA VA |
$53.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.92
|
|
|
HC WC EVAL JOB SITE ANALYSIS FIRST 60 MIN
|
Facility
|
OP
|
$293.00
|
|
| Hospital Charge Code |
42000044
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$69.59 |
| Max. Negotiated Rate |
$263.70 |
| Rate for Payer: Aetna Commercial |
$249.05
|
| Rate for Payer: Aetna Medicare |
$76.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.56
|
| Rate for Payer: BCBS Complete |
$117.20
|
| Rate for Payer: BCBS MAPPO |
$73.25
|
| Rate for Payer: BCBS Trust/PPO |
$227.81
|
| Rate for Payer: BCN Commercial |
$227.81
|
| Rate for Payer: BCN Medicare Advantage |
$73.25
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cofinity Commercial |
$251.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.25
|
| Rate for Payer: Healthscope Commercial |
$263.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$76.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.05
|
| Rate for Payer: PACE Senior Care Partners |
$69.59
|
| Rate for Payer: PACE SWMI |
$73.25
|
| Rate for Payer: PHP Commercial |
$249.05
|
| Rate for Payer: PHP Medicare Advantage |
$73.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.91
|
| Rate for Payer: Priority Health Medicare |
$73.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$178.70
|
| Rate for Payer: Railroad Medicare Medicare |
$73.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.84
|
| Rate for Payer: UHC Core |
$244.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.25
|
| Rate for Payer: UHC Medicare Advantage |
$75.45
|
| Rate for Payer: VA VA |
$73.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.75
|
|
|
HC WC EVAL JOB SITE ANALYSIS FIRST 60 MIN
|
Facility
|
IP
|
$293.00
|
|
| Hospital Charge Code |
42000044
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$178.70 |
| Max. Negotiated Rate |
$263.70 |
| Rate for Payer: Aetna Commercial |
$249.05
|
| Rate for Payer: BCBS Trust/PPO |
$226.43
|
| Rate for Payer: BCN Commercial |
$226.43
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cofinity Commercial |
$251.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.40
|
| Rate for Payer: Healthscope Commercial |
$263.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.05
|
| Rate for Payer: PHP Commercial |
$249.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$178.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.84
|
| Rate for Payer: UHC Core |
$244.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.75
|
|
|
HC WC UNLISTED BREAST PROCEDURE
|
Facility
|
IP
|
$2,181.48
|
|
|
Service Code
|
CPT 19499
|
| Hospital Charge Code |
36100321
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,330.48 |
| Max. Negotiated Rate |
$1,963.33 |
| Rate for Payer: Aetna Commercial |
$1,854.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,685.85
|
| Rate for Payer: BCN Commercial |
$1,685.85
|
| Rate for Payer: Cash Price |
$1,745.18
|
| Rate for Payer: Cofinity Commercial |
$1,876.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,745.18
|
| Rate for Payer: Healthscope Commercial |
$1,963.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,636.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,854.26
|
| Rate for Payer: PHP Commercial |
$1,854.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,527.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,897.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,330.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,919.70
|
| Rate for Payer: UHC Core |
$1,821.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,636.11
|
|
|
HC WC UNLISTED BREAST PROCEDURE
|
Facility
|
OP
|
$2,181.48
|
|
|
Service Code
|
CPT 19499
|
| Hospital Charge Code |
36100321
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$518.10 |
| Max. Negotiated Rate |
$2,625.49 |
| Rate for Payer: Aetna Commercial |
$1,854.26
|
| Rate for Payer: Aetna Medicare |
$567.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$681.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$681.71
|
| Rate for Payer: BCBS Complete |
$2,625.49
|
| Rate for Payer: BCBS MAPPO |
$545.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,696.10
|
| Rate for Payer: BCN Commercial |
$1,696.10
|
| Rate for Payer: BCN Medicare Advantage |
$545.37
|
| Rate for Payer: Cash Price |
$1,745.18
|
| Rate for Payer: Cash Price |
$1,745.18
|
| Rate for Payer: Cofinity Commercial |
$1,876.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,745.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$545.37
|
| Rate for Payer: Healthscope Commercial |
$1,963.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,636.11
|
| Rate for Payer: Mclaren Medicaid |
$2,500.47
|
| Rate for Payer: Meridian Medicaid |
$2,625.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$572.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$627.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,854.26
|
| Rate for Payer: PACE Senior Care Partners |
$518.10
|
| Rate for Payer: PACE SWMI |
$545.37
|
| Rate for Payer: PHP Commercial |
$1,854.26
|
| Rate for Payer: PHP Medicare Advantage |
$545.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,500.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,527.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,897.89
|
| Rate for Payer: Priority Health Medicare |
$545.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,330.48
|
| Rate for Payer: Railroad Medicare Medicare |
$545.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,919.70
|
| Rate for Payer: UHC Core |
$1,821.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$545.37
|
| Rate for Payer: UHC Medicare Advantage |
$561.73
|
| Rate for Payer: VA VA |
$545.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,636.11
|
|
|
HC WEDGE EXCISION SKIN NAIL FOLD
|
Facility
|
IP
|
$564.41
|
|
|
Service Code
|
CPT 11765
|
| Hospital Charge Code |
76100313
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$344.23 |
| Max. Negotiated Rate |
$507.97 |
| Rate for Payer: Aetna Commercial |
$479.75
|
| Rate for Payer: BCBS Trust/PPO |
$436.18
|
| Rate for Payer: BCN Commercial |
$436.18
|
| Rate for Payer: Cash Price |
$451.53
|
| Rate for Payer: Cofinity Commercial |
$485.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$451.53
|
| Rate for Payer: Healthscope Commercial |
$507.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$479.75
|
| Rate for Payer: PHP Commercial |
$479.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$395.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$496.68
|
| Rate for Payer: UHC Core |
$471.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.31
|
|
|
HC WEDGE EXCISION SKIN NAIL FOLD
|
Facility
|
OP
|
$564.41
|
|
|
Service Code
|
CPT 11765
|
| Hospital Charge Code |
76100313
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$134.05 |
| Max. Negotiated Rate |
$507.97 |
| Rate for Payer: Aetna Commercial |
$479.75
|
| Rate for Payer: Aetna Medicare |
$146.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$176.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$176.38
|
| Rate for Payer: BCBS Complete |
$274.65
|
| Rate for Payer: BCBS MAPPO |
$141.10
|
| Rate for Payer: BCBS Trust/PPO |
$438.83
|
| Rate for Payer: BCN Commercial |
$438.83
|
| Rate for Payer: BCN Medicare Advantage |
$141.10
|
| Rate for Payer: Cash Price |
$451.53
|
| Rate for Payer: Cash Price |
$451.53
|
| Rate for Payer: Cofinity Commercial |
$485.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$451.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.10
|
| Rate for Payer: Healthscope Commercial |
$507.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.31
|
| Rate for Payer: Mclaren Medicaid |
$261.57
|
| Rate for Payer: Meridian Medicaid |
$274.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$148.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$479.75
|
| Rate for Payer: PACE Senior Care Partners |
$134.05
|
| Rate for Payer: PACE SWMI |
$141.10
|
| Rate for Payer: PHP Commercial |
$479.75
|
| Rate for Payer: PHP Medicare Advantage |
$141.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$395.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.04
|
| Rate for Payer: Priority Health Medicare |
$141.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.23
|
| Rate for Payer: Railroad Medicare Medicare |
$141.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$496.68
|
| Rate for Payer: UHC Core |
$471.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.10
|
| Rate for Payer: UHC Medicare Advantage |
$145.34
|
| Rate for Payer: VA VA |
$141.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.31
|
|
|
HC WEST NILE VIRUS AB IGG & IGM
|
Facility
|
OP
|
$31.62
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200329
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.51 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: Aetna Medicare |
$8.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.88
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: BCBS MAPPO |
$7.90
|
| Rate for Payer: BCBS Trust/PPO |
$24.58
|
| Rate for Payer: BCN Commercial |
$24.58
|
| Rate for Payer: BCN Medicare Advantage |
$7.90
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.90
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.72
|
| Rate for Payer: Mclaren Medicaid |
$12.44
|
| Rate for Payer: Meridian Medicaid |
$13.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.88
|
| Rate for Payer: PACE Senior Care Partners |
$7.51
|
| Rate for Payer: PACE SWMI |
$7.90
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: PHP Medicare Advantage |
$7.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.51
|
| Rate for Payer: Priority Health Medicare |
$7.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.29
|
| Rate for Payer: Railroad Medicare Medicare |
$7.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.83
|
| Rate for Payer: UHC Core |
$26.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.90
|
| Rate for Payer: UHC Medicare Advantage |
$8.14
|
| Rate for Payer: VA VA |
$7.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.72
|
|
|
HC WEST NILE VIRUS AB IGG & IGM
|
Facility
|
IP
|
$31.62
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200329
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.29 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: BCBS Trust/PPO |
$24.44
|
| Rate for Payer: BCN Commercial |
$24.44
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.88
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.83
|
| Rate for Payer: UHC Core |
$26.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.72
|
|
|
HC WEST NILE VIRUS AB IGG & IGM CSF
|
Facility
|
OP
|
$43.86
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200330
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.42 |
| Max. Negotiated Rate |
$39.47 |
| Rate for Payer: Aetna Commercial |
$37.28
|
| Rate for Payer: Aetna Medicare |
$11.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.71
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: BCBS MAPPO |
$10.96
|
| Rate for Payer: BCBS Trust/PPO |
$34.10
|
| Rate for Payer: BCN Commercial |
$34.10
|
| Rate for Payer: BCN Medicare Advantage |
$10.96
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$37.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.96
|
| Rate for Payer: Healthscope Commercial |
$39.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.90
|
| Rate for Payer: Mclaren Medicaid |
$12.44
|
| Rate for Payer: Meridian Medicaid |
$13.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.28
|
| Rate for Payer: PACE Senior Care Partners |
$10.42
|
| Rate for Payer: PACE SWMI |
$10.96
|
| Rate for Payer: PHP Commercial |
$37.28
|
| Rate for Payer: PHP Medicare Advantage |
$10.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.16
|
| Rate for Payer: Priority Health Medicare |
$10.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.75
|
| Rate for Payer: Railroad Medicare Medicare |
$10.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.60
|
| Rate for Payer: UHC Core |
$36.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.96
|
| Rate for Payer: UHC Medicare Advantage |
$11.29
|
| Rate for Payer: VA VA |
$10.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.90
|
|
|
HC WEST NILE VIRUS AB IGG & IGM CSF
|
Facility
|
IP
|
$43.86
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200330
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.75 |
| Max. Negotiated Rate |
$39.47 |
| Rate for Payer: Aetna Commercial |
$37.28
|
| Rate for Payer: BCBS Trust/PPO |
$33.90
|
| Rate for Payer: BCN Commercial |
$33.90
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$37.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$39.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.28
|
| Rate for Payer: PHP Commercial |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.60
|
| Rate for Payer: UHC Core |
$36.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.90
|
|
|
HC WEST NILE VIRUS CMPT
|
Facility
|
IP
|
$31.62
|
|
|
Service Code
|
CPT 86789
|
| Hospital Charge Code |
30200331
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.29 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: BCBS Trust/PPO |
$24.44
|
| Rate for Payer: BCN Commercial |
$24.44
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.88
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.83
|
| Rate for Payer: UHC Core |
$26.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.72
|
|
|
HC WEST NILE VIRUS CMPT
|
Facility
|
OP
|
$31.62
|
|
|
Service Code
|
CPT 86789
|
| Hospital Charge Code |
30200331
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.51 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: Aetna Medicare |
$8.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.88
|
| Rate for Payer: BCBS Complete |
$11.15
|
| Rate for Payer: BCBS MAPPO |
$7.90
|
| Rate for Payer: BCBS Trust/PPO |
$24.58
|
| Rate for Payer: BCN Commercial |
$24.58
|
| Rate for Payer: BCN Medicare Advantage |
$7.90
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.90
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.72
|
| Rate for Payer: Mclaren Medicaid |
$10.62
|
| Rate for Payer: Meridian Medicaid |
$11.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.88
|
| Rate for Payer: PACE Senior Care Partners |
$7.51
|
| Rate for Payer: PACE SWMI |
$7.90
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: PHP Medicare Advantage |
$7.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.51
|
| Rate for Payer: Priority Health Medicare |
$7.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.29
|
| Rate for Payer: Railroad Medicare Medicare |
$7.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.83
|
| Rate for Payer: UHC Core |
$26.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.90
|
| Rate for Payer: UHC Medicare Advantage |
$8.14
|
| Rate for Payer: VA VA |
$7.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.72
|
|
