|
HC REPLACE MULTICHAMBER ICD
|
Facility
|
IP
|
$21,913.52
|
|
|
Service Code
|
CPT 33264
|
| Hospital Charge Code |
36100359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14,243.79 |
| Max. Negotiated Rate |
$19,722.17 |
| Rate for Payer: Aetna Commercial |
$18,626.49
|
| Rate for Payer: BCBS Trust/PPO |
$17,888.01
|
| Rate for Payer: BCN Commercial |
$16,934.77
|
| Rate for Payer: Cash Price |
$17,530.82
|
| Rate for Payer: Cofinity Commercial |
$18,845.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,530.82
|
| Rate for Payer: Healthscope Commercial |
$19,722.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,435.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,626.49
|
| Rate for Payer: Nomi Health Commercial |
$17,969.09
|
| Rate for Payer: PHP Commercial |
$18,626.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,243.79
|
| Rate for Payer: Priority Health HMO/PPO |
$19,064.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,682.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19,283.90
|
| Rate for Payer: UHC Core |
$18,297.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,435.14
|
|
|
HC REPLACE MULTI CHAMBER PPM
|
Facility
|
OP
|
$18,480.40
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
36100356
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,389.10 |
| Max. Negotiated Rate |
$16,632.36 |
| Rate for Payer: Aetna Commercial |
$15,708.34
|
| Rate for Payer: Aetna Medicare |
$4,804.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,775.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,775.12
|
| Rate for Payer: BCBS Complete |
$14,186.06
|
| Rate for Payer: BCBS MAPPO |
$4,620.10
|
| Rate for Payer: BCBS Trust/PPO |
$15,192.74
|
| Rate for Payer: BCN Commercial |
$14,368.51
|
| Rate for Payer: BCN Medicare Advantage |
$4,620.10
|
| Rate for Payer: Cash Price |
$14,784.32
|
| Rate for Payer: Cash Price |
$14,784.32
|
| Rate for Payer: Cofinity Commercial |
$15,893.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,784.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,620.10
|
| Rate for Payer: Healthscope Commercial |
$16,632.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,860.30
|
| Rate for Payer: Mclaren Medicaid |
$13,509.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,851.10
|
| Rate for Payer: Meridian Medicaid |
$14,186.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,313.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,708.34
|
| Rate for Payer: Nomi Health Commercial |
$15,153.93
|
| Rate for Payer: PACE Senior Care Partners |
$4,389.10
|
| Rate for Payer: PACE SWMI |
$4,620.10
|
| Rate for Payer: PHP Commercial |
$15,708.34
|
| Rate for Payer: PHP Medicare Advantage |
$4,620.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$13,509.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,012.26
|
| Rate for Payer: Priority Health HMO/PPO |
$16,077.95
|
| Rate for Payer: Priority Health Medicare |
$4,666.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,381.87
|
| Rate for Payer: Railroad Medicare Medicare |
$4,620.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,262.75
|
| Rate for Payer: UHC Core |
$15,431.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,620.10
|
| Rate for Payer: UHC Exchange |
$4,620.10
|
| Rate for Payer: UHC Medicare Advantage |
$4,620.10
|
| Rate for Payer: UHCCP Medicaid |
$13,509.65
|
| Rate for Payer: VA VA |
$4,620.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,860.30
|
|
|
HC REPLACE MULTI CHAMBER PPM
|
Facility
|
IP
|
$18,480.40
|
|
|
Service Code
|
CPT 33229
|
| Hospital Charge Code |
36100356
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,012.26 |
| Max. Negotiated Rate |
$16,632.36 |
| Rate for Payer: Aetna Commercial |
$15,708.34
|
| Rate for Payer: BCBS Trust/PPO |
$15,085.55
|
| Rate for Payer: BCN Commercial |
$14,281.65
|
| Rate for Payer: Cash Price |
$14,784.32
|
| Rate for Payer: Cofinity Commercial |
$15,893.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,784.32
|
| Rate for Payer: Healthscope Commercial |
$16,632.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,860.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,708.34
|
| Rate for Payer: Nomi Health Commercial |
$15,153.93
|
| Rate for Payer: PHP Commercial |
$15,708.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,012.26
|
| Rate for Payer: Priority Health HMO/PPO |
$16,077.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,381.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,262.75
|
| Rate for Payer: UHC Core |
$15,431.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,860.30
|
|
|
HC REPLACE SINGLE CHAMBER ICD
|
Facility
|
OP
|
$17,881.43
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,246.84 |
| Max. Negotiated Rate |
$16,696.58 |
| Rate for Payer: Aetna Commercial |
$15,199.22
|
| Rate for Payer: Aetna Medicare |
$4,649.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,587.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,587.95
|
| Rate for Payer: BCBS Complete |
$16,696.58
|
| Rate for Payer: BCBS MAPPO |
$4,470.36
|
| Rate for Payer: BCBS Trust/PPO |
$14,700.32
|
| Rate for Payer: BCN Commercial |
$13,902.81
|
| Rate for Payer: BCN Medicare Advantage |
$4,470.36
|
| Rate for Payer: Cash Price |
$14,305.14
|
| Rate for Payer: Cash Price |
$14,305.14
|
| Rate for Payer: Cofinity Commercial |
$15,378.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,305.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,470.36
|
| Rate for Payer: Healthscope Commercial |
$16,093.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,411.07
|
| Rate for Payer: Mclaren Medicaid |
$15,900.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,693.88
|
| Rate for Payer: Meridian Medicaid |
$16,696.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,140.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,199.22
|
| Rate for Payer: Nomi Health Commercial |
$14,662.77
|
| Rate for Payer: PACE Senior Care Partners |
$4,246.84
|
| Rate for Payer: PACE SWMI |
$4,470.36
|
| Rate for Payer: PHP Commercial |
$15,199.22
|
| Rate for Payer: PHP Medicare Advantage |
$4,470.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,900.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,622.93
|
| Rate for Payer: Priority Health HMO/PPO |
$15,556.84
|
| Rate for Payer: Priority Health Medicare |
$4,515.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,980.56
|
| Rate for Payer: Railroad Medicare Medicare |
$4,470.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,735.66
|
| Rate for Payer: UHC Core |
$14,930.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,470.36
|
| Rate for Payer: UHC Exchange |
$4,470.36
|
| Rate for Payer: UHC Medicare Advantage |
$4,470.36
|
| Rate for Payer: UHCCP Medicaid |
$15,900.45
|
| Rate for Payer: VA VA |
$4,470.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,411.07
|
|
|
HC REPLACE SINGLE CHAMBER ICD
|
Facility
|
IP
|
$17,881.43
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,622.93 |
| Max. Negotiated Rate |
$16,093.29 |
| Rate for Payer: Aetna Commercial |
$15,199.22
|
| Rate for Payer: BCBS Trust/PPO |
$14,596.61
|
| Rate for Payer: BCN Commercial |
$13,818.77
|
| Rate for Payer: Cash Price |
$14,305.14
|
| Rate for Payer: Cofinity Commercial |
$15,378.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,305.14
|
| Rate for Payer: Healthscope Commercial |
$16,093.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,411.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,199.22
|
| Rate for Payer: Nomi Health Commercial |
$14,662.77
|
| Rate for Payer: PHP Commercial |
$15,199.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,622.93
|
| Rate for Payer: Priority Health HMO/PPO |
$15,556.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,980.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,735.66
|
| Rate for Payer: UHC Core |
$14,930.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,411.07
|
|
|
HC REPLACE SINGLE CHAMBER PPM
|
Facility
|
OP
|
$12,181.07
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
36100354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,893.00 |
| Max. Negotiated Rate |
$10,962.96 |
| Rate for Payer: Aetna Commercial |
$10,353.91
|
| Rate for Payer: Aetna Medicare |
$3,167.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,806.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,806.58
|
| Rate for Payer: BCBS Complete |
$6,156.08
|
| Rate for Payer: BCBS MAPPO |
$3,045.27
|
| Rate for Payer: BCBS Trust/PPO |
$10,014.06
|
| Rate for Payer: BCN Commercial |
$9,470.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,045.27
|
| Rate for Payer: Cash Price |
$9,744.86
|
| Rate for Payer: Cash Price |
$9,744.86
|
| Rate for Payer: Cofinity Commercial |
$10,475.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,744.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,045.27
|
| Rate for Payer: Healthscope Commercial |
$10,962.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,135.80
|
| Rate for Payer: Mclaren Medicaid |
$5,862.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,197.53
|
| Rate for Payer: Meridian Medicaid |
$6,156.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,502.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,353.91
|
| Rate for Payer: Nomi Health Commercial |
$9,988.48
|
| Rate for Payer: PACE Senior Care Partners |
$2,893.00
|
| Rate for Payer: PACE SWMI |
$3,045.27
|
| Rate for Payer: PHP Commercial |
$10,353.91
|
| Rate for Payer: PHP Medicare Advantage |
$3,045.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,862.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,917.70
|
| Rate for Payer: Priority Health HMO/PPO |
$10,597.53
|
| Rate for Payer: Priority Health Medicare |
$3,075.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,161.32
|
| Rate for Payer: Railroad Medicare Medicare |
$3,045.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,719.34
|
| Rate for Payer: UHC Core |
$10,171.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,045.27
|
| Rate for Payer: UHC Exchange |
$3,045.27
|
| Rate for Payer: UHC Medicare Advantage |
$3,045.27
|
| Rate for Payer: UHCCP Medicaid |
$5,862.55
|
| Rate for Payer: VA VA |
$3,045.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,135.80
|
|
|
HC REPLACE SINGLE CHAMBER PPM
|
Facility
|
IP
|
$12,181.07
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
36100354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,917.70 |
| Max. Negotiated Rate |
$10,962.96 |
| Rate for Payer: Aetna Commercial |
$10,353.91
|
| Rate for Payer: BCBS Trust/PPO |
$9,943.41
|
| Rate for Payer: BCN Commercial |
$9,413.53
|
| Rate for Payer: Cash Price |
$9,744.86
|
| Rate for Payer: Cofinity Commercial |
$10,475.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,744.86
|
| Rate for Payer: Healthscope Commercial |
$10,962.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,135.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,353.91
|
| Rate for Payer: Nomi Health Commercial |
$9,988.48
|
| Rate for Payer: PHP Commercial |
$10,353.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,917.70
|
| Rate for Payer: Priority Health HMO/PPO |
$10,597.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,161.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,719.34
|
| Rate for Payer: UHC Core |
$10,171.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,135.80
|
|
|
HC REPLACE SQ ICD ONLY
|
Facility
|
OP
|
$36,230.98
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,604.86 |
| Max. Negotiated Rate |
$32,607.88 |
| Rate for Payer: Aetna Commercial |
$30,796.33
|
| Rate for Payer: Aetna Medicare |
$9,420.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,322.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,322.18
|
| Rate for Payer: BCBS Complete |
$16,696.58
|
| Rate for Payer: BCBS MAPPO |
$9,057.74
|
| Rate for Payer: BCBS Trust/PPO |
$29,785.49
|
| Rate for Payer: BCN Commercial |
$28,169.59
|
| Rate for Payer: BCN Medicare Advantage |
$9,057.74
|
| Rate for Payer: Cash Price |
$28,984.78
|
| Rate for Payer: Cash Price |
$28,984.78
|
| Rate for Payer: Cofinity Commercial |
$31,158.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28,984.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,057.74
|
| Rate for Payer: Healthscope Commercial |
$32,607.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27,173.24
|
| Rate for Payer: Mclaren Medicaid |
$15,900.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9,510.63
|
| Rate for Payer: Meridian Medicaid |
$16,696.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,416.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30,796.33
|
| Rate for Payer: Nomi Health Commercial |
$29,709.40
|
| Rate for Payer: PACE Senior Care Partners |
$8,604.86
|
| Rate for Payer: PACE SWMI |
$9,057.74
|
| Rate for Payer: PHP Commercial |
$30,796.33
|
| Rate for Payer: PHP Medicare Advantage |
$9,057.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,900.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23,550.14
|
| Rate for Payer: Priority Health HMO/PPO |
$31,520.95
|
| Rate for Payer: Priority Health Medicare |
$9,148.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24,274.76
|
| Rate for Payer: Railroad Medicare Medicare |
$9,057.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,883.26
|
| Rate for Payer: UHC Core |
$30,252.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,057.74
|
| Rate for Payer: UHC Exchange |
$9,057.74
|
| Rate for Payer: UHC Medicare Advantage |
$9,057.74
|
| Rate for Payer: UHCCP Medicaid |
$15,900.45
|
| Rate for Payer: VA VA |
$9,057.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27,173.24
|
|
|
HC REPLACE SQ ICD ONLY
|
Facility
|
IP
|
$36,230.98
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$23,550.14 |
| Max. Negotiated Rate |
$32,607.88 |
| Rate for Payer: Aetna Commercial |
$30,796.33
|
| Rate for Payer: BCBS Trust/PPO |
$29,575.35
|
| Rate for Payer: BCN Commercial |
$27,999.30
|
| Rate for Payer: Cash Price |
$28,984.78
|
| Rate for Payer: Cofinity Commercial |
$31,158.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28,984.78
|
| Rate for Payer: Healthscope Commercial |
$32,607.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27,173.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30,796.33
|
| Rate for Payer: Nomi Health Commercial |
$29,709.40
|
| Rate for Payer: PHP Commercial |
$30,796.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23,550.14
|
| Rate for Payer: Priority Health HMO/PPO |
$31,520.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24,274.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,883.26
|
| Rate for Payer: UHC Core |
$30,252.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27,173.24
|
|
|
HC REPOSITION CVAC
|
Facility
|
OP
|
$2,508.82
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
36100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$595.84 |
| Max. Negotiated Rate |
$2,257.94 |
| Rate for Payer: Aetna Commercial |
$2,132.50
|
| Rate for Payer: Aetna Medicare |
$652.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$784.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$784.01
|
| Rate for Payer: BCBS Complete |
$1,155.53
|
| Rate for Payer: BCBS MAPPO |
$627.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,062.50
|
| Rate for Payer: BCN Commercial |
$1,950.61
|
| Rate for Payer: BCN Medicare Advantage |
$627.20
|
| Rate for Payer: Cash Price |
$2,007.06
|
| Rate for Payer: Cash Price |
$2,007.06
|
| Rate for Payer: Cofinity Commercial |
$2,157.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,007.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.20
|
| Rate for Payer: Healthscope Commercial |
$2,257.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,881.62
|
| Rate for Payer: Mclaren Medicaid |
$1,100.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$658.57
|
| Rate for Payer: Meridian Medicaid |
$1,155.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$721.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,132.50
|
| Rate for Payer: Nomi Health Commercial |
$2,057.23
|
| Rate for Payer: PACE Senior Care Partners |
$595.84
|
| Rate for Payer: PACE SWMI |
$627.20
|
| Rate for Payer: PHP Commercial |
$2,132.50
|
| Rate for Payer: PHP Medicare Advantage |
$627.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,100.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.73
|
| Rate for Payer: Priority Health HMO/PPO |
$2,182.67
|
| Rate for Payer: Priority Health Medicare |
$633.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,680.91
|
| Rate for Payer: Railroad Medicare Medicare |
$627.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,207.76
|
| Rate for Payer: UHC Core |
$2,094.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$627.20
|
| Rate for Payer: UHC Exchange |
$627.20
|
| Rate for Payer: UHC Medicare Advantage |
$627.20
|
| Rate for Payer: UHCCP Medicaid |
$1,100.43
|
| Rate for Payer: VA VA |
$627.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,881.62
|
|
|
HC REPOSITION CVAC
|
Facility
|
IP
|
$2,508.82
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
36100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,630.73 |
| Max. Negotiated Rate |
$2,257.94 |
| Rate for Payer: Aetna Commercial |
$2,132.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,047.95
|
| Rate for Payer: BCN Commercial |
$1,938.82
|
| Rate for Payer: Cash Price |
$2,007.06
|
| Rate for Payer: Cofinity Commercial |
$2,157.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,007.06
|
| Rate for Payer: Healthscope Commercial |
$2,257.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,881.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,132.50
|
| Rate for Payer: Nomi Health Commercial |
$2,057.23
|
| Rate for Payer: PHP Commercial |
$2,132.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.73
|
| Rate for Payer: Priority Health HMO/PPO |
$2,182.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,680.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,207.76
|
| Rate for Payer: UHC Core |
$2,094.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,881.62
|
|
|
HC REPOSITION RA/RV ELECTRODE
|
Facility
|
IP
|
$2,941.63
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
36100064
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,912.06 |
| Max. Negotiated Rate |
$2,647.47 |
| Rate for Payer: Aetna Commercial |
$2,500.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,401.25
|
| Rate for Payer: BCN Commercial |
$2,273.29
|
| Rate for Payer: Cash Price |
$2,353.30
|
| Rate for Payer: Cofinity Commercial |
$2,529.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,353.30
|
| Rate for Payer: Healthscope Commercial |
$2,647.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,206.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,500.39
|
| Rate for Payer: Nomi Health Commercial |
$2,412.14
|
| Rate for Payer: PHP Commercial |
$2,500.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,912.06
|
| Rate for Payer: Priority Health HMO/PPO |
$2,559.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,970.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,588.63
|
| Rate for Payer: UHC Core |
$2,456.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,206.22
|
|
|
HC REPOSITION RA/RV ELECTRODE
|
Facility
|
OP
|
$2,941.63
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
36100064
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$698.64 |
| Max. Negotiated Rate |
$2,647.47 |
| Rate for Payer: Aetna Commercial |
$2,500.39
|
| Rate for Payer: Aetna Medicare |
$764.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$919.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$919.26
|
| Rate for Payer: BCBS Complete |
$2,341.27
|
| Rate for Payer: BCBS MAPPO |
$735.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,418.31
|
| Rate for Payer: BCN Commercial |
$2,287.12
|
| Rate for Payer: BCN Medicare Advantage |
$735.41
|
| Rate for Payer: Cash Price |
$2,353.30
|
| Rate for Payer: Cash Price |
$2,353.30
|
| Rate for Payer: Cofinity Commercial |
$2,529.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,353.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$735.41
|
| Rate for Payer: Healthscope Commercial |
$2,647.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,206.22
|
| Rate for Payer: Mclaren Medicaid |
$2,229.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$772.18
|
| Rate for Payer: Meridian Medicaid |
$2,341.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$845.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,500.39
|
| Rate for Payer: Nomi Health Commercial |
$2,412.14
|
| Rate for Payer: PACE Senior Care Partners |
$698.64
|
| Rate for Payer: PACE SWMI |
$735.41
|
| Rate for Payer: PHP Commercial |
$2,500.39
|
| Rate for Payer: PHP Medicare Advantage |
$735.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,229.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,912.06
|
| Rate for Payer: Priority Health HMO/PPO |
$2,559.22
|
| Rate for Payer: Priority Health Medicare |
$742.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,970.89
|
| Rate for Payer: Railroad Medicare Medicare |
$735.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,588.63
|
| Rate for Payer: UHC Core |
$2,456.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$735.41
|
| Rate for Payer: UHC Exchange |
$735.41
|
| Rate for Payer: UHC Medicare Advantage |
$735.41
|
| Rate for Payer: UHCCP Medicaid |
$2,229.63
|
| Rate for Payer: VA VA |
$735.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,206.22
|
|
|
HC RESERVOIR 20 MICRON
|
Facility
|
OP
|
$107.10
|
|
| Hospital Charge Code |
27000039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$25.44 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.04
|
| Rate for Payer: Aetna Medicare |
$27.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.47
|
| Rate for Payer: BCBS Complete |
$42.84
|
| Rate for Payer: BCBS MAPPO |
$26.78
|
| Rate for Payer: BCBS Trust/PPO |
$88.05
|
| Rate for Payer: BCN Commercial |
$83.27
|
| Rate for Payer: BCN Medicare Advantage |
$26.78
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.78
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.04
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: PACE Senior Care Partners |
$25.44
|
| Rate for Payer: PACE SWMI |
$26.78
|
| Rate for Payer: PHP Commercial |
$91.04
|
| Rate for Payer: PHP Medicare Advantage |
$26.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.62
|
| Rate for Payer: Priority Health HMO/PPO |
$93.18
|
| Rate for Payer: Priority Health Medicare |
$27.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.76
|
| Rate for Payer: Railroad Medicare Medicare |
$26.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.25
|
| Rate for Payer: UHC Core |
$89.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.78
|
| Rate for Payer: UHC Exchange |
$26.78
|
| Rate for Payer: UHC Medicare Advantage |
$26.78
|
| Rate for Payer: VA VA |
$26.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.32
|
|
|
HC RESERVOIR 20 MICRON
|
Facility
|
IP
|
$107.10
|
|
| Hospital Charge Code |
27000039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$69.62 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.04
|
| Rate for Payer: BCBS Trust/PPO |
$87.43
|
| Rate for Payer: BCN Commercial |
$82.77
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.04
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: PHP Commercial |
$91.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.62
|
| Rate for Payer: Priority Health HMO/PPO |
$93.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.25
|
| Rate for Payer: UHC Core |
$89.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.32
|
|
|
HC RESERVOIR OUTLET Y
|
Facility
|
IP
|
$30.60
|
|
| Hospital Charge Code |
27000668
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$24.98
|
| Rate for Payer: BCN Commercial |
$23.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO |
$26.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC RESERVOIR OUTLET Y
|
Facility
|
OP
|
$30.60
|
|
| Hospital Charge Code |
27000668
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.27 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.56
|
| Rate for Payer: BCBS Complete |
$12.24
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$25.16
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.65
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PACE Senior Care Partners |
$7.27
|
| Rate for Payer: PACE SWMI |
$7.65
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO |
$26.62
|
| Rate for Payer: Priority Health Medicare |
$7.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.50
|
| Rate for Payer: Railroad Medicare Medicare |
$7.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.65
|
| Rate for Payer: UHC Exchange |
$7.65
|
| Rate for Payer: UHC Medicare Advantage |
$7.65
|
| Rate for Payer: VA VA |
$7.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC RESERVOIR TANDEM Y
|
Facility
|
OP
|
$30.60
|
|
| Hospital Charge Code |
27000667
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.27 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.56
|
| Rate for Payer: BCBS Complete |
$12.24
|
| Rate for Payer: BCBS MAPPO |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$25.16
|
| Rate for Payer: BCN Commercial |
$23.79
|
| Rate for Payer: BCN Medicare Advantage |
$7.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.65
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PACE Senior Care Partners |
$7.27
|
| Rate for Payer: PACE SWMI |
$7.65
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$7.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO |
$26.62
|
| Rate for Payer: Priority Health Medicare |
$7.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.50
|
| Rate for Payer: Railroad Medicare Medicare |
$7.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.65
|
| Rate for Payer: UHC Exchange |
$7.65
|
| Rate for Payer: UHC Medicare Advantage |
$7.65
|
| Rate for Payer: VA VA |
$7.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC RESERVOIR TANDEM Y
|
Facility
|
IP
|
$30.60
|
|
| Hospital Charge Code |
27000667
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$24.98
|
| Rate for Payer: BCN Commercial |
$23.65
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$25.09
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health HMO/PPO |
$26.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.93
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC RESERVOIR VEN STAND ALONE
|
Facility
|
OP
|
$841.50
|
|
| Hospital Charge Code |
27000653
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$199.86 |
| Max. Negotiated Rate |
$757.35 |
| Rate for Payer: Aetna Commercial |
$715.28
|
| Rate for Payer: Aetna Medicare |
$218.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.97
|
| Rate for Payer: BCBS Complete |
$336.60
|
| Rate for Payer: BCBS MAPPO |
$210.38
|
| Rate for Payer: BCBS Trust/PPO |
$691.80
|
| Rate for Payer: BCN Commercial |
$654.27
|
| Rate for Payer: BCN Medicare Advantage |
$210.38
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cofinity Commercial |
$723.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.38
|
| Rate for Payer: Healthscope Commercial |
$757.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$220.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.28
|
| Rate for Payer: Nomi Health Commercial |
$690.03
|
| Rate for Payer: PACE Senior Care Partners |
$199.86
|
| Rate for Payer: PACE SWMI |
$210.38
|
| Rate for Payer: PHP Commercial |
$715.28
|
| Rate for Payer: PHP Medicare Advantage |
$210.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.98
|
| Rate for Payer: Priority Health HMO/PPO |
$732.10
|
| Rate for Payer: Priority Health Medicare |
$212.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$563.80
|
| Rate for Payer: Railroad Medicare Medicare |
$210.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.52
|
| Rate for Payer: UHC Core |
$702.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.38
|
| Rate for Payer: UHC Exchange |
$210.38
|
| Rate for Payer: UHC Medicare Advantage |
$210.38
|
| Rate for Payer: VA VA |
$210.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.12
|
|
|
HC RESERVOIR VEN STAND ALONE
|
Facility
|
IP
|
$841.50
|
|
| Hospital Charge Code |
27000653
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$546.98 |
| Max. Negotiated Rate |
$757.35 |
| Rate for Payer: Aetna Commercial |
$715.28
|
| Rate for Payer: BCBS Trust/PPO |
$686.92
|
| Rate for Payer: BCN Commercial |
$650.31
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cofinity Commercial |
$723.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.20
|
| Rate for Payer: Healthscope Commercial |
$757.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.28
|
| Rate for Payer: Nomi Health Commercial |
$690.03
|
| Rate for Payer: PHP Commercial |
$715.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.98
|
| Rate for Payer: Priority Health HMO/PPO |
$732.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$563.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.52
|
| Rate for Payer: UHC Core |
$702.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.12
|
|
|
HC RESPIRATORY ALLERGEN PROFILE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200121
|
|
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 RESPIRATORY ALLERGEN PROFILE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200121
|
|
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 RESPIRATORY FLOW VOLUME
|
Facility
|
IP
|
$178.41
|
|
|
Service Code
|
CPT 94375
|
| Hospital Charge Code |
46000023
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$115.97 |
| Max. Negotiated Rate |
$160.57 |
| Rate for Payer: Aetna Commercial |
$151.65
|
| Rate for Payer: BCBS Trust/PPO |
$145.64
|
| Rate for Payer: BCN Commercial |
$137.88
|
| Rate for Payer: Cash Price |
$142.73
|
| Rate for Payer: Cofinity Commercial |
$153.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.73
|
| Rate for Payer: Healthscope Commercial |
$160.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.65
|
| Rate for Payer: Nomi Health Commercial |
$146.30
|
| Rate for Payer: PHP Commercial |
$151.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.97
|
| Rate for Payer: Priority Health HMO/PPO |
$155.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$119.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.00
|
| Rate for Payer: UHC Core |
$148.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.81
|
|
|
HC RESPIRATORY FLOW VOLUME
|
Facility
|
OP
|
$178.41
|
|
|
Service Code
|
CPT 94375
|
| Hospital Charge Code |
46000023
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$42.37 |
| Max. Negotiated Rate |
$231.63 |
| Rate for Payer: Aetna Commercial |
$151.65
|
| Rate for Payer: Aetna Medicare |
$46.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.75
|
| Rate for Payer: BCBS Complete |
$231.63
|
| Rate for Payer: BCBS MAPPO |
$44.60
|
| Rate for Payer: BCBS Trust/PPO |
$146.67
|
| Rate for Payer: BCN Commercial |
$138.71
|
| Rate for Payer: BCN Medicare Advantage |
$44.60
|
| Rate for Payer: Cash Price |
$142.73
|
| Rate for Payer: Cash Price |
$142.73
|
| Rate for Payer: Cofinity Commercial |
$153.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.60
|
| Rate for Payer: Healthscope Commercial |
$160.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.81
|
| Rate for Payer: Mclaren Medicaid |
$220.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.83
|
| Rate for Payer: Meridian Medicaid |
$231.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.65
|
| Rate for Payer: Nomi Health Commercial |
$146.30
|
| Rate for Payer: PACE Senior Care Partners |
$42.37
|
| Rate for Payer: PACE SWMI |
$44.60
|
| Rate for Payer: PHP Commercial |
$151.65
|
| Rate for Payer: PHP Medicare Advantage |
$44.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.97
|
| Rate for Payer: Priority Health HMO/PPO |
$155.22
|
| Rate for Payer: Priority Health Medicare |
$45.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$119.53
|
| Rate for Payer: Railroad Medicare Medicare |
$44.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.00
|
| Rate for Payer: UHC Core |
$148.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.60
|
| Rate for Payer: UHC Exchange |
$44.60
|
| Rate for Payer: UHC Medicare Advantage |
$44.60
|
| Rate for Payer: UHCCP Medicaid |
$220.59
|
| Rate for Payer: VA VA |
$44.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.81
|
|
