|
HC TICK-BORNE AB CMPT 2
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 86753
|
| Hospital Charge Code |
30200521
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna Commercial |
$28.90
|
| Rate for Payer: Aetna Medicare |
$8.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.62
|
| Rate for Payer: BCBS Complete |
$6.29
|
| Rate for Payer: BCBS MAPPO |
$8.50
|
| Rate for Payer: BCBS Trust/PPO |
$27.95
|
| Rate for Payer: BCN Commercial |
$27.95
|
| Rate for Payer: BCN Medicare Advantage |
$8.50
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$29.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.50
|
| Rate for Payer: Healthscope Commercial |
$30.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.50
|
| Rate for Payer: Mclaren Medicaid |
$5.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.93
|
| Rate for Payer: Meridian Medicaid |
$6.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.90
|
| Rate for Payer: Nomi Health Commercial |
$27.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: PACE Senior Care Partners |
$8.07
|
| Rate for Payer: PACE SWMI |
$8.50
|
| Rate for Payer: PHP Commercial |
$28.90
|
| Rate for Payer: PHP Medicare Advantage |
$8.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.58
|
| Rate for Payer: Priority Health Medicare |
$8.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.66
|
| Rate for Payer: Railroad Medicare Medicare |
$8.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.92
|
| Rate for Payer: UHC Core |
$28.39
|
| Rate for Payer: UHC Exchange |
$8.50
|
| Rate for Payer: UHC Medicaid |
$5.99
|
| Rate for Payer: UHC Medicare Advantage |
$8.50
|
| Rate for Payer: UHCCP Medicaid |
$5.99
|
| Rate for Payer: VA VA |
$8.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.50
|
|
|
HC TICK-BORNE AB CMPT 3
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
CPT 86666
|
| Hospital Charge Code |
30200520
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$25.20 |
| Rate for Payer: Aetna Commercial |
$23.80
|
| Rate for Payer: Aetna Medicare |
$7.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.75
|
| Rate for Payer: BCBS Complete |
$5.18
|
| Rate for Payer: BCBS MAPPO |
$7.00
|
| Rate for Payer: BCBS Trust/PPO |
$23.02
|
| Rate for Payer: BCN Commercial |
$23.02
|
| Rate for Payer: BCN Medicare Advantage |
$7.00
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$24.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.00
|
| Rate for Payer: Healthscope Commercial |
$25.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.00
|
| Rate for Payer: Mclaren Medicaid |
$4.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.35
|
| Rate for Payer: Meridian Medicaid |
$5.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.80
|
| Rate for Payer: Nomi Health Commercial |
$22.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.00
|
| Rate for Payer: PACE Senior Care Partners |
$6.65
|
| Rate for Payer: PACE SWMI |
$7.00
|
| Rate for Payer: PHP Commercial |
$23.80
|
| Rate for Payer: PHP Medicare Advantage |
$7.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.36
|
| Rate for Payer: Priority Health Medicare |
$7.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.49
|
| Rate for Payer: Railroad Medicare Medicare |
$7.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.64
|
| Rate for Payer: UHC Core |
$23.38
|
| Rate for Payer: UHC Exchange |
$7.00
|
| Rate for Payer: UHC Medicaid |
$4.94
|
| Rate for Payer: UHC Medicare Advantage |
$7.00
|
| Rate for Payer: UHCCP Medicaid |
$4.94
|
| Rate for Payer: VA VA |
$7.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.00
|
|
|
HC TICK-BORNE AB CMPT 3
|
Facility
|
IP
|
$28.00
|
|
|
Service Code
|
CPT 86666
|
| Hospital Charge Code |
30200520
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.49 |
| Max. Negotiated Rate |
$25.20 |
| Rate for Payer: Aetna Commercial |
$23.80
|
| Rate for Payer: BCBS Trust/PPO |
$23.13
|
| Rate for Payer: BCN Commercial |
$23.13
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$24.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.40
|
| Rate for Payer: Healthscope Commercial |
$25.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.80
|
| Rate for Payer: Nomi Health Commercial |
$22.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.00
|
| Rate for Payer: PHP Commercial |
$23.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.64
|
| Rate for Payer: UHC Core |
$23.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.00
|
|
|
HC TIER 1 MAJOR TRAUMA RESUSCITATION
|
Facility
|
IP
|
$6,142.45
|
|
| Hospital Charge Code |
68100001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$4,275.15 |
| Max. Negotiated Rate |
$5,528.20 |
| Rate for Payer: Aetna Commercial |
$5,221.08
|
| Rate for Payer: BCBS Trust/PPO |
$5,073.05
|
| Rate for Payer: BCN Commercial |
$5,073.05
|
| Rate for Payer: Cash Price |
$4,913.96
|
| Rate for Payer: Cofinity Commercial |
$5,282.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,913.96
|
| Rate for Payer: Healthscope Commercial |
$5,528.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,606.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,221.08
|
| Rate for Payer: Nomi Health Commercial |
$5,036.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,606.84
|
| Rate for Payer: PHP Commercial |
$5,221.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,343.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,275.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,405.36
|
| Rate for Payer: UHC Core |
$5,128.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,606.84
|
|
|
HC TIER 1 MAJOR TRAUMA RESUSCITATION
|
Facility
|
OP
|
$6,142.45
|
|
| Hospital Charge Code |
68100001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$1,082.91 |
| Max. Negotiated Rate |
$5,528.20 |
| Rate for Payer: Aetna Commercial |
$5,221.08
|
| Rate for Payer: Aetna Medicare |
$1,597.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,919.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,919.52
|
| Rate for Payer: BCBS Complete |
$1,136.97
|
| Rate for Payer: BCBS MAPPO |
$1,535.61
|
| Rate for Payer: BCBS Trust/PPO |
$5,049.71
|
| Rate for Payer: BCN Commercial |
$5,049.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,535.61
|
| Rate for Payer: Cash Price |
$4,913.96
|
| Rate for Payer: Cofinity Commercial |
$5,282.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,913.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,535.61
|
| Rate for Payer: Healthscope Commercial |
$5,528.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,606.84
|
| Rate for Payer: Mclaren Medicaid |
$1,082.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,612.39
|
| Rate for Payer: Meridian Medicaid |
$1,136.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,765.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,689.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,221.08
|
| Rate for Payer: Nomi Health Commercial |
$5,036.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,606.84
|
| Rate for Payer: PACE Senior Care Partners |
$1,458.83
|
| Rate for Payer: PACE SWMI |
$1,535.61
|
| Rate for Payer: PHP Commercial |
$5,221.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,535.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,082.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,343.93
|
| Rate for Payer: Priority Health Medicare |
$1,550.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,275.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,535.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,405.36
|
| Rate for Payer: UHC Core |
$5,128.95
|
| Rate for Payer: UHC Exchange |
$1,535.61
|
| Rate for Payer: UHC Medicaid |
$1,082.91
|
| Rate for Payer: UHC Medicare Advantage |
$1,535.61
|
| Rate for Payer: UHCCP Medicaid |
$1,082.91
|
| Rate for Payer: VA VA |
$1,535.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,606.84
|
|
|
HC TIER 2 TRAUMA RESUSCITATION
|
Facility
|
IP
|
$4,684.51
|
|
| Hospital Charge Code |
68200001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$3,260.42 |
| Max. Negotiated Rate |
$4,216.06 |
| Rate for Payer: Aetna Commercial |
$3,981.83
|
| Rate for Payer: BCBS Trust/PPO |
$3,868.94
|
| Rate for Payer: BCN Commercial |
$3,868.94
|
| Rate for Payer: Cash Price |
$3,747.61
|
| Rate for Payer: Cofinity Commercial |
$4,028.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,747.61
|
| Rate for Payer: Healthscope Commercial |
$4,216.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,513.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,981.83
|
| Rate for Payer: Nomi Health Commercial |
$3,841.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,513.38
|
| Rate for Payer: PHP Commercial |
$3,981.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,075.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,260.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,122.37
|
| Rate for Payer: UHC Core |
$3,911.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,513.38
|
|
|
HC TIER 2 TRAUMA RESUSCITATION
|
Facility
|
OP
|
$4,684.51
|
|
| Hospital Charge Code |
68200001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$825.88 |
| Max. Negotiated Rate |
$4,216.06 |
| Rate for Payer: Aetna Commercial |
$3,981.83
|
| Rate for Payer: Aetna Medicare |
$1,217.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,463.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,463.91
|
| Rate for Payer: BCBS Complete |
$867.10
|
| Rate for Payer: BCBS MAPPO |
$1,171.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,851.14
|
| Rate for Payer: BCN Commercial |
$3,851.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,171.13
|
| Rate for Payer: Cash Price |
$3,747.61
|
| Rate for Payer: Cofinity Commercial |
$4,028.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,747.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,171.13
|
| Rate for Payer: Healthscope Commercial |
$4,216.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,513.38
|
| Rate for Payer: Mclaren Medicaid |
$825.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,229.68
|
| Rate for Payer: Meridian Medicaid |
$867.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,346.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,288.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,981.83
|
| Rate for Payer: Nomi Health Commercial |
$3,841.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,513.38
|
| Rate for Payer: PACE Senior Care Partners |
$1,112.57
|
| Rate for Payer: PACE SWMI |
$1,171.13
|
| Rate for Payer: PHP Commercial |
$3,981.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,171.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$825.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,075.52
|
| Rate for Payer: Priority Health Medicare |
$1,182.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,260.42
|
| Rate for Payer: Railroad Medicare Medicare |
$1,171.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,122.37
|
| Rate for Payer: UHC Core |
$3,911.57
|
| Rate for Payer: UHC Exchange |
$1,171.13
|
| Rate for Payer: UHC Medicaid |
$825.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,171.13
|
| Rate for Payer: UHCCP Medicaid |
$825.88
|
| Rate for Payer: VA VA |
$1,171.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,513.38
|
|
|
HC TIER 3 TRAUMA CONSULT
|
Facility
|
IP
|
$3,573.09
|
|
| Hospital Charge Code |
68100002
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$2,486.87 |
| Max. Negotiated Rate |
$3,215.78 |
| Rate for Payer: Aetna Commercial |
$3,037.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,951.02
|
| Rate for Payer: BCN Commercial |
$2,951.02
|
| Rate for Payer: Cash Price |
$2,858.47
|
| Rate for Payer: Cofinity Commercial |
$3,072.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,858.47
|
| Rate for Payer: Healthscope Commercial |
$3,215.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,679.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,037.13
|
| Rate for Payer: Nomi Health Commercial |
$2,929.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,679.82
|
| Rate for Payer: PHP Commercial |
$3,037.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,108.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,486.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,144.32
|
| Rate for Payer: UHC Core |
$2,983.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,679.82
|
|
|
HC TIER 3 TRAUMA CONSULT
|
Facility
|
OP
|
$3,573.09
|
|
| Hospital Charge Code |
68100002
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$629.94 |
| Max. Negotiated Rate |
$3,215.78 |
| Rate for Payer: Aetna Commercial |
$3,037.13
|
| Rate for Payer: Aetna Medicare |
$929.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,116.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,116.59
|
| Rate for Payer: BCBS Complete |
$661.38
|
| Rate for Payer: BCBS MAPPO |
$893.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,937.44
|
| Rate for Payer: BCN Commercial |
$2,937.44
|
| Rate for Payer: BCN Medicare Advantage |
$893.27
|
| Rate for Payer: Cash Price |
$2,858.47
|
| Rate for Payer: Cofinity Commercial |
$3,072.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,858.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$893.27
|
| Rate for Payer: Healthscope Commercial |
$3,215.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,679.82
|
| Rate for Payer: Mclaren Medicaid |
$629.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$937.94
|
| Rate for Payer: Meridian Medicaid |
$661.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,027.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$982.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,037.13
|
| Rate for Payer: Nomi Health Commercial |
$2,929.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,679.82
|
| Rate for Payer: PACE Senior Care Partners |
$848.61
|
| Rate for Payer: PACE SWMI |
$893.27
|
| Rate for Payer: PHP Commercial |
$3,037.13
|
| Rate for Payer: PHP Medicare Advantage |
$893.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$629.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,108.59
|
| Rate for Payer: Priority Health Medicare |
$902.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,486.87
|
| Rate for Payer: Railroad Medicare Medicare |
$893.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,144.32
|
| Rate for Payer: UHC Core |
$2,983.53
|
| Rate for Payer: UHC Exchange |
$893.27
|
| Rate for Payer: UHC Medicaid |
$629.94
|
| Rate for Payer: UHC Medicare Advantage |
$893.27
|
| Rate for Payer: UHCCP Medicaid |
$629.94
|
| Rate for Payer: VA VA |
$893.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,679.82
|
|
|
HC TIER 4 TRAUMA CONSULT
|
Facility
|
OP
|
$2,726.25
|
|
| Hospital Charge Code |
68100003
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$480.64 |
| Max. Negotiated Rate |
$2,453.62 |
| Rate for Payer: Aetna Commercial |
$2,317.31
|
| Rate for Payer: Aetna Medicare |
$708.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$851.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$851.95
|
| Rate for Payer: BCBS Complete |
$504.63
|
| Rate for Payer: BCBS MAPPO |
$681.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,241.25
|
| Rate for Payer: BCN Commercial |
$2,241.25
|
| Rate for Payer: BCN Medicare Advantage |
$681.56
|
| Rate for Payer: Cash Price |
$2,181.00
|
| Rate for Payer: Cofinity Commercial |
$2,344.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,181.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$681.56
|
| Rate for Payer: Healthscope Commercial |
$2,453.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,044.69
|
| Rate for Payer: Mclaren Medicaid |
$480.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$715.64
|
| Rate for Payer: Meridian Medicaid |
$504.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$783.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$749.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,317.31
|
| Rate for Payer: Nomi Health Commercial |
$2,235.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,044.69
|
| Rate for Payer: PACE Senior Care Partners |
$647.48
|
| Rate for Payer: PACE SWMI |
$681.56
|
| Rate for Payer: PHP Commercial |
$2,317.31
|
| Rate for Payer: PHP Medicare Advantage |
$681.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$480.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,371.84
|
| Rate for Payer: Priority Health Medicare |
$688.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,897.47
|
| Rate for Payer: Railroad Medicare Medicare |
$681.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,399.10
|
| Rate for Payer: UHC Core |
$2,276.42
|
| Rate for Payer: UHC Exchange |
$681.56
|
| Rate for Payer: UHC Medicaid |
$480.64
|
| Rate for Payer: UHC Medicare Advantage |
$681.56
|
| Rate for Payer: UHCCP Medicaid |
$480.64
|
| Rate for Payer: VA VA |
$681.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,044.69
|
|
|
HC TIER 4 TRAUMA CONSULT
|
Facility
|
IP
|
$2,726.25
|
|
| Hospital Charge Code |
68100003
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$1,897.47 |
| Max. Negotiated Rate |
$2,453.62 |
| Rate for Payer: Aetna Commercial |
$2,317.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,251.61
|
| Rate for Payer: BCN Commercial |
$2,251.61
|
| Rate for Payer: Cash Price |
$2,181.00
|
| Rate for Payer: Cofinity Commercial |
$2,344.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,181.00
|
| Rate for Payer: Healthscope Commercial |
$2,453.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,044.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,317.31
|
| Rate for Payer: Nomi Health Commercial |
$2,235.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,044.69
|
| Rate for Payer: PHP Commercial |
$2,317.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,371.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,897.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,399.10
|
| Rate for Payer: UHC Core |
$2,276.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,044.69
|
|
|
HC TILT TABLE STRESS
|
Facility
|
IP
|
$1,145.32
|
|
|
Service Code
|
CPT 93660
|
| Hospital Charge Code |
48200002
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$797.14 |
| Max. Negotiated Rate |
$1,030.79 |
| Rate for Payer: Aetna Commercial |
$973.52
|
| Rate for Payer: BCBS Trust/PPO |
$945.92
|
| Rate for Payer: BCN Commercial |
$945.92
|
| Rate for Payer: Cash Price |
$916.26
|
| Rate for Payer: Cofinity Commercial |
$984.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.26
|
| Rate for Payer: Healthscope Commercial |
$1,030.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.52
|
| Rate for Payer: Nomi Health Commercial |
$939.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.99
|
| Rate for Payer: PHP Commercial |
$973.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$996.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$797.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.88
|
| Rate for Payer: UHC Core |
$956.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.99
|
|
|
HC TILT TABLE STRESS
|
Facility
|
OP
|
$1,145.32
|
|
|
Service Code
|
CPT 93660
|
| Hospital Charge Code |
48200002
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$201.92 |
| Max. Negotiated Rate |
$1,030.79 |
| Rate for Payer: Aetna Commercial |
$973.52
|
| Rate for Payer: Aetna Medicare |
$297.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$357.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$357.91
|
| Rate for Payer: BCBS Complete |
$212.00
|
| Rate for Payer: BCBS MAPPO |
$286.33
|
| Rate for Payer: BCBS Trust/PPO |
$941.57
|
| Rate for Payer: BCN Commercial |
$941.57
|
| Rate for Payer: BCN Medicare Advantage |
$286.33
|
| Rate for Payer: Cash Price |
$916.26
|
| Rate for Payer: Cofinity Commercial |
$984.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$286.33
|
| Rate for Payer: Healthscope Commercial |
$1,030.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.99
|
| Rate for Payer: Mclaren Medicaid |
$201.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$300.65
|
| Rate for Payer: Meridian Medicaid |
$212.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$329.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$314.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.52
|
| Rate for Payer: Nomi Health Commercial |
$939.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.99
|
| Rate for Payer: PACE Senior Care Partners |
$272.01
|
| Rate for Payer: PACE SWMI |
$286.33
|
| Rate for Payer: PHP Commercial |
$973.52
|
| Rate for Payer: PHP Medicare Advantage |
$286.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$996.43
|
| Rate for Payer: Priority Health Medicare |
$289.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$797.14
|
| Rate for Payer: Railroad Medicare Medicare |
$286.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,007.88
|
| Rate for Payer: UHC Core |
$956.34
|
| Rate for Payer: UHC Exchange |
$286.33
|
| Rate for Payer: UHC Medicaid |
$201.92
|
| Rate for Payer: UHC Medicare Advantage |
$286.33
|
| Rate for Payer: UHCCP Medicaid |
$201.92
|
| Rate for Payer: VA VA |
$286.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.99
|
|
|
HC TIMOTHY GRASS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200063
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC TIMOTHY GRASS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200063
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC TIP PUMP SUCTION
|
Facility
|
OP
|
$43.70
|
|
| Hospital Charge Code |
27000111
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$39.33 |
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: Aetna Medicare |
$11.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.66
|
| Rate for Payer: BCBS Complete |
$8.09
|
| Rate for Payer: BCBS MAPPO |
$10.93
|
| Rate for Payer: BCBS Trust/PPO |
$35.93
|
| Rate for Payer: BCN Commercial |
$35.93
|
| Rate for Payer: BCN Medicare Advantage |
$10.93
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$37.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.93
|
| Rate for Payer: Healthscope Commercial |
$39.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.77
|
| Rate for Payer: Mclaren Medicaid |
$7.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.47
|
| Rate for Payer: Meridian Medicaid |
$8.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.77
|
| Rate for Payer: PACE Senior Care Partners |
$10.38
|
| Rate for Payer: PACE SWMI |
$10.93
|
| Rate for Payer: PHP Commercial |
$37.15
|
| Rate for Payer: PHP Medicare Advantage |
$10.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.02
|
| Rate for Payer: Priority Health Medicare |
$11.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.42
|
| Rate for Payer: Railroad Medicare Medicare |
$10.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.46
|
| Rate for Payer: UHC Core |
$36.49
|
| Rate for Payer: UHC Exchange |
$10.93
|
| Rate for Payer: UHC Medicaid |
$7.70
|
| Rate for Payer: UHC Medicare Advantage |
$10.93
|
| Rate for Payer: UHCCP Medicaid |
$7.70
|
| Rate for Payer: VA VA |
$10.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.77
|
|
|
HC TIP PUMP SUCTION
|
Facility
|
IP
|
$43.70
|
|
| Hospital Charge Code |
27000111
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.42 |
| Max. Negotiated Rate |
$39.33 |
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: BCBS Trust/PPO |
$36.09
|
| Rate for Payer: BCN Commercial |
$36.09
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$37.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Healthscope Commercial |
$39.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.77
|
| Rate for Payer: PHP Commercial |
$37.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.46
|
| Rate for Payer: UHC Core |
$36.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.77
|
|
|
HC TISSUE IN SITU HYB QUANT EA ADD
|
Facility
|
IP
|
$274.85
|
|
|
Service Code
|
CPT 88369
|
| Hospital Charge Code |
31000123
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$191.30 |
| Max. Negotiated Rate |
$247.37 |
| Rate for Payer: Aetna Commercial |
$233.62
|
| Rate for Payer: BCBS Trust/PPO |
$227.00
|
| Rate for Payer: BCN Commercial |
$227.00
|
| Rate for Payer: Cash Price |
$219.88
|
| Rate for Payer: Cofinity Commercial |
$236.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.88
|
| Rate for Payer: Healthscope Commercial |
$247.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.62
|
| Rate for Payer: Nomi Health Commercial |
$225.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.14
|
| Rate for Payer: PHP Commercial |
$233.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$239.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.87
|
| Rate for Payer: UHC Core |
$229.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.14
|
|
|
HC TISSUE IN SITU HYB QUANT EA ADD
|
Facility
|
OP
|
$274.85
|
|
|
Service Code
|
CPT 88369
|
| Hospital Charge Code |
31000123
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$48.46 |
| Max. Negotiated Rate |
$247.37 |
| Rate for Payer: Aetna Commercial |
$233.62
|
| Rate for Payer: Aetna Medicare |
$71.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.89
|
| Rate for Payer: BCBS Complete |
$50.87
|
| Rate for Payer: BCBS MAPPO |
$68.71
|
| Rate for Payer: BCBS Trust/PPO |
$225.95
|
| Rate for Payer: BCCCP Commercial |
$121.51
|
| Rate for Payer: BCN Commercial |
$225.95
|
| Rate for Payer: BCN Medicare Advantage |
$68.71
|
| Rate for Payer: Cash Price |
$219.88
|
| Rate for Payer: Cash Price |
$219.88
|
| Rate for Payer: Cofinity Commercial |
$236.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.71
|
| Rate for Payer: Healthscope Commercial |
$247.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.14
|
| Rate for Payer: Mclaren Medicaid |
$48.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.15
|
| Rate for Payer: Meridian Medicaid |
$50.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$75.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.62
|
| Rate for Payer: Nomi Health Commercial |
$225.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.14
|
| Rate for Payer: PACE Senior Care Partners |
$65.28
|
| Rate for Payer: PACE SWMI |
$68.71
|
| Rate for Payer: PHP Commercial |
$233.62
|
| Rate for Payer: PHP Medicare Advantage |
$68.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$239.12
|
| Rate for Payer: Priority Health Medicare |
$69.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.30
|
| Rate for Payer: Railroad Medicare Medicare |
$68.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.87
|
| Rate for Payer: UHC Core |
$229.50
|
| Rate for Payer: UHC Exchange |
$68.71
|
| Rate for Payer: UHC Medicaid |
$48.46
|
| Rate for Payer: UHC Medicare Advantage |
$68.71
|
| Rate for Payer: UHCCP Medicaid |
$48.46
|
| Rate for Payer: VA VA |
$68.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.14
|
|
|
HC TISSUE IN SITU HYBRIDIZATION
|
Facility
|
OP
|
$379.45
|
|
|
Service Code
|
CPT 88365
|
| Hospital Charge Code |
31000060
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$66.90 |
| Max. Negotiated Rate |
$341.50 |
| Rate for Payer: Aetna Commercial |
$322.53
|
| Rate for Payer: Aetna Medicare |
$98.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.58
|
| Rate for Payer: BCBS Complete |
$70.24
|
| Rate for Payer: BCBS MAPPO |
$94.86
|
| Rate for Payer: BCBS Trust/PPO |
$311.95
|
| Rate for Payer: BCCCP Commercial |
$161.79
|
| Rate for Payer: BCN Commercial |
$311.95
|
| Rate for Payer: BCN Medicare Advantage |
$94.86
|
| Rate for Payer: Cash Price |
$303.56
|
| Rate for Payer: Cash Price |
$303.56
|
| Rate for Payer: Cofinity Commercial |
$326.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.86
|
| Rate for Payer: Healthscope Commercial |
$341.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.59
|
| Rate for Payer: Mclaren Medicaid |
$66.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.61
|
| Rate for Payer: Meridian Medicaid |
$70.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.53
|
| Rate for Payer: Nomi Health Commercial |
$311.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.59
|
| Rate for Payer: PACE Senior Care Partners |
$90.12
|
| Rate for Payer: PACE SWMI |
$94.86
|
| Rate for Payer: PHP Commercial |
$322.53
|
| Rate for Payer: PHP Medicare Advantage |
$94.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$330.12
|
| Rate for Payer: Priority Health Medicare |
$95.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$264.10
|
| Rate for Payer: Railroad Medicare Medicare |
$94.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.92
|
| Rate for Payer: UHC Core |
$316.84
|
| Rate for Payer: UHC Exchange |
$94.86
|
| Rate for Payer: UHC Medicaid |
$66.90
|
| Rate for Payer: UHC Medicare Advantage |
$94.86
|
| Rate for Payer: UHCCP Medicaid |
$66.90
|
| Rate for Payer: VA VA |
$94.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.59
|
|
|
HC TISSUE IN SITU HYBRIDIZATION
|
Facility
|
IP
|
$379.45
|
|
|
Service Code
|
CPT 88365
|
| Hospital Charge Code |
31000060
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$264.10 |
| Max. Negotiated Rate |
$341.50 |
| Rate for Payer: Aetna Commercial |
$322.53
|
| Rate for Payer: BCBS Trust/PPO |
$313.39
|
| Rate for Payer: BCN Commercial |
$313.39
|
| Rate for Payer: Cash Price |
$303.56
|
| Rate for Payer: Cofinity Commercial |
$326.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.56
|
| Rate for Payer: Healthscope Commercial |
$341.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.53
|
| Rate for Payer: Nomi Health Commercial |
$311.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.59
|
| Rate for Payer: PHP Commercial |
$322.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$330.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$264.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.92
|
| Rate for Payer: UHC Core |
$316.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.59
|
|
|
HC TISSUE IN SITU HYBRID QUANT
|
Facility
|
OP
|
$274.85
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000122
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$48.46 |
| Max. Negotiated Rate |
$247.37 |
| Rate for Payer: Aetna Commercial |
$233.62
|
| Rate for Payer: Aetna Medicare |
$71.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.89
|
| Rate for Payer: BCBS Complete |
$50.87
|
| Rate for Payer: BCBS MAPPO |
$68.71
|
| Rate for Payer: BCBS Trust/PPO |
$225.95
|
| Rate for Payer: BCCCP Commercial |
$138.78
|
| Rate for Payer: BCN Commercial |
$225.95
|
| Rate for Payer: BCN Medicare Advantage |
$68.71
|
| Rate for Payer: Cash Price |
$219.88
|
| Rate for Payer: Cash Price |
$219.88
|
| Rate for Payer: Cofinity Commercial |
$236.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.71
|
| Rate for Payer: Healthscope Commercial |
$247.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.14
|
| Rate for Payer: Mclaren Medicaid |
$48.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.15
|
| Rate for Payer: Meridian Medicaid |
$50.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$75.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.62
|
| Rate for Payer: Nomi Health Commercial |
$225.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.14
|
| Rate for Payer: PACE Senior Care Partners |
$65.28
|
| Rate for Payer: PACE SWMI |
$68.71
|
| Rate for Payer: PHP Commercial |
$233.62
|
| Rate for Payer: PHP Medicare Advantage |
$68.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$239.12
|
| Rate for Payer: Priority Health Medicare |
$69.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.30
|
| Rate for Payer: Railroad Medicare Medicare |
$68.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.87
|
| Rate for Payer: UHC Core |
$229.50
|
| Rate for Payer: UHC Exchange |
$68.71
|
| Rate for Payer: UHC Medicaid |
$48.46
|
| Rate for Payer: UHC Medicare Advantage |
$68.71
|
| Rate for Payer: UHCCP Medicaid |
$48.46
|
| Rate for Payer: VA VA |
$68.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.14
|
|
|
HC TISSUE IN SITU HYBRID QUANT
|
Facility
|
IP
|
$274.85
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000122
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$191.30 |
| Max. Negotiated Rate |
$247.37 |
| Rate for Payer: Aetna Commercial |
$233.62
|
| Rate for Payer: BCBS Trust/PPO |
$227.00
|
| Rate for Payer: BCN Commercial |
$227.00
|
| Rate for Payer: Cash Price |
$219.88
|
| Rate for Payer: Cofinity Commercial |
$236.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.88
|
| Rate for Payer: Healthscope Commercial |
$247.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.62
|
| Rate for Payer: Nomi Health Commercial |
$225.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.14
|
| Rate for Payer: PHP Commercial |
$233.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$239.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.87
|
| Rate for Payer: UHC Core |
$229.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.14
|
|
|
HC TISSUE MARKER IMPLANTABLE
|
Facility
|
OP
|
$1,499.49
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800108
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$264.36 |
| Max. Negotiated Rate |
$1,349.54 |
| Rate for Payer: Aetna Commercial |
$1,274.57
|
| Rate for Payer: Aetna Medicare |
$389.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$468.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$468.59
|
| Rate for Payer: BCBS Complete |
$277.56
|
| Rate for Payer: BCBS MAPPO |
$374.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,232.73
|
| Rate for Payer: BCN Commercial |
$1,232.73
|
| Rate for Payer: BCN Medicare Advantage |
$374.87
|
| Rate for Payer: Cash Price |
$1,199.59
|
| Rate for Payer: Cofinity Commercial |
$1,289.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,199.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$374.87
|
| Rate for Payer: Healthscope Commercial |
$1,349.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,124.62
|
| Rate for Payer: Mclaren Medicaid |
$264.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$393.62
|
| Rate for Payer: Meridian Medicaid |
$277.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$431.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$412.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,274.57
|
| Rate for Payer: Nomi Health Commercial |
$1,229.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,124.62
|
| Rate for Payer: PACE Senior Care Partners |
$356.13
|
| Rate for Payer: PACE SWMI |
$374.87
|
| Rate for Payer: PHP Commercial |
$1,274.57
|
| Rate for Payer: PHP Medicare Advantage |
$374.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,304.56
|
| Rate for Payer: Priority Health Medicare |
$378.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,043.65
|
| Rate for Payer: Railroad Medicare Medicare |
$374.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,319.55
|
| Rate for Payer: UHC Core |
$1,252.07
|
| Rate for Payer: UHC Exchange |
$374.87
|
| Rate for Payer: UHC Medicaid |
$264.36
|
| Rate for Payer: UHC Medicare Advantage |
$374.87
|
| Rate for Payer: UHCCP Medicaid |
$264.36
|
| Rate for Payer: VA VA |
$374.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,124.62
|
|
|
HC TISSUE MARKER IMPLANTABLE
|
Facility
|
IP
|
$1,499.49
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800108
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,043.65 |
| Max. Negotiated Rate |
$1,349.54 |
| Rate for Payer: Aetna Commercial |
$1,274.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,238.43
|
| Rate for Payer: BCN Commercial |
$1,238.43
|
| Rate for Payer: Cash Price |
$1,199.59
|
| Rate for Payer: Cofinity Commercial |
$1,289.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,199.59
|
| Rate for Payer: Healthscope Commercial |
$1,349.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,124.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,274.57
|
| Rate for Payer: Nomi Health Commercial |
$1,229.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,124.62
|
| Rate for Payer: PHP Commercial |
$1,274.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,304.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,043.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,319.55
|
| Rate for Payer: UHC Core |
$1,252.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,124.62
|
|
