|
HC PACK W/O RESERV TERUMO
|
Facility
|
OP
|
$841.50
|
|
| Hospital Charge Code |
27000648
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$199.86 |
| Max. Negotiated Rate |
$757.35 |
| Rate for Payer: Aetna Commercial |
$715.27
|
| Rate for Payer: Aetna Medicare |
$218.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.97
|
| Rate for Payer: BCBS Complete |
$336.60
|
| Rate for Payer: BCBS MAPPO |
$210.38
|
| Rate for Payer: BCBS Trust/PPO |
$691.80
|
| Rate for Payer: BCN Commercial |
$654.27
|
| Rate for Payer: BCN Medicare Advantage |
$210.38
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cofinity Commercial |
$723.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.38
|
| Rate for Payer: Healthscope Commercial |
$757.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$220.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.27
|
| Rate for Payer: Nomi Health Commercial |
$690.03
|
| Rate for Payer: PACE Senior Care Partners |
$199.86
|
| Rate for Payer: PACE SWMI |
$210.38
|
| Rate for Payer: PHP Commercial |
$715.27
|
| Rate for Payer: PHP Medicare Advantage |
$210.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.98
|
| Rate for Payer: Priority Health HMO/PPO |
$732.11
|
| Rate for Payer: Priority Health Medicare |
$212.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$563.80
|
| Rate for Payer: Railroad Medicare Medicare |
$210.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.52
|
| Rate for Payer: UHC Core |
$702.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.38
|
| Rate for Payer: UHC Exchange |
$210.38
|
| Rate for Payer: UHC Medicare Advantage |
$210.38
|
| Rate for Payer: VA VA |
$210.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.12
|
|
|
HC PAIN CLINIC DRUG SCREEN, U
|
Facility
|
IP
|
$164.38
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100680
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$106.85 |
| Max. Negotiated Rate |
$147.94 |
| Rate for Payer: Aetna Commercial |
$139.72
|
| Rate for Payer: BCBS Trust/PPO |
$134.18
|
| Rate for Payer: BCN Commercial |
$127.03
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cofinity Commercial |
$141.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.50
|
| Rate for Payer: Healthscope Commercial |
$147.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.72
|
| Rate for Payer: Nomi Health Commercial |
$134.79
|
| Rate for Payer: PHP Commercial |
$139.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.85
|
| Rate for Payer: Priority Health HMO/PPO |
$143.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.65
|
| Rate for Payer: UHC Core |
$137.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.28
|
|
|
HC PAIN CLINIC DRUG SCREEN, U
|
Facility
|
OP
|
$164.38
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100680
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.04 |
| Max. Negotiated Rate |
$147.94 |
| Rate for Payer: Aetna Commercial |
$139.72
|
| Rate for Payer: Aetna Medicare |
$42.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.37
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$41.09
|
| Rate for Payer: BCBS Trust/PPO |
$135.14
|
| Rate for Payer: BCN Commercial |
$127.81
|
| Rate for Payer: BCN Medicare Advantage |
$41.09
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cofinity Commercial |
$141.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.09
|
| Rate for Payer: Healthscope Commercial |
$147.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.28
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.15
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.72
|
| Rate for Payer: Nomi Health Commercial |
$134.79
|
| Rate for Payer: PACE Senior Care Partners |
$39.04
|
| Rate for Payer: PACE SWMI |
$41.09
|
| Rate for Payer: PHP Commercial |
$139.72
|
| Rate for Payer: PHP Medicare Advantage |
$41.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.85
|
| Rate for Payer: Priority Health HMO/PPO |
$143.01
|
| Rate for Payer: Priority Health Medicare |
$41.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.13
|
| Rate for Payer: Railroad Medicare Medicare |
$41.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.65
|
| Rate for Payer: UHC Core |
$137.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.09
|
| Rate for Payer: UHC Exchange |
$41.09
|
| Rate for Payer: UHC Medicare Advantage |
$41.09
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$41.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.28
|
|
|
HC PAIN PUMP ADJUSTMENT
|
Facility
|
IP
|
$151.79
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
76100028
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.66 |
| Max. Negotiated Rate |
$136.61 |
| Rate for Payer: Aetna Commercial |
$129.02
|
| Rate for Payer: BCBS Trust/PPO |
$123.91
|
| Rate for Payer: BCN Commercial |
$117.30
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Cofinity Commercial |
$130.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.43
|
| Rate for Payer: Healthscope Commercial |
$136.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.02
|
| Rate for Payer: Nomi Health Commercial |
$124.47
|
| Rate for Payer: PHP Commercial |
$129.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.66
|
| Rate for Payer: Priority Health HMO/PPO |
$132.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.58
|
| Rate for Payer: UHC Core |
$126.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.84
|
|
|
HC PAIN PUMP ADJUSTMENT
|
Facility
|
OP
|
$151.79
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
76100028
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$36.05 |
| Max. Negotiated Rate |
$136.61 |
| Rate for Payer: Aetna Commercial |
$129.02
|
| Rate for Payer: Aetna Medicare |
$39.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.43
|
| Rate for Payer: BCBS Complete |
$60.72
|
| Rate for Payer: BCBS MAPPO |
$37.95
|
| Rate for Payer: BCBS Trust/PPO |
$124.79
|
| Rate for Payer: BCN Commercial |
$118.02
|
| Rate for Payer: BCN Medicare Advantage |
$37.95
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Cofinity Commercial |
$130.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.95
|
| Rate for Payer: Healthscope Commercial |
$136.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.02
|
| Rate for Payer: Nomi Health Commercial |
$124.47
|
| Rate for Payer: PACE Senior Care Partners |
$36.05
|
| Rate for Payer: PACE SWMI |
$37.95
|
| Rate for Payer: PHP Commercial |
$129.02
|
| Rate for Payer: PHP Medicare Advantage |
$37.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.66
|
| Rate for Payer: Priority Health HMO/PPO |
$132.06
|
| Rate for Payer: Priority Health Medicare |
$38.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.70
|
| Rate for Payer: Railroad Medicare Medicare |
$37.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.58
|
| Rate for Payer: UHC Core |
$126.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.95
|
| Rate for Payer: UHC Exchange |
$37.95
|
| Rate for Payer: UHC Medicare Advantage |
$37.95
|
| Rate for Payer: VA VA |
$37.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.84
|
|
|
HC PAIN PUMP SUPPLY
|
Facility
|
OP
|
$923.62
|
|
| Hospital Charge Code |
27000130
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$219.36 |
| Max. Negotiated Rate |
$831.26 |
| Rate for Payer: Aetna Commercial |
$785.08
|
| Rate for Payer: Aetna Medicare |
$240.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$288.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$288.63
|
| Rate for Payer: BCBS Complete |
$369.45
|
| Rate for Payer: BCBS MAPPO |
$230.91
|
| Rate for Payer: BCBS Trust/PPO |
$759.31
|
| Rate for Payer: BCN Commercial |
$718.11
|
| Rate for Payer: BCN Medicare Advantage |
$230.91
|
| Rate for Payer: Cash Price |
$738.90
|
| Rate for Payer: Cofinity Commercial |
$794.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$738.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.91
|
| Rate for Payer: Healthscope Commercial |
$831.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$692.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$265.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.08
|
| Rate for Payer: Nomi Health Commercial |
$757.37
|
| Rate for Payer: PACE Senior Care Partners |
$219.36
|
| Rate for Payer: PACE SWMI |
$230.91
|
| Rate for Payer: PHP Commercial |
$785.08
|
| Rate for Payer: PHP Medicare Advantage |
$230.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.35
|
| Rate for Payer: Priority Health HMO/PPO |
$803.55
|
| Rate for Payer: Priority Health Medicare |
$233.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$618.83
|
| Rate for Payer: Railroad Medicare Medicare |
$230.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$812.79
|
| Rate for Payer: UHC Core |
$771.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.91
|
| Rate for Payer: UHC Exchange |
$230.91
|
| Rate for Payer: UHC Medicare Advantage |
$230.91
|
| Rate for Payer: VA VA |
$230.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$692.72
|
|
|
HC PAIN PUMP SUPPLY
|
Facility
|
IP
|
$923.62
|
|
| Hospital Charge Code |
27000130
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$600.35 |
| Max. Negotiated Rate |
$831.26 |
| Rate for Payer: Aetna Commercial |
$785.08
|
| Rate for Payer: BCBS Trust/PPO |
$753.95
|
| Rate for Payer: BCN Commercial |
$713.77
|
| Rate for Payer: Cash Price |
$738.90
|
| Rate for Payer: Cofinity Commercial |
$794.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$738.90
|
| Rate for Payer: Healthscope Commercial |
$831.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$692.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.08
|
| Rate for Payer: Nomi Health Commercial |
$757.37
|
| Rate for Payer: PHP Commercial |
$785.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.35
|
| Rate for Payer: Priority Health HMO/PPO |
$803.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$618.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$812.79
|
| Rate for Payer: UHC Core |
$771.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$692.72
|
|
|
HC PANCREATIC AMYLASE
|
Facility
|
OP
|
$67.32
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.69 |
| Max. Negotiated Rate |
$60.59 |
| Rate for Payer: Aetna Commercial |
$57.22
|
| Rate for Payer: Aetna Medicare |
$17.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.04
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS MAPPO |
$16.83
|
| Rate for Payer: BCBS Trust/PPO |
$55.34
|
| Rate for Payer: BCN Commercial |
$52.34
|
| Rate for Payer: BCN Medicare Advantage |
$16.83
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$57.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.83
|
| Rate for Payer: Healthscope Commercial |
$60.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.49
|
| Rate for Payer: Mclaren Medicaid |
$4.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.67
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.22
|
| Rate for Payer: Nomi Health Commercial |
$55.20
|
| Rate for Payer: PACE Senior Care Partners |
$15.99
|
| Rate for Payer: PACE SWMI |
$16.83
|
| Rate for Payer: PHP Commercial |
$57.22
|
| Rate for Payer: PHP Medicare Advantage |
$16.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.76
|
| Rate for Payer: Priority Health HMO/PPO |
$58.57
|
| Rate for Payer: Priority Health Medicare |
$17.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.10
|
| Rate for Payer: Railroad Medicare Medicare |
$16.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.24
|
| Rate for Payer: UHC Core |
$56.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.83
|
| Rate for Payer: UHC Exchange |
$16.83
|
| Rate for Payer: UHC Medicare Advantage |
$16.83
|
| Rate for Payer: UHCCP Medicaid |
$4.69
|
| Rate for Payer: VA VA |
$16.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.49
|
|
|
HC PANCREATIC AMYLASE
|
Facility
|
IP
|
$67.32
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.76 |
| Max. Negotiated Rate |
$60.59 |
| Rate for Payer: Aetna Commercial |
$57.22
|
| Rate for Payer: BCBS Trust/PPO |
$54.95
|
| Rate for Payer: BCN Commercial |
$52.02
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$57.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Healthscope Commercial |
$60.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.22
|
| Rate for Payer: Nomi Health Commercial |
$55.20
|
| Rate for Payer: PHP Commercial |
$57.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.76
|
| Rate for Payer: Priority Health HMO/PPO |
$58.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.24
|
| Rate for Payer: UHC Core |
$56.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.49
|
|
|
HC PANCREATIC ELAST IN STOOL
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
30100632
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$76.25 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: BCBS Trust/PPO |
$95.75
|
| Rate for Payer: BCN Commercial |
$90.65
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.25
|
| Rate for Payer: Priority Health HMO/PPO |
$102.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.22
|
| Rate for Payer: UHC Core |
$97.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.97
|
|
|
HC PANCREATIC ELAST IN STOOL
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
30100632
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.66
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: BCBS MAPPO |
$29.32
|
| Rate for Payer: BCBS Trust/PPO |
$96.43
|
| Rate for Payer: BCN Commercial |
$91.20
|
| Rate for Payer: BCN Medicare Advantage |
$29.32
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.32
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.97
|
| Rate for Payer: Mclaren Medicaid |
$16.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.79
|
| Rate for Payer: Meridian Medicaid |
$17.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$96.19
|
| Rate for Payer: PACE Senior Care Partners |
$27.86
|
| Rate for Payer: PACE SWMI |
$29.32
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.25
|
| Rate for Payer: Priority Health HMO/PPO |
$102.05
|
| Rate for Payer: Priority Health Medicare |
$29.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.59
|
| Rate for Payer: Railroad Medicare Medicare |
$29.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.22
|
| Rate for Payer: UHC Core |
$97.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.32
|
| Rate for Payer: UHC Exchange |
$29.32
|
| Rate for Payer: UHC Medicare Advantage |
$29.32
|
| Rate for Payer: UHCCP Medicaid |
$16.61
|
| Rate for Payer: VA VA |
$29.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.97
|
|
|
HC PANTOTHENIC ACID (B-5) BIOASSAY
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100762
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.50 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: BCBS Trust/PPO |
$89.79
|
| Rate for Payer: BCN Commercial |
$85.01
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: Nomi Health Commercial |
$90.20
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health HMO/PPO |
$95.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.80
|
| Rate for Payer: UHC Core |
$91.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
HC PANTOTHENIC ACID (B-5) BIOASSAY
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100762
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna Medicare |
$28.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.38
|
| Rate for Payer: BCBS Complete |
$12.95
|
| Rate for Payer: BCBS MAPPO |
$27.50
|
| Rate for Payer: BCBS Trust/PPO |
$90.43
|
| Rate for Payer: BCN Commercial |
$85.53
|
| Rate for Payer: BCN Medicare Advantage |
$27.50
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.50
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Mclaren Medicaid |
$12.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.88
|
| Rate for Payer: Meridian Medicaid |
$12.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: Nomi Health Commercial |
$90.20
|
| Rate for Payer: PACE Senior Care Partners |
$26.12
|
| Rate for Payer: PACE SWMI |
$27.50
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: PHP Medicare Advantage |
$27.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health HMO/PPO |
$95.70
|
| Rate for Payer: Priority Health Medicare |
$27.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.70
|
| Rate for Payer: Railroad Medicare Medicare |
$27.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.80
|
| Rate for Payer: UHC Core |
$91.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.50
|
| Rate for Payer: UHC Exchange |
$27.50
|
| Rate for Payer: UHC Medicare Advantage |
$27.50
|
| Rate for Payer: UHCCP Medicaid |
$12.33
|
| Rate for Payer: VA VA |
$27.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
HC PAPER WASP IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200096
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC PAPER WASP IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200096
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC PAP NAP
|
Facility
|
IP
|
$2,312.24
|
|
|
Service Code
|
CPT 95807
|
| Hospital Charge Code |
92000019
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,502.96 |
| Max. Negotiated Rate |
$2,081.02 |
| Rate for Payer: Aetna Commercial |
$1,965.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,887.48
|
| Rate for Payer: BCN Commercial |
$1,786.90
|
| Rate for Payer: Cash Price |
$1,849.79
|
| Rate for Payer: Cofinity Commercial |
$1,988.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,849.79
|
| Rate for Payer: Healthscope Commercial |
$2,081.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,734.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,965.40
|
| Rate for Payer: Nomi Health Commercial |
$1,896.04
|
| Rate for Payer: PHP Commercial |
$1,965.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,502.96
|
| Rate for Payer: Priority Health HMO/PPO |
$2,011.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,549.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,034.77
|
| Rate for Payer: UHC Core |
$1,930.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,734.18
|
|
|
HC PAP NAP
|
Facility
|
OP
|
$2,312.24
|
|
|
Service Code
|
CPT 95807
|
| Hospital Charge Code |
92000019
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$383.62 |
| Max. Negotiated Rate |
$2,081.02 |
| Rate for Payer: Aetna Commercial |
$1,965.40
|
| Rate for Payer: Aetna Medicare |
$601.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$722.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$722.58
|
| Rate for Payer: BCBS Complete |
$402.83
|
| Rate for Payer: BCBS MAPPO |
$578.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,900.89
|
| Rate for Payer: BCN Commercial |
$1,797.77
|
| Rate for Payer: BCN Medicare Advantage |
$578.06
|
| Rate for Payer: Cash Price |
$1,849.79
|
| Rate for Payer: Cash Price |
$1,849.79
|
| Rate for Payer: Cofinity Commercial |
$1,988.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,849.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$578.06
|
| Rate for Payer: Healthscope Commercial |
$2,081.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,734.18
|
| Rate for Payer: Mclaren Medicaid |
$383.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$606.96
|
| Rate for Payer: Meridian Medicaid |
$402.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$664.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,965.40
|
| Rate for Payer: Nomi Health Commercial |
$1,896.04
|
| Rate for Payer: PACE Senior Care Partners |
$549.16
|
| Rate for Payer: PACE SWMI |
$578.06
|
| Rate for Payer: PHP Commercial |
$1,965.40
|
| Rate for Payer: PHP Medicare Advantage |
$578.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,502.96
|
| Rate for Payer: Priority Health HMO/PPO |
$2,011.65
|
| Rate for Payer: Priority Health Medicare |
$583.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,549.20
|
| Rate for Payer: Railroad Medicare Medicare |
$578.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,034.77
|
| Rate for Payer: UHC Core |
$1,930.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$578.06
|
| Rate for Payer: UHC Exchange |
$578.06
|
| Rate for Payer: UHC Medicare Advantage |
$578.06
|
| Rate for Payer: UHCCP Medicaid |
$383.62
|
| Rate for Payer: VA VA |
$578.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,734.18
|
|
|
HC PAP SMEAR, SCREENING
|
Facility
|
OP
|
$56.10
|
|
|
Service Code
|
HCPCS P3000
|
| Hospital Charge Code |
31100027
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$13.15 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna Commercial |
$47.69
|
| Rate for Payer: Aetna Medicare |
$14.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.53
|
| Rate for Payer: BCBS Complete |
$13.81
|
| Rate for Payer: BCBS MAPPO |
$14.03
|
| Rate for Payer: BCBS Trust/PPO |
$46.12
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$14.03
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.03
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.08
|
| Rate for Payer: Mclaren Medicaid |
$13.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.73
|
| Rate for Payer: Meridian Medicaid |
$13.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.69
|
| Rate for Payer: Nomi Health Commercial |
$46.00
|
| Rate for Payer: PACE Senior Care Partners |
$13.32
|
| Rate for Payer: PACE SWMI |
$14.03
|
| Rate for Payer: PHP Commercial |
$47.69
|
| Rate for Payer: PHP Medicare Advantage |
$14.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.47
|
| Rate for Payer: Priority Health HMO/PPO |
$48.81
|
| Rate for Payer: Priority Health Medicare |
$14.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.59
|
| Rate for Payer: Railroad Medicare Medicare |
$14.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.37
|
| Rate for Payer: UHC Core |
$46.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.03
|
| Rate for Payer: UHC Exchange |
$14.03
|
| Rate for Payer: UHC Medicare Advantage |
$14.03
|
| Rate for Payer: UHCCP Medicaid |
$13.15
|
| Rate for Payer: VA VA |
$14.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.08
|
|
|
HC PAP SMEAR, SCREENING
|
Facility
|
IP
|
$56.10
|
|
|
Service Code
|
HCPCS P3000
|
| Hospital Charge Code |
31100027
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$36.47 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna Commercial |
$47.69
|
| Rate for Payer: BCBS Trust/PPO |
$45.79
|
| Rate for Payer: BCN Commercial |
$43.35
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.69
|
| Rate for Payer: Nomi Health Commercial |
$46.00
|
| Rate for Payer: PHP Commercial |
$47.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.47
|
| Rate for Payer: Priority Health HMO/PPO |
$48.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.37
|
| Rate for Payer: UHC Core |
$46.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.08
|
|
|
HC PARACENTESIS
|
Facility
|
OP
|
$995.71
|
|
| Hospital Charge Code |
36000078
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$236.48 |
| Max. Negotiated Rate |
$896.14 |
| Rate for Payer: Aetna Commercial |
$846.35
|
| Rate for Payer: Aetna Medicare |
$258.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.16
|
| Rate for Payer: BCBS Complete |
$398.28
|
| Rate for Payer: BCBS MAPPO |
$248.93
|
| Rate for Payer: BCBS Trust/PPO |
$818.57
|
| Rate for Payer: BCN Commercial |
$774.16
|
| Rate for Payer: BCN Medicare Advantage |
$248.93
|
| Rate for Payer: Cash Price |
$796.57
|
| Rate for Payer: Cofinity Commercial |
$856.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.93
|
| Rate for Payer: Healthscope Commercial |
$896.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$846.35
|
| Rate for Payer: Nomi Health Commercial |
$816.48
|
| Rate for Payer: PACE Senior Care Partners |
$236.48
|
| Rate for Payer: PACE SWMI |
$248.93
|
| Rate for Payer: PHP Commercial |
$846.35
|
| Rate for Payer: PHP Medicare Advantage |
$248.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$647.21
|
| Rate for Payer: Priority Health HMO/PPO |
$866.27
|
| Rate for Payer: Priority Health Medicare |
$251.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$667.13
|
| Rate for Payer: Railroad Medicare Medicare |
$248.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$876.22
|
| Rate for Payer: UHC Core |
$831.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$248.93
|
| Rate for Payer: UHC Exchange |
$248.93
|
| Rate for Payer: UHC Medicare Advantage |
$248.93
|
| Rate for Payer: VA VA |
$248.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.78
|
|
|
HC PARACENTESIS
|
Facility
|
IP
|
$995.71
|
|
| Hospital Charge Code |
36000078
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$647.21 |
| Max. Negotiated Rate |
$896.14 |
| Rate for Payer: Aetna Commercial |
$846.35
|
| Rate for Payer: BCBS Trust/PPO |
$812.80
|
| Rate for Payer: BCN Commercial |
$769.48
|
| Rate for Payer: Cash Price |
$796.57
|
| Rate for Payer: Cofinity Commercial |
$856.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.57
|
| Rate for Payer: Healthscope Commercial |
$896.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$846.35
|
| Rate for Payer: Nomi Health Commercial |
$816.48
|
| Rate for Payer: PHP Commercial |
$846.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$647.21
|
| Rate for Payer: Priority Health HMO/PPO |
$866.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$667.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$876.22
|
| Rate for Payer: UHC Core |
$831.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.78
|
|
|
HC PARACERVIAL/PUDENDAL ANES
|
Facility
|
OP
|
$380.34
|
|
| Hospital Charge Code |
37000004
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$90.33 |
| Max. Negotiated Rate |
$342.31 |
| Rate for Payer: Aetna Commercial |
$323.29
|
| Rate for Payer: Aetna Medicare |
$98.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.86
|
| Rate for Payer: BCBS Complete |
$152.14
|
| Rate for Payer: BCBS MAPPO |
$95.08
|
| Rate for Payer: BCBS Trust/PPO |
$312.68
|
| Rate for Payer: BCN Commercial |
$295.71
|
| Rate for Payer: BCN Medicare Advantage |
$95.08
|
| Rate for Payer: Cash Price |
$304.27
|
| Rate for Payer: Cofinity Commercial |
$327.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.08
|
| Rate for Payer: Healthscope Commercial |
$342.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.29
|
| Rate for Payer: Nomi Health Commercial |
$311.88
|
| Rate for Payer: PACE Senior Care Partners |
$90.33
|
| Rate for Payer: PACE SWMI |
$95.08
|
| Rate for Payer: PHP Commercial |
$323.29
|
| Rate for Payer: PHP Medicare Advantage |
$95.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.22
|
| Rate for Payer: Priority Health HMO/PPO |
$330.90
|
| Rate for Payer: Priority Health Medicare |
$96.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.83
|
| Rate for Payer: Railroad Medicare Medicare |
$95.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.70
|
| Rate for Payer: UHC Core |
$317.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.08
|
| Rate for Payer: UHC Exchange |
$95.08
|
| Rate for Payer: UHC Medicare Advantage |
$95.08
|
| Rate for Payer: VA VA |
$95.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.25
|
|
|
HC PARACERVIAL/PUDENDAL ANES
|
Facility
|
IP
|
$380.34
|
|
| Hospital Charge Code |
37000004
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$247.22 |
| Max. Negotiated Rate |
$342.31 |
| Rate for Payer: Aetna Commercial |
$323.29
|
| Rate for Payer: BCBS Trust/PPO |
$310.47
|
| Rate for Payer: BCN Commercial |
$293.93
|
| Rate for Payer: Cash Price |
$304.27
|
| Rate for Payer: Cofinity Commercial |
$327.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.27
|
| Rate for Payer: Healthscope Commercial |
$342.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.29
|
| Rate for Payer: Nomi Health Commercial |
$311.88
|
| Rate for Payer: PHP Commercial |
$323.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.22
|
| Rate for Payer: Priority Health HMO/PPO |
$330.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.70
|
| Rate for Payer: UHC Core |
$317.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.25
|
|
|
HC PARAFFIN BATH
|
Facility
|
IP
|
$64.50
|
|
|
Service Code
|
CPT 97018
|
| Hospital Charge Code |
43000008
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$41.92 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: BCBS Trust/PPO |
$52.65
|
| Rate for Payer: BCN Commercial |
$49.85
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.92
|
| Rate for Payer: Priority Health HMO/PPO |
$56.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.76
|
| Rate for Payer: UHC Core |
$53.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
|
HC PARAFFIN BATH
|
Facility
|
OP
|
$64.50
|
|
|
Service Code
|
CPT 97018
|
| Hospital Charge Code |
43000008
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$15.32 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: Aetna Medicare |
$16.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.16
|
| Rate for Payer: BCBS Complete |
$25.80
|
| Rate for Payer: BCBS MAPPO |
$16.12
|
| Rate for Payer: BCBS Trust/PPO |
$53.03
|
| Rate for Payer: BCN Commercial |
$50.15
|
| Rate for Payer: BCN Medicare Advantage |
$16.12
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.12
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: PACE Senior Care Partners |
$15.32
|
| Rate for Payer: PACE SWMI |
$16.12
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: PHP Medicare Advantage |
$16.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.92
|
| Rate for Payer: Priority Health HMO/PPO |
$56.12
|
| Rate for Payer: Priority Health Medicare |
$16.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.22
|
| Rate for Payer: Railroad Medicare Medicare |
$16.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.76
|
| Rate for Payer: UHC Core |
$53.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.12
|
| Rate for Payer: UHC Exchange |
$16.12
|
| Rate for Payer: UHC Medicare Advantage |
$16.12
|
| Rate for Payer: VA VA |
$16.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
