|
HC TOMO GUIDED BREAST LOCALIZATION
|
Facility
|
IP
|
$3,312.83
|
|
|
Service Code
|
CPT 19499
|
| Hospital Charge Code |
36100567
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,305.73 |
| Max. Negotiated Rate |
$2,981.55 |
| Rate for Payer: Aetna Commercial |
$2,815.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,736.07
|
| Rate for Payer: BCN Commercial |
$2,736.07
|
| Rate for Payer: Cash Price |
$2,650.26
|
| Rate for Payer: Cofinity Commercial |
$2,849.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,650.26
|
| Rate for Payer: Healthscope Commercial |
$2,981.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,484.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,815.91
|
| Rate for Payer: Nomi Health Commercial |
$2,716.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,484.62
|
| Rate for Payer: PHP Commercial |
$2,815.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,882.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,305.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,915.29
|
| Rate for Payer: UHC Core |
$2,766.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,484.62
|
|
|
HC TONE DECAY HEARING TEST
|
Facility
|
IP
|
$58.26
|
|
|
Service Code
|
CPT 92563
|
| Hospital Charge Code |
76100501
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$40.55 |
| Max. Negotiated Rate |
$52.43 |
| Rate for Payer: Aetna Commercial |
$49.52
|
| Rate for Payer: BCBS Trust/PPO |
$48.12
|
| Rate for Payer: BCN Commercial |
$48.12
|
| Rate for Payer: Cash Price |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$50.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.61
|
| Rate for Payer: Healthscope Commercial |
$52.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.52
|
| Rate for Payer: Nomi Health Commercial |
$47.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.70
|
| Rate for Payer: PHP Commercial |
$49.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.27
|
| Rate for Payer: UHC Core |
$48.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.70
|
|
|
HC TONE DECAY HEARING TEST
|
Facility
|
OP
|
$58.26
|
|
|
Service Code
|
CPT 92563
|
| Hospital Charge Code |
76100501
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$52.43 |
| Rate for Payer: Aetna Commercial |
$49.52
|
| Rate for Payer: Aetna Medicare |
$15.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.21
|
| Rate for Payer: BCBS Complete |
$10.78
|
| Rate for Payer: BCBS MAPPO |
$14.56
|
| Rate for Payer: BCBS Trust/PPO |
$47.90
|
| Rate for Payer: BCN Commercial |
$47.90
|
| Rate for Payer: BCN Medicare Advantage |
$14.56
|
| Rate for Payer: Cash Price |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$50.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.56
|
| Rate for Payer: Healthscope Commercial |
$52.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.70
|
| Rate for Payer: Mclaren Medicaid |
$10.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.29
|
| Rate for Payer: Meridian Medicaid |
$10.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.52
|
| Rate for Payer: Nomi Health Commercial |
$47.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.70
|
| Rate for Payer: PACE Senior Care Partners |
$13.84
|
| Rate for Payer: PACE SWMI |
$14.56
|
| Rate for Payer: PHP Commercial |
$49.52
|
| Rate for Payer: PHP Medicare Advantage |
$14.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.69
|
| Rate for Payer: Priority Health Medicare |
$14.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.55
|
| Rate for Payer: Railroad Medicare Medicare |
$14.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.27
|
| Rate for Payer: UHC Core |
$48.65
|
| Rate for Payer: UHC Exchange |
$14.56
|
| Rate for Payer: UHC Medicaid |
$10.27
|
| Rate for Payer: UHC Medicare Advantage |
$14.56
|
| Rate for Payer: UHCCP Medicaid |
$10.27
|
| Rate for Payer: VA VA |
$14.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.70
|
|
|
HC TOPIRAMATE LEVEL
|
Facility
|
IP
|
$59.79
|
|
|
Service Code
|
CPT 80201
|
| Hospital Charge Code |
30100050
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.61 |
| Max. Negotiated Rate |
$53.81 |
| Rate for Payer: Aetna Commercial |
$50.82
|
| Rate for Payer: BCBS Trust/PPO |
$49.38
|
| Rate for Payer: BCN Commercial |
$49.38
|
| Rate for Payer: Cash Price |
$47.83
|
| Rate for Payer: Cofinity Commercial |
$51.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.83
|
| Rate for Payer: Healthscope Commercial |
$53.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.82
|
| Rate for Payer: Nomi Health Commercial |
$49.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.84
|
| Rate for Payer: PHP Commercial |
$50.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.62
|
| Rate for Payer: UHC Core |
$49.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.84
|
|
|
HC TOPIRAMATE LEVEL
|
Facility
|
OP
|
$59.79
|
|
|
Service Code
|
CPT 80201
|
| Hospital Charge Code |
30100050
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$53.81 |
| Rate for Payer: Aetna Commercial |
$50.82
|
| Rate for Payer: Aetna Medicare |
$15.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.68
|
| Rate for Payer: BCBS Complete |
$11.07
|
| Rate for Payer: BCBS MAPPO |
$14.95
|
| Rate for Payer: BCBS Trust/PPO |
$49.15
|
| Rate for Payer: BCN Commercial |
$49.15
|
| Rate for Payer: BCN Medicare Advantage |
$14.95
|
| Rate for Payer: Cash Price |
$47.83
|
| Rate for Payer: Cofinity Commercial |
$51.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.95
|
| Rate for Payer: Healthscope Commercial |
$53.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.84
|
| Rate for Payer: Mclaren Medicaid |
$10.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.69
|
| Rate for Payer: Meridian Medicaid |
$11.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.82
|
| Rate for Payer: Nomi Health Commercial |
$49.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.84
|
| Rate for Payer: PACE Senior Care Partners |
$14.20
|
| Rate for Payer: PACE SWMI |
$14.95
|
| Rate for Payer: PHP Commercial |
$50.82
|
| Rate for Payer: PHP Medicare Advantage |
$14.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.02
|
| Rate for Payer: Priority Health Medicare |
$15.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.61
|
| Rate for Payer: Railroad Medicare Medicare |
$14.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.62
|
| Rate for Payer: UHC Core |
$49.92
|
| Rate for Payer: UHC Exchange |
$14.95
|
| Rate for Payer: UHC Medicaid |
$10.54
|
| Rate for Payer: UHC Medicare Advantage |
$14.95
|
| Rate for Payer: UHCCP Medicaid |
$10.54
|
| Rate for Payer: VA VA |
$14.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.84
|
|
|
HC TORCH PROFILE IGG
|
Facility
|
IP
|
$14.86
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200251
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$13.37 |
| Rate for Payer: Aetna Commercial |
$12.63
|
| Rate for Payer: BCBS Trust/PPO |
$12.27
|
| Rate for Payer: BCN Commercial |
$12.27
|
| Rate for Payer: Cash Price |
$11.89
|
| Rate for Payer: Cofinity Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.89
|
| Rate for Payer: Healthscope Commercial |
$13.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.63
|
| Rate for Payer: Nomi Health Commercial |
$12.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.14
|
| Rate for Payer: PHP Commercial |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.08
|
| Rate for Payer: UHC Core |
$12.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.14
|
|
|
HC TORCH PROFILE IGG
|
Facility
|
OP
|
$14.86
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200251
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.62 |
| Max. Negotiated Rate |
$13.37 |
| Rate for Payer: Aetna Commercial |
$12.63
|
| Rate for Payer: Aetna Medicare |
$3.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.64
|
| Rate for Payer: BCBS Complete |
$2.75
|
| Rate for Payer: BCBS MAPPO |
$3.71
|
| Rate for Payer: BCBS Trust/PPO |
$12.22
|
| Rate for Payer: BCN Commercial |
$12.22
|
| Rate for Payer: BCN Medicare Advantage |
$3.71
|
| Rate for Payer: Cash Price |
$11.89
|
| Rate for Payer: Cofinity Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.71
|
| Rate for Payer: Healthscope Commercial |
$13.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.14
|
| Rate for Payer: Mclaren Medicaid |
$2.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.90
|
| Rate for Payer: Meridian Medicaid |
$2.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.63
|
| Rate for Payer: Nomi Health Commercial |
$12.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.14
|
| Rate for Payer: PACE Senior Care Partners |
$3.53
|
| Rate for Payer: PACE SWMI |
$3.71
|
| Rate for Payer: PHP Commercial |
$12.63
|
| Rate for Payer: PHP Medicare Advantage |
$3.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.93
|
| Rate for Payer: Priority Health Medicare |
$3.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.34
|
| Rate for Payer: Railroad Medicare Medicare |
$3.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.08
|
| Rate for Payer: UHC Core |
$12.41
|
| Rate for Payer: UHC Exchange |
$3.71
|
| Rate for Payer: UHC Medicaid |
$2.62
|
| Rate for Payer: UHC Medicare Advantage |
$3.71
|
| Rate for Payer: UHCCP Medicaid |
$2.62
|
| Rate for Payer: VA VA |
$3.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.14
|
|
|
HC TORCH PROFILE IGG CMPT 1
|
Facility
|
OP
|
$14.86
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
30200354
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.62 |
| Max. Negotiated Rate |
$13.37 |
| Rate for Payer: Aetna Commercial |
$12.63
|
| Rate for Payer: Aetna Medicare |
$3.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.64
|
| Rate for Payer: BCBS Complete |
$2.75
|
| Rate for Payer: BCBS MAPPO |
$3.71
|
| Rate for Payer: BCBS Trust/PPO |
$12.22
|
| Rate for Payer: BCN Commercial |
$12.22
|
| Rate for Payer: BCN Medicare Advantage |
$3.71
|
| Rate for Payer: Cash Price |
$11.89
|
| Rate for Payer: Cofinity Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.71
|
| Rate for Payer: Healthscope Commercial |
$13.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.14
|
| Rate for Payer: Mclaren Medicaid |
$2.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.90
|
| Rate for Payer: Meridian Medicaid |
$2.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.63
|
| Rate for Payer: Nomi Health Commercial |
$12.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.14
|
| Rate for Payer: PACE Senior Care Partners |
$3.53
|
| Rate for Payer: PACE SWMI |
$3.71
|
| Rate for Payer: PHP Commercial |
$12.63
|
| Rate for Payer: PHP Medicare Advantage |
$3.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.93
|
| Rate for Payer: Priority Health Medicare |
$3.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.34
|
| Rate for Payer: Railroad Medicare Medicare |
$3.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.08
|
| Rate for Payer: UHC Core |
$12.41
|
| Rate for Payer: UHC Exchange |
$3.71
|
| Rate for Payer: UHC Medicaid |
$2.62
|
| Rate for Payer: UHC Medicare Advantage |
$3.71
|
| Rate for Payer: UHCCP Medicaid |
$2.62
|
| Rate for Payer: VA VA |
$3.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.14
|
|
|
HC TORCH PROFILE IGG CMPT 1
|
Facility
|
IP
|
$14.86
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
30200354
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$13.37 |
| Rate for Payer: Aetna Commercial |
$12.63
|
| Rate for Payer: BCBS Trust/PPO |
$12.27
|
| Rate for Payer: BCN Commercial |
$12.27
|
| Rate for Payer: Cash Price |
$11.89
|
| Rate for Payer: Cofinity Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.89
|
| Rate for Payer: Healthscope Commercial |
$13.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.63
|
| Rate for Payer: Nomi Health Commercial |
$12.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.14
|
| Rate for Payer: PHP Commercial |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.08
|
| Rate for Payer: UHC Core |
$12.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.14
|
|
|
HC TORCH PROFILE IGG CMPT 2
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
30200285
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC TORCH PROFILE IGG CMPT 2
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
30200285
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$17.53
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC TORCH PROFILE IGG CMPT 4
|
Facility
|
IP
|
$14.86
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
30200322
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$13.37 |
| Rate for Payer: Aetna Commercial |
$12.63
|
| Rate for Payer: BCBS Trust/PPO |
$12.27
|
| Rate for Payer: BCN Commercial |
$12.27
|
| Rate for Payer: Cash Price |
$11.89
|
| Rate for Payer: Cofinity Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.89
|
| Rate for Payer: Healthscope Commercial |
$13.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.63
|
| Rate for Payer: Nomi Health Commercial |
$12.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.14
|
| Rate for Payer: PHP Commercial |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.08
|
| Rate for Payer: UHC Core |
$12.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.14
|
|
|
HC TORCH PROFILE IGG CMPT 4
|
Facility
|
OP
|
$14.86
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
30200322
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.62 |
| Max. Negotiated Rate |
$13.37 |
| Rate for Payer: Aetna Commercial |
$12.63
|
| Rate for Payer: Aetna Medicare |
$3.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.64
|
| Rate for Payer: BCBS Complete |
$2.75
|
| Rate for Payer: BCBS MAPPO |
$3.71
|
| Rate for Payer: BCBS Trust/PPO |
$12.22
|
| Rate for Payer: BCN Commercial |
$12.22
|
| Rate for Payer: BCN Medicare Advantage |
$3.71
|
| Rate for Payer: Cash Price |
$11.89
|
| Rate for Payer: Cofinity Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.71
|
| Rate for Payer: Healthscope Commercial |
$13.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.14
|
| Rate for Payer: Mclaren Medicaid |
$2.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.90
|
| Rate for Payer: Meridian Medicaid |
$2.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.63
|
| Rate for Payer: Nomi Health Commercial |
$12.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.14
|
| Rate for Payer: PACE Senior Care Partners |
$3.53
|
| Rate for Payer: PACE SWMI |
$3.71
|
| Rate for Payer: PHP Commercial |
$12.63
|
| Rate for Payer: PHP Medicare Advantage |
$3.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.93
|
| Rate for Payer: Priority Health Medicare |
$3.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.34
|
| Rate for Payer: Railroad Medicare Medicare |
$3.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.08
|
| Rate for Payer: UHC Core |
$12.41
|
| Rate for Payer: UHC Exchange |
$3.71
|
| Rate for Payer: UHC Medicaid |
$2.62
|
| Rate for Payer: UHC Medicare Advantage |
$3.71
|
| Rate for Payer: UHCCP Medicaid |
$2.62
|
| Rate for Payer: VA VA |
$3.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.14
|
|
|
HC TORCH PROFILE IGM CMPT 1
|
Facility
|
OP
|
$70.04
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200280
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$63.04 |
| Rate for Payer: Aetna Commercial |
$59.53
|
| Rate for Payer: Aetna Medicare |
$18.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.89
|
| Rate for Payer: BCBS Complete |
$12.96
|
| Rate for Payer: BCBS MAPPO |
$17.51
|
| Rate for Payer: BCBS Trust/PPO |
$57.58
|
| Rate for Payer: BCN Commercial |
$57.58
|
| Rate for Payer: BCN Medicare Advantage |
$17.51
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Cofinity Commercial |
$60.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.51
|
| Rate for Payer: Healthscope Commercial |
$63.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.53
|
| Rate for Payer: Mclaren Medicaid |
$12.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.39
|
| Rate for Payer: Meridian Medicaid |
$12.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.53
|
| Rate for Payer: Nomi Health Commercial |
$57.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.53
|
| Rate for Payer: PACE Senior Care Partners |
$16.63
|
| Rate for Payer: PACE SWMI |
$17.51
|
| Rate for Payer: PHP Commercial |
$59.53
|
| Rate for Payer: PHP Medicare Advantage |
$17.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.93
|
| Rate for Payer: Priority Health Medicare |
$17.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.75
|
| Rate for Payer: Railroad Medicare Medicare |
$17.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.64
|
| Rate for Payer: UHC Core |
$58.48
|
| Rate for Payer: UHC Exchange |
$17.51
|
| Rate for Payer: UHC Medicaid |
$12.35
|
| Rate for Payer: UHC Medicare Advantage |
$17.51
|
| Rate for Payer: UHCCP Medicaid |
$12.35
|
| Rate for Payer: VA VA |
$17.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.53
|
|
|
HC TORCH PROFILE IGM CMPT 1
|
Facility
|
IP
|
$70.04
|
|
|
Service Code
|
CPT 86694
|
| Hospital Charge Code |
30200280
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.75 |
| Max. Negotiated Rate |
$63.04 |
| Rate for Payer: Aetna Commercial |
$59.53
|
| Rate for Payer: BCBS Trust/PPO |
$57.85
|
| Rate for Payer: BCN Commercial |
$57.85
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Cofinity Commercial |
$60.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.03
|
| Rate for Payer: Healthscope Commercial |
$63.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.53
|
| Rate for Payer: Nomi Health Commercial |
$57.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.53
|
| Rate for Payer: PHP Commercial |
$59.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.64
|
| Rate for Payer: UHC Core |
$58.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.53
|
|
|
HC TORCH PROFILE IGM CMPT 2
|
Facility
|
IP
|
$70.04
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200324
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.75 |
| Max. Negotiated Rate |
$63.04 |
| Rate for Payer: Aetna Commercial |
$59.53
|
| Rate for Payer: BCBS Trust/PPO |
$57.85
|
| Rate for Payer: BCN Commercial |
$57.85
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Cofinity Commercial |
$60.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.03
|
| Rate for Payer: Healthscope Commercial |
$63.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.53
|
| Rate for Payer: Nomi Health Commercial |
$57.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.53
|
| Rate for Payer: PHP Commercial |
$59.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.64
|
| Rate for Payer: UHC Core |
$58.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.53
|
|
|
HC TORCH PROFILE IGM CMPT 2
|
Facility
|
OP
|
$70.04
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200324
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$63.04 |
| Rate for Payer: Aetna Commercial |
$59.53
|
| Rate for Payer: Aetna Medicare |
$18.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.89
|
| Rate for Payer: BCBS Complete |
$12.96
|
| Rate for Payer: BCBS MAPPO |
$17.51
|
| Rate for Payer: BCBS Trust/PPO |
$57.58
|
| Rate for Payer: BCN Commercial |
$57.58
|
| Rate for Payer: BCN Medicare Advantage |
$17.51
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Cofinity Commercial |
$60.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.51
|
| Rate for Payer: Healthscope Commercial |
$63.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.53
|
| Rate for Payer: Mclaren Medicaid |
$12.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.39
|
| Rate for Payer: Meridian Medicaid |
$12.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.53
|
| Rate for Payer: Nomi Health Commercial |
$57.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.53
|
| Rate for Payer: PACE Senior Care Partners |
$16.63
|
| Rate for Payer: PACE SWMI |
$17.51
|
| Rate for Payer: PHP Commercial |
$59.53
|
| Rate for Payer: PHP Medicare Advantage |
$17.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.93
|
| Rate for Payer: Priority Health Medicare |
$17.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.75
|
| Rate for Payer: Railroad Medicare Medicare |
$17.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.64
|
| Rate for Payer: UHC Core |
$58.48
|
| Rate for Payer: UHC Exchange |
$17.51
|
| Rate for Payer: UHC Medicaid |
$12.35
|
| Rate for Payer: UHC Medicare Advantage |
$17.51
|
| Rate for Payer: UHCCP Medicaid |
$12.35
|
| Rate for Payer: VA VA |
$17.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.53
|
|
|
HC TOTAL BODY TUMOR SCAN 2 OR MORE DAYS
|
Facility
|
OP
|
$2,379.77
|
|
|
Service Code
|
CPT 78804
|
| Hospital Charge Code |
34100057
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$419.55 |
| Max. Negotiated Rate |
$2,141.79 |
| Rate for Payer: Aetna Commercial |
$2,022.80
|
| Rate for Payer: Aetna Medicare |
$618.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$743.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$743.68
|
| Rate for Payer: BCBS Complete |
$440.50
|
| Rate for Payer: BCBS MAPPO |
$594.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,956.41
|
| Rate for Payer: BCN Commercial |
$1,956.41
|
| Rate for Payer: BCN Medicare Advantage |
$594.94
|
| Rate for Payer: Cash Price |
$1,903.82
|
| Rate for Payer: Cofinity Commercial |
$2,046.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,903.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$594.94
|
| Rate for Payer: Healthscope Commercial |
$2,141.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,784.83
|
| Rate for Payer: Mclaren Medicaid |
$419.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$624.69
|
| Rate for Payer: Meridian Medicaid |
$440.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$684.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$654.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,022.80
|
| Rate for Payer: Nomi Health Commercial |
$1,951.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,784.83
|
| Rate for Payer: PACE Senior Care Partners |
$565.20
|
| Rate for Payer: PACE SWMI |
$594.94
|
| Rate for Payer: PHP Commercial |
$2,022.80
|
| Rate for Payer: PHP Medicare Advantage |
$594.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,070.40
|
| Rate for Payer: Priority Health Medicare |
$600.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,656.32
|
| Rate for Payer: Railroad Medicare Medicare |
$594.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,094.20
|
| Rate for Payer: UHC Core |
$1,987.11
|
| Rate for Payer: UHC Exchange |
$594.94
|
| Rate for Payer: UHC Medicaid |
$419.55
|
| Rate for Payer: UHC Medicare Advantage |
$594.94
|
| Rate for Payer: UHCCP Medicaid |
$419.55
|
| Rate for Payer: VA VA |
$594.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,784.83
|
|
|
HC TOTAL BODY TUMOR SCAN 2 OR MORE DAYS
|
Facility
|
IP
|
$2,379.77
|
|
|
Service Code
|
CPT 78804
|
| Hospital Charge Code |
34100057
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,656.32 |
| Max. Negotiated Rate |
$2,141.79 |
| Rate for Payer: Aetna Commercial |
$2,022.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,965.45
|
| Rate for Payer: BCN Commercial |
$1,965.45
|
| Rate for Payer: Cash Price |
$1,903.82
|
| Rate for Payer: Cofinity Commercial |
$2,046.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,903.82
|
| Rate for Payer: Healthscope Commercial |
$2,141.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,784.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,022.80
|
| Rate for Payer: Nomi Health Commercial |
$1,951.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,784.83
|
| Rate for Payer: PHP Commercial |
$2,022.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,070.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,656.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,094.20
|
| Rate for Payer: UHC Core |
$1,987.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,784.83
|
|
|
HC TOTAL IRON BIND CALC & TRANSFE
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100483
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC TOTAL IRON BIND CALC & TRANSFE
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100483
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC TOTAL PROTEIN
|
Facility
|
IP
|
$39.64
|
|
|
Service Code
|
CPT 84155
|
| Hospital Charge Code |
30100406
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.59 |
| Max. Negotiated Rate |
$35.68 |
| Rate for Payer: Aetna Commercial |
$33.69
|
| Rate for Payer: BCBS Trust/PPO |
$32.74
|
| Rate for Payer: BCN Commercial |
$32.74
|
| Rate for Payer: Cash Price |
$31.71
|
| Rate for Payer: Cofinity Commercial |
$34.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.71
|
| Rate for Payer: Healthscope Commercial |
$35.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.69
|
| Rate for Payer: Nomi Health Commercial |
$32.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.73
|
| Rate for Payer: PHP Commercial |
$33.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.88
|
| Rate for Payer: UHC Core |
$33.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.73
|
|
|
HC TOTAL PROTEIN
|
Facility
|
OP
|
$39.64
|
|
|
Service Code
|
CPT 84155
|
| Hospital Charge Code |
30100406
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.99 |
| Max. Negotiated Rate |
$35.68 |
| Rate for Payer: Aetna Commercial |
$33.69
|
| Rate for Payer: Aetna Medicare |
$10.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.39
|
| Rate for Payer: BCBS Complete |
$7.34
|
| Rate for Payer: BCBS MAPPO |
$9.91
|
| Rate for Payer: BCBS Trust/PPO |
$32.59
|
| Rate for Payer: BCN Commercial |
$32.59
|
| Rate for Payer: BCN Medicare Advantage |
$9.91
|
| Rate for Payer: Cash Price |
$31.71
|
| Rate for Payer: Cofinity Commercial |
$34.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.91
|
| Rate for Payer: Healthscope Commercial |
$35.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.73
|
| Rate for Payer: Mclaren Medicaid |
$6.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.41
|
| Rate for Payer: Meridian Medicaid |
$7.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.69
|
| Rate for Payer: Nomi Health Commercial |
$32.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.73
|
| Rate for Payer: PACE Senior Care Partners |
$9.41
|
| Rate for Payer: PACE SWMI |
$9.91
|
| Rate for Payer: PHP Commercial |
$33.69
|
| Rate for Payer: PHP Medicare Advantage |
$9.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.49
|
| Rate for Payer: Priority Health Medicare |
$10.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.59
|
| Rate for Payer: Railroad Medicare Medicare |
$9.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.88
|
| Rate for Payer: UHC Core |
$33.10
|
| Rate for Payer: UHC Exchange |
$9.91
|
| Rate for Payer: UHC Medicaid |
$6.99
|
| Rate for Payer: UHC Medicare Advantage |
$9.91
|
| Rate for Payer: UHCCP Medicaid |
$6.99
|
| Rate for Payer: VA VA |
$9.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.73
|
|
|
HC TOTAL PROTEIN FLUID
|
Facility
|
IP
|
$39.64
|
|
|
Service Code
|
CPT 84157
|
| Hospital Charge Code |
30100408
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.59 |
| Max. Negotiated Rate |
$35.68 |
| Rate for Payer: Aetna Commercial |
$33.69
|
| Rate for Payer: BCBS Trust/PPO |
$32.74
|
| Rate for Payer: BCN Commercial |
$32.74
|
| Rate for Payer: Cash Price |
$31.71
|
| Rate for Payer: Cofinity Commercial |
$34.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.71
|
| Rate for Payer: Healthscope Commercial |
$35.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.69
|
| Rate for Payer: Nomi Health Commercial |
$32.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.73
|
| Rate for Payer: PHP Commercial |
$33.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.88
|
| Rate for Payer: UHC Core |
$33.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.73
|
|
|
HC TOTAL PROTEIN FLUID
|
Facility
|
OP
|
$39.64
|
|
|
Service Code
|
CPT 84157
|
| Hospital Charge Code |
30100408
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.99 |
| Max. Negotiated Rate |
$35.68 |
| Rate for Payer: Aetna Commercial |
$33.69
|
| Rate for Payer: Aetna Medicare |
$10.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.39
|
| Rate for Payer: BCBS Complete |
$7.34
|
| Rate for Payer: BCBS MAPPO |
$9.91
|
| Rate for Payer: BCBS Trust/PPO |
$32.59
|
| Rate for Payer: BCN Commercial |
$32.59
|
| Rate for Payer: BCN Medicare Advantage |
$9.91
|
| Rate for Payer: Cash Price |
$31.71
|
| Rate for Payer: Cofinity Commercial |
$34.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.91
|
| Rate for Payer: Healthscope Commercial |
$35.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.73
|
| Rate for Payer: Mclaren Medicaid |
$6.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.41
|
| Rate for Payer: Meridian Medicaid |
$7.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.69
|
| Rate for Payer: Nomi Health Commercial |
$32.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.73
|
| Rate for Payer: PACE Senior Care Partners |
$9.41
|
| Rate for Payer: PACE SWMI |
$9.91
|
| Rate for Payer: PHP Commercial |
$33.69
|
| Rate for Payer: PHP Medicare Advantage |
$9.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.49
|
| Rate for Payer: Priority Health Medicare |
$10.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.59
|
| Rate for Payer: Railroad Medicare Medicare |
$9.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.88
|
| Rate for Payer: UHC Core |
$33.10
|
| Rate for Payer: UHC Exchange |
$9.91
|
| Rate for Payer: UHC Medicaid |
$6.99
|
| Rate for Payer: UHC Medicare Advantage |
$9.91
|
| Rate for Payer: UHCCP Medicaid |
$6.99
|
| Rate for Payer: VA VA |
$9.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.73
|
|
