|
HC ST JUDE CRT ICD
|
Facility
|
OP
|
$28,090.80
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500009
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,671.56 |
| Max. Negotiated Rate |
$25,281.72 |
| Rate for Payer: Aetna Commercial |
$23,877.18
|
| Rate for Payer: Aetna Medicare |
$7,303.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,778.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,778.38
|
| Rate for Payer: BCBS Complete |
$11,236.32
|
| Rate for Payer: BCBS MAPPO |
$7,022.70
|
| Rate for Payer: BCBS Trust/PPO |
$23,093.45
|
| Rate for Payer: BCN Commercial |
$21,840.60
|
| Rate for Payer: BCN Medicare Advantage |
$7,022.70
|
| Rate for Payer: Cash Price |
$22,472.64
|
| Rate for Payer: Cofinity Commercial |
$24,158.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,472.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,022.70
|
| Rate for Payer: Healthscope Commercial |
$25,281.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,068.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,373.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,076.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,877.18
|
| Rate for Payer: Nomi Health Commercial |
$23,034.46
|
| Rate for Payer: PACE Senior Care Partners |
$6,671.56
|
| Rate for Payer: PACE SWMI |
$7,022.70
|
| Rate for Payer: PHP Commercial |
$23,877.18
|
| Rate for Payer: PHP Medicare Advantage |
$7,022.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,259.02
|
| Rate for Payer: Priority Health HMO/PPO |
$24,439.00
|
| Rate for Payer: Priority Health Medicare |
$7,092.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,820.84
|
| Rate for Payer: Railroad Medicare Medicare |
$7,022.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,719.90
|
| Rate for Payer: UHC Core |
$23,455.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,022.70
|
| Rate for Payer: UHC Exchange |
$7,022.70
|
| Rate for Payer: UHC Medicare Advantage |
$7,022.70
|
| Rate for Payer: VA VA |
$7,022.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,068.10
|
|
|
HC ST JUDE CRT ICD
|
Facility
|
IP
|
$28,090.80
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500009
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$18,259.02 |
| Max. Negotiated Rate |
$25,281.72 |
| Rate for Payer: Aetna Commercial |
$23,877.18
|
| Rate for Payer: BCBS Trust/PPO |
$22,930.52
|
| Rate for Payer: BCN Commercial |
$21,708.57
|
| Rate for Payer: Cash Price |
$22,472.64
|
| Rate for Payer: Cofinity Commercial |
$24,158.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,472.64
|
| Rate for Payer: Healthscope Commercial |
$25,281.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,068.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,877.18
|
| Rate for Payer: Nomi Health Commercial |
$23,034.46
|
| Rate for Payer: PHP Commercial |
$23,877.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,259.02
|
| Rate for Payer: Priority Health HMO/PPO |
$24,439.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,820.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,719.90
|
| Rate for Payer: UHC Core |
$23,455.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,068.10
|
|
|
HC ST JUDE CRT LEAD
|
Facility
|
OP
|
$5,826.24
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,383.73 |
| Max. Negotiated Rate |
$5,243.62 |
| Rate for Payer: Aetna Commercial |
$4,952.30
|
| Rate for Payer: Aetna Medicare |
$1,514.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,820.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,820.70
|
| Rate for Payer: BCBS Complete |
$2,330.50
|
| Rate for Payer: BCBS MAPPO |
$1,456.56
|
| Rate for Payer: BCBS Trust/PPO |
$4,789.75
|
| Rate for Payer: BCN Commercial |
$4,529.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,456.56
|
| Rate for Payer: Cash Price |
$4,660.99
|
| Rate for Payer: Cofinity Commercial |
$5,010.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,660.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,456.56
|
| Rate for Payer: Healthscope Commercial |
$5,243.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,369.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,529.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,675.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,952.30
|
| Rate for Payer: Nomi Health Commercial |
$4,777.52
|
| Rate for Payer: PACE Senior Care Partners |
$1,383.73
|
| Rate for Payer: PACE SWMI |
$1,456.56
|
| Rate for Payer: PHP Commercial |
$4,952.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,456.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,787.06
|
| Rate for Payer: Priority Health HMO/PPO |
$5,068.83
|
| Rate for Payer: Priority Health Medicare |
$1,471.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,903.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,456.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,127.09
|
| Rate for Payer: UHC Core |
$4,864.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,456.56
|
| Rate for Payer: UHC Exchange |
$1,456.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,456.56
|
| Rate for Payer: VA VA |
$1,456.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,369.68
|
|
|
HC ST JUDE CRT LEAD
|
Facility
|
IP
|
$5,826.24
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,787.06 |
| Max. Negotiated Rate |
$5,243.62 |
| Rate for Payer: Aetna Commercial |
$4,952.30
|
| Rate for Payer: BCBS Trust/PPO |
$4,755.96
|
| Rate for Payer: BCN Commercial |
$4,502.52
|
| Rate for Payer: Cash Price |
$4,660.99
|
| Rate for Payer: Cofinity Commercial |
$5,010.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,660.99
|
| Rate for Payer: Healthscope Commercial |
$5,243.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,369.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,952.30
|
| Rate for Payer: Nomi Health Commercial |
$4,777.52
|
| Rate for Payer: PHP Commercial |
$4,952.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,787.06
|
| Rate for Payer: Priority Health HMO/PPO |
$5,068.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,903.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,127.09
|
| Rate for Payer: UHC Core |
$4,864.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,369.68
|
|
|
HC ST JUDE DUAL PACEMAKER
|
Facility
|
OP
|
$9,363.60
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500010
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,223.86 |
| Max. Negotiated Rate |
$8,427.24 |
| Rate for Payer: Aetna Commercial |
$7,959.06
|
| Rate for Payer: Aetna Medicare |
$2,434.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,926.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,926.12
|
| Rate for Payer: BCBS Complete |
$3,745.44
|
| Rate for Payer: BCBS MAPPO |
$2,340.90
|
| Rate for Payer: BCBS Trust/PPO |
$7,697.82
|
| Rate for Payer: BCN Commercial |
$7,280.20
|
| Rate for Payer: BCN Medicare Advantage |
$2,340.90
|
| Rate for Payer: Cash Price |
$7,490.88
|
| Rate for Payer: Cofinity Commercial |
$8,052.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,490.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,340.90
|
| Rate for Payer: Healthscope Commercial |
$8,427.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,022.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,457.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,692.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,959.06
|
| Rate for Payer: Nomi Health Commercial |
$7,678.15
|
| Rate for Payer: PACE Senior Care Partners |
$2,223.86
|
| Rate for Payer: PACE SWMI |
$2,340.90
|
| Rate for Payer: PHP Commercial |
$7,959.06
|
| Rate for Payer: PHP Medicare Advantage |
$2,340.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,086.34
|
| Rate for Payer: Priority Health HMO/PPO |
$8,146.33
|
| Rate for Payer: Priority Health Medicare |
$2,364.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,273.61
|
| Rate for Payer: Railroad Medicare Medicare |
$2,340.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,239.97
|
| Rate for Payer: UHC Core |
$7,818.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,340.90
|
| Rate for Payer: UHC Exchange |
$2,340.90
|
| Rate for Payer: UHC Medicare Advantage |
$2,340.90
|
| Rate for Payer: VA VA |
$2,340.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,022.70
|
|
|
HC ST JUDE DUAL PACEMAKER
|
Facility
|
IP
|
$9,363.60
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500010
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,086.34 |
| Max. Negotiated Rate |
$8,427.24 |
| Rate for Payer: Aetna Commercial |
$7,959.06
|
| Rate for Payer: BCBS Trust/PPO |
$7,643.51
|
| Rate for Payer: BCN Commercial |
$7,236.19
|
| Rate for Payer: Cash Price |
$7,490.88
|
| Rate for Payer: Cofinity Commercial |
$8,052.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,490.88
|
| Rate for Payer: Healthscope Commercial |
$8,427.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,022.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,959.06
|
| Rate for Payer: Nomi Health Commercial |
$7,678.15
|
| Rate for Payer: PHP Commercial |
$7,959.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,086.34
|
| Rate for Payer: Priority Health HMO/PPO |
$8,146.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,273.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,239.97
|
| Rate for Payer: UHC Core |
$7,818.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,022.70
|
|
|
HC ST JUDE ICD DUAL
|
Facility
|
IP
|
$21,224.16
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,795.70 |
| Max. Negotiated Rate |
$19,101.74 |
| Rate for Payer: Aetna Commercial |
$18,040.54
|
| Rate for Payer: BCBS Trust/PPO |
$17,325.28
|
| Rate for Payer: BCN Commercial |
$16,402.03
|
| Rate for Payer: Cash Price |
$16,979.33
|
| Rate for Payer: Cofinity Commercial |
$18,252.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,979.33
|
| Rate for Payer: Healthscope Commercial |
$19,101.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,918.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,040.54
|
| Rate for Payer: Nomi Health Commercial |
$17,403.81
|
| Rate for Payer: PHP Commercial |
$18,040.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,795.70
|
| Rate for Payer: Priority Health HMO/PPO |
$18,465.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,220.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,677.26
|
| Rate for Payer: UHC Core |
$17,722.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,918.12
|
|
|
HC ST JUDE ICD DUAL
|
Facility
|
OP
|
$21,224.16
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,040.74 |
| Max. Negotiated Rate |
$19,101.74 |
| Rate for Payer: Aetna Commercial |
$18,040.54
|
| Rate for Payer: Aetna Medicare |
$5,518.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,632.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,632.55
|
| Rate for Payer: BCBS Complete |
$8,489.66
|
| Rate for Payer: BCBS MAPPO |
$5,306.04
|
| Rate for Payer: BCBS Trust/PPO |
$17,448.38
|
| Rate for Payer: BCN Commercial |
$16,501.78
|
| Rate for Payer: BCN Medicare Advantage |
$5,306.04
|
| Rate for Payer: Cash Price |
$16,979.33
|
| Rate for Payer: Cofinity Commercial |
$18,252.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,979.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,306.04
|
| Rate for Payer: Healthscope Commercial |
$19,101.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,918.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,571.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,101.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,040.54
|
| Rate for Payer: Nomi Health Commercial |
$17,403.81
|
| Rate for Payer: PACE Senior Care Partners |
$5,040.74
|
| Rate for Payer: PACE SWMI |
$5,306.04
|
| Rate for Payer: PHP Commercial |
$18,040.54
|
| Rate for Payer: PHP Medicare Advantage |
$5,306.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,795.70
|
| Rate for Payer: Priority Health HMO/PPO |
$18,465.02
|
| Rate for Payer: Priority Health Medicare |
$5,359.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14,220.19
|
| Rate for Payer: Railroad Medicare Medicare |
$5,306.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,677.26
|
| Rate for Payer: UHC Core |
$17,722.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,306.04
|
| Rate for Payer: UHC Exchange |
$5,306.04
|
| Rate for Payer: UHC Medicare Advantage |
$5,306.04
|
| Rate for Payer: VA VA |
$5,306.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,918.12
|
|
|
HC ST JUDE ICD SINGLE
|
Facility
|
IP
|
$14,066.21
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,143.04 |
| Max. Negotiated Rate |
$12,659.59 |
| Rate for Payer: Aetna Commercial |
$11,956.28
|
| Rate for Payer: BCBS Trust/PPO |
$11,482.25
|
| Rate for Payer: BCN Commercial |
$10,870.37
|
| Rate for Payer: Cash Price |
$11,252.97
|
| Rate for Payer: Cofinity Commercial |
$12,096.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,252.97
|
| Rate for Payer: Healthscope Commercial |
$12,659.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,549.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,956.28
|
| Rate for Payer: Nomi Health Commercial |
$11,534.29
|
| Rate for Payer: PHP Commercial |
$11,956.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,143.04
|
| Rate for Payer: Priority Health HMO/PPO |
$12,237.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,424.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,378.26
|
| Rate for Payer: UHC Core |
$11,745.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,549.66
|
|
|
HC ST JUDE ICD SINGLE
|
Facility
|
OP
|
$14,066.21
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,340.72 |
| Max. Negotiated Rate |
$12,659.59 |
| Rate for Payer: Aetna Commercial |
$11,956.28
|
| Rate for Payer: Aetna Medicare |
$3,657.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,395.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,395.69
|
| Rate for Payer: BCBS Complete |
$5,626.48
|
| Rate for Payer: BCBS MAPPO |
$3,516.55
|
| Rate for Payer: BCBS Trust/PPO |
$11,563.83
|
| Rate for Payer: BCN Commercial |
$10,936.48
|
| Rate for Payer: BCN Medicare Advantage |
$3,516.55
|
| Rate for Payer: Cash Price |
$11,252.97
|
| Rate for Payer: Cofinity Commercial |
$12,096.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,252.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,516.55
|
| Rate for Payer: Healthscope Commercial |
$12,659.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,549.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,692.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,044.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,956.28
|
| Rate for Payer: Nomi Health Commercial |
$11,534.29
|
| Rate for Payer: PACE Senior Care Partners |
$3,340.72
|
| Rate for Payer: PACE SWMI |
$3,516.55
|
| Rate for Payer: PHP Commercial |
$11,956.28
|
| Rate for Payer: PHP Medicare Advantage |
$3,516.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,143.04
|
| Rate for Payer: Priority Health HMO/PPO |
$12,237.60
|
| Rate for Payer: Priority Health Medicare |
$3,551.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,424.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3,516.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,378.26
|
| Rate for Payer: UHC Core |
$11,745.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,516.55
|
| Rate for Payer: UHC Exchange |
$3,516.55
|
| Rate for Payer: UHC Medicare Advantage |
$3,516.55
|
| Rate for Payer: VA VA |
$3,516.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,549.66
|
|
|
HC ST JUDE SINGLE PACEMAKER
|
Facility
|
OP
|
$7,178.76
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500011
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,704.96 |
| Max. Negotiated Rate |
$6,460.88 |
| Rate for Payer: Aetna Commercial |
$6,101.95
|
| Rate for Payer: Aetna Medicare |
$1,866.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,243.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,243.36
|
| Rate for Payer: BCBS Complete |
$2,871.50
|
| Rate for Payer: BCBS MAPPO |
$1,794.69
|
| Rate for Payer: BCBS Trust/PPO |
$5,901.66
|
| Rate for Payer: BCN Commercial |
$5,581.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,794.69
|
| Rate for Payer: Cash Price |
$5,743.01
|
| Rate for Payer: Cofinity Commercial |
$6,173.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,743.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,794.69
|
| Rate for Payer: Healthscope Commercial |
$6,460.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,384.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,884.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,063.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,101.95
|
| Rate for Payer: Nomi Health Commercial |
$5,886.58
|
| Rate for Payer: PACE Senior Care Partners |
$1,704.96
|
| Rate for Payer: PACE SWMI |
$1,794.69
|
| Rate for Payer: PHP Commercial |
$6,101.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,794.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,666.19
|
| Rate for Payer: Priority Health HMO/PPO |
$6,245.52
|
| Rate for Payer: Priority Health Medicare |
$1,812.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,809.77
|
| Rate for Payer: Railroad Medicare Medicare |
$1,794.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,317.31
|
| Rate for Payer: UHC Core |
$5,994.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,794.69
|
| Rate for Payer: UHC Exchange |
$1,794.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,794.69
|
| Rate for Payer: VA VA |
$1,794.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,384.07
|
|
|
HC ST JUDE SINGLE PACEMAKER
|
Facility
|
IP
|
$7,178.76
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500011
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,666.19 |
| Max. Negotiated Rate |
$6,460.88 |
| Rate for Payer: Aetna Commercial |
$6,101.95
|
| Rate for Payer: BCBS Trust/PPO |
$5,860.02
|
| Rate for Payer: BCN Commercial |
$5,547.75
|
| Rate for Payer: Cash Price |
$5,743.01
|
| Rate for Payer: Cofinity Commercial |
$6,173.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,743.01
|
| Rate for Payer: Healthscope Commercial |
$6,460.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,384.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,101.95
|
| Rate for Payer: Nomi Health Commercial |
$5,886.58
|
| Rate for Payer: PHP Commercial |
$6,101.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,666.19
|
| Rate for Payer: Priority Health HMO/PPO |
$6,245.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,809.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,317.31
|
| Rate for Payer: UHC Core |
$5,994.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,384.07
|
|
|
HC ST JUDE TACHY (ICD) LEAD
|
Facility
|
OP
|
$8,164.72
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,939.12 |
| Max. Negotiated Rate |
$7,348.25 |
| Rate for Payer: Aetna Commercial |
$6,940.01
|
| Rate for Payer: Aetna Medicare |
$2,122.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,551.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,551.47
|
| Rate for Payer: BCBS Complete |
$3,265.89
|
| Rate for Payer: BCBS MAPPO |
$2,041.18
|
| Rate for Payer: BCBS Trust/PPO |
$6,712.22
|
| Rate for Payer: BCN Commercial |
$6,348.07
|
| Rate for Payer: BCN Medicare Advantage |
$2,041.18
|
| Rate for Payer: Cash Price |
$6,531.78
|
| Rate for Payer: Cofinity Commercial |
$7,021.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,531.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,041.18
|
| Rate for Payer: Healthscope Commercial |
$7,348.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,123.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,143.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,347.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,940.01
|
| Rate for Payer: Nomi Health Commercial |
$6,695.07
|
| Rate for Payer: PACE Senior Care Partners |
$1,939.12
|
| Rate for Payer: PACE SWMI |
$2,041.18
|
| Rate for Payer: PHP Commercial |
$6,940.01
|
| Rate for Payer: PHP Medicare Advantage |
$2,041.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,307.07
|
| Rate for Payer: Priority Health HMO/PPO |
$7,103.31
|
| Rate for Payer: Priority Health Medicare |
$2,061.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,470.36
|
| Rate for Payer: Railroad Medicare Medicare |
$2,041.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,184.95
|
| Rate for Payer: UHC Core |
$6,817.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,041.18
|
| Rate for Payer: UHC Exchange |
$2,041.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,041.18
|
| Rate for Payer: VA VA |
$2,041.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,123.54
|
|
|
HC ST JUDE TACHY (ICD) LEAD
|
Facility
|
IP
|
$8,164.72
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,307.07 |
| Max. Negotiated Rate |
$7,348.25 |
| Rate for Payer: Aetna Commercial |
$6,940.01
|
| Rate for Payer: BCBS Trust/PPO |
$6,664.86
|
| Rate for Payer: BCN Commercial |
$6,309.70
|
| Rate for Payer: Cash Price |
$6,531.78
|
| Rate for Payer: Cofinity Commercial |
$7,021.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,531.78
|
| Rate for Payer: Healthscope Commercial |
$7,348.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,123.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,940.01
|
| Rate for Payer: Nomi Health Commercial |
$6,695.07
|
| Rate for Payer: PHP Commercial |
$6,940.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,307.07
|
| Rate for Payer: Priority Health HMO/PPO |
$7,103.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,470.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,184.95
|
| Rate for Payer: UHC Core |
$6,817.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,123.54
|
|
|
HC STOOL CULTURE
|
Facility
|
OP
|
$39.95
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
30600073
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.83 |
| Max. Negotiated Rate |
$35.95 |
| Rate for Payer: Aetna Commercial |
$33.96
|
| Rate for Payer: Aetna Medicare |
$10.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.48
|
| Rate for Payer: BCBS Complete |
$7.17
|
| Rate for Payer: BCBS MAPPO |
$9.99
|
| Rate for Payer: BCBS Trust/PPO |
$32.84
|
| Rate for Payer: BCN Commercial |
$31.06
|
| Rate for Payer: BCN Medicare Advantage |
$9.99
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cofinity Commercial |
$34.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.99
|
| Rate for Payer: Healthscope Commercial |
$35.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.96
|
| Rate for Payer: Mclaren Medicaid |
$6.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.49
|
| Rate for Payer: Meridian Medicaid |
$7.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.96
|
| Rate for Payer: Nomi Health Commercial |
$32.76
|
| Rate for Payer: PACE Senior Care Partners |
$9.49
|
| Rate for Payer: PACE SWMI |
$9.99
|
| Rate for Payer: PHP Commercial |
$33.96
|
| Rate for Payer: PHP Medicare Advantage |
$9.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.97
|
| Rate for Payer: Priority Health HMO/PPO |
$34.76
|
| Rate for Payer: Priority Health Medicare |
$10.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.77
|
| Rate for Payer: Railroad Medicare Medicare |
$9.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.16
|
| Rate for Payer: UHC Core |
$33.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.99
|
| Rate for Payer: UHC Exchange |
$9.99
|
| Rate for Payer: UHC Medicare Advantage |
$9.99
|
| Rate for Payer: UHCCP Medicaid |
$6.83
|
| Rate for Payer: VA VA |
$9.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.96
|
|
|
HC STOOL CULTURE
|
Facility
|
IP
|
$39.95
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
30600073
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.97 |
| Max. Negotiated Rate |
$35.95 |
| Rate for Payer: Aetna Commercial |
$33.96
|
| Rate for Payer: BCBS Trust/PPO |
$32.61
|
| Rate for Payer: BCN Commercial |
$30.87
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cofinity Commercial |
$34.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.96
|
| Rate for Payer: Healthscope Commercial |
$35.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.96
|
| Rate for Payer: Nomi Health Commercial |
$32.76
|
| Rate for Payer: PHP Commercial |
$33.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.97
|
| Rate for Payer: Priority Health HMO/PPO |
$34.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.16
|
| Rate for Payer: UHC Core |
$33.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.96
|
|
|
HC STOOL CULTURE CMPT
|
Facility
|
OP
|
$39.95
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
30600074
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.83 |
| Max. Negotiated Rate |
$35.95 |
| Rate for Payer: Aetna Commercial |
$33.96
|
| Rate for Payer: Aetna Medicare |
$10.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.48
|
| Rate for Payer: BCBS Complete |
$7.17
|
| Rate for Payer: BCBS MAPPO |
$9.99
|
| Rate for Payer: BCBS Trust/PPO |
$32.84
|
| Rate for Payer: BCN Commercial |
$31.06
|
| Rate for Payer: BCN Medicare Advantage |
$9.99
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cofinity Commercial |
$34.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.99
|
| Rate for Payer: Healthscope Commercial |
$35.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.96
|
| Rate for Payer: Mclaren Medicaid |
$6.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.49
|
| Rate for Payer: Meridian Medicaid |
$7.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.96
|
| Rate for Payer: Nomi Health Commercial |
$32.76
|
| Rate for Payer: PACE Senior Care Partners |
$9.49
|
| Rate for Payer: PACE SWMI |
$9.99
|
| Rate for Payer: PHP Commercial |
$33.96
|
| Rate for Payer: PHP Medicare Advantage |
$9.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.97
|
| Rate for Payer: Priority Health HMO/PPO |
$34.76
|
| Rate for Payer: Priority Health Medicare |
$10.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.77
|
| Rate for Payer: Railroad Medicare Medicare |
$9.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.16
|
| Rate for Payer: UHC Core |
$33.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.99
|
| Rate for Payer: UHC Exchange |
$9.99
|
| Rate for Payer: UHC Medicare Advantage |
$9.99
|
| Rate for Payer: UHCCP Medicaid |
$6.83
|
| Rate for Payer: VA VA |
$9.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.96
|
|
|
HC STOOL CULTURE CMPT
|
Facility
|
IP
|
$39.95
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
30600074
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.97 |
| Max. Negotiated Rate |
$35.95 |
| Rate for Payer: Aetna Commercial |
$33.96
|
| Rate for Payer: BCBS Trust/PPO |
$32.61
|
| Rate for Payer: BCN Commercial |
$30.87
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cofinity Commercial |
$34.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.96
|
| Rate for Payer: Healthscope Commercial |
$35.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.96
|
| Rate for Payer: Nomi Health Commercial |
$32.76
|
| Rate for Payer: PHP Commercial |
$33.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.97
|
| Rate for Payer: Priority Health HMO/PPO |
$34.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.16
|
| Rate for Payer: UHC Core |
$33.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.96
|
|
|
HC STOOL CULTURE CMPT2
|
Facility
|
OP
|
$13.32
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600069
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.16 |
| Max. Negotiated Rate |
$11.99 |
| Rate for Payer: Aetna Commercial |
$11.32
|
| Rate for Payer: Aetna Medicare |
$3.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.16
|
| Rate for Payer: BCBS Complete |
$5.07
|
| Rate for Payer: BCBS MAPPO |
$3.33
|
| Rate for Payer: BCBS Trust/PPO |
$10.95
|
| Rate for Payer: BCN Commercial |
$10.36
|
| Rate for Payer: BCN Medicare Advantage |
$3.33
|
| Rate for Payer: Cash Price |
$10.66
|
| Rate for Payer: Cash Price |
$10.66
|
| Rate for Payer: Cofinity Commercial |
$11.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.33
|
| Rate for Payer: Healthscope Commercial |
$11.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.99
|
| Rate for Payer: Mclaren Medicaid |
$4.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.50
|
| Rate for Payer: Meridian Medicaid |
$5.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.32
|
| Rate for Payer: Nomi Health Commercial |
$10.92
|
| Rate for Payer: PACE Senior Care Partners |
$3.16
|
| Rate for Payer: PACE SWMI |
$3.33
|
| Rate for Payer: PHP Commercial |
$11.32
|
| Rate for Payer: PHP Medicare Advantage |
$3.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.66
|
| Rate for Payer: Priority Health HMO/PPO |
$11.59
|
| Rate for Payer: Priority Health Medicare |
$3.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.92
|
| Rate for Payer: Railroad Medicare Medicare |
$3.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.72
|
| Rate for Payer: UHC Core |
$11.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.33
|
| Rate for Payer: UHC Exchange |
$3.33
|
| Rate for Payer: UHC Medicare Advantage |
$3.33
|
| Rate for Payer: UHCCP Medicaid |
$4.83
|
| Rate for Payer: VA VA |
$3.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.99
|
|
|
HC STOOL CULTURE CMPT2
|
Facility
|
IP
|
$13.32
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600069
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.66 |
| Max. Negotiated Rate |
$11.99 |
| Rate for Payer: Aetna Commercial |
$11.32
|
| Rate for Payer: BCBS Trust/PPO |
$10.87
|
| Rate for Payer: BCN Commercial |
$10.29
|
| Rate for Payer: Cash Price |
$10.66
|
| Rate for Payer: Cofinity Commercial |
$11.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.66
|
| Rate for Payer: Healthscope Commercial |
$11.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.32
|
| Rate for Payer: Nomi Health Commercial |
$10.92
|
| Rate for Payer: PHP Commercial |
$11.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.66
|
| Rate for Payer: Priority Health HMO/PPO |
$11.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.72
|
| Rate for Payer: UHC Core |
$11.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.99
|
|
|
HC STOOL CULTURE CMPT 3
|
Facility
|
OP
|
$42.55
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600177
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.11 |
| Max. Negotiated Rate |
$38.30 |
| Rate for Payer: Aetna Commercial |
$36.17
|
| Rate for Payer: Aetna Medicare |
$11.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.30
|
| Rate for Payer: BCBS Complete |
$12.20
|
| Rate for Payer: BCBS MAPPO |
$10.64
|
| Rate for Payer: BCBS Trust/PPO |
$34.98
|
| Rate for Payer: BCN Commercial |
$33.08
|
| Rate for Payer: BCN Medicare Advantage |
$10.64
|
| Rate for Payer: Cash Price |
$34.04
|
| Rate for Payer: Cash Price |
$34.04
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.64
|
| Rate for Payer: Healthscope Commercial |
$38.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.91
|
| Rate for Payer: Mclaren Medicaid |
$11.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.17
|
| Rate for Payer: Meridian Medicaid |
$12.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.17
|
| Rate for Payer: Nomi Health Commercial |
$34.89
|
| Rate for Payer: PACE Senior Care Partners |
$10.11
|
| Rate for Payer: PACE SWMI |
$10.64
|
| Rate for Payer: PHP Commercial |
$36.17
|
| Rate for Payer: PHP Medicare Advantage |
$10.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.66
|
| Rate for Payer: Priority Health HMO/PPO |
$37.02
|
| Rate for Payer: Priority Health Medicare |
$10.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.51
|
| Rate for Payer: Railroad Medicare Medicare |
$10.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.44
|
| Rate for Payer: UHC Core |
$35.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.64
|
| Rate for Payer: UHC Exchange |
$10.64
|
| Rate for Payer: UHC Medicare Advantage |
$10.64
|
| Rate for Payer: UHCCP Medicaid |
$11.62
|
| Rate for Payer: VA VA |
$10.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.91
|
|
|
HC STOOL CULTURE CMPT 3
|
Facility
|
IP
|
$42.55
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600177
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.66 |
| Max. Negotiated Rate |
$38.30 |
| Rate for Payer: Aetna Commercial |
$36.17
|
| Rate for Payer: BCBS Trust/PPO |
$34.73
|
| Rate for Payer: BCN Commercial |
$32.88
|
| Rate for Payer: Cash Price |
$34.04
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.04
|
| Rate for Payer: Healthscope Commercial |
$38.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.17
|
| Rate for Payer: Nomi Health Commercial |
$34.89
|
| Rate for Payer: PHP Commercial |
$36.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.66
|
| Rate for Payer: Priority Health HMO/PPO |
$37.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.44
|
| Rate for Payer: UHC Core |
$35.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.91
|
|
|
HC STRAPPING ANKLE AND OR FOOT
|
Facility
|
OP
|
$134.52
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
42000005
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$31.95 |
| Max. Negotiated Rate |
$121.07 |
| Rate for Payer: Aetna Commercial |
$114.34
|
| Rate for Payer: Aetna Medicare |
$34.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.04
|
| Rate for Payer: BCBS Complete |
$119.79
|
| Rate for Payer: BCBS MAPPO |
$33.63
|
| Rate for Payer: BCBS Trust/PPO |
$110.59
|
| Rate for Payer: BCN Commercial |
$104.59
|
| Rate for Payer: BCN Medicare Advantage |
$33.63
|
| Rate for Payer: Cash Price |
$107.62
|
| Rate for Payer: Cash Price |
$107.62
|
| Rate for Payer: Cofinity Commercial |
$115.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.63
|
| Rate for Payer: Healthscope Commercial |
$121.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.89
|
| Rate for Payer: Mclaren Medicaid |
$114.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.31
|
| Rate for Payer: Meridian Medicaid |
$119.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.34
|
| Rate for Payer: Nomi Health Commercial |
$110.31
|
| Rate for Payer: PACE Senior Care Partners |
$31.95
|
| Rate for Payer: PACE SWMI |
$33.63
|
| Rate for Payer: PHP Commercial |
$114.34
|
| Rate for Payer: PHP Medicare Advantage |
$33.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.44
|
| Rate for Payer: Priority Health HMO/PPO |
$117.03
|
| Rate for Payer: Priority Health Medicare |
$33.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.13
|
| Rate for Payer: Railroad Medicare Medicare |
$33.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.38
|
| Rate for Payer: UHC Core |
$112.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.63
|
| Rate for Payer: UHC Exchange |
$33.63
|
| Rate for Payer: UHC Medicare Advantage |
$33.63
|
| Rate for Payer: UHCCP Medicaid |
$114.08
|
| Rate for Payer: VA VA |
$33.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.89
|
|
|
HC STRAPPING ANKLE AND OR FOOT
|
Facility
|
IP
|
$134.52
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
42000005
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$87.44 |
| Max. Negotiated Rate |
$121.07 |
| Rate for Payer: Aetna Commercial |
$114.34
|
| Rate for Payer: BCBS Trust/PPO |
$109.81
|
| Rate for Payer: BCN Commercial |
$103.96
|
| Rate for Payer: Cash Price |
$107.62
|
| Rate for Payer: Cofinity Commercial |
$115.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.62
|
| Rate for Payer: Healthscope Commercial |
$121.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.34
|
| Rate for Payer: Nomi Health Commercial |
$110.31
|
| Rate for Payer: PHP Commercial |
$114.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.44
|
| Rate for Payer: Priority Health HMO/PPO |
$117.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.38
|
| Rate for Payer: UHC Core |
$112.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.89
|
|
|
HC STRAPPING CASTING UNLISTED
|
Facility
|
IP
|
$232.22
|
|
|
Service Code
|
CPT 29799
|
| Hospital Charge Code |
42000053
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$150.94 |
| Max. Negotiated Rate |
$209.00 |
| Rate for Payer: Aetna Commercial |
$197.39
|
| Rate for Payer: BCBS Trust/PPO |
$189.56
|
| Rate for Payer: BCN Commercial |
$179.46
|
| Rate for Payer: Cash Price |
$185.78
|
| Rate for Payer: Cofinity Commercial |
$199.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.78
|
| Rate for Payer: Healthscope Commercial |
$209.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.39
|
| Rate for Payer: Nomi Health Commercial |
$190.42
|
| Rate for Payer: PHP Commercial |
$197.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.94
|
| Rate for Payer: Priority Health HMO/PPO |
$202.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.35
|
| Rate for Payer: UHC Core |
$193.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.16
|
|
