|
HC PRIMARY MEMBRANOUS NEPH DX CASCADE S
|
Facility
|
OP
|
$211.14
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100757
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$190.03 |
| Rate for Payer: Aetna Commercial |
$179.47
|
| Rate for Payer: Aetna Medicare |
$54.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.98
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$52.78
|
| Rate for Payer: BCBS Trust/PPO |
$173.58
|
| Rate for Payer: BCN Commercial |
$164.16
|
| Rate for Payer: BCN Medicare Advantage |
$52.78
|
| Rate for Payer: Cash Price |
$168.91
|
| Rate for Payer: Cash Price |
$168.91
|
| Rate for Payer: Cofinity Commercial |
$181.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.78
|
| Rate for Payer: Healthscope Commercial |
$190.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.36
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.42
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.47
|
| Rate for Payer: Nomi Health Commercial |
$173.13
|
| Rate for Payer: PACE Senior Care Partners |
$50.15
|
| Rate for Payer: PACE SWMI |
$52.78
|
| Rate for Payer: PHP Commercial |
$179.47
|
| Rate for Payer: PHP Medicare Advantage |
$52.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.24
|
| Rate for Payer: Priority Health HMO/PPO |
$183.69
|
| Rate for Payer: Priority Health Medicare |
$53.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.46
|
| Rate for Payer: Railroad Medicare Medicare |
$52.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.80
|
| Rate for Payer: UHC Core |
$176.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.78
|
| Rate for Payer: UHC Exchange |
$52.78
|
| Rate for Payer: UHC Medicare Advantage |
$52.78
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$52.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.36
|
|
|
HC PRIMIDONE MYSOLINE LEVEL
|
Facility
|
IP
|
$27.05
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.58 |
| Max. Negotiated Rate |
$24.34 |
| Rate for Payer: Aetna Commercial |
$22.99
|
| Rate for Payer: BCBS Trust/PPO |
$22.08
|
| Rate for Payer: BCN Commercial |
$20.90
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cofinity Commercial |
$23.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.64
|
| Rate for Payer: Healthscope Commercial |
$24.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.99
|
| Rate for Payer: Nomi Health Commercial |
$22.18
|
| Rate for Payer: PHP Commercial |
$22.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.58
|
| Rate for Payer: Priority Health HMO/PPO |
$23.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.80
|
| Rate for Payer: UHC Core |
$22.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.29
|
|
|
HC PRIMIDONE MYSOLINE LEVEL
|
Facility
|
OP
|
$27.05
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$24.34 |
| Rate for Payer: Aetna Commercial |
$22.99
|
| Rate for Payer: Aetna Medicare |
$7.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.45
|
| Rate for Payer: BCBS Complete |
$11.62
|
| Rate for Payer: BCBS MAPPO |
$6.76
|
| Rate for Payer: BCBS Trust/PPO |
$22.24
|
| Rate for Payer: BCN Commercial |
$21.03
|
| Rate for Payer: BCN Medicare Advantage |
$6.76
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cofinity Commercial |
$23.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.76
|
| Rate for Payer: Healthscope Commercial |
$24.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.29
|
| Rate for Payer: Mclaren Medicaid |
$11.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.10
|
| Rate for Payer: Meridian Medicaid |
$11.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.99
|
| Rate for Payer: Nomi Health Commercial |
$22.18
|
| Rate for Payer: PACE Senior Care Partners |
$6.42
|
| Rate for Payer: PACE SWMI |
$6.76
|
| Rate for Payer: PHP Commercial |
$22.99
|
| Rate for Payer: PHP Medicare Advantage |
$6.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.58
|
| Rate for Payer: Priority Health HMO/PPO |
$23.53
|
| Rate for Payer: Priority Health Medicare |
$6.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.12
|
| Rate for Payer: Railroad Medicare Medicare |
$6.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.80
|
| Rate for Payer: UHC Core |
$22.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.76
|
| Rate for Payer: UHC Exchange |
$6.76
|
| Rate for Payer: UHC Medicare Advantage |
$6.76
|
| Rate for Payer: UHCCP Medicaid |
$11.06
|
| Rate for Payer: VA VA |
$6.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.29
|
|
|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
IP
|
$38.49
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.02 |
| Max. Negotiated Rate |
$34.64 |
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: BCBS Trust/PPO |
$31.42
|
| Rate for Payer: BCN Commercial |
$29.75
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Nomi Health Commercial |
$31.56
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: Priority Health HMO/PPO |
$33.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.87
|
| Rate for Payer: UHC Core |
$32.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
OP
|
$38.49
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$34.64 |
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: Aetna Medicare |
$10.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.03
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$9.62
|
| Rate for Payer: BCBS Trust/PPO |
$31.64
|
| Rate for Payer: BCN Commercial |
$29.93
|
| Rate for Payer: BCN Medicare Advantage |
$9.62
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.62
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Mclaren Medicaid |
$11.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.10
|
| Rate for Payer: Meridian Medicaid |
$12.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Nomi Health Commercial |
$31.56
|
| Rate for Payer: PACE Senior Care Partners |
$9.14
|
| Rate for Payer: PACE SWMI |
$9.62
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: PHP Medicare Advantage |
$9.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: Priority Health HMO/PPO |
$33.49
|
| Rate for Payer: Priority Health Medicare |
$9.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.79
|
| Rate for Payer: Railroad Medicare Medicare |
$9.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.87
|
| Rate for Payer: UHC Core |
$32.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.62
|
| Rate for Payer: UHC Exchange |
$9.62
|
| Rate for Payer: UHC Medicare Advantage |
$9.62
|
| Rate for Payer: UHCCP Medicaid |
$11.99
|
| Rate for Payer: VA VA |
$9.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$252.96
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$164.42 |
| Max. Negotiated Rate |
$227.66 |
| Rate for Payer: Aetna Commercial |
$215.02
|
| Rate for Payer: BCBS Trust/PPO |
$206.49
|
| Rate for Payer: BCN Commercial |
$195.49
|
| Rate for Payer: Cash Price |
$202.37
|
| Rate for Payer: Cofinity Commercial |
$217.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.37
|
| Rate for Payer: Healthscope Commercial |
$227.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.02
|
| Rate for Payer: Nomi Health Commercial |
$207.43
|
| Rate for Payer: PHP Commercial |
$215.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.42
|
| Rate for Payer: Priority Health HMO/PPO |
$220.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.60
|
| Rate for Payer: UHC Core |
$211.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.72
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$252.96
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$60.08 |
| Max. Negotiated Rate |
$227.66 |
| Rate for Payer: Aetna Commercial |
$215.02
|
| Rate for Payer: Aetna Medicare |
$65.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.05
|
| Rate for Payer: BCBS Complete |
$68.81
|
| Rate for Payer: BCBS MAPPO |
$63.24
|
| Rate for Payer: BCBS Trust/PPO |
$207.96
|
| Rate for Payer: BCN Commercial |
$196.68
|
| Rate for Payer: BCN Medicare Advantage |
$63.24
|
| Rate for Payer: Cash Price |
$202.37
|
| Rate for Payer: Cash Price |
$202.37
|
| Rate for Payer: Cofinity Commercial |
$217.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.24
|
| Rate for Payer: Healthscope Commercial |
$227.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.72
|
| Rate for Payer: Mclaren Medicaid |
$65.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.40
|
| Rate for Payer: Meridian Medicaid |
$68.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.02
|
| Rate for Payer: Nomi Health Commercial |
$207.43
|
| Rate for Payer: PACE Senior Care Partners |
$60.08
|
| Rate for Payer: PACE SWMI |
$63.24
|
| Rate for Payer: PHP Commercial |
$215.02
|
| Rate for Payer: PHP Medicare Advantage |
$63.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.42
|
| Rate for Payer: Priority Health HMO/PPO |
$220.08
|
| Rate for Payer: Priority Health Medicare |
$63.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.48
|
| Rate for Payer: Railroad Medicare Medicare |
$63.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.60
|
| Rate for Payer: UHC Core |
$211.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.24
|
| Rate for Payer: UHC Exchange |
$63.24
|
| Rate for Payer: UHC Medicare Advantage |
$63.24
|
| Rate for Payer: UHCCP Medicaid |
$65.53
|
| Rate for Payer: VA VA |
$63.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.72
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$193.80
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$125.97 |
| Max. Negotiated Rate |
$174.42 |
| Rate for Payer: Aetna Commercial |
$164.73
|
| Rate for Payer: BCBS Trust/PPO |
$158.20
|
| Rate for Payer: BCN Commercial |
$149.77
|
| Rate for Payer: Cash Price |
$155.04
|
| Rate for Payer: Cofinity Commercial |
$166.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.04
|
| Rate for Payer: Healthscope Commercial |
$174.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.73
|
| Rate for Payer: Nomi Health Commercial |
$158.92
|
| Rate for Payer: PHP Commercial |
$164.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.97
|
| Rate for Payer: Priority Health HMO/PPO |
$168.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.54
|
| Rate for Payer: UHC Core |
$161.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.35
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$193.80
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$174.42 |
| Rate for Payer: Aetna Commercial |
$164.73
|
| Rate for Payer: Aetna Medicare |
$50.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.56
|
| Rate for Payer: BCBS Complete |
$77.52
|
| Rate for Payer: BCBS MAPPO |
$48.45
|
| Rate for Payer: BCBS Trust/PPO |
$159.32
|
| Rate for Payer: BCN Commercial |
$150.68
|
| Rate for Payer: BCN Medicare Advantage |
$48.45
|
| Rate for Payer: Cash Price |
$155.04
|
| Rate for Payer: Cofinity Commercial |
$166.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.45
|
| Rate for Payer: Healthscope Commercial |
$174.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.73
|
| Rate for Payer: Nomi Health Commercial |
$158.92
|
| Rate for Payer: PACE Senior Care Partners |
$46.03
|
| Rate for Payer: PACE SWMI |
$48.45
|
| Rate for Payer: PHP Commercial |
$164.73
|
| Rate for Payer: PHP Medicare Advantage |
$48.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.97
|
| Rate for Payer: Priority Health HMO/PPO |
$168.61
|
| Rate for Payer: Priority Health Medicare |
$48.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.85
|
| Rate for Payer: Railroad Medicare Medicare |
$48.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.54
|
| Rate for Payer: UHC Core |
$161.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.45
|
| Rate for Payer: UHC Exchange |
$48.45
|
| Rate for Payer: UHC Medicare Advantage |
$48.45
|
| Rate for Payer: VA VA |
$48.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.35
|
|
|
HC PRO BNP
|
Facility
|
OP
|
$154.22
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
30100304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.38 |
| Max. Negotiated Rate |
$138.80 |
| Rate for Payer: Aetna Commercial |
$131.09
|
| Rate for Payer: Aetna Medicare |
$40.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.19
|
| Rate for Payer: BCBS Complete |
$29.81
|
| Rate for Payer: BCBS MAPPO |
$38.56
|
| Rate for Payer: BCBS Trust/PPO |
$126.78
|
| Rate for Payer: BCN Commercial |
$119.91
|
| Rate for Payer: BCN Medicare Advantage |
$38.56
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cofinity Commercial |
$132.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.56
|
| Rate for Payer: Healthscope Commercial |
$138.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.66
|
| Rate for Payer: Mclaren Medicaid |
$28.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.48
|
| Rate for Payer: Meridian Medicaid |
$29.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.09
|
| Rate for Payer: Nomi Health Commercial |
$126.46
|
| Rate for Payer: PACE Senior Care Partners |
$36.63
|
| Rate for Payer: PACE SWMI |
$38.56
|
| Rate for Payer: PHP Commercial |
$131.09
|
| Rate for Payer: PHP Medicare Advantage |
$38.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.24
|
| Rate for Payer: Priority Health HMO/PPO |
$134.17
|
| Rate for Payer: Priority Health Medicare |
$38.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.33
|
| Rate for Payer: Railroad Medicare Medicare |
$38.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.71
|
| Rate for Payer: UHC Core |
$128.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.56
|
| Rate for Payer: UHC Exchange |
$38.56
|
| Rate for Payer: UHC Medicare Advantage |
$38.56
|
| Rate for Payer: UHCCP Medicaid |
$28.38
|
| Rate for Payer: VA VA |
$38.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.66
|
|
|
HC PRO BNP
|
Facility
|
IP
|
$154.22
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
30100304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.24 |
| Max. Negotiated Rate |
$138.80 |
| Rate for Payer: Aetna Commercial |
$131.09
|
| Rate for Payer: BCBS Trust/PPO |
$125.89
|
| Rate for Payer: BCN Commercial |
$119.18
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cofinity Commercial |
$132.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.38
|
| Rate for Payer: Healthscope Commercial |
$138.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.09
|
| Rate for Payer: Nomi Health Commercial |
$126.46
|
| Rate for Payer: PHP Commercial |
$131.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.24
|
| Rate for Payer: Priority Health HMO/PPO |
$134.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.71
|
| Rate for Payer: UHC Core |
$128.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.66
|
|
|
HC PROCAINAMIDE AND NAPA LEVEL
|
Facility
|
IP
|
$68.34
|
|
|
Service Code
|
CPT 80192
|
| Hospital Charge Code |
30100042
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.42 |
| Max. Negotiated Rate |
$61.51 |
| Rate for Payer: Aetna Commercial |
$58.09
|
| Rate for Payer: BCBS Trust/PPO |
$55.79
|
| Rate for Payer: BCN Commercial |
$52.81
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$58.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Healthscope Commercial |
$61.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.09
|
| Rate for Payer: Nomi Health Commercial |
$56.04
|
| Rate for Payer: PHP Commercial |
$58.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.42
|
| Rate for Payer: Priority Health HMO/PPO |
$59.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.14
|
| Rate for Payer: UHC Core |
$57.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.26
|
|
|
HC PROCAINAMIDE AND NAPA LEVEL
|
Facility
|
OP
|
$68.34
|
|
|
Service Code
|
CPT 80192
|
| Hospital Charge Code |
30100042
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$61.51 |
| Rate for Payer: Aetna Commercial |
$58.09
|
| Rate for Payer: Aetna Medicare |
$17.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.36
|
| Rate for Payer: BCBS Complete |
$12.72
|
| Rate for Payer: BCBS MAPPO |
$17.08
|
| Rate for Payer: BCBS Trust/PPO |
$56.18
|
| Rate for Payer: BCN Commercial |
$53.13
|
| Rate for Payer: BCN Medicare Advantage |
$17.08
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$58.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.08
|
| Rate for Payer: Healthscope Commercial |
$61.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.26
|
| Rate for Payer: Mclaren Medicaid |
$12.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.94
|
| Rate for Payer: Meridian Medicaid |
$12.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.09
|
| Rate for Payer: Nomi Health Commercial |
$56.04
|
| Rate for Payer: PACE Senior Care Partners |
$16.23
|
| Rate for Payer: PACE SWMI |
$17.08
|
| Rate for Payer: PHP Commercial |
$58.09
|
| Rate for Payer: PHP Medicare Advantage |
$17.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.42
|
| Rate for Payer: Priority Health HMO/PPO |
$59.46
|
| Rate for Payer: Priority Health Medicare |
$17.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.79
|
| Rate for Payer: Railroad Medicare Medicare |
$17.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.14
|
| Rate for Payer: UHC Core |
$57.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.08
|
| Rate for Payer: UHC Exchange |
$17.08
|
| Rate for Payer: UHC Medicare Advantage |
$17.08
|
| Rate for Payer: UHCCP Medicaid |
$12.11
|
| Rate for Payer: VA VA |
$17.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.26
|
|
|
HC PROCAINAMIDE CHALLENGE
|
Facility
|
IP
|
$7,423.93
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100123
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,825.55 |
| Max. Negotiated Rate |
$6,681.54 |
| Rate for Payer: Aetna Commercial |
$6,310.34
|
| Rate for Payer: BCBS Trust/PPO |
$6,060.15
|
| Rate for Payer: BCN Commercial |
$5,737.21
|
| Rate for Payer: Cash Price |
$5,939.14
|
| Rate for Payer: Cofinity Commercial |
$6,384.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,939.14
|
| Rate for Payer: Healthscope Commercial |
$6,681.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,567.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,310.34
|
| Rate for Payer: Nomi Health Commercial |
$6,087.62
|
| Rate for Payer: PHP Commercial |
$6,310.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,825.55
|
| Rate for Payer: Priority Health HMO/PPO |
$6,458.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,974.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,533.06
|
| Rate for Payer: UHC Core |
$6,198.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,567.95
|
|
|
HC PROCAINAMIDE CHALLENGE
|
Facility
|
OP
|
$7,423.93
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100123
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$110.84 |
| Max. Negotiated Rate |
$6,681.54 |
| Rate for Payer: Aetna Commercial |
$6,310.34
|
| Rate for Payer: Aetna Medicare |
$1,930.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,319.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,319.98
|
| Rate for Payer: BCBS Complete |
$116.39
|
| Rate for Payer: BCBS MAPPO |
$1,855.98
|
| Rate for Payer: BCBS Trust/PPO |
$6,103.21
|
| Rate for Payer: BCN Commercial |
$5,772.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,855.98
|
| Rate for Payer: Cash Price |
$5,939.14
|
| Rate for Payer: Cash Price |
$5,939.14
|
| Rate for Payer: Cofinity Commercial |
$6,384.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,939.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,855.98
|
| Rate for Payer: Healthscope Commercial |
$6,681.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,567.95
|
| Rate for Payer: Mclaren Medicaid |
$110.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,948.78
|
| Rate for Payer: Meridian Medicaid |
$116.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,134.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,310.34
|
| Rate for Payer: Nomi Health Commercial |
$6,087.62
|
| Rate for Payer: PACE Senior Care Partners |
$1,763.18
|
| Rate for Payer: PACE SWMI |
$1,855.98
|
| Rate for Payer: PHP Commercial |
$6,310.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,855.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,825.55
|
| Rate for Payer: Priority Health HMO/PPO |
$6,458.82
|
| Rate for Payer: Priority Health Medicare |
$1,874.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,974.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,855.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,533.06
|
| Rate for Payer: UHC Core |
$6,198.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,855.98
|
| Rate for Payer: UHC Exchange |
$1,855.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,855.98
|
| Rate for Payer: UHCCP Medicaid |
$110.84
|
| Rate for Payer: VA VA |
$1,855.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,567.95
|
|
|
HC PROCALCITONIN
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
30100480
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.63 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: BCBS Trust/PPO |
$84.93
|
| Rate for Payer: BCN Commercial |
$80.40
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC PROCALCITONIN
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
30100480
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.68 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna Medicare |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.51
|
| Rate for Payer: BCBS Complete |
$20.67
|
| Rate for Payer: BCBS MAPPO |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$85.53
|
| Rate for Payer: BCN Commercial |
$80.89
|
| Rate for Payer: BCN Medicare Advantage |
$26.01
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.01
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Mclaren Medicaid |
$19.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.31
|
| Rate for Payer: Meridian Medicaid |
$20.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: PACE Senior Care Partners |
$24.71
|
| Rate for Payer: PACE SWMI |
$26.01
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: PHP Medicare Advantage |
$26.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Medicare |
$26.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.71
|
| Rate for Payer: Railroad Medicare Medicare |
$26.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.01
|
| Rate for Payer: UHC Exchange |
$26.01
|
| Rate for Payer: UHC Medicare Advantage |
$26.01
|
| Rate for Payer: UHCCP Medicaid |
$19.68
|
| Rate for Payer: VA VA |
$26.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC PROCESS FEE
|
Facility
|
IP
|
$36.72
|
|
| Hospital Charge Code |
30000106
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.87 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: BCBS Trust/PPO |
$29.97
|
| Rate for Payer: BCN Commercial |
$28.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.21
|
| Rate for Payer: Nomi Health Commercial |
$30.11
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.87
|
| Rate for Payer: Priority Health HMO/PPO |
$31.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.31
|
| Rate for Payer: UHC Core |
$30.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC PROCESS FEE
|
Facility
|
OP
|
$36.72
|
|
| Hospital Charge Code |
30000106
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.72 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare |
$9.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.48
|
| Rate for Payer: BCBS Complete |
$14.69
|
| Rate for Payer: BCBS MAPPO |
$9.18
|
| Rate for Payer: BCBS Trust/PPO |
$30.19
|
| Rate for Payer: BCN Commercial |
$28.55
|
| Rate for Payer: BCN Medicare Advantage |
$9.18
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.18
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.21
|
| Rate for Payer: Nomi Health Commercial |
$30.11
|
| Rate for Payer: PACE Senior Care Partners |
$8.72
|
| Rate for Payer: PACE SWMI |
$9.18
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: PHP Medicare Advantage |
$9.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.87
|
| Rate for Payer: Priority Health HMO/PPO |
$31.95
|
| Rate for Payer: Priority Health Medicare |
$9.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.60
|
| Rate for Payer: Railroad Medicare Medicare |
$9.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.31
|
| Rate for Payer: UHC Core |
$30.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.18
|
| Rate for Payer: UHC Exchange |
$9.18
|
| Rate for Payer: UHC Medicare Advantage |
$9.18
|
| Rate for Payer: VA VA |
$9.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC PROCTOSIGMOIDOSCOY RIGID DX
|
Facility
|
IP
|
$1,162.48
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
76100185
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$755.61 |
| Max. Negotiated Rate |
$1,046.23 |
| Rate for Payer: Aetna Commercial |
$988.11
|
| Rate for Payer: BCBS Trust/PPO |
$948.93
|
| Rate for Payer: BCN Commercial |
$898.36
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cofinity Commercial |
$999.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.98
|
| Rate for Payer: Healthscope Commercial |
$1,046.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$871.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.11
|
| Rate for Payer: Nomi Health Commercial |
$953.23
|
| Rate for Payer: PHP Commercial |
$988.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$755.61
|
| Rate for Payer: Priority Health HMO/PPO |
$1,011.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$778.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,022.98
|
| Rate for Payer: UHC Core |
$970.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$871.86
|
|
|
HC PROCTOSIGMOIDOSCOY RIGID DX
|
Facility
|
OP
|
$1,162.48
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
76100185
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$276.09 |
| Max. Negotiated Rate |
$1,046.23 |
| Rate for Payer: Aetna Commercial |
$988.11
|
| Rate for Payer: Aetna Medicare |
$302.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$363.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$363.28
|
| Rate for Payer: BCBS Complete |
$678.18
|
| Rate for Payer: BCBS MAPPO |
$290.62
|
| Rate for Payer: BCBS Trust/PPO |
$955.67
|
| Rate for Payer: BCN Commercial |
$903.83
|
| Rate for Payer: BCN Medicare Advantage |
$290.62
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cofinity Commercial |
$999.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.62
|
| Rate for Payer: Healthscope Commercial |
$1,046.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$871.86
|
| Rate for Payer: Mclaren Medicaid |
$645.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.15
|
| Rate for Payer: Meridian Medicaid |
$678.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$334.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.11
|
| Rate for Payer: Nomi Health Commercial |
$953.23
|
| Rate for Payer: PACE Senior Care Partners |
$276.09
|
| Rate for Payer: PACE SWMI |
$290.62
|
| Rate for Payer: PHP Commercial |
$988.11
|
| Rate for Payer: PHP Medicare Advantage |
$290.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$755.61
|
| Rate for Payer: Priority Health HMO/PPO |
$1,011.36
|
| Rate for Payer: Priority Health Medicare |
$293.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$778.86
|
| Rate for Payer: Railroad Medicare Medicare |
$290.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,022.98
|
| Rate for Payer: UHC Core |
$970.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$290.62
|
| Rate for Payer: UHC Exchange |
$290.62
|
| Rate for Payer: UHC Medicare Advantage |
$290.62
|
| Rate for Payer: UHCCP Medicaid |
$645.84
|
| Rate for Payer: VA VA |
$290.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$871.86
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY 2 OR MORE INJECT
|
Facility
|
IP
|
$38.54
|
|
|
Service Code
|
CPT 95117
|
| Hospital Charge Code |
51000082
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$25.05 |
| Max. Negotiated Rate |
$34.69 |
| Rate for Payer: Aetna Commercial |
$32.76
|
| Rate for Payer: BCBS Trust/PPO |
$31.46
|
| Rate for Payer: BCN Commercial |
$29.78
|
| Rate for Payer: Cash Price |
$30.83
|
| Rate for Payer: Cofinity Commercial |
$33.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.83
|
| Rate for Payer: Healthscope Commercial |
$34.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.76
|
| Rate for Payer: Nomi Health Commercial |
$31.60
|
| Rate for Payer: PHP Commercial |
$32.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.05
|
| Rate for Payer: Priority Health HMO/PPO |
$33.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Core |
$32.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.90
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY 2 OR MORE INJECT
|
Facility
|
OP
|
$38.54
|
|
|
Service Code
|
CPT 95117
|
| Hospital Charge Code |
51000082
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$9.15 |
| Max. Negotiated Rate |
$34.69 |
| Rate for Payer: Aetna Commercial |
$32.76
|
| Rate for Payer: Aetna Medicare |
$10.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.04
|
| Rate for Payer: BCBS Complete |
$34.32
|
| Rate for Payer: BCBS MAPPO |
$9.64
|
| Rate for Payer: BCBS Trust/PPO |
$31.68
|
| Rate for Payer: BCN Commercial |
$29.96
|
| Rate for Payer: BCN Medicare Advantage |
$9.64
|
| Rate for Payer: Cash Price |
$30.83
|
| Rate for Payer: Cash Price |
$30.83
|
| Rate for Payer: Cofinity Commercial |
$33.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.64
|
| Rate for Payer: Healthscope Commercial |
$34.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.90
|
| Rate for Payer: Mclaren Medicaid |
$32.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.12
|
| Rate for Payer: Meridian Medicaid |
$34.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.76
|
| Rate for Payer: Nomi Health Commercial |
$31.60
|
| Rate for Payer: PACE Senior Care Partners |
$9.15
|
| Rate for Payer: PACE SWMI |
$9.64
|
| Rate for Payer: PHP Commercial |
$32.76
|
| Rate for Payer: PHP Medicare Advantage |
$9.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.05
|
| Rate for Payer: Priority Health HMO/PPO |
$33.53
|
| Rate for Payer: Priority Health Medicare |
$9.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.82
|
| Rate for Payer: Railroad Medicare Medicare |
$9.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Core |
$32.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.64
|
| Rate for Payer: UHC Exchange |
$9.64
|
| Rate for Payer: UHC Medicare Advantage |
$9.64
|
| Rate for Payer: UHCCP Medicaid |
$32.69
|
| Rate for Payer: VA VA |
$9.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.90
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY SINGLE INJECT
|
Facility
|
IP
|
$38.54
|
|
|
Service Code
|
CPT 95115
|
| Hospital Charge Code |
51000081
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$25.05 |
| Max. Negotiated Rate |
$34.69 |
| Rate for Payer: Aetna Commercial |
$32.76
|
| Rate for Payer: BCBS Trust/PPO |
$31.46
|
| Rate for Payer: BCN Commercial |
$29.78
|
| Rate for Payer: Cash Price |
$30.83
|
| Rate for Payer: Cofinity Commercial |
$33.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.83
|
| Rate for Payer: Healthscope Commercial |
$34.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.76
|
| Rate for Payer: Nomi Health Commercial |
$31.60
|
| Rate for Payer: PHP Commercial |
$32.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.05
|
| Rate for Payer: Priority Health HMO/PPO |
$33.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Core |
$32.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.90
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY SINGLE INJECT
|
Facility
|
OP
|
$38.54
|
|
|
Service Code
|
CPT 95115
|
| Hospital Charge Code |
51000081
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$9.15 |
| Max. Negotiated Rate |
$34.69 |
| Rate for Payer: Aetna Commercial |
$32.76
|
| Rate for Payer: Aetna Medicare |
$10.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.04
|
| Rate for Payer: BCBS Complete |
$34.32
|
| Rate for Payer: BCBS MAPPO |
$9.64
|
| Rate for Payer: BCBS Trust/PPO |
$31.68
|
| Rate for Payer: BCN Commercial |
$29.96
|
| Rate for Payer: BCN Medicare Advantage |
$9.64
|
| Rate for Payer: Cash Price |
$30.83
|
| Rate for Payer: Cash Price |
$30.83
|
| Rate for Payer: Cofinity Commercial |
$33.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.64
|
| Rate for Payer: Healthscope Commercial |
$34.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.90
|
| Rate for Payer: Mclaren Medicaid |
$32.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.12
|
| Rate for Payer: Meridian Medicaid |
$34.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.76
|
| Rate for Payer: Nomi Health Commercial |
$31.60
|
| Rate for Payer: PACE Senior Care Partners |
$9.15
|
| Rate for Payer: PACE SWMI |
$9.64
|
| Rate for Payer: PHP Commercial |
$32.76
|
| Rate for Payer: PHP Medicare Advantage |
$9.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.05
|
| Rate for Payer: Priority Health HMO/PPO |
$33.53
|
| Rate for Payer: Priority Health Medicare |
$9.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.82
|
| Rate for Payer: Railroad Medicare Medicare |
$9.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Core |
$32.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.64
|
| Rate for Payer: UHC Exchange |
$9.64
|
| Rate for Payer: UHC Medicare Advantage |
$9.64
|
| Rate for Payer: UHCCP Medicaid |
$32.69
|
| Rate for Payer: VA VA |
$9.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.90
|
|
