|
HC TOTAL PROTEIN URINE
|
Facility
|
IP
|
$39.64
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
30100407
|
|
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 URINE
|
Facility
|
OP
|
$39.64
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
30100407
|
|
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 T3
|
Facility
|
OP
|
$48.72
|
|
|
Service Code
|
CPT 84480
|
| Hospital Charge Code |
30100447
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.59 |
| Max. Negotiated Rate |
$43.85 |
| Rate for Payer: Aetna Commercial |
$41.41
|
| Rate for Payer: Aetna Medicare |
$12.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.22
|
| Rate for Payer: BCBS Complete |
$9.02
|
| Rate for Payer: BCBS MAPPO |
$12.18
|
| Rate for Payer: BCBS Trust/PPO |
$40.05
|
| Rate for Payer: BCN Commercial |
$40.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.18
|
| Rate for Payer: Cash Price |
$38.98
|
| Rate for Payer: Cofinity Commercial |
$41.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.18
|
| Rate for Payer: Healthscope Commercial |
$43.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.54
|
| Rate for Payer: Mclaren Medicaid |
$8.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.79
|
| Rate for Payer: Meridian Medicaid |
$9.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.41
|
| Rate for Payer: Nomi Health Commercial |
$39.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.54
|
| Rate for Payer: PACE Senior Care Partners |
$11.57
|
| Rate for Payer: PACE SWMI |
$12.18
|
| Rate for Payer: PHP Commercial |
$41.41
|
| Rate for Payer: PHP Medicare Advantage |
$12.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.39
|
| Rate for Payer: Priority Health Medicare |
$12.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.91
|
| Rate for Payer: Railroad Medicare Medicare |
$12.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.87
|
| Rate for Payer: UHC Core |
$40.68
|
| Rate for Payer: UHC Exchange |
$12.18
|
| Rate for Payer: UHC Medicaid |
$8.59
|
| Rate for Payer: UHC Medicare Advantage |
$12.18
|
| Rate for Payer: UHCCP Medicaid |
$8.59
|
| Rate for Payer: VA VA |
$12.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.54
|
|
|
HC TOTAL T3
|
Facility
|
IP
|
$48.72
|
|
|
Service Code
|
CPT 84480
|
| Hospital Charge Code |
30100447
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.91 |
| Max. Negotiated Rate |
$43.85 |
| Rate for Payer: Aetna Commercial |
$41.41
|
| Rate for Payer: BCBS Trust/PPO |
$40.24
|
| Rate for Payer: BCN Commercial |
$40.24
|
| Rate for Payer: Cash Price |
$38.98
|
| Rate for Payer: Cofinity Commercial |
$41.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.98
|
| Rate for Payer: Healthscope Commercial |
$43.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.41
|
| Rate for Payer: Nomi Health Commercial |
$39.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.54
|
| Rate for Payer: PHP Commercial |
$41.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.87
|
| Rate for Payer: UHC Core |
$40.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.54
|
|
|
HC TOXICOLOGY SCREEN SALIVA
|
Facility
|
OP
|
$169.79
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100665
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.93 |
| Max. Negotiated Rate |
$152.81 |
| Rate for Payer: Aetna Commercial |
$144.32
|
| Rate for Payer: Aetna Medicare |
$44.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.06
|
| Rate for Payer: BCBS Complete |
$31.43
|
| Rate for Payer: BCBS MAPPO |
$42.45
|
| Rate for Payer: BCBS Trust/PPO |
$139.58
|
| Rate for Payer: BCN Commercial |
$139.58
|
| Rate for Payer: BCN Medicare Advantage |
$42.45
|
| Rate for Payer: Cash Price |
$135.83
|
| Rate for Payer: Cofinity Commercial |
$146.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$152.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.34
|
| Rate for Payer: Mclaren Medicaid |
$29.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.57
|
| Rate for Payer: Meridian Medicaid |
$31.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.32
|
| Rate for Payer: Nomi Health Commercial |
$139.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.34
|
| Rate for Payer: PACE Senior Care Partners |
$40.33
|
| Rate for Payer: PACE SWMI |
$42.45
|
| Rate for Payer: PHP Commercial |
$144.32
|
| Rate for Payer: PHP Medicare Advantage |
$42.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$147.72
|
| Rate for Payer: Priority Health Medicare |
$42.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.17
|
| Rate for Payer: Railroad Medicare Medicare |
$42.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.42
|
| Rate for Payer: UHC Core |
$141.77
|
| Rate for Payer: UHC Exchange |
$42.45
|
| Rate for Payer: UHC Medicaid |
$29.93
|
| Rate for Payer: UHC Medicare Advantage |
$42.45
|
| Rate for Payer: UHCCP Medicaid |
$29.93
|
| Rate for Payer: VA VA |
$42.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.34
|
|
|
HC TOXICOLOGY SCREEN SALIVA
|
Facility
|
IP
|
$169.79
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100665
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$118.17 |
| Max. Negotiated Rate |
$152.81 |
| Rate for Payer: Aetna Commercial |
$144.32
|
| Rate for Payer: BCBS Trust/PPO |
$140.23
|
| Rate for Payer: BCN Commercial |
$140.23
|
| Rate for Payer: Cash Price |
$135.83
|
| Rate for Payer: Cofinity Commercial |
$146.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.83
|
| Rate for Payer: Healthscope Commercial |
$152.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.32
|
| Rate for Payer: Nomi Health Commercial |
$139.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.34
|
| Rate for Payer: PHP Commercial |
$144.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$147.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.42
|
| Rate for Payer: UHC Core |
$141.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.34
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
OP
|
$117.57
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
30200321
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.73 |
| Max. Negotiated Rate |
$105.81 |
| Rate for Payer: Aetna Commercial |
$99.93
|
| Rate for Payer: Aetna Medicare |
$30.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.74
|
| Rate for Payer: BCBS Complete |
$21.76
|
| Rate for Payer: BCBS MAPPO |
$29.39
|
| Rate for Payer: BCBS Trust/PPO |
$96.65
|
| Rate for Payer: BCN Commercial |
$96.65
|
| Rate for Payer: BCN Medicare Advantage |
$29.39
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cofinity Commercial |
$101.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.39
|
| Rate for Payer: Healthscope Commercial |
$105.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.18
|
| Rate for Payer: Mclaren Medicaid |
$20.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.86
|
| Rate for Payer: Meridian Medicaid |
$21.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.93
|
| Rate for Payer: Nomi Health Commercial |
$96.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.18
|
| Rate for Payer: PACE Senior Care Partners |
$27.92
|
| Rate for Payer: PACE SWMI |
$29.39
|
| Rate for Payer: PHP Commercial |
$99.93
|
| Rate for Payer: PHP Medicare Advantage |
$29.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.29
|
| Rate for Payer: Priority Health Medicare |
$29.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.83
|
| Rate for Payer: Railroad Medicare Medicare |
$29.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.46
|
| Rate for Payer: UHC Core |
$98.17
|
| Rate for Payer: UHC Exchange |
$29.39
|
| Rate for Payer: UHC Medicaid |
$20.73
|
| Rate for Payer: UHC Medicare Advantage |
$29.39
|
| Rate for Payer: UHCCP Medicaid |
$20.73
|
| Rate for Payer: VA VA |
$29.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.18
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
IP
|
$117.57
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
30200321
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$81.83 |
| Max. Negotiated Rate |
$105.81 |
| Rate for Payer: Aetna Commercial |
$99.93
|
| Rate for Payer: BCBS Trust/PPO |
$97.10
|
| Rate for Payer: BCN Commercial |
$97.10
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cofinity Commercial |
$101.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.06
|
| Rate for Payer: Healthscope Commercial |
$105.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.93
|
| Rate for Payer: Nomi Health Commercial |
$96.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.18
|
| Rate for Payer: PHP Commercial |
$99.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.46
|
| Rate for Payer: UHC Core |
$98.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.18
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC TPMT AND NUDT15 GENOTYPE
|
Facility
|
OP
|
$540.06
|
|
|
Service Code
|
CPT 0034U
|
| Hospital Charge Code |
31000138
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$95.21 |
| Max. Negotiated Rate |
$486.05 |
| Rate for Payer: Aetna Commercial |
$459.05
|
| Rate for Payer: Aetna Medicare |
$140.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$168.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$168.77
|
| Rate for Payer: BCBS Complete |
$99.97
|
| Rate for Payer: BCBS MAPPO |
$135.01
|
| Rate for Payer: BCBS Trust/PPO |
$443.98
|
| Rate for Payer: BCN Commercial |
$443.98
|
| Rate for Payer: BCN Medicare Advantage |
$135.01
|
| Rate for Payer: Cash Price |
$432.05
|
| Rate for Payer: Cofinity Commercial |
$464.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$432.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.01
|
| Rate for Payer: Healthscope Commercial |
$486.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$405.05
|
| Rate for Payer: Mclaren Medicaid |
$95.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.77
|
| Rate for Payer: Meridian Medicaid |
$99.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$155.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$148.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$459.05
|
| Rate for Payer: Nomi Health Commercial |
$442.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$405.05
|
| Rate for Payer: PACE Senior Care Partners |
$128.26
|
| Rate for Payer: PACE SWMI |
$135.01
|
| Rate for Payer: PHP Commercial |
$459.05
|
| Rate for Payer: PHP Medicare Advantage |
$135.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$469.85
|
| Rate for Payer: Priority Health Medicare |
$136.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$375.88
|
| Rate for Payer: Railroad Medicare Medicare |
$135.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$475.25
|
| Rate for Payer: UHC Core |
$450.95
|
| Rate for Payer: UHC Exchange |
$135.01
|
| Rate for Payer: UHC Medicaid |
$95.21
|
| Rate for Payer: UHC Medicare Advantage |
$135.01
|
| Rate for Payer: UHCCP Medicaid |
$95.21
|
| Rate for Payer: VA VA |
$135.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$405.05
|
|
|
HC TPMT AND NUDT15 GENOTYPE
|
Facility
|
IP
|
$540.06
|
|
|
Service Code
|
CPT 0034U
|
| Hospital Charge Code |
31000138
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$375.88 |
| Max. Negotiated Rate |
$486.05 |
| Rate for Payer: Aetna Commercial |
$459.05
|
| Rate for Payer: BCBS Trust/PPO |
$446.04
|
| Rate for Payer: BCN Commercial |
$446.04
|
| Rate for Payer: Cash Price |
$432.05
|
| Rate for Payer: Cofinity Commercial |
$464.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$432.05
|
| Rate for Payer: Healthscope Commercial |
$486.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$405.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$459.05
|
| Rate for Payer: Nomi Health Commercial |
$442.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$405.05
|
| Rate for Payer: PHP Commercial |
$459.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$469.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$375.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$475.25
|
| Rate for Payer: UHC Core |
$450.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$405.05
|
|
|
HC TRACH BUTTON SUPPLY
|
Facility
|
IP
|
$305.31
|
|
| Hospital Charge Code |
27000159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$212.50 |
| Max. Negotiated Rate |
$274.78 |
| Rate for Payer: Aetna Commercial |
$259.51
|
| Rate for Payer: BCBS Trust/PPO |
$252.16
|
| Rate for Payer: BCN Commercial |
$252.16
|
| Rate for Payer: Cash Price |
$244.25
|
| Rate for Payer: Cofinity Commercial |
$262.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.25
|
| Rate for Payer: Healthscope Commercial |
$274.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.51
|
| Rate for Payer: Nomi Health Commercial |
$250.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.98
|
| Rate for Payer: PHP Commercial |
$259.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$265.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.67
|
| Rate for Payer: UHC Core |
$254.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.98
|
|
|
HC TRACH BUTTON SUPPLY
|
Facility
|
OP
|
$305.31
|
|
| Hospital Charge Code |
27000159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$53.83 |
| Max. Negotiated Rate |
$274.78 |
| Rate for Payer: Aetna Commercial |
$259.51
|
| Rate for Payer: Aetna Medicare |
$79.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.41
|
| Rate for Payer: BCBS Complete |
$56.51
|
| Rate for Payer: BCBS MAPPO |
$76.33
|
| Rate for Payer: BCBS Trust/PPO |
$251.00
|
| Rate for Payer: BCN Commercial |
$251.00
|
| Rate for Payer: BCN Medicare Advantage |
$76.33
|
| Rate for Payer: Cash Price |
$244.25
|
| Rate for Payer: Cofinity Commercial |
$262.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.33
|
| Rate for Payer: Healthscope Commercial |
$274.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.98
|
| Rate for Payer: Mclaren Medicaid |
$53.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.14
|
| Rate for Payer: Meridian Medicaid |
$56.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.51
|
| Rate for Payer: Nomi Health Commercial |
$250.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.98
|
| Rate for Payer: PACE Senior Care Partners |
$72.51
|
| Rate for Payer: PACE SWMI |
$76.33
|
| Rate for Payer: PHP Commercial |
$259.51
|
| Rate for Payer: PHP Medicare Advantage |
$76.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$265.62
|
| Rate for Payer: Priority Health Medicare |
$77.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.50
|
| Rate for Payer: Railroad Medicare Medicare |
$76.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.67
|
| Rate for Payer: UHC Core |
$254.93
|
| Rate for Payer: UHC Exchange |
$76.33
|
| Rate for Payer: UHC Medicaid |
$53.83
|
| Rate for Payer: UHC Medicare Advantage |
$76.33
|
| Rate for Payer: UHCCP Medicaid |
$53.83
|
| Rate for Payer: VA VA |
$76.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.98
|
|
|
HC TRACHEOBRNCHSC THRU EST TRACHS INC
|
Facility
|
OP
|
$1,352.52
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
76100389
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.45 |
| Max. Negotiated Rate |
$1,217.27 |
| Rate for Payer: Aetna Commercial |
$1,149.64
|
| Rate for Payer: Aetna Medicare |
$351.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$422.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$422.66
|
| Rate for Payer: BCBS Complete |
$250.35
|
| Rate for Payer: BCBS MAPPO |
$338.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,111.91
|
| Rate for Payer: BCN Commercial |
$1,111.91
|
| Rate for Payer: BCN Medicare Advantage |
$338.13
|
| Rate for Payer: Cash Price |
$1,082.02
|
| Rate for Payer: Cofinity Commercial |
$1,163.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.13
|
| Rate for Payer: Healthscope Commercial |
$1,217.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,014.39
|
| Rate for Payer: Mclaren Medicaid |
$238.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$355.04
|
| Rate for Payer: Meridian Medicaid |
$250.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$388.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$371.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,149.64
|
| Rate for Payer: Nomi Health Commercial |
$1,109.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,014.39
|
| Rate for Payer: PACE Senior Care Partners |
$321.22
|
| Rate for Payer: PACE SWMI |
$338.13
|
| Rate for Payer: PHP Commercial |
$1,149.64
|
| Rate for Payer: PHP Medicare Advantage |
$338.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$238.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,176.69
|
| Rate for Payer: Priority Health Medicare |
$341.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$941.35
|
| Rate for Payer: Railroad Medicare Medicare |
$338.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,190.22
|
| Rate for Payer: UHC Core |
$1,129.35
|
| Rate for Payer: UHC Exchange |
$338.13
|
| Rate for Payer: UHC Medicaid |
$238.45
|
| Rate for Payer: UHC Medicare Advantage |
$338.13
|
| Rate for Payer: UHCCP Medicaid |
$238.45
|
| Rate for Payer: VA VA |
$338.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,014.39
|
|
|
HC TRACHEOBRNCHSC THRU EST TRACHS INC
|
Facility
|
IP
|
$1,352.52
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
76100389
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$941.35 |
| Max. Negotiated Rate |
$1,217.27 |
| Rate for Payer: Aetna Commercial |
$1,149.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,117.05
|
| Rate for Payer: BCN Commercial |
$1,117.05
|
| Rate for Payer: Cash Price |
$1,082.02
|
| Rate for Payer: Cofinity Commercial |
$1,163.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.02
|
| Rate for Payer: Healthscope Commercial |
$1,217.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,014.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,149.64
|
| Rate for Payer: Nomi Health Commercial |
$1,109.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,014.39
|
| Rate for Payer: PHP Commercial |
$1,149.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,176.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$941.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,190.22
|
| Rate for Payer: UHC Core |
$1,129.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,014.39
|
|
|
HC TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Facility
|
OP
|
$8,229.56
|
|
|
Service Code
|
CPT 31613
|
| Hospital Charge Code |
76100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,450.87 |
| Max. Negotiated Rate |
$7,406.60 |
| Rate for Payer: Aetna Commercial |
$6,995.13
|
| Rate for Payer: Aetna Medicare |
$2,139.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,571.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,571.74
|
| Rate for Payer: BCBS Complete |
$1,523.29
|
| Rate for Payer: BCBS MAPPO |
$2,057.39
|
| Rate for Payer: BCBS Trust/PPO |
$6,765.52
|
| Rate for Payer: BCN Commercial |
$6,765.52
|
| Rate for Payer: BCN Medicare Advantage |
$2,057.39
|
| Rate for Payer: Cash Price |
$6,583.65
|
| Rate for Payer: Cofinity Commercial |
$7,077.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,583.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,057.39
|
| Rate for Payer: Healthscope Commercial |
$7,406.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,172.17
|
| Rate for Payer: Mclaren Medicaid |
$1,450.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,160.26
|
| Rate for Payer: Meridian Medicaid |
$1,523.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,366.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,263.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,995.13
|
| Rate for Payer: Nomi Health Commercial |
$6,748.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,172.17
|
| Rate for Payer: PACE Senior Care Partners |
$1,954.52
|
| Rate for Payer: PACE SWMI |
$2,057.39
|
| Rate for Payer: PHP Commercial |
$6,995.13
|
| Rate for Payer: PHP Medicare Advantage |
$2,057.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,450.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,159.72
|
| Rate for Payer: Priority Health Medicare |
$2,077.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,727.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,057.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,242.01
|
| Rate for Payer: UHC Core |
$6,871.68
|
| Rate for Payer: UHC Exchange |
$2,057.39
|
| Rate for Payer: UHC Medicaid |
$1,450.87
|
| Rate for Payer: UHC Medicare Advantage |
$2,057.39
|
| Rate for Payer: UHCCP Medicaid |
$1,450.87
|
| Rate for Payer: VA VA |
$2,057.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,172.17
|
|
|
HC TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Facility
|
IP
|
$8,229.56
|
|
|
Service Code
|
CPT 31613
|
| Hospital Charge Code |
76100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,727.77 |
| Max. Negotiated Rate |
$7,406.60 |
| Rate for Payer: Aetna Commercial |
$6,995.13
|
| Rate for Payer: BCBS Trust/PPO |
$6,796.79
|
| Rate for Payer: BCN Commercial |
$6,796.79
|
| Rate for Payer: Cash Price |
$6,583.65
|
| Rate for Payer: Cofinity Commercial |
$7,077.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,583.65
|
| Rate for Payer: Healthscope Commercial |
$7,406.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,172.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,995.13
|
| Rate for Payer: Nomi Health Commercial |
$6,748.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,172.17
|
| Rate for Payer: PHP Commercial |
$6,995.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,159.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,727.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,242.01
|
| Rate for Payer: UHC Core |
$6,871.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,172.17
|
|
|
HC TRACH TUBE INSERTION
|
Facility
|
IP
|
$517.69
|
|
| Hospital Charge Code |
27000160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$360.31 |
| Max. Negotiated Rate |
$465.92 |
| Rate for Payer: Aetna Commercial |
$440.04
|
| Rate for Payer: BCBS Trust/PPO |
$427.56
|
| Rate for Payer: BCN Commercial |
$427.56
|
| Rate for Payer: Cash Price |
$414.15
|
| Rate for Payer: Cofinity Commercial |
$445.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.15
|
| Rate for Payer: Healthscope Commercial |
$465.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$388.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.04
|
| Rate for Payer: Nomi Health Commercial |
$424.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$388.27
|
| Rate for Payer: PHP Commercial |
$440.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$450.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.57
|
| Rate for Payer: UHC Core |
$432.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$388.27
|
|
|
HC TRACH TUBE INSERTION
|
Facility
|
OP
|
$517.69
|
|
| Hospital Charge Code |
27000160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$91.27 |
| Max. Negotiated Rate |
$465.92 |
| Rate for Payer: Aetna Commercial |
$440.04
|
| Rate for Payer: Aetna Medicare |
$134.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$161.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$161.78
|
| Rate for Payer: BCBS Complete |
$95.82
|
| Rate for Payer: BCBS MAPPO |
$129.42
|
| Rate for Payer: BCBS Trust/PPO |
$425.59
|
| Rate for Payer: BCN Commercial |
$425.59
|
| Rate for Payer: BCN Medicare Advantage |
$129.42
|
| Rate for Payer: Cash Price |
$414.15
|
| Rate for Payer: Cofinity Commercial |
$445.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.42
|
| Rate for Payer: Healthscope Commercial |
$465.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$388.27
|
| Rate for Payer: Mclaren Medicaid |
$91.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.89
|
| Rate for Payer: Meridian Medicaid |
$95.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$142.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.04
|
| Rate for Payer: Nomi Health Commercial |
$424.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$388.27
|
| Rate for Payer: PACE Senior Care Partners |
$122.95
|
| Rate for Payer: PACE SWMI |
$129.42
|
| Rate for Payer: PHP Commercial |
$440.04
|
| Rate for Payer: PHP Medicare Advantage |
$129.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$450.39
|
| Rate for Payer: Priority Health Medicare |
$130.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$360.31
|
| Rate for Payer: Railroad Medicare Medicare |
$129.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.57
|
| Rate for Payer: UHC Core |
$432.27
|
| Rate for Payer: UHC Exchange |
$129.42
|
| Rate for Payer: UHC Medicaid |
$91.27
|
| Rate for Payer: UHC Medicare Advantage |
$129.42
|
| Rate for Payer: UHCCP Medicaid |
$91.27
|
| Rate for Payer: VA VA |
$129.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$388.27
|
|
|
HC TRACH TUBE REPLACEMENT
|
Facility
|
IP
|
$181.11
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
45000072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$126.05 |
| Max. Negotiated Rate |
$163.00 |
| Rate for Payer: Aetna Commercial |
$153.94
|
| Rate for Payer: BCBS Trust/PPO |
$149.58
|
| Rate for Payer: BCN Commercial |
$149.58
|
| Rate for Payer: Cash Price |
$144.89
|
| Rate for Payer: Cofinity Commercial |
$155.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.89
|
| Rate for Payer: Healthscope Commercial |
$163.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.94
|
| Rate for Payer: Nomi Health Commercial |
$148.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.83
|
| Rate for Payer: PHP Commercial |
$153.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$157.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.38
|
| Rate for Payer: UHC Core |
$151.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.83
|
|
|
HC TRACH TUBE REPLACEMENT
|
Facility
|
OP
|
$181.11
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
45000072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$31.93 |
| Max. Negotiated Rate |
$163.00 |
| Rate for Payer: Aetna Commercial |
$153.94
|
| Rate for Payer: Aetna Medicare |
$47.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.60
|
| Rate for Payer: BCBS Complete |
$33.52
|
| Rate for Payer: BCBS MAPPO |
$45.28
|
| Rate for Payer: BCBS Trust/PPO |
$148.89
|
| Rate for Payer: BCN Commercial |
$148.89
|
| Rate for Payer: BCN Medicare Advantage |
$45.28
|
| Rate for Payer: Cash Price |
$144.89
|
| Rate for Payer: Cash Price |
$144.89
|
| Rate for Payer: Cofinity Commercial |
$155.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.28
|
| Rate for Payer: Healthscope Commercial |
$163.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.83
|
| Rate for Payer: Mclaren Medicaid |
$31.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.54
|
| Rate for Payer: Meridian Medicaid |
$33.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.94
|
| Rate for Payer: Nomi Health Commercial |
$148.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.83
|
| Rate for Payer: PACE Senior Care Partners |
$43.01
|
| Rate for Payer: PACE SWMI |
$45.28
|
| Rate for Payer: PHP Commercial |
$153.94
|
| Rate for Payer: PHP Medicare Advantage |
$45.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$157.57
|
| Rate for Payer: Priority Health Medicare |
$45.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.05
|
| Rate for Payer: Railroad Medicare Medicare |
$45.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.38
|
| Rate for Payer: UHC Core |
$151.23
|
| Rate for Payer: UHC Exchange |
$45.28
|
| Rate for Payer: UHC Medicaid |
$31.93
|
| Rate for Payer: UHC Medicare Advantage |
$45.28
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$45.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.83
|
|
|
HC TRACTION MECHANICAL
|
Facility
|
OP
|
$122.04
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
42000009
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.52 |
| Max. Negotiated Rate |
$109.84 |
| Rate for Payer: Aetna Commercial |
$103.73
|
| Rate for Payer: Aetna Medicare |
$31.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.14
|
| Rate for Payer: BCBS Complete |
$22.59
|
| Rate for Payer: BCBS MAPPO |
$30.51
|
| Rate for Payer: BCBS Trust/PPO |
$100.33
|
| Rate for Payer: BCN Commercial |
$100.33
|
| Rate for Payer: BCN Medicare Advantage |
$30.51
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cofinity Commercial |
$104.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.51
|
| Rate for Payer: Healthscope Commercial |
$109.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.53
|
| Rate for Payer: Mclaren Medicaid |
$21.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.04
|
| Rate for Payer: Meridian Medicaid |
$22.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.73
|
| Rate for Payer: Nomi Health Commercial |
$100.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.53
|
| Rate for Payer: PACE Senior Care Partners |
$28.98
|
| Rate for Payer: PACE SWMI |
$30.51
|
| Rate for Payer: PHP Commercial |
$103.73
|
| Rate for Payer: PHP Medicare Advantage |
$30.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$106.17
|
| Rate for Payer: Priority Health Medicare |
$30.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.94
|
| Rate for Payer: Railroad Medicare Medicare |
$30.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.40
|
| Rate for Payer: UHC Core |
$101.90
|
| Rate for Payer: UHC Exchange |
$30.51
|
| Rate for Payer: UHC Medicaid |
$21.52
|
| Rate for Payer: UHC Medicare Advantage |
$30.51
|
| Rate for Payer: UHCCP Medicaid |
$21.52
|
| Rate for Payer: VA VA |
$30.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.53
|
|
|
HC TRACTION MECHANICAL
|
Facility
|
IP
|
$122.04
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
42000009
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$84.94 |
| Max. Negotiated Rate |
$109.84 |
| Rate for Payer: Aetna Commercial |
$103.73
|
| Rate for Payer: BCBS Trust/PPO |
$100.79
|
| Rate for Payer: BCN Commercial |
$100.79
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cofinity Commercial |
$104.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.63
|
| Rate for Payer: Healthscope Commercial |
$109.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.73
|
| Rate for Payer: Nomi Health Commercial |
$100.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.53
|
| Rate for Payer: PHP Commercial |
$103.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$106.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.40
|
| Rate for Payer: UHC Core |
$101.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.53
|
|
|
HC TRANS CARE MGMT 14 DAYS
|
Facility
|
OP
|
$122.04
|
|
|
Service Code
|
CPT 99495
|
| Hospital Charge Code |
51000086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.52 |
| Max. Negotiated Rate |
$109.84 |
| Rate for Payer: Aetna Commercial |
$103.73
|
| Rate for Payer: Aetna Medicare |
$31.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.14
|
| Rate for Payer: BCBS Complete |
$22.59
|
| Rate for Payer: BCBS MAPPO |
$30.51
|
| Rate for Payer: BCBS Trust/PPO |
$100.33
|
| Rate for Payer: BCN Commercial |
$100.33
|
| Rate for Payer: BCN Medicare Advantage |
$30.51
|
| Rate for Payer: Cash Price |
$97.63
|
| Rate for Payer: Cofinity Commercial |
$104.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.51
|
| Rate for Payer: Healthscope Commercial |
$109.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.53
|
| Rate for Payer: Mclaren Medicaid |
$21.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.04
|
| Rate for Payer: Meridian Medicaid |
$22.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.73
|
| Rate for Payer: Nomi Health Commercial |
$100.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.53
|
| Rate for Payer: PACE Senior Care Partners |
$28.98
|
| Rate for Payer: PACE SWMI |
$30.51
|
| Rate for Payer: PHP Commercial |
$103.73
|
| Rate for Payer: PHP Medicare Advantage |
$30.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$106.17
|
| Rate for Payer: Priority Health Medicare |
$30.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.94
|
| Rate for Payer: Railroad Medicare Medicare |
$30.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.40
|
| Rate for Payer: UHC Core |
$101.90
|
| Rate for Payer: UHC Exchange |
$30.51
|
| Rate for Payer: UHC Medicaid |
$21.52
|
| Rate for Payer: UHC Medicare Advantage |
$30.51
|
| Rate for Payer: UHCCP Medicaid |
$21.52
|
| Rate for Payer: VA VA |
$30.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.53
|
|
