|
HC STREPTOCOCCUS AGALACTIAE
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87653
|
| Hospital Charge Code |
30600276
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC STREPTOCOCCUS AGALACTIAE
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87653
|
| Hospital Charge Code |
30600276
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.01
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC STREPTOCOCCUS PNEUMONIA
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600277
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.01
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC STREPTOCOCCUS PNEUMONIA
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600277
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC STRESS COMPLETE PHYSIOLOGY ARTERIES
|
Facility
|
OP
|
$355.74
|
|
|
Service Code
|
CPT 93924
|
| Hospital Charge Code |
92100021
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$84.49 |
| Max. Negotiated Rate |
$320.17 |
| Rate for Payer: Aetna Commercial |
$302.38
|
| Rate for Payer: Aetna Medicare |
$92.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.17
|
| Rate for Payer: BCBS Complete |
$118.78
|
| Rate for Payer: BCBS MAPPO |
$88.94
|
| Rate for Payer: BCBS Trust/PPO |
$292.45
|
| Rate for Payer: BCN Commercial |
$276.59
|
| Rate for Payer: BCN Medicare Advantage |
$88.94
|
| Rate for Payer: Cash Price |
$284.59
|
| Rate for Payer: Cash Price |
$284.59
|
| Rate for Payer: Cofinity Commercial |
$305.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.94
|
| Rate for Payer: Healthscope Commercial |
$320.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.81
|
| Rate for Payer: Mclaren Medicaid |
$113.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.38
|
| Rate for Payer: Meridian Medicaid |
$118.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.38
|
| Rate for Payer: Nomi Health Commercial |
$291.71
|
| Rate for Payer: PACE Senior Care Partners |
$84.49
|
| Rate for Payer: PACE SWMI |
$88.94
|
| Rate for Payer: PHP Commercial |
$302.38
|
| Rate for Payer: PHP Medicare Advantage |
$88.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.23
|
| Rate for Payer: Priority Health HMO/PPO |
$309.49
|
| Rate for Payer: Priority Health Medicare |
$89.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.35
|
| Rate for Payer: Railroad Medicare Medicare |
$88.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.05
|
| Rate for Payer: UHC Core |
$297.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.94
|
| Rate for Payer: UHC Exchange |
$88.94
|
| Rate for Payer: UHC Medicare Advantage |
$88.94
|
| Rate for Payer: UHCCP Medicaid |
$113.12
|
| Rate for Payer: VA VA |
$88.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.81
|
|
|
HC STRESS COMPLETE PHYSIOLOGY ARTERIES
|
Facility
|
IP
|
$355.74
|
|
|
Service Code
|
CPT 93924
|
| Hospital Charge Code |
92100021
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$231.23 |
| Max. Negotiated Rate |
$320.17 |
| Rate for Payer: Aetna Commercial |
$302.38
|
| Rate for Payer: BCBS Trust/PPO |
$290.39
|
| Rate for Payer: BCN Commercial |
$274.92
|
| Rate for Payer: Cash Price |
$284.59
|
| Rate for Payer: Cofinity Commercial |
$305.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.59
|
| Rate for Payer: Healthscope Commercial |
$320.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.38
|
| Rate for Payer: Nomi Health Commercial |
$291.71
|
| Rate for Payer: PHP Commercial |
$302.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.23
|
| Rate for Payer: Priority Health HMO/PPO |
$309.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.05
|
| Rate for Payer: UHC Core |
$297.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.81
|
|
|
HC STRESS ECHO
|
Facility
|
IP
|
$1,515.37
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
48000008
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$984.99 |
| Max. Negotiated Rate |
$1,363.83 |
| Rate for Payer: Aetna Commercial |
$1,288.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,237.00
|
| Rate for Payer: BCN Commercial |
$1,171.08
|
| Rate for Payer: Cash Price |
$1,212.30
|
| Rate for Payer: Cofinity Commercial |
$1,303.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,212.30
|
| Rate for Payer: Healthscope Commercial |
$1,363.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,136.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,288.06
|
| Rate for Payer: Nomi Health Commercial |
$1,242.60
|
| Rate for Payer: PHP Commercial |
$1,288.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.99
|
| Rate for Payer: Priority Health HMO/PPO |
$1,318.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,015.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,333.53
|
| Rate for Payer: UHC Core |
$1,265.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,136.53
|
|
|
HC STRESS ECHO
|
Facility
|
OP
|
$1,515.37
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
48000008
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$359.90 |
| Max. Negotiated Rate |
$1,363.83 |
| Rate for Payer: Aetna Commercial |
$1,288.06
|
| Rate for Payer: Aetna Medicare |
$394.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$473.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$473.55
|
| Rate for Payer: BCBS Complete |
$416.27
|
| Rate for Payer: BCBS MAPPO |
$378.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,245.79
|
| Rate for Payer: BCN Commercial |
$1,178.20
|
| Rate for Payer: BCN Medicare Advantage |
$378.84
|
| Rate for Payer: Cash Price |
$1,212.30
|
| Rate for Payer: Cash Price |
$1,212.30
|
| Rate for Payer: Cofinity Commercial |
$1,303.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,212.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$378.84
|
| Rate for Payer: Healthscope Commercial |
$1,363.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,136.53
|
| Rate for Payer: Mclaren Medicaid |
$396.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$397.78
|
| Rate for Payer: Meridian Medicaid |
$416.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$435.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,288.06
|
| Rate for Payer: Nomi Health Commercial |
$1,242.60
|
| Rate for Payer: PACE Senior Care Partners |
$359.90
|
| Rate for Payer: PACE SWMI |
$378.84
|
| Rate for Payer: PHP Commercial |
$1,288.06
|
| Rate for Payer: PHP Medicare Advantage |
$378.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.99
|
| Rate for Payer: Priority Health HMO/PPO |
$1,318.37
|
| Rate for Payer: Priority Health Medicare |
$382.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,015.30
|
| Rate for Payer: Railroad Medicare Medicare |
$378.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,333.53
|
| Rate for Payer: UHC Core |
$1,265.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$378.84
|
| Rate for Payer: UHC Exchange |
$378.84
|
| Rate for Payer: UHC Medicare Advantage |
$378.84
|
| Rate for Payer: UHCCP Medicaid |
$396.42
|
| Rate for Payer: VA VA |
$378.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,136.53
|
|
|
HC STRESS TEST
|
Facility
|
OP
|
$901.94
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200001
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$214.21 |
| Max. Negotiated Rate |
$811.75 |
| Rate for Payer: Aetna Commercial |
$766.65
|
| Rate for Payer: Aetna Medicare |
$234.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$281.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$281.86
|
| Rate for Payer: BCBS Complete |
$236.41
|
| Rate for Payer: BCBS MAPPO |
$225.49
|
| Rate for Payer: BCBS Trust/PPO |
$741.48
|
| Rate for Payer: BCN Commercial |
$701.26
|
| Rate for Payer: BCN Medicare Advantage |
$225.49
|
| Rate for Payer: Cash Price |
$721.55
|
| Rate for Payer: Cash Price |
$721.55
|
| Rate for Payer: Cofinity Commercial |
$775.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.49
|
| Rate for Payer: Healthscope Commercial |
$811.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$676.46
|
| Rate for Payer: Mclaren Medicaid |
$225.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.76
|
| Rate for Payer: Meridian Medicaid |
$236.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$259.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.65
|
| Rate for Payer: Nomi Health Commercial |
$739.59
|
| Rate for Payer: PACE Senior Care Partners |
$214.21
|
| Rate for Payer: PACE SWMI |
$225.49
|
| Rate for Payer: PHP Commercial |
$766.65
|
| Rate for Payer: PHP Medicare Advantage |
$225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$225.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$586.26
|
| Rate for Payer: Priority Health HMO/PPO |
$784.69
|
| Rate for Payer: Priority Health Medicare |
$227.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$604.30
|
| Rate for Payer: Railroad Medicare Medicare |
$225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$793.71
|
| Rate for Payer: UHC Core |
$753.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.49
|
| Rate for Payer: UHC Exchange |
$225.49
|
| Rate for Payer: UHC Medicare Advantage |
$225.49
|
| Rate for Payer: UHCCP Medicaid |
$225.14
|
| Rate for Payer: VA VA |
$225.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$676.46
|
|
|
HC STRESS TEST
|
Facility
|
IP
|
$901.94
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200001
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$586.26 |
| Max. Negotiated Rate |
$811.75 |
| Rate for Payer: Aetna Commercial |
$766.65
|
| Rate for Payer: BCBS Trust/PPO |
$736.25
|
| Rate for Payer: BCN Commercial |
$697.02
|
| Rate for Payer: Cash Price |
$721.55
|
| Rate for Payer: Cofinity Commercial |
$775.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.55
|
| Rate for Payer: Healthscope Commercial |
$811.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$676.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.65
|
| Rate for Payer: Nomi Health Commercial |
$739.59
|
| Rate for Payer: PHP Commercial |
$766.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$586.26
|
| Rate for Payer: Priority Health HMO/PPO |
$784.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$604.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$793.71
|
| Rate for Payer: UHC Core |
$753.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$676.46
|
|
|
HC STRIP PASTE
|
Facility
|
OP
|
$4.50
|
|
| Hospital Charge Code |
27000109
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$4.05 |
| Rate for Payer: Aetna Commercial |
$3.83
|
| Rate for Payer: Aetna Medicare |
$1.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.41
|
| Rate for Payer: BCBS Complete |
$1.80
|
| Rate for Payer: BCBS MAPPO |
$1.12
|
| Rate for Payer: BCBS Trust/PPO |
$3.70
|
| Rate for Payer: BCN Commercial |
$3.50
|
| Rate for Payer: BCN Medicare Advantage |
$1.12
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cofinity Commercial |
$3.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.12
|
| Rate for Payer: Healthscope Commercial |
$4.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.83
|
| Rate for Payer: Nomi Health Commercial |
$3.69
|
| Rate for Payer: PACE Senior Care Partners |
$1.07
|
| Rate for Payer: PACE SWMI |
$1.12
|
| Rate for Payer: PHP Commercial |
$3.83
|
| Rate for Payer: PHP Medicare Advantage |
$1.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.92
|
| Rate for Payer: Priority Health HMO/PPO |
$3.92
|
| Rate for Payer: Priority Health Medicare |
$1.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.02
|
| Rate for Payer: Railroad Medicare Medicare |
$1.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.96
|
| Rate for Payer: UHC Core |
$3.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.12
|
| Rate for Payer: UHC Exchange |
$1.12
|
| Rate for Payer: UHC Medicare Advantage |
$1.12
|
| Rate for Payer: VA VA |
$1.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.38
|
|
|
HC STRIP PASTE
|
Facility
|
IP
|
$4.50
|
|
| Hospital Charge Code |
27000109
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.92 |
| Max. Negotiated Rate |
$4.05 |
| Rate for Payer: Aetna Commercial |
$3.83
|
| Rate for Payer: BCBS Trust/PPO |
$3.67
|
| Rate for Payer: BCN Commercial |
$3.48
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cofinity Commercial |
$3.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.60
|
| Rate for Payer: Healthscope Commercial |
$4.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.83
|
| Rate for Payer: Nomi Health Commercial |
$3.69
|
| Rate for Payer: PHP Commercial |
$3.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.92
|
| Rate for Payer: Priority Health HMO/PPO |
$3.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.96
|
| Rate for Payer: UHC Core |
$3.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.38
|
|
|
HC STRONGYLOIDES ANTIBODY, IGG, SERUM
|
Facility
|
IP
|
$87.31
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200490
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$56.75 |
| Max. Negotiated Rate |
$78.58 |
| Rate for Payer: Aetna Commercial |
$74.21
|
| Rate for Payer: BCBS Trust/PPO |
$71.27
|
| Rate for Payer: BCN Commercial |
$67.47
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Cofinity Commercial |
$75.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.85
|
| Rate for Payer: Healthscope Commercial |
$78.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.21
|
| Rate for Payer: Nomi Health Commercial |
$71.59
|
| Rate for Payer: PHP Commercial |
$74.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.75
|
| Rate for Payer: Priority Health HMO/PPO |
$75.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.83
|
| Rate for Payer: UHC Core |
$72.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.48
|
|
|
HC STRONGYLOIDES ANTIBODY, IGG, SERUM
|
Facility
|
OP
|
$87.31
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200490
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.41 |
| Max. Negotiated Rate |
$78.58 |
| Rate for Payer: Aetna Commercial |
$74.21
|
| Rate for Payer: Aetna Medicare |
$22.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.28
|
| Rate for Payer: BCBS Complete |
$9.88
|
| Rate for Payer: BCBS MAPPO |
$21.83
|
| Rate for Payer: BCBS Trust/PPO |
$71.78
|
| Rate for Payer: BCN Commercial |
$67.88
|
| Rate for Payer: BCN Medicare Advantage |
$21.83
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Cofinity Commercial |
$75.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.83
|
| Rate for Payer: Healthscope Commercial |
$78.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.48
|
| Rate for Payer: Mclaren Medicaid |
$9.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.92
|
| Rate for Payer: Meridian Medicaid |
$9.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.21
|
| Rate for Payer: Nomi Health Commercial |
$71.59
|
| Rate for Payer: PACE Senior Care Partners |
$20.74
|
| Rate for Payer: PACE SWMI |
$21.83
|
| Rate for Payer: PHP Commercial |
$74.21
|
| Rate for Payer: PHP Medicare Advantage |
$21.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.75
|
| Rate for Payer: Priority Health HMO/PPO |
$75.96
|
| Rate for Payer: Priority Health Medicare |
$22.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.50
|
| Rate for Payer: Railroad Medicare Medicare |
$21.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.83
|
| Rate for Payer: UHC Core |
$72.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.83
|
| Rate for Payer: UHC Exchange |
$21.83
|
| Rate for Payer: UHC Medicare Advantage |
$21.83
|
| Rate for Payer: UHCCP Medicaid |
$9.41
|
| Rate for Payer: VA VA |
$21.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.48
|
|
|
HC STUDY INSERT NON TUNNELED CENTRAL LINE > 5 YRS
|
Facility
|
IP
|
$39.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100588
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Aetna Commercial |
$33.15
|
| Rate for Payer: BCBS Trust/PPO |
$31.84
|
| Rate for Payer: BCN Commercial |
$30.14
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$33.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.20
|
| Rate for Payer: Healthscope Commercial |
$35.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Nomi Health Commercial |
$31.98
|
| Rate for Payer: PHP Commercial |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health HMO/PPO |
$33.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.32
|
| Rate for Payer: UHC Core |
$32.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.25
|
|
|
HC STUDY INSERT NON TUNNELED CENTRAL LINE > 5 YRS
|
Facility
|
OP
|
$39.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100588
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$2,389.58 |
| Rate for Payer: Aetna Commercial |
$33.15
|
| Rate for Payer: Aetna Medicare |
$10.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.19
|
| Rate for Payer: BCBS Complete |
$2,389.58
|
| Rate for Payer: BCBS MAPPO |
$9.75
|
| Rate for Payer: BCBS Trust/PPO |
$32.06
|
| Rate for Payer: BCN Commercial |
$30.32
|
| Rate for Payer: BCN Medicare Advantage |
$9.75
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$33.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.75
|
| Rate for Payer: Healthscope Commercial |
$35.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.25
|
| Rate for Payer: Mclaren Medicaid |
$2,275.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.24
|
| Rate for Payer: Meridian Medicaid |
$2,389.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: Nomi Health Commercial |
$31.98
|
| Rate for Payer: PACE Senior Care Partners |
$9.26
|
| Rate for Payer: PACE SWMI |
$9.75
|
| Rate for Payer: PHP Commercial |
$33.15
|
| Rate for Payer: PHP Medicare Advantage |
$9.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,275.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health HMO/PPO |
$33.93
|
| Rate for Payer: Priority Health Medicare |
$9.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.13
|
| Rate for Payer: Railroad Medicare Medicare |
$9.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.32
|
| Rate for Payer: UHC Core |
$32.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.75
|
| Rate for Payer: UHC Exchange |
$9.75
|
| Rate for Payer: UHC Medicare Advantage |
$9.75
|
| Rate for Payer: UHCCP Medicaid |
$2,275.64
|
| Rate for Payer: VA VA |
$9.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.25
|
|
|
HC SUBCLASS IGG4, SERUM
|
Facility
|
IP
|
$132.60
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100720
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$86.19 |
| Max. Negotiated Rate |
$119.34 |
| Rate for Payer: Aetna Commercial |
$112.71
|
| Rate for Payer: BCBS Trust/PPO |
$108.24
|
| Rate for Payer: BCN Commercial |
$102.47
|
| Rate for Payer: Cash Price |
$106.08
|
| Rate for Payer: Cofinity Commercial |
$114.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.08
|
| Rate for Payer: Healthscope Commercial |
$119.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.71
|
| Rate for Payer: Nomi Health Commercial |
$108.73
|
| Rate for Payer: PHP Commercial |
$112.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.19
|
| Rate for Payer: Priority Health HMO/PPO |
$115.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.69
|
| Rate for Payer: UHC Core |
$110.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.45
|
|
|
HC SUBCLASS IGG4, SERUM
|
Facility
|
OP
|
$132.60
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100720
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.80 |
| Max. Negotiated Rate |
$119.34 |
| Rate for Payer: Aetna Commercial |
$112.71
|
| Rate for Payer: Aetna Medicare |
$34.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.44
|
| Rate for Payer: BCBS Complete |
$6.09
|
| Rate for Payer: BCBS MAPPO |
$33.15
|
| Rate for Payer: BCBS Trust/PPO |
$109.01
|
| Rate for Payer: BCN Commercial |
$103.10
|
| Rate for Payer: BCN Medicare Advantage |
$33.15
|
| Rate for Payer: Cash Price |
$106.08
|
| Rate for Payer: Cash Price |
$106.08
|
| Rate for Payer: Cofinity Commercial |
$114.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.15
|
| Rate for Payer: Healthscope Commercial |
$119.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.45
|
| Rate for Payer: Mclaren Medicaid |
$5.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.81
|
| Rate for Payer: Meridian Medicaid |
$6.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.71
|
| Rate for Payer: Nomi Health Commercial |
$108.73
|
| Rate for Payer: PACE Senior Care Partners |
$31.49
|
| Rate for Payer: PACE SWMI |
$33.15
|
| Rate for Payer: PHP Commercial |
$112.71
|
| Rate for Payer: PHP Medicare Advantage |
$33.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.19
|
| Rate for Payer: Priority Health HMO/PPO |
$115.36
|
| Rate for Payer: Priority Health Medicare |
$33.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.84
|
| Rate for Payer: Railroad Medicare Medicare |
$33.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.69
|
| Rate for Payer: UHC Core |
$110.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.15
|
| Rate for Payer: UHC Exchange |
$33.15
|
| Rate for Payer: UHC Medicare Advantage |
$33.15
|
| Rate for Payer: UHCCP Medicaid |
$5.80
|
| Rate for Payer: VA VA |
$33.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.45
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL
|
Facility
|
OP
|
$8,109.00
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100377
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,925.89 |
| Max. Negotiated Rate |
$7,298.10 |
| Rate for Payer: Aetna Commercial |
$6,892.65
|
| Rate for Payer: Aetna Medicare |
$2,108.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,534.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,534.06
|
| Rate for Payer: BCBS Complete |
$2,462.14
|
| Rate for Payer: BCBS MAPPO |
$2,027.25
|
| Rate for Payer: BCBS Trust/PPO |
$6,666.41
|
| Rate for Payer: BCN Commercial |
$6,304.75
|
| Rate for Payer: BCN Medicare Advantage |
$2,027.25
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cofinity Commercial |
$6,973.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,487.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,027.25
|
| Rate for Payer: Healthscope Commercial |
$7,298.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,081.75
|
| Rate for Payer: Mclaren Medicaid |
$2,344.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,128.61
|
| Rate for Payer: Meridian Medicaid |
$2,462.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,331.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,892.65
|
| Rate for Payer: Nomi Health Commercial |
$6,649.38
|
| Rate for Payer: PACE Senior Care Partners |
$1,925.89
|
| Rate for Payer: PACE SWMI |
$2,027.25
|
| Rate for Payer: PHP Commercial |
$6,892.65
|
| Rate for Payer: PHP Medicare Advantage |
$2,027.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,344.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,270.85
|
| Rate for Payer: Priority Health HMO/PPO |
$7,054.83
|
| Rate for Payer: Priority Health Medicare |
$2,047.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,433.03
|
| Rate for Payer: Railroad Medicare Medicare |
$2,027.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,135.92
|
| Rate for Payer: UHC Core |
$6,771.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,027.25
|
| Rate for Payer: UHC Exchange |
$2,027.25
|
| Rate for Payer: UHC Medicare Advantage |
$2,027.25
|
| Rate for Payer: UHCCP Medicaid |
$2,344.74
|
| Rate for Payer: VA VA |
$2,027.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,081.75
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL
|
Facility
|
IP
|
$8,109.00
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100377
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,270.85 |
| Max. Negotiated Rate |
$7,298.10 |
| Rate for Payer: Aetna Commercial |
$6,892.65
|
| Rate for Payer: BCBS Trust/PPO |
$6,619.38
|
| Rate for Payer: BCN Commercial |
$6,266.64
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cofinity Commercial |
$6,973.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,487.20
|
| Rate for Payer: Healthscope Commercial |
$7,298.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,081.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,892.65
|
| Rate for Payer: Nomi Health Commercial |
$6,649.38
|
| Rate for Payer: PHP Commercial |
$6,892.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,270.85
|
| Rate for Payer: Priority Health HMO/PPO |
$7,054.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,433.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,135.92
|
| Rate for Payer: UHC Core |
$6,771.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,081.75
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL BILAT
|
Facility
|
IP
|
$12,163.50
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100378
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7,906.27 |
| Max. Negotiated Rate |
$10,947.15 |
| Rate for Payer: Aetna Commercial |
$10,338.98
|
| Rate for Payer: BCBS Trust/PPO |
$9,929.07
|
| Rate for Payer: BCN Commercial |
$9,399.95
|
| Rate for Payer: Cash Price |
$9,730.80
|
| Rate for Payer: Cofinity Commercial |
$10,460.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,730.80
|
| Rate for Payer: Healthscope Commercial |
$10,947.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,122.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,338.98
|
| Rate for Payer: Nomi Health Commercial |
$9,974.07
|
| Rate for Payer: PHP Commercial |
$10,338.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,906.27
|
| Rate for Payer: Priority Health HMO/PPO |
$10,582.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,149.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,703.88
|
| Rate for Payer: UHC Core |
$10,156.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,122.62
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL BILAT
|
Facility
|
OP
|
$12,163.50
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100378
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,344.74 |
| Max. Negotiated Rate |
$10,947.15 |
| Rate for Payer: Aetna Commercial |
$10,338.98
|
| Rate for Payer: Aetna Medicare |
$3,162.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,801.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,801.09
|
| Rate for Payer: BCBS Complete |
$2,462.14
|
| Rate for Payer: BCBS MAPPO |
$3,040.88
|
| Rate for Payer: BCBS Trust/PPO |
$9,999.61
|
| Rate for Payer: BCN Commercial |
$9,457.12
|
| Rate for Payer: BCN Medicare Advantage |
$3,040.88
|
| Rate for Payer: Cash Price |
$9,730.80
|
| Rate for Payer: Cash Price |
$9,730.80
|
| Rate for Payer: Cofinity Commercial |
$10,460.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,730.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,040.88
|
| Rate for Payer: Healthscope Commercial |
$10,947.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,122.62
|
| Rate for Payer: Mclaren Medicaid |
$2,344.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,192.92
|
| Rate for Payer: Meridian Medicaid |
$2,462.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,497.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,338.98
|
| Rate for Payer: Nomi Health Commercial |
$9,974.07
|
| Rate for Payer: PACE Senior Care Partners |
$2,888.83
|
| Rate for Payer: PACE SWMI |
$3,040.88
|
| Rate for Payer: PHP Commercial |
$10,338.98
|
| Rate for Payer: PHP Medicare Advantage |
$3,040.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,344.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,906.27
|
| Rate for Payer: Priority Health HMO/PPO |
$10,582.25
|
| Rate for Payer: Priority Health Medicare |
$3,071.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,149.55
|
| Rate for Payer: Railroad Medicare Medicare |
$3,040.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,703.88
|
| Rate for Payer: UHC Core |
$10,156.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,040.88
|
| Rate for Payer: UHC Exchange |
$3,040.88
|
| Rate for Payer: UHC Medicare Advantage |
$3,040.88
|
| Rate for Payer: UHCCP Medicaid |
$2,344.74
|
| Rate for Payer: VA VA |
$3,040.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,122.62
|
|
|
HC SUCTION A&A LINE
|
Facility
|
IP
|
$32.13
|
|
| Hospital Charge Code |
27000110
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.88 |
| Max. Negotiated Rate |
$28.92 |
| Rate for Payer: Aetna Commercial |
$27.31
|
| Rate for Payer: BCBS Trust/PPO |
$26.23
|
| Rate for Payer: BCN Commercial |
$24.83
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$27.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.70
|
| Rate for Payer: Healthscope Commercial |
$28.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.31
|
| Rate for Payer: Nomi Health Commercial |
$26.35
|
| Rate for Payer: PHP Commercial |
$27.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.88
|
| Rate for Payer: Priority Health HMO/PPO |
$27.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.27
|
| Rate for Payer: UHC Core |
$26.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.10
|
|
|
HC SUCTION A&A LINE
|
Facility
|
OP
|
$32.13
|
|
| Hospital Charge Code |
27000110
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.63 |
| Max. Negotiated Rate |
$28.92 |
| Rate for Payer: Aetna Commercial |
$27.31
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.04
|
| Rate for Payer: BCBS Complete |
$12.85
|
| Rate for Payer: BCBS MAPPO |
$8.03
|
| Rate for Payer: BCBS Trust/PPO |
$26.41
|
| Rate for Payer: BCN Commercial |
$24.98
|
| Rate for Payer: BCN Medicare Advantage |
$8.03
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$27.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.03
|
| Rate for Payer: Healthscope Commercial |
$28.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.31
|
| Rate for Payer: Nomi Health Commercial |
$26.35
|
| Rate for Payer: PACE Senior Care Partners |
$7.63
|
| Rate for Payer: PACE SWMI |
$8.03
|
| Rate for Payer: PHP Commercial |
$27.31
|
| Rate for Payer: PHP Medicare Advantage |
$8.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.88
|
| Rate for Payer: Priority Health HMO/PPO |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$8.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.53
|
| Rate for Payer: Railroad Medicare Medicare |
$8.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.27
|
| Rate for Payer: UHC Core |
$26.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.03
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicare Advantage |
$8.03
|
| Rate for Payer: VA VA |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.10
|
|
|
HC SUMP VENTRICULAR LIVANOVA
|
Facility
|
IP
|
$44.37
|
|
| Hospital Charge Code |
27000659
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.84 |
| Max. Negotiated Rate |
$39.93 |
| Rate for Payer: Aetna Commercial |
$37.71
|
| Rate for Payer: BCBS Trust/PPO |
$36.22
|
| Rate for Payer: BCN Commercial |
$34.29
|
| Rate for Payer: Cash Price |
$35.50
|
| Rate for Payer: Cofinity Commercial |
$38.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.50
|
| Rate for Payer: Healthscope Commercial |
$39.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.71
|
| Rate for Payer: Nomi Health Commercial |
$36.38
|
| Rate for Payer: PHP Commercial |
$37.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.84
|
| Rate for Payer: Priority Health HMO/PPO |
$38.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.05
|
| Rate for Payer: UHC Core |
$37.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.28
|
|
