|
HC SICKLE CELL TEST
|
Facility
|
IP
|
$31.94
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
30500061
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.23 |
| Max. Negotiated Rate |
$28.75 |
| Rate for Payer: Aetna Commercial |
$27.15
|
| Rate for Payer: BCBS Trust/PPO |
$26.38
|
| Rate for Payer: BCN Commercial |
$26.38
|
| Rate for Payer: Cash Price |
$25.55
|
| Rate for Payer: Cofinity Commercial |
$27.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.55
|
| Rate for Payer: Healthscope Commercial |
$28.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.15
|
| Rate for Payer: Nomi Health Commercial |
$26.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.95
|
| Rate for Payer: PHP Commercial |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.11
|
| Rate for Payer: UHC Core |
$26.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.95
|
|
|
HC SICKLE CELL TEST
|
Facility
|
OP
|
$31.94
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
30500061
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.63 |
| Max. Negotiated Rate |
$28.75 |
| Rate for Payer: Aetna Commercial |
$27.15
|
| Rate for Payer: Aetna Medicare |
$8.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.98
|
| Rate for Payer: BCBS Complete |
$5.91
|
| Rate for Payer: BCBS MAPPO |
$7.99
|
| Rate for Payer: BCBS Trust/PPO |
$26.26
|
| Rate for Payer: BCN Commercial |
$26.26
|
| Rate for Payer: BCN Medicare Advantage |
$7.99
|
| Rate for Payer: Cash Price |
$25.55
|
| Rate for Payer: Cofinity Commercial |
$27.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.99
|
| Rate for Payer: Healthscope Commercial |
$28.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.95
|
| Rate for Payer: Mclaren Medicaid |
$5.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.38
|
| Rate for Payer: Meridian Medicaid |
$5.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.15
|
| Rate for Payer: Nomi Health Commercial |
$26.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.95
|
| Rate for Payer: PACE Senior Care Partners |
$7.59
|
| Rate for Payer: PACE SWMI |
$7.99
|
| Rate for Payer: PHP Commercial |
$27.15
|
| Rate for Payer: PHP Medicare Advantage |
$7.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.79
|
| Rate for Payer: Priority Health Medicare |
$8.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.23
|
| Rate for Payer: Railroad Medicare Medicare |
$7.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.11
|
| Rate for Payer: UHC Core |
$26.67
|
| Rate for Payer: UHC Exchange |
$7.99
|
| Rate for Payer: UHC Medicaid |
$5.63
|
| Rate for Payer: UHC Medicare Advantage |
$7.99
|
| Rate for Payer: UHCCP Medicaid |
$5.63
|
| Rate for Payer: VA VA |
$7.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.95
|
|
|
HC SIGMOIDOSCOPY FLX DX W/COLL SPEC BR/WA
|
Facility
|
IP
|
$1,185.73
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
76100186
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$825.27 |
| Max. Negotiated Rate |
$1,067.16 |
| Rate for Payer: Aetna Commercial |
$1,007.87
|
| Rate for Payer: BCBS Trust/PPO |
$979.29
|
| Rate for Payer: BCN Commercial |
$979.29
|
| Rate for Payer: Cash Price |
$948.58
|
| Rate for Payer: Cofinity Commercial |
$1,019.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.58
|
| Rate for Payer: Healthscope Commercial |
$1,067.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$889.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.87
|
| Rate for Payer: Nomi Health Commercial |
$972.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$889.30
|
| Rate for Payer: PHP Commercial |
$1,007.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,031.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$825.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,043.44
|
| Rate for Payer: UHC Core |
$990.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$889.30
|
|
|
HC SIGMOIDOSCOPY FLX DX W/COLL SPEC BR/WA
|
Facility
|
OP
|
$1,185.73
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
76100186
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$209.04 |
| Max. Negotiated Rate |
$1,067.16 |
| Rate for Payer: Aetna Commercial |
$1,007.87
|
| Rate for Payer: Aetna Medicare |
$308.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$370.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$370.54
|
| Rate for Payer: BCBS Complete |
$219.48
|
| Rate for Payer: BCBS MAPPO |
$296.43
|
| Rate for Payer: BCBS Trust/PPO |
$974.79
|
| Rate for Payer: BCN Commercial |
$974.79
|
| Rate for Payer: BCN Medicare Advantage |
$296.43
|
| Rate for Payer: Cash Price |
$948.58
|
| Rate for Payer: Cofinity Commercial |
$1,019.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.43
|
| Rate for Payer: Healthscope Commercial |
$1,067.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$889.30
|
| Rate for Payer: Mclaren Medicaid |
$209.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.25
|
| Rate for Payer: Meridian Medicaid |
$219.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$340.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$326.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.87
|
| Rate for Payer: Nomi Health Commercial |
$972.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$889.30
|
| Rate for Payer: PACE Senior Care Partners |
$281.61
|
| Rate for Payer: PACE SWMI |
$296.43
|
| Rate for Payer: PHP Commercial |
$1,007.87
|
| Rate for Payer: PHP Medicare Advantage |
$296.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,031.59
|
| Rate for Payer: Priority Health Medicare |
$299.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$825.27
|
| Rate for Payer: Railroad Medicare Medicare |
$296.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,043.44
|
| Rate for Payer: UHC Core |
$990.08
|
| Rate for Payer: UHC Exchange |
$296.43
|
| Rate for Payer: UHC Medicaid |
$209.04
|
| Rate for Payer: UHC Medicare Advantage |
$296.43
|
| Rate for Payer: UHCCP Medicaid |
$209.04
|
| Rate for Payer: VA VA |
$296.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$889.30
|
|
|
HC SIGMOIDOSCOPY W EUS EXAM
|
Facility
|
IP
|
$2,673.54
|
|
| Hospital Charge Code |
36000082
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,860.78 |
| Max. Negotiated Rate |
$2,406.19 |
| Rate for Payer: Aetna Commercial |
$2,272.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,208.08
|
| Rate for Payer: BCN Commercial |
$2,208.08
|
| Rate for Payer: Cash Price |
$2,138.83
|
| Rate for Payer: Cofinity Commercial |
$2,299.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,138.83
|
| Rate for Payer: Healthscope Commercial |
$2,406.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,005.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,272.51
|
| Rate for Payer: Nomi Health Commercial |
$2,192.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,005.15
|
| Rate for Payer: PHP Commercial |
$2,272.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,325.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,860.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,352.72
|
| Rate for Payer: UHC Core |
$2,232.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,005.15
|
|
|
HC SIGMOIDOSCOPY W EUS EXAM
|
Facility
|
OP
|
$2,673.54
|
|
| Hospital Charge Code |
36000082
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$471.35 |
| Max. Negotiated Rate |
$2,406.19 |
| Rate for Payer: Aetna Commercial |
$2,272.51
|
| Rate for Payer: Aetna Medicare |
$695.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$835.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$835.48
|
| Rate for Payer: BCBS Complete |
$494.87
|
| Rate for Payer: BCBS MAPPO |
$668.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,197.92
|
| Rate for Payer: BCN Commercial |
$2,197.92
|
| Rate for Payer: BCN Medicare Advantage |
$668.38
|
| Rate for Payer: Cash Price |
$2,138.83
|
| Rate for Payer: Cofinity Commercial |
$2,299.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,138.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$668.38
|
| Rate for Payer: Healthscope Commercial |
$2,406.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,005.15
|
| Rate for Payer: Mclaren Medicaid |
$471.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$701.80
|
| Rate for Payer: Meridian Medicaid |
$494.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$768.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$735.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,272.51
|
| Rate for Payer: Nomi Health Commercial |
$2,192.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,005.15
|
| Rate for Payer: PACE Senior Care Partners |
$634.97
|
| Rate for Payer: PACE SWMI |
$668.38
|
| Rate for Payer: PHP Commercial |
$2,272.51
|
| Rate for Payer: PHP Medicare Advantage |
$668.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$471.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,325.98
|
| Rate for Payer: Priority Health Medicare |
$675.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,860.78
|
| Rate for Payer: Railroad Medicare Medicare |
$668.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,352.72
|
| Rate for Payer: UHC Core |
$2,232.41
|
| Rate for Payer: UHC Exchange |
$668.38
|
| Rate for Payer: UHC Medicaid |
$471.35
|
| Rate for Payer: UHC Medicare Advantage |
$668.38
|
| Rate for Payer: UHCCP Medicaid |
$471.35
|
| Rate for Payer: VA VA |
$668.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,005.15
|
|
|
HC SIGMOIDOSCOPY WITH BIOPSY
|
Facility
|
OP
|
$1,290.13
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
36000111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$227.45 |
| Max. Negotiated Rate |
$1,161.12 |
| Rate for Payer: Aetna Commercial |
$1,096.61
|
| Rate for Payer: Aetna Medicare |
$335.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$403.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$403.17
|
| Rate for Payer: BCBS Complete |
$238.80
|
| Rate for Payer: BCBS MAPPO |
$322.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,060.62
|
| Rate for Payer: BCN Commercial |
$1,060.62
|
| Rate for Payer: BCN Medicare Advantage |
$322.53
|
| Rate for Payer: Cash Price |
$1,032.10
|
| Rate for Payer: Cofinity Commercial |
$1,109.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,032.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$322.53
|
| Rate for Payer: Healthscope Commercial |
$1,161.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$967.60
|
| Rate for Payer: Mclaren Medicaid |
$227.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$338.66
|
| Rate for Payer: Meridian Medicaid |
$238.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$370.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$354.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,096.61
|
| Rate for Payer: Nomi Health Commercial |
$1,057.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$967.60
|
| Rate for Payer: PACE Senior Care Partners |
$306.41
|
| Rate for Payer: PACE SWMI |
$322.53
|
| Rate for Payer: PHP Commercial |
$1,096.61
|
| Rate for Payer: PHP Medicare Advantage |
$322.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,122.41
|
| Rate for Payer: Priority Health Medicare |
$325.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$897.93
|
| Rate for Payer: Railroad Medicare Medicare |
$322.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,135.31
|
| Rate for Payer: UHC Core |
$1,077.26
|
| Rate for Payer: UHC Exchange |
$322.53
|
| Rate for Payer: UHC Medicaid |
$227.45
|
| Rate for Payer: UHC Medicare Advantage |
$322.53
|
| Rate for Payer: UHCCP Medicaid |
$227.45
|
| Rate for Payer: VA VA |
$322.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$967.60
|
|
|
HC SIGMOIDOSCOPY WITH BIOPSY
|
Facility
|
IP
|
$1,290.13
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
36000111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$897.93 |
| Max. Negotiated Rate |
$1,161.12 |
| Rate for Payer: Aetna Commercial |
$1,096.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,065.52
|
| Rate for Payer: BCN Commercial |
$1,065.52
|
| Rate for Payer: Cash Price |
$1,032.10
|
| Rate for Payer: Cofinity Commercial |
$1,109.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,032.10
|
| Rate for Payer: Healthscope Commercial |
$1,161.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$967.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,096.61
|
| Rate for Payer: Nomi Health Commercial |
$1,057.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$967.60
|
| Rate for Payer: PHP Commercial |
$1,096.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,122.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$897.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,135.31
|
| Rate for Payer: UHC Core |
$1,077.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$967.60
|
|
|
HC SIGNAL AVERAGE EKG
|
Facility
|
OP
|
$257.93
|
|
|
Service Code
|
CPT 93278
|
| Hospital Charge Code |
73100004
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$45.47 |
| Max. Negotiated Rate |
$232.14 |
| Rate for Payer: Aetna Commercial |
$219.24
|
| Rate for Payer: Aetna Medicare |
$67.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.60
|
| Rate for Payer: BCBS Complete |
$47.74
|
| Rate for Payer: BCBS MAPPO |
$64.48
|
| Rate for Payer: BCBS Trust/PPO |
$212.04
|
| Rate for Payer: BCN Commercial |
$212.04
|
| Rate for Payer: BCN Medicare Advantage |
$64.48
|
| Rate for Payer: Cash Price |
$206.34
|
| Rate for Payer: Cofinity Commercial |
$221.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.48
|
| Rate for Payer: Healthscope Commercial |
$232.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.45
|
| Rate for Payer: Mclaren Medicaid |
$45.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.71
|
| Rate for Payer: Meridian Medicaid |
$47.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.24
|
| Rate for Payer: Nomi Health Commercial |
$211.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.45
|
| Rate for Payer: PACE Senior Care Partners |
$61.26
|
| Rate for Payer: PACE SWMI |
$64.48
|
| Rate for Payer: PHP Commercial |
$219.24
|
| Rate for Payer: PHP Medicare Advantage |
$64.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$224.40
|
| Rate for Payer: Priority Health Medicare |
$65.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.52
|
| Rate for Payer: Railroad Medicare Medicare |
$64.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.98
|
| Rate for Payer: UHC Core |
$215.37
|
| Rate for Payer: UHC Exchange |
$64.48
|
| Rate for Payer: UHC Medicaid |
$45.47
|
| Rate for Payer: UHC Medicare Advantage |
$64.48
|
| Rate for Payer: UHCCP Medicaid |
$45.47
|
| Rate for Payer: VA VA |
$64.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.45
|
|
|
HC SIGNAL AVERAGE EKG
|
Facility
|
IP
|
$257.93
|
|
|
Service Code
|
CPT 93278
|
| Hospital Charge Code |
73100004
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$179.52 |
| Max. Negotiated Rate |
$232.14 |
| Rate for Payer: Aetna Commercial |
$219.24
|
| Rate for Payer: BCBS Trust/PPO |
$213.02
|
| Rate for Payer: BCN Commercial |
$213.02
|
| Rate for Payer: Cash Price |
$206.34
|
| Rate for Payer: Cofinity Commercial |
$221.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.34
|
| Rate for Payer: Healthscope Commercial |
$232.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.24
|
| Rate for Payer: Nomi Health Commercial |
$211.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.45
|
| Rate for Payer: PHP Commercial |
$219.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$224.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.98
|
| Rate for Payer: UHC Core |
$215.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.45
|
|
|
HC SILICA CLOTTING TIME ASSAY
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500099
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC SILICA CLOTTING TIME ASSAY
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500099
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC SILVADENE 400 GM
|
Facility
|
OP
|
$258.59
|
|
| Hospital Charge Code |
27100016
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$45.59 |
| Max. Negotiated Rate |
$232.73 |
| Rate for Payer: Aetna Commercial |
$219.80
|
| Rate for Payer: Aetna Medicare |
$67.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.81
|
| Rate for Payer: BCBS Complete |
$47.87
|
| Rate for Payer: BCBS MAPPO |
$64.65
|
| Rate for Payer: BCBS Trust/PPO |
$212.59
|
| Rate for Payer: BCN Commercial |
$212.59
|
| Rate for Payer: BCN Medicare Advantage |
$64.65
|
| Rate for Payer: Cash Price |
$206.87
|
| Rate for Payer: Cofinity Commercial |
$222.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.65
|
| Rate for Payer: Healthscope Commercial |
$232.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.94
|
| Rate for Payer: Mclaren Medicaid |
$45.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.88
|
| Rate for Payer: Meridian Medicaid |
$47.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.80
|
| Rate for Payer: Nomi Health Commercial |
$212.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.94
|
| Rate for Payer: PACE Senior Care Partners |
$61.42
|
| Rate for Payer: PACE SWMI |
$64.65
|
| Rate for Payer: PHP Commercial |
$219.80
|
| Rate for Payer: PHP Medicare Advantage |
$64.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$224.97
|
| Rate for Payer: Priority Health Medicare |
$65.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.98
|
| Rate for Payer: Railroad Medicare Medicare |
$64.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.56
|
| Rate for Payer: UHC Core |
$215.92
|
| Rate for Payer: UHC Exchange |
$64.65
|
| Rate for Payer: UHC Medicaid |
$45.59
|
| Rate for Payer: UHC Medicare Advantage |
$64.65
|
| Rate for Payer: UHCCP Medicaid |
$45.59
|
| Rate for Payer: VA VA |
$64.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.94
|
|
|
HC SILVADENE 400 GM
|
Facility
|
IP
|
$258.59
|
|
| Hospital Charge Code |
27100016
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$179.98 |
| Max. Negotiated Rate |
$232.73 |
| Rate for Payer: Aetna Commercial |
$219.80
|
| Rate for Payer: BCBS Trust/PPO |
$213.57
|
| Rate for Payer: BCN Commercial |
$213.57
|
| Rate for Payer: Cash Price |
$206.87
|
| Rate for Payer: Cofinity Commercial |
$222.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.87
|
| Rate for Payer: Healthscope Commercial |
$232.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.80
|
| Rate for Payer: Nomi Health Commercial |
$212.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.94
|
| Rate for Payer: PHP Commercial |
$219.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$224.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.56
|
| Rate for Payer: UHC Core |
$215.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.94
|
|
|
HC SILVADENE 85 GM
|
Facility
|
IP
|
$106.71
|
|
| Hospital Charge Code |
27100017
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$74.27 |
| Max. Negotiated Rate |
$96.04 |
| Rate for Payer: Aetna Commercial |
$90.70
|
| Rate for Payer: BCBS Trust/PPO |
$88.13
|
| Rate for Payer: BCN Commercial |
$88.13
|
| Rate for Payer: Cash Price |
$85.37
|
| Rate for Payer: Cofinity Commercial |
$91.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.37
|
| Rate for Payer: Healthscope Commercial |
$96.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.70
|
| Rate for Payer: Nomi Health Commercial |
$87.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.03
|
| Rate for Payer: PHP Commercial |
$90.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$92.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.90
|
| Rate for Payer: UHC Core |
$89.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.03
|
|
|
HC SILVADENE 85 GM
|
Facility
|
OP
|
$106.71
|
|
| Hospital Charge Code |
27100017
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$96.04 |
| Rate for Payer: Aetna Commercial |
$90.70
|
| Rate for Payer: Aetna Medicare |
$27.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.35
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$26.68
|
| Rate for Payer: BCBS Trust/PPO |
$87.73
|
| Rate for Payer: BCN Commercial |
$87.73
|
| Rate for Payer: BCN Medicare Advantage |
$26.68
|
| Rate for Payer: Cash Price |
$85.37
|
| Rate for Payer: Cofinity Commercial |
$91.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.68
|
| Rate for Payer: Healthscope Commercial |
$96.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.03
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.01
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.70
|
| Rate for Payer: Nomi Health Commercial |
$87.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.03
|
| Rate for Payer: PACE Senior Care Partners |
$25.34
|
| Rate for Payer: PACE SWMI |
$26.68
|
| Rate for Payer: PHP Commercial |
$90.70
|
| Rate for Payer: PHP Medicare Advantage |
$26.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$92.84
|
| Rate for Payer: Priority Health Medicare |
$26.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.27
|
| Rate for Payer: Railroad Medicare Medicare |
$26.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.90
|
| Rate for Payer: UHC Core |
$89.10
|
| Rate for Payer: UHC Exchange |
$26.68
|
| Rate for Payer: UHC Medicaid |
$18.81
|
| Rate for Payer: UHC Medicare Advantage |
$26.68
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: VA VA |
$26.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.03
|
|
|
HC SILVER 4X4
|
Facility
|
IP
|
$66.72
|
|
| Hospital Charge Code |
27000146
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$46.44 |
| Max. Negotiated Rate |
$60.05 |
| Rate for Payer: Aetna Commercial |
$56.71
|
| Rate for Payer: BCBS Trust/PPO |
$55.10
|
| Rate for Payer: BCN Commercial |
$55.10
|
| Rate for Payer: Cash Price |
$53.38
|
| Rate for Payer: Cofinity Commercial |
$57.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.38
|
| Rate for Payer: Healthscope Commercial |
$60.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.71
|
| Rate for Payer: Nomi Health Commercial |
$54.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.04
|
| Rate for Payer: PHP Commercial |
$56.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.71
|
| Rate for Payer: UHC Core |
$55.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.04
|
|
|
HC SILVER 4X4
|
Facility
|
OP
|
$66.72
|
|
| Hospital Charge Code |
27000146
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.76 |
| Max. Negotiated Rate |
$60.05 |
| Rate for Payer: Aetna Commercial |
$56.71
|
| Rate for Payer: Aetna Medicare |
$17.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.85
|
| Rate for Payer: BCBS Complete |
$12.35
|
| Rate for Payer: BCBS MAPPO |
$16.68
|
| Rate for Payer: BCBS Trust/PPO |
$54.85
|
| Rate for Payer: BCN Commercial |
$54.85
|
| Rate for Payer: BCN Medicare Advantage |
$16.68
|
| Rate for Payer: Cash Price |
$53.38
|
| Rate for Payer: Cofinity Commercial |
$57.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.68
|
| Rate for Payer: Healthscope Commercial |
$60.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.04
|
| Rate for Payer: Mclaren Medicaid |
$11.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.51
|
| Rate for Payer: Meridian Medicaid |
$12.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.71
|
| Rate for Payer: Nomi Health Commercial |
$54.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.04
|
| Rate for Payer: PACE Senior Care Partners |
$15.85
|
| Rate for Payer: PACE SWMI |
$16.68
|
| Rate for Payer: PHP Commercial |
$56.71
|
| Rate for Payer: PHP Medicare Advantage |
$16.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.05
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.44
|
| Rate for Payer: Railroad Medicare Medicare |
$16.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.71
|
| Rate for Payer: UHC Core |
$55.71
|
| Rate for Payer: UHC Exchange |
$16.68
|
| Rate for Payer: UHC Medicaid |
$11.76
|
| Rate for Payer: UHC Medicare Advantage |
$16.68
|
| Rate for Payer: UHCCP Medicaid |
$11.76
|
| Rate for Payer: VA VA |
$16.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.04
|
|
|
HC SILVER HAWK CATHETER
|
Facility
|
OP
|
$8,921.49
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200070
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,572.86 |
| Max. Negotiated Rate |
$8,029.34 |
| Rate for Payer: Aetna Commercial |
$7,583.27
|
| Rate for Payer: Aetna Medicare |
$2,319.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,787.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,787.97
|
| Rate for Payer: BCBS Complete |
$1,651.37
|
| Rate for Payer: BCBS MAPPO |
$2,230.37
|
| Rate for Payer: BCBS Trust/PPO |
$7,334.36
|
| Rate for Payer: BCN Commercial |
$7,334.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,230.37
|
| Rate for Payer: Cash Price |
$7,137.19
|
| Rate for Payer: Cofinity Commercial |
$7,672.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,137.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,230.37
|
| Rate for Payer: Healthscope Commercial |
$8,029.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,691.12
|
| Rate for Payer: Mclaren Medicaid |
$1,572.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,341.89
|
| Rate for Payer: Meridian Medicaid |
$1,651.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,564.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,453.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,583.27
|
| Rate for Payer: Nomi Health Commercial |
$7,315.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,691.12
|
| Rate for Payer: PACE Senior Care Partners |
$2,118.85
|
| Rate for Payer: PACE SWMI |
$2,230.37
|
| Rate for Payer: PHP Commercial |
$7,583.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,230.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,572.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,761.70
|
| Rate for Payer: Priority Health Medicare |
$2,252.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,209.36
|
| Rate for Payer: Railroad Medicare Medicare |
$2,230.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,850.91
|
| Rate for Payer: UHC Core |
$7,449.44
|
| Rate for Payer: UHC Exchange |
$2,230.37
|
| Rate for Payer: UHC Medicaid |
$1,572.86
|
| Rate for Payer: UHC Medicare Advantage |
$2,230.37
|
| Rate for Payer: UHCCP Medicaid |
$1,572.86
|
| Rate for Payer: VA VA |
$2,230.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,691.12
|
|
|
HC SILVER HAWK CATHETER
|
Facility
|
IP
|
$8,921.49
|
|
|
Service Code
|
HCPCS C1888
|
| Hospital Charge Code |
27200070
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6,209.36 |
| Max. Negotiated Rate |
$8,029.34 |
| Rate for Payer: Aetna Commercial |
$7,583.27
|
| Rate for Payer: BCBS Trust/PPO |
$7,368.26
|
| Rate for Payer: BCN Commercial |
$7,368.26
|
| Rate for Payer: Cash Price |
$7,137.19
|
| Rate for Payer: Cofinity Commercial |
$7,672.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,137.19
|
| Rate for Payer: Healthscope Commercial |
$8,029.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,691.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,583.27
|
| Rate for Payer: Nomi Health Commercial |
$7,315.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,691.12
|
| Rate for Payer: PHP Commercial |
$7,583.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,761.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,209.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,850.91
|
| Rate for Payer: UHC Core |
$7,449.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,691.12
|
|
|
HC SILVER ROPE
|
Facility
|
IP
|
$55.67
|
|
| Hospital Charge Code |
27000147
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.75 |
| Max. Negotiated Rate |
$50.10 |
| Rate for Payer: Aetna Commercial |
$47.32
|
| Rate for Payer: BCBS Trust/PPO |
$45.98
|
| Rate for Payer: BCN Commercial |
$45.98
|
| Rate for Payer: Cash Price |
$44.54
|
| Rate for Payer: Cofinity Commercial |
$47.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.54
|
| Rate for Payer: Healthscope Commercial |
$50.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.32
|
| Rate for Payer: Nomi Health Commercial |
$45.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.75
|
| Rate for Payer: PHP Commercial |
$47.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.99
|
| Rate for Payer: UHC Core |
$46.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.75
|
|
|
HC SILVER ROPE
|
Facility
|
OP
|
$55.67
|
|
| Hospital Charge Code |
27000147
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.81 |
| Max. Negotiated Rate |
$50.10 |
| Rate for Payer: Aetna Commercial |
$47.32
|
| Rate for Payer: Aetna Medicare |
$14.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.40
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS MAPPO |
$13.92
|
| Rate for Payer: BCBS Trust/PPO |
$45.77
|
| Rate for Payer: BCN Commercial |
$45.77
|
| Rate for Payer: BCN Medicare Advantage |
$13.92
|
| Rate for Payer: Cash Price |
$44.54
|
| Rate for Payer: Cofinity Commercial |
$47.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.92
|
| Rate for Payer: Healthscope Commercial |
$50.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.75
|
| Rate for Payer: Mclaren Medicaid |
$9.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.61
|
| Rate for Payer: Meridian Medicaid |
$10.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.32
|
| Rate for Payer: Nomi Health Commercial |
$45.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.75
|
| Rate for Payer: PACE Senior Care Partners |
$13.22
|
| Rate for Payer: PACE SWMI |
$13.92
|
| Rate for Payer: PHP Commercial |
$47.32
|
| Rate for Payer: PHP Medicare Advantage |
$13.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.43
|
| Rate for Payer: Priority Health Medicare |
$14.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.75
|
| Rate for Payer: Railroad Medicare Medicare |
$13.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.99
|
| Rate for Payer: UHC Core |
$46.48
|
| Rate for Payer: UHC Exchange |
$13.92
|
| Rate for Payer: UHC Medicaid |
$9.81
|
| Rate for Payer: UHC Medicare Advantage |
$13.92
|
| Rate for Payer: UHCCP Medicaid |
$9.81
|
| Rate for Payer: VA VA |
$13.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.75
|
|
|
HC SIMIAN B AB
|
Facility
|
IP
|
$92.91
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
30200333
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$64.67 |
| Max. Negotiated Rate |
$83.62 |
| Rate for Payer: Aetna Commercial |
$78.97
|
| Rate for Payer: BCBS Trust/PPO |
$76.73
|
| Rate for Payer: BCN Commercial |
$76.73
|
| Rate for Payer: Cash Price |
$74.33
|
| Rate for Payer: Cofinity Commercial |
$79.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.33
|
| Rate for Payer: Healthscope Commercial |
$83.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.97
|
| Rate for Payer: Nomi Health Commercial |
$76.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.68
|
| Rate for Payer: PHP Commercial |
$78.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$80.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.76
|
| Rate for Payer: UHC Core |
$77.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.68
|
|
|
HC SIMIAN B AB
|
Facility
|
OP
|
$92.91
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
30200333
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.38 |
| Max. Negotiated Rate |
$83.62 |
| Rate for Payer: Aetna Commercial |
$78.97
|
| Rate for Payer: Aetna Medicare |
$24.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.03
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$23.23
|
| Rate for Payer: BCBS Trust/PPO |
$76.38
|
| Rate for Payer: BCN Commercial |
$76.38
|
| Rate for Payer: BCN Medicare Advantage |
$23.23
|
| Rate for Payer: Cash Price |
$74.33
|
| Rate for Payer: Cofinity Commercial |
$79.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.23
|
| Rate for Payer: Healthscope Commercial |
$83.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.68
|
| Rate for Payer: Mclaren Medicaid |
$16.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.39
|
| Rate for Payer: Meridian Medicaid |
$17.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.97
|
| Rate for Payer: Nomi Health Commercial |
$76.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.68
|
| Rate for Payer: PACE Senior Care Partners |
$22.07
|
| Rate for Payer: PACE SWMI |
$23.23
|
| Rate for Payer: PHP Commercial |
$78.97
|
| Rate for Payer: PHP Medicare Advantage |
$23.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$80.83
|
| Rate for Payer: Priority Health Medicare |
$23.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.67
|
| Rate for Payer: Railroad Medicare Medicare |
$23.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.76
|
| Rate for Payer: UHC Core |
$77.58
|
| Rate for Payer: UHC Exchange |
$23.23
|
| Rate for Payer: UHC Medicaid |
$16.38
|
| Rate for Payer: UHC Medicare Advantage |
$23.23
|
| Rate for Payer: UHCCP Medicaid |
$16.38
|
| Rate for Payer: VA VA |
$23.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.68
|
|
|
HC SIMPLE CYSTOMETROGRAM
|
Facility
|
OP
|
$368.37
|
|
|
Service Code
|
CPT 51725
|
| Hospital Charge Code |
76100189
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.94 |
| Max. Negotiated Rate |
$331.53 |
| Rate for Payer: Aetna Commercial |
$313.11
|
| Rate for Payer: Aetna Medicare |
$95.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.12
|
| Rate for Payer: BCBS Complete |
$68.19
|
| Rate for Payer: BCBS MAPPO |
$92.09
|
| Rate for Payer: BCBS Trust/PPO |
$302.84
|
| Rate for Payer: BCN Commercial |
$302.84
|
| Rate for Payer: BCN Medicare Advantage |
$92.09
|
| Rate for Payer: Cash Price |
$294.70
|
| Rate for Payer: Cofinity Commercial |
$316.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.09
|
| Rate for Payer: Healthscope Commercial |
$331.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.28
|
| Rate for Payer: Mclaren Medicaid |
$64.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.70
|
| Rate for Payer: Meridian Medicaid |
$68.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$101.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.11
|
| Rate for Payer: Nomi Health Commercial |
$302.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.28
|
| Rate for Payer: PACE Senior Care Partners |
$87.49
|
| Rate for Payer: PACE SWMI |
$92.09
|
| Rate for Payer: PHP Commercial |
$313.11
|
| Rate for Payer: PHP Medicare Advantage |
$92.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$320.48
|
| Rate for Payer: Priority Health Medicare |
$93.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.39
|
| Rate for Payer: Railroad Medicare Medicare |
$92.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.17
|
| Rate for Payer: UHC Core |
$307.59
|
| Rate for Payer: UHC Exchange |
$92.09
|
| Rate for Payer: UHC Medicaid |
$64.94
|
| Rate for Payer: UHC Medicare Advantage |
$92.09
|
| Rate for Payer: UHCCP Medicaid |
$64.94
|
| Rate for Payer: VA VA |
$92.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.28
|
|
