|
HC SHAVE LESION TRUNK, ARM, LEGS OVER 2.0 CM
|
Facility
|
OP
|
$147.11
|
|
|
Service Code
|
CPT 11303
|
| Hospital Charge Code |
76100083
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$34.94 |
| Max. Negotiated Rate |
$303.32 |
| Rate for Payer: Aetna Commercial |
$125.04
|
| Rate for Payer: Aetna Medicare |
$38.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.97
|
| Rate for Payer: BCBS Complete |
$303.32
|
| Rate for Payer: BCBS MAPPO |
$36.78
|
| Rate for Payer: BCBS Trust/PPO |
$120.94
|
| Rate for Payer: BCN Commercial |
$114.38
|
| Rate for Payer: BCN Medicare Advantage |
$36.78
|
| Rate for Payer: Cash Price |
$117.69
|
| Rate for Payer: Cash Price |
$117.69
|
| Rate for Payer: Cofinity Commercial |
$126.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.78
|
| Rate for Payer: Healthscope Commercial |
$132.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.33
|
| Rate for Payer: Mclaren Medicaid |
$288.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.62
|
| Rate for Payer: Meridian Medicaid |
$303.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.04
|
| Rate for Payer: Nomi Health Commercial |
$120.63
|
| Rate for Payer: PACE Senior Care Partners |
$34.94
|
| Rate for Payer: PACE SWMI |
$36.78
|
| Rate for Payer: PHP Commercial |
$125.04
|
| Rate for Payer: PHP Medicare Advantage |
$36.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.62
|
| Rate for Payer: Priority Health HMO/PPO |
$127.99
|
| Rate for Payer: Priority Health Medicare |
$37.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.56
|
| Rate for Payer: Railroad Medicare Medicare |
$36.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.46
|
| Rate for Payer: UHC Core |
$122.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.78
|
| Rate for Payer: UHC Exchange |
$36.78
|
| Rate for Payer: UHC Medicare Advantage |
$36.78
|
| Rate for Payer: UHCCP Medicaid |
$288.86
|
| Rate for Payer: VA VA |
$36.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.33
|
|
|
HC SHEEP SORREL IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SHEEP SORREL IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SHINGLES VACCINE
|
Facility
|
OP
|
$276.95
|
|
|
Service Code
|
CPT 90736
|
| Hospital Charge Code |
63600063
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$65.78 |
| Max. Negotiated Rate |
$249.25 |
| Rate for Payer: Aetna Commercial |
$235.41
|
| Rate for Payer: Aetna Medicare |
$72.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.55
|
| Rate for Payer: BCBS Complete |
$110.78
|
| Rate for Payer: BCBS MAPPO |
$69.24
|
| Rate for Payer: BCBS Trust/PPO |
$227.68
|
| Rate for Payer: BCN Commercial |
$215.33
|
| Rate for Payer: BCN Medicare Advantage |
$69.24
|
| Rate for Payer: Cash Price |
$221.56
|
| Rate for Payer: Cofinity Commercial |
$238.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.24
|
| Rate for Payer: Healthscope Commercial |
$249.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.41
|
| Rate for Payer: Nomi Health Commercial |
$227.10
|
| Rate for Payer: PACE Senior Care Partners |
$65.78
|
| Rate for Payer: PACE SWMI |
$69.24
|
| Rate for Payer: PHP Commercial |
$235.41
|
| Rate for Payer: PHP Medicare Advantage |
$69.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.02
|
| Rate for Payer: Priority Health HMO/PPO |
$240.95
|
| Rate for Payer: Priority Health Medicare |
$69.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.56
|
| Rate for Payer: Railroad Medicare Medicare |
$69.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.72
|
| Rate for Payer: UHC Core |
$231.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.24
|
| Rate for Payer: UHC Exchange |
$69.24
|
| Rate for Payer: UHC Medicare Advantage |
$69.24
|
| Rate for Payer: VA VA |
$69.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.71
|
|
|
HC SHINGLES VACCINE
|
Facility
|
IP
|
$276.95
|
|
|
Service Code
|
CPT 90736
|
| Hospital Charge Code |
63600063
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$180.02 |
| Max. Negotiated Rate |
$249.25 |
| Rate for Payer: Aetna Commercial |
$235.41
|
| Rate for Payer: BCBS Trust/PPO |
$226.07
|
| Rate for Payer: BCN Commercial |
$214.03
|
| Rate for Payer: Cash Price |
$221.56
|
| Rate for Payer: Cofinity Commercial |
$238.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.56
|
| Rate for Payer: Healthscope Commercial |
$249.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.41
|
| Rate for Payer: Nomi Health Commercial |
$227.10
|
| Rate for Payer: PHP Commercial |
$235.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.02
|
| Rate for Payer: Priority Health HMO/PPO |
$240.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$185.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.72
|
| Rate for Payer: UHC Core |
$231.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.71
|
|
|
HC SHRIMP IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200061
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SHRIMP IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200061
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SICKLE CELL CMS F/U
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51500011
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$81.25 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: BCBS Trust/PPO |
$102.04
|
| Rate for Payer: BCN Commercial |
$96.60
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.25
|
| Rate for Payer: Nomi Health Commercial |
$102.50
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO |
$108.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.00
|
| Rate for Payer: UHC Core |
$104.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.75
|
|
|
HC SICKLE CELL CMS F/U
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51500011
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$29.69 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: Aetna Medicare |
$32.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.06
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS MAPPO |
$31.25
|
| Rate for Payer: BCBS Trust/PPO |
$102.76
|
| Rate for Payer: BCN Commercial |
$97.19
|
| Rate for Payer: BCN Medicare Advantage |
$31.25
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.25
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.25
|
| Rate for Payer: Nomi Health Commercial |
$102.50
|
| Rate for Payer: PACE Senior Care Partners |
$29.69
|
| Rate for Payer: PACE SWMI |
$31.25
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: PHP Medicare Advantage |
$31.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO |
$108.75
|
| Rate for Payer: Priority Health Medicare |
$31.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.75
|
| Rate for Payer: Railroad Medicare Medicare |
$31.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.00
|
| Rate for Payer: UHC Core |
$104.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.25
|
| Rate for Payer: UHC Exchange |
$31.25
|
| Rate for Payer: UHC Medicare Advantage |
$31.25
|
| Rate for Payer: VA VA |
$31.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.75
|
|
|
HC SICKLE CELL CMS INITIAL COMP
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500009
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$106.88 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna Commercial |
$382.50
|
| Rate for Payer: Aetna Medicare |
$117.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$140.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$140.62
|
| Rate for Payer: BCBS Complete |
$180.00
|
| Rate for Payer: BCBS MAPPO |
$112.50
|
| Rate for Payer: BCBS Trust/PPO |
$369.94
|
| Rate for Payer: BCN Commercial |
$349.88
|
| Rate for Payer: BCN Medicare Advantage |
$112.50
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$387.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.50
|
| Rate for Payer: Healthscope Commercial |
$405.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.50
|
| Rate for Payer: Nomi Health Commercial |
$369.00
|
| Rate for Payer: PACE Senior Care Partners |
$106.88
|
| Rate for Payer: PACE SWMI |
$112.50
|
| Rate for Payer: PHP Commercial |
$382.50
|
| Rate for Payer: PHP Medicare Advantage |
$112.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.50
|
| Rate for Payer: Priority Health HMO/PPO |
$391.50
|
| Rate for Payer: Priority Health Medicare |
$113.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$301.50
|
| Rate for Payer: Railroad Medicare Medicare |
$112.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.00
|
| Rate for Payer: UHC Core |
$375.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.50
|
| Rate for Payer: UHC Exchange |
$112.50
|
| Rate for Payer: UHC Medicare Advantage |
$112.50
|
| Rate for Payer: VA VA |
$112.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.50
|
|
|
HC SICKLE CELL CMS INITIAL COMP
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500009
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$292.50 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna Commercial |
$382.50
|
| Rate for Payer: BCBS Trust/PPO |
$367.33
|
| Rate for Payer: BCN Commercial |
$347.76
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$387.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Healthscope Commercial |
$405.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.50
|
| Rate for Payer: Nomi Health Commercial |
$369.00
|
| Rate for Payer: PHP Commercial |
$382.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.50
|
| Rate for Payer: Priority Health HMO/PPO |
$391.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$301.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.00
|
| Rate for Payer: UHC Core |
$375.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.50
|
|
|
HC SICKLE CELL CMS SUPP/SERV
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51500012
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$17.81 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.44
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCBS MAPPO |
$18.75
|
| Rate for Payer: BCBS Trust/PPO |
$61.66
|
| Rate for Payer: BCN Commercial |
$58.31
|
| Rate for Payer: BCN Medicare Advantage |
$18.75
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.75
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.75
|
| Rate for Payer: Nomi Health Commercial |
$61.50
|
| Rate for Payer: PACE Senior Care Partners |
$17.81
|
| Rate for Payer: PACE SWMI |
$18.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: PHP Medicare Advantage |
$18.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health HMO/PPO |
$65.25
|
| Rate for Payer: Priority Health Medicare |
$18.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.25
|
| Rate for Payer: Railroad Medicare Medicare |
$18.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.75
|
| Rate for Payer: UHC Exchange |
$18.75
|
| Rate for Payer: UHC Medicare Advantage |
$18.75
|
| Rate for Payer: VA VA |
$18.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC SICKLE CELL CMS SUPP/SERV
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51500012
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$48.75 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$61.22
|
| Rate for Payer: BCN Commercial |
$57.96
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.75
|
| Rate for Payer: Nomi Health Commercial |
$61.50
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health HMO/PPO |
$65.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC SICKLE CELLS CMS COMP
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500010
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$195.00 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: BCBS Trust/PPO |
$244.89
|
| Rate for Payer: BCN Commercial |
$231.84
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.00
|
| Rate for Payer: Nomi Health Commercial |
$246.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.00
|
| Rate for Payer: Priority Health HMO/PPO |
$261.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.00
|
| Rate for Payer: UHC Core |
$250.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.00
|
|
|
HC SICKLE CELLS CMS COMP
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500010
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$71.25 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: Aetna Medicare |
$78.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.75
|
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: BCBS MAPPO |
$75.00
|
| Rate for Payer: BCBS Trust/PPO |
$246.63
|
| Rate for Payer: BCN Commercial |
$233.25
|
| Rate for Payer: BCN Medicare Advantage |
$75.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.00
|
| Rate for Payer: Nomi Health Commercial |
$246.00
|
| Rate for Payer: PACE Senior Care Partners |
$71.25
|
| Rate for Payer: PACE SWMI |
$75.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: PHP Medicare Advantage |
$75.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.00
|
| Rate for Payer: Priority Health HMO/PPO |
$261.00
|
| Rate for Payer: Priority Health Medicare |
$75.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.00
|
| Rate for Payer: Railroad Medicare Medicare |
$75.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.00
|
| Rate for Payer: UHC Core |
$250.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.00
|
| Rate for Payer: UHC Exchange |
$75.00
|
| Rate for Payer: UHC Medicare Advantage |
$75.00
|
| Rate for Payer: VA VA |
$75.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.00
|
|
|
HC SICKLE CELL TEST
|
Facility
|
OP
|
$31.31
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
30500061
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$28.18 |
| Rate for Payer: Aetna Commercial |
$26.61
|
| Rate for Payer: Aetna Medicare |
$8.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.78
|
| Rate for Payer: BCBS Complete |
$4.18
|
| Rate for Payer: BCBS MAPPO |
$7.83
|
| Rate for Payer: BCBS Trust/PPO |
$25.74
|
| Rate for Payer: BCN Commercial |
$24.34
|
| Rate for Payer: BCN Medicare Advantage |
$7.83
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$26.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.83
|
| Rate for Payer: Healthscope Commercial |
$28.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.48
|
| Rate for Payer: Mclaren Medicaid |
$3.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.22
|
| Rate for Payer: Meridian Medicaid |
$4.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.61
|
| Rate for Payer: Nomi Health Commercial |
$25.67
|
| Rate for Payer: PACE Senior Care Partners |
$7.44
|
| Rate for Payer: PACE SWMI |
$7.83
|
| Rate for Payer: PHP Commercial |
$26.61
|
| Rate for Payer: PHP Medicare Advantage |
$7.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.35
|
| Rate for Payer: Priority Health HMO/PPO |
$27.24
|
| Rate for Payer: Priority Health Medicare |
$7.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.98
|
| Rate for Payer: Railroad Medicare Medicare |
$7.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.55
|
| Rate for Payer: UHC Core |
$26.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.83
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicare Advantage |
$7.83
|
| Rate for Payer: UHCCP Medicaid |
$3.98
|
| Rate for Payer: VA VA |
$7.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.48
|
|
|
HC SICKLE CELL TEST
|
Facility
|
IP
|
$31.31
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
30500061
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$20.35 |
| Max. Negotiated Rate |
$28.18 |
| Rate for Payer: Aetna Commercial |
$26.61
|
| Rate for Payer: BCBS Trust/PPO |
$25.56
|
| Rate for Payer: BCN Commercial |
$24.20
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$26.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.05
|
| Rate for Payer: Healthscope Commercial |
$28.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.61
|
| Rate for Payer: Nomi Health Commercial |
$25.67
|
| Rate for Payer: PHP Commercial |
$26.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.35
|
| Rate for Payer: Priority Health HMO/PPO |
$27.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.55
|
| Rate for Payer: UHC Core |
$26.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.48
|
|
|
HC SIGMOIDOSCOPY FLX DX W/COLL SPEC BR/WA
|
Facility
|
OP
|
$1,162.48
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
76100186
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$276.09 |
| Max. Negotiated Rate |
$1,046.23 |
| Rate for Payer: Aetna Commercial |
$988.11
|
| Rate for Payer: Aetna Medicare |
$302.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$363.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$363.27
|
| Rate for Payer: BCBS Complete |
$692.17
|
| Rate for Payer: BCBS MAPPO |
$290.62
|
| Rate for Payer: BCBS Trust/PPO |
$955.67
|
| Rate for Payer: BCN Commercial |
$903.83
|
| Rate for Payer: BCN Medicare Advantage |
$290.62
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cofinity Commercial |
$999.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.62
|
| Rate for Payer: Healthscope Commercial |
$1,046.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$871.86
|
| Rate for Payer: Mclaren Medicaid |
$659.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.15
|
| Rate for Payer: Meridian Medicaid |
$692.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$334.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.11
|
| Rate for Payer: Nomi Health Commercial |
$953.23
|
| Rate for Payer: PACE Senior Care Partners |
$276.09
|
| Rate for Payer: PACE SWMI |
$290.62
|
| Rate for Payer: PHP Commercial |
$988.11
|
| Rate for Payer: PHP Medicare Advantage |
$290.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$659.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$755.61
|
| Rate for Payer: Priority Health HMO/PPO |
$1,011.36
|
| Rate for Payer: Priority Health Medicare |
$293.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$778.86
|
| Rate for Payer: Railroad Medicare Medicare |
$290.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,022.98
|
| Rate for Payer: UHC Core |
$970.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$290.62
|
| Rate for Payer: UHC Exchange |
$290.62
|
| Rate for Payer: UHC Medicare Advantage |
$290.62
|
| Rate for Payer: UHCCP Medicaid |
$659.17
|
| Rate for Payer: VA VA |
$290.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$871.86
|
|
|
HC SIGMOIDOSCOPY FLX DX W/COLL SPEC BR/WA
|
Facility
|
IP
|
$1,162.48
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
76100186
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$755.61 |
| Max. Negotiated Rate |
$1,046.23 |
| Rate for Payer: Aetna Commercial |
$988.11
|
| Rate for Payer: BCBS Trust/PPO |
$948.93
|
| Rate for Payer: BCN Commercial |
$898.36
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cofinity Commercial |
$999.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.98
|
| Rate for Payer: Healthscope Commercial |
$1,046.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$871.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.11
|
| Rate for Payer: Nomi Health Commercial |
$953.23
|
| Rate for Payer: PHP Commercial |
$988.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$755.61
|
| Rate for Payer: Priority Health HMO/PPO |
$1,011.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$778.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,022.98
|
| Rate for Payer: UHC Core |
$970.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$871.86
|
|
|
HC SIGMOIDOSCOPY W EUS EXAM
|
Facility
|
IP
|
$2,621.12
|
|
| Hospital Charge Code |
36000082
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,703.73 |
| Max. Negotiated Rate |
$2,359.01 |
| Rate for Payer: Aetna Commercial |
$2,227.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,139.62
|
| Rate for Payer: BCN Commercial |
$2,025.60
|
| Rate for Payer: Cash Price |
$2,096.90
|
| Rate for Payer: Cofinity Commercial |
$2,254.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,096.90
|
| Rate for Payer: Healthscope Commercial |
$2,359.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,965.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,227.95
|
| Rate for Payer: Nomi Health Commercial |
$2,149.32
|
| Rate for Payer: PHP Commercial |
$2,227.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,703.73
|
| Rate for Payer: Priority Health HMO/PPO |
$2,280.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,756.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,306.59
|
| Rate for Payer: UHC Core |
$2,188.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,965.84
|
|
|
HC SIGMOIDOSCOPY W EUS EXAM
|
Facility
|
OP
|
$2,621.12
|
|
| Hospital Charge Code |
36000082
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$622.52 |
| Max. Negotiated Rate |
$2,359.01 |
| Rate for Payer: Aetna Commercial |
$2,227.95
|
| Rate for Payer: Aetna Medicare |
$681.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$819.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$819.10
|
| Rate for Payer: BCBS Complete |
$1,048.45
|
| Rate for Payer: BCBS MAPPO |
$655.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,154.82
|
| Rate for Payer: BCN Commercial |
$2,037.92
|
| Rate for Payer: BCN Medicare Advantage |
$655.28
|
| Rate for Payer: Cash Price |
$2,096.90
|
| Rate for Payer: Cofinity Commercial |
$2,254.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,096.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$655.28
|
| Rate for Payer: Healthscope Commercial |
$2,359.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,965.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$688.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$753.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,227.95
|
| Rate for Payer: Nomi Health Commercial |
$2,149.32
|
| Rate for Payer: PACE Senior Care Partners |
$622.52
|
| Rate for Payer: PACE SWMI |
$655.28
|
| Rate for Payer: PHP Commercial |
$2,227.95
|
| Rate for Payer: PHP Medicare Advantage |
$655.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,703.73
|
| Rate for Payer: Priority Health HMO/PPO |
$2,280.37
|
| Rate for Payer: Priority Health Medicare |
$661.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,756.15
|
| Rate for Payer: Railroad Medicare Medicare |
$655.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,306.59
|
| Rate for Payer: UHC Core |
$2,188.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$655.28
|
| Rate for Payer: UHC Exchange |
$655.28
|
| Rate for Payer: UHC Medicare Advantage |
$655.28
|
| Rate for Payer: VA VA |
$655.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,965.84
|
|
|
HC SIGMOIDOSCOPY WITH BIOPSY
|
Facility
|
OP
|
$1,264.83
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
36000111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$300.40 |
| Max. Negotiated Rate |
$1,138.35 |
| Rate for Payer: Aetna Commercial |
$1,075.11
|
| Rate for Payer: Aetna Medicare |
$328.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$395.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$395.26
|
| Rate for Payer: BCBS Complete |
$692.17
|
| Rate for Payer: BCBS MAPPO |
$316.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,039.82
|
| Rate for Payer: BCN Commercial |
$983.41
|
| Rate for Payer: BCN Medicare Advantage |
$316.21
|
| Rate for Payer: Cash Price |
$1,011.86
|
| Rate for Payer: Cash Price |
$1,011.86
|
| Rate for Payer: Cofinity Commercial |
$1,087.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,011.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.21
|
| Rate for Payer: Healthscope Commercial |
$1,138.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$948.62
|
| Rate for Payer: Mclaren Medicaid |
$659.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.02
|
| Rate for Payer: Meridian Medicaid |
$692.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$363.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,075.11
|
| Rate for Payer: Nomi Health Commercial |
$1,037.16
|
| Rate for Payer: PACE Senior Care Partners |
$300.40
|
| Rate for Payer: PACE SWMI |
$316.21
|
| Rate for Payer: PHP Commercial |
$1,075.11
|
| Rate for Payer: PHP Medicare Advantage |
$316.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$659.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.14
|
| Rate for Payer: Priority Health HMO/PPO |
$1,100.40
|
| Rate for Payer: Priority Health Medicare |
$319.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$847.44
|
| Rate for Payer: Railroad Medicare Medicare |
$316.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,113.05
|
| Rate for Payer: UHC Core |
$1,056.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$316.21
|
| Rate for Payer: UHC Exchange |
$316.21
|
| Rate for Payer: UHC Medicare Advantage |
$316.21
|
| Rate for Payer: UHCCP Medicaid |
$659.17
|
| Rate for Payer: VA VA |
$316.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$948.62
|
|
|
HC SIGMOIDOSCOPY WITH BIOPSY
|
Facility
|
IP
|
$1,264.83
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
36000111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$822.14 |
| Max. Negotiated Rate |
$1,138.35 |
| Rate for Payer: Aetna Commercial |
$1,075.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,032.48
|
| Rate for Payer: BCN Commercial |
$977.46
|
| Rate for Payer: Cash Price |
$1,011.86
|
| Rate for Payer: Cofinity Commercial |
$1,087.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,011.86
|
| Rate for Payer: Healthscope Commercial |
$1,138.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$948.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,075.11
|
| Rate for Payer: Nomi Health Commercial |
$1,037.16
|
| Rate for Payer: PHP Commercial |
$1,075.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.14
|
| Rate for Payer: Priority Health HMO/PPO |
$1,100.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$847.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,113.05
|
| Rate for Payer: UHC Core |
$1,056.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$948.62
|
|
|
HC SIGNAL AVERAGE EKG
|
Facility
|
OP
|
$252.87
|
|
|
Service Code
|
CPT 93278
|
| Hospital Charge Code |
73100004
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$42.95 |
| Max. Negotiated Rate |
$227.58 |
| Rate for Payer: Aetna Commercial |
$214.94
|
| Rate for Payer: Aetna Medicare |
$65.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.02
|
| Rate for Payer: BCBS Complete |
$45.10
|
| Rate for Payer: BCBS MAPPO |
$63.22
|
| Rate for Payer: BCBS Trust/PPO |
$207.88
|
| Rate for Payer: BCN Commercial |
$196.61
|
| Rate for Payer: BCN Medicare Advantage |
$63.22
|
| Rate for Payer: Cash Price |
$202.30
|
| Rate for Payer: Cash Price |
$202.30
|
| Rate for Payer: Cofinity Commercial |
$217.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.22
|
| Rate for Payer: Healthscope Commercial |
$227.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.65
|
| Rate for Payer: Mclaren Medicaid |
$42.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.38
|
| Rate for Payer: Meridian Medicaid |
$45.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.94
|
| Rate for Payer: Nomi Health Commercial |
$207.35
|
| Rate for Payer: PACE Senior Care Partners |
$60.06
|
| Rate for Payer: PACE SWMI |
$63.22
|
| Rate for Payer: PHP Commercial |
$214.94
|
| Rate for Payer: PHP Medicare Advantage |
$63.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.37
|
| Rate for Payer: Priority Health HMO/PPO |
$220.00
|
| Rate for Payer: Priority Health Medicare |
$63.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.42
|
| Rate for Payer: Railroad Medicare Medicare |
$63.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.53
|
| Rate for Payer: UHC Core |
$211.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.22
|
| Rate for Payer: UHC Exchange |
$63.22
|
| Rate for Payer: UHC Medicare Advantage |
$63.22
|
| Rate for Payer: UHCCP Medicaid |
$42.95
|
| Rate for Payer: VA VA |
$63.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.65
|
|
|
HC SIGNAL AVERAGE EKG
|
Facility
|
IP
|
$252.87
|
|
|
Service Code
|
CPT 93278
|
| Hospital Charge Code |
73100004
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$164.37 |
| Max. Negotiated Rate |
$227.58 |
| Rate for Payer: Aetna Commercial |
$214.94
|
| Rate for Payer: BCBS Trust/PPO |
$206.42
|
| Rate for Payer: BCN Commercial |
$195.42
|
| Rate for Payer: Cash Price |
$202.30
|
| Rate for Payer: Cofinity Commercial |
$217.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.30
|
| Rate for Payer: Healthscope Commercial |
$227.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.94
|
| Rate for Payer: Nomi Health Commercial |
$207.35
|
| Rate for Payer: PHP Commercial |
$214.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.37
|
| Rate for Payer: Priority Health HMO/PPO |
$220.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.53
|
| Rate for Payer: UHC Core |
$211.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.65
|
|
