|
HC SWAN GANZ CATHETER
|
Facility
|
OP
|
$235.47
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200073
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.92 |
| Max. Negotiated Rate |
$211.92 |
| Rate for Payer: Aetna Commercial |
$200.15
|
| Rate for Payer: Aetna Medicare |
$61.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.58
|
| Rate for Payer: BCBS Complete |
$94.19
|
| Rate for Payer: BCBS MAPPO |
$58.87
|
| Rate for Payer: BCBS Trust/PPO |
$193.58
|
| Rate for Payer: BCN Commercial |
$183.08
|
| Rate for Payer: BCN Medicare Advantage |
$58.87
|
| Rate for Payer: Cash Price |
$188.38
|
| Rate for Payer: Cofinity Commercial |
$202.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.87
|
| Rate for Payer: Healthscope Commercial |
$211.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.15
|
| Rate for Payer: Nomi Health Commercial |
$193.09
|
| Rate for Payer: PACE Senior Care Partners |
$55.92
|
| Rate for Payer: PACE SWMI |
$58.87
|
| Rate for Payer: PHP Commercial |
$200.15
|
| Rate for Payer: PHP Medicare Advantage |
$58.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.06
|
| Rate for Payer: Priority Health HMO/PPO |
$204.86
|
| Rate for Payer: Priority Health Medicare |
$59.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.76
|
| Rate for Payer: Railroad Medicare Medicare |
$58.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.21
|
| Rate for Payer: UHC Core |
$196.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.87
|
| Rate for Payer: UHC Exchange |
$58.87
|
| Rate for Payer: UHC Medicare Advantage |
$58.87
|
| Rate for Payer: VA VA |
$58.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.60
|
|
|
HC SWAN GANZ CATHETER
|
Facility
|
IP
|
$235.47
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200073
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$153.06 |
| Max. Negotiated Rate |
$211.92 |
| Rate for Payer: Aetna Commercial |
$200.15
|
| Rate for Payer: BCBS Trust/PPO |
$192.21
|
| Rate for Payer: BCN Commercial |
$181.97
|
| Rate for Payer: Cash Price |
$188.38
|
| Rate for Payer: Cofinity Commercial |
$202.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.38
|
| Rate for Payer: Healthscope Commercial |
$211.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.15
|
| Rate for Payer: Nomi Health Commercial |
$193.09
|
| Rate for Payer: PHP Commercial |
$200.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.06
|
| Rate for Payer: Priority Health HMO/PPO |
$204.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.21
|
| Rate for Payer: UHC Core |
$196.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.60
|
|
|
HC SWAN GANZ PLACEMENT
|
Facility
|
OP
|
$1,644.87
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
48100024
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$390.66 |
| Max. Negotiated Rate |
$1,480.38 |
| Rate for Payer: Aetna Commercial |
$1,398.14
|
| Rate for Payer: Aetna Medicare |
$427.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$514.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$514.02
|
| Rate for Payer: BCBS Complete |
$1,179.37
|
| Rate for Payer: BCBS MAPPO |
$411.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,352.25
|
| Rate for Payer: BCN Commercial |
$1,278.89
|
| Rate for Payer: BCN Medicare Advantage |
$411.22
|
| Rate for Payer: Cash Price |
$1,315.90
|
| Rate for Payer: Cash Price |
$1,315.90
|
| Rate for Payer: Cofinity Commercial |
$1,414.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,315.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$411.22
|
| Rate for Payer: Healthscope Commercial |
$1,480.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,233.65
|
| Rate for Payer: Mclaren Medicaid |
$1,123.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$431.78
|
| Rate for Payer: Meridian Medicaid |
$1,179.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$472.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,398.14
|
| Rate for Payer: Nomi Health Commercial |
$1,348.79
|
| Rate for Payer: PACE Senior Care Partners |
$390.66
|
| Rate for Payer: PACE SWMI |
$411.22
|
| Rate for Payer: PHP Commercial |
$1,398.14
|
| Rate for Payer: PHP Medicare Advantage |
$411.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,123.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,069.17
|
| Rate for Payer: Priority Health HMO/PPO |
$1,431.04
|
| Rate for Payer: Priority Health Medicare |
$415.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,102.06
|
| Rate for Payer: Railroad Medicare Medicare |
$411.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,447.49
|
| Rate for Payer: UHC Core |
$1,373.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$411.22
|
| Rate for Payer: UHC Exchange |
$411.22
|
| Rate for Payer: UHC Medicare Advantage |
$411.22
|
| Rate for Payer: UHCCP Medicaid |
$1,123.14
|
| Rate for Payer: VA VA |
$411.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,233.65
|
|
|
HC SWAN GANZ PLACEMENT
|
Facility
|
IP
|
$1,644.87
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
48100024
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,069.17 |
| Max. Negotiated Rate |
$1,480.38 |
| Rate for Payer: Aetna Commercial |
$1,398.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,342.71
|
| Rate for Payer: BCN Commercial |
$1,271.16
|
| Rate for Payer: Cash Price |
$1,315.90
|
| Rate for Payer: Cofinity Commercial |
$1,414.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,315.90
|
| Rate for Payer: Healthscope Commercial |
$1,480.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,233.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,398.14
|
| Rate for Payer: Nomi Health Commercial |
$1,348.79
|
| Rate for Payer: PHP Commercial |
$1,398.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,069.17
|
| Rate for Payer: Priority Health HMO/PPO |
$1,431.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,102.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,447.49
|
| Rate for Payer: UHC Core |
$1,373.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,233.65
|
|
|
HC SWEAT CHLORIDE
|
Facility
|
OP
|
$79.25
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100154
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$71.33 |
| Rate for Payer: Aetna Commercial |
$67.36
|
| Rate for Payer: Aetna Medicare |
$20.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.77
|
| Rate for Payer: BCBS Complete |
$3.80
|
| Rate for Payer: BCBS MAPPO |
$19.81
|
| Rate for Payer: BCBS Trust/PPO |
$65.15
|
| Rate for Payer: BCN Commercial |
$61.62
|
| Rate for Payer: BCN Medicare Advantage |
$19.81
|
| Rate for Payer: Cash Price |
$63.40
|
| Rate for Payer: Cash Price |
$63.40
|
| Rate for Payer: Cofinity Commercial |
$68.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.81
|
| Rate for Payer: Healthscope Commercial |
$71.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.44
|
| Rate for Payer: Mclaren Medicaid |
$3.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.80
|
| Rate for Payer: Meridian Medicaid |
$3.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.36
|
| Rate for Payer: Nomi Health Commercial |
$64.98
|
| Rate for Payer: PACE Senior Care Partners |
$18.82
|
| Rate for Payer: PACE SWMI |
$19.81
|
| Rate for Payer: PHP Commercial |
$67.36
|
| Rate for Payer: PHP Medicare Advantage |
$19.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.51
|
| Rate for Payer: Priority Health HMO/PPO |
$68.95
|
| Rate for Payer: Priority Health Medicare |
$20.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.10
|
| Rate for Payer: Railroad Medicare Medicare |
$19.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.74
|
| Rate for Payer: UHC Core |
$66.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.81
|
| Rate for Payer: UHC Exchange |
$19.81
|
| Rate for Payer: UHC Medicare Advantage |
$19.81
|
| Rate for Payer: UHCCP Medicaid |
$3.62
|
| Rate for Payer: VA VA |
$19.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.44
|
|
|
HC SWEAT CHLORIDE
|
Facility
|
IP
|
$79.25
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100154
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.51 |
| Max. Negotiated Rate |
$71.33 |
| Rate for Payer: Aetna Commercial |
$67.36
|
| Rate for Payer: BCBS Trust/PPO |
$64.69
|
| Rate for Payer: BCN Commercial |
$61.24
|
| Rate for Payer: Cash Price |
$63.40
|
| Rate for Payer: Cofinity Commercial |
$68.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.40
|
| Rate for Payer: Healthscope Commercial |
$71.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.36
|
| Rate for Payer: Nomi Health Commercial |
$64.98
|
| Rate for Payer: PHP Commercial |
$67.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.51
|
| Rate for Payer: Priority Health HMO/PPO |
$68.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.74
|
| Rate for Payer: UHC Core |
$66.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.44
|
|
|
HC SWEAT COLLECTION
|
Facility
|
OP
|
$99.14
|
|
|
Service Code
|
CPT 89230
|
| Hospital Charge Code |
30000004
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.55 |
| Max. Negotiated Rate |
$89.23 |
| Rate for Payer: Aetna Commercial |
$84.27
|
| Rate for Payer: Aetna Medicare |
$25.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.98
|
| Rate for Payer: BCBS Complete |
$40.56
|
| Rate for Payer: BCBS MAPPO |
$24.79
|
| Rate for Payer: BCBS Trust/PPO |
$81.50
|
| Rate for Payer: BCN Commercial |
$77.08
|
| Rate for Payer: BCN Medicare Advantage |
$24.79
|
| Rate for Payer: Cash Price |
$79.31
|
| Rate for Payer: Cash Price |
$79.31
|
| Rate for Payer: Cofinity Commercial |
$85.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.79
|
| Rate for Payer: Healthscope Commercial |
$89.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.36
|
| Rate for Payer: Mclaren Medicaid |
$38.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.02
|
| Rate for Payer: Meridian Medicaid |
$40.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.27
|
| Rate for Payer: Nomi Health Commercial |
$81.29
|
| Rate for Payer: PACE Senior Care Partners |
$23.55
|
| Rate for Payer: PACE SWMI |
$24.79
|
| Rate for Payer: PHP Commercial |
$84.27
|
| Rate for Payer: PHP Medicare Advantage |
$24.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.44
|
| Rate for Payer: Priority Health HMO/PPO |
$86.25
|
| Rate for Payer: Priority Health Medicare |
$25.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.42
|
| Rate for Payer: Railroad Medicare Medicare |
$24.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.24
|
| Rate for Payer: UHC Core |
$82.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.79
|
| Rate for Payer: UHC Exchange |
$24.79
|
| Rate for Payer: UHC Medicare Advantage |
$24.79
|
| Rate for Payer: UHCCP Medicaid |
$38.63
|
| Rate for Payer: VA VA |
$24.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.36
|
|
|
HC SWEAT COLLECTION
|
Facility
|
IP
|
$99.14
|
|
|
Service Code
|
CPT 89230
|
| Hospital Charge Code |
30000004
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$64.44 |
| Max. Negotiated Rate |
$89.23 |
| Rate for Payer: Aetna Commercial |
$84.27
|
| Rate for Payer: BCBS Trust/PPO |
$80.93
|
| Rate for Payer: BCN Commercial |
$76.62
|
| Rate for Payer: Cash Price |
$79.31
|
| Rate for Payer: Cofinity Commercial |
$85.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.31
|
| Rate for Payer: Healthscope Commercial |
$89.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.27
|
| Rate for Payer: Nomi Health Commercial |
$81.29
|
| Rate for Payer: PHP Commercial |
$84.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.44
|
| Rate for Payer: Priority Health HMO/PPO |
$86.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.24
|
| Rate for Payer: UHC Core |
$82.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.36
|
|
|
HC SWEET VERNAL IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200103
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SWEET VERNAL IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200103
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SYCAMORE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200104
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SYCAMORE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200104
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SYPHILIS ANTIBODY CMPT
|
Facility
|
OP
|
$32.25
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200215
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna Medicare |
$8.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.08
|
| Rate for Payer: BCBS Complete |
$3.24
|
| Rate for Payer: BCBS MAPPO |
$8.06
|
| Rate for Payer: BCBS Trust/PPO |
$26.51
|
| Rate for Payer: BCN Commercial |
$25.07
|
| Rate for Payer: BCN Medicare Advantage |
$8.06
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.06
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: Mclaren Medicaid |
$3.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.47
|
| Rate for Payer: Meridian Medicaid |
$3.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.45
|
| Rate for Payer: PACE Senior Care Partners |
$7.66
|
| Rate for Payer: PACE SWMI |
$8.06
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: PHP Medicare Advantage |
$8.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: Priority Health HMO/PPO |
$28.06
|
| Rate for Payer: Priority Health Medicare |
$8.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.61
|
| Rate for Payer: Railroad Medicare Medicare |
$8.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.38
|
| Rate for Payer: UHC Core |
$26.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.06
|
| Rate for Payer: UHC Exchange |
$8.06
|
| Rate for Payer: UHC Medicare Advantage |
$8.06
|
| Rate for Payer: UHCCP Medicaid |
$3.09
|
| Rate for Payer: VA VA |
$8.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
|
HC SYPHILIS ANTIBODY CMPT
|
Facility
|
IP
|
$32.25
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200215
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.96 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: BCBS Trust/PPO |
$26.33
|
| Rate for Payer: BCN Commercial |
$24.92
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.45
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: Priority Health HMO/PPO |
$28.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.38
|
| Rate for Payer: UHC Core |
$26.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
|
HC SYPHILLIS AB TP-PA REFLEX
|
Facility
|
IP
|
$81.60
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000082
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$73.44 |
| Rate for Payer: Aetna Commercial |
$69.36
|
| Rate for Payer: BCBS Trust/PPO |
$66.61
|
| Rate for Payer: BCN Commercial |
$63.06
|
| Rate for Payer: Cash Price |
$65.28
|
| Rate for Payer: Cofinity Commercial |
$70.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.28
|
| Rate for Payer: Healthscope Commercial |
$73.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.36
|
| Rate for Payer: Nomi Health Commercial |
$66.91
|
| Rate for Payer: PHP Commercial |
$69.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.04
|
| Rate for Payer: Priority Health HMO/PPO |
$70.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.81
|
| Rate for Payer: UHC Core |
$68.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.20
|
|
|
HC SYPHILLIS AB TP-PA REFLEX
|
Facility
|
OP
|
$81.60
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000082
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.57 |
| Max. Negotiated Rate |
$73.44 |
| Rate for Payer: Aetna Commercial |
$69.36
|
| Rate for Payer: Aetna Medicare |
$21.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.50
|
| Rate for Payer: BCBS Complete |
$10.05
|
| Rate for Payer: BCBS MAPPO |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$67.08
|
| Rate for Payer: BCN Commercial |
$63.44
|
| Rate for Payer: BCN Medicare Advantage |
$20.40
|
| Rate for Payer: Cash Price |
$65.28
|
| Rate for Payer: Cash Price |
$65.28
|
| Rate for Payer: Cofinity Commercial |
$70.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$73.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.20
|
| Rate for Payer: Mclaren Medicaid |
$9.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.42
|
| Rate for Payer: Meridian Medicaid |
$10.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.36
|
| Rate for Payer: Nomi Health Commercial |
$66.91
|
| Rate for Payer: PACE Senior Care Partners |
$19.38
|
| Rate for Payer: PACE SWMI |
$20.40
|
| Rate for Payer: PHP Commercial |
$69.36
|
| Rate for Payer: PHP Medicare Advantage |
$20.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.04
|
| Rate for Payer: Priority Health HMO/PPO |
$70.99
|
| Rate for Payer: Priority Health Medicare |
$20.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.67
|
| Rate for Payer: Railroad Medicare Medicare |
$20.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.81
|
| Rate for Payer: UHC Core |
$68.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.40
|
| Rate for Payer: UHC Exchange |
$20.40
|
| Rate for Payer: UHC Medicare Advantage |
$20.40
|
| Rate for Payer: UHCCP Medicaid |
$9.57
|
| Rate for Payer: VA VA |
$20.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.20
|
|
|
HC SYPHYLIS NON-TREPONEMAL AB (RPR)
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 0065U
|
| Hospital Charge Code |
30200437
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$13.73
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$41.93
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$13.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: Meridian Medicaid |
$13.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.17
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Exchange |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$12.75
|
| Rate for Payer: UHCCP Medicaid |
$13.08
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC SYPHYLIS NON-TREPONEMAL AB (RPR)
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 0065U
|
| Hospital Charge Code |
30200437
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.15 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$41.63
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC T3 FREE
|
Facility
|
IP
|
$132.19
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
30100448
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$85.92 |
| Max. Negotiated Rate |
$118.97 |
| Rate for Payer: Aetna Commercial |
$112.36
|
| Rate for Payer: BCBS Trust/PPO |
$107.91
|
| Rate for Payer: BCN Commercial |
$102.16
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Cofinity Commercial |
$113.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.75
|
| Rate for Payer: Healthscope Commercial |
$118.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.36
|
| Rate for Payer: Nomi Health Commercial |
$108.40
|
| Rate for Payer: PHP Commercial |
$112.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.92
|
| Rate for Payer: Priority Health HMO/PPO |
$115.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.33
|
| Rate for Payer: UHC Core |
$110.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.14
|
|
|
HC T3 FREE
|
Facility
|
OP
|
$132.19
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
30100448
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.25 |
| Max. Negotiated Rate |
$118.97 |
| Rate for Payer: Aetna Commercial |
$112.36
|
| Rate for Payer: Aetna Medicare |
$34.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.31
|
| Rate for Payer: BCBS Complete |
$12.86
|
| Rate for Payer: BCBS MAPPO |
$33.05
|
| Rate for Payer: BCBS Trust/PPO |
$108.67
|
| Rate for Payer: BCN Commercial |
$102.78
|
| Rate for Payer: BCN Medicare Advantage |
$33.05
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Cash Price |
$105.75
|
| Rate for Payer: Cofinity Commercial |
$113.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.05
|
| Rate for Payer: Healthscope Commercial |
$118.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.14
|
| Rate for Payer: Mclaren Medicaid |
$12.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.70
|
| Rate for Payer: Meridian Medicaid |
$12.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.36
|
| Rate for Payer: Nomi Health Commercial |
$108.40
|
| Rate for Payer: PACE Senior Care Partners |
$31.40
|
| Rate for Payer: PACE SWMI |
$33.05
|
| Rate for Payer: PHP Commercial |
$112.36
|
| Rate for Payer: PHP Medicare Advantage |
$33.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.92
|
| Rate for Payer: Priority Health HMO/PPO |
$115.01
|
| Rate for Payer: Priority Health Medicare |
$33.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.57
|
| Rate for Payer: Railroad Medicare Medicare |
$33.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.33
|
| Rate for Payer: UHC Core |
$110.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.05
|
| Rate for Payer: UHC Exchange |
$33.05
|
| Rate for Payer: UHC Medicare Advantage |
$33.05
|
| Rate for Payer: UHCCP Medicaid |
$12.25
|
| Rate for Payer: VA VA |
$33.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.14
|
|
|
HC T3 REVERSE
|
Facility
|
IP
|
$58.14
|
|
|
Service Code
|
CPT 84482
|
| Hospital Charge Code |
30100660
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: BCBS Trust/PPO |
$47.46
|
| Rate for Payer: BCN Commercial |
$44.93
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO |
$50.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.16
|
| Rate for Payer: UHC Core |
$48.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
|
HC T3 REVERSE
|
Facility
|
OP
|
$58.14
|
|
|
Service Code
|
CPT 84482
|
| Hospital Charge Code |
30100660
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.39 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: Aetna Medicare |
$15.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.17
|
| Rate for Payer: BCBS Complete |
$11.96
|
| Rate for Payer: BCBS MAPPO |
$14.54
|
| Rate for Payer: BCBS Trust/PPO |
$47.80
|
| Rate for Payer: BCN Commercial |
$45.20
|
| Rate for Payer: BCN Medicare Advantage |
$14.54
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.54
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
| Rate for Payer: Mclaren Medicaid |
$11.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.26
|
| Rate for Payer: Meridian Medicaid |
$11.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: PACE Senior Care Partners |
$13.81
|
| Rate for Payer: PACE SWMI |
$14.54
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: PHP Medicare Advantage |
$14.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO |
$50.58
|
| Rate for Payer: Priority Health Medicare |
$14.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.95
|
| Rate for Payer: Railroad Medicare Medicare |
$14.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.16
|
| Rate for Payer: UHC Core |
$48.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.54
|
| Rate for Payer: UHC Exchange |
$14.54
|
| Rate for Payer: UHC Medicare Advantage |
$14.54
|
| Rate for Payer: UHCCP Medicaid |
$11.39
|
| Rate for Payer: VA VA |
$14.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
|
HC T3 UPTAKE
|
Facility
|
IP
|
$136.68
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
30100446
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$88.84 |
| Max. Negotiated Rate |
$123.01 |
| Rate for Payer: Aetna Commercial |
$116.18
|
| Rate for Payer: BCBS Trust/PPO |
$111.57
|
| Rate for Payer: BCN Commercial |
$105.63
|
| Rate for Payer: Cash Price |
$109.34
|
| Rate for Payer: Cofinity Commercial |
$117.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.34
|
| Rate for Payer: Healthscope Commercial |
$123.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.18
|
| Rate for Payer: Nomi Health Commercial |
$112.08
|
| Rate for Payer: PHP Commercial |
$116.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.84
|
| Rate for Payer: Priority Health HMO/PPO |
$118.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.28
|
| Rate for Payer: UHC Core |
$114.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.51
|
|
|
HC T3 UPTAKE
|
Facility
|
OP
|
$136.68
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
30100446
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$123.01 |
| Rate for Payer: Aetna Commercial |
$116.18
|
| Rate for Payer: Aetna Medicare |
$35.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.71
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$34.17
|
| Rate for Payer: BCBS Trust/PPO |
$112.36
|
| Rate for Payer: BCN Commercial |
$106.27
|
| Rate for Payer: BCN Medicare Advantage |
$34.17
|
| Rate for Payer: Cash Price |
$109.34
|
| Rate for Payer: Cash Price |
$109.34
|
| Rate for Payer: Cofinity Commercial |
$117.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.17
|
| Rate for Payer: Healthscope Commercial |
$123.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.51
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.88
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.18
|
| Rate for Payer: Nomi Health Commercial |
$112.08
|
| Rate for Payer: PACE Senior Care Partners |
$32.46
|
| Rate for Payer: PACE SWMI |
$34.17
|
| Rate for Payer: PHP Commercial |
$116.18
|
| Rate for Payer: PHP Medicare Advantage |
$34.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.84
|
| Rate for Payer: Priority Health HMO/PPO |
$118.91
|
| Rate for Payer: Priority Health Medicare |
$34.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.58
|
| Rate for Payer: Railroad Medicare Medicare |
$34.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.28
|
| Rate for Payer: UHC Core |
$114.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.17
|
| Rate for Payer: UHC Exchange |
$34.17
|
| Rate for Payer: UHC Medicare Advantage |
$34.17
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$34.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.51
|
|
|
HC T4 TOTAL
|
Facility
|
OP
|
$46.92
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100435
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.97 |
| Max. Negotiated Rate |
$42.23 |
| Rate for Payer: Aetna Commercial |
$39.88
|
| Rate for Payer: Aetna Medicare |
$12.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.66
|
| Rate for Payer: BCBS Complete |
$5.22
|
| Rate for Payer: BCBS MAPPO |
$11.73
|
| Rate for Payer: BCBS Trust/PPO |
$38.57
|
| Rate for Payer: BCN Commercial |
$36.48
|
| Rate for Payer: BCN Medicare Advantage |
$11.73
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$40.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.73
|
| Rate for Payer: Healthscope Commercial |
$42.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.19
|
| Rate for Payer: Mclaren Medicaid |
$4.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.32
|
| Rate for Payer: Meridian Medicaid |
$5.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.88
|
| Rate for Payer: Nomi Health Commercial |
$38.47
|
| Rate for Payer: PACE Senior Care Partners |
$11.14
|
| Rate for Payer: PACE SWMI |
$11.73
|
| Rate for Payer: PHP Commercial |
$39.88
|
| Rate for Payer: PHP Medicare Advantage |
$11.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.50
|
| Rate for Payer: Priority Health HMO/PPO |
$40.82
|
| Rate for Payer: Priority Health Medicare |
$11.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.44
|
| Rate for Payer: Railroad Medicare Medicare |
$11.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.29
|
| Rate for Payer: UHC Core |
$39.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.73
|
| Rate for Payer: UHC Exchange |
$11.73
|
| Rate for Payer: UHC Medicare Advantage |
$11.73
|
| Rate for Payer: UHCCP Medicaid |
$4.97
|
| Rate for Payer: VA VA |
$11.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.19
|
|
