|
HC STRESS TEST W/ ECHO
|
Facility
|
IP
|
$967.23
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200007
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$673.19 |
| Max. Negotiated Rate |
$870.51 |
| Rate for Payer: Aetna Commercial |
$822.15
|
| Rate for Payer: BCBS Trust/PPO |
$798.84
|
| Rate for Payer: BCN Commercial |
$798.84
|
| Rate for Payer: Cash Price |
$773.78
|
| Rate for Payer: Cofinity Commercial |
$831.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.78
|
| Rate for Payer: Healthscope Commercial |
$870.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$822.15
|
| Rate for Payer: Nomi Health Commercial |
$793.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$725.42
|
| Rate for Payer: PHP Commercial |
$822.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$841.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$673.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$851.16
|
| Rate for Payer: UHC Core |
$807.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.42
|
|
|
HC STRIP PASTE
|
Facility
|
OP
|
$4.59
|
|
| Hospital Charge Code |
27000109
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.81 |
| Max. Negotiated Rate |
$4.13 |
| Rate for Payer: Aetna Commercial |
$3.90
|
| Rate for Payer: Aetna Medicare |
$1.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.43
|
| Rate for Payer: BCBS Complete |
$0.85
|
| Rate for Payer: BCBS MAPPO |
$1.15
|
| Rate for Payer: BCBS Trust/PPO |
$3.77
|
| Rate for Payer: BCN Commercial |
$3.77
|
| Rate for Payer: BCN Medicare Advantage |
$1.15
|
| Rate for Payer: Cash Price |
$3.67
|
| Rate for Payer: Cofinity Commercial |
$3.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.15
|
| Rate for Payer: Healthscope Commercial |
$4.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.44
|
| Rate for Payer: Mclaren Medicaid |
$0.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.20
|
| Rate for Payer: Meridian Medicaid |
$0.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.90
|
| Rate for Payer: Nomi Health Commercial |
$3.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.44
|
| Rate for Payer: PACE Senior Care Partners |
$1.09
|
| Rate for Payer: PACE SWMI |
$1.15
|
| Rate for Payer: PHP Commercial |
$3.90
|
| Rate for Payer: PHP Medicare Advantage |
$1.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.99
|
| Rate for Payer: Priority Health Medicare |
$1.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.19
|
| Rate for Payer: Railroad Medicare Medicare |
$1.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.04
|
| Rate for Payer: UHC Core |
$3.83
|
| Rate for Payer: UHC Exchange |
$1.15
|
| Rate for Payer: UHC Medicaid |
$0.81
|
| Rate for Payer: UHC Medicare Advantage |
$1.15
|
| Rate for Payer: UHCCP Medicaid |
$0.81
|
| Rate for Payer: VA VA |
$1.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.44
|
|
|
HC STRIP PASTE
|
Facility
|
IP
|
$4.59
|
|
| Hospital Charge Code |
27000109
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.19 |
| Max. Negotiated Rate |
$4.13 |
| Rate for Payer: Aetna Commercial |
$3.90
|
| Rate for Payer: BCBS Trust/PPO |
$3.79
|
| Rate for Payer: BCN Commercial |
$3.79
|
| Rate for Payer: Cash Price |
$3.67
|
| Rate for Payer: Cofinity Commercial |
$3.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.67
|
| Rate for Payer: Healthscope Commercial |
$4.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.90
|
| Rate for Payer: Nomi Health Commercial |
$3.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.44
|
| Rate for Payer: PHP Commercial |
$3.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.04
|
| Rate for Payer: UHC Core |
$3.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.44
|
|
|
HC STRONGYLOIDES ANTIBODY, IGG, SERUM
|
Facility
|
IP
|
$89.06
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200490
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$61.99 |
| Max. Negotiated Rate |
$80.15 |
| Rate for Payer: Aetna Commercial |
$75.70
|
| Rate for Payer: BCBS Trust/PPO |
$73.55
|
| Rate for Payer: BCN Commercial |
$73.55
|
| Rate for Payer: Cash Price |
$71.25
|
| Rate for Payer: Cofinity Commercial |
$76.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.25
|
| Rate for Payer: Healthscope Commercial |
$80.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.70
|
| Rate for Payer: Nomi Health Commercial |
$73.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.80
|
| Rate for Payer: PHP Commercial |
$75.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.37
|
| Rate for Payer: UHC Core |
$74.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.80
|
|
|
HC STRONGYLOIDES ANTIBODY, IGG, SERUM
|
Facility
|
OP
|
$89.06
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200490
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.70 |
| Max. Negotiated Rate |
$80.15 |
| Rate for Payer: Aetna Commercial |
$75.70
|
| Rate for Payer: Aetna Medicare |
$23.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.83
|
| Rate for Payer: BCBS Complete |
$16.49
|
| Rate for Payer: BCBS MAPPO |
$22.27
|
| Rate for Payer: BCBS Trust/PPO |
$73.22
|
| Rate for Payer: BCN Commercial |
$73.22
|
| Rate for Payer: BCN Medicare Advantage |
$22.27
|
| Rate for Payer: Cash Price |
$71.25
|
| Rate for Payer: Cofinity Commercial |
$76.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.27
|
| Rate for Payer: Healthscope Commercial |
$80.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.80
|
| Rate for Payer: Mclaren Medicaid |
$15.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.38
|
| Rate for Payer: Meridian Medicaid |
$16.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.70
|
| Rate for Payer: Nomi Health Commercial |
$73.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.80
|
| Rate for Payer: PACE Senior Care Partners |
$21.15
|
| Rate for Payer: PACE SWMI |
$22.27
|
| Rate for Payer: PHP Commercial |
$75.70
|
| Rate for Payer: PHP Medicare Advantage |
$22.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.48
|
| Rate for Payer: Priority Health Medicare |
$22.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.99
|
| Rate for Payer: Railroad Medicare Medicare |
$22.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.37
|
| Rate for Payer: UHC Core |
$74.37
|
| Rate for Payer: UHC Exchange |
$22.27
|
| Rate for Payer: UHC Medicaid |
$15.70
|
| Rate for Payer: UHC Medicare Advantage |
$22.27
|
| Rate for Payer: UHCCP Medicaid |
$15.70
|
| Rate for Payer: VA VA |
$22.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.80
|
|
|
HC STUDY INSERT NON TUNNELED CENTRAL LINE > 5 YRS
|
Facility
|
OP
|
$39.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100588
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6.88 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Aetna Commercial |
$33.15
|
| Rate for Payer: Aetna Medicare |
$10.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.19
|
| Rate for Payer: BCBS Complete |
$7.22
|
| Rate for Payer: BCBS MAPPO |
$9.75
|
| Rate for Payer: BCBS Trust/PPO |
$32.06
|
| Rate for Payer: BCN Commercial |
$32.06
|
| Rate for Payer: BCN Medicare Advantage |
$9.75
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$33.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.75
|
| Rate for Payer: Healthscope Commercial |
$35.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.25
|
| Rate for Payer: Mclaren Medicaid |
$6.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.24
|
| Rate for Payer: Meridian Medicaid |
$7.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Nomi Health Commercial |
$31.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.25
|
| Rate for Payer: PACE Senior Care Partners |
$9.26
|
| Rate for Payer: PACE SWMI |
$9.75
|
| Rate for Payer: PHP Commercial |
$33.15
|
| Rate for Payer: PHP Medicare Advantage |
$9.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.93
|
| Rate for Payer: Priority Health Medicare |
$9.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.14
|
| Rate for Payer: Railroad Medicare Medicare |
$9.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.32
|
| Rate for Payer: UHC Core |
$32.56
|
| Rate for Payer: UHC Exchange |
$9.75
|
| Rate for Payer: UHC Medicaid |
$6.88
|
| Rate for Payer: UHC Medicare Advantage |
$9.75
|
| Rate for Payer: UHCCP Medicaid |
$6.88
|
| Rate for Payer: VA VA |
$9.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.25
|
|
|
HC STUDY INSERT NON TUNNELED CENTRAL LINE > 5 YRS
|
Facility
|
IP
|
$39.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100588
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$27.14 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Aetna Commercial |
$33.15
|
| Rate for Payer: BCBS Trust/PPO |
$32.21
|
| Rate for Payer: BCN Commercial |
$32.21
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$33.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.20
|
| Rate for Payer: Healthscope Commercial |
$35.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Nomi Health Commercial |
$31.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.25
|
| Rate for Payer: PHP Commercial |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.32
|
| Rate for Payer: UHC Core |
$32.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.25
|
|
|
HC SUBCLASS IGG4, SERUM
|
Facility
|
OP
|
$135.25
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100720
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.84 |
| Max. Negotiated Rate |
$121.72 |
| Rate for Payer: Aetna Commercial |
$114.96
|
| Rate for Payer: Aetna Medicare |
$35.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.27
|
| Rate for Payer: BCBS Complete |
$25.03
|
| Rate for Payer: BCBS MAPPO |
$33.81
|
| Rate for Payer: BCBS Trust/PPO |
$111.19
|
| Rate for Payer: BCN Commercial |
$111.19
|
| Rate for Payer: BCN Medicare Advantage |
$33.81
|
| Rate for Payer: Cash Price |
$108.20
|
| Rate for Payer: Cofinity Commercial |
$116.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.81
|
| Rate for Payer: Healthscope Commercial |
$121.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.44
|
| Rate for Payer: Mclaren Medicaid |
$23.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.50
|
| Rate for Payer: Meridian Medicaid |
$25.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.96
|
| Rate for Payer: Nomi Health Commercial |
$110.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.44
|
| Rate for Payer: PACE Senior Care Partners |
$32.12
|
| Rate for Payer: PACE SWMI |
$33.81
|
| Rate for Payer: PHP Commercial |
$114.96
|
| Rate for Payer: PHP Medicare Advantage |
$33.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$117.67
|
| Rate for Payer: Priority Health Medicare |
$34.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.13
|
| Rate for Payer: Railroad Medicare Medicare |
$33.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.02
|
| Rate for Payer: UHC Core |
$112.93
|
| Rate for Payer: UHC Exchange |
$33.81
|
| Rate for Payer: UHC Medicaid |
$23.84
|
| Rate for Payer: UHC Medicare Advantage |
$33.81
|
| Rate for Payer: UHCCP Medicaid |
$23.84
|
| Rate for Payer: VA VA |
$33.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.44
|
|
|
HC SUBCLASS IGG4, SERUM
|
Facility
|
IP
|
$135.25
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100720
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$94.13 |
| Max. Negotiated Rate |
$121.72 |
| Rate for Payer: Aetna Commercial |
$114.96
|
| Rate for Payer: BCBS Trust/PPO |
$111.70
|
| Rate for Payer: BCN Commercial |
$111.70
|
| Rate for Payer: Cash Price |
$108.20
|
| Rate for Payer: Cofinity Commercial |
$116.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.20
|
| Rate for Payer: Healthscope Commercial |
$121.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.96
|
| Rate for Payer: Nomi Health Commercial |
$110.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.44
|
| Rate for Payer: PHP Commercial |
$114.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$117.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.02
|
| Rate for Payer: UHC Core |
$112.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.44
|
|
|
HC SUBCUTANEOUS INF EA ADDL HR
|
Facility
|
IP
|
$135.66
|
|
|
Service Code
|
CPT 96370
|
| Hospital Charge Code |
26000014
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$94.42 |
| Max. Negotiated Rate |
$122.09 |
| Rate for Payer: Aetna Commercial |
$115.31
|
| Rate for Payer: BCBS Trust/PPO |
$112.04
|
| Rate for Payer: BCN Commercial |
$112.04
|
| Rate for Payer: Cash Price |
$108.53
|
| Rate for Payer: Cofinity Commercial |
$116.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.53
|
| Rate for Payer: Healthscope Commercial |
$122.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.31
|
| Rate for Payer: Nomi Health Commercial |
$111.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.75
|
| Rate for Payer: PHP Commercial |
$115.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$118.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.38
|
| Rate for Payer: UHC Core |
$113.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.75
|
|
|
HC SUBCUTANEOUS INF EA ADDL HR
|
Facility
|
OP
|
$135.66
|
|
|
Service Code
|
CPT 96370
|
| Hospital Charge Code |
26000014
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$23.92 |
| Max. Negotiated Rate |
$122.09 |
| Rate for Payer: Aetna Commercial |
$115.31
|
| Rate for Payer: Aetna Medicare |
$35.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.39
|
| Rate for Payer: BCBS Complete |
$25.11
|
| Rate for Payer: BCBS MAPPO |
$33.91
|
| Rate for Payer: BCBS Trust/PPO |
$111.53
|
| Rate for Payer: BCN Commercial |
$111.53
|
| Rate for Payer: BCN Medicare Advantage |
$33.91
|
| Rate for Payer: Cash Price |
$108.53
|
| Rate for Payer: Cofinity Commercial |
$116.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.91
|
| Rate for Payer: Healthscope Commercial |
$122.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.75
|
| Rate for Payer: Mclaren Medicaid |
$23.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.61
|
| Rate for Payer: Meridian Medicaid |
$25.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.31
|
| Rate for Payer: Nomi Health Commercial |
$111.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.75
|
| Rate for Payer: PACE Senior Care Partners |
$32.22
|
| Rate for Payer: PACE SWMI |
$33.91
|
| Rate for Payer: PHP Commercial |
$115.31
|
| Rate for Payer: PHP Medicare Advantage |
$33.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$118.02
|
| Rate for Payer: Priority Health Medicare |
$34.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.42
|
| Rate for Payer: Railroad Medicare Medicare |
$33.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.38
|
| Rate for Payer: UHC Core |
$113.28
|
| Rate for Payer: UHC Exchange |
$33.91
|
| Rate for Payer: UHC Medicaid |
$23.92
|
| Rate for Payer: UHC Medicare Advantage |
$33.91
|
| Rate for Payer: UHCCP Medicaid |
$23.92
|
| Rate for Payer: VA VA |
$33.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.75
|
|
|
HC SUBCUTANEOUS INF INIT HR W/PUMP SET UP
|
Facility
|
OP
|
$751.74
|
|
|
Service Code
|
CPT 96369
|
| Hospital Charge Code |
26000013
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$132.53 |
| Max. Negotiated Rate |
$676.57 |
| Rate for Payer: Aetna Commercial |
$638.98
|
| Rate for Payer: Aetna Medicare |
$195.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$234.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$234.92
|
| Rate for Payer: BCBS Complete |
$139.15
|
| Rate for Payer: BCBS MAPPO |
$187.94
|
| Rate for Payer: BCBS Trust/PPO |
$618.01
|
| Rate for Payer: BCN Commercial |
$618.01
|
| Rate for Payer: BCN Medicare Advantage |
$187.94
|
| Rate for Payer: Cash Price |
$601.39
|
| Rate for Payer: Cofinity Commercial |
$646.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$601.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.94
|
| Rate for Payer: Healthscope Commercial |
$676.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$563.80
|
| Rate for Payer: Mclaren Medicaid |
$132.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.33
|
| Rate for Payer: Meridian Medicaid |
$139.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$216.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$206.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.98
|
| Rate for Payer: Nomi Health Commercial |
$616.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$563.80
|
| Rate for Payer: PACE Senior Care Partners |
$178.54
|
| Rate for Payer: PACE SWMI |
$187.94
|
| Rate for Payer: PHP Commercial |
$638.98
|
| Rate for Payer: PHP Medicare Advantage |
$187.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$132.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$654.01
|
| Rate for Payer: Priority Health Medicare |
$189.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$523.21
|
| Rate for Payer: Railroad Medicare Medicare |
$187.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.53
|
| Rate for Payer: UHC Core |
$627.70
|
| Rate for Payer: UHC Exchange |
$187.94
|
| Rate for Payer: UHC Medicaid |
$132.53
|
| Rate for Payer: UHC Medicare Advantage |
$187.94
|
| Rate for Payer: UHCCP Medicaid |
$132.53
|
| Rate for Payer: VA VA |
$187.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$563.80
|
|
|
HC SUBCUTANEOUS INF INIT HR W/PUMP SET UP
|
Facility
|
IP
|
$751.74
|
|
|
Service Code
|
CPT 96369
|
| Hospital Charge Code |
26000013
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$523.21 |
| Max. Negotiated Rate |
$676.57 |
| Rate for Payer: Aetna Commercial |
$638.98
|
| Rate for Payer: BCBS Trust/PPO |
$620.86
|
| Rate for Payer: BCN Commercial |
$620.86
|
| Rate for Payer: Cash Price |
$601.39
|
| Rate for Payer: Cofinity Commercial |
$646.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$601.39
|
| Rate for Payer: Healthscope Commercial |
$676.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$563.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$638.98
|
| Rate for Payer: Nomi Health Commercial |
$616.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$563.80
|
| Rate for Payer: PHP Commercial |
$638.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$654.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$523.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.53
|
| Rate for Payer: UHC Core |
$627.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$563.80
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL
|
Facility
|
OP
|
$8,271.18
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100377
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,458.21 |
| Max. Negotiated Rate |
$7,444.06 |
| Rate for Payer: Aetna Commercial |
$7,030.50
|
| Rate for Payer: Aetna Medicare |
$2,150.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,584.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,584.74
|
| Rate for Payer: BCBS Complete |
$1,531.00
|
| Rate for Payer: BCBS MAPPO |
$2,067.80
|
| Rate for Payer: BCBS Trust/PPO |
$6,799.74
|
| Rate for Payer: BCN Commercial |
$6,799.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,067.80
|
| Rate for Payer: Cash Price |
$6,616.94
|
| Rate for Payer: Cofinity Commercial |
$7,113.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,616.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,067.80
|
| Rate for Payer: Healthscope Commercial |
$7,444.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,203.39
|
| Rate for Payer: Mclaren Medicaid |
$1,458.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,171.18
|
| Rate for Payer: Meridian Medicaid |
$1,531.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,377.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,274.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,030.50
|
| Rate for Payer: Nomi Health Commercial |
$6,782.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,203.39
|
| Rate for Payer: PACE Senior Care Partners |
$1,964.41
|
| Rate for Payer: PACE SWMI |
$2,067.80
|
| Rate for Payer: PHP Commercial |
$7,030.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,067.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,458.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,195.93
|
| Rate for Payer: Priority Health Medicare |
$2,088.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,756.74
|
| Rate for Payer: Railroad Medicare Medicare |
$2,067.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,278.64
|
| Rate for Payer: UHC Core |
$6,906.44
|
| Rate for Payer: UHC Exchange |
$2,067.80
|
| Rate for Payer: UHC Medicaid |
$1,458.21
|
| Rate for Payer: UHC Medicare Advantage |
$2,067.80
|
| Rate for Payer: UHCCP Medicaid |
$1,458.21
|
| Rate for Payer: VA VA |
$2,067.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,203.39
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL
|
Facility
|
IP
|
$8,271.18
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100377
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,756.74 |
| Max. Negotiated Rate |
$7,444.06 |
| Rate for Payer: Aetna Commercial |
$7,030.50
|
| Rate for Payer: BCBS Trust/PPO |
$6,831.17
|
| Rate for Payer: BCN Commercial |
$6,831.17
|
| Rate for Payer: Cash Price |
$6,616.94
|
| Rate for Payer: Cofinity Commercial |
$7,113.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,616.94
|
| Rate for Payer: Healthscope Commercial |
$7,444.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,203.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,030.50
|
| Rate for Payer: Nomi Health Commercial |
$6,782.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,203.39
|
| Rate for Payer: PHP Commercial |
$7,030.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,195.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,756.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,278.64
|
| Rate for Payer: UHC Core |
$6,906.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,203.39
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL BILAT
|
Facility
|
IP
|
$12,406.77
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100378
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8,635.11 |
| Max. Negotiated Rate |
$11,166.09 |
| Rate for Payer: Aetna Commercial |
$10,545.75
|
| Rate for Payer: BCBS Trust/PPO |
$10,246.75
|
| Rate for Payer: BCN Commercial |
$10,246.75
|
| Rate for Payer: Cash Price |
$9,925.42
|
| Rate for Payer: Cofinity Commercial |
$10,669.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,925.42
|
| Rate for Payer: Healthscope Commercial |
$11,166.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,305.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,545.75
|
| Rate for Payer: Nomi Health Commercial |
$10,173.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,305.08
|
| Rate for Payer: PHP Commercial |
$10,545.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,793.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,635.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,917.96
|
| Rate for Payer: UHC Core |
$10,359.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,305.08
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL BILAT
|
Facility
|
OP
|
$12,406.77
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100378
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,187.31 |
| Max. Negotiated Rate |
$11,166.09 |
| Rate for Payer: Aetna Commercial |
$10,545.75
|
| Rate for Payer: Aetna Medicare |
$3,225.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,877.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,877.12
|
| Rate for Payer: BCBS Complete |
$2,296.49
|
| Rate for Payer: BCBS MAPPO |
$3,101.69
|
| Rate for Payer: BCBS Trust/PPO |
$10,199.61
|
| Rate for Payer: BCN Commercial |
$10,199.61
|
| Rate for Payer: BCN Medicare Advantage |
$3,101.69
|
| Rate for Payer: Cash Price |
$9,925.42
|
| Rate for Payer: Cofinity Commercial |
$10,669.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,925.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,101.69
|
| Rate for Payer: Healthscope Commercial |
$11,166.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,305.08
|
| Rate for Payer: Mclaren Medicaid |
$2,187.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,256.78
|
| Rate for Payer: Meridian Medicaid |
$2,296.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,566.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,411.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,545.75
|
| Rate for Payer: Nomi Health Commercial |
$10,173.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,305.08
|
| Rate for Payer: PACE Senior Care Partners |
$2,946.61
|
| Rate for Payer: PACE SWMI |
$3,101.69
|
| Rate for Payer: PHP Commercial |
$10,545.75
|
| Rate for Payer: PHP Medicare Advantage |
$3,101.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,187.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,793.89
|
| Rate for Payer: Priority Health Medicare |
$3,132.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,635.11
|
| Rate for Payer: Railroad Medicare Medicare |
$3,101.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,917.96
|
| Rate for Payer: UHC Core |
$10,359.65
|
| Rate for Payer: UHC Exchange |
$3,101.69
|
| Rate for Payer: UHC Medicaid |
$2,187.31
|
| Rate for Payer: UHC Medicare Advantage |
$3,101.69
|
| Rate for Payer: UHCCP Medicaid |
$2,187.31
|
| Rate for Payer: VA VA |
$3,101.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,305.08
|
|
|
HC SUCTION A&A LINE
|
Facility
|
IP
|
$32.77
|
|
| Hospital Charge Code |
27000110
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.81 |
| Max. Negotiated Rate |
$29.49 |
| Rate for Payer: Aetna Commercial |
$27.85
|
| Rate for Payer: BCBS Trust/PPO |
$27.06
|
| Rate for Payer: BCN Commercial |
$27.06
|
| Rate for Payer: Cash Price |
$26.22
|
| Rate for Payer: Cofinity Commercial |
$28.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.22
|
| Rate for Payer: Healthscope Commercial |
$29.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.85
|
| Rate for Payer: Nomi Health Commercial |
$26.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.58
|
| Rate for Payer: PHP Commercial |
$27.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.84
|
| Rate for Payer: UHC Core |
$27.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.58
|
|
|
HC SUCTION A&A LINE
|
Facility
|
OP
|
$32.77
|
|
| Hospital Charge Code |
27000110
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.78 |
| Max. Negotiated Rate |
$29.49 |
| Rate for Payer: Aetna Commercial |
$27.85
|
| Rate for Payer: Aetna Medicare |
$8.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.24
|
| Rate for Payer: BCBS Complete |
$6.07
|
| Rate for Payer: BCBS MAPPO |
$8.19
|
| Rate for Payer: BCBS Trust/PPO |
$26.94
|
| Rate for Payer: BCN Commercial |
$26.94
|
| Rate for Payer: BCN Medicare Advantage |
$8.19
|
| Rate for Payer: Cash Price |
$26.22
|
| Rate for Payer: Cofinity Commercial |
$28.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.19
|
| Rate for Payer: Healthscope Commercial |
$29.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.58
|
| Rate for Payer: Mclaren Medicaid |
$5.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.60
|
| Rate for Payer: Meridian Medicaid |
$6.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.85
|
| Rate for Payer: Nomi Health Commercial |
$26.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.58
|
| Rate for Payer: PACE Senior Care Partners |
$7.78
|
| Rate for Payer: PACE SWMI |
$8.19
|
| Rate for Payer: PHP Commercial |
$27.85
|
| Rate for Payer: PHP Medicare Advantage |
$8.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.51
|
| Rate for Payer: Priority Health Medicare |
$8.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.81
|
| Rate for Payer: Railroad Medicare Medicare |
$8.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.84
|
| Rate for Payer: UHC Core |
$27.36
|
| Rate for Payer: UHC Exchange |
$8.19
|
| Rate for Payer: UHC Medicaid |
$5.78
|
| Rate for Payer: UHC Medicare Advantage |
$8.19
|
| Rate for Payer: UHCCP Medicaid |
$5.78
|
| Rate for Payer: VA VA |
$8.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.58
|
|
|
HC SUMP VENTRICULAR LIVANOVA
|
Facility
|
OP
|
$45.26
|
|
| Hospital Charge Code |
27000659
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.98 |
| Max. Negotiated Rate |
$40.73 |
| Rate for Payer: Aetna Commercial |
$38.47
|
| Rate for Payer: Aetna Medicare |
$11.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.14
|
| Rate for Payer: BCBS Complete |
$8.38
|
| Rate for Payer: BCBS MAPPO |
$11.31
|
| Rate for Payer: BCBS Trust/PPO |
$37.21
|
| Rate for Payer: BCN Commercial |
$37.21
|
| Rate for Payer: BCN Medicare Advantage |
$11.31
|
| Rate for Payer: Cash Price |
$36.21
|
| Rate for Payer: Cofinity Commercial |
$38.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.31
|
| Rate for Payer: Healthscope Commercial |
$40.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.95
|
| Rate for Payer: Mclaren Medicaid |
$7.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.88
|
| Rate for Payer: Meridian Medicaid |
$8.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.47
|
| Rate for Payer: Nomi Health Commercial |
$37.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.95
|
| Rate for Payer: PACE Senior Care Partners |
$10.75
|
| Rate for Payer: PACE SWMI |
$11.31
|
| Rate for Payer: PHP Commercial |
$38.47
|
| Rate for Payer: PHP Medicare Advantage |
$11.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.38
|
| Rate for Payer: Priority Health Medicare |
$11.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.50
|
| Rate for Payer: Railroad Medicare Medicare |
$11.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.83
|
| Rate for Payer: UHC Core |
$37.79
|
| Rate for Payer: UHC Exchange |
$11.31
|
| Rate for Payer: UHC Medicaid |
$7.98
|
| Rate for Payer: UHC Medicare Advantage |
$11.31
|
| Rate for Payer: UHCCP Medicaid |
$7.98
|
| Rate for Payer: VA VA |
$11.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.95
|
|
|
HC SUMP VENTRICULAR LIVANOVA
|
Facility
|
IP
|
$45.26
|
|
| Hospital Charge Code |
27000659
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.50 |
| Max. Negotiated Rate |
$40.73 |
| Rate for Payer: Aetna Commercial |
$38.47
|
| Rate for Payer: BCBS Trust/PPO |
$37.38
|
| Rate for Payer: BCN Commercial |
$37.38
|
| Rate for Payer: Cash Price |
$36.21
|
| Rate for Payer: Cofinity Commercial |
$38.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.21
|
| Rate for Payer: Healthscope Commercial |
$40.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.47
|
| Rate for Payer: Nomi Health Commercial |
$37.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.95
|
| Rate for Payer: PHP Commercial |
$38.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$39.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.83
|
| Rate for Payer: UHC Core |
$37.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.95
|
|
|
HC SUMP VENTRICULAR MEDTRONIC
|
Facility
|
IP
|
$43.70
|
|
| Hospital Charge Code |
27000122
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.42 |
| Max. Negotiated Rate |
$39.33 |
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: BCBS Trust/PPO |
$36.09
|
| Rate for Payer: BCN Commercial |
$36.09
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$37.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Healthscope Commercial |
$39.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.77
|
| Rate for Payer: PHP Commercial |
$37.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.46
|
| Rate for Payer: UHC Core |
$36.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.77
|
|
|
HC SUMP VENTRICULAR MEDTRONIC
|
Facility
|
OP
|
$43.70
|
|
| Hospital Charge Code |
27000122
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$39.33 |
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: Aetna Medicare |
$11.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.66
|
| Rate for Payer: BCBS Complete |
$8.09
|
| Rate for Payer: BCBS MAPPO |
$10.93
|
| Rate for Payer: BCBS Trust/PPO |
$35.93
|
| Rate for Payer: BCN Commercial |
$35.93
|
| Rate for Payer: BCN Medicare Advantage |
$10.93
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$37.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.93
|
| Rate for Payer: Healthscope Commercial |
$39.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.77
|
| Rate for Payer: Mclaren Medicaid |
$7.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.47
|
| Rate for Payer: Meridian Medicaid |
$8.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.77
|
| Rate for Payer: PACE Senior Care Partners |
$10.38
|
| Rate for Payer: PACE SWMI |
$10.93
|
| Rate for Payer: PHP Commercial |
$37.15
|
| Rate for Payer: PHP Medicare Advantage |
$10.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.02
|
| Rate for Payer: Priority Health Medicare |
$11.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.42
|
| Rate for Payer: Railroad Medicare Medicare |
$10.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.46
|
| Rate for Payer: UHC Core |
$36.49
|
| Rate for Payer: UHC Exchange |
$10.93
|
| Rate for Payer: UHC Medicaid |
$7.70
|
| Rate for Payer: UHC Medicare Advantage |
$10.93
|
| Rate for Payer: UHCCP Medicaid |
$7.70
|
| Rate for Payer: VA VA |
$10.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.77
|
|
|
HC SUPERVISION & HANDLING
|
Facility
|
OP
|
$160.24
|
|
|
Service Code
|
CPT 77790
|
| Hospital Charge Code |
33300029
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$28.25 |
| Max. Negotiated Rate |
$144.22 |
| Rate for Payer: Aetna Commercial |
$136.20
|
| Rate for Payer: Aetna Medicare |
$41.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.08
|
| Rate for Payer: BCBS Complete |
$29.66
|
| Rate for Payer: BCBS MAPPO |
$40.06
|
| Rate for Payer: BCBS Trust/PPO |
$131.73
|
| Rate for Payer: BCN Commercial |
$131.73
|
| Rate for Payer: BCN Medicare Advantage |
$40.06
|
| Rate for Payer: Cash Price |
$128.19
|
| Rate for Payer: Cofinity Commercial |
$137.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.06
|
| Rate for Payer: Healthscope Commercial |
$144.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.18
|
| Rate for Payer: Mclaren Medicaid |
$28.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.06
|
| Rate for Payer: Meridian Medicaid |
$29.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.20
|
| Rate for Payer: Nomi Health Commercial |
$131.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.18
|
| Rate for Payer: PACE Senior Care Partners |
$38.06
|
| Rate for Payer: PACE SWMI |
$40.06
|
| Rate for Payer: PHP Commercial |
$136.20
|
| Rate for Payer: PHP Medicare Advantage |
$40.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.41
|
| Rate for Payer: Priority Health Medicare |
$40.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.53
|
| Rate for Payer: Railroad Medicare Medicare |
$40.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.01
|
| Rate for Payer: UHC Core |
$133.80
|
| Rate for Payer: UHC Exchange |
$40.06
|
| Rate for Payer: UHC Medicaid |
$28.25
|
| Rate for Payer: UHC Medicare Advantage |
$40.06
|
| Rate for Payer: UHCCP Medicaid |
$28.25
|
| Rate for Payer: VA VA |
$40.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.18
|
|
|
HC SUPERVISION & HANDLING
|
Facility
|
IP
|
$160.24
|
|
|
Service Code
|
CPT 77790
|
| Hospital Charge Code |
33300029
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$111.53 |
| Max. Negotiated Rate |
$144.22 |
| Rate for Payer: Aetna Commercial |
$136.20
|
| Rate for Payer: BCBS Trust/PPO |
$132.34
|
| Rate for Payer: BCN Commercial |
$132.34
|
| Rate for Payer: Cash Price |
$128.19
|
| Rate for Payer: Cofinity Commercial |
$137.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.19
|
| Rate for Payer: Healthscope Commercial |
$144.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.20
|
| Rate for Payer: Nomi Health Commercial |
$131.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.18
|
| Rate for Payer: PHP Commercial |
$136.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.01
|
| Rate for Payer: UHC Core |
$133.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.18
|
|
