|
HC PRO BNP
|
Facility
|
IP
|
$157.30
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
30100304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$109.48 |
| Max. Negotiated Rate |
$141.57 |
| Rate for Payer: Aetna Commercial |
$133.71
|
| Rate for Payer: BCBS Trust/PPO |
$129.91
|
| Rate for Payer: BCN Commercial |
$129.91
|
| 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: Healthscope Commercial |
$141.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.97
|
| 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: PHP Commercial |
$133.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$136.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.42
|
| Rate for Payer: UHC Core |
$131.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.97
|
|
|
HC PROCAINAMIDE AND NAPA LEVEL
|
Facility
|
IP
|
$69.71
|
|
|
Service Code
|
CPT 80192
|
| Hospital Charge Code |
30100042
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.52 |
| Max. Negotiated Rate |
$62.74 |
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: BCBS Trust/PPO |
$57.57
|
| Rate for Payer: BCN Commercial |
$57.57
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$57.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.28
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.34
|
| Rate for Payer: UHC Core |
$58.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC PROCAINAMIDE AND NAPA LEVEL
|
Facility
|
OP
|
$69.71
|
|
|
Service Code
|
CPT 80192
|
| Hospital Charge Code |
30100042
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.29 |
| Max. Negotiated Rate |
$62.74 |
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: Aetna Medicare |
$18.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.78
|
| Rate for Payer: BCBS Complete |
$12.90
|
| Rate for Payer: BCBS MAPPO |
$17.43
|
| Rate for Payer: BCBS Trust/PPO |
$57.31
|
| Rate for Payer: BCN Commercial |
$57.31
|
| Rate for Payer: BCN Medicare Advantage |
$17.43
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.43
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: Mclaren Medicaid |
$12.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.30
|
| Rate for Payer: Meridian Medicaid |
$12.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$57.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.28
|
| Rate for Payer: PACE Senior Care Partners |
$16.56
|
| Rate for Payer: PACE SWMI |
$17.43
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: PHP Medicare Advantage |
$17.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.65
|
| Rate for Payer: Priority Health Medicare |
$17.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.52
|
| Rate for Payer: Railroad Medicare Medicare |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.34
|
| Rate for Payer: UHC Core |
$58.21
|
| Rate for Payer: UHC Exchange |
$17.43
|
| Rate for Payer: UHC Medicaid |
$12.29
|
| Rate for Payer: UHC Medicare Advantage |
$17.43
|
| Rate for Payer: UHCCP Medicaid |
$12.29
|
| Rate for Payer: VA VA |
$17.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC PROCAINAMIDE CHALLENGE
|
Facility
|
IP
|
$7,572.41
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100123
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,270.40 |
| Max. Negotiated Rate |
$6,815.17 |
| Rate for Payer: Aetna Commercial |
$6,436.55
|
| Rate for Payer: BCBS Trust/PPO |
$6,254.05
|
| Rate for Payer: BCN Commercial |
$6,254.05
|
| Rate for Payer: Cash Price |
$6,057.93
|
| Rate for Payer: Cofinity Commercial |
$6,512.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,057.93
|
| Rate for Payer: Healthscope Commercial |
$6,815.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,679.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,436.55
|
| Rate for Payer: Nomi Health Commercial |
$6,209.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,679.31
|
| Rate for Payer: PHP Commercial |
$6,436.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,588.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,270.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,663.72
|
| Rate for Payer: UHC Core |
$6,322.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,679.31
|
|
|
HC PROCAINAMIDE CHALLENGE
|
Facility
|
OP
|
$7,572.41
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100123
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,335.02 |
| Max. Negotiated Rate |
$6,815.17 |
| Rate for Payer: Aetna Commercial |
$6,436.55
|
| Rate for Payer: Aetna Medicare |
$1,968.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,366.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,366.38
|
| Rate for Payer: BCBS Complete |
$1,401.65
|
| Rate for Payer: BCBS MAPPO |
$1,893.10
|
| Rate for Payer: BCBS Trust/PPO |
$6,225.28
|
| Rate for Payer: BCN Commercial |
$6,225.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,893.10
|
| Rate for Payer: Cash Price |
$6,057.93
|
| Rate for Payer: Cofinity Commercial |
$6,512.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,057.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,893.10
|
| Rate for Payer: Healthscope Commercial |
$6,815.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,679.31
|
| Rate for Payer: Mclaren Medicaid |
$1,335.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,987.76
|
| Rate for Payer: Meridian Medicaid |
$1,401.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,177.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,082.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,436.55
|
| Rate for Payer: Nomi Health Commercial |
$6,209.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,679.31
|
| Rate for Payer: PACE Senior Care Partners |
$1,798.45
|
| Rate for Payer: PACE SWMI |
$1,893.10
|
| Rate for Payer: PHP Commercial |
$6,436.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,893.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,335.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,588.00
|
| Rate for Payer: Priority Health Medicare |
$1,912.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,270.40
|
| Rate for Payer: Railroad Medicare Medicare |
$1,893.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,663.72
|
| Rate for Payer: UHC Core |
$6,322.96
|
| Rate for Payer: UHC Exchange |
$1,893.10
|
| Rate for Payer: UHC Medicaid |
$1,335.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,893.10
|
| Rate for Payer: UHCCP Medicaid |
$1,335.02
|
| Rate for Payer: VA VA |
$1,893.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,679.31
|
|
|
HC PROCALCITONIN
|
Facility
|
IP
|
$106.12
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
30100480
|
|
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 PROCALCITONIN
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
30100480
|
|
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 PROCESS FEE
|
Facility
|
IP
|
$37.45
|
|
| Hospital Charge Code |
30000106
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.07 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: BCBS Trust/PPO |
$30.93
|
| Rate for Payer: BCN Commercial |
$30.93
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Nomi Health Commercial |
$30.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.09
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.96
|
| Rate for Payer: UHC Core |
$31.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC PROCESS FEE
|
Facility
|
OP
|
$37.45
|
|
| Hospital Charge Code |
30000106
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna Medicare |
$9.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.70
|
| Rate for Payer: BCBS Complete |
$6.93
|
| Rate for Payer: BCBS MAPPO |
$9.36
|
| Rate for Payer: BCBS Trust/PPO |
$30.79
|
| Rate for Payer: BCN Commercial |
$30.79
|
| Rate for Payer: BCN Medicare Advantage |
$9.36
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.36
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$6.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.83
|
| Rate for Payer: Meridian Medicaid |
$6.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Nomi Health Commercial |
$30.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.09
|
| Rate for Payer: PACE Senior Care Partners |
$8.89
|
| Rate for Payer: PACE SWMI |
$9.36
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: PHP Medicare Advantage |
$9.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.58
|
| Rate for Payer: Priority Health Medicare |
$9.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.07
|
| Rate for Payer: Railroad Medicare Medicare |
$9.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.96
|
| Rate for Payer: UHC Core |
$31.27
|
| Rate for Payer: UHC Exchange |
$9.36
|
| Rate for Payer: UHC Medicaid |
$6.60
|
| Rate for Payer: UHC Medicare Advantage |
$9.36
|
| Rate for Payer: UHCCP Medicaid |
$6.60
|
| Rate for Payer: VA VA |
$9.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC PROCTOSIGMOIDOSCOY RIGID DX
|
Facility
|
IP
|
$1,185.73
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
76100185
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$825.27 |
| Max. Negotiated Rate |
$1,067.16 |
| Rate for Payer: Aetna Commercial |
$1,007.87
|
| Rate for Payer: BCBS Trust/PPO |
$979.29
|
| Rate for Payer: BCN Commercial |
$979.29
|
| Rate for Payer: Cash Price |
$948.58
|
| Rate for Payer: Cofinity Commercial |
$1,019.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.58
|
| Rate for Payer: Healthscope Commercial |
$1,067.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$889.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.87
|
| Rate for Payer: Nomi Health Commercial |
$972.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$889.30
|
| Rate for Payer: PHP Commercial |
$1,007.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,031.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$825.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,043.44
|
| Rate for Payer: UHC Core |
$990.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$889.30
|
|
|
HC PROCTOSIGMOIDOSCOY RIGID DX
|
Facility
|
OP
|
$1,185.73
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
76100185
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$209.04 |
| Max. Negotiated Rate |
$1,067.16 |
| Rate for Payer: Aetna Commercial |
$1,007.87
|
| Rate for Payer: Aetna Medicare |
$308.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$370.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$370.54
|
| Rate for Payer: BCBS Complete |
$219.48
|
| Rate for Payer: BCBS MAPPO |
$296.43
|
| Rate for Payer: BCBS Trust/PPO |
$974.79
|
| Rate for Payer: BCN Commercial |
$974.79
|
| Rate for Payer: BCN Medicare Advantage |
$296.43
|
| Rate for Payer: Cash Price |
$948.58
|
| Rate for Payer: Cofinity Commercial |
$1,019.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.43
|
| Rate for Payer: Healthscope Commercial |
$1,067.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$889.30
|
| Rate for Payer: Mclaren Medicaid |
$209.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.25
|
| Rate for Payer: Meridian Medicaid |
$219.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$340.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$326.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.87
|
| Rate for Payer: Nomi Health Commercial |
$972.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$889.30
|
| Rate for Payer: PACE Senior Care Partners |
$281.61
|
| Rate for Payer: PACE SWMI |
$296.43
|
| Rate for Payer: PHP Commercial |
$1,007.87
|
| Rate for Payer: PHP Medicare Advantage |
$296.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,031.59
|
| Rate for Payer: Priority Health Medicare |
$299.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$825.27
|
| Rate for Payer: Railroad Medicare Medicare |
$296.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,043.44
|
| Rate for Payer: UHC Core |
$990.08
|
| Rate for Payer: UHC Exchange |
$296.43
|
| Rate for Payer: UHC Medicaid |
$209.04
|
| Rate for Payer: UHC Medicare Advantage |
$296.43
|
| Rate for Payer: UHCCP Medicaid |
$209.04
|
| Rate for Payer: VA VA |
$296.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$889.30
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY 2 OR MORE INJECT
|
Facility
|
IP
|
$39.31
|
|
|
Service Code
|
CPT 95117
|
| Hospital Charge Code |
51000082
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$27.36 |
| Max. Negotiated Rate |
$35.38 |
| Rate for Payer: Aetna Commercial |
$33.41
|
| Rate for Payer: BCBS Trust/PPO |
$32.47
|
| Rate for Payer: BCN Commercial |
$32.47
|
| Rate for Payer: Cash Price |
$31.45
|
| Rate for Payer: Cofinity Commercial |
$33.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.45
|
| Rate for Payer: Healthscope Commercial |
$35.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.41
|
| Rate for Payer: Nomi Health Commercial |
$32.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.48
|
| Rate for Payer: PHP Commercial |
$33.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.59
|
| Rate for Payer: UHC Core |
$32.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.48
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY 2 OR MORE INJECT
|
Facility
|
OP
|
$39.31
|
|
|
Service Code
|
CPT 95117
|
| Hospital Charge Code |
51000082
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$35.38 |
| Rate for Payer: Aetna Commercial |
$33.41
|
| Rate for Payer: Aetna Medicare |
$10.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.28
|
| Rate for Payer: BCBS Complete |
$7.28
|
| Rate for Payer: BCBS MAPPO |
$9.83
|
| Rate for Payer: BCBS Trust/PPO |
$32.32
|
| Rate for Payer: BCN Commercial |
$32.32
|
| Rate for Payer: BCN Medicare Advantage |
$9.83
|
| Rate for Payer: Cash Price |
$31.45
|
| Rate for Payer: Cofinity Commercial |
$33.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.83
|
| Rate for Payer: Healthscope Commercial |
$35.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.48
|
| Rate for Payer: Mclaren Medicaid |
$6.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.32
|
| Rate for Payer: Meridian Medicaid |
$7.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.41
|
| Rate for Payer: Nomi Health Commercial |
$32.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.48
|
| Rate for Payer: PACE Senior Care Partners |
$9.34
|
| Rate for Payer: PACE SWMI |
$9.83
|
| Rate for Payer: PHP Commercial |
$33.41
|
| Rate for Payer: PHP Medicare Advantage |
$9.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.20
|
| Rate for Payer: Priority Health Medicare |
$9.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.36
|
| Rate for Payer: Railroad Medicare Medicare |
$9.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.59
|
| Rate for Payer: UHC Core |
$32.82
|
| Rate for Payer: UHC Exchange |
$9.83
|
| Rate for Payer: UHC Medicaid |
$6.93
|
| Rate for Payer: UHC Medicare Advantage |
$9.83
|
| Rate for Payer: UHCCP Medicaid |
$6.93
|
| Rate for Payer: VA VA |
$9.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.48
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY SINGLE INJECT
|
Facility
|
OP
|
$39.31
|
|
|
Service Code
|
CPT 95115
|
| Hospital Charge Code |
51000081
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$35.38 |
| Rate for Payer: Aetna Commercial |
$33.41
|
| Rate for Payer: Aetna Medicare |
$10.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.28
|
| Rate for Payer: BCBS Complete |
$7.28
|
| Rate for Payer: BCBS MAPPO |
$9.83
|
| Rate for Payer: BCBS Trust/PPO |
$32.32
|
| Rate for Payer: BCN Commercial |
$32.32
|
| Rate for Payer: BCN Medicare Advantage |
$9.83
|
| Rate for Payer: Cash Price |
$31.45
|
| Rate for Payer: Cofinity Commercial |
$33.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.83
|
| Rate for Payer: Healthscope Commercial |
$35.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.48
|
| Rate for Payer: Mclaren Medicaid |
$6.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.32
|
| Rate for Payer: Meridian Medicaid |
$7.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.41
|
| Rate for Payer: Nomi Health Commercial |
$32.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.48
|
| Rate for Payer: PACE Senior Care Partners |
$9.34
|
| Rate for Payer: PACE SWMI |
$9.83
|
| Rate for Payer: PHP Commercial |
$33.41
|
| Rate for Payer: PHP Medicare Advantage |
$9.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.20
|
| Rate for Payer: Priority Health Medicare |
$9.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.36
|
| Rate for Payer: Railroad Medicare Medicare |
$9.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.59
|
| Rate for Payer: UHC Core |
$32.82
|
| Rate for Payer: UHC Exchange |
$9.83
|
| Rate for Payer: UHC Medicaid |
$6.93
|
| Rate for Payer: UHC Medicare Advantage |
$9.83
|
| Rate for Payer: UHCCP Medicaid |
$6.93
|
| Rate for Payer: VA VA |
$9.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.48
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY SINGLE INJECT
|
Facility
|
IP
|
$39.31
|
|
|
Service Code
|
CPT 95115
|
| Hospital Charge Code |
51000081
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$27.36 |
| Max. Negotiated Rate |
$35.38 |
| Rate for Payer: Aetna Commercial |
$33.41
|
| Rate for Payer: BCBS Trust/PPO |
$32.47
|
| Rate for Payer: BCN Commercial |
$32.47
|
| Rate for Payer: Cash Price |
$31.45
|
| Rate for Payer: Cofinity Commercial |
$33.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.45
|
| Rate for Payer: Healthscope Commercial |
$35.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.41
|
| Rate for Payer: Nomi Health Commercial |
$32.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.48
|
| Rate for Payer: PHP Commercial |
$33.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.59
|
| Rate for Payer: UHC Core |
$32.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.48
|
|
|
HC PROGESTERONE LEVEL
|
Facility
|
IP
|
$80.08
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
30100400
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.74 |
| Max. Negotiated Rate |
$72.07 |
| Rate for Payer: Aetna Commercial |
$68.07
|
| Rate for Payer: BCBS Trust/PPO |
$66.14
|
| Rate for Payer: BCN Commercial |
$66.14
|
| Rate for Payer: Cash Price |
$64.06
|
| Rate for Payer: Cofinity Commercial |
$68.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.06
|
| Rate for Payer: Healthscope Commercial |
$72.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.07
|
| Rate for Payer: Nomi Health Commercial |
$65.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.06
|
| Rate for Payer: PHP Commercial |
$68.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.47
|
| Rate for Payer: UHC Core |
$66.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.06
|
|
|
HC PROGESTERONE LEVEL
|
Facility
|
OP
|
$80.08
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
30100400
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.12 |
| Max. Negotiated Rate |
$72.07 |
| Rate for Payer: Aetna Commercial |
$68.07
|
| Rate for Payer: Aetna Medicare |
$20.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.02
|
| Rate for Payer: BCBS Complete |
$14.82
|
| Rate for Payer: BCBS MAPPO |
$20.02
|
| Rate for Payer: BCBS Trust/PPO |
$65.83
|
| Rate for Payer: BCN Commercial |
$65.83
|
| Rate for Payer: BCN Medicare Advantage |
$20.02
|
| Rate for Payer: Cash Price |
$64.06
|
| Rate for Payer: Cofinity Commercial |
$68.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.02
|
| Rate for Payer: Healthscope Commercial |
$72.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.06
|
| Rate for Payer: Mclaren Medicaid |
$14.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.02
|
| Rate for Payer: Meridian Medicaid |
$14.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.07
|
| Rate for Payer: Nomi Health Commercial |
$65.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.06
|
| Rate for Payer: PACE Senior Care Partners |
$19.02
|
| Rate for Payer: PACE SWMI |
$20.02
|
| Rate for Payer: PHP Commercial |
$68.07
|
| Rate for Payer: PHP Medicare Advantage |
$20.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.67
|
| Rate for Payer: Priority Health Medicare |
$20.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.74
|
| Rate for Payer: Railroad Medicare Medicare |
$20.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.47
|
| Rate for Payer: UHC Core |
$66.87
|
| Rate for Payer: UHC Exchange |
$20.02
|
| Rate for Payer: UHC Medicaid |
$14.12
|
| Rate for Payer: UHC Medicare Advantage |
$20.02
|
| Rate for Payer: UHCCP Medicaid |
$14.12
|
| Rate for Payer: VA VA |
$20.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.06
|
|
|
HC PROLACTIN
|
Facility
|
IP
|
$75.35
|
|
|
Service Code
|
CPT 84146
|
| Hospital Charge Code |
30100402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.44 |
| Max. Negotiated Rate |
$67.81 |
| Rate for Payer: Aetna Commercial |
$64.05
|
| Rate for Payer: BCBS Trust/PPO |
$62.23
|
| Rate for Payer: BCN Commercial |
$62.23
|
| Rate for Payer: Cash Price |
$60.28
|
| Rate for Payer: Cofinity Commercial |
$64.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.28
|
| Rate for Payer: Healthscope Commercial |
$67.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.05
|
| Rate for Payer: Nomi Health Commercial |
$61.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.51
|
| Rate for Payer: PHP Commercial |
$64.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.31
|
| Rate for Payer: UHC Core |
$62.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.51
|
|
|
HC PROLACTIN
|
Facility
|
OP
|
$75.35
|
|
|
Service Code
|
CPT 84146
|
| Hospital Charge Code |
30100402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$67.81 |
| Rate for Payer: Aetna Commercial |
$64.05
|
| Rate for Payer: Aetna Medicare |
$19.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.55
|
| Rate for Payer: BCBS Complete |
$13.95
|
| Rate for Payer: BCBS MAPPO |
$18.84
|
| Rate for Payer: BCBS Trust/PPO |
$61.95
|
| Rate for Payer: BCN Commercial |
$61.95
|
| Rate for Payer: BCN Medicare Advantage |
$18.84
|
| Rate for Payer: Cash Price |
$60.28
|
| Rate for Payer: Cofinity Commercial |
$64.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.84
|
| Rate for Payer: Healthscope Commercial |
$67.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.51
|
| Rate for Payer: Mclaren Medicaid |
$13.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.78
|
| Rate for Payer: Meridian Medicaid |
$13.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.05
|
| Rate for Payer: Nomi Health Commercial |
$61.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.51
|
| Rate for Payer: PACE Senior Care Partners |
$17.90
|
| Rate for Payer: PACE SWMI |
$18.84
|
| Rate for Payer: PHP Commercial |
$64.05
|
| Rate for Payer: PHP Medicare Advantage |
$18.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.55
|
| Rate for Payer: Priority Health Medicare |
$19.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.44
|
| Rate for Payer: Railroad Medicare Medicare |
$18.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.31
|
| Rate for Payer: UHC Core |
$62.92
|
| Rate for Payer: UHC Exchange |
$18.84
|
| Rate for Payer: UHC Medicaid |
$13.28
|
| Rate for Payer: UHC Medicare Advantage |
$18.84
|
| Rate for Payer: UHCCP Medicaid |
$13.28
|
| Rate for Payer: VA VA |
$18.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.51
|
|
|
HC PROLONGED E/M BEFORE/AFTER DIRECT CARE 1ST HR
|
Facility
|
OP
|
$134.24
|
|
|
Service Code
|
CPT 99358
|
| Hospital Charge Code |
51000084
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$23.67 |
| Max. Negotiated Rate |
$120.82 |
| Rate for Payer: Aetna Commercial |
$114.10
|
| Rate for Payer: Aetna Medicare |
$34.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.95
|
| Rate for Payer: BCBS Complete |
$24.85
|
| Rate for Payer: BCBS MAPPO |
$33.56
|
| Rate for Payer: BCBS Trust/PPO |
$110.36
|
| Rate for Payer: BCN Commercial |
$110.36
|
| Rate for Payer: BCN Medicare Advantage |
$33.56
|
| Rate for Payer: Cash Price |
$107.39
|
| Rate for Payer: Cofinity Commercial |
$115.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.56
|
| Rate for Payer: Healthscope Commercial |
$120.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.68
|
| Rate for Payer: Mclaren Medicaid |
$23.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.24
|
| Rate for Payer: Meridian Medicaid |
$24.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.10
|
| Rate for Payer: Nomi Health Commercial |
$110.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.68
|
| Rate for Payer: PACE Senior Care Partners |
$31.88
|
| Rate for Payer: PACE SWMI |
$33.56
|
| Rate for Payer: PHP Commercial |
$114.10
|
| Rate for Payer: PHP Medicare Advantage |
$33.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.79
|
| Rate for Payer: Priority Health Medicare |
$33.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.43
|
| Rate for Payer: Railroad Medicare Medicare |
$33.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.13
|
| Rate for Payer: UHC Core |
$112.09
|
| Rate for Payer: UHC Exchange |
$33.56
|
| Rate for Payer: UHC Medicaid |
$23.67
|
| Rate for Payer: UHC Medicare Advantage |
$33.56
|
| Rate for Payer: UHCCP Medicaid |
$23.67
|
| Rate for Payer: VA VA |
$33.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.68
|
|
|
HC PROLONGED E/M BEFORE/AFTER DIRECT CARE 1ST HR
|
Facility
|
IP
|
$134.24
|
|
|
Service Code
|
CPT 99358
|
| Hospital Charge Code |
51000084
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$93.43 |
| Max. Negotiated Rate |
$120.82 |
| Rate for Payer: Aetna Commercial |
$114.10
|
| Rate for Payer: BCBS Trust/PPO |
$110.87
|
| Rate for Payer: BCN Commercial |
$110.87
|
| Rate for Payer: Cash Price |
$107.39
|
| Rate for Payer: Cofinity Commercial |
$115.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.39
|
| Rate for Payer: Healthscope Commercial |
$120.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.10
|
| Rate for Payer: Nomi Health Commercial |
$110.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.68
|
| Rate for Payer: PHP Commercial |
$114.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.13
|
| Rate for Payer: UHC Core |
$112.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.68
|
|
|
HC PROLONGED OUTPATIENT OFFICE VISIT
|
Facility
|
OP
|
$30.52
|
|
|
Service Code
|
HCPCS G2212
|
| Hospital Charge Code |
51000098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5.38 |
| Max. Negotiated Rate |
$27.47 |
| Rate for Payer: Aetna Commercial |
$25.94
|
| Rate for Payer: Aetna Medicare |
$7.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.54
|
| Rate for Payer: BCBS Complete |
$5.65
|
| Rate for Payer: BCBS MAPPO |
$7.63
|
| Rate for Payer: BCBS Trust/PPO |
$25.09
|
| Rate for Payer: BCN Commercial |
$25.09
|
| Rate for Payer: BCN Medicare Advantage |
$7.63
|
| Rate for Payer: Cash Price |
$24.42
|
| Rate for Payer: Cofinity Commercial |
$26.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.63
|
| Rate for Payer: Healthscope Commercial |
$27.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.89
|
| Rate for Payer: Mclaren Medicaid |
$5.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.01
|
| Rate for Payer: Meridian Medicaid |
$5.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.94
|
| Rate for Payer: Nomi Health Commercial |
$25.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.89
|
| Rate for Payer: PACE Senior Care Partners |
$7.25
|
| Rate for Payer: PACE SWMI |
$7.63
|
| Rate for Payer: PHP Commercial |
$25.94
|
| Rate for Payer: PHP Medicare Advantage |
$7.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.55
|
| Rate for Payer: Priority Health Medicare |
$7.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.24
|
| Rate for Payer: Railroad Medicare Medicare |
$7.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.86
|
| Rate for Payer: UHC Core |
$25.48
|
| Rate for Payer: UHC Exchange |
$7.63
|
| Rate for Payer: UHC Medicaid |
$5.38
|
| Rate for Payer: UHC Medicare Advantage |
$7.63
|
| Rate for Payer: UHCCP Medicaid |
$5.38
|
| Rate for Payer: VA VA |
$7.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.89
|
|
|
HC PROLONGED OUTPATIENT OFFICE VISIT
|
Facility
|
IP
|
$30.52
|
|
|
Service Code
|
HCPCS G2212
|
| Hospital Charge Code |
51000098
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$21.24 |
| Max. Negotiated Rate |
$27.47 |
| Rate for Payer: Aetna Commercial |
$25.94
|
| Rate for Payer: BCBS Trust/PPO |
$25.21
|
| Rate for Payer: BCN Commercial |
$25.21
|
| Rate for Payer: Cash Price |
$24.42
|
| Rate for Payer: Cofinity Commercial |
$26.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.42
|
| Rate for Payer: Healthscope Commercial |
$27.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.94
|
| Rate for Payer: Nomi Health Commercial |
$25.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.89
|
| Rate for Payer: PHP Commercial |
$25.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.86
|
| Rate for Payer: UHC Core |
$25.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.89
|
|
|
HC PROPOXYPHENE URINE
|
Facility
|
IP
|
$32.90
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100055
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.90 |
| Max. Negotiated Rate |
$29.61 |
| Rate for Payer: Aetna Commercial |
$27.96
|
| Rate for Payer: BCBS Trust/PPO |
$27.17
|
| Rate for Payer: BCN Commercial |
$27.17
|
| Rate for Payer: Cash Price |
$26.32
|
| Rate for Payer: Cofinity Commercial |
$28.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.32
|
| Rate for Payer: Healthscope Commercial |
$29.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.96
|
| Rate for Payer: Nomi Health Commercial |
$26.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.68
|
| Rate for Payer: PHP Commercial |
$27.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.95
|
| Rate for Payer: UHC Core |
$27.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.68
|
|
|
HC PROPOXYPHENE URINE
|
Facility
|
OP
|
$32.90
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100055
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.80 |
| Max. Negotiated Rate |
$29.61 |
| Rate for Payer: Aetna Commercial |
$27.96
|
| Rate for Payer: Aetna Medicare |
$8.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.28
|
| Rate for Payer: BCBS Complete |
$6.09
|
| Rate for Payer: BCBS MAPPO |
$8.22
|
| Rate for Payer: BCBS Trust/PPO |
$27.05
|
| Rate for Payer: BCN Commercial |
$27.05
|
| Rate for Payer: BCN Medicare Advantage |
$8.22
|
| Rate for Payer: Cash Price |
$26.32
|
| Rate for Payer: Cofinity Commercial |
$28.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.22
|
| Rate for Payer: Healthscope Commercial |
$29.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.68
|
| Rate for Payer: Mclaren Medicaid |
$5.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.64
|
| Rate for Payer: Meridian Medicaid |
$6.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.96
|
| Rate for Payer: Nomi Health Commercial |
$26.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.68
|
| Rate for Payer: PACE Senior Care Partners |
$7.81
|
| Rate for Payer: PACE SWMI |
$8.22
|
| Rate for Payer: PHP Commercial |
$27.96
|
| Rate for Payer: PHP Medicare Advantage |
$8.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.62
|
| Rate for Payer: Priority Health Medicare |
$8.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.90
|
| Rate for Payer: Railroad Medicare Medicare |
$8.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.95
|
| Rate for Payer: UHC Core |
$27.47
|
| Rate for Payer: UHC Exchange |
$8.22
|
| Rate for Payer: UHC Medicaid |
$5.80
|
| Rate for Payer: UHC Medicare Advantage |
$8.22
|
| Rate for Payer: UHCCP Medicaid |
$5.80
|
| Rate for Payer: VA VA |
$8.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.68
|
|
