|
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 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 |
$1,179.37
|
| Rate for Payer: BCBS MAPPO |
$627.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,062.50
|
| Rate for Payer: BCN Commercial |
$1,950.61
|
| Rate for Payer: BCN Medicare Advantage |
$627.21
|
| 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 |
$627.21
|
| Rate for Payer: Healthscope Commercial |
$2,257.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,881.62
|
| Rate for Payer: Mclaren Medicaid |
$1,123.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$658.57
|
| Rate for Payer: Meridian Medicaid |
$1,179.37
|
| 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 |
$627.21
|
| Rate for Payer: PHP Commercial |
$2,132.50
|
| Rate for Payer: PHP Medicare Advantage |
$627.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,123.14
|
| 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 |
$627.21
|
| 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 |
$627.21
|
| Rate for Payer: UHC Exchange |
$627.21
|
| Rate for Payer: UHC Medicare Advantage |
$627.21
|
| Rate for Payer: UHCCP Medicaid |
$1,123.14
|
| Rate for Payer: VA VA |
$627.21
|
| 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 |
$2,389.58
|
| 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 |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$772.18
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| 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 |
$2,275.64
|
| 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 |
$2,275.64
|
| 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 |
$91.03
|
| 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 |
$26.77
|
| Rate for Payer: BCBS Trust/PPO |
$88.05
|
| Rate for Payer: BCN Commercial |
$83.27
|
| Rate for Payer: BCN Medicare Advantage |
$26.77
|
| 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: Health Alliance Plan Medicare Advantage |
$26.77
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.33
|
| 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 |
$91.03
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: PACE Senior Care Partners |
$25.44
|
| Rate for Payer: PACE SWMI |
$26.77
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: PHP Medicare Advantage |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| 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 |
$26.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.25
|
| Rate for Payer: UHC Core |
$89.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.77
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicare Advantage |
$26.77
|
| Rate for Payer: VA VA |
$26.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.33
|
|
|
HC RESERVOIR 20 MICRON
|
Facility
|
IP
|
$107.10
|
|
| Hospital Charge Code |
27000039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$69.61 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| 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 |
$80.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| 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 |
$80.33
|
|
|
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 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 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 |
$715.27
|
| 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 |
$715.27
|
| 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 |
$715.27
|
| 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 |
$732.11
|
| 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 |
$715.27
|
| 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 |
$715.27
|
| Rate for Payer: Nomi Health Commercial |
$690.03
|
| Rate for Payer: PHP Commercial |
$715.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.98
|
| Rate for Payer: Priority Health HMO/PPO |
$732.11
|
| 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
|
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 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 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 |
$236.41 |
| 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 |
$236.41
|
| 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 |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.83
|
| Rate for Payer: Meridian Medicaid |
$236.41
|
| 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 |
$225.14
|
| 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 |
$225.14
|
| Rate for Payer: VA VA |
$44.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.81
|
|
|
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 MOTION SIMULATION
|
Facility
|
OP
|
$1,054.61
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$250.47 |
| Max. Negotiated Rate |
$949.15 |
| Rate for Payer: Aetna Commercial |
$896.42
|
| Rate for Payer: Aetna Medicare |
$274.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.57
|
| Rate for Payer: BCBS Complete |
$421.84
|
| Rate for Payer: BCBS MAPPO |
$263.65
|
| Rate for Payer: BCBS Trust/PPO |
$866.99
|
| Rate for Payer: BCN Commercial |
$819.96
|
| Rate for Payer: BCN Medicare Advantage |
$263.65
|
| Rate for Payer: Cash Price |
$843.69
|
| Rate for Payer: Cofinity Commercial |
$906.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$843.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.65
|
| Rate for Payer: Healthscope Commercial |
$949.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$303.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$896.42
|
| Rate for Payer: Nomi Health Commercial |
$864.78
|
| Rate for Payer: PACE Senior Care Partners |
$250.47
|
| Rate for Payer: PACE SWMI |
$263.65
|
| Rate for Payer: PHP Commercial |
$896.42
|
| Rate for Payer: PHP Medicare Advantage |
$263.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$685.50
|
| Rate for Payer: Priority Health HMO/PPO |
$917.51
|
| Rate for Payer: Priority Health Medicare |
$266.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$706.59
|
| Rate for Payer: Railroad Medicare Medicare |
$263.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$928.06
|
| Rate for Payer: UHC Core |
$880.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.65
|
| Rate for Payer: UHC Exchange |
$263.65
|
| Rate for Payer: UHC Medicare Advantage |
$263.65
|
| Rate for Payer: VA VA |
$263.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.96
|
|
|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
IP
|
$1,054.61
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$685.50 |
| Max. Negotiated Rate |
$949.15 |
| Rate for Payer: Aetna Commercial |
$896.42
|
| Rate for Payer: BCBS Trust/PPO |
$860.88
|
| Rate for Payer: BCN Commercial |
$815.00
|
| Rate for Payer: Cash Price |
$843.69
|
| Rate for Payer: Cofinity Commercial |
$906.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$843.69
|
| Rate for Payer: Healthscope Commercial |
$949.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$896.42
|
| Rate for Payer: Nomi Health Commercial |
$864.78
|
| Rate for Payer: PHP Commercial |
$896.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$685.50
|
| Rate for Payer: Priority Health HMO/PPO |
$917.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$706.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$928.06
|
| Rate for Payer: UHC Core |
$880.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.96
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
IP
|
$101.59
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$66.03 |
| Max. Negotiated Rate |
$91.43 |
| Rate for Payer: Aetna Commercial |
$86.35
|
| Rate for Payer: BCBS Trust/PPO |
$82.93
|
| Rate for Payer: BCN Commercial |
$78.51
|
| Rate for Payer: Cash Price |
$81.27
|
| Rate for Payer: Cofinity Commercial |
$87.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.27
|
| Rate for Payer: Healthscope Commercial |
$91.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.35
|
| Rate for Payer: Nomi Health Commercial |
$83.30
|
| Rate for Payer: PHP Commercial |
$86.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.03
|
| Rate for Payer: Priority Health HMO/PPO |
$88.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.40
|
| Rate for Payer: UHC Core |
$84.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.19
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
OP
|
$101.59
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.47 |
| Max. Negotiated Rate |
$91.43 |
| Rate for Payer: Aetna Commercial |
$86.35
|
| Rate for Payer: Aetna Medicare |
$26.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.75
|
| Rate for Payer: BCBS Complete |
$9.95
|
| Rate for Payer: BCBS MAPPO |
$25.40
|
| Rate for Payer: BCBS Trust/PPO |
$83.52
|
| Rate for Payer: BCN Commercial |
$78.99
|
| Rate for Payer: BCN Medicare Advantage |
$25.40
|
| Rate for Payer: Cash Price |
$81.27
|
| Rate for Payer: Cash Price |
$81.27
|
| Rate for Payer: Cofinity Commercial |
$87.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.40
|
| Rate for Payer: Healthscope Commercial |
$91.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.19
|
| Rate for Payer: Mclaren Medicaid |
$9.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.67
|
| Rate for Payer: Meridian Medicaid |
$9.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.35
|
| Rate for Payer: Nomi Health Commercial |
$83.30
|
| Rate for Payer: PACE Senior Care Partners |
$24.13
|
| Rate for Payer: PACE SWMI |
$25.40
|
| Rate for Payer: PHP Commercial |
$86.35
|
| Rate for Payer: PHP Medicare Advantage |
$25.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.03
|
| Rate for Payer: Priority Health HMO/PPO |
$88.38
|
| Rate for Payer: Priority Health Medicare |
$25.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.07
|
| Rate for Payer: Railroad Medicare Medicare |
$25.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.40
|
| Rate for Payer: UHC Core |
$84.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.40
|
| Rate for Payer: UHC Exchange |
$25.40
|
| Rate for Payer: UHC Medicare Advantage |
$25.40
|
| Rate for Payer: UHCCP Medicaid |
$9.47
|
| Rate for Payer: VA VA |
$25.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.19
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
OP
|
$73.24
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.70 |
| Max. Negotiated Rate |
$65.92 |
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: Aetna Medicare |
$19.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.89
|
| Rate for Payer: BCBS Complete |
$10.19
|
| Rate for Payer: BCBS MAPPO |
$18.31
|
| Rate for Payer: BCBS Trust/PPO |
$60.21
|
| Rate for Payer: BCN Commercial |
$56.94
|
| Rate for Payer: BCN Medicare Advantage |
$18.31
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cofinity Commercial |
$62.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$65.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.93
|
| Rate for Payer: Mclaren Medicaid |
$9.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.23
|
| Rate for Payer: Meridian Medicaid |
$10.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Nomi Health Commercial |
$60.06
|
| Rate for Payer: PACE Senior Care Partners |
$17.39
|
| Rate for Payer: PACE SWMI |
$18.31
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: PHP Medicare Advantage |
$18.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.61
|
| Rate for Payer: Priority Health HMO/PPO |
$63.72
|
| Rate for Payer: Priority Health Medicare |
$18.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.07
|
| Rate for Payer: Railroad Medicare Medicare |
$18.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.45
|
| Rate for Payer: UHC Core |
$61.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.31
|
| Rate for Payer: UHC Exchange |
$18.31
|
| Rate for Payer: UHC Medicare Advantage |
$18.31
|
| Rate for Payer: UHCCP Medicaid |
$9.70
|
| Rate for Payer: VA VA |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.93
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
IP
|
$73.24
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.61 |
| Max. Negotiated Rate |
$65.92 |
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: BCBS Trust/PPO |
$59.79
|
| Rate for Payer: BCN Commercial |
$56.60
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cofinity Commercial |
$62.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.59
|
| Rate for Payer: Healthscope Commercial |
$65.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Nomi Health Commercial |
$60.06
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.61
|
| Rate for Payer: Priority Health HMO/PPO |
$63.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.45
|
| Rate for Payer: UHC Core |
$61.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.93
|
|
|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
IP
|
$70.38
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$63.34 |
| Rate for Payer: Aetna Commercial |
$59.82
|
| Rate for Payer: BCBS Trust/PPO |
$57.45
|
| Rate for Payer: BCN Commercial |
$54.39
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$60.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Healthscope Commercial |
$63.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: Nomi Health Commercial |
$57.71
|
| Rate for Payer: PHP Commercial |
$59.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health HMO/PPO |
$61.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.93
|
| Rate for Payer: UHC Core |
$58.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.78
|
|
|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
OP
|
$70.38
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.66 |
| Max. Negotiated Rate |
$63.34 |
| Rate for Payer: Aetna Commercial |
$59.82
|
| Rate for Payer: Aetna Medicare |
$18.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.99
|
| Rate for Payer: BCBS Complete |
$9.10
|
| Rate for Payer: BCBS MAPPO |
$17.59
|
| Rate for Payer: BCBS Trust/PPO |
$57.86
|
| Rate for Payer: BCN Commercial |
$54.72
|
| Rate for Payer: BCN Medicare Advantage |
$17.59
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$60.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.59
|
| Rate for Payer: Healthscope Commercial |
$63.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.78
|
| Rate for Payer: Mclaren Medicaid |
$8.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.47
|
| Rate for Payer: Meridian Medicaid |
$9.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: Nomi Health Commercial |
$57.71
|
| Rate for Payer: PACE Senior Care Partners |
$16.72
|
| Rate for Payer: PACE SWMI |
$17.59
|
| Rate for Payer: PHP Commercial |
$59.82
|
| Rate for Payer: PHP Medicare Advantage |
$17.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health HMO/PPO |
$61.23
|
| Rate for Payer: Priority Health Medicare |
$17.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.15
|
| Rate for Payer: Railroad Medicare Medicare |
$17.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.93
|
| Rate for Payer: UHC Core |
$58.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.59
|
| Rate for Payer: UHC Exchange |
$17.59
|
| Rate for Payer: UHC Medicare Advantage |
$17.59
|
| Rate for Payer: UHCCP Medicaid |
$8.66
|
| Rate for Payer: VA VA |
$17.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.78
|
|
|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
OP
|
$5,030.37
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$520.47 |
| Max. Negotiated Rate |
$4,527.33 |
| Rate for Payer: Aetna Commercial |
$4,275.81
|
| Rate for Payer: Aetna Medicare |
$1,307.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,571.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,571.99
|
| Rate for Payer: BCBS Complete |
$546.53
|
| Rate for Payer: BCBS MAPPO |
$1,257.59
|
| Rate for Payer: BCBS Trust/PPO |
$4,135.47
|
| Rate for Payer: BCN Commercial |
$3,911.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,257.59
|
| Rate for Payer: Cash Price |
$4,024.30
|
| Rate for Payer: Cash Price |
$4,024.30
|
| Rate for Payer: Cofinity Commercial |
$4,326.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,024.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,257.59
|
| Rate for Payer: Healthscope Commercial |
$4,527.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,772.78
|
| Rate for Payer: Mclaren Medicaid |
$520.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,320.47
|
| Rate for Payer: Meridian Medicaid |
$546.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,446.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,275.81
|
| Rate for Payer: Nomi Health Commercial |
$4,124.90
|
| Rate for Payer: PACE Senior Care Partners |
$1,194.71
|
| Rate for Payer: PACE SWMI |
$1,257.59
|
| Rate for Payer: PHP Commercial |
$4,275.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,257.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$520.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,269.74
|
| Rate for Payer: Priority Health HMO/PPO |
$4,376.42
|
| Rate for Payer: Priority Health Medicare |
$1,270.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,370.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,257.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,426.73
|
| Rate for Payer: UHC Core |
$4,200.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,257.59
|
| Rate for Payer: UHC Exchange |
$1,257.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,257.59
|
| Rate for Payer: UHCCP Medicaid |
$520.47
|
| Rate for Payer: VA VA |
$1,257.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,772.78
|
|
