|
HC SUPPLEMENTAL NEWBORN SCRN
|
Facility
|
IP
|
$88.43
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
30100686
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.55 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna Commercial |
$75.17
|
| Rate for Payer: BCBS Trust/PPO |
$73.03
|
| Rate for Payer: BCN Commercial |
$73.03
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cofinity Commercial |
$76.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.74
|
| Rate for Payer: Healthscope Commercial |
$79.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Nomi Health Commercial |
$72.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.32
|
| Rate for Payer: PHP Commercial |
$75.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$76.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.82
|
| Rate for Payer: UHC Core |
$73.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.32
|
|
|
HC SUPPLEMENTAL NEWBORN SCRN
|
Facility
|
OP
|
$88.43
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
30100686
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.59 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna Commercial |
$75.17
|
| Rate for Payer: Aetna Medicare |
$22.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.63
|
| Rate for Payer: BCBS Complete |
$16.37
|
| Rate for Payer: BCBS MAPPO |
$22.11
|
| Rate for Payer: BCBS Trust/PPO |
$72.70
|
| Rate for Payer: BCN Commercial |
$72.70
|
| Rate for Payer: BCN Medicare Advantage |
$22.11
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cofinity Commercial |
$76.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.11
|
| Rate for Payer: Healthscope Commercial |
$79.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.32
|
| Rate for Payer: Mclaren Medicaid |
$15.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.21
|
| Rate for Payer: Meridian Medicaid |
$16.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Nomi Health Commercial |
$72.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.32
|
| Rate for Payer: PACE Senior Care Partners |
$21.00
|
| Rate for Payer: PACE SWMI |
$22.11
|
| Rate for Payer: PHP Commercial |
$75.17
|
| Rate for Payer: PHP Medicare Advantage |
$22.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$76.93
|
| Rate for Payer: Priority Health Medicare |
$22.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.55
|
| Rate for Payer: Railroad Medicare Medicare |
$22.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.82
|
| Rate for Payer: UHC Core |
$73.84
|
| Rate for Payer: UHC Exchange |
$22.11
|
| Rate for Payer: UHC Medicaid |
$15.59
|
| Rate for Payer: UHC Medicare Advantage |
$22.11
|
| Rate for Payer: UHCCP Medicaid |
$15.59
|
| Rate for Payer: VA VA |
$22.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.32
|
|
|
HC SUPRAPUBIC CATHETER
|
Facility
|
IP
|
$121.35
|
|
|
Service Code
|
HCPCS C2627
|
| Hospital Charge Code |
27200072
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.46 |
| Max. Negotiated Rate |
$109.22 |
| Rate for Payer: Aetna Commercial |
$103.15
|
| Rate for Payer: BCBS Trust/PPO |
$100.22
|
| Rate for Payer: BCN Commercial |
$100.22
|
| Rate for Payer: Cash Price |
$97.08
|
| Rate for Payer: Cofinity Commercial |
$104.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.08
|
| Rate for Payer: Healthscope Commercial |
$109.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.15
|
| Rate for Payer: Nomi Health Commercial |
$99.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.01
|
| Rate for Payer: PHP Commercial |
$103.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$105.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.79
|
| Rate for Payer: UHC Core |
$101.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.01
|
|
|
HC SUPRAPUBIC CATHETER
|
Facility
|
OP
|
$121.35
|
|
|
Service Code
|
HCPCS C2627
|
| Hospital Charge Code |
27200072
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.39 |
| Max. Negotiated Rate |
$109.22 |
| Rate for Payer: Aetna Commercial |
$103.15
|
| Rate for Payer: Aetna Medicare |
$31.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.92
|
| Rate for Payer: BCBS Complete |
$22.46
|
| Rate for Payer: BCBS MAPPO |
$30.34
|
| Rate for Payer: BCBS Trust/PPO |
$99.76
|
| Rate for Payer: BCN Commercial |
$99.76
|
| Rate for Payer: BCN Medicare Advantage |
$30.34
|
| Rate for Payer: Cash Price |
$97.08
|
| Rate for Payer: Cofinity Commercial |
$104.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.34
|
| Rate for Payer: Healthscope Commercial |
$109.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.01
|
| Rate for Payer: Mclaren Medicaid |
$21.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.85
|
| Rate for Payer: Meridian Medicaid |
$22.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.15
|
| Rate for Payer: Nomi Health Commercial |
$99.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.01
|
| Rate for Payer: PACE Senior Care Partners |
$28.82
|
| Rate for Payer: PACE SWMI |
$30.34
|
| Rate for Payer: PHP Commercial |
$103.15
|
| Rate for Payer: PHP Medicare Advantage |
$30.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$105.57
|
| Rate for Payer: Priority Health Medicare |
$30.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.46
|
| Rate for Payer: Railroad Medicare Medicare |
$30.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.79
|
| Rate for Payer: UHC Core |
$101.33
|
| Rate for Payer: UHC Exchange |
$30.34
|
| Rate for Payer: UHC Medicaid |
$21.39
|
| Rate for Payer: UHC Medicare Advantage |
$30.34
|
| Rate for Payer: UHCCP Medicaid |
$21.39
|
| Rate for Payer: VA VA |
$30.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.01
|
|
|
HC SURGERY FROZEN EA ADDL
|
Facility
|
OP
|
$76.19
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
31000057
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$13.43 |
| Max. Negotiated Rate |
$68.57 |
| Rate for Payer: Aetna Commercial |
$64.76
|
| Rate for Payer: Aetna Medicare |
$19.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.81
|
| Rate for Payer: BCBS Complete |
$14.10
|
| Rate for Payer: BCBS MAPPO |
$19.05
|
| Rate for Payer: BCBS Trust/PPO |
$62.64
|
| Rate for Payer: BCCCP Commercial |
$51.41
|
| Rate for Payer: BCN Commercial |
$62.64
|
| Rate for Payer: BCN Medicare Advantage |
$19.05
|
| Rate for Payer: Cash Price |
$60.95
|
| Rate for Payer: Cash Price |
$60.95
|
| Rate for Payer: Cofinity Commercial |
$65.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.05
|
| Rate for Payer: Healthscope Commercial |
$68.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.14
|
| Rate for Payer: Mclaren Medicaid |
$13.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.00
|
| Rate for Payer: Meridian Medicaid |
$14.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.76
|
| Rate for Payer: Nomi Health Commercial |
$62.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.14
|
| Rate for Payer: PACE Senior Care Partners |
$18.10
|
| Rate for Payer: PACE SWMI |
$19.05
|
| Rate for Payer: PHP Commercial |
$64.76
|
| Rate for Payer: PHP Medicare Advantage |
$19.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.29
|
| Rate for Payer: Priority Health Medicare |
$19.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.03
|
| Rate for Payer: Railroad Medicare Medicare |
$19.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.05
|
| Rate for Payer: UHC Core |
$63.62
|
| Rate for Payer: UHC Exchange |
$19.05
|
| Rate for Payer: UHC Medicaid |
$13.43
|
| Rate for Payer: UHC Medicare Advantage |
$19.05
|
| Rate for Payer: UHCCP Medicaid |
$13.43
|
| Rate for Payer: VA VA |
$19.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.14
|
|
|
HC SURGERY FROZEN EA ADDL
|
Facility
|
IP
|
$76.19
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
31000057
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$53.03 |
| Max. Negotiated Rate |
$68.57 |
| Rate for Payer: Aetna Commercial |
$64.76
|
| Rate for Payer: BCBS Trust/PPO |
$62.93
|
| Rate for Payer: BCN Commercial |
$62.93
|
| Rate for Payer: Cash Price |
$60.95
|
| Rate for Payer: Cofinity Commercial |
$65.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.95
|
| Rate for Payer: Healthscope Commercial |
$68.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.76
|
| Rate for Payer: Nomi Health Commercial |
$62.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.14
|
| Rate for Payer: PHP Commercial |
$64.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.05
|
| Rate for Payer: UHC Core |
$63.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.14
|
|
|
HC SURGICAL HAND
|
Facility
|
OP
|
$718.51
|
|
| Hospital Charge Code |
45000053
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$646.66 |
| Rate for Payer: Aetna Commercial |
$610.73
|
| Rate for Payer: Aetna Medicare |
$186.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$224.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$224.53
|
| Rate for Payer: BCBS Complete |
$133.00
|
| Rate for Payer: BCBS MAPPO |
$179.63
|
| Rate for Payer: BCBS Trust/PPO |
$590.69
|
| Rate for Payer: BCN Commercial |
$590.69
|
| Rate for Payer: BCN Medicare Advantage |
$179.63
|
| Rate for Payer: Cash Price |
$574.81
|
| Rate for Payer: Cash Price |
$574.81
|
| Rate for Payer: Cofinity Commercial |
$617.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$574.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.63
|
| Rate for Payer: Healthscope Commercial |
$646.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$538.88
|
| Rate for Payer: Mclaren Medicaid |
$126.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.61
|
| Rate for Payer: Meridian Medicaid |
$133.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$206.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$197.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$610.73
|
| Rate for Payer: Nomi Health Commercial |
$589.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$538.88
|
| Rate for Payer: PACE Senior Care Partners |
$170.65
|
| Rate for Payer: PACE SWMI |
$179.63
|
| Rate for Payer: PHP Commercial |
$610.73
|
| Rate for Payer: PHP Medicare Advantage |
$179.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$625.10
|
| Rate for Payer: Priority Health Medicare |
$181.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.08
|
| Rate for Payer: Railroad Medicare Medicare |
$179.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$632.29
|
| Rate for Payer: UHC Core |
$599.96
|
| Rate for Payer: UHC Exchange |
$179.63
|
| Rate for Payer: UHC Medicaid |
$126.67
|
| Rate for Payer: UHC Medicare Advantage |
$179.63
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$179.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$538.88
|
|
|
HC SURGICAL HAND
|
Facility
|
IP
|
$718.51
|
|
| Hospital Charge Code |
45000053
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$500.08 |
| Max. Negotiated Rate |
$646.66 |
| Rate for Payer: Aetna Commercial |
$610.73
|
| Rate for Payer: BCBS Trust/PPO |
$593.42
|
| Rate for Payer: BCN Commercial |
$593.42
|
| Rate for Payer: Cash Price |
$574.81
|
| Rate for Payer: Cofinity Commercial |
$617.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$574.81
|
| Rate for Payer: Healthscope Commercial |
$646.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$538.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$610.73
|
| Rate for Payer: Nomi Health Commercial |
$589.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$538.88
|
| Rate for Payer: PHP Commercial |
$610.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$625.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$632.29
|
| Rate for Payer: UHC Core |
$599.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$538.88
|
|
|
HC SURG SUPPLY MISC
|
Facility
|
OP
|
$88.16
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
62300132
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$15.54 |
| Max. Negotiated Rate |
$79.34 |
| Rate for Payer: Aetna Commercial |
$74.94
|
| Rate for Payer: Aetna Medicare |
$22.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.55
|
| Rate for Payer: BCBS Complete |
$16.32
|
| Rate for Payer: BCBS MAPPO |
$22.04
|
| Rate for Payer: BCBS Trust/PPO |
$72.48
|
| Rate for Payer: BCN Commercial |
$72.48
|
| Rate for Payer: BCN Medicare Advantage |
$22.04
|
| Rate for Payer: Cash Price |
$70.53
|
| Rate for Payer: Cofinity Commercial |
$75.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.04
|
| Rate for Payer: Healthscope Commercial |
$79.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.12
|
| Rate for Payer: Mclaren Medicaid |
$15.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.14
|
| Rate for Payer: Meridian Medicaid |
$16.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.94
|
| Rate for Payer: Nomi Health Commercial |
$72.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.12
|
| Rate for Payer: PACE Senior Care Partners |
$20.94
|
| Rate for Payer: PACE SWMI |
$22.04
|
| Rate for Payer: PHP Commercial |
$74.94
|
| Rate for Payer: PHP Medicare Advantage |
$22.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$76.70
|
| Rate for Payer: Priority Health Medicare |
$22.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.36
|
| Rate for Payer: Railroad Medicare Medicare |
$22.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.58
|
| Rate for Payer: UHC Core |
$73.61
|
| Rate for Payer: UHC Exchange |
$22.04
|
| Rate for Payer: UHC Medicaid |
$15.54
|
| Rate for Payer: UHC Medicare Advantage |
$22.04
|
| Rate for Payer: UHCCP Medicaid |
$15.54
|
| Rate for Payer: VA VA |
$22.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.12
|
|
|
HC SURG SUPPLY MISC
|
Facility
|
IP
|
$88.16
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
62300132
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$61.36 |
| Max. Negotiated Rate |
$79.34 |
| Rate for Payer: Aetna Commercial |
$74.94
|
| Rate for Payer: BCBS Trust/PPO |
$72.81
|
| Rate for Payer: BCN Commercial |
$72.81
|
| Rate for Payer: Cash Price |
$70.53
|
| Rate for Payer: Cofinity Commercial |
$75.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.53
|
| Rate for Payer: Healthscope Commercial |
$79.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.94
|
| Rate for Payer: Nomi Health Commercial |
$72.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.12
|
| Rate for Payer: PHP Commercial |
$74.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$76.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.58
|
| Rate for Payer: UHC Core |
$73.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.12
|
|
|
HC SUSCEPTIBILITY DISK
|
Facility
|
IP
|
$59.82
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
30600098
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$41.63 |
| Max. Negotiated Rate |
$53.84 |
| Rate for Payer: Aetna Commercial |
$50.85
|
| Rate for Payer: BCBS Trust/PPO |
$49.41
|
| Rate for Payer: BCN Commercial |
$49.41
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cofinity Commercial |
$51.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.86
|
| Rate for Payer: Healthscope Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.85
|
| Rate for Payer: Nomi Health Commercial |
$49.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.87
|
| Rate for Payer: PHP Commercial |
$50.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$49.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.87
|
|
|
HC SUSCEPTIBILITY DISK
|
Facility
|
OP
|
$59.82
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
30600098
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.55 |
| Max. Negotiated Rate |
$53.84 |
| Rate for Payer: Aetna Commercial |
$50.85
|
| Rate for Payer: Aetna Medicare |
$15.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.69
|
| Rate for Payer: BCBS Complete |
$11.07
|
| Rate for Payer: BCBS MAPPO |
$14.96
|
| Rate for Payer: BCBS Trust/PPO |
$49.18
|
| Rate for Payer: BCN Commercial |
$49.18
|
| Rate for Payer: BCN Medicare Advantage |
$14.96
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cofinity Commercial |
$51.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.96
|
| Rate for Payer: Healthscope Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.87
|
| Rate for Payer: Mclaren Medicaid |
$10.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.70
|
| Rate for Payer: Meridian Medicaid |
$11.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.85
|
| Rate for Payer: Nomi Health Commercial |
$49.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.87
|
| Rate for Payer: PACE Senior Care Partners |
$14.21
|
| Rate for Payer: PACE SWMI |
$14.96
|
| Rate for Payer: PHP Commercial |
$50.85
|
| Rate for Payer: PHP Medicare Advantage |
$14.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.04
|
| Rate for Payer: Priority Health Medicare |
$15.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.63
|
| Rate for Payer: Railroad Medicare Medicare |
$14.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$49.95
|
| Rate for Payer: UHC Exchange |
$14.96
|
| Rate for Payer: UHC Medicaid |
$10.55
|
| Rate for Payer: UHC Medicare Advantage |
$14.96
|
| Rate for Payer: UHCCP Medicaid |
$10.55
|
| Rate for Payer: VA VA |
$14.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.87
|
|
|
HC SUSCEPTIBILITY E TEST
|
Facility
|
IP
|
$33.43
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
30600097
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.27 |
| Max. Negotiated Rate |
$30.09 |
| Rate for Payer: Aetna Commercial |
$28.42
|
| Rate for Payer: BCBS Trust/PPO |
$27.61
|
| Rate for Payer: BCN Commercial |
$27.61
|
| Rate for Payer: Cash Price |
$26.74
|
| Rate for Payer: Cofinity Commercial |
$28.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.74
|
| Rate for Payer: Healthscope Commercial |
$30.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.42
|
| Rate for Payer: Nomi Health Commercial |
$27.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.07
|
| Rate for Payer: PHP Commercial |
$28.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.42
|
| Rate for Payer: UHC Core |
$27.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.07
|
|
|
HC SUSCEPTIBILITY E TEST
|
Facility
|
OP
|
$33.43
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
30600097
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$30.09 |
| Rate for Payer: Aetna Commercial |
$28.42
|
| Rate for Payer: Aetna Medicare |
$8.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.45
|
| Rate for Payer: BCBS Complete |
$6.19
|
| Rate for Payer: BCBS MAPPO |
$8.36
|
| Rate for Payer: BCBS Trust/PPO |
$27.48
|
| Rate for Payer: BCN Commercial |
$27.48
|
| Rate for Payer: BCN Medicare Advantage |
$8.36
|
| Rate for Payer: Cash Price |
$26.74
|
| Rate for Payer: Cofinity Commercial |
$28.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.36
|
| Rate for Payer: Healthscope Commercial |
$30.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.07
|
| Rate for Payer: Mclaren Medicaid |
$5.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.78
|
| Rate for Payer: Meridian Medicaid |
$6.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.42
|
| Rate for Payer: Nomi Health Commercial |
$27.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.07
|
| Rate for Payer: PACE Senior Care Partners |
$7.94
|
| Rate for Payer: PACE SWMI |
$8.36
|
| Rate for Payer: PHP Commercial |
$28.42
|
| Rate for Payer: PHP Medicare Advantage |
$8.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.08
|
| Rate for Payer: Priority Health Medicare |
$8.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.27
|
| Rate for Payer: Railroad Medicare Medicare |
$8.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.42
|
| Rate for Payer: UHC Core |
$27.91
|
| Rate for Payer: UHC Exchange |
$8.36
|
| Rate for Payer: UHC Medicaid |
$5.89
|
| Rate for Payer: UHC Medicare Advantage |
$8.36
|
| Rate for Payer: UHCCP Medicaid |
$5.89
|
| Rate for Payer: VA VA |
$8.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.07
|
|
|
HC SUSCEPTIBILITY, MIC
|
Facility
|
IP
|
$82.19
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600100
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$73.97 |
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: BCBS Trust/PPO |
$67.88
|
| Rate for Payer: BCN Commercial |
$67.88
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Nomi Health Commercial |
$67.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.64
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.33
|
| Rate for Payer: UHC Core |
$68.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.64
|
|
|
HC SUSCEPTIBILITY, MIC
|
Facility
|
OP
|
$82.19
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600100
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.49 |
| Max. Negotiated Rate |
$73.97 |
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: Aetna Medicare |
$21.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.68
|
| Rate for Payer: BCBS Complete |
$15.21
|
| Rate for Payer: BCBS MAPPO |
$20.55
|
| Rate for Payer: BCBS Trust/PPO |
$67.57
|
| Rate for Payer: BCN Commercial |
$67.57
|
| Rate for Payer: BCN Medicare Advantage |
$20.55
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.55
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.64
|
| Rate for Payer: Mclaren Medicaid |
$14.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.57
|
| Rate for Payer: Meridian Medicaid |
$15.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Nomi Health Commercial |
$67.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.64
|
| Rate for Payer: PACE Senior Care Partners |
$19.52
|
| Rate for Payer: PACE SWMI |
$20.55
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: PHP Medicare Advantage |
$20.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.51
|
| Rate for Payer: Priority Health Medicare |
$20.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.20
|
| Rate for Payer: Railroad Medicare Medicare |
$20.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.33
|
| Rate for Payer: UHC Core |
$68.63
|
| Rate for Payer: UHC Exchange |
$20.55
|
| Rate for Payer: UHC Medicaid |
$14.49
|
| Rate for Payer: UHC Medicare Advantage |
$20.55
|
| Rate for Payer: UHCCP Medicaid |
$14.49
|
| Rate for Payer: VA VA |
$20.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.64
|
|
|
HC SWALLOW EVALUATION
|
Facility
|
OP
|
$340.02
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
44400004
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$59.95 |
| Max. Negotiated Rate |
$306.02 |
| Rate for Payer: Aetna Commercial |
$289.02
|
| Rate for Payer: Aetna Medicare |
$88.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.26
|
| Rate for Payer: BCBS Complete |
$62.94
|
| Rate for Payer: BCBS MAPPO |
$85.00
|
| Rate for Payer: BCBS Trust/PPO |
$279.53
|
| Rate for Payer: BCN Commercial |
$279.53
|
| Rate for Payer: BCN Medicare Advantage |
$85.00
|
| Rate for Payer: Cash Price |
$272.02
|
| Rate for Payer: Cofinity Commercial |
$292.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.00
|
| Rate for Payer: Healthscope Commercial |
$306.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.01
|
| Rate for Payer: Mclaren Medicaid |
$59.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.26
|
| Rate for Payer: Meridian Medicaid |
$62.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.02
|
| Rate for Payer: Nomi Health Commercial |
$278.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.01
|
| Rate for Payer: PACE Senior Care Partners |
$80.75
|
| Rate for Payer: PACE SWMI |
$85.00
|
| Rate for Payer: PHP Commercial |
$289.02
|
| Rate for Payer: PHP Medicare Advantage |
$85.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$295.82
|
| Rate for Payer: Priority Health Medicare |
$85.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$236.65
|
| Rate for Payer: Railroad Medicare Medicare |
$85.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.22
|
| Rate for Payer: UHC Core |
$283.92
|
| Rate for Payer: UHC Exchange |
$85.00
|
| Rate for Payer: UHC Medicaid |
$59.95
|
| Rate for Payer: UHC Medicare Advantage |
$85.00
|
| Rate for Payer: UHCCP Medicaid |
$59.95
|
| Rate for Payer: VA VA |
$85.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.01
|
|
|
HC SWALLOW EVALUATION
|
Facility
|
IP
|
$340.02
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
44400004
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$236.65 |
| Max. Negotiated Rate |
$306.02 |
| Rate for Payer: Aetna Commercial |
$289.02
|
| Rate for Payer: BCBS Trust/PPO |
$280.82
|
| Rate for Payer: BCN Commercial |
$280.82
|
| Rate for Payer: Cash Price |
$272.02
|
| Rate for Payer: Cofinity Commercial |
$292.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.02
|
| Rate for Payer: Healthscope Commercial |
$306.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.02
|
| Rate for Payer: Nomi Health Commercial |
$278.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.01
|
| Rate for Payer: PHP Commercial |
$289.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$295.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$236.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.22
|
| Rate for Payer: UHC Core |
$283.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.01
|
|
|
HC SWALLOWING THERAPY
|
Facility
|
OP
|
$247.16
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
43000020
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$43.57 |
| Max. Negotiated Rate |
$222.44 |
| Rate for Payer: Aetna Commercial |
$210.09
|
| Rate for Payer: Aetna Medicare |
$64.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.24
|
| Rate for Payer: BCBS Complete |
$45.75
|
| Rate for Payer: BCBS MAPPO |
$61.79
|
| Rate for Payer: BCBS Trust/PPO |
$203.19
|
| Rate for Payer: BCN Commercial |
$203.19
|
| Rate for Payer: BCN Medicare Advantage |
$61.79
|
| Rate for Payer: Cash Price |
$197.73
|
| Rate for Payer: Cofinity Commercial |
$212.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.79
|
| Rate for Payer: Healthscope Commercial |
$222.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.37
|
| Rate for Payer: Mclaren Medicaid |
$43.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.88
|
| Rate for Payer: Meridian Medicaid |
$45.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.09
|
| Rate for Payer: Nomi Health Commercial |
$202.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.37
|
| Rate for Payer: PACE Senior Care Partners |
$58.70
|
| Rate for Payer: PACE SWMI |
$61.79
|
| Rate for Payer: PHP Commercial |
$210.09
|
| Rate for Payer: PHP Medicare Advantage |
$61.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.03
|
| Rate for Payer: Priority Health Medicare |
$62.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.02
|
| Rate for Payer: Railroad Medicare Medicare |
$61.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.50
|
| Rate for Payer: UHC Core |
$206.38
|
| Rate for Payer: UHC Exchange |
$61.79
|
| Rate for Payer: UHC Medicaid |
$43.57
|
| Rate for Payer: UHC Medicare Advantage |
$61.79
|
| Rate for Payer: UHCCP Medicaid |
$43.57
|
| Rate for Payer: VA VA |
$61.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.37
|
|
|
HC SWALLOWING THERAPY
|
Facility
|
IP
|
$247.16
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
43000020
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$172.02 |
| Max. Negotiated Rate |
$222.44 |
| Rate for Payer: Aetna Commercial |
$210.09
|
| Rate for Payer: BCBS Trust/PPO |
$204.13
|
| Rate for Payer: BCN Commercial |
$204.13
|
| Rate for Payer: Cash Price |
$197.73
|
| Rate for Payer: Cofinity Commercial |
$212.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.73
|
| Rate for Payer: Healthscope Commercial |
$222.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.09
|
| Rate for Payer: Nomi Health Commercial |
$202.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.37
|
| Rate for Payer: PHP Commercial |
$210.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.50
|
| Rate for Payer: UHC Core |
$206.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.37
|
|
|
HC SWAN GANZ CATHETER
|
Facility
|
OP
|
$240.18
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200073
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.34 |
| Max. Negotiated Rate |
$216.16 |
| Rate for Payer: Aetna Commercial |
$204.15
|
| Rate for Payer: Aetna Medicare |
$62.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75.06
|
| Rate for Payer: BCBS Complete |
$44.46
|
| Rate for Payer: BCBS MAPPO |
$60.05
|
| Rate for Payer: BCBS Trust/PPO |
$197.45
|
| Rate for Payer: BCN Commercial |
$197.45
|
| Rate for Payer: BCN Medicare Advantage |
$60.05
|
| Rate for Payer: Cash Price |
$192.14
|
| Rate for Payer: Cofinity Commercial |
$206.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.05
|
| Rate for Payer: Healthscope Commercial |
$216.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.13
|
| Rate for Payer: Mclaren Medicaid |
$42.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.05
|
| Rate for Payer: Meridian Medicaid |
$44.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$66.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.15
|
| Rate for Payer: Nomi Health Commercial |
$196.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.13
|
| Rate for Payer: PACE Senior Care Partners |
$57.04
|
| Rate for Payer: PACE SWMI |
$60.05
|
| Rate for Payer: PHP Commercial |
$204.15
|
| Rate for Payer: PHP Medicare Advantage |
$60.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$208.96
|
| Rate for Payer: Priority Health Medicare |
$60.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.17
|
| Rate for Payer: Railroad Medicare Medicare |
$60.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.36
|
| Rate for Payer: UHC Core |
$200.55
|
| Rate for Payer: UHC Exchange |
$60.05
|
| Rate for Payer: UHC Medicaid |
$42.34
|
| Rate for Payer: UHC Medicare Advantage |
$60.05
|
| Rate for Payer: UHCCP Medicaid |
$42.34
|
| Rate for Payer: VA VA |
$60.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.13
|
|
|
HC SWAN GANZ CATHETER
|
Facility
|
IP
|
$240.18
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200073
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$167.17 |
| Max. Negotiated Rate |
$216.16 |
| Rate for Payer: Aetna Commercial |
$204.15
|
| Rate for Payer: BCBS Trust/PPO |
$198.36
|
| Rate for Payer: BCN Commercial |
$198.36
|
| Rate for Payer: Cash Price |
$192.14
|
| Rate for Payer: Cofinity Commercial |
$206.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.14
|
| Rate for Payer: Healthscope Commercial |
$216.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.15
|
| Rate for Payer: Nomi Health Commercial |
$196.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.13
|
| Rate for Payer: PHP Commercial |
$204.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$208.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.36
|
| Rate for Payer: UHC Core |
$200.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.13
|
|
|
HC SWAN GANZ PLACEMENT
|
Facility
|
OP
|
$1,677.77
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
48100024
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$295.79 |
| Max. Negotiated Rate |
$1,509.99 |
| Rate for Payer: Aetna Commercial |
$1,426.10
|
| Rate for Payer: Aetna Medicare |
$436.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$524.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$524.30
|
| Rate for Payer: BCBS Complete |
$310.56
|
| Rate for Payer: BCBS MAPPO |
$419.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,379.29
|
| Rate for Payer: BCN Commercial |
$1,379.29
|
| Rate for Payer: BCN Medicare Advantage |
$419.44
|
| Rate for Payer: Cash Price |
$1,342.22
|
| Rate for Payer: Cofinity Commercial |
$1,442.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,342.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$419.44
|
| Rate for Payer: Healthscope Commercial |
$1,509.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,258.33
|
| Rate for Payer: Mclaren Medicaid |
$295.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$440.41
|
| Rate for Payer: Meridian Medicaid |
$310.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$482.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$461.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,426.10
|
| Rate for Payer: Nomi Health Commercial |
$1,375.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,258.33
|
| Rate for Payer: PACE Senior Care Partners |
$398.47
|
| Rate for Payer: PACE SWMI |
$419.44
|
| Rate for Payer: PHP Commercial |
$1,426.10
|
| Rate for Payer: PHP Medicare Advantage |
$419.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$295.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,459.66
|
| Rate for Payer: Priority Health Medicare |
$423.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,167.73
|
| Rate for Payer: Railroad Medicare Medicare |
$419.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,476.44
|
| Rate for Payer: UHC Core |
$1,400.94
|
| Rate for Payer: UHC Exchange |
$419.44
|
| Rate for Payer: UHC Medicaid |
$295.79
|
| Rate for Payer: UHC Medicare Advantage |
$419.44
|
| Rate for Payer: UHCCP Medicaid |
$295.79
|
| Rate for Payer: VA VA |
$419.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,258.33
|
|
|
HC SWAN GANZ PLACEMENT
|
Facility
|
IP
|
$1,677.77
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
48100024
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,167.73 |
| Max. Negotiated Rate |
$1,509.99 |
| Rate for Payer: Aetna Commercial |
$1,426.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,385.67
|
| Rate for Payer: BCN Commercial |
$1,385.67
|
| Rate for Payer: Cash Price |
$1,342.22
|
| Rate for Payer: Cofinity Commercial |
$1,442.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,342.22
|
| Rate for Payer: Healthscope Commercial |
$1,509.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,258.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,426.10
|
| Rate for Payer: Nomi Health Commercial |
$1,375.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,258.33
|
| Rate for Payer: PHP Commercial |
$1,426.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,459.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,167.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,476.44
|
| Rate for Payer: UHC Core |
$1,400.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,258.33
|
|
|
HC SWEAT CHLORIDE
|
Facility
|
IP
|
$80.84
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100154
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.26 |
| Max. Negotiated Rate |
$72.76 |
| Rate for Payer: Aetna Commercial |
$68.71
|
| Rate for Payer: BCBS Trust/PPO |
$66.77
|
| Rate for Payer: BCN Commercial |
$66.77
|
| Rate for Payer: Cash Price |
$64.67
|
| Rate for Payer: Cofinity Commercial |
$69.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.67
|
| Rate for Payer: Healthscope Commercial |
$72.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.71
|
| Rate for Payer: Nomi Health Commercial |
$66.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.63
|
| Rate for Payer: PHP Commercial |
$68.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$70.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.14
|
| Rate for Payer: UHC Core |
$67.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.63
|
|
