|
HC V5264 EAR MOLD INSERT NOT DISPOSABLE ANY TYPE
|
Facility
|
IP
|
$72.83
|
|
|
Service Code
|
CPT V5264
|
| Hospital Charge Code |
47000005
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$50.69 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: BCBS Trust/PPO |
$60.15
|
| Rate for Payer: BCN Commercial |
$60.15
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.09
|
| Rate for Payer: UHC Core |
$60.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC V5264 EAR MOLD INSERT NOT DISPOSABLE ANY TYPE
|
Facility
|
OP
|
$72.83
|
|
|
Service Code
|
CPT V5264
|
| Hospital Charge Code |
47000005
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$12.84 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: Aetna Medicare |
$18.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.76
|
| Rate for Payer: BCBS Complete |
$13.48
|
| Rate for Payer: BCBS MAPPO |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$59.87
|
| Rate for Payer: BCN Commercial |
$59.87
|
| Rate for Payer: BCN Medicare Advantage |
$18.21
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.21
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: Mclaren Medicaid |
$12.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.12
|
| Rate for Payer: Meridian Medicaid |
$13.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PACE Senior Care Partners |
$17.30
|
| Rate for Payer: PACE SWMI |
$18.21
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: PHP Medicare Advantage |
$18.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.36
|
| Rate for Payer: Priority Health Medicare |
$18.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.69
|
| Rate for Payer: Railroad Medicare Medicare |
$18.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.09
|
| Rate for Payer: UHC Core |
$60.81
|
| Rate for Payer: UHC Exchange |
$18.21
|
| Rate for Payer: UHC Medicaid |
$12.84
|
| Rate for Payer: UHC Medicare Advantage |
$18.21
|
| Rate for Payer: UHCCP Medicaid |
$12.84
|
| Rate for Payer: VA VA |
$18.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC VACC AIIV4 NO PRSRV 0.5ML IM
|
Facility
|
OP
|
$185.47
|
|
|
Service Code
|
CPT 90694
|
| Hospital Charge Code |
63600224
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$32.70 |
| Max. Negotiated Rate |
$166.92 |
| Rate for Payer: Aetna Commercial |
$157.65
|
| Rate for Payer: Aetna Medicare |
$48.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.96
|
| Rate for Payer: BCBS Complete |
$34.33
|
| Rate for Payer: BCBS MAPPO |
$46.37
|
| Rate for Payer: BCBS Trust/PPO |
$152.47
|
| Rate for Payer: BCN Commercial |
$152.47
|
| Rate for Payer: BCN Medicare Advantage |
$46.37
|
| Rate for Payer: Cash Price |
$148.38
|
| Rate for Payer: Cofinity Commercial |
$159.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.37
|
| Rate for Payer: Healthscope Commercial |
$166.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.10
|
| Rate for Payer: Mclaren Medicaid |
$32.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.69
|
| Rate for Payer: Meridian Medicaid |
$34.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.65
|
| Rate for Payer: Nomi Health Commercial |
$152.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.10
|
| Rate for Payer: PACE Senior Care Partners |
$44.05
|
| Rate for Payer: PACE SWMI |
$46.37
|
| Rate for Payer: PHP Commercial |
$157.65
|
| Rate for Payer: PHP Medicare Advantage |
$46.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$161.36
|
| Rate for Payer: Priority Health Medicare |
$46.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.09
|
| Rate for Payer: Railroad Medicare Medicare |
$46.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.21
|
| Rate for Payer: UHC Core |
$154.87
|
| Rate for Payer: UHC Exchange |
$46.37
|
| Rate for Payer: UHC Medicaid |
$32.70
|
| Rate for Payer: UHC Medicare Advantage |
$46.37
|
| Rate for Payer: UHCCP Medicaid |
$32.70
|
| Rate for Payer: VA VA |
$46.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.10
|
|
|
HC VACC AIIV4 NO PRSRV 0.5ML IM
|
Facility
|
IP
|
$185.47
|
|
|
Service Code
|
CPT 90694
|
| Hospital Charge Code |
63600224
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$129.09 |
| Max. Negotiated Rate |
$166.92 |
| Rate for Payer: Aetna Commercial |
$157.65
|
| Rate for Payer: BCBS Trust/PPO |
$153.18
|
| Rate for Payer: BCN Commercial |
$153.18
|
| Rate for Payer: Cash Price |
$148.38
|
| Rate for Payer: Cofinity Commercial |
$159.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.38
|
| Rate for Payer: Healthscope Commercial |
$166.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.65
|
| Rate for Payer: Nomi Health Commercial |
$152.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.10
|
| Rate for Payer: PHP Commercial |
$157.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$161.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.21
|
| Rate for Payer: UHC Core |
$154.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.10
|
|
|
HC VACC CCIIV4 ABX FREE 0.5 ML IM
|
Facility
|
OP
|
$69.38
|
|
|
Service Code
|
CPT 90756
|
| Hospital Charge Code |
63600223
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.23 |
| Max. Negotiated Rate |
$62.44 |
| Rate for Payer: Aetna Commercial |
$58.97
|
| Rate for Payer: Aetna Medicare |
$18.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.68
|
| Rate for Payer: BCBS Complete |
$12.84
|
| Rate for Payer: BCBS MAPPO |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$57.04
|
| Rate for Payer: BCN Commercial |
$57.04
|
| Rate for Payer: BCN Medicare Advantage |
$17.34
|
| Rate for Payer: Cash Price |
$55.50
|
| Rate for Payer: Cofinity Commercial |
$59.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.34
|
| Rate for Payer: Healthscope Commercial |
$62.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.03
|
| Rate for Payer: Mclaren Medicaid |
$12.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.21
|
| Rate for Payer: Meridian Medicaid |
$12.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.97
|
| Rate for Payer: Nomi Health Commercial |
$56.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.03
|
| Rate for Payer: PACE Senior Care Partners |
$16.48
|
| Rate for Payer: PACE SWMI |
$17.34
|
| Rate for Payer: PHP Commercial |
$58.97
|
| Rate for Payer: PHP Medicare Advantage |
$17.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.36
|
| Rate for Payer: Priority Health Medicare |
$17.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.29
|
| Rate for Payer: Railroad Medicare Medicare |
$17.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.05
|
| Rate for Payer: UHC Core |
$57.93
|
| Rate for Payer: UHC Exchange |
$17.34
|
| Rate for Payer: UHC Medicaid |
$12.23
|
| Rate for Payer: UHC Medicare Advantage |
$17.34
|
| Rate for Payer: UHCCP Medicaid |
$12.23
|
| Rate for Payer: VA VA |
$17.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.03
|
|
|
HC VACC CCIIV4 ABX FREE 0.5 ML IM
|
Facility
|
IP
|
$69.38
|
|
|
Service Code
|
CPT 90756
|
| Hospital Charge Code |
63600223
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$48.29 |
| Max. Negotiated Rate |
$62.44 |
| Rate for Payer: Aetna Commercial |
$58.97
|
| Rate for Payer: BCBS Trust/PPO |
$57.30
|
| Rate for Payer: BCN Commercial |
$57.30
|
| Rate for Payer: Cash Price |
$55.50
|
| Rate for Payer: Cofinity Commercial |
$59.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.50
|
| Rate for Payer: Healthscope Commercial |
$62.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.97
|
| Rate for Payer: Nomi Health Commercial |
$56.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.03
|
| Rate for Payer: PHP Commercial |
$58.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.05
|
| Rate for Payer: UHC Core |
$57.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.03
|
|
|
HC VACC CCIIV4 NO PRSV 0.5 ML IM
|
Facility
|
OP
|
$74.29
|
|
|
Service Code
|
CPT 90674
|
| Hospital Charge Code |
63600222
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.10 |
| Max. Negotiated Rate |
$66.86 |
| Rate for Payer: Aetna Commercial |
$63.15
|
| Rate for Payer: Aetna Medicare |
$19.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.22
|
| Rate for Payer: BCBS Complete |
$13.75
|
| Rate for Payer: BCBS MAPPO |
$18.57
|
| Rate for Payer: BCBS Trust/PPO |
$61.07
|
| Rate for Payer: BCN Commercial |
$61.07
|
| Rate for Payer: BCN Medicare Advantage |
$18.57
|
| Rate for Payer: Cash Price |
$59.43
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.57
|
| Rate for Payer: Healthscope Commercial |
$66.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.72
|
| Rate for Payer: Mclaren Medicaid |
$13.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.50
|
| Rate for Payer: Meridian Medicaid |
$13.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.15
|
| Rate for Payer: Nomi Health Commercial |
$60.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.72
|
| Rate for Payer: PACE Senior Care Partners |
$17.64
|
| Rate for Payer: PACE SWMI |
$18.57
|
| Rate for Payer: PHP Commercial |
$63.15
|
| Rate for Payer: PHP Medicare Advantage |
$18.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.63
|
| Rate for Payer: Priority Health Medicare |
$18.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.71
|
| Rate for Payer: Railroad Medicare Medicare |
$18.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.38
|
| Rate for Payer: UHC Core |
$62.03
|
| Rate for Payer: UHC Exchange |
$18.57
|
| Rate for Payer: UHC Medicaid |
$13.10
|
| Rate for Payer: UHC Medicare Advantage |
$18.57
|
| Rate for Payer: UHCCP Medicaid |
$13.10
|
| Rate for Payer: VA VA |
$18.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.72
|
|
|
HC VACC CCIIV4 NO PRSV 0.5 ML IM
|
Facility
|
IP
|
$74.29
|
|
|
Service Code
|
CPT 90674
|
| Hospital Charge Code |
63600222
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$51.71 |
| Max. Negotiated Rate |
$66.86 |
| Rate for Payer: Aetna Commercial |
$63.15
|
| Rate for Payer: BCBS Trust/PPO |
$61.36
|
| Rate for Payer: BCN Commercial |
$61.36
|
| Rate for Payer: Cash Price |
$59.43
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.43
|
| Rate for Payer: Healthscope Commercial |
$66.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.15
|
| Rate for Payer: Nomi Health Commercial |
$60.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.72
|
| Rate for Payer: PHP Commercial |
$63.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.38
|
| Rate for Payer: UHC Core |
$62.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.72
|
|
|
HC VACC RSV PREF BIVALENT IM
|
Facility
|
OP
|
$856.30
|
|
|
Service Code
|
CPT 90678
|
| Hospital Charge Code |
63600226
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$150.97 |
| Max. Negotiated Rate |
$770.67 |
| Rate for Payer: Aetna Commercial |
$727.86
|
| Rate for Payer: Aetna Medicare |
$222.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$267.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$267.59
|
| Rate for Payer: BCBS Complete |
$158.50
|
| Rate for Payer: BCBS MAPPO |
$214.07
|
| Rate for Payer: BCBS Trust/PPO |
$703.96
|
| Rate for Payer: BCN Commercial |
$703.96
|
| Rate for Payer: BCN Medicare Advantage |
$214.07
|
| Rate for Payer: Cash Price |
$685.04
|
| Rate for Payer: Cofinity Commercial |
$736.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$685.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.07
|
| Rate for Payer: Healthscope Commercial |
$770.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$642.23
|
| Rate for Payer: Mclaren Medicaid |
$150.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$224.78
|
| Rate for Payer: Meridian Medicaid |
$158.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$246.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$235.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$727.86
|
| Rate for Payer: Nomi Health Commercial |
$702.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$642.23
|
| Rate for Payer: PACE Senior Care Partners |
$203.37
|
| Rate for Payer: PACE SWMI |
$214.07
|
| Rate for Payer: PHP Commercial |
$727.86
|
| Rate for Payer: PHP Medicare Advantage |
$214.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$744.98
|
| Rate for Payer: Priority Health Medicare |
$216.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$595.98
|
| Rate for Payer: Railroad Medicare Medicare |
$214.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$753.54
|
| Rate for Payer: UHC Core |
$715.01
|
| Rate for Payer: UHC Exchange |
$214.07
|
| Rate for Payer: UHC Medicaid |
$150.97
|
| Rate for Payer: UHC Medicare Advantage |
$214.07
|
| Rate for Payer: UHCCP Medicaid |
$150.97
|
| Rate for Payer: VA VA |
$214.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$642.23
|
|
|
HC VACC RSV PREF BIVALENT IM
|
Facility
|
IP
|
$856.30
|
|
|
Service Code
|
CPT 90678
|
| Hospital Charge Code |
63600226
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$595.98 |
| Max. Negotiated Rate |
$770.67 |
| Rate for Payer: Aetna Commercial |
$727.86
|
| Rate for Payer: BCBS Trust/PPO |
$707.22
|
| Rate for Payer: BCN Commercial |
$707.22
|
| Rate for Payer: Cash Price |
$685.04
|
| Rate for Payer: Cofinity Commercial |
$736.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$685.04
|
| Rate for Payer: Healthscope Commercial |
$770.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$642.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$727.86
|
| Rate for Payer: Nomi Health Commercial |
$702.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$642.23
|
| Rate for Payer: PHP Commercial |
$727.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$744.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$595.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$753.54
|
| Rate for Payer: UHC Core |
$715.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$642.23
|
|
|
HC VACC RSV PREF RECOMB ADJT IM
|
Facility
|
IP
|
$812.76
|
|
|
Service Code
|
CPT 90679
|
| Hospital Charge Code |
63600225
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$565.68 |
| Max. Negotiated Rate |
$731.48 |
| Rate for Payer: Aetna Commercial |
$690.85
|
| Rate for Payer: BCBS Trust/PPO |
$671.26
|
| Rate for Payer: BCN Commercial |
$671.26
|
| Rate for Payer: Cash Price |
$650.21
|
| Rate for Payer: Cofinity Commercial |
$698.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.21
|
| Rate for Payer: Healthscope Commercial |
$731.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$609.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$690.85
|
| Rate for Payer: Nomi Health Commercial |
$666.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$609.57
|
| Rate for Payer: PHP Commercial |
$690.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$707.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$565.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$715.23
|
| Rate for Payer: UHC Core |
$678.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$609.57
|
|
|
HC VACC RSV PREF RECOMB ADJT IM
|
Facility
|
OP
|
$812.76
|
|
|
Service Code
|
CPT 90679
|
| Hospital Charge Code |
63600225
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$143.29 |
| Max. Negotiated Rate |
$731.48 |
| Rate for Payer: Aetna Commercial |
$690.85
|
| Rate for Payer: Aetna Medicare |
$211.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$253.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$253.99
|
| Rate for Payer: BCBS Complete |
$150.44
|
| Rate for Payer: BCBS MAPPO |
$203.19
|
| Rate for Payer: BCBS Trust/PPO |
$668.17
|
| Rate for Payer: BCN Commercial |
$668.17
|
| Rate for Payer: BCN Medicare Advantage |
$203.19
|
| Rate for Payer: Cash Price |
$650.21
|
| Rate for Payer: Cofinity Commercial |
$698.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.19
|
| Rate for Payer: Healthscope Commercial |
$731.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$609.57
|
| Rate for Payer: Mclaren Medicaid |
$143.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.35
|
| Rate for Payer: Meridian Medicaid |
$150.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$233.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$223.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$690.85
|
| Rate for Payer: Nomi Health Commercial |
$666.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$609.57
|
| Rate for Payer: PACE Senior Care Partners |
$193.03
|
| Rate for Payer: PACE SWMI |
$203.19
|
| Rate for Payer: PHP Commercial |
$690.85
|
| Rate for Payer: PHP Medicare Advantage |
$203.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$707.10
|
| Rate for Payer: Priority Health Medicare |
$205.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$565.68
|
| Rate for Payer: Railroad Medicare Medicare |
$203.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$715.23
|
| Rate for Payer: UHC Core |
$678.65
|
| Rate for Payer: UHC Exchange |
$203.19
|
| Rate for Payer: UHC Medicaid |
$143.29
|
| Rate for Payer: UHC Medicare Advantage |
$203.19
|
| Rate for Payer: UHCCP Medicaid |
$143.29
|
| Rate for Payer: VA VA |
$203.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$609.57
|
|
|
HC VAC WOUND PREVENA
|
Facility
|
IP
|
$1,511.95
|
|
| Hospital Charge Code |
27000697
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,052.32 |
| Max. Negotiated Rate |
$1,360.76 |
| Rate for Payer: Aetna Commercial |
$1,285.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.72
|
| Rate for Payer: BCN Commercial |
$1,248.72
|
| Rate for Payer: Cash Price |
$1,209.56
|
| Rate for Payer: Cofinity Commercial |
$1,300.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,209.56
|
| Rate for Payer: Healthscope Commercial |
$1,360.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,133.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,285.16
|
| Rate for Payer: Nomi Health Commercial |
$1,239.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,133.96
|
| Rate for Payer: PHP Commercial |
$1,285.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,315.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,052.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,330.52
|
| Rate for Payer: UHC Core |
$1,262.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,133.96
|
|
|
HC VAC WOUND PREVENA
|
Facility
|
OP
|
$1,511.95
|
|
| Hospital Charge Code |
27000697
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$266.56 |
| Max. Negotiated Rate |
$1,360.76 |
| Rate for Payer: Aetna Commercial |
$1,285.16
|
| Rate for Payer: Aetna Medicare |
$393.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$472.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$472.48
|
| Rate for Payer: BCBS Complete |
$279.86
|
| Rate for Payer: BCBS MAPPO |
$377.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,242.97
|
| Rate for Payer: BCN Commercial |
$1,242.97
|
| Rate for Payer: BCN Medicare Advantage |
$377.99
|
| Rate for Payer: Cash Price |
$1,209.56
|
| Rate for Payer: Cofinity Commercial |
$1,300.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,209.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$377.99
|
| Rate for Payer: Healthscope Commercial |
$1,360.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,133.96
|
| Rate for Payer: Mclaren Medicaid |
$266.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$396.89
|
| Rate for Payer: Meridian Medicaid |
$279.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$434.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$415.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,285.16
|
| Rate for Payer: Nomi Health Commercial |
$1,239.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,133.96
|
| Rate for Payer: PACE Senior Care Partners |
$359.09
|
| Rate for Payer: PACE SWMI |
$377.99
|
| Rate for Payer: PHP Commercial |
$1,285.16
|
| Rate for Payer: PHP Medicare Advantage |
$377.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,315.40
|
| Rate for Payer: Priority Health Medicare |
$381.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,052.32
|
| Rate for Payer: Railroad Medicare Medicare |
$377.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,330.52
|
| Rate for Payer: UHC Core |
$1,262.48
|
| Rate for Payer: UHC Exchange |
$377.99
|
| Rate for Payer: UHC Medicaid |
$266.56
|
| Rate for Payer: UHC Medicare Advantage |
$377.99
|
| Rate for Payer: UHCCP Medicaid |
$266.56
|
| Rate for Payer: VA VA |
$377.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,133.96
|
|
|
HC VAGINAL DELIVERY (OB)
|
Facility
|
OP
|
$1,828.26
|
|
| Hospital Charge Code |
72000006
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$322.32 |
| Max. Negotiated Rate |
$1,645.43 |
| Rate for Payer: Aetna Commercial |
$1,554.02
|
| Rate for Payer: Aetna Medicare |
$475.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$571.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$571.33
|
| Rate for Payer: BCBS Complete |
$338.41
|
| Rate for Payer: BCBS MAPPO |
$457.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,503.01
|
| Rate for Payer: BCN Commercial |
$1,503.01
|
| Rate for Payer: BCN Medicare Advantage |
$457.06
|
| Rate for Payer: Cash Price |
$1,462.61
|
| Rate for Payer: Cofinity Commercial |
$1,572.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,462.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.06
|
| Rate for Payer: Healthscope Commercial |
$1,645.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,371.19
|
| Rate for Payer: Mclaren Medicaid |
$322.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$479.92
|
| Rate for Payer: Meridian Medicaid |
$338.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$525.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$502.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,554.02
|
| Rate for Payer: Nomi Health Commercial |
$1,499.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,371.19
|
| Rate for Payer: PACE Senior Care Partners |
$434.21
|
| Rate for Payer: PACE SWMI |
$457.06
|
| Rate for Payer: PHP Commercial |
$1,554.02
|
| Rate for Payer: PHP Medicare Advantage |
$457.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,590.59
|
| Rate for Payer: Priority Health Medicare |
$461.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,272.47
|
| Rate for Payer: Railroad Medicare Medicare |
$457.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,608.87
|
| Rate for Payer: UHC Core |
$1,526.60
|
| Rate for Payer: UHC Exchange |
$457.06
|
| Rate for Payer: UHC Medicaid |
$322.32
|
| Rate for Payer: UHC Medicare Advantage |
$457.06
|
| Rate for Payer: UHCCP Medicaid |
$322.32
|
| Rate for Payer: VA VA |
$457.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,371.19
|
|
|
HC VAGINAL DELIVERY (OB)
|
Facility
|
IP
|
$1,828.26
|
|
| Hospital Charge Code |
72000006
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,272.47 |
| Max. Negotiated Rate |
$1,645.43 |
| Rate for Payer: Aetna Commercial |
$1,554.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,509.96
|
| Rate for Payer: BCN Commercial |
$1,509.96
|
| Rate for Payer: Cash Price |
$1,462.61
|
| Rate for Payer: Cofinity Commercial |
$1,572.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,462.61
|
| Rate for Payer: Healthscope Commercial |
$1,645.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,371.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,554.02
|
| Rate for Payer: Nomi Health Commercial |
$1,499.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,371.19
|
| Rate for Payer: PHP Commercial |
$1,554.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,590.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,272.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,608.87
|
| Rate for Payer: UHC Core |
$1,526.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,371.19
|
|
|
HC VALPROIC ACID DEPAKENE LVL
|
Facility
|
OP
|
$109.66
|
|
|
Service Code
|
CPT 80164
|
| Hospital Charge Code |
30100589
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.33 |
| Max. Negotiated Rate |
$98.69 |
| Rate for Payer: Aetna Commercial |
$93.21
|
| Rate for Payer: Aetna Medicare |
$28.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.27
|
| Rate for Payer: BCBS Complete |
$20.30
|
| Rate for Payer: BCBS MAPPO |
$27.41
|
| Rate for Payer: BCBS Trust/PPO |
$90.15
|
| Rate for Payer: BCN Commercial |
$90.15
|
| Rate for Payer: BCN Medicare Advantage |
$27.41
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cofinity Commercial |
$94.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.41
|
| Rate for Payer: Healthscope Commercial |
$98.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.25
|
| Rate for Payer: Mclaren Medicaid |
$19.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.79
|
| Rate for Payer: Meridian Medicaid |
$20.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.21
|
| Rate for Payer: Nomi Health Commercial |
$89.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.25
|
| Rate for Payer: PACE Senior Care Partners |
$26.04
|
| Rate for Payer: PACE SWMI |
$27.41
|
| Rate for Payer: PHP Commercial |
$93.21
|
| Rate for Payer: PHP Medicare Advantage |
$27.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.40
|
| Rate for Payer: Priority Health Medicare |
$27.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.32
|
| Rate for Payer: Railroad Medicare Medicare |
$27.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.50
|
| Rate for Payer: UHC Core |
$91.57
|
| Rate for Payer: UHC Exchange |
$27.41
|
| Rate for Payer: UHC Medicaid |
$19.33
|
| Rate for Payer: UHC Medicare Advantage |
$27.41
|
| Rate for Payer: UHCCP Medicaid |
$19.33
|
| Rate for Payer: VA VA |
$27.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.25
|
|
|
HC VALPROIC ACID DEPAKENE LVL
|
Facility
|
IP
|
$109.66
|
|
|
Service Code
|
CPT 80164
|
| Hospital Charge Code |
30100589
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$76.32 |
| Max. Negotiated Rate |
$98.69 |
| Rate for Payer: Aetna Commercial |
$93.21
|
| Rate for Payer: BCBS Trust/PPO |
$90.57
|
| Rate for Payer: BCN Commercial |
$90.57
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cofinity Commercial |
$94.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.73
|
| Rate for Payer: Healthscope Commercial |
$98.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.21
|
| Rate for Payer: Nomi Health Commercial |
$89.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.25
|
| Rate for Payer: PHP Commercial |
$93.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.50
|
| Rate for Payer: UHC Core |
$91.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.25
|
|
|
HC VALVE VENT NONADJ
|
Facility
|
OP
|
$53.06
|
|
| Hospital Charge Code |
27000277
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC VALVE VENT NONADJ
|
Facility
|
IP
|
$53.06
|
|
| Hospital Charge Code |
27000277
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC VALVE VENT ONE WAY
|
Facility
|
IP
|
$43.70
|
|
| Hospital Charge Code |
27000662
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.42 |
| Max. Negotiated Rate |
$39.33 |
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: BCBS Trust/PPO |
$36.09
|
| Rate for Payer: BCN Commercial |
$36.09
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$37.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Healthscope Commercial |
$39.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.77
|
| Rate for Payer: PHP Commercial |
$37.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.46
|
| Rate for Payer: UHC Core |
$36.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.77
|
|
|
HC VALVE VENT ONE WAY
|
Facility
|
OP
|
$43.70
|
|
| Hospital Charge Code |
27000662
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$39.33 |
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: Aetna Medicare |
$11.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.66
|
| Rate for Payer: BCBS Complete |
$8.09
|
| Rate for Payer: BCBS MAPPO |
$10.93
|
| Rate for Payer: BCBS Trust/PPO |
$35.93
|
| Rate for Payer: BCN Commercial |
$35.93
|
| Rate for Payer: BCN Medicare Advantage |
$10.93
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$37.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.93
|
| Rate for Payer: Healthscope Commercial |
$39.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.77
|
| Rate for Payer: Mclaren Medicaid |
$7.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.47
|
| Rate for Payer: Meridian Medicaid |
$8.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.77
|
| Rate for Payer: PACE Senior Care Partners |
$10.38
|
| Rate for Payer: PACE SWMI |
$10.93
|
| Rate for Payer: PHP Commercial |
$37.15
|
| Rate for Payer: PHP Medicare Advantage |
$10.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.02
|
| Rate for Payer: Priority Health Medicare |
$11.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.42
|
| Rate for Payer: Railroad Medicare Medicare |
$10.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.46
|
| Rate for Payer: UHC Core |
$36.49
|
| Rate for Payer: UHC Exchange |
$10.93
|
| Rate for Payer: UHC Medicaid |
$7.70
|
| Rate for Payer: UHC Medicare Advantage |
$10.93
|
| Rate for Payer: UHCCP Medicaid |
$7.70
|
| Rate for Payer: VA VA |
$10.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.77
|
|
|
HC VANCOMYCIN LEVEL
|
Facility
|
IP
|
$141.18
|
|
|
Service Code
|
CPT 80202
|
| Hospital Charge Code |
30100051
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$98.26 |
| Max. Negotiated Rate |
$127.06 |
| Rate for Payer: Aetna Commercial |
$120.00
|
| Rate for Payer: BCBS Trust/PPO |
$116.60
|
| Rate for Payer: BCN Commercial |
$116.60
|
| Rate for Payer: Cash Price |
$112.94
|
| Rate for Payer: Cofinity Commercial |
$121.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.94
|
| Rate for Payer: Healthscope Commercial |
$127.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.00
|
| Rate for Payer: Nomi Health Commercial |
$115.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.89
|
| Rate for Payer: PHP Commercial |
$120.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$122.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.24
|
| Rate for Payer: UHC Core |
$117.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.89
|
|
|
HC VANCOMYCIN LEVEL
|
Facility
|
OP
|
$141.18
|
|
|
Service Code
|
CPT 80202
|
| Hospital Charge Code |
30100051
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.89 |
| Max. Negotiated Rate |
$127.06 |
| Rate for Payer: Aetna Commercial |
$120.00
|
| Rate for Payer: Aetna Medicare |
$36.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.12
|
| Rate for Payer: BCBS Complete |
$26.13
|
| Rate for Payer: BCBS MAPPO |
$35.30
|
| Rate for Payer: BCBS Trust/PPO |
$116.06
|
| Rate for Payer: BCN Commercial |
$116.06
|
| Rate for Payer: BCN Medicare Advantage |
$35.30
|
| Rate for Payer: Cash Price |
$112.94
|
| Rate for Payer: Cofinity Commercial |
$121.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.30
|
| Rate for Payer: Healthscope Commercial |
$127.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.89
|
| Rate for Payer: Mclaren Medicaid |
$24.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.06
|
| Rate for Payer: Meridian Medicaid |
$26.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.00
|
| Rate for Payer: Nomi Health Commercial |
$115.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.89
|
| Rate for Payer: PACE Senior Care Partners |
$33.53
|
| Rate for Payer: PACE SWMI |
$35.30
|
| Rate for Payer: PHP Commercial |
$120.00
|
| Rate for Payer: PHP Medicare Advantage |
$35.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$122.83
|
| Rate for Payer: Priority Health Medicare |
$35.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.26
|
| Rate for Payer: Railroad Medicare Medicare |
$35.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.24
|
| Rate for Payer: UHC Core |
$117.89
|
| Rate for Payer: UHC Exchange |
$35.30
|
| Rate for Payer: UHC Medicaid |
$24.89
|
| Rate for Payer: UHC Medicare Advantage |
$35.30
|
| Rate for Payer: UHCCP Medicaid |
$24.89
|
| Rate for Payer: VA VA |
$35.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.89
|
|
|
HC VAP CHOLESTEROL
|
Facility
|
IP
|
$84.89
|
|
|
Service Code
|
CPT 83701
|
| Hospital Charge Code |
30100281
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.08 |
| Max. Negotiated Rate |
$76.40 |
| Rate for Payer: Aetna Commercial |
$72.16
|
| Rate for Payer: BCBS Trust/PPO |
$70.11
|
| Rate for Payer: BCN Commercial |
$70.11
|
| Rate for Payer: Cash Price |
$67.91
|
| Rate for Payer: Cofinity Commercial |
$73.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.91
|
| Rate for Payer: Healthscope Commercial |
$76.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.16
|
| Rate for Payer: Nomi Health Commercial |
$69.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.67
|
| Rate for Payer: PHP Commercial |
$72.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$73.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.70
|
| Rate for Payer: UHC Core |
$70.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.67
|
|
