|
HC PATHOLOGY LEVEL IV
|
Facility
|
OP
|
$209.12
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000048
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$38.63 |
| Max. Negotiated Rate |
$188.21 |
| Rate for Payer: Aetna Commercial |
$177.75
|
| Rate for Payer: Aetna Medicare |
$54.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.35
|
| Rate for Payer: BCBS Complete |
$40.56
|
| Rate for Payer: BCBS MAPPO |
$52.28
|
| Rate for Payer: BCBS Trust/PPO |
$171.92
|
| Rate for Payer: BCN Commercial |
$162.59
|
| Rate for Payer: BCN Medicare Advantage |
$52.28
|
| Rate for Payer: Cash Price |
$167.30
|
| Rate for Payer: Cash Price |
$167.30
|
| Rate for Payer: Cofinity Commercial |
$179.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.28
|
| Rate for Payer: Healthscope Commercial |
$188.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.84
|
| Rate for Payer: Mclaren Medicaid |
$38.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.89
|
| Rate for Payer: Meridian Medicaid |
$40.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.75
|
| Rate for Payer: Nomi Health Commercial |
$171.48
|
| Rate for Payer: PACE Senior Care Partners |
$49.67
|
| Rate for Payer: PACE SWMI |
$52.28
|
| Rate for Payer: PHP Commercial |
$177.75
|
| Rate for Payer: PHP Medicare Advantage |
$52.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.93
|
| Rate for Payer: Priority Health HMO/PPO |
$181.93
|
| Rate for Payer: Priority Health Medicare |
$52.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.11
|
| Rate for Payer: Railroad Medicare Medicare |
$52.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.03
|
| Rate for Payer: UHC Core |
$174.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.28
|
| Rate for Payer: UHC Exchange |
$52.28
|
| Rate for Payer: UHC Medicare Advantage |
$52.28
|
| Rate for Payer: UHCCP Medicaid |
$38.63
|
| Rate for Payer: VA VA |
$52.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.84
|
|
|
HC PATHOLOGY LEVEL IV
|
Facility
|
IP
|
$209.12
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000048
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$135.93 |
| Max. Negotiated Rate |
$188.21 |
| Rate for Payer: Aetna Commercial |
$177.75
|
| Rate for Payer: BCBS Trust/PPO |
$170.70
|
| Rate for Payer: BCN Commercial |
$161.61
|
| Rate for Payer: Cash Price |
$167.30
|
| Rate for Payer: Cofinity Commercial |
$179.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.30
|
| Rate for Payer: Healthscope Commercial |
$188.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.75
|
| Rate for Payer: Nomi Health Commercial |
$171.48
|
| Rate for Payer: PHP Commercial |
$177.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.93
|
| Rate for Payer: Priority Health HMO/PPO |
$181.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.03
|
| Rate for Payer: UHC Core |
$174.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.84
|
|
|
HC PATHOLOGY LEVEL IV DERM
|
Facility
|
OP
|
$112.20
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000106
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.65 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: Aetna Medicare |
$29.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.06
|
| Rate for Payer: BCBS Complete |
$40.56
|
| Rate for Payer: BCBS MAPPO |
$28.05
|
| Rate for Payer: BCBS Trust/PPO |
$92.24
|
| Rate for Payer: BCN Commercial |
$87.24
|
| Rate for Payer: BCN Medicare Advantage |
$28.05
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.05
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.15
|
| Rate for Payer: Mclaren Medicaid |
$38.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.45
|
| Rate for Payer: Meridian Medicaid |
$40.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$92.00
|
| Rate for Payer: PACE Senior Care Partners |
$26.65
|
| Rate for Payer: PACE SWMI |
$28.05
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: PHP Medicare Advantage |
$28.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: Priority Health HMO/PPO |
$97.61
|
| Rate for Payer: Priority Health Medicare |
$28.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.17
|
| Rate for Payer: Railroad Medicare Medicare |
$28.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.74
|
| Rate for Payer: UHC Core |
$93.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.05
|
| Rate for Payer: UHC Exchange |
$28.05
|
| Rate for Payer: UHC Medicare Advantage |
$28.05
|
| Rate for Payer: UHCCP Medicaid |
$38.63
|
| Rate for Payer: VA VA |
$28.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.15
|
|
|
HC PATHOLOGY LEVEL IV DERM
|
Facility
|
IP
|
$112.20
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000106
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$72.93 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: BCBS Trust/PPO |
$91.59
|
| Rate for Payer: BCN Commercial |
$86.71
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$92.00
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: Priority Health HMO/PPO |
$97.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.74
|
| Rate for Payer: UHC Core |
$93.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.15
|
|
|
HC PATHOLOGY LEVEL V
|
Facility
|
OP
|
$524.15
|
|
|
Service Code
|
CPT 88307
|
| Hospital Charge Code |
31000049
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$124.49 |
| Max. Negotiated Rate |
$471.74 |
| Rate for Payer: Aetna Commercial |
$445.53
|
| Rate for Payer: Aetna Medicare |
$136.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$163.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$163.80
|
| Rate for Payer: BCBS Complete |
$273.10
|
| Rate for Payer: BCBS MAPPO |
$131.04
|
| Rate for Payer: BCBS Trust/PPO |
$430.90
|
| Rate for Payer: BCN Commercial |
$407.53
|
| Rate for Payer: BCN Medicare Advantage |
$131.04
|
| Rate for Payer: Cash Price |
$419.32
|
| Rate for Payer: Cash Price |
$419.32
|
| Rate for Payer: Cofinity Commercial |
$450.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.04
|
| Rate for Payer: Healthscope Commercial |
$471.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.11
|
| Rate for Payer: Mclaren Medicaid |
$260.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.59
|
| Rate for Payer: Meridian Medicaid |
$273.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$150.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.53
|
| Rate for Payer: Nomi Health Commercial |
$429.80
|
| Rate for Payer: PACE Senior Care Partners |
$124.49
|
| Rate for Payer: PACE SWMI |
$131.04
|
| Rate for Payer: PHP Commercial |
$445.53
|
| Rate for Payer: PHP Medicare Advantage |
$131.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$340.70
|
| Rate for Payer: Priority Health HMO/PPO |
$456.01
|
| Rate for Payer: Priority Health Medicare |
$132.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$351.18
|
| Rate for Payer: Railroad Medicare Medicare |
$131.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.25
|
| Rate for Payer: UHC Core |
$437.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.04
|
| Rate for Payer: UHC Exchange |
$131.04
|
| Rate for Payer: UHC Medicare Advantage |
$131.04
|
| Rate for Payer: UHCCP Medicaid |
$260.08
|
| Rate for Payer: VA VA |
$131.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.11
|
|
|
HC PATHOLOGY LEVEL V
|
Facility
|
IP
|
$524.15
|
|
|
Service Code
|
CPT 88307
|
| Hospital Charge Code |
31000049
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$340.70 |
| Max. Negotiated Rate |
$471.74 |
| Rate for Payer: Aetna Commercial |
$445.53
|
| Rate for Payer: BCBS Trust/PPO |
$427.86
|
| Rate for Payer: BCN Commercial |
$405.06
|
| Rate for Payer: Cash Price |
$419.32
|
| Rate for Payer: Cofinity Commercial |
$450.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.32
|
| Rate for Payer: Healthscope Commercial |
$471.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$445.53
|
| Rate for Payer: Nomi Health Commercial |
$429.80
|
| Rate for Payer: PHP Commercial |
$445.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$340.70
|
| Rate for Payer: Priority Health HMO/PPO |
$456.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$351.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.25
|
| Rate for Payer: UHC Core |
$437.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.11
|
|
|
HC PATHOLOGY LEVEL VI
|
Facility
|
IP
|
$771.67
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
31000050
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$501.59 |
| Max. Negotiated Rate |
$694.50 |
| Rate for Payer: Aetna Commercial |
$655.92
|
| Rate for Payer: BCBS Trust/PPO |
$629.91
|
| Rate for Payer: BCN Commercial |
$596.35
|
| Rate for Payer: Cash Price |
$617.34
|
| Rate for Payer: Cofinity Commercial |
$663.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$617.34
|
| Rate for Payer: Healthscope Commercial |
$694.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$578.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$655.92
|
| Rate for Payer: Nomi Health Commercial |
$632.77
|
| Rate for Payer: PHP Commercial |
$655.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$501.59
|
| Rate for Payer: Priority Health HMO/PPO |
$671.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$517.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$679.07
|
| Rate for Payer: UHC Core |
$644.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$578.75
|
|
|
HC PATHOLOGY LEVEL VI
|
Facility
|
OP
|
$771.67
|
|
|
Service Code
|
CPT 88309
|
| Hospital Charge Code |
31000050
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$183.27 |
| Max. Negotiated Rate |
$694.50 |
| Rate for Payer: Aetna Commercial |
$655.92
|
| Rate for Payer: Aetna Medicare |
$200.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$241.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$241.15
|
| Rate for Payer: BCBS Complete |
$620.19
|
| Rate for Payer: BCBS MAPPO |
$192.92
|
| Rate for Payer: BCBS Trust/PPO |
$634.39
|
| Rate for Payer: BCN Commercial |
$599.97
|
| Rate for Payer: BCN Medicare Advantage |
$192.92
|
| Rate for Payer: Cash Price |
$617.34
|
| Rate for Payer: Cash Price |
$617.34
|
| Rate for Payer: Cofinity Commercial |
$663.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$617.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.92
|
| Rate for Payer: Healthscope Commercial |
$694.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$578.75
|
| Rate for Payer: Mclaren Medicaid |
$590.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$202.56
|
| Rate for Payer: Meridian Medicaid |
$620.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$221.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$655.92
|
| Rate for Payer: Nomi Health Commercial |
$632.77
|
| Rate for Payer: PACE Senior Care Partners |
$183.27
|
| Rate for Payer: PACE SWMI |
$192.92
|
| Rate for Payer: PHP Commercial |
$655.92
|
| Rate for Payer: PHP Medicare Advantage |
$192.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$590.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$501.59
|
| Rate for Payer: Priority Health HMO/PPO |
$671.35
|
| Rate for Payer: Priority Health Medicare |
$194.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$517.02
|
| Rate for Payer: Railroad Medicare Medicare |
$192.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$679.07
|
| Rate for Payer: UHC Core |
$644.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.92
|
| Rate for Payer: UHC Exchange |
$192.92
|
| Rate for Payer: UHC Medicare Advantage |
$192.92
|
| Rate for Payer: UHCCP Medicaid |
$590.62
|
| Rate for Payer: VA VA |
$192.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$578.75
|
|
|
HC PATH SURGERY CYTO ADDITIONAL
|
Facility
|
IP
|
$57.22
|
|
|
Service Code
|
CPT 88334
|
| Hospital Charge Code |
30000068
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.19 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: BCBS Trust/PPO |
$46.71
|
| Rate for Payer: BCN Commercial |
$44.22
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health HMO/PPO |
$49.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.35
|
| Rate for Payer: UHC Core |
$47.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC PATH SURGERY CYTO ADDITIONAL
|
Facility
|
OP
|
$57.22
|
|
|
Service Code
|
CPT 88334
|
| Hospital Charge Code |
30000068
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.59 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna Medicare |
$14.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.88
|
| Rate for Payer: BCBS Complete |
$22.89
|
| Rate for Payer: BCBS MAPPO |
$14.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.04
|
| Rate for Payer: BCN Commercial |
$44.49
|
| Rate for Payer: BCN Medicare Advantage |
$14.30
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.30
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: PACE Senior Care Partners |
$13.59
|
| Rate for Payer: PACE SWMI |
$14.30
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: PHP Medicare Advantage |
$14.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health HMO/PPO |
$49.78
|
| Rate for Payer: Priority Health Medicare |
$14.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.34
|
| Rate for Payer: Railroad Medicare Medicare |
$14.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.35
|
| Rate for Payer: UHC Core |
$47.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.30
|
| Rate for Payer: UHC Exchange |
$14.30
|
| Rate for Payer: UHC Medicare Advantage |
$14.30
|
| Rate for Payer: VA VA |
$14.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC PATH SURGERY CYTO INITIAL SITE
|
Facility
|
IP
|
$90.51
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
30000067
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.83 |
| Max. Negotiated Rate |
$81.46 |
| Rate for Payer: Aetna Commercial |
$76.93
|
| Rate for Payer: BCBS Trust/PPO |
$73.88
|
| Rate for Payer: BCN Commercial |
$69.95
|
| Rate for Payer: Cash Price |
$72.41
|
| Rate for Payer: Cofinity Commercial |
$77.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.41
|
| Rate for Payer: Healthscope Commercial |
$81.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.93
|
| Rate for Payer: Nomi Health Commercial |
$74.22
|
| Rate for Payer: PHP Commercial |
$76.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.83
|
| Rate for Payer: Priority Health HMO/PPO |
$78.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.65
|
| Rate for Payer: UHC Core |
$75.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.88
|
|
|
HC PATH SURGERY CYTO INITIAL SITE
|
Facility
|
OP
|
$90.51
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
30000067
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.50 |
| Max. Negotiated Rate |
$620.19 |
| Rate for Payer: Aetna Commercial |
$76.93
|
| Rate for Payer: Aetna Medicare |
$23.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.28
|
| Rate for Payer: BCBS Complete |
$620.19
|
| Rate for Payer: BCBS MAPPO |
$22.63
|
| Rate for Payer: BCBS Trust/PPO |
$74.41
|
| Rate for Payer: BCN Commercial |
$70.37
|
| Rate for Payer: BCN Medicare Advantage |
$22.63
|
| Rate for Payer: Cash Price |
$72.41
|
| Rate for Payer: Cash Price |
$72.41
|
| Rate for Payer: Cofinity Commercial |
$77.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.63
|
| Rate for Payer: Healthscope Commercial |
$81.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.88
|
| Rate for Payer: Mclaren Medicaid |
$590.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.76
|
| Rate for Payer: Meridian Medicaid |
$620.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.93
|
| Rate for Payer: Nomi Health Commercial |
$74.22
|
| Rate for Payer: PACE Senior Care Partners |
$21.50
|
| Rate for Payer: PACE SWMI |
$22.63
|
| Rate for Payer: PHP Commercial |
$76.93
|
| Rate for Payer: PHP Medicare Advantage |
$22.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$590.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.83
|
| Rate for Payer: Priority Health HMO/PPO |
$78.74
|
| Rate for Payer: Priority Health Medicare |
$22.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.64
|
| Rate for Payer: Railroad Medicare Medicare |
$22.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.65
|
| Rate for Payer: UHC Core |
$75.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.63
|
| Rate for Payer: UHC Exchange |
$22.63
|
| Rate for Payer: UHC Medicare Advantage |
$22.63
|
| Rate for Payer: UHCCP Medicaid |
$590.62
|
| Rate for Payer: VA VA |
$22.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.88
|
|
|
HC PCP SCREEN URIN
|
Facility
|
OP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000136
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$85.08 |
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: Aetna Medicare |
$24.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.54
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$23.63
|
| Rate for Payer: BCBS Trust/PPO |
$77.71
|
| Rate for Payer: BCN Commercial |
$73.50
|
| Rate for Payer: BCN Medicare Advantage |
$23.63
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.63
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.90
|
| Rate for Payer: Mclaren Medicaid |
$44.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.81
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: PACE Senior Care Partners |
$22.45
|
| Rate for Payer: PACE SWMI |
$23.63
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: PHP Medicare Advantage |
$23.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO |
$82.24
|
| Rate for Payer: Priority Health Medicare |
$23.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.34
|
| Rate for Payer: Railroad Medicare Medicare |
$23.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.19
|
| Rate for Payer: UHC Core |
$78.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.63
|
| Rate for Payer: UHC Exchange |
$23.63
|
| Rate for Payer: UHC Medicare Advantage |
$23.63
|
| Rate for Payer: UHCCP Medicaid |
$44.93
|
| Rate for Payer: VA VA |
$23.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.90
|
|
|
HC PCP SCREEN URIN
|
Facility
|
IP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000136
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$61.44 |
| Max. Negotiated Rate |
$85.08 |
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: BCBS Trust/PPO |
$77.16
|
| Rate for Payer: BCN Commercial |
$73.05
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: Nomi Health Commercial |
$77.51
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health HMO/PPO |
$82.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.19
|
| Rate for Payer: UHC Core |
$78.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.90
|
|
|
HC PCP SCREEN URN.
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC PCP SCREEN URN.
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000120
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.11 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$9.57
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$9.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$9.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$9.11
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Facility
|
OP
|
$394.74
|
|
|
Service Code
|
CPT 90677
|
| Hospital Charge Code |
63600208
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$93.75 |
| Max. Negotiated Rate |
$355.27 |
| Rate for Payer: Aetna Commercial |
$335.53
|
| Rate for Payer: Aetna Medicare |
$102.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.36
|
| Rate for Payer: BCBS Complete |
$157.90
|
| Rate for Payer: BCBS MAPPO |
$98.69
|
| Rate for Payer: BCBS Trust/PPO |
$324.52
|
| Rate for Payer: BCN Commercial |
$306.91
|
| Rate for Payer: BCN Medicare Advantage |
$98.69
|
| Rate for Payer: Cash Price |
$315.79
|
| Rate for Payer: Cofinity Commercial |
$339.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.69
|
| Rate for Payer: Healthscope Commercial |
$355.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$296.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.53
|
| Rate for Payer: Nomi Health Commercial |
$323.69
|
| Rate for Payer: PACE Senior Care Partners |
$93.75
|
| Rate for Payer: PACE SWMI |
$98.69
|
| Rate for Payer: PHP Commercial |
$335.53
|
| Rate for Payer: PHP Medicare Advantage |
$98.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.58
|
| Rate for Payer: Priority Health HMO/PPO |
$343.42
|
| Rate for Payer: Priority Health Medicare |
$99.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$264.48
|
| Rate for Payer: Railroad Medicare Medicare |
$98.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$347.37
|
| Rate for Payer: UHC Core |
$329.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.69
|
| Rate for Payer: UHC Exchange |
$98.69
|
| Rate for Payer: UHC Medicare Advantage |
$98.69
|
| Rate for Payer: VA VA |
$98.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$296.06
|
|
|
HC PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Facility
|
IP
|
$394.74
|
|
|
Service Code
|
CPT 90677
|
| Hospital Charge Code |
63600208
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$256.58 |
| Max. Negotiated Rate |
$355.27 |
| Rate for Payer: Aetna Commercial |
$335.53
|
| Rate for Payer: BCBS Trust/PPO |
$322.23
|
| Rate for Payer: BCN Commercial |
$305.06
|
| Rate for Payer: Cash Price |
$315.79
|
| Rate for Payer: Cofinity Commercial |
$339.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.79
|
| Rate for Payer: Healthscope Commercial |
$355.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$296.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.53
|
| Rate for Payer: Nomi Health Commercial |
$323.69
|
| Rate for Payer: PHP Commercial |
$335.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.58
|
| Rate for Payer: Priority Health HMO/PPO |
$343.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$264.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$347.37
|
| Rate for Payer: UHC Core |
$329.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$296.06
|
|
|
HC PEAK FLOW METER
|
Facility
|
IP
|
$29.15
|
|
| Hospital Charge Code |
27000132
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.95 |
| Max. Negotiated Rate |
$26.23 |
| Rate for Payer: Aetna Commercial |
$24.78
|
| Rate for Payer: BCBS Trust/PPO |
$23.80
|
| Rate for Payer: BCN Commercial |
$22.53
|
| Rate for Payer: Cash Price |
$23.32
|
| Rate for Payer: Cofinity Commercial |
$25.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.32
|
| Rate for Payer: Healthscope Commercial |
$26.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.78
|
| Rate for Payer: Nomi Health Commercial |
$23.90
|
| Rate for Payer: PHP Commercial |
$24.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.95
|
| Rate for Payer: Priority Health HMO/PPO |
$25.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.65
|
| Rate for Payer: UHC Core |
$24.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.86
|
|
|
HC PEAK FLOW METER
|
Facility
|
OP
|
$29.15
|
|
| Hospital Charge Code |
27000132
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.92 |
| Max. Negotiated Rate |
$26.23 |
| Rate for Payer: Aetna Commercial |
$24.78
|
| Rate for Payer: Aetna Medicare |
$7.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.11
|
| Rate for Payer: BCBS Complete |
$11.66
|
| Rate for Payer: BCBS MAPPO |
$7.29
|
| Rate for Payer: BCBS Trust/PPO |
$23.96
|
| Rate for Payer: BCN Commercial |
$22.66
|
| Rate for Payer: BCN Medicare Advantage |
$7.29
|
| Rate for Payer: Cash Price |
$23.32
|
| Rate for Payer: Cofinity Commercial |
$25.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.29
|
| Rate for Payer: Healthscope Commercial |
$26.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.78
|
| Rate for Payer: Nomi Health Commercial |
$23.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.92
|
| Rate for Payer: PACE SWMI |
$7.29
|
| Rate for Payer: PHP Commercial |
$24.78
|
| Rate for Payer: PHP Medicare Advantage |
$7.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.95
|
| Rate for Payer: Priority Health HMO/PPO |
$25.36
|
| Rate for Payer: Priority Health Medicare |
$7.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.53
|
| Rate for Payer: Railroad Medicare Medicare |
$7.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.65
|
| Rate for Payer: UHC Core |
$24.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.29
|
| Rate for Payer: UHC Exchange |
$7.29
|
| Rate for Payer: UHC Medicare Advantage |
$7.29
|
| Rate for Payer: VA VA |
$7.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.86
|
|
|
HC PEANUT IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200054
|
|
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 PEANUT IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200054
|
|
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 PECAN NUT IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200117
|
|
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 PECAN NUT IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200117
|
|
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 PED MINOR TREATMENT RM
|
Facility
|
OP
|
$129.02
|
|
| Hospital Charge Code |
51000044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.64 |
| Max. Negotiated Rate |
$116.12 |
| Rate for Payer: Aetna Commercial |
$109.67
|
| Rate for Payer: Aetna Medicare |
$33.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.32
|
| Rate for Payer: BCBS Complete |
$51.61
|
| Rate for Payer: BCBS MAPPO |
$32.26
|
| Rate for Payer: BCBS Trust/PPO |
$106.07
|
| Rate for Payer: BCN Commercial |
$100.31
|
| Rate for Payer: BCN Medicare Advantage |
$32.26
|
| Rate for Payer: Cash Price |
$103.22
|
| Rate for Payer: Cofinity Commercial |
$110.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.26
|
| Rate for Payer: Healthscope Commercial |
$116.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.67
|
| Rate for Payer: Nomi Health Commercial |
$105.80
|
| Rate for Payer: PACE Senior Care Partners |
$30.64
|
| Rate for Payer: PACE SWMI |
$32.26
|
| Rate for Payer: PHP Commercial |
$109.67
|
| Rate for Payer: PHP Medicare Advantage |
$32.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.86
|
| Rate for Payer: Priority Health HMO/PPO |
$112.25
|
| Rate for Payer: Priority Health Medicare |
$32.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.44
|
| Rate for Payer: Railroad Medicare Medicare |
$32.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.54
|
| Rate for Payer: UHC Core |
$107.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.26
|
| Rate for Payer: UHC Exchange |
$32.26
|
| Rate for Payer: UHC Medicare Advantage |
$32.26
|
| Rate for Payer: VA VA |
$32.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.77
|
|
