|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
IP
|
$5,030.37
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3,269.74 |
| Max. Negotiated Rate |
$4,527.33 |
| Rate for Payer: Aetna Commercial |
$4,275.81
|
| Rate for Payer: BCBS Trust/PPO |
$4,106.29
|
| Rate for Payer: BCN Commercial |
$3,887.47
|
| 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: Healthscope Commercial |
$4,527.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,772.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,275.81
|
| Rate for Payer: Nomi Health Commercial |
$4,124.90
|
| Rate for Payer: PHP Commercial |
$4,275.81
|
| 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 Narrow/Tiered Network |
$3,370.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,426.73
|
| Rate for Payer: UHC Core |
$4,200.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,772.78
|
|
|
HC RESP SYNCYTIAL VIRUS W/OPTIC
|
Facility
|
OP
|
$22.44
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30000172
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: Aetna Medicare |
$5.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.01
|
| Rate for Payer: BCBS Complete |
$9.95
|
| Rate for Payer: BCBS MAPPO |
$5.61
|
| Rate for Payer: BCBS Trust/PPO |
$18.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.61
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.61
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Mclaren Medicaid |
$9.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.89
|
| Rate for Payer: Meridian Medicaid |
$9.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.07
|
| Rate for Payer: Nomi Health Commercial |
$18.40
|
| Rate for Payer: PACE Senior Care Partners |
$5.33
|
| Rate for Payer: PACE SWMI |
$5.61
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: PHP Medicare Advantage |
$5.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.59
|
| Rate for Payer: Priority Health HMO/PPO |
$19.52
|
| Rate for Payer: Priority Health Medicare |
$5.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.03
|
| Rate for Payer: Railroad Medicare Medicare |
$5.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.75
|
| Rate for Payer: UHC Core |
$18.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.61
|
| Rate for Payer: UHC Exchange |
$5.61
|
| Rate for Payer: UHC Medicare Advantage |
$5.61
|
| Rate for Payer: UHCCP Medicaid |
$9.47
|
| Rate for Payer: VA VA |
$5.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC RESP SYNCYTIAL VIRUS W/OPTIC
|
Facility
|
IP
|
$22.44
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30000172
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.59 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: BCBS Trust/PPO |
$18.32
|
| Rate for Payer: BCN Commercial |
$17.34
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.07
|
| Rate for Payer: Nomi Health Commercial |
$18.40
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.59
|
| Rate for Payer: Priority Health HMO/PPO |
$19.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.75
|
| Rate for Payer: UHC Core |
$18.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC RESP VIRAL PANEL BORDETELLA
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600189
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.82 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.51
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$48.53
|
| Rate for Payer: BCN Medicare Advantage |
$15.61
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.61
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.82
|
| Rate for Payer: PACE SWMI |
$15.61
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: Railroad Medicare Medicare |
$15.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.61
|
| Rate for Payer: UHC Exchange |
$15.61
|
| Rate for Payer: UHC Medicare Advantage |
$15.61
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$15.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC RESP VIRAL PANEL BORDETELLA
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600189
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$50.95
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC RESP VIRAL PANEL CHLAMYDIA
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
30600186
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$50.95
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC RESP VIRAL PANEL CHLAMYDIA
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
30600186
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.82 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.51
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$48.53
|
| Rate for Payer: BCN Medicare Advantage |
$15.61
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.61
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.82
|
| Rate for Payer: PACE SWMI |
$15.61
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: Railroad Medicare Medicare |
$15.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.61
|
| Rate for Payer: UHC Exchange |
$15.61
|
| Rate for Payer: UHC Medicare Advantage |
$15.61
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$15.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC RESP VIRAL PANEL MYCOPLASMA
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$50.95
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC RESP VIRAL PANEL MYCOPLASMA
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.82 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.51
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$48.53
|
| Rate for Payer: BCN Medicare Advantage |
$15.61
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.61
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.82
|
| Rate for Payer: PACE SWMI |
$15.61
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: Railroad Medicare Medicare |
$15.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.61
|
| Rate for Payer: UHC Exchange |
$15.61
|
| Rate for Payer: UHC Medicare Advantage |
$15.61
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$15.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC RESP VIRAL PANEL RP2.1
|
Facility
|
IP
|
$624.24
|
|
|
Service Code
|
HCPCS 0202U
|
| Hospital Charge Code |
30000162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$405.76 |
| Max. Negotiated Rate |
$561.82 |
| Rate for Payer: Aetna Commercial |
$530.60
|
| Rate for Payer: BCBS Trust/PPO |
$509.57
|
| Rate for Payer: BCN Commercial |
$482.41
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cofinity Commercial |
$536.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.39
|
| Rate for Payer: Healthscope Commercial |
$561.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.60
|
| Rate for Payer: Nomi Health Commercial |
$511.88
|
| Rate for Payer: PHP Commercial |
$530.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$405.76
|
| Rate for Payer: Priority Health HMO/PPO |
$543.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$418.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.33
|
| Rate for Payer: UHC Core |
$521.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.18
|
|
|
HC RESP VIRAL PANEL RP2.1
|
Facility
|
OP
|
$624.24
|
|
|
Service Code
|
HCPCS 0202U
|
| Hospital Charge Code |
30000162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$148.26 |
| Max. Negotiated Rate |
$561.82 |
| Rate for Payer: Aetna Commercial |
$530.60
|
| Rate for Payer: Aetna Medicare |
$162.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.07
|
| Rate for Payer: BCBS Complete |
$316.42
|
| Rate for Payer: BCBS MAPPO |
$156.06
|
| Rate for Payer: BCBS Trust/PPO |
$513.19
|
| Rate for Payer: BCN Commercial |
$485.35
|
| Rate for Payer: BCN Medicare Advantage |
$156.06
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cofinity Commercial |
$536.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.06
|
| Rate for Payer: Healthscope Commercial |
$561.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.18
|
| Rate for Payer: Mclaren Medicaid |
$301.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.86
|
| Rate for Payer: Meridian Medicaid |
$316.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.60
|
| Rate for Payer: Nomi Health Commercial |
$511.88
|
| Rate for Payer: PACE Senior Care Partners |
$148.26
|
| Rate for Payer: PACE SWMI |
$156.06
|
| Rate for Payer: PHP Commercial |
$530.60
|
| Rate for Payer: PHP Medicare Advantage |
$156.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$301.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$405.76
|
| Rate for Payer: Priority Health HMO/PPO |
$543.09
|
| Rate for Payer: Priority Health Medicare |
$157.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$418.24
|
| Rate for Payer: Railroad Medicare Medicare |
$156.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.33
|
| Rate for Payer: UHC Core |
$521.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.06
|
| Rate for Payer: UHC Exchange |
$156.06
|
| Rate for Payer: UHC Medicare Advantage |
$156.06
|
| Rate for Payer: UHCCP Medicaid |
$301.33
|
| Rate for Payer: VA VA |
$156.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.18
|
|
|
HC RESTORE HYDROGEL 3 OZ
|
Facility
|
IP
|
$18.85
|
|
| Hospital Charge Code |
27100015
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$12.25 |
| Max. Negotiated Rate |
$16.96 |
| Rate for Payer: Aetna Commercial |
$16.02
|
| Rate for Payer: BCBS Trust/PPO |
$15.39
|
| Rate for Payer: BCN Commercial |
$14.57
|
| Rate for Payer: Cash Price |
$15.08
|
| Rate for Payer: Cofinity Commercial |
$16.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$16.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.02
|
| Rate for Payer: Nomi Health Commercial |
$15.46
|
| Rate for Payer: PHP Commercial |
$16.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.25
|
| Rate for Payer: Priority Health HMO/PPO |
$16.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.59
|
| Rate for Payer: UHC Core |
$15.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.14
|
|
|
HC RESTORE HYDROGEL 3 OZ
|
Facility
|
OP
|
$18.85
|
|
| Hospital Charge Code |
27100015
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.48 |
| Max. Negotiated Rate |
$16.96 |
| Rate for Payer: Aetna Commercial |
$16.02
|
| Rate for Payer: Aetna Medicare |
$4.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.89
|
| Rate for Payer: BCBS Complete |
$7.54
|
| Rate for Payer: BCBS MAPPO |
$4.71
|
| Rate for Payer: BCBS Trust/PPO |
$15.50
|
| Rate for Payer: BCN Commercial |
$14.66
|
| Rate for Payer: BCN Medicare Advantage |
$4.71
|
| Rate for Payer: Cash Price |
$15.08
|
| Rate for Payer: Cofinity Commercial |
$16.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.71
|
| Rate for Payer: Healthscope Commercial |
$16.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.02
|
| Rate for Payer: Nomi Health Commercial |
$15.46
|
| Rate for Payer: PACE Senior Care Partners |
$4.48
|
| Rate for Payer: PACE SWMI |
$4.71
|
| Rate for Payer: PHP Commercial |
$16.02
|
| Rate for Payer: PHP Medicare Advantage |
$4.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.25
|
| Rate for Payer: Priority Health HMO/PPO |
$16.40
|
| Rate for Payer: Priority Health Medicare |
$4.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.63
|
| Rate for Payer: Railroad Medicare Medicare |
$4.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.59
|
| Rate for Payer: UHC Core |
$15.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.71
|
| Rate for Payer: UHC Exchange |
$4.71
|
| Rate for Payer: UHC Medicare Advantage |
$4.71
|
| Rate for Payer: VA VA |
$4.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.14
|
|
|
HC RESUPERF WND BODY <2.5 CM
|
Facility
|
IP
|
$275.71
|
|
|
Service Code
|
CPT 12001
|
| Hospital Charge Code |
76100181
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$179.21 |
| Max. Negotiated Rate |
$248.14 |
| Rate for Payer: Aetna Commercial |
$234.35
|
| Rate for Payer: BCBS Trust/PPO |
$225.06
|
| Rate for Payer: BCN Commercial |
$213.07
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cofinity Commercial |
$237.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.57
|
| Rate for Payer: Healthscope Commercial |
$248.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.35
|
| Rate for Payer: Nomi Health Commercial |
$226.08
|
| Rate for Payer: PHP Commercial |
$234.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.21
|
| Rate for Payer: Priority Health HMO/PPO |
$239.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.62
|
| Rate for Payer: UHC Core |
$230.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.78
|
|
|
HC RESUPERF WND BODY <2.5 CM
|
Facility
|
OP
|
$275.71
|
|
|
Service Code
|
CPT 12001
|
| Hospital Charge Code |
76100181
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.48 |
| Max. Negotiated Rate |
$248.14 |
| Rate for Payer: Aetna Commercial |
$234.35
|
| Rate for Payer: Aetna Medicare |
$71.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.16
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$68.93
|
| Rate for Payer: BCBS Trust/PPO |
$226.66
|
| Rate for Payer: BCN Commercial |
$214.36
|
| Rate for Payer: BCN Medicare Advantage |
$68.93
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cofinity Commercial |
$237.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.93
|
| Rate for Payer: Healthscope Commercial |
$248.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.78
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.37
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.35
|
| Rate for Payer: Nomi Health Commercial |
$226.08
|
| Rate for Payer: PACE Senior Care Partners |
$65.48
|
| Rate for Payer: PACE SWMI |
$68.93
|
| Rate for Payer: PHP Commercial |
$234.35
|
| Rate for Payer: PHP Medicare Advantage |
$68.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.21
|
| Rate for Payer: Priority Health HMO/PPO |
$239.87
|
| Rate for Payer: Priority Health Medicare |
$69.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.73
|
| Rate for Payer: Railroad Medicare Medicare |
$68.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.62
|
| Rate for Payer: UHC Core |
$230.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.93
|
| Rate for Payer: UHC Exchange |
$68.93
|
| Rate for Payer: UHC Medicare Advantage |
$68.93
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$68.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.78
|
|
|
HC RETICULOCYTE COUNT
|
Facility
|
OP
|
$41.51
|
|
|
Service Code
|
CPT 85046
|
| Hospital Charge Code |
30500010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.03 |
| Max. Negotiated Rate |
$37.36 |
| Rate for Payer: Aetna Commercial |
$35.28
|
| Rate for Payer: Aetna Medicare |
$10.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.97
|
| Rate for Payer: BCBS Complete |
$4.23
|
| Rate for Payer: BCBS MAPPO |
$10.38
|
| Rate for Payer: BCBS Trust/PPO |
$34.13
|
| Rate for Payer: BCN Commercial |
$32.27
|
| Rate for Payer: BCN Medicare Advantage |
$10.38
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.38
|
| Rate for Payer: Healthscope Commercial |
$37.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.13
|
| Rate for Payer: Mclaren Medicaid |
$4.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.90
|
| Rate for Payer: Meridian Medicaid |
$4.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.28
|
| Rate for Payer: Nomi Health Commercial |
$34.04
|
| Rate for Payer: PACE Senior Care Partners |
$9.86
|
| Rate for Payer: PACE SWMI |
$10.38
|
| Rate for Payer: PHP Commercial |
$35.28
|
| Rate for Payer: PHP Medicare Advantage |
$10.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.98
|
| Rate for Payer: Priority Health HMO/PPO |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$10.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.81
|
| Rate for Payer: Railroad Medicare Medicare |
$10.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.53
|
| Rate for Payer: UHC Core |
$34.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.38
|
| Rate for Payer: UHC Exchange |
$10.38
|
| Rate for Payer: UHC Medicare Advantage |
$10.38
|
| Rate for Payer: UHCCP Medicaid |
$4.03
|
| Rate for Payer: VA VA |
$10.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.13
|
|
|
HC RETICULOCYTE COUNT
|
Facility
|
IP
|
$41.51
|
|
|
Service Code
|
CPT 85046
|
| Hospital Charge Code |
30500010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$26.98 |
| Max. Negotiated Rate |
$37.36 |
| Rate for Payer: Aetna Commercial |
$35.28
|
| Rate for Payer: BCBS Trust/PPO |
$33.88
|
| Rate for Payer: BCN Commercial |
$32.08
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.21
|
| Rate for Payer: Healthscope Commercial |
$37.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.28
|
| Rate for Payer: Nomi Health Commercial |
$34.04
|
| Rate for Payer: PHP Commercial |
$35.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.98
|
| Rate for Payer: Priority Health HMO/PPO |
$36.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.53
|
| Rate for Payer: UHC Core |
$34.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.13
|
|
|
HC REVAS ADD.VESSEL/DES
|
Facility
|
IP
|
$19,352.18
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
48100090
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,578.92 |
| Max. Negotiated Rate |
$17,416.96 |
| Rate for Payer: Aetna Commercial |
$16,449.35
|
| Rate for Payer: BCBS Trust/PPO |
$15,797.18
|
| Rate for Payer: BCN Commercial |
$14,955.36
|
| Rate for Payer: Cash Price |
$15,481.74
|
| Rate for Payer: Cofinity Commercial |
$16,642.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,481.74
|
| Rate for Payer: Healthscope Commercial |
$17,416.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,514.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,449.35
|
| Rate for Payer: Nomi Health Commercial |
$15,868.79
|
| Rate for Payer: PHP Commercial |
$16,449.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,578.92
|
| Rate for Payer: Priority Health HMO/PPO |
$16,836.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,965.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,029.92
|
| Rate for Payer: UHC Core |
$16,159.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,514.14
|
|
|
HC REVAS ADD.VESSEL/DES
|
Facility
|
OP
|
$19,352.18
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
48100090
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,596.14 |
| Max. Negotiated Rate |
$17,416.96 |
| Rate for Payer: Aetna Commercial |
$16,449.35
|
| Rate for Payer: Aetna Medicare |
$5,031.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,047.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,047.56
|
| Rate for Payer: BCBS Complete |
$7,740.87
|
| Rate for Payer: BCBS MAPPO |
$4,838.05
|
| Rate for Payer: BCBS Trust/PPO |
$15,909.43
|
| Rate for Payer: BCN Commercial |
$15,046.32
|
| Rate for Payer: BCN Medicare Advantage |
$4,838.05
|
| Rate for Payer: Cash Price |
$15,481.74
|
| Rate for Payer: Cofinity Commercial |
$16,642.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,481.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,838.05
|
| Rate for Payer: Healthscope Commercial |
$17,416.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,514.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,079.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,563.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,449.35
|
| Rate for Payer: Nomi Health Commercial |
$15,868.79
|
| Rate for Payer: PACE Senior Care Partners |
$4,596.14
|
| Rate for Payer: PACE SWMI |
$4,838.05
|
| Rate for Payer: PHP Commercial |
$16,449.35
|
| Rate for Payer: PHP Medicare Advantage |
$4,838.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,578.92
|
| Rate for Payer: Priority Health HMO/PPO |
$16,836.40
|
| Rate for Payer: Priority Health Medicare |
$4,886.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,965.96
|
| Rate for Payer: Railroad Medicare Medicare |
$4,838.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,029.92
|
| Rate for Payer: UHC Core |
$16,159.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,838.05
|
| Rate for Payer: UHC Exchange |
$4,838.05
|
| Rate for Payer: UHC Medicare Advantage |
$4,838.05
|
| Rate for Payer: VA VA |
$4,838.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,514.14
|
|
|
HC REVAS ADD.VESSEL/STENT
|
Facility
|
IP
|
$19,352.18
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
48100089
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,578.92 |
| Max. Negotiated Rate |
$17,416.96 |
| Rate for Payer: Aetna Commercial |
$16,449.35
|
| Rate for Payer: BCBS Trust/PPO |
$15,797.18
|
| Rate for Payer: BCN Commercial |
$14,955.36
|
| Rate for Payer: Cash Price |
$15,481.74
|
| Rate for Payer: Cofinity Commercial |
$16,642.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,481.74
|
| Rate for Payer: Healthscope Commercial |
$17,416.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,514.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,449.35
|
| Rate for Payer: Nomi Health Commercial |
$15,868.79
|
| Rate for Payer: PHP Commercial |
$16,449.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,578.92
|
| Rate for Payer: Priority Health HMO/PPO |
$16,836.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,965.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,029.92
|
| Rate for Payer: UHC Core |
$16,159.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,514.14
|
|
|
HC REVAS ADD.VESSEL/STENT
|
Facility
|
OP
|
$19,352.18
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
48100089
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,596.14 |
| Max. Negotiated Rate |
$17,416.96 |
| Rate for Payer: Aetna Commercial |
$16,449.35
|
| Rate for Payer: Aetna Medicare |
$5,031.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,047.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,047.56
|
| Rate for Payer: BCBS Complete |
$7,740.87
|
| Rate for Payer: BCBS MAPPO |
$4,838.05
|
| Rate for Payer: BCBS Trust/PPO |
$15,909.43
|
| Rate for Payer: BCN Commercial |
$15,046.32
|
| Rate for Payer: BCN Medicare Advantage |
$4,838.05
|
| Rate for Payer: Cash Price |
$15,481.74
|
| Rate for Payer: Cofinity Commercial |
$16,642.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,481.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,838.05
|
| Rate for Payer: Healthscope Commercial |
$17,416.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,514.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,079.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,563.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,449.35
|
| Rate for Payer: Nomi Health Commercial |
$15,868.79
|
| Rate for Payer: PACE Senior Care Partners |
$4,596.14
|
| Rate for Payer: PACE SWMI |
$4,838.05
|
| Rate for Payer: PHP Commercial |
$16,449.35
|
| Rate for Payer: PHP Medicare Advantage |
$4,838.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,578.92
|
| Rate for Payer: Priority Health HMO/PPO |
$16,836.40
|
| Rate for Payer: Priority Health Medicare |
$4,886.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,965.96
|
| Rate for Payer: Railroad Medicare Medicare |
$4,838.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,029.92
|
| Rate for Payer: UHC Core |
$16,159.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,838.05
|
| Rate for Payer: UHC Exchange |
$4,838.05
|
| Rate for Payer: UHC Medicare Advantage |
$4,838.05
|
| Rate for Payer: VA VA |
$4,838.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,514.14
|
|
|
HC REVAS CABG ADD.BRANCH
|
Facility
|
OP
|
$19,101.90
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
48100082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,536.70 |
| Max. Negotiated Rate |
$17,191.71 |
| Rate for Payer: Aetna Commercial |
$16,236.61
|
| Rate for Payer: Aetna Medicare |
$4,966.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,969.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,969.34
|
| Rate for Payer: BCBS Complete |
$7,640.76
|
| Rate for Payer: BCBS MAPPO |
$4,775.48
|
| Rate for Payer: BCBS Trust/PPO |
$15,703.67
|
| Rate for Payer: BCN Commercial |
$14,851.73
|
| Rate for Payer: BCN Medicare Advantage |
$4,775.48
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cofinity Commercial |
$16,427.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,281.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,775.48
|
| Rate for Payer: Healthscope Commercial |
$17,191.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,326.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,014.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,491.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,236.61
|
| Rate for Payer: Nomi Health Commercial |
$15,663.56
|
| Rate for Payer: PACE Senior Care Partners |
$4,536.70
|
| Rate for Payer: PACE SWMI |
$4,775.48
|
| Rate for Payer: PHP Commercial |
$16,236.61
|
| Rate for Payer: PHP Medicare Advantage |
$4,775.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,416.24
|
| Rate for Payer: Priority Health HMO/PPO |
$16,618.65
|
| Rate for Payer: Priority Health Medicare |
$4,823.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,798.27
|
| Rate for Payer: Railroad Medicare Medicare |
$4,775.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,809.67
|
| Rate for Payer: UHC Core |
$15,950.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,775.48
|
| Rate for Payer: UHC Exchange |
$4,775.48
|
| Rate for Payer: UHC Medicare Advantage |
$4,775.48
|
| Rate for Payer: VA VA |
$4,775.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,326.42
|
|
|
HC REVAS CABG ADD.BRANCH
|
Facility
|
IP
|
$19,101.90
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
48100082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,416.24 |
| Max. Negotiated Rate |
$17,191.71 |
| Rate for Payer: Aetna Commercial |
$16,236.61
|
| Rate for Payer: BCBS Trust/PPO |
$15,592.88
|
| Rate for Payer: BCN Commercial |
$14,761.95
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cofinity Commercial |
$16,427.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,281.52
|
| Rate for Payer: Healthscope Commercial |
$17,191.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,326.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,236.61
|
| Rate for Payer: Nomi Health Commercial |
$15,663.56
|
| Rate for Payer: PHP Commercial |
$16,236.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,416.24
|
| Rate for Payer: Priority Health HMO/PPO |
$16,618.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,798.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,809.67
|
| Rate for Payer: UHC Core |
$15,950.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,326.42
|
|
|
HC REVAS CABG VES/BRANCH
|
Facility
|
IP
|
$29,158.60
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
48100081
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$18,953.09 |
| Max. Negotiated Rate |
$26,242.74 |
| Rate for Payer: Aetna Commercial |
$24,784.81
|
| Rate for Payer: BCBS Trust/PPO |
$23,802.17
|
| Rate for Payer: BCN Commercial |
$22,533.77
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cofinity Commercial |
$25,076.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,326.88
|
| Rate for Payer: Healthscope Commercial |
$26,242.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,868.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,784.81
|
| Rate for Payer: Nomi Health Commercial |
$23,910.05
|
| Rate for Payer: PHP Commercial |
$24,784.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,953.09
|
| Rate for Payer: Priority Health HMO/PPO |
$25,367.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,536.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,659.57
|
| Rate for Payer: UHC Core |
$24,347.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,868.95
|
|
|
HC REVAS CABG VES/BRANCH
|
Facility
|
OP
|
$29,158.60
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
48100081
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,925.17 |
| Max. Negotiated Rate |
$26,242.74 |
| Rate for Payer: Aetna Commercial |
$24,784.81
|
| Rate for Payer: Aetna Medicare |
$7,581.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,112.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,112.06
|
| Rate for Payer: BCBS Complete |
$8,609.76
|
| Rate for Payer: BCBS MAPPO |
$7,289.65
|
| Rate for Payer: BCBS Trust/PPO |
$23,971.29
|
| Rate for Payer: BCN Commercial |
$22,670.81
|
| Rate for Payer: BCN Medicare Advantage |
$7,289.65
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cofinity Commercial |
$25,076.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,326.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,289.65
|
| Rate for Payer: Healthscope Commercial |
$26,242.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,868.95
|
| Rate for Payer: Mclaren Medicaid |
$8,199.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,654.13
|
| Rate for Payer: Meridian Medicaid |
$8,609.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,383.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,784.81
|
| Rate for Payer: Nomi Health Commercial |
$23,910.05
|
| Rate for Payer: PACE Senior Care Partners |
$6,925.17
|
| Rate for Payer: PACE SWMI |
$7,289.65
|
| Rate for Payer: PHP Commercial |
$24,784.81
|
| Rate for Payer: PHP Medicare Advantage |
$7,289.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,199.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,953.09
|
| Rate for Payer: Priority Health HMO/PPO |
$25,367.98
|
| Rate for Payer: Priority Health Medicare |
$7,362.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,536.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7,289.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,659.57
|
| Rate for Payer: UHC Core |
$24,347.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,289.65
|
| Rate for Payer: UHC Exchange |
$7,289.65
|
| Rate for Payer: UHC Medicare Advantage |
$7,289.65
|
| Rate for Payer: UHCCP Medicaid |
$8,199.23
|
| Rate for Payer: VA VA |
$7,289.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,868.95
|
|
