|
HC PT EVAL MODERATE COMPLEXITY
|
Facility
|
IP
|
$291.83
|
|
|
Service Code
|
CPT 97162
|
| Hospital Charge Code |
42400007
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$203.11 |
| Max. Negotiated Rate |
$262.65 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: BCBS Trust/PPO |
$241.02
|
| Rate for Payer: BCN Commercial |
$241.02
|
| Rate for Payer: Cash Price |
$233.46
|
| Rate for Payer: Cofinity Commercial |
$250.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.46
|
| Rate for Payer: Healthscope Commercial |
$262.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.87
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$253.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.81
|
| Rate for Payer: UHC Core |
$243.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.87
|
|
|
HC PT EVAL MODERATE COMPLEXITY
|
Facility
|
OP
|
$291.83
|
|
|
Service Code
|
CPT 97162
|
| Hospital Charge Code |
42400007
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$51.45 |
| Max. Negotiated Rate |
$262.65 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna Medicare |
$75.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.20
|
| Rate for Payer: BCBS Complete |
$54.02
|
| Rate for Payer: BCBS MAPPO |
$72.96
|
| Rate for Payer: BCBS Trust/PPO |
$239.91
|
| Rate for Payer: BCN Commercial |
$239.91
|
| Rate for Payer: BCN Medicare Advantage |
$72.96
|
| Rate for Payer: Cash Price |
$233.46
|
| Rate for Payer: Cofinity Commercial |
$250.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.96
|
| Rate for Payer: Healthscope Commercial |
$262.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.87
|
| Rate for Payer: Mclaren Medicaid |
$51.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.61
|
| Rate for Payer: Meridian Medicaid |
$54.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.87
|
| Rate for Payer: PACE Senior Care Partners |
$69.31
|
| Rate for Payer: PACE SWMI |
$72.96
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: PHP Medicare Advantage |
$72.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$253.89
|
| Rate for Payer: Priority Health Medicare |
$73.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.11
|
| Rate for Payer: Railroad Medicare Medicare |
$72.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.81
|
| Rate for Payer: UHC Core |
$243.68
|
| Rate for Payer: UHC Exchange |
$72.96
|
| Rate for Payer: UHC Medicaid |
$51.45
|
| Rate for Payer: UHC Medicare Advantage |
$72.96
|
| Rate for Payer: UHCCP Medicaid |
$51.45
|
| Rate for Payer: VA VA |
$72.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.87
|
|
|
HC PT MIX 1:1
|
Facility
|
IP
|
$71.85
|
|
|
Service Code
|
CPT 85611
|
| Hospital Charge Code |
30500107
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$50.01 |
| Max. Negotiated Rate |
$64.67 |
| Rate for Payer: Aetna Commercial |
$61.07
|
| Rate for Payer: BCBS Trust/PPO |
$59.34
|
| Rate for Payer: BCN Commercial |
$59.34
|
| Rate for Payer: Cash Price |
$57.48
|
| Rate for Payer: Cofinity Commercial |
$61.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.48
|
| Rate for Payer: Healthscope Commercial |
$64.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.07
|
| Rate for Payer: Nomi Health Commercial |
$58.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.89
|
| Rate for Payer: PHP Commercial |
$61.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.23
|
| Rate for Payer: UHC Core |
$59.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.89
|
|
|
HC PT MIX 1:1
|
Facility
|
OP
|
$71.85
|
|
|
Service Code
|
CPT 85611
|
| Hospital Charge Code |
30500107
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.67 |
| Max. Negotiated Rate |
$64.67 |
| Rate for Payer: Aetna Commercial |
$61.07
|
| Rate for Payer: Aetna Medicare |
$18.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.45
|
| Rate for Payer: BCBS Complete |
$13.30
|
| Rate for Payer: BCBS MAPPO |
$17.96
|
| Rate for Payer: BCBS Trust/PPO |
$59.07
|
| Rate for Payer: BCN Commercial |
$59.07
|
| Rate for Payer: BCN Medicare Advantage |
$17.96
|
| Rate for Payer: Cash Price |
$57.48
|
| Rate for Payer: Cofinity Commercial |
$61.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.96
|
| Rate for Payer: Healthscope Commercial |
$64.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.89
|
| Rate for Payer: Mclaren Medicaid |
$12.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.86
|
| Rate for Payer: Meridian Medicaid |
$13.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.07
|
| Rate for Payer: Nomi Health Commercial |
$58.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.89
|
| Rate for Payer: PACE Senior Care Partners |
$17.06
|
| Rate for Payer: PACE SWMI |
$17.96
|
| Rate for Payer: PHP Commercial |
$61.07
|
| Rate for Payer: PHP Medicare Advantage |
$17.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.51
|
| Rate for Payer: Priority Health Medicare |
$18.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.01
|
| Rate for Payer: Railroad Medicare Medicare |
$17.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.23
|
| Rate for Payer: UHC Core |
$59.99
|
| Rate for Payer: UHC Exchange |
$17.96
|
| Rate for Payer: UHC Medicaid |
$12.67
|
| Rate for Payer: UHC Medicare Advantage |
$17.96
|
| Rate for Payer: UHCCP Medicaid |
$12.67
|
| Rate for Payer: VA VA |
$17.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.89
|
|
|
HC PT NEUROSTIM
|
Facility
|
OP
|
$99.08
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
42000007
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$17.47 |
| Max. Negotiated Rate |
$89.17 |
| Rate for Payer: Aetna Commercial |
$84.22
|
| Rate for Payer: Aetna Medicare |
$25.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.96
|
| Rate for Payer: BCBS Complete |
$18.34
|
| Rate for Payer: BCBS MAPPO |
$24.77
|
| Rate for Payer: BCBS Trust/PPO |
$81.45
|
| Rate for Payer: BCN Commercial |
$81.45
|
| Rate for Payer: BCN Medicare Advantage |
$24.77
|
| Rate for Payer: Cash Price |
$79.26
|
| Rate for Payer: Cofinity Commercial |
$85.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.77
|
| Rate for Payer: Healthscope Commercial |
$89.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.31
|
| Rate for Payer: Mclaren Medicaid |
$17.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.01
|
| Rate for Payer: Meridian Medicaid |
$18.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.22
|
| Rate for Payer: Nomi Health Commercial |
$81.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.31
|
| Rate for Payer: PACE Senior Care Partners |
$23.53
|
| Rate for Payer: PACE SWMI |
$24.77
|
| Rate for Payer: PHP Commercial |
$84.22
|
| Rate for Payer: PHP Medicare Advantage |
$24.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.20
|
| Rate for Payer: Priority Health Medicare |
$25.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.96
|
| Rate for Payer: Railroad Medicare Medicare |
$24.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.19
|
| Rate for Payer: UHC Core |
$82.73
|
| Rate for Payer: UHC Exchange |
$24.77
|
| Rate for Payer: UHC Medicaid |
$17.47
|
| Rate for Payer: UHC Medicare Advantage |
$24.77
|
| Rate for Payer: UHCCP Medicaid |
$17.47
|
| Rate for Payer: VA VA |
$24.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.31
|
|
|
HC PT NEUROSTIM
|
Facility
|
IP
|
$99.08
|
|
|
Service Code
|
CPT 97032
|
| Hospital Charge Code |
42000007
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$68.96 |
| Max. Negotiated Rate |
$89.17 |
| Rate for Payer: Aetna Commercial |
$84.22
|
| Rate for Payer: BCBS Trust/PPO |
$81.83
|
| Rate for Payer: BCN Commercial |
$81.83
|
| Rate for Payer: Cash Price |
$79.26
|
| Rate for Payer: Cofinity Commercial |
$85.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.26
|
| Rate for Payer: Healthscope Commercial |
$89.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.22
|
| Rate for Payer: Nomi Health Commercial |
$81.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.31
|
| Rate for Payer: PHP Commercial |
$84.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.19
|
| Rate for Payer: UHC Core |
$82.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.31
|
|
|
HC PT RE-EVALUATION
|
Facility
|
OP
|
$130.72
|
|
|
Service Code
|
CPT 97164
|
| Hospital Charge Code |
42400009
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$23.05 |
| Max. Negotiated Rate |
$117.65 |
| Rate for Payer: Aetna Commercial |
$111.11
|
| Rate for Payer: Aetna Medicare |
$33.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.85
|
| Rate for Payer: BCBS Complete |
$24.20
|
| Rate for Payer: BCBS MAPPO |
$32.68
|
| Rate for Payer: BCBS Trust/PPO |
$107.46
|
| Rate for Payer: BCN Commercial |
$107.46
|
| Rate for Payer: BCN Medicare Advantage |
$32.68
|
| Rate for Payer: Cash Price |
$104.58
|
| Rate for Payer: Cofinity Commercial |
$112.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.68
|
| Rate for Payer: Healthscope Commercial |
$117.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.04
|
| Rate for Payer: Mclaren Medicaid |
$23.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.31
|
| Rate for Payer: Meridian Medicaid |
$24.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.11
|
| Rate for Payer: Nomi Health Commercial |
$107.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.04
|
| Rate for Payer: PACE Senior Care Partners |
$31.05
|
| Rate for Payer: PACE SWMI |
$32.68
|
| Rate for Payer: PHP Commercial |
$111.11
|
| Rate for Payer: PHP Medicare Advantage |
$32.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.73
|
| Rate for Payer: Priority Health Medicare |
$33.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.98
|
| Rate for Payer: Railroad Medicare Medicare |
$32.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.03
|
| Rate for Payer: UHC Core |
$109.15
|
| Rate for Payer: UHC Exchange |
$32.68
|
| Rate for Payer: UHC Medicaid |
$23.05
|
| Rate for Payer: UHC Medicare Advantage |
$32.68
|
| Rate for Payer: UHCCP Medicaid |
$23.05
|
| Rate for Payer: VA VA |
$32.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.04
|
|
|
HC PT RE-EVALUATION
|
Facility
|
IP
|
$130.72
|
|
|
Service Code
|
CPT 97164
|
| Hospital Charge Code |
42400009
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$90.98 |
| Max. Negotiated Rate |
$117.65 |
| Rate for Payer: Aetna Commercial |
$111.11
|
| Rate for Payer: BCBS Trust/PPO |
$107.96
|
| Rate for Payer: BCN Commercial |
$107.96
|
| Rate for Payer: Cash Price |
$104.58
|
| Rate for Payer: Cofinity Commercial |
$112.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.58
|
| Rate for Payer: Healthscope Commercial |
$117.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.11
|
| Rate for Payer: Nomi Health Commercial |
$107.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.04
|
| Rate for Payer: PHP Commercial |
$111.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.03
|
| Rate for Payer: UHC Core |
$109.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.04
|
|
|
HC PULM EXER FUNCTION INDIV 15 MIN
|
Facility
|
IP
|
$89.43
|
|
|
Service Code
|
HCPCS G0238
|
| Hospital Charge Code |
41000045
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$62.24 |
| Max. Negotiated Rate |
$80.49 |
| Rate for Payer: Aetna Commercial |
$76.02
|
| Rate for Payer: BCBS Trust/PPO |
$73.86
|
| Rate for Payer: BCN Commercial |
$73.86
|
| Rate for Payer: Cash Price |
$71.54
|
| Rate for Payer: Cofinity Commercial |
$76.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.54
|
| Rate for Payer: Healthscope Commercial |
$80.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.02
|
| Rate for Payer: Nomi Health Commercial |
$73.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.07
|
| Rate for Payer: PHP Commercial |
$76.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.70
|
| Rate for Payer: UHC Core |
$74.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.07
|
|
|
HC PULM EXER FUNCTION INDIV 15 MIN
|
Facility
|
OP
|
$89.43
|
|
|
Service Code
|
HCPCS G0238
|
| Hospital Charge Code |
41000045
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$15.77 |
| Max. Negotiated Rate |
$80.49 |
| Rate for Payer: Aetna Commercial |
$76.02
|
| Rate for Payer: Aetna Medicare |
$23.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.95
|
| Rate for Payer: BCBS Complete |
$16.55
|
| Rate for Payer: BCBS MAPPO |
$22.36
|
| Rate for Payer: BCBS Trust/PPO |
$73.52
|
| Rate for Payer: BCN Commercial |
$73.52
|
| Rate for Payer: BCN Medicare Advantage |
$22.36
|
| Rate for Payer: Cash Price |
$71.54
|
| Rate for Payer: Cofinity Commercial |
$76.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.36
|
| Rate for Payer: Healthscope Commercial |
$80.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.07
|
| Rate for Payer: Mclaren Medicaid |
$15.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.48
|
| Rate for Payer: Meridian Medicaid |
$16.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.02
|
| Rate for Payer: Nomi Health Commercial |
$73.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.07
|
| Rate for Payer: PACE Senior Care Partners |
$21.24
|
| Rate for Payer: PACE SWMI |
$22.36
|
| Rate for Payer: PHP Commercial |
$76.02
|
| Rate for Payer: PHP Medicare Advantage |
$22.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.80
|
| Rate for Payer: Priority Health Medicare |
$22.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.24
|
| Rate for Payer: Railroad Medicare Medicare |
$22.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.70
|
| Rate for Payer: UHC Core |
$74.67
|
| Rate for Payer: UHC Exchange |
$22.36
|
| Rate for Payer: UHC Medicaid |
$15.77
|
| Rate for Payer: UHC Medicare Advantage |
$22.36
|
| Rate for Payer: UHCCP Medicaid |
$15.77
|
| Rate for Payer: VA VA |
$22.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.07
|
|
|
HC PULMONARY ARTERIOGRAM NONSELECTIVE
|
Facility
|
IP
|
$1,735.21
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
32000197
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,207.71 |
| Max. Negotiated Rate |
$1,561.69 |
| Rate for Payer: Aetna Commercial |
$1,474.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,433.11
|
| Rate for Payer: BCN Commercial |
$1,433.11
|
| Rate for Payer: Cash Price |
$1,388.17
|
| Rate for Payer: Cofinity Commercial |
$1,492.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,388.17
|
| Rate for Payer: Healthscope Commercial |
$1,561.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,301.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,474.93
|
| Rate for Payer: Nomi Health Commercial |
$1,422.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,301.41
|
| Rate for Payer: PHP Commercial |
$1,474.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,509.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,207.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,526.98
|
| Rate for Payer: UHC Core |
$1,448.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,301.41
|
|
|
HC PULMONARY ARTERIOGRAM NONSELECTIVE
|
Facility
|
OP
|
$1,735.21
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
32000197
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$305.92 |
| Max. Negotiated Rate |
$1,561.69 |
| Rate for Payer: Aetna Commercial |
$1,474.93
|
| Rate for Payer: Aetna Medicare |
$451.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$542.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$542.25
|
| Rate for Payer: BCBS Complete |
$321.19
|
| Rate for Payer: BCBS MAPPO |
$433.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,426.52
|
| Rate for Payer: BCN Commercial |
$1,426.52
|
| Rate for Payer: BCN Medicare Advantage |
$433.80
|
| Rate for Payer: Cash Price |
$1,388.17
|
| Rate for Payer: Cofinity Commercial |
$1,492.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,388.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.80
|
| Rate for Payer: Healthscope Commercial |
$1,561.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,301.41
|
| Rate for Payer: Mclaren Medicaid |
$305.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$455.49
|
| Rate for Payer: Meridian Medicaid |
$321.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$498.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$477.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,474.93
|
| Rate for Payer: Nomi Health Commercial |
$1,422.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,301.41
|
| Rate for Payer: PACE Senior Care Partners |
$412.11
|
| Rate for Payer: PACE SWMI |
$433.80
|
| Rate for Payer: PHP Commercial |
$1,474.93
|
| Rate for Payer: PHP Medicare Advantage |
$433.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,509.63
|
| Rate for Payer: Priority Health Medicare |
$438.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,207.71
|
| Rate for Payer: Railroad Medicare Medicare |
$433.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,526.98
|
| Rate for Payer: UHC Core |
$1,448.90
|
| Rate for Payer: UHC Exchange |
$433.80
|
| Rate for Payer: UHC Medicaid |
$305.92
|
| Rate for Payer: UHC Medicare Advantage |
$433.80
|
| Rate for Payer: UHCCP Medicaid |
$305.92
|
| Rate for Payer: VA VA |
$433.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,301.41
|
|
|
HC PULMONARY EXERCISE GROUP
|
Facility
|
IP
|
$107.30
|
|
|
Service Code
|
HCPCS G0239
|
| Hospital Charge Code |
41000044
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$74.68 |
| Max. Negotiated Rate |
$96.57 |
| Rate for Payer: Aetna Commercial |
$91.20
|
| Rate for Payer: BCBS Trust/PPO |
$88.62
|
| Rate for Payer: BCN Commercial |
$88.62
|
| Rate for Payer: Cash Price |
$85.84
|
| Rate for Payer: Cofinity Commercial |
$92.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.84
|
| Rate for Payer: Healthscope Commercial |
$96.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.20
|
| Rate for Payer: Nomi Health Commercial |
$87.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.47
|
| Rate for Payer: PHP Commercial |
$91.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.42
|
| Rate for Payer: UHC Core |
$89.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.47
|
|
|
HC PULMONARY EXERCISE GROUP
|
Facility
|
OP
|
$107.30
|
|
|
Service Code
|
HCPCS G0239
|
| Hospital Charge Code |
41000044
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$18.92 |
| Max. Negotiated Rate |
$96.57 |
| Rate for Payer: Aetna Commercial |
$91.20
|
| Rate for Payer: Aetna Medicare |
$27.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.53
|
| Rate for Payer: BCBS Complete |
$19.86
|
| Rate for Payer: BCBS MAPPO |
$26.82
|
| Rate for Payer: BCBS Trust/PPO |
$88.21
|
| Rate for Payer: BCN Commercial |
$88.21
|
| Rate for Payer: BCN Medicare Advantage |
$26.82
|
| Rate for Payer: Cash Price |
$85.84
|
| Rate for Payer: Cofinity Commercial |
$92.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.82
|
| Rate for Payer: Healthscope Commercial |
$96.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.47
|
| Rate for Payer: Mclaren Medicaid |
$18.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.17
|
| Rate for Payer: Meridian Medicaid |
$19.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.20
|
| Rate for Payer: Nomi Health Commercial |
$87.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.47
|
| Rate for Payer: PACE Senior Care Partners |
$25.48
|
| Rate for Payer: PACE SWMI |
$26.82
|
| Rate for Payer: PHP Commercial |
$91.20
|
| Rate for Payer: PHP Medicare Advantage |
$26.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.35
|
| Rate for Payer: Priority Health Medicare |
$27.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.68
|
| Rate for Payer: Railroad Medicare Medicare |
$26.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.42
|
| Rate for Payer: UHC Core |
$89.60
|
| Rate for Payer: UHC Exchange |
$26.82
|
| Rate for Payer: UHC Medicaid |
$18.92
|
| Rate for Payer: UHC Medicare Advantage |
$26.82
|
| Rate for Payer: UHCCP Medicaid |
$18.92
|
| Rate for Payer: VA VA |
$26.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.47
|
|
|
HC PULMONARY STRESS TESTING (EG 6 MIN WALK)
|
Facility
|
OP
|
$379.26
|
|
|
Service Code
|
CPT 94618
|
| Hospital Charge Code |
46000030
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$66.86 |
| Max. Negotiated Rate |
$341.33 |
| Rate for Payer: Aetna Commercial |
$322.37
|
| Rate for Payer: Aetna Medicare |
$98.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.52
|
| Rate for Payer: BCBS Complete |
$70.20
|
| Rate for Payer: BCBS MAPPO |
$94.81
|
| Rate for Payer: BCBS Trust/PPO |
$311.79
|
| Rate for Payer: BCN Commercial |
$311.79
|
| Rate for Payer: BCN Medicare Advantage |
$94.81
|
| Rate for Payer: Cash Price |
$303.41
|
| Rate for Payer: Cofinity Commercial |
$326.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.81
|
| Rate for Payer: Healthscope Commercial |
$341.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.44
|
| Rate for Payer: Mclaren Medicaid |
$66.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.56
|
| Rate for Payer: Meridian Medicaid |
$70.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.37
|
| Rate for Payer: Nomi Health Commercial |
$310.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.44
|
| Rate for Payer: PACE Senior Care Partners |
$90.07
|
| Rate for Payer: PACE SWMI |
$94.81
|
| Rate for Payer: PHP Commercial |
$322.37
|
| Rate for Payer: PHP Medicare Advantage |
$94.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$329.96
|
| Rate for Payer: Priority Health Medicare |
$95.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$263.96
|
| Rate for Payer: Railroad Medicare Medicare |
$94.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.75
|
| Rate for Payer: UHC Core |
$316.68
|
| Rate for Payer: UHC Exchange |
$94.81
|
| Rate for Payer: UHC Medicaid |
$66.86
|
| Rate for Payer: UHC Medicare Advantage |
$94.81
|
| Rate for Payer: UHCCP Medicaid |
$66.86
|
| Rate for Payer: VA VA |
$94.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.44
|
|
|
HC PULMONARY STRESS TESTING (EG 6 MIN WALK)
|
Facility
|
IP
|
$379.26
|
|
|
Service Code
|
CPT 94618
|
| Hospital Charge Code |
46000030
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$263.96 |
| Max. Negotiated Rate |
$341.33 |
| Rate for Payer: Aetna Commercial |
$322.37
|
| Rate for Payer: BCBS Trust/PPO |
$313.23
|
| Rate for Payer: BCN Commercial |
$313.23
|
| Rate for Payer: Cash Price |
$303.41
|
| Rate for Payer: Cofinity Commercial |
$326.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.41
|
| Rate for Payer: Healthscope Commercial |
$341.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.37
|
| Rate for Payer: Nomi Health Commercial |
$310.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.44
|
| Rate for Payer: PHP Commercial |
$322.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$329.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$263.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.75
|
| Rate for Payer: UHC Core |
$316.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.44
|
|
|
HC PULM REHAB W/ CONT OXIMTRY MNTR
|
Facility
|
OP
|
$263.50
|
|
|
Service Code
|
CPT 94626
|
| Hospital Charge Code |
94800004
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$46.46 |
| Max. Negotiated Rate |
$237.15 |
| Rate for Payer: Aetna Commercial |
$223.97
|
| Rate for Payer: Aetna Medicare |
$68.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.34
|
| Rate for Payer: BCBS Complete |
$48.77
|
| Rate for Payer: BCBS MAPPO |
$65.88
|
| Rate for Payer: BCBS Trust/PPO |
$216.62
|
| Rate for Payer: BCN Commercial |
$216.62
|
| Rate for Payer: BCN Medicare Advantage |
$65.88
|
| Rate for Payer: Cash Price |
$210.80
|
| Rate for Payer: Cofinity Commercial |
$226.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.88
|
| Rate for Payer: Healthscope Commercial |
$237.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.62
|
| Rate for Payer: Mclaren Medicaid |
$46.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.17
|
| Rate for Payer: Meridian Medicaid |
$48.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.97
|
| Rate for Payer: Nomi Health Commercial |
$216.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.62
|
| Rate for Payer: PACE Senior Care Partners |
$62.58
|
| Rate for Payer: PACE SWMI |
$65.88
|
| Rate for Payer: PHP Commercial |
$223.97
|
| Rate for Payer: PHP Medicare Advantage |
$65.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$229.25
|
| Rate for Payer: Priority Health Medicare |
$66.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.40
|
| Rate for Payer: Railroad Medicare Medicare |
$65.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.88
|
| Rate for Payer: UHC Core |
$220.02
|
| Rate for Payer: UHC Exchange |
$65.88
|
| Rate for Payer: UHC Medicaid |
$46.46
|
| Rate for Payer: UHC Medicare Advantage |
$65.88
|
| Rate for Payer: UHCCP Medicaid |
$46.46
|
| Rate for Payer: VA VA |
$65.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.62
|
|
|
HC PULM REHAB W/ CONT OXIMTRY MNTR
|
Facility
|
IP
|
$263.50
|
|
|
Service Code
|
CPT 94626
|
| Hospital Charge Code |
94800004
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$183.40 |
| Max. Negotiated Rate |
$237.15 |
| Rate for Payer: Aetna Commercial |
$223.97
|
| Rate for Payer: BCBS Trust/PPO |
$217.62
|
| Rate for Payer: BCN Commercial |
$217.62
|
| Rate for Payer: Cash Price |
$210.80
|
| Rate for Payer: Cofinity Commercial |
$226.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.80
|
| Rate for Payer: Healthscope Commercial |
$237.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.97
|
| Rate for Payer: Nomi Health Commercial |
$216.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.62
|
| Rate for Payer: PHP Commercial |
$223.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$229.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.88
|
| Rate for Payer: UHC Core |
$220.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.62
|
|
|
HC PULM REHAB W/O CONT OXIMTRY MNTR
|
Facility
|
OP
|
$223.97
|
|
|
Service Code
|
CPT 94625
|
| Hospital Charge Code |
94800003
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$39.49 |
| Max. Negotiated Rate |
$201.57 |
| Rate for Payer: Aetna Commercial |
$190.37
|
| Rate for Payer: Aetna Medicare |
$58.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.99
|
| Rate for Payer: BCBS Complete |
$41.46
|
| Rate for Payer: BCBS MAPPO |
$55.99
|
| Rate for Payer: BCBS Trust/PPO |
$184.13
|
| Rate for Payer: BCN Commercial |
$184.13
|
| Rate for Payer: BCN Medicare Advantage |
$55.99
|
| Rate for Payer: Cash Price |
$179.18
|
| Rate for Payer: Cofinity Commercial |
$192.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.99
|
| Rate for Payer: Healthscope Commercial |
$201.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.98
|
| Rate for Payer: Mclaren Medicaid |
$39.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.79
|
| Rate for Payer: Meridian Medicaid |
$41.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.37
|
| Rate for Payer: Nomi Health Commercial |
$183.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.98
|
| Rate for Payer: PACE Senior Care Partners |
$53.19
|
| Rate for Payer: PACE SWMI |
$55.99
|
| Rate for Payer: PHP Commercial |
$190.37
|
| Rate for Payer: PHP Medicare Advantage |
$55.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$194.85
|
| Rate for Payer: Priority Health Medicare |
$56.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.88
|
| Rate for Payer: Railroad Medicare Medicare |
$55.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.09
|
| Rate for Payer: UHC Core |
$187.01
|
| Rate for Payer: UHC Exchange |
$55.99
|
| Rate for Payer: UHC Medicaid |
$39.49
|
| Rate for Payer: UHC Medicare Advantage |
$55.99
|
| Rate for Payer: UHCCP Medicaid |
$39.49
|
| Rate for Payer: VA VA |
$55.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.98
|
|
|
HC PULM REHAB W/O CONT OXIMTRY MNTR
|
Facility
|
IP
|
$223.97
|
|
|
Service Code
|
CPT 94625
|
| Hospital Charge Code |
94800003
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$155.88 |
| Max. Negotiated Rate |
$201.57 |
| Rate for Payer: Aetna Commercial |
$190.37
|
| Rate for Payer: BCBS Trust/PPO |
$184.98
|
| Rate for Payer: BCN Commercial |
$184.98
|
| Rate for Payer: Cash Price |
$179.18
|
| Rate for Payer: Cofinity Commercial |
$192.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.18
|
| Rate for Payer: Healthscope Commercial |
$201.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.37
|
| Rate for Payer: Nomi Health Commercial |
$183.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.98
|
| Rate for Payer: PHP Commercial |
$190.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$194.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.09
|
| Rate for Payer: UHC Core |
$187.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.98
|
|
|
HC PULSE OXIMETRY MULTI DETER
|
Facility
|
OP
|
$130.80
|
|
|
Service Code
|
CPT 94761
|
| Hospital Charge Code |
46000012
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$23.06 |
| Max. Negotiated Rate |
$117.72 |
| Rate for Payer: Aetna Commercial |
$111.18
|
| Rate for Payer: Aetna Medicare |
$34.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.88
|
| Rate for Payer: BCBS Complete |
$24.21
|
| Rate for Payer: BCBS MAPPO |
$32.70
|
| Rate for Payer: BCBS Trust/PPO |
$107.53
|
| Rate for Payer: BCN Commercial |
$107.53
|
| Rate for Payer: BCN Medicare Advantage |
$32.70
|
| Rate for Payer: Cash Price |
$104.64
|
| Rate for Payer: Cofinity Commercial |
$112.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.70
|
| Rate for Payer: Healthscope Commercial |
$117.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.10
|
| Rate for Payer: Mclaren Medicaid |
$23.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.34
|
| Rate for Payer: Meridian Medicaid |
$24.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.18
|
| Rate for Payer: Nomi Health Commercial |
$107.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.10
|
| Rate for Payer: PACE Senior Care Partners |
$31.07
|
| Rate for Payer: PACE SWMI |
$32.70
|
| Rate for Payer: PHP Commercial |
$111.18
|
| Rate for Payer: PHP Medicare Advantage |
$32.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.80
|
| Rate for Payer: Priority Health Medicare |
$33.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.04
|
| Rate for Payer: Railroad Medicare Medicare |
$32.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.10
|
| Rate for Payer: UHC Core |
$109.22
|
| Rate for Payer: UHC Exchange |
$32.70
|
| Rate for Payer: UHC Medicaid |
$23.06
|
| Rate for Payer: UHC Medicare Advantage |
$32.70
|
| Rate for Payer: UHCCP Medicaid |
$23.06
|
| Rate for Payer: VA VA |
$32.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.10
|
|
|
HC PULSE OXIMETRY MULTI DETER
|
Facility
|
IP
|
$130.80
|
|
|
Service Code
|
CPT 94761
|
| Hospital Charge Code |
46000012
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$91.04 |
| Max. Negotiated Rate |
$117.72 |
| Rate for Payer: Aetna Commercial |
$111.18
|
| Rate for Payer: BCBS Trust/PPO |
$108.03
|
| Rate for Payer: BCN Commercial |
$108.03
|
| Rate for Payer: Cash Price |
$104.64
|
| Rate for Payer: Cofinity Commercial |
$112.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.64
|
| Rate for Payer: Healthscope Commercial |
$117.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.18
|
| Rate for Payer: Nomi Health Commercial |
$107.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.10
|
| Rate for Payer: PHP Commercial |
$111.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.10
|
| Rate for Payer: UHC Core |
$109.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.10
|
|
|
HC PULSE OX OVERNIGHT
|
Facility
|
OP
|
$209.53
|
|
|
Service Code
|
CPT 94762
|
| Hospital Charge Code |
46000027
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$36.94 |
| Max. Negotiated Rate |
$188.58 |
| Rate for Payer: Aetna Commercial |
$178.10
|
| Rate for Payer: Aetna Medicare |
$54.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.48
|
| Rate for Payer: BCBS Complete |
$38.78
|
| Rate for Payer: BCBS MAPPO |
$52.38
|
| Rate for Payer: BCBS Trust/PPO |
$172.25
|
| Rate for Payer: BCN Commercial |
$172.25
|
| Rate for Payer: BCN Medicare Advantage |
$52.38
|
| Rate for Payer: Cash Price |
$167.62
|
| Rate for Payer: Cofinity Commercial |
$180.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.38
|
| Rate for Payer: Healthscope Commercial |
$188.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.15
|
| Rate for Payer: Mclaren Medicaid |
$36.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.00
|
| Rate for Payer: Meridian Medicaid |
$38.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.10
|
| Rate for Payer: Nomi Health Commercial |
$171.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.15
|
| Rate for Payer: PACE Senior Care Partners |
$49.76
|
| Rate for Payer: PACE SWMI |
$52.38
|
| Rate for Payer: PHP Commercial |
$178.10
|
| Rate for Payer: PHP Medicare Advantage |
$52.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$182.29
|
| Rate for Payer: Priority Health Medicare |
$52.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.83
|
| Rate for Payer: Railroad Medicare Medicare |
$52.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.39
|
| Rate for Payer: UHC Core |
$174.96
|
| Rate for Payer: UHC Exchange |
$52.38
|
| Rate for Payer: UHC Medicaid |
$36.94
|
| Rate for Payer: UHC Medicare Advantage |
$52.38
|
| Rate for Payer: UHCCP Medicaid |
$36.94
|
| Rate for Payer: VA VA |
$52.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.15
|
|
|
HC PULSE OX OVERNIGHT
|
Facility
|
IP
|
$209.53
|
|
|
Service Code
|
CPT 94762
|
| Hospital Charge Code |
46000027
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$145.83 |
| Max. Negotiated Rate |
$188.58 |
| Rate for Payer: Aetna Commercial |
$178.10
|
| Rate for Payer: BCBS Trust/PPO |
$173.05
|
| Rate for Payer: BCN Commercial |
$173.05
|
| Rate for Payer: Cash Price |
$167.62
|
| Rate for Payer: Cofinity Commercial |
$180.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.62
|
| Rate for Payer: Healthscope Commercial |
$188.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.10
|
| Rate for Payer: Nomi Health Commercial |
$171.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.15
|
| Rate for Payer: PHP Commercial |
$178.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$182.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.39
|
| Rate for Payer: UHC Core |
$174.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.15
|
|
|
HC PULSE OX SINGLE
|
Facility
|
IP
|
$88.16
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
46000026
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$61.36 |
| Max. Negotiated Rate |
$79.34 |
| Rate for Payer: Aetna Commercial |
$74.94
|
| Rate for Payer: BCBS Trust/PPO |
$72.81
|
| Rate for Payer: BCN Commercial |
$72.81
|
| Rate for Payer: Cash Price |
$70.53
|
| Rate for Payer: Cofinity Commercial |
$75.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.53
|
| Rate for Payer: Healthscope Commercial |
$79.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.94
|
| Rate for Payer: Nomi Health Commercial |
$72.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.12
|
| Rate for Payer: PHP Commercial |
$74.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$76.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.58
|
| Rate for Payer: UHC Core |
$73.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.12
|
|
