|
HC PICU OR PED INTERMEDIATE CARE R&B
|
Facility
|
IP
|
$6,510.25
|
|
| Hospital Charge Code |
20600002
|
|
Hospital Revenue Code
|
206
|
| Min. Negotiated Rate |
$1,776.50 |
| Max. Negotiated Rate |
$5,859.22 |
| Rate for Payer: Aetna Commercial |
$5,533.71
|
| Rate for Payer: Aetna Medicare |
$1,944.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,337.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,337.50
|
| Rate for Payer: BCBS MAPPO |
$1,870.00
|
| Rate for Payer: BCBS Trust/PPO |
$5,314.32
|
| Rate for Payer: BCN Commercial |
$5,031.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,870.00
|
| Rate for Payer: Cash Price |
$5,208.20
|
| Rate for Payer: Cash Price |
$5,208.20
|
| Rate for Payer: Cofinity Commercial |
$5,598.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,208.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,870.00
|
| Rate for Payer: Healthscope Commercial |
$5,859.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,882.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,963.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,150.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,533.71
|
| Rate for Payer: Nomi Health Commercial |
$5,338.40
|
| Rate for Payer: PACE Senior Care Partners |
$1,776.50
|
| Rate for Payer: PACE SWMI |
$1,870.00
|
| Rate for Payer: PHP Commercial |
$5,533.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,870.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.66
|
| Rate for Payer: Priority Health HMO/PPO |
$5,663.92
|
| Rate for Payer: Priority Health Medicare |
$1,888.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,361.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,870.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,729.02
|
| Rate for Payer: UHC Core |
$5,436.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,870.00
|
| Rate for Payer: UHC Exchange |
$1,870.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,870.00
|
| Rate for Payer: VA VA |
$1,870.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,882.69
|
|
|
HC PICU/PEDS 30" SEDATION RECOVERY
|
Facility
|
IP
|
$315.06
|
|
| Hospital Charge Code |
71000009
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$204.79 |
| Max. Negotiated Rate |
$283.55 |
| Rate for Payer: Aetna Commercial |
$267.80
|
| Rate for Payer: BCBS Trust/PPO |
$257.18
|
| Rate for Payer: BCN Commercial |
$243.48
|
| Rate for Payer: Cash Price |
$252.05
|
| Rate for Payer: Cofinity Commercial |
$270.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.05
|
| Rate for Payer: Healthscope Commercial |
$283.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.80
|
| Rate for Payer: Nomi Health Commercial |
$258.35
|
| Rate for Payer: PHP Commercial |
$267.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.79
|
| Rate for Payer: Priority Health HMO/PPO |
$274.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$211.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.25
|
| Rate for Payer: UHC Core |
$263.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.30
|
|
|
HC PICU/PEDS 30" SEDATION RECOVERY
|
Facility
|
OP
|
$315.06
|
|
| Hospital Charge Code |
71000009
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$74.83 |
| Max. Negotiated Rate |
$283.55 |
| Rate for Payer: Aetna Commercial |
$267.80
|
| Rate for Payer: Aetna Medicare |
$81.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.46
|
| Rate for Payer: BCBS Complete |
$126.02
|
| Rate for Payer: BCBS MAPPO |
$78.76
|
| Rate for Payer: BCBS Trust/PPO |
$259.01
|
| Rate for Payer: BCN Commercial |
$244.96
|
| Rate for Payer: BCN Medicare Advantage |
$78.76
|
| Rate for Payer: Cash Price |
$252.05
|
| Rate for Payer: Cofinity Commercial |
$270.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.76
|
| Rate for Payer: Healthscope Commercial |
$283.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.80
|
| Rate for Payer: Nomi Health Commercial |
$258.35
|
| Rate for Payer: PACE Senior Care Partners |
$74.83
|
| Rate for Payer: PACE SWMI |
$78.76
|
| Rate for Payer: PHP Commercial |
$267.80
|
| Rate for Payer: PHP Medicare Advantage |
$78.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.79
|
| Rate for Payer: Priority Health HMO/PPO |
$274.10
|
| Rate for Payer: Priority Health Medicare |
$79.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$211.09
|
| Rate for Payer: Railroad Medicare Medicare |
$78.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$277.25
|
| Rate for Payer: UHC Core |
$263.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.76
|
| Rate for Payer: UHC Exchange |
$78.76
|
| Rate for Payer: UHC Medicare Advantage |
$78.76
|
| Rate for Payer: VA VA |
$78.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.30
|
|
|
HC PIFLUFOLASTAT PER MILLICURIE
|
Facility
|
OP
|
$1,560.60
|
|
|
Service Code
|
CPT A9595
|
| Hospital Charge Code |
34300369
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$240.35 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna Commercial |
$1,326.51
|
| Rate for Payer: Aetna Medicare |
$405.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.69
|
| Rate for Payer: BCBS Complete |
$252.39
|
| Rate for Payer: BCBS MAPPO |
$390.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,282.97
|
| Rate for Payer: BCN Commercial |
$1,213.37
|
| Rate for Payer: BCN Medicare Advantage |
$390.15
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Commercial |
$1,342.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.15
|
| Rate for Payer: Healthscope Commercial |
$1,404.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,170.45
|
| Rate for Payer: Mclaren Medicaid |
$240.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.66
|
| Rate for Payer: Meridian Medicaid |
$252.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Nomi Health Commercial |
$1,279.69
|
| Rate for Payer: PACE Senior Care Partners |
$370.64
|
| Rate for Payer: PACE SWMI |
$390.15
|
| Rate for Payer: PHP Commercial |
$1,326.51
|
| Rate for Payer: PHP Medicare Advantage |
$390.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.39
|
| Rate for Payer: Priority Health HMO/PPO |
$1,357.72
|
| Rate for Payer: Priority Health Medicare |
$394.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,045.60
|
| Rate for Payer: Railroad Medicare Medicare |
$390.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,373.33
|
| Rate for Payer: UHC Core |
$1,303.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.15
|
| Rate for Payer: UHC Exchange |
$390.15
|
| Rate for Payer: UHC Medicare Advantage |
$390.15
|
| Rate for Payer: UHCCP Medicaid |
$240.35
|
| Rate for Payer: VA VA |
$390.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,170.45
|
|
|
HC PIFLUFOLASTAT PER MILLICURIE
|
Facility
|
IP
|
$1,560.60
|
|
|
Service Code
|
CPT A9595
|
| Hospital Charge Code |
34300369
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,014.39 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna Commercial |
$1,326.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,273.92
|
| Rate for Payer: BCN Commercial |
$1,206.03
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Commercial |
$1,342.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Healthscope Commercial |
$1,404.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,170.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Nomi Health Commercial |
$1,279.69
|
| Rate for Payer: PHP Commercial |
$1,326.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.39
|
| Rate for Payer: Priority Health HMO/PPO |
$1,357.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,045.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,373.33
|
| Rate for Payer: UHC Core |
$1,303.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,170.45
|
|
|
HC PIGWEED IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200098
|
|
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 PIGWEED IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200098
|
|
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 PI LINKED ANTIGEN
|
Facility
|
OP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000004
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$40.56 |
| Max. Negotiated Rate |
$267.58 |
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: Aetna Medicare |
$44.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.37
|
| Rate for Payer: BCBS Complete |
$267.58
|
| Rate for Payer: BCBS MAPPO |
$42.70
|
| Rate for Payer: BCBS Trust/PPO |
$140.40
|
| Rate for Payer: BCN Commercial |
$132.78
|
| Rate for Payer: BCN Medicare Advantage |
$42.70
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.70
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.08
|
| Rate for Payer: Mclaren Medicaid |
$254.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.83
|
| Rate for Payer: Meridian Medicaid |
$267.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: Nomi Health Commercial |
$140.04
|
| Rate for Payer: PACE Senior Care Partners |
$40.56
|
| Rate for Payer: PACE SWMI |
$42.70
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: PHP Medicare Advantage |
$42.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health HMO/PPO |
$148.58
|
| Rate for Payer: Priority Health Medicare |
$43.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.42
|
| Rate for Payer: Railroad Medicare Medicare |
$42.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.29
|
| Rate for Payer: UHC Core |
$142.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.70
|
| Rate for Payer: UHC Exchange |
$42.70
|
| Rate for Payer: UHC Medicare Advantage |
$42.70
|
| Rate for Payer: UHCCP Medicaid |
$254.82
|
| Rate for Payer: VA VA |
$42.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.08
|
|
|
HC PI LINKED ANTIGEN
|
Facility
|
IP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000004
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$111.01 |
| Max. Negotiated Rate |
$153.70 |
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: BCBS Trust/PPO |
$139.41
|
| Rate for Payer: BCN Commercial |
$131.98
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: Nomi Health Commercial |
$140.04
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health HMO/PPO |
$148.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.29
|
| Rate for Payer: UHC Core |
$142.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.08
|
|
|
HC PI LINKED ANTIGEN CMPT
|
Facility
|
IP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000005
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$111.01 |
| Max. Negotiated Rate |
$153.70 |
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: BCBS Trust/PPO |
$139.41
|
| Rate for Payer: BCN Commercial |
$131.98
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: Nomi Health Commercial |
$140.04
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health HMO/PPO |
$148.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.29
|
| Rate for Payer: UHC Core |
$142.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.08
|
|
|
HC PI LINKED ANTIGEN CMPT
|
Facility
|
OP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000005
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$40.56 |
| Max. Negotiated Rate |
$267.58 |
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: Aetna Medicare |
$44.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.37
|
| Rate for Payer: BCBS Complete |
$267.58
|
| Rate for Payer: BCBS MAPPO |
$42.70
|
| Rate for Payer: BCBS Trust/PPO |
$140.40
|
| Rate for Payer: BCN Commercial |
$132.78
|
| Rate for Payer: BCN Medicare Advantage |
$42.70
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.70
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.08
|
| Rate for Payer: Mclaren Medicaid |
$254.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.83
|
| Rate for Payer: Meridian Medicaid |
$267.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: Nomi Health Commercial |
$140.04
|
| Rate for Payer: PACE Senior Care Partners |
$40.56
|
| Rate for Payer: PACE SWMI |
$42.70
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: PHP Medicare Advantage |
$42.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health HMO/PPO |
$148.58
|
| Rate for Payer: Priority Health Medicare |
$43.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.42
|
| Rate for Payer: Railroad Medicare Medicare |
$42.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.29
|
| Rate for Payer: UHC Core |
$142.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.70
|
| Rate for Payer: UHC Exchange |
$42.70
|
| Rate for Payer: UHC Medicare Advantage |
$42.70
|
| Rate for Payer: UHCCP Medicaid |
$254.82
|
| Rate for Payer: VA VA |
$42.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.08
|
|
|
HC PI LINKED ANTIGEN CMPT2
|
Facility
|
OP
|
$61.85
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.69 |
| Max. Negotiated Rate |
$55.66 |
| Rate for Payer: Aetna Commercial |
$52.57
|
| Rate for Payer: Aetna Medicare |
$16.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.33
|
| Rate for Payer: BCBS Complete |
$24.74
|
| Rate for Payer: BCBS MAPPO |
$15.46
|
| Rate for Payer: BCBS Trust/PPO |
$50.85
|
| Rate for Payer: BCN Commercial |
$48.09
|
| Rate for Payer: BCN Medicare Advantage |
$15.46
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$53.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.46
|
| Rate for Payer: Healthscope Commercial |
$55.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.57
|
| Rate for Payer: Nomi Health Commercial |
$50.72
|
| Rate for Payer: PACE Senior Care Partners |
$14.69
|
| Rate for Payer: PACE SWMI |
$15.46
|
| Rate for Payer: PHP Commercial |
$52.57
|
| Rate for Payer: PHP Medicare Advantage |
$15.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.20
|
| Rate for Payer: Priority Health HMO/PPO |
$53.81
|
| Rate for Payer: Priority Health Medicare |
$15.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.44
|
| Rate for Payer: Railroad Medicare Medicare |
$15.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.43
|
| Rate for Payer: UHC Core |
$51.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.46
|
| Rate for Payer: UHC Exchange |
$15.46
|
| Rate for Payer: UHC Medicare Advantage |
$15.46
|
| Rate for Payer: VA VA |
$15.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.39
|
|
|
HC PI LINKED ANTIGEN CMPT2
|
Facility
|
IP
|
$61.85
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$40.20 |
| Max. Negotiated Rate |
$55.66 |
| Rate for Payer: Aetna Commercial |
$52.57
|
| Rate for Payer: BCBS Trust/PPO |
$50.49
|
| Rate for Payer: BCN Commercial |
$47.80
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$53.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.48
|
| Rate for Payer: Healthscope Commercial |
$55.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.57
|
| Rate for Payer: Nomi Health Commercial |
$50.72
|
| Rate for Payer: PHP Commercial |
$52.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.20
|
| Rate for Payer: Priority Health HMO/PPO |
$53.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.43
|
| Rate for Payer: UHC Core |
$51.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.39
|
|
|
HC PINWORM EXAM
|
Facility
|
OP
|
$55.49
|
|
|
Service Code
|
CPT 87172
|
| Hospital Charge Code |
30600094
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$49.94 |
| Rate for Payer: Aetna Commercial |
$47.17
|
| Rate for Payer: Aetna Medicare |
$14.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.34
|
| Rate for Payer: BCBS Complete |
$3.24
|
| Rate for Payer: BCBS MAPPO |
$13.87
|
| Rate for Payer: BCBS Trust/PPO |
$45.62
|
| Rate for Payer: BCN Commercial |
$43.14
|
| Rate for Payer: BCN Medicare Advantage |
$13.87
|
| Rate for Payer: Cash Price |
$44.39
|
| Rate for Payer: Cash Price |
$44.39
|
| Rate for Payer: Cofinity Commercial |
$47.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.87
|
| Rate for Payer: Healthscope Commercial |
$49.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.62
|
| Rate for Payer: Mclaren Medicaid |
$3.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.57
|
| Rate for Payer: Meridian Medicaid |
$3.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.17
|
| Rate for Payer: Nomi Health Commercial |
$45.50
|
| Rate for Payer: PACE Senior Care Partners |
$13.18
|
| Rate for Payer: PACE SWMI |
$13.87
|
| Rate for Payer: PHP Commercial |
$47.17
|
| Rate for Payer: PHP Medicare Advantage |
$13.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.07
|
| Rate for Payer: Priority Health HMO/PPO |
$48.28
|
| Rate for Payer: Priority Health Medicare |
$14.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.18
|
| Rate for Payer: Railroad Medicare Medicare |
$13.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.83
|
| Rate for Payer: UHC Core |
$46.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.87
|
| Rate for Payer: UHC Exchange |
$13.87
|
| Rate for Payer: UHC Medicare Advantage |
$13.87
|
| Rate for Payer: UHCCP Medicaid |
$3.09
|
| Rate for Payer: VA VA |
$13.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.62
|
|
|
HC PINWORM EXAM
|
Facility
|
IP
|
$55.49
|
|
|
Service Code
|
CPT 87172
|
| Hospital Charge Code |
30600094
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.07 |
| Max. Negotiated Rate |
$49.94 |
| Rate for Payer: Aetna Commercial |
$47.17
|
| Rate for Payer: BCBS Trust/PPO |
$45.30
|
| Rate for Payer: BCN Commercial |
$42.88
|
| Rate for Payer: Cash Price |
$44.39
|
| Rate for Payer: Cofinity Commercial |
$47.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.39
|
| Rate for Payer: Healthscope Commercial |
$49.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.17
|
| Rate for Payer: Nomi Health Commercial |
$45.50
|
| Rate for Payer: PHP Commercial |
$47.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.07
|
| Rate for Payer: Priority Health HMO/PPO |
$48.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.83
|
| Rate for Payer: UHC Core |
$46.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.62
|
|
|
HC PIONEER RE-ENTRY CATHETER
|
Facility
|
IP
|
$9,316.79
|
|
|
Service Code
|
HCPCS C1753
|
| Hospital Charge Code |
27200063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6,055.91 |
| Max. Negotiated Rate |
$8,385.11 |
| Rate for Payer: Aetna Commercial |
$7,919.27
|
| Rate for Payer: BCBS Trust/PPO |
$7,605.30
|
| Rate for Payer: BCN Commercial |
$7,200.02
|
| Rate for Payer: Cash Price |
$7,453.43
|
| Rate for Payer: Cofinity Commercial |
$8,012.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,453.43
|
| Rate for Payer: Healthscope Commercial |
$8,385.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,987.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,919.27
|
| Rate for Payer: Nomi Health Commercial |
$7,639.77
|
| Rate for Payer: PHP Commercial |
$7,919.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,055.91
|
| Rate for Payer: Priority Health HMO/PPO |
$8,105.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,242.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,198.78
|
| Rate for Payer: UHC Core |
$7,779.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,987.59
|
|
|
HC PIONEER RE-ENTRY CATHETER
|
Facility
|
OP
|
$9,316.79
|
|
|
Service Code
|
HCPCS C1753
|
| Hospital Charge Code |
27200063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,212.74 |
| Max. Negotiated Rate |
$8,385.11 |
| Rate for Payer: Aetna Commercial |
$7,919.27
|
| Rate for Payer: Aetna Medicare |
$2,422.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,911.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,911.50
|
| Rate for Payer: BCBS Complete |
$3,726.72
|
| Rate for Payer: BCBS MAPPO |
$2,329.20
|
| Rate for Payer: BCBS Trust/PPO |
$7,659.33
|
| Rate for Payer: BCN Commercial |
$7,243.80
|
| Rate for Payer: BCN Medicare Advantage |
$2,329.20
|
| Rate for Payer: Cash Price |
$7,453.43
|
| Rate for Payer: Cofinity Commercial |
$8,012.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,453.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,329.20
|
| Rate for Payer: Healthscope Commercial |
$8,385.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,987.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,445.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,678.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,919.27
|
| Rate for Payer: Nomi Health Commercial |
$7,639.77
|
| Rate for Payer: PACE Senior Care Partners |
$2,212.74
|
| Rate for Payer: PACE SWMI |
$2,329.20
|
| Rate for Payer: PHP Commercial |
$7,919.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,329.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,055.91
|
| Rate for Payer: Priority Health HMO/PPO |
$8,105.61
|
| Rate for Payer: Priority Health Medicare |
$2,352.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,242.25
|
| Rate for Payer: Railroad Medicare Medicare |
$2,329.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,198.78
|
| Rate for Payer: UHC Core |
$7,779.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,329.20
|
| Rate for Payer: UHC Exchange |
$2,329.20
|
| Rate for Payer: UHC Medicare Advantage |
$2,329.20
|
| Rate for Payer: VA VA |
$2,329.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,987.59
|
|
|
HC PIPELINE EMBOLIZATION DEVICE
|
Facility
|
OP
|
$19,571.39
|
|
| Hospital Charge Code |
27800081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,648.21 |
| Max. Negotiated Rate |
$17,614.25 |
| Rate for Payer: Aetna Commercial |
$16,635.68
|
| Rate for Payer: Aetna Medicare |
$5,088.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,116.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,116.06
|
| Rate for Payer: BCBS Complete |
$7,828.56
|
| Rate for Payer: BCBS MAPPO |
$4,892.85
|
| Rate for Payer: BCBS Trust/PPO |
$16,089.64
|
| Rate for Payer: BCN Commercial |
$15,216.76
|
| Rate for Payer: BCN Medicare Advantage |
$4,892.85
|
| Rate for Payer: Cash Price |
$15,657.11
|
| Rate for Payer: Cofinity Commercial |
$16,831.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,657.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,892.85
|
| Rate for Payer: Healthscope Commercial |
$17,614.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,678.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,137.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,626.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,635.68
|
| Rate for Payer: Nomi Health Commercial |
$16,048.54
|
| Rate for Payer: PACE Senior Care Partners |
$4,648.21
|
| Rate for Payer: PACE SWMI |
$4,892.85
|
| Rate for Payer: PHP Commercial |
$16,635.68
|
| Rate for Payer: PHP Medicare Advantage |
$4,892.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,721.40
|
| Rate for Payer: Priority Health HMO/PPO |
$17,027.11
|
| Rate for Payer: Priority Health Medicare |
$4,941.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,112.83
|
| Rate for Payer: Railroad Medicare Medicare |
$4,892.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,222.82
|
| Rate for Payer: UHC Core |
$16,342.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,892.85
|
| Rate for Payer: UHC Exchange |
$4,892.85
|
| Rate for Payer: UHC Medicare Advantage |
$4,892.85
|
| Rate for Payer: VA VA |
$4,892.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,678.54
|
|
|
HC PIPELINE EMBOLIZATION DEVICE
|
Facility
|
IP
|
$19,571.39
|
|
| Hospital Charge Code |
27800081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,721.40 |
| Max. Negotiated Rate |
$17,614.25 |
| Rate for Payer: Aetna Commercial |
$16,635.68
|
| Rate for Payer: BCBS Trust/PPO |
$15,976.13
|
| Rate for Payer: BCN Commercial |
$15,124.77
|
| Rate for Payer: Cash Price |
$15,657.11
|
| Rate for Payer: Cofinity Commercial |
$16,831.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,657.11
|
| Rate for Payer: Healthscope Commercial |
$17,614.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,678.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,635.68
|
| Rate for Payer: Nomi Health Commercial |
$16,048.54
|
| Rate for Payer: PHP Commercial |
$16,635.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,721.40
|
| Rate for Payer: Priority Health HMO/PPO |
$17,027.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,112.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,222.82
|
| Rate for Payer: UHC Core |
$16,342.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,678.54
|
|
|
HC PISTACHIO NUT IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200118
|
|
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 PISTACHIO NUT IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200118
|
|
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 PITOCIN AUGMENTATION
|
Facility
|
IP
|
$475.03
|
|
| Hospital Charge Code |
25800002
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$308.77 |
| Max. Negotiated Rate |
$427.53 |
| Rate for Payer: Aetna Commercial |
$403.78
|
| Rate for Payer: BCBS Trust/PPO |
$387.77
|
| Rate for Payer: BCN Commercial |
$367.10
|
| Rate for Payer: Cash Price |
$380.02
|
| Rate for Payer: Cofinity Commercial |
$408.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.02
|
| Rate for Payer: Healthscope Commercial |
$427.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$403.78
|
| Rate for Payer: Nomi Health Commercial |
$389.52
|
| Rate for Payer: PHP Commercial |
$403.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.77
|
| Rate for Payer: Priority Health HMO/PPO |
$413.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$418.03
|
| Rate for Payer: UHC Core |
$396.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.27
|
|
|
HC PITOCIN AUGMENTATION
|
Facility
|
OP
|
$475.03
|
|
| Hospital Charge Code |
25800002
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$112.82 |
| Max. Negotiated Rate |
$427.53 |
| Rate for Payer: Aetna Commercial |
$403.78
|
| Rate for Payer: Aetna Medicare |
$123.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$148.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$148.45
|
| Rate for Payer: BCBS Complete |
$190.01
|
| Rate for Payer: BCBS MAPPO |
$118.76
|
| Rate for Payer: BCBS Trust/PPO |
$390.52
|
| Rate for Payer: BCN Commercial |
$369.34
|
| Rate for Payer: BCN Medicare Advantage |
$118.76
|
| Rate for Payer: Cash Price |
$380.02
|
| Rate for Payer: Cofinity Commercial |
$408.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.76
|
| Rate for Payer: Healthscope Commercial |
$427.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$136.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$403.78
|
| Rate for Payer: Nomi Health Commercial |
$389.52
|
| Rate for Payer: PACE Senior Care Partners |
$112.82
|
| Rate for Payer: PACE SWMI |
$118.76
|
| Rate for Payer: PHP Commercial |
$403.78
|
| Rate for Payer: PHP Medicare Advantage |
$118.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.77
|
| Rate for Payer: Priority Health HMO/PPO |
$413.28
|
| Rate for Payer: Priority Health Medicare |
$119.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.27
|
| Rate for Payer: Railroad Medicare Medicare |
$118.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$418.03
|
| Rate for Payer: UHC Core |
$396.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.76
|
| Rate for Payer: UHC Exchange |
$118.76
|
| Rate for Payer: UHC Medicare Advantage |
$118.76
|
| Rate for Payer: VA VA |
$118.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.27
|
|
|
HC PKU STATE TESTING
|
Facility
|
OP
|
$21.83
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
30100387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$19.65 |
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: Aetna Medicare |
$5.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.82
|
| Rate for Payer: BCBS Complete |
$4.18
|
| Rate for Payer: BCBS MAPPO |
$5.46
|
| Rate for Payer: BCBS Trust/PPO |
$17.95
|
| Rate for Payer: BCN Commercial |
$16.97
|
| Rate for Payer: BCN Medicare Advantage |
$5.46
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cofinity Commercial |
$18.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.46
|
| Rate for Payer: Healthscope Commercial |
$19.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.37
|
| Rate for Payer: Mclaren Medicaid |
$3.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.73
|
| Rate for Payer: Meridian Medicaid |
$4.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.56
|
| Rate for Payer: Nomi Health Commercial |
$17.90
|
| Rate for Payer: PACE Senior Care Partners |
$5.18
|
| Rate for Payer: PACE SWMI |
$5.46
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Medicare Advantage |
$5.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.19
|
| Rate for Payer: Priority Health HMO/PPO |
$18.99
|
| Rate for Payer: Priority Health Medicare |
$5.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.63
|
| Rate for Payer: Railroad Medicare Medicare |
$5.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.21
|
| Rate for Payer: UHC Core |
$18.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.46
|
| Rate for Payer: UHC Exchange |
$5.46
|
| Rate for Payer: UHC Medicare Advantage |
$5.46
|
| Rate for Payer: UHCCP Medicaid |
$3.98
|
| Rate for Payer: VA VA |
$5.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.37
|
|
|
HC PKU STATE TESTING
|
Facility
|
IP
|
$21.83
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
30100387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.19 |
| Max. Negotiated Rate |
$19.65 |
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: BCBS Trust/PPO |
$17.82
|
| Rate for Payer: BCN Commercial |
$16.87
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cofinity Commercial |
$18.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Healthscope Commercial |
$19.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.56
|
| Rate for Payer: Nomi Health Commercial |
$17.90
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.19
|
| Rate for Payer: Priority Health HMO/PPO |
$18.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.21
|
| Rate for Payer: UHC Core |
$18.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.37
|
|
