|
HC SODIUM URINE
|
Facility
|
OP
|
$35.19
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
30100424
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.66 |
| Max. Negotiated Rate |
$31.67 |
| Rate for Payer: Aetna Commercial |
$29.91
|
| Rate for Payer: Aetna Medicare |
$9.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.00
|
| Rate for Payer: BCBS Complete |
$3.84
|
| Rate for Payer: BCBS MAPPO |
$8.80
|
| Rate for Payer: BCBS Trust/PPO |
$28.93
|
| Rate for Payer: BCN Commercial |
$27.36
|
| Rate for Payer: BCN Medicare Advantage |
$8.80
|
| Rate for Payer: Cash Price |
$28.15
|
| Rate for Payer: Cash Price |
$28.15
|
| Rate for Payer: Cofinity Commercial |
$30.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.80
|
| Rate for Payer: Healthscope Commercial |
$31.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.39
|
| Rate for Payer: Mclaren Medicaid |
$3.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.24
|
| Rate for Payer: Meridian Medicaid |
$3.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.91
|
| Rate for Payer: Nomi Health Commercial |
$28.86
|
| Rate for Payer: PACE Senior Care Partners |
$8.36
|
| Rate for Payer: PACE SWMI |
$8.80
|
| Rate for Payer: PHP Commercial |
$29.91
|
| Rate for Payer: PHP Medicare Advantage |
$8.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.87
|
| Rate for Payer: Priority Health HMO/PPO |
$30.62
|
| Rate for Payer: Priority Health Medicare |
$8.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.58
|
| Rate for Payer: Railroad Medicare Medicare |
$8.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.97
|
| Rate for Payer: UHC Core |
$29.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.80
|
| Rate for Payer: UHC Exchange |
$8.80
|
| Rate for Payer: UHC Medicare Advantage |
$8.80
|
| Rate for Payer: UHCCP Medicaid |
$3.66
|
| Rate for Payer: VA VA |
$8.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.39
|
|
|
HC SOFTGOOD FOOT DROP PREVENT
|
Facility
|
OP
|
$195.19
|
|
| Hospital Charge Code |
27000148
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$46.36 |
| Max. Negotiated Rate |
$175.67 |
| Rate for Payer: Aetna Commercial |
$165.91
|
| Rate for Payer: Aetna Medicare |
$50.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.00
|
| Rate for Payer: BCBS Complete |
$78.08
|
| Rate for Payer: BCBS MAPPO |
$48.80
|
| Rate for Payer: BCBS Trust/PPO |
$160.47
|
| Rate for Payer: BCN Commercial |
$151.76
|
| Rate for Payer: BCN Medicare Advantage |
$48.80
|
| Rate for Payer: Cash Price |
$156.15
|
| Rate for Payer: Cofinity Commercial |
$167.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.80
|
| Rate for Payer: Healthscope Commercial |
$175.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.91
|
| Rate for Payer: Nomi Health Commercial |
$160.06
|
| Rate for Payer: PACE Senior Care Partners |
$46.36
|
| Rate for Payer: PACE SWMI |
$48.80
|
| Rate for Payer: PHP Commercial |
$165.91
|
| Rate for Payer: PHP Medicare Advantage |
$48.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.87
|
| Rate for Payer: Priority Health HMO/PPO |
$169.82
|
| Rate for Payer: Priority Health Medicare |
$49.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.78
|
| Rate for Payer: Railroad Medicare Medicare |
$48.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.77
|
| Rate for Payer: UHC Core |
$162.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.80
|
| Rate for Payer: UHC Exchange |
$48.80
|
| Rate for Payer: UHC Medicare Advantage |
$48.80
|
| Rate for Payer: VA VA |
$48.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.39
|
|
|
HC SOFTGOOD FOOT DROP PREVENT
|
Facility
|
IP
|
$195.19
|
|
| Hospital Charge Code |
27000148
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$126.87 |
| Max. Negotiated Rate |
$175.67 |
| Rate for Payer: Aetna Commercial |
$165.91
|
| Rate for Payer: BCBS Trust/PPO |
$159.33
|
| Rate for Payer: BCN Commercial |
$150.84
|
| Rate for Payer: Cash Price |
$156.15
|
| Rate for Payer: Cofinity Commercial |
$167.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.15
|
| Rate for Payer: Healthscope Commercial |
$175.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.91
|
| Rate for Payer: Nomi Health Commercial |
$160.06
|
| Rate for Payer: PHP Commercial |
$165.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.87
|
| Rate for Payer: Priority Health HMO/PPO |
$169.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.77
|
| Rate for Payer: UHC Core |
$162.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.39
|
|
|
HC SOFTGOOD HIP PILLOW ABD
|
Facility
|
OP
|
$161.54
|
|
| Hospital Charge Code |
27000149
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.37 |
| Max. Negotiated Rate |
$145.39 |
| Rate for Payer: Aetna Commercial |
$137.31
|
| Rate for Payer: Aetna Medicare |
$42.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.48
|
| Rate for Payer: BCBS Complete |
$64.62
|
| Rate for Payer: BCBS MAPPO |
$40.38
|
| Rate for Payer: BCBS Trust/PPO |
$132.80
|
| Rate for Payer: BCN Commercial |
$125.60
|
| Rate for Payer: BCN Medicare Advantage |
$40.38
|
| Rate for Payer: Cash Price |
$129.23
|
| Rate for Payer: Cofinity Commercial |
$138.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.38
|
| Rate for Payer: Healthscope Commercial |
$145.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.31
|
| Rate for Payer: Nomi Health Commercial |
$132.46
|
| Rate for Payer: PACE Senior Care Partners |
$38.37
|
| Rate for Payer: PACE SWMI |
$40.38
|
| Rate for Payer: PHP Commercial |
$137.31
|
| Rate for Payer: PHP Medicare Advantage |
$40.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health HMO/PPO |
$140.54
|
| Rate for Payer: Priority Health Medicare |
$40.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.23
|
| Rate for Payer: Railroad Medicare Medicare |
$40.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.16
|
| Rate for Payer: UHC Core |
$134.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.38
|
| Rate for Payer: UHC Exchange |
$40.38
|
| Rate for Payer: UHC Medicare Advantage |
$40.38
|
| Rate for Payer: VA VA |
$40.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.16
|
|
|
HC SOFTGOOD HIP PILLOW ABD
|
Facility
|
IP
|
$161.54
|
|
| Hospital Charge Code |
27000149
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$145.39 |
| Rate for Payer: Aetna Commercial |
$137.31
|
| Rate for Payer: BCBS Trust/PPO |
$131.87
|
| Rate for Payer: BCN Commercial |
$124.84
|
| Rate for Payer: Cash Price |
$129.23
|
| Rate for Payer: Cofinity Commercial |
$138.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.23
|
| Rate for Payer: Healthscope Commercial |
$145.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.31
|
| Rate for Payer: Nomi Health Commercial |
$132.46
|
| Rate for Payer: PHP Commercial |
$137.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health HMO/PPO |
$140.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.16
|
| Rate for Payer: UHC Core |
$134.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.16
|
|
|
HC SOFTGOOD SHOULDER PILLOW ABD
|
Facility
|
IP
|
$239.20
|
|
| Hospital Charge Code |
27000150
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$155.48 |
| Max. Negotiated Rate |
$215.28 |
| Rate for Payer: Aetna Commercial |
$203.32
|
| Rate for Payer: BCBS Trust/PPO |
$195.26
|
| Rate for Payer: BCN Commercial |
$184.85
|
| Rate for Payer: Cash Price |
$191.36
|
| Rate for Payer: Cofinity Commercial |
$205.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.36
|
| Rate for Payer: Healthscope Commercial |
$215.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203.32
|
| Rate for Payer: Nomi Health Commercial |
$196.14
|
| Rate for Payer: PHP Commercial |
$203.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.48
|
| Rate for Payer: Priority Health HMO/PPO |
$208.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.50
|
| Rate for Payer: UHC Core |
$199.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.40
|
|
|
HC SOFTGOOD SHOULDER PILLOW ABD
|
Facility
|
OP
|
$239.20
|
|
| Hospital Charge Code |
27000150
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$56.81 |
| Max. Negotiated Rate |
$215.28 |
| Rate for Payer: Aetna Commercial |
$203.32
|
| Rate for Payer: Aetna Medicare |
$62.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.75
|
| Rate for Payer: BCBS Complete |
$95.68
|
| Rate for Payer: BCBS MAPPO |
$59.80
|
| Rate for Payer: BCBS Trust/PPO |
$196.65
|
| Rate for Payer: BCN Commercial |
$185.98
|
| Rate for Payer: BCN Medicare Advantage |
$59.80
|
| Rate for Payer: Cash Price |
$191.36
|
| Rate for Payer: Cofinity Commercial |
$205.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.80
|
| Rate for Payer: Healthscope Commercial |
$215.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203.32
|
| Rate for Payer: Nomi Health Commercial |
$196.14
|
| Rate for Payer: PACE Senior Care Partners |
$56.81
|
| Rate for Payer: PACE SWMI |
$59.80
|
| Rate for Payer: PHP Commercial |
$203.32
|
| Rate for Payer: PHP Medicare Advantage |
$59.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.48
|
| Rate for Payer: Priority Health HMO/PPO |
$208.10
|
| Rate for Payer: Priority Health Medicare |
$60.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.26
|
| Rate for Payer: Railroad Medicare Medicare |
$59.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.50
|
| Rate for Payer: UHC Core |
$199.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.80
|
| Rate for Payer: UHC Exchange |
$59.80
|
| Rate for Payer: UHC Medicare Advantage |
$59.80
|
| Rate for Payer: VA VA |
$59.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.40
|
|
|
HC SOLUBLE TRANSFERRIN RECEPTOR
|
Facility
|
IP
|
$59.82
|
|
|
Service Code
|
CPT 84238
|
| Hospital Charge Code |
30100631
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.88 |
| Max. Negotiated Rate |
$53.84 |
| Rate for Payer: Aetna Commercial |
$50.85
|
| Rate for Payer: BCBS Trust/PPO |
$48.83
|
| Rate for Payer: BCN Commercial |
$46.23
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cofinity Commercial |
$51.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.86
|
| Rate for Payer: Healthscope Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.85
|
| Rate for Payer: Nomi Health Commercial |
$49.05
|
| Rate for Payer: PHP Commercial |
$50.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.88
|
| Rate for Payer: Priority Health HMO/PPO |
$52.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$49.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.87
|
|
|
HC SOLUBLE TRANSFERRIN RECEPTOR
|
Facility
|
OP
|
$59.82
|
|
|
Service Code
|
CPT 84238
|
| Hospital Charge Code |
30100631
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.21 |
| Max. Negotiated Rate |
$53.84 |
| Rate for Payer: Aetna Commercial |
$50.85
|
| Rate for Payer: Aetna Medicare |
$15.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.69
|
| Rate for Payer: BCBS Complete |
$27.76
|
| Rate for Payer: BCBS MAPPO |
$14.96
|
| Rate for Payer: BCBS Trust/PPO |
$49.18
|
| Rate for Payer: BCN Commercial |
$46.51
|
| Rate for Payer: BCN Medicare Advantage |
$14.96
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cofinity Commercial |
$51.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.96
|
| Rate for Payer: Healthscope Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.87
|
| Rate for Payer: Mclaren Medicaid |
$26.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.70
|
| Rate for Payer: Meridian Medicaid |
$27.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.85
|
| Rate for Payer: Nomi Health Commercial |
$49.05
|
| Rate for Payer: PACE Senior Care Partners |
$14.21
|
| Rate for Payer: PACE SWMI |
$14.96
|
| Rate for Payer: PHP Commercial |
$50.85
|
| Rate for Payer: PHP Medicare Advantage |
$14.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.88
|
| Rate for Payer: Priority Health HMO/PPO |
$52.04
|
| Rate for Payer: Priority Health Medicare |
$15.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.08
|
| Rate for Payer: Railroad Medicare Medicare |
$14.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$49.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.96
|
| Rate for Payer: UHC Exchange |
$14.96
|
| Rate for Payer: UHC Medicare Advantage |
$14.96
|
| Rate for Payer: UHCCP Medicaid |
$26.44
|
| Rate for Payer: VA VA |
$14.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.87
|
|
|
HC SOMATOMEDIN
|
Facility
|
OP
|
$55.14
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
30100425
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$49.63 |
| Rate for Payer: Aetna Commercial |
$46.87
|
| Rate for Payer: Aetna Medicare |
$14.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.23
|
| Rate for Payer: BCBS Complete |
$16.14
|
| Rate for Payer: BCBS MAPPO |
$13.79
|
| Rate for Payer: BCBS Trust/PPO |
$45.33
|
| Rate for Payer: BCN Commercial |
$42.87
|
| Rate for Payer: BCN Medicare Advantage |
$13.79
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$47.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.79
|
| Rate for Payer: Healthscope Commercial |
$49.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.35
|
| Rate for Payer: Mclaren Medicaid |
$15.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.47
|
| Rate for Payer: Meridian Medicaid |
$16.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: Nomi Health Commercial |
$45.21
|
| Rate for Payer: PACE Senior Care Partners |
$13.10
|
| Rate for Payer: PACE SWMI |
$13.79
|
| Rate for Payer: PHP Commercial |
$46.87
|
| Rate for Payer: PHP Medicare Advantage |
$13.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.84
|
| Rate for Payer: Priority Health HMO/PPO |
$47.97
|
| Rate for Payer: Priority Health Medicare |
$13.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.94
|
| Rate for Payer: Railroad Medicare Medicare |
$13.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.52
|
| Rate for Payer: UHC Core |
$46.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.79
|
| Rate for Payer: UHC Exchange |
$13.79
|
| Rate for Payer: UHC Medicare Advantage |
$13.79
|
| Rate for Payer: UHCCP Medicaid |
$15.37
|
| Rate for Payer: VA VA |
$13.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.35
|
|
|
HC SOMATOMEDIN
|
Facility
|
IP
|
$55.14
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
30100425
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.84 |
| Max. Negotiated Rate |
$49.63 |
| Rate for Payer: Aetna Commercial |
$46.87
|
| Rate for Payer: BCBS Trust/PPO |
$45.01
|
| Rate for Payer: BCN Commercial |
$42.61
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$47.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Healthscope Commercial |
$49.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: Nomi Health Commercial |
$45.21
|
| Rate for Payer: PHP Commercial |
$46.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.84
|
| Rate for Payer: Priority Health HMO/PPO |
$47.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.52
|
| Rate for Payer: UHC Core |
$46.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.35
|
|
|
HC SOYBEAN IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200062
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SOYBEAN IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200062
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SPACEOAR HYDROGEL
|
Facility
|
IP
|
$6,048.60
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,931.59 |
| Max. Negotiated Rate |
$5,443.74 |
| Rate for Payer: Aetna Commercial |
$5,141.31
|
| Rate for Payer: BCBS Trust/PPO |
$4,937.47
|
| Rate for Payer: BCN Commercial |
$4,674.36
|
| Rate for Payer: Cash Price |
$4,838.88
|
| Rate for Payer: Cofinity Commercial |
$5,201.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,838.88
|
| Rate for Payer: Healthscope Commercial |
$5,443.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,536.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,141.31
|
| Rate for Payer: Nomi Health Commercial |
$4,959.85
|
| Rate for Payer: PHP Commercial |
$5,141.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,931.59
|
| Rate for Payer: Priority Health HMO/PPO |
$5,262.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,052.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,322.77
|
| Rate for Payer: UHC Core |
$5,050.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,536.45
|
|
|
HC SPACEOAR HYDROGEL
|
Facility
|
OP
|
$6,048.60
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,436.54 |
| Max. Negotiated Rate |
$5,443.74 |
| Rate for Payer: Aetna Commercial |
$5,141.31
|
| Rate for Payer: Aetna Medicare |
$1,572.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,890.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,890.19
|
| Rate for Payer: BCBS Complete |
$2,419.44
|
| Rate for Payer: BCBS MAPPO |
$1,512.15
|
| Rate for Payer: BCBS Trust/PPO |
$4,972.55
|
| Rate for Payer: BCN Commercial |
$4,702.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,512.15
|
| Rate for Payer: Cash Price |
$4,838.88
|
| Rate for Payer: Cofinity Commercial |
$5,201.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,838.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,512.15
|
| Rate for Payer: Healthscope Commercial |
$5,443.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,536.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,587.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,738.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,141.31
|
| Rate for Payer: Nomi Health Commercial |
$4,959.85
|
| Rate for Payer: PACE Senior Care Partners |
$1,436.54
|
| Rate for Payer: PACE SWMI |
$1,512.15
|
| Rate for Payer: PHP Commercial |
$5,141.31
|
| Rate for Payer: PHP Medicare Advantage |
$1,512.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,931.59
|
| Rate for Payer: Priority Health HMO/PPO |
$5,262.28
|
| Rate for Payer: Priority Health Medicare |
$1,527.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,052.56
|
| Rate for Payer: Railroad Medicare Medicare |
$1,512.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,322.77
|
| Rate for Payer: UHC Core |
$5,050.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,512.15
|
| Rate for Payer: UHC Exchange |
$1,512.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,512.15
|
| Rate for Payer: VA VA |
$1,512.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,536.45
|
|
|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
OP
|
$3,849.48
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$914.25 |
| Max. Negotiated Rate |
$3,464.53 |
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: Aetna Medicare |
$1,000.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,202.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,202.96
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$962.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,164.66
|
| Rate for Payer: BCN Commercial |
$2,992.97
|
| Rate for Payer: BCN Medicare Advantage |
$962.37
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,310.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$962.37
|
| Rate for Payer: Healthscope Commercial |
$3,464.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,887.11
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,010.49
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,106.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: Nomi Health Commercial |
$3,156.57
|
| Rate for Payer: PACE Senior Care Partners |
$914.25
|
| Rate for Payer: PACE SWMI |
$962.37
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: PHP Medicare Advantage |
$962.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health HMO/PPO |
$3,349.05
|
| Rate for Payer: Priority Health Medicare |
$971.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,579.15
|
| Rate for Payer: Railroad Medicare Medicare |
$962.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,387.54
|
| Rate for Payer: UHC Core |
$3,214.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$962.37
|
| Rate for Payer: UHC Exchange |
$962.37
|
| Rate for Payer: UHC Medicare Advantage |
$962.37
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$962.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
IP
|
$3,849.48
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,502.16 |
| Max. Negotiated Rate |
$3,464.53 |
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: BCBS Trust/PPO |
$3,142.33
|
| Rate for Payer: BCN Commercial |
$2,974.88
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,310.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Healthscope Commercial |
$3,464.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,887.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: Nomi Health Commercial |
$3,156.57
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health HMO/PPO |
$3,349.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,579.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,387.54
|
| Rate for Payer: UHC Core |
$3,214.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
IP
|
$3,982.07
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,588.35 |
| Max. Negotiated Rate |
$3,583.86 |
| Rate for Payer: Aetna Commercial |
$3,384.76
|
| Rate for Payer: BCBS Trust/PPO |
$3,250.56
|
| Rate for Payer: BCN Commercial |
$3,077.34
|
| Rate for Payer: Cash Price |
$3,185.66
|
| Rate for Payer: Cofinity Commercial |
$3,424.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,185.66
|
| Rate for Payer: Healthscope Commercial |
$3,583.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,986.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,384.76
|
| Rate for Payer: Nomi Health Commercial |
$3,265.30
|
| Rate for Payer: PHP Commercial |
$3,384.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,588.35
|
| Rate for Payer: Priority Health HMO/PPO |
$3,464.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,667.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,504.22
|
| Rate for Payer: UHC Core |
$3,325.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,986.55
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
OP
|
$3,982.07
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$945.74 |
| Max. Negotiated Rate |
$3,583.86 |
| Rate for Payer: Aetna Commercial |
$3,384.76
|
| Rate for Payer: Aetna Medicare |
$1,035.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,244.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,244.40
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$995.52
|
| Rate for Payer: BCBS Trust/PPO |
$3,273.66
|
| Rate for Payer: BCN Commercial |
$3,096.06
|
| Rate for Payer: BCN Medicare Advantage |
$995.52
|
| Rate for Payer: Cash Price |
$3,185.66
|
| Rate for Payer: Cash Price |
$3,185.66
|
| Rate for Payer: Cofinity Commercial |
$3,424.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,185.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$995.52
|
| Rate for Payer: Healthscope Commercial |
$3,583.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,986.55
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,045.29
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,144.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,384.76
|
| Rate for Payer: Nomi Health Commercial |
$3,265.30
|
| Rate for Payer: PACE Senior Care Partners |
$945.74
|
| Rate for Payer: PACE SWMI |
$995.52
|
| Rate for Payer: PHP Commercial |
$3,384.76
|
| Rate for Payer: PHP Medicare Advantage |
$995.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,588.35
|
| Rate for Payer: Priority Health HMO/PPO |
$3,464.40
|
| Rate for Payer: Priority Health Medicare |
$1,005.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,667.99
|
| Rate for Payer: Railroad Medicare Medicare |
$995.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,504.22
|
| Rate for Payer: UHC Core |
$3,325.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$995.52
|
| Rate for Payer: UHC Exchange |
$995.52
|
| Rate for Payer: UHC Medicare Advantage |
$995.52
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$995.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,986.55
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
IP
|
$3,266.13
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,122.98 |
| Max. Negotiated Rate |
$2,939.52 |
| Rate for Payer: Aetna Commercial |
$2,776.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,666.14
|
| Rate for Payer: BCN Commercial |
$2,524.07
|
| Rate for Payer: Cash Price |
$2,612.90
|
| Rate for Payer: Cofinity Commercial |
$2,808.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,612.90
|
| Rate for Payer: Healthscope Commercial |
$2,939.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,449.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,776.21
|
| Rate for Payer: Nomi Health Commercial |
$2,678.23
|
| Rate for Payer: PHP Commercial |
$2,776.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,122.98
|
| Rate for Payer: Priority Health HMO/PPO |
$2,841.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,188.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,874.19
|
| Rate for Payer: UHC Core |
$2,727.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,449.60
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
OP
|
$3,266.13
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$775.71 |
| Max. Negotiated Rate |
$2,939.52 |
| Rate for Payer: Aetna Commercial |
$2,776.21
|
| Rate for Payer: Aetna Medicare |
$849.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,020.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,020.67
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$816.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,685.09
|
| Rate for Payer: BCN Commercial |
$2,539.42
|
| Rate for Payer: BCN Medicare Advantage |
$816.53
|
| Rate for Payer: Cash Price |
$2,612.90
|
| Rate for Payer: Cash Price |
$2,612.90
|
| Rate for Payer: Cofinity Commercial |
$2,808.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,612.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$816.53
|
| Rate for Payer: Healthscope Commercial |
$2,939.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,449.60
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$857.36
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$939.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,776.21
|
| Rate for Payer: Nomi Health Commercial |
$2,678.23
|
| Rate for Payer: PACE Senior Care Partners |
$775.71
|
| Rate for Payer: PACE SWMI |
$816.53
|
| Rate for Payer: PHP Commercial |
$2,776.21
|
| Rate for Payer: PHP Medicare Advantage |
$816.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,122.98
|
| Rate for Payer: Priority Health HMO/PPO |
$2,841.53
|
| Rate for Payer: Priority Health Medicare |
$824.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,188.31
|
| Rate for Payer: Railroad Medicare Medicare |
$816.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,874.19
|
| Rate for Payer: UHC Core |
$2,727.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$816.53
|
| Rate for Payer: UHC Exchange |
$816.53
|
| Rate for Payer: UHC Medicare Advantage |
$816.53
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$816.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,449.60
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
IP
|
$153.98
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$100.09 |
| Max. Negotiated Rate |
$138.58 |
| Rate for Payer: Aetna Commercial |
$130.88
|
| Rate for Payer: BCBS Trust/PPO |
$125.69
|
| Rate for Payer: BCN Commercial |
$119.00
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$132.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Healthscope Commercial |
$138.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.88
|
| Rate for Payer: Nomi Health Commercial |
$126.26
|
| Rate for Payer: PHP Commercial |
$130.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.09
|
| Rate for Payer: Priority Health HMO/PPO |
$133.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.50
|
| Rate for Payer: UHC Core |
$128.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.48
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
OP
|
$153.98
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$36.57 |
| Max. Negotiated Rate |
$138.58 |
| Rate for Payer: Aetna Commercial |
$130.88
|
| Rate for Payer: Aetna Medicare |
$40.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.12
|
| Rate for Payer: BCBS Complete |
$100.80
|
| Rate for Payer: BCBS MAPPO |
$38.49
|
| Rate for Payer: BCBS Trust/PPO |
$126.59
|
| Rate for Payer: BCN Commercial |
$119.72
|
| Rate for Payer: BCN Medicare Advantage |
$38.49
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cash Price |
$123.18
|
| Rate for Payer: Cofinity Commercial |
$132.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.49
|
| Rate for Payer: Healthscope Commercial |
$138.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.48
|
| Rate for Payer: Mclaren Medicaid |
$95.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.42
|
| Rate for Payer: Meridian Medicaid |
$100.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.88
|
| Rate for Payer: Nomi Health Commercial |
$126.26
|
| Rate for Payer: PACE Senior Care Partners |
$36.57
|
| Rate for Payer: PACE SWMI |
$38.49
|
| Rate for Payer: PHP Commercial |
$130.88
|
| Rate for Payer: PHP Medicare Advantage |
$38.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.09
|
| Rate for Payer: Priority Health HMO/PPO |
$133.96
|
| Rate for Payer: Priority Health Medicare |
$38.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.17
|
| Rate for Payer: Railroad Medicare Medicare |
$38.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.50
|
| Rate for Payer: UHC Core |
$128.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.49
|
| Rate for Payer: UHC Exchange |
$38.49
|
| Rate for Payer: UHC Medicare Advantage |
$38.49
|
| Rate for Payer: UHCCP Medicaid |
$95.99
|
| Rate for Payer: VA VA |
$38.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.48
|
|
|
HC SPECIAL STAINS
|
Facility
|
OP
|
$225.55
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$38.63 |
| Max. Negotiated Rate |
$203.00 |
| Rate for Payer: Aetna Commercial |
$191.72
|
| Rate for Payer: Aetna Medicare |
$58.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.48
|
| Rate for Payer: BCBS Complete |
$40.56
|
| Rate for Payer: BCBS MAPPO |
$56.39
|
| Rate for Payer: BCBS Trust/PPO |
$185.42
|
| Rate for Payer: BCN Commercial |
$175.37
|
| Rate for Payer: BCN Medicare Advantage |
$56.39
|
| Rate for Payer: Cash Price |
$180.44
|
| Rate for Payer: Cash Price |
$180.44
|
| Rate for Payer: Cofinity Commercial |
$193.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.39
|
| Rate for Payer: Healthscope Commercial |
$203.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.16
|
| Rate for Payer: Mclaren Medicaid |
$38.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.21
|
| Rate for Payer: Meridian Medicaid |
$40.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.72
|
| Rate for Payer: Nomi Health Commercial |
$184.95
|
| Rate for Payer: PACE Senior Care Partners |
$53.57
|
| Rate for Payer: PACE SWMI |
$56.39
|
| Rate for Payer: PHP Commercial |
$191.72
|
| Rate for Payer: PHP Medicare Advantage |
$56.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.61
|
| Rate for Payer: Priority Health HMO/PPO |
$196.23
|
| Rate for Payer: Priority Health Medicare |
$56.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.12
|
| Rate for Payer: Railroad Medicare Medicare |
$56.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.48
|
| Rate for Payer: UHC Core |
$188.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.39
|
| Rate for Payer: UHC Exchange |
$56.39
|
| Rate for Payer: UHC Medicare Advantage |
$56.39
|
| Rate for Payer: UHCCP Medicaid |
$38.63
|
| Rate for Payer: VA VA |
$56.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.16
|
|
|
HC SPECIAL STAINS
|
Facility
|
IP
|
$225.55
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$146.61 |
| Max. Negotiated Rate |
$203.00 |
| Rate for Payer: Aetna Commercial |
$191.72
|
| Rate for Payer: BCBS Trust/PPO |
$184.12
|
| Rate for Payer: BCN Commercial |
$174.31
|
| Rate for Payer: Cash Price |
$180.44
|
| Rate for Payer: Cofinity Commercial |
$193.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.44
|
| Rate for Payer: Healthscope Commercial |
$203.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.72
|
| Rate for Payer: Nomi Health Commercial |
$184.95
|
| Rate for Payer: PHP Commercial |
$191.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.61
|
| Rate for Payer: Priority Health HMO/PPO |
$196.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.48
|
| Rate for Payer: UHC Core |
$188.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.16
|
|
