|
HC SUMP VENTRICULAR LIVANOVA
|
Facility
|
OP
|
$44.37
|
|
| Hospital Charge Code |
27000659
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$39.93 |
| Rate for Payer: Aetna Commercial |
$37.71
|
| Rate for Payer: Aetna Medicare |
$11.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.87
|
| Rate for Payer: BCBS Complete |
$17.75
|
| Rate for Payer: BCBS MAPPO |
$11.09
|
| Rate for Payer: BCBS Trust/PPO |
$36.48
|
| Rate for Payer: BCN Commercial |
$34.50
|
| Rate for Payer: BCN Medicare Advantage |
$11.09
|
| 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: Health Alliance Plan Medicare Advantage |
$11.09
|
| Rate for Payer: Healthscope Commercial |
$39.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.71
|
| Rate for Payer: Nomi Health Commercial |
$36.38
|
| Rate for Payer: PACE Senior Care Partners |
$10.54
|
| Rate for Payer: PACE SWMI |
$11.09
|
| Rate for Payer: PHP Commercial |
$37.71
|
| Rate for Payer: PHP Medicare Advantage |
$11.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.84
|
| Rate for Payer: Priority Health HMO/PPO |
$38.60
|
| Rate for Payer: Priority Health Medicare |
$11.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.73
|
| Rate for Payer: Railroad Medicare Medicare |
$11.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.05
|
| Rate for Payer: UHC Core |
$37.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.09
|
| Rate for Payer: UHC Exchange |
$11.09
|
| Rate for Payer: UHC Medicare Advantage |
$11.09
|
| Rate for Payer: VA VA |
$11.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.28
|
|
|
HC SUMP VENTRICULAR MEDTRONIC
|
Facility
|
OP
|
$42.84
|
|
| Hospital Charge Code |
27000122
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.17 |
| Max. Negotiated Rate |
$38.56 |
| Rate for Payer: Aetna Commercial |
$36.41
|
| Rate for Payer: Aetna Medicare |
$11.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.39
|
| Rate for Payer: BCBS Complete |
$17.14
|
| Rate for Payer: BCBS MAPPO |
$10.71
|
| Rate for Payer: BCBS Trust/PPO |
$35.22
|
| Rate for Payer: BCN Commercial |
$33.31
|
| Rate for Payer: BCN Medicare Advantage |
$10.71
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$36.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.71
|
| Rate for Payer: Healthscope Commercial |
$38.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.41
|
| Rate for Payer: Nomi Health Commercial |
$35.13
|
| Rate for Payer: PACE Senior Care Partners |
$10.17
|
| Rate for Payer: PACE SWMI |
$10.71
|
| Rate for Payer: PHP Commercial |
$36.41
|
| Rate for Payer: PHP Medicare Advantage |
$10.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: Priority Health HMO/PPO |
$37.27
|
| Rate for Payer: Priority Health Medicare |
$10.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.70
|
| Rate for Payer: Railroad Medicare Medicare |
$10.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.70
|
| Rate for Payer: UHC Core |
$35.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.71
|
| Rate for Payer: UHC Exchange |
$10.71
|
| Rate for Payer: UHC Medicare Advantage |
$10.71
|
| Rate for Payer: VA VA |
$10.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.13
|
|
|
HC SUMP VENTRICULAR MEDTRONIC
|
Facility
|
IP
|
$42.84
|
|
| Hospital Charge Code |
27000122
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.85 |
| Max. Negotiated Rate |
$38.56 |
| Rate for Payer: Aetna Commercial |
$36.41
|
| Rate for Payer: BCBS Trust/PPO |
$34.97
|
| Rate for Payer: BCN Commercial |
$33.11
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$36.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$38.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.41
|
| Rate for Payer: Nomi Health Commercial |
$35.13
|
| Rate for Payer: PHP Commercial |
$36.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: Priority Health HMO/PPO |
$37.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.70
|
| Rate for Payer: UHC Core |
$35.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.13
|
|
|
HC SUPERVISION & HANDLING
|
Facility
|
OP
|
$157.10
|
|
|
Service Code
|
CPT 77790
|
| Hospital Charge Code |
33300029
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$37.31 |
| Max. Negotiated Rate |
$141.39 |
| Rate for Payer: Aetna Commercial |
$133.53
|
| Rate for Payer: Aetna Medicare |
$40.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.09
|
| Rate for Payer: BCBS Complete |
$62.84
|
| Rate for Payer: BCBS MAPPO |
$39.27
|
| Rate for Payer: BCBS Trust/PPO |
$129.15
|
| Rate for Payer: BCN Commercial |
$122.15
|
| Rate for Payer: BCN Medicare Advantage |
$39.27
|
| Rate for Payer: Cash Price |
$125.68
|
| Rate for Payer: Cofinity Commercial |
$135.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.27
|
| Rate for Payer: Healthscope Commercial |
$141.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.53
|
| Rate for Payer: Nomi Health Commercial |
$128.82
|
| Rate for Payer: PACE Senior Care Partners |
$37.31
|
| Rate for Payer: PACE SWMI |
$39.27
|
| Rate for Payer: PHP Commercial |
$133.53
|
| Rate for Payer: PHP Medicare Advantage |
$39.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.11
|
| Rate for Payer: Priority Health HMO/PPO |
$136.68
|
| Rate for Payer: Priority Health Medicare |
$39.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.26
|
| Rate for Payer: Railroad Medicare Medicare |
$39.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.25
|
| Rate for Payer: UHC Core |
$131.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.27
|
| Rate for Payer: UHC Exchange |
$39.27
|
| Rate for Payer: UHC Medicare Advantage |
$39.27
|
| Rate for Payer: VA VA |
$39.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.83
|
|
|
HC SUPERVISION & HANDLING
|
Facility
|
IP
|
$157.10
|
|
|
Service Code
|
CPT 77790
|
| Hospital Charge Code |
33300029
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$102.11 |
| Max. Negotiated Rate |
$141.39 |
| Rate for Payer: Aetna Commercial |
$133.53
|
| Rate for Payer: BCBS Trust/PPO |
$128.24
|
| Rate for Payer: BCN Commercial |
$121.41
|
| Rate for Payer: Cash Price |
$125.68
|
| Rate for Payer: Cofinity Commercial |
$135.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.68
|
| Rate for Payer: Healthscope Commercial |
$141.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.53
|
| Rate for Payer: Nomi Health Commercial |
$128.82
|
| Rate for Payer: PHP Commercial |
$133.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.11
|
| Rate for Payer: Priority Health HMO/PPO |
$136.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.25
|
| Rate for Payer: UHC Core |
$131.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.83
|
|
|
HC SUPPLEMENTAL NEWBORN SCRN
|
Facility
|
IP
|
$86.70
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
30100686
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.35 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$73.69
|
| Rate for Payer: BCBS Trust/PPO |
$70.77
|
| Rate for Payer: BCN Commercial |
$67.00
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$74.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.36
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.69
|
| Rate for Payer: Nomi Health Commercial |
$71.09
|
| Rate for Payer: PHP Commercial |
$73.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.35
|
| Rate for Payer: Priority Health HMO/PPO |
$75.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.30
|
| Rate for Payer: UHC Core |
$72.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.03
|
|
|
HC SUPPLEMENTAL NEWBORN SCRN
|
Facility
|
OP
|
$86.70
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
30100686
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.43 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna Commercial |
$73.69
|
| Rate for Payer: Aetna Medicare |
$22.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.09
|
| Rate for Payer: BCBS Complete |
$18.30
|
| Rate for Payer: BCBS MAPPO |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$71.28
|
| Rate for Payer: BCN Commercial |
$67.41
|
| Rate for Payer: BCN Medicare Advantage |
$21.68
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$74.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.68
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.03
|
| Rate for Payer: Mclaren Medicaid |
$17.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.76
|
| Rate for Payer: Meridian Medicaid |
$18.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.69
|
| Rate for Payer: Nomi Health Commercial |
$71.09
|
| Rate for Payer: PACE Senior Care Partners |
$20.59
|
| Rate for Payer: PACE SWMI |
$21.68
|
| Rate for Payer: PHP Commercial |
$73.69
|
| Rate for Payer: PHP Medicare Advantage |
$21.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.35
|
| Rate for Payer: Priority Health HMO/PPO |
$75.43
|
| Rate for Payer: Priority Health Medicare |
$21.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.09
|
| Rate for Payer: Railroad Medicare Medicare |
$21.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.30
|
| Rate for Payer: UHC Core |
$72.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.68
|
| Rate for Payer: UHC Exchange |
$21.68
|
| Rate for Payer: UHC Medicare Advantage |
$21.68
|
| Rate for Payer: UHCCP Medicaid |
$17.43
|
| Rate for Payer: VA VA |
$21.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.03
|
|
|
HC SUPRAPUBIC CATHETER
|
Facility
|
IP
|
$118.97
|
|
|
Service Code
|
HCPCS C2627
|
| Hospital Charge Code |
27200072
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.33 |
| Max. Negotiated Rate |
$107.07 |
| Rate for Payer: Aetna Commercial |
$101.12
|
| Rate for Payer: BCBS Trust/PPO |
$97.12
|
| Rate for Payer: BCN Commercial |
$91.94
|
| Rate for Payer: Cash Price |
$95.18
|
| Rate for Payer: Cofinity Commercial |
$102.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.18
|
| Rate for Payer: Healthscope Commercial |
$107.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.12
|
| Rate for Payer: Nomi Health Commercial |
$97.56
|
| Rate for Payer: PHP Commercial |
$101.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.33
|
| Rate for Payer: Priority Health HMO/PPO |
$103.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.69
|
| Rate for Payer: UHC Core |
$99.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.23
|
|
|
HC SUPRAPUBIC CATHETER
|
Facility
|
OP
|
$118.97
|
|
|
Service Code
|
HCPCS C2627
|
| Hospital Charge Code |
27200072
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.26 |
| Max. Negotiated Rate |
$107.07 |
| Rate for Payer: Aetna Commercial |
$101.12
|
| Rate for Payer: Aetna Medicare |
$30.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.18
|
| Rate for Payer: BCBS Complete |
$47.59
|
| Rate for Payer: BCBS MAPPO |
$29.74
|
| Rate for Payer: BCBS Trust/PPO |
$97.81
|
| Rate for Payer: BCN Commercial |
$92.50
|
| Rate for Payer: BCN Medicare Advantage |
$29.74
|
| Rate for Payer: Cash Price |
$95.18
|
| Rate for Payer: Cofinity Commercial |
$102.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.74
|
| Rate for Payer: Healthscope Commercial |
$107.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.12
|
| Rate for Payer: Nomi Health Commercial |
$97.56
|
| Rate for Payer: PACE Senior Care Partners |
$28.26
|
| Rate for Payer: PACE SWMI |
$29.74
|
| Rate for Payer: PHP Commercial |
$101.12
|
| Rate for Payer: PHP Medicare Advantage |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.33
|
| Rate for Payer: Priority Health HMO/PPO |
$103.50
|
| Rate for Payer: Priority Health Medicare |
$30.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.71
|
| Rate for Payer: Railroad Medicare Medicare |
$29.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.69
|
| Rate for Payer: UHC Core |
$99.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.74
|
| Rate for Payer: UHC Exchange |
$29.74
|
| Rate for Payer: UHC Medicare Advantage |
$29.74
|
| Rate for Payer: VA VA |
$29.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.23
|
|
|
HC SURGERY FROZEN EA ADDL
|
Facility
|
OP
|
$74.70
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
31000057
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.74 |
| Max. Negotiated Rate |
$67.23 |
| Rate for Payer: Aetna Commercial |
$63.49
|
| Rate for Payer: Aetna Medicare |
$19.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.34
|
| Rate for Payer: BCBS Complete |
$29.88
|
| Rate for Payer: BCBS MAPPO |
$18.68
|
| Rate for Payer: BCBS Trust/PPO |
$61.41
|
| Rate for Payer: BCN Commercial |
$58.08
|
| Rate for Payer: BCN Medicare Advantage |
$18.68
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cofinity Commercial |
$64.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.68
|
| Rate for Payer: Healthscope Commercial |
$67.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.49
|
| Rate for Payer: Nomi Health Commercial |
$61.25
|
| Rate for Payer: PACE Senior Care Partners |
$17.74
|
| Rate for Payer: PACE SWMI |
$18.68
|
| Rate for Payer: PHP Commercial |
$63.49
|
| Rate for Payer: PHP Medicare Advantage |
$18.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health HMO/PPO |
$64.99
|
| Rate for Payer: Priority Health Medicare |
$18.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.05
|
| Rate for Payer: Railroad Medicare Medicare |
$18.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.74
|
| Rate for Payer: UHC Core |
$62.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.68
|
| Rate for Payer: UHC Exchange |
$18.68
|
| Rate for Payer: UHC Medicare Advantage |
$18.68
|
| Rate for Payer: VA VA |
$18.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.02
|
|
|
HC SURGERY FROZEN EA ADDL
|
Facility
|
IP
|
$74.70
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
31000057
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$48.55 |
| Max. Negotiated Rate |
$67.23 |
| Rate for Payer: Aetna Commercial |
$63.49
|
| Rate for Payer: BCBS Trust/PPO |
$60.98
|
| Rate for Payer: BCN Commercial |
$57.73
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cofinity Commercial |
$64.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.76
|
| Rate for Payer: Healthscope Commercial |
$67.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.49
|
| Rate for Payer: Nomi Health Commercial |
$61.25
|
| Rate for Payer: PHP Commercial |
$63.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health HMO/PPO |
$64.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.74
|
| Rate for Payer: UHC Core |
$62.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.02
|
|
|
HC SURGICAL HAND
|
Facility
|
OP
|
$704.42
|
|
| Hospital Charge Code |
45000053
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$167.30 |
| Max. Negotiated Rate |
$633.98 |
| Rate for Payer: Aetna Commercial |
$598.76
|
| Rate for Payer: Aetna Medicare |
$183.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.13
|
| Rate for Payer: BCBS Complete |
$281.77
|
| Rate for Payer: BCBS MAPPO |
$176.10
|
| Rate for Payer: BCBS Trust/PPO |
$579.10
|
| Rate for Payer: BCN Commercial |
$547.69
|
| Rate for Payer: BCN Medicare Advantage |
$176.10
|
| Rate for Payer: Cash Price |
$563.54
|
| Rate for Payer: Cofinity Commercial |
$605.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.10
|
| Rate for Payer: Healthscope Commercial |
$633.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.76
|
| Rate for Payer: Nomi Health Commercial |
$577.62
|
| Rate for Payer: PACE Senior Care Partners |
$167.30
|
| Rate for Payer: PACE SWMI |
$176.10
|
| Rate for Payer: PHP Commercial |
$598.76
|
| Rate for Payer: PHP Medicare Advantage |
$176.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.87
|
| Rate for Payer: Priority Health HMO/PPO |
$612.85
|
| Rate for Payer: Priority Health Medicare |
$177.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$471.96
|
| Rate for Payer: Railroad Medicare Medicare |
$176.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.89
|
| Rate for Payer: UHC Core |
$588.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.10
|
| Rate for Payer: UHC Exchange |
$176.10
|
| Rate for Payer: UHC Medicare Advantage |
$176.10
|
| Rate for Payer: VA VA |
$176.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.32
|
|
|
HC SURGICAL HAND
|
Facility
|
IP
|
$704.42
|
|
| Hospital Charge Code |
45000053
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$457.87 |
| Max. Negotiated Rate |
$633.98 |
| Rate for Payer: Aetna Commercial |
$598.76
|
| Rate for Payer: BCBS Trust/PPO |
$575.02
|
| Rate for Payer: BCN Commercial |
$544.38
|
| Rate for Payer: Cash Price |
$563.54
|
| Rate for Payer: Cofinity Commercial |
$605.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.54
|
| Rate for Payer: Healthscope Commercial |
$633.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.76
|
| Rate for Payer: Nomi Health Commercial |
$577.62
|
| Rate for Payer: PHP Commercial |
$598.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.87
|
| Rate for Payer: Priority Health HMO/PPO |
$612.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$471.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.89
|
| Rate for Payer: UHC Core |
$588.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.32
|
|
|
HC SURG SUPPLY MISC
|
Facility
|
OP
|
$86.43
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
62300132
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$20.53 |
| Max. Negotiated Rate |
$77.79 |
| Rate for Payer: Aetna Commercial |
$73.47
|
| Rate for Payer: Aetna Medicare |
$22.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.01
|
| Rate for Payer: BCBS Complete |
$34.57
|
| Rate for Payer: BCBS MAPPO |
$21.61
|
| Rate for Payer: BCBS Trust/PPO |
$71.05
|
| Rate for Payer: BCN Commercial |
$67.20
|
| Rate for Payer: BCN Medicare Advantage |
$21.61
|
| Rate for Payer: Cash Price |
$69.14
|
| Rate for Payer: Cofinity Commercial |
$74.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.61
|
| Rate for Payer: Healthscope Commercial |
$77.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.47
|
| Rate for Payer: Nomi Health Commercial |
$70.87
|
| Rate for Payer: PACE Senior Care Partners |
$20.53
|
| Rate for Payer: PACE SWMI |
$21.61
|
| Rate for Payer: PHP Commercial |
$73.47
|
| Rate for Payer: PHP Medicare Advantage |
$21.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.18
|
| Rate for Payer: Priority Health HMO/PPO |
$75.19
|
| Rate for Payer: Priority Health Medicare |
$21.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.91
|
| Rate for Payer: Railroad Medicare Medicare |
$21.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.06
|
| Rate for Payer: UHC Core |
$72.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.61
|
| Rate for Payer: UHC Exchange |
$21.61
|
| Rate for Payer: UHC Medicare Advantage |
$21.61
|
| Rate for Payer: VA VA |
$21.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.82
|
|
|
HC SURG SUPPLY MISC
|
Facility
|
IP
|
$86.43
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
62300132
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$56.18 |
| Max. Negotiated Rate |
$77.79 |
| Rate for Payer: Aetna Commercial |
$73.47
|
| Rate for Payer: BCBS Trust/PPO |
$70.55
|
| Rate for Payer: BCN Commercial |
$66.79
|
| Rate for Payer: Cash Price |
$69.14
|
| Rate for Payer: Cofinity Commercial |
$74.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.14
|
| Rate for Payer: Healthscope Commercial |
$77.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.47
|
| Rate for Payer: Nomi Health Commercial |
$70.87
|
| Rate for Payer: PHP Commercial |
$73.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.18
|
| Rate for Payer: Priority Health HMO/PPO |
$75.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.06
|
| Rate for Payer: UHC Core |
$72.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.82
|
|
|
HC SUSCEPTIBILITY DISK
|
Facility
|
OP
|
$58.65
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
30600098
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$52.78 |
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: Aetna Medicare |
$15.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.33
|
| Rate for Payer: BCBS Complete |
$5.68
|
| Rate for Payer: BCBS MAPPO |
$14.66
|
| Rate for Payer: BCBS Trust/PPO |
$48.22
|
| Rate for Payer: BCN Commercial |
$45.60
|
| Rate for Payer: BCN Medicare Advantage |
$14.66
|
| Rate for Payer: Cash Price |
$46.92
|
| Rate for Payer: Cash Price |
$46.92
|
| Rate for Payer: Cofinity Commercial |
$50.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.66
|
| Rate for Payer: Healthscope Commercial |
$52.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.99
|
| Rate for Payer: Mclaren Medicaid |
$5.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.40
|
| Rate for Payer: Meridian Medicaid |
$5.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.85
|
| Rate for Payer: Nomi Health Commercial |
$48.09
|
| Rate for Payer: PACE Senior Care Partners |
$13.93
|
| Rate for Payer: PACE SWMI |
$14.66
|
| Rate for Payer: PHP Commercial |
$49.85
|
| Rate for Payer: PHP Medicare Advantage |
$14.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.12
|
| Rate for Payer: Priority Health HMO/PPO |
$51.03
|
| Rate for Payer: Priority Health Medicare |
$14.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.30
|
| Rate for Payer: Railroad Medicare Medicare |
$14.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.61
|
| Rate for Payer: UHC Core |
$48.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.66
|
| Rate for Payer: UHC Exchange |
$14.66
|
| Rate for Payer: UHC Medicare Advantage |
$14.66
|
| Rate for Payer: UHCCP Medicaid |
$5.41
|
| Rate for Payer: VA VA |
$14.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.99
|
|
|
HC SUSCEPTIBILITY DISK
|
Facility
|
IP
|
$58.65
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
30600098
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$38.12 |
| Max. Negotiated Rate |
$52.78 |
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: BCBS Trust/PPO |
$47.88
|
| Rate for Payer: BCN Commercial |
$45.32
|
| Rate for Payer: Cash Price |
$46.92
|
| Rate for Payer: Cofinity Commercial |
$50.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.92
|
| Rate for Payer: Healthscope Commercial |
$52.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.85
|
| Rate for Payer: Nomi Health Commercial |
$48.09
|
| Rate for Payer: PHP Commercial |
$49.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.12
|
| Rate for Payer: Priority Health HMO/PPO |
$51.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.61
|
| Rate for Payer: UHC Core |
$48.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.99
|
|
|
HC SUSCEPTIBILITY E TEST
|
Facility
|
IP
|
$32.77
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
30600097
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$29.49 |
| Rate for Payer: Aetna Commercial |
$27.85
|
| Rate for Payer: BCBS Trust/PPO |
$26.75
|
| Rate for Payer: BCN Commercial |
$25.32
|
| Rate for Payer: Cash Price |
$26.22
|
| Rate for Payer: Cofinity Commercial |
$28.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.22
|
| Rate for Payer: Healthscope Commercial |
$29.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.85
|
| Rate for Payer: Nomi Health Commercial |
$26.87
|
| Rate for Payer: PHP Commercial |
$27.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.30
|
| Rate for Payer: Priority Health HMO/PPO |
$28.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.84
|
| Rate for Payer: UHC Core |
$27.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.58
|
|
|
HC SUSCEPTIBILITY E TEST
|
Facility
|
OP
|
$32.77
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
30600097
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.43 |
| Max. Negotiated Rate |
$29.49 |
| Rate for Payer: Aetna Commercial |
$27.85
|
| Rate for Payer: Aetna Medicare |
$8.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.24
|
| Rate for Payer: BCBS Complete |
$3.61
|
| Rate for Payer: BCBS MAPPO |
$8.19
|
| Rate for Payer: BCBS Trust/PPO |
$26.94
|
| Rate for Payer: BCN Commercial |
$25.48
|
| Rate for Payer: BCN Medicare Advantage |
$8.19
|
| Rate for Payer: Cash Price |
$26.22
|
| Rate for Payer: Cash Price |
$26.22
|
| Rate for Payer: Cofinity Commercial |
$28.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.19
|
| Rate for Payer: Healthscope Commercial |
$29.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.58
|
| Rate for Payer: Mclaren Medicaid |
$3.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.60
|
| Rate for Payer: Meridian Medicaid |
$3.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.85
|
| Rate for Payer: Nomi Health Commercial |
$26.87
|
| Rate for Payer: PACE Senior Care Partners |
$7.78
|
| Rate for Payer: PACE SWMI |
$8.19
|
| Rate for Payer: PHP Commercial |
$27.85
|
| Rate for Payer: PHP Medicare Advantage |
$8.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.30
|
| Rate for Payer: Priority Health HMO/PPO |
$28.51
|
| Rate for Payer: Priority Health Medicare |
$8.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.96
|
| Rate for Payer: Railroad Medicare Medicare |
$8.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.84
|
| Rate for Payer: UHC Core |
$27.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.19
|
| Rate for Payer: UHC Exchange |
$8.19
|
| Rate for Payer: UHC Medicare Advantage |
$8.19
|
| Rate for Payer: UHCCP Medicaid |
$3.43
|
| Rate for Payer: VA VA |
$8.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.58
|
|
|
HC SUSCEPTIBILITY, MIC
|
Facility
|
OP
|
$80.58
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600100
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.25 |
| Max. Negotiated Rate |
$72.52 |
| Rate for Payer: Aetna Commercial |
$68.49
|
| Rate for Payer: Aetna Medicare |
$20.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.18
|
| Rate for Payer: BCBS Complete |
$6.57
|
| Rate for Payer: BCBS MAPPO |
$20.14
|
| Rate for Payer: BCBS Trust/PPO |
$66.24
|
| Rate for Payer: BCN Commercial |
$62.65
|
| Rate for Payer: BCN Medicare Advantage |
$20.14
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$69.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.14
|
| Rate for Payer: Healthscope Commercial |
$72.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.44
|
| Rate for Payer: Mclaren Medicaid |
$6.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.15
|
| Rate for Payer: Meridian Medicaid |
$6.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.49
|
| Rate for Payer: Nomi Health Commercial |
$66.08
|
| Rate for Payer: PACE Senior Care Partners |
$19.14
|
| Rate for Payer: PACE SWMI |
$20.14
|
| Rate for Payer: PHP Commercial |
$68.49
|
| Rate for Payer: PHP Medicare Advantage |
$20.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.38
|
| Rate for Payer: Priority Health HMO/PPO |
$70.10
|
| Rate for Payer: Priority Health Medicare |
$20.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.99
|
| Rate for Payer: Railroad Medicare Medicare |
$20.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.91
|
| Rate for Payer: UHC Core |
$67.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.14
|
| Rate for Payer: UHC Exchange |
$20.14
|
| Rate for Payer: UHC Medicare Advantage |
$20.14
|
| Rate for Payer: UHCCP Medicaid |
$6.25
|
| Rate for Payer: VA VA |
$20.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.44
|
|
|
HC SUSCEPTIBILITY, MIC
|
Facility
|
IP
|
$80.58
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600100
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$52.38 |
| Max. Negotiated Rate |
$72.52 |
| Rate for Payer: Aetna Commercial |
$68.49
|
| Rate for Payer: BCBS Trust/PPO |
$65.78
|
| Rate for Payer: BCN Commercial |
$62.27
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$69.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Healthscope Commercial |
$72.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.49
|
| Rate for Payer: Nomi Health Commercial |
$66.08
|
| Rate for Payer: PHP Commercial |
$68.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.38
|
| Rate for Payer: Priority Health HMO/PPO |
$70.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.91
|
| Rate for Payer: UHC Core |
$67.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.44
|
|
|
HC SWALLOW EVALUATION
|
Facility
|
OP
|
$333.35
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
44400004
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$79.17 |
| Max. Negotiated Rate |
$300.01 |
| Rate for Payer: Aetna Commercial |
$283.35
|
| Rate for Payer: Aetna Medicare |
$86.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.17
|
| Rate for Payer: BCBS Complete |
$133.34
|
| Rate for Payer: BCBS MAPPO |
$83.34
|
| Rate for Payer: BCBS Trust/PPO |
$274.05
|
| Rate for Payer: BCN Commercial |
$259.18
|
| Rate for Payer: BCN Medicare Advantage |
$83.34
|
| Rate for Payer: Cash Price |
$266.68
|
| Rate for Payer: Cofinity Commercial |
$286.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.34
|
| Rate for Payer: Healthscope Commercial |
$300.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.35
|
| Rate for Payer: Nomi Health Commercial |
$273.35
|
| Rate for Payer: PACE Senior Care Partners |
$79.17
|
| Rate for Payer: PACE SWMI |
$83.34
|
| Rate for Payer: PHP Commercial |
$283.35
|
| Rate for Payer: PHP Medicare Advantage |
$83.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.68
|
| Rate for Payer: Priority Health HMO/PPO |
$290.01
|
| Rate for Payer: Priority Health Medicare |
$84.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$223.34
|
| Rate for Payer: Railroad Medicare Medicare |
$83.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.35
|
| Rate for Payer: UHC Core |
$278.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.34
|
| Rate for Payer: UHC Exchange |
$83.34
|
| Rate for Payer: UHC Medicare Advantage |
$83.34
|
| Rate for Payer: VA VA |
$83.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.01
|
|
|
HC SWALLOW EVALUATION
|
Facility
|
IP
|
$333.35
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
44400004
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$216.68 |
| Max. Negotiated Rate |
$300.01 |
| Rate for Payer: Aetna Commercial |
$283.35
|
| Rate for Payer: BCBS Trust/PPO |
$272.11
|
| Rate for Payer: BCN Commercial |
$257.61
|
| Rate for Payer: Cash Price |
$266.68
|
| Rate for Payer: Cofinity Commercial |
$286.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.68
|
| Rate for Payer: Healthscope Commercial |
$300.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$283.35
|
| Rate for Payer: Nomi Health Commercial |
$273.35
|
| Rate for Payer: PHP Commercial |
$283.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.68
|
| Rate for Payer: Priority Health HMO/PPO |
$290.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$223.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.35
|
| Rate for Payer: UHC Core |
$278.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.01
|
|
|
HC SWALLOWING THERAPY
|
Facility
|
OP
|
$222.68
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
43000020
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$52.89 |
| Max. Negotiated Rate |
$200.41 |
| Rate for Payer: Aetna Commercial |
$189.28
|
| Rate for Payer: Aetna Medicare |
$57.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.59
|
| Rate for Payer: BCBS Complete |
$89.07
|
| Rate for Payer: BCBS MAPPO |
$55.67
|
| Rate for Payer: BCBS Trust/PPO |
$183.07
|
| Rate for Payer: BCN Commercial |
$173.13
|
| Rate for Payer: BCN Medicare Advantage |
$55.67
|
| Rate for Payer: Cash Price |
$178.14
|
| Rate for Payer: Cofinity Commercial |
$191.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.67
|
| Rate for Payer: Healthscope Commercial |
$200.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.28
|
| Rate for Payer: Nomi Health Commercial |
$182.60
|
| Rate for Payer: PACE Senior Care Partners |
$52.89
|
| Rate for Payer: PACE SWMI |
$55.67
|
| Rate for Payer: PHP Commercial |
$189.28
|
| Rate for Payer: PHP Medicare Advantage |
$55.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.74
|
| Rate for Payer: Priority Health HMO/PPO |
$193.73
|
| Rate for Payer: Priority Health Medicare |
$56.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.20
|
| Rate for Payer: Railroad Medicare Medicare |
$55.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.96
|
| Rate for Payer: UHC Core |
$185.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.67
|
| Rate for Payer: UHC Exchange |
$55.67
|
| Rate for Payer: UHC Medicare Advantage |
$55.67
|
| Rate for Payer: VA VA |
$55.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.01
|
|
|
HC SWALLOWING THERAPY
|
Facility
|
IP
|
$222.68
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
43000020
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$144.74 |
| Max. Negotiated Rate |
$200.41 |
| Rate for Payer: Aetna Commercial |
$189.28
|
| Rate for Payer: BCBS Trust/PPO |
$181.77
|
| Rate for Payer: BCN Commercial |
$172.09
|
| Rate for Payer: Cash Price |
$178.14
|
| Rate for Payer: Cofinity Commercial |
$191.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.14
|
| Rate for Payer: Healthscope Commercial |
$200.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.28
|
| Rate for Payer: Nomi Health Commercial |
$182.60
|
| Rate for Payer: PHP Commercial |
$189.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.74
|
| Rate for Payer: Priority Health HMO/PPO |
$193.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.96
|
| Rate for Payer: UHC Core |
$185.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.01
|
|
