|
HC VDRL TITER CSF
|
Facility
|
OP
|
$76.99
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
30200397
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$69.29 |
| Rate for Payer: Aetna Commercial |
$65.44
|
| Rate for Payer: Aetna Medicare |
$20.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.06
|
| Rate for Payer: BCBS Complete |
$14.25
|
| Rate for Payer: BCBS MAPPO |
$19.25
|
| Rate for Payer: BCBS Trust/PPO |
$63.29
|
| Rate for Payer: BCN Commercial |
$63.29
|
| Rate for Payer: BCN Medicare Advantage |
$19.25
|
| Rate for Payer: Cash Price |
$61.59
|
| Rate for Payer: Cofinity Commercial |
$66.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.25
|
| Rate for Payer: Healthscope Commercial |
$69.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.74
|
| Rate for Payer: Mclaren Medicaid |
$13.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.21
|
| Rate for Payer: Meridian Medicaid |
$14.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.44
|
| Rate for Payer: Nomi Health Commercial |
$63.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.74
|
| Rate for Payer: PACE Senior Care Partners |
$18.29
|
| Rate for Payer: PACE SWMI |
$19.25
|
| Rate for Payer: PHP Commercial |
$65.44
|
| Rate for Payer: PHP Medicare Advantage |
$19.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.98
|
| Rate for Payer: Priority Health Medicare |
$19.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.59
|
| Rate for Payer: Railroad Medicare Medicare |
$19.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.75
|
| Rate for Payer: UHC Core |
$64.29
|
| Rate for Payer: UHC Exchange |
$19.25
|
| Rate for Payer: UHC Medicaid |
$13.57
|
| Rate for Payer: UHC Medicare Advantage |
$19.25
|
| Rate for Payer: UHCCP Medicaid |
$13.57
|
| Rate for Payer: VA VA |
$19.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.74
|
|
|
HC VDRL TITER CSF
|
Facility
|
IP
|
$76.99
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
30200397
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$53.59 |
| Max. Negotiated Rate |
$69.29 |
| Rate for Payer: Aetna Commercial |
$65.44
|
| Rate for Payer: BCBS Trust/PPO |
$63.59
|
| Rate for Payer: BCN Commercial |
$63.59
|
| Rate for Payer: Cash Price |
$61.59
|
| Rate for Payer: Cofinity Commercial |
$66.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.59
|
| Rate for Payer: Healthscope Commercial |
$69.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.44
|
| Rate for Payer: Nomi Health Commercial |
$63.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.74
|
| Rate for Payer: PHP Commercial |
$65.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$66.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.75
|
| Rate for Payer: UHC Core |
$64.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.74
|
|
|
HC VEDOLIZUMAB
|
Facility
|
OP
|
$169.59
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100671
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.90 |
| Max. Negotiated Rate |
$152.63 |
| Rate for Payer: Aetna Commercial |
$144.15
|
| Rate for Payer: Aetna Medicare |
$44.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.00
|
| Rate for Payer: BCBS Complete |
$31.39
|
| Rate for Payer: BCBS MAPPO |
$42.40
|
| Rate for Payer: BCBS Trust/PPO |
$139.42
|
| Rate for Payer: BCN Commercial |
$139.42
|
| Rate for Payer: BCN Medicare Advantage |
$42.40
|
| Rate for Payer: Cash Price |
$135.67
|
| Rate for Payer: Cofinity Commercial |
$145.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.40
|
| Rate for Payer: Healthscope Commercial |
$152.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.19
|
| Rate for Payer: Mclaren Medicaid |
$29.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.52
|
| Rate for Payer: Meridian Medicaid |
$31.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.15
|
| Rate for Payer: Nomi Health Commercial |
$139.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.19
|
| Rate for Payer: PACE Senior Care Partners |
$40.28
|
| Rate for Payer: PACE SWMI |
$42.40
|
| Rate for Payer: PHP Commercial |
$144.15
|
| Rate for Payer: PHP Medicare Advantage |
$42.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$147.54
|
| Rate for Payer: Priority Health Medicare |
$42.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.03
|
| Rate for Payer: Railroad Medicare Medicare |
$42.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.24
|
| Rate for Payer: UHC Core |
$141.61
|
| Rate for Payer: UHC Exchange |
$42.40
|
| Rate for Payer: UHC Medicaid |
$29.90
|
| Rate for Payer: UHC Medicare Advantage |
$42.40
|
| Rate for Payer: UHCCP Medicaid |
$29.90
|
| Rate for Payer: VA VA |
$42.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.19
|
|
|
HC VEDOLIZUMAB
|
Facility
|
IP
|
$169.59
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100671
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$118.03 |
| Max. Negotiated Rate |
$152.63 |
| Rate for Payer: Aetna Commercial |
$144.15
|
| Rate for Payer: BCBS Trust/PPO |
$140.06
|
| Rate for Payer: BCN Commercial |
$140.06
|
| Rate for Payer: Cash Price |
$135.67
|
| Rate for Payer: Cofinity Commercial |
$145.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.67
|
| Rate for Payer: Healthscope Commercial |
$152.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.15
|
| Rate for Payer: Nomi Health Commercial |
$139.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.19
|
| Rate for Payer: PHP Commercial |
$144.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$147.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.24
|
| Rate for Payer: UHC Core |
$141.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.19
|
|
|
HC VEDOLIZUMAB, ANTIBODY
|
Facility
|
OP
|
$134.21
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
30100683
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.66 |
| Max. Negotiated Rate |
$120.79 |
| Rate for Payer: Aetna Commercial |
$114.08
|
| Rate for Payer: Aetna Medicare |
$34.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.94
|
| Rate for Payer: BCBS Complete |
$24.84
|
| Rate for Payer: BCBS MAPPO |
$33.55
|
| Rate for Payer: BCBS Trust/PPO |
$110.33
|
| Rate for Payer: BCN Commercial |
$110.33
|
| Rate for Payer: BCN Medicare Advantage |
$33.55
|
| Rate for Payer: Cash Price |
$107.37
|
| Rate for Payer: Cofinity Commercial |
$115.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.55
|
| Rate for Payer: Healthscope Commercial |
$120.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.66
|
| Rate for Payer: Mclaren Medicaid |
$23.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.23
|
| Rate for Payer: Meridian Medicaid |
$24.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.08
|
| Rate for Payer: Nomi Health Commercial |
$110.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.66
|
| Rate for Payer: PACE Senior Care Partners |
$31.87
|
| Rate for Payer: PACE SWMI |
$33.55
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: PHP Medicare Advantage |
$33.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.76
|
| Rate for Payer: Priority Health Medicare |
$33.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.41
|
| Rate for Payer: Railroad Medicare Medicare |
$33.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.10
|
| Rate for Payer: UHC Core |
$112.07
|
| Rate for Payer: UHC Exchange |
$33.55
|
| Rate for Payer: UHC Medicaid |
$23.66
|
| Rate for Payer: UHC Medicare Advantage |
$33.55
|
| Rate for Payer: UHCCP Medicaid |
$23.66
|
| Rate for Payer: VA VA |
$33.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.66
|
|
|
HC VEDOLIZUMAB, ANTIBODY
|
Facility
|
IP
|
$134.21
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
30100683
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$93.41 |
| Max. Negotiated Rate |
$120.79 |
| Rate for Payer: Aetna Commercial |
$114.08
|
| Rate for Payer: BCBS Trust/PPO |
$110.84
|
| Rate for Payer: BCN Commercial |
$110.84
|
| Rate for Payer: Cash Price |
$107.37
|
| Rate for Payer: Cofinity Commercial |
$115.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.37
|
| Rate for Payer: Healthscope Commercial |
$120.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.08
|
| Rate for Payer: Nomi Health Commercial |
$110.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.66
|
| Rate for Payer: PHP Commercial |
$114.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.10
|
| Rate for Payer: UHC Core |
$112.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.66
|
|
|
HC VEDOLIZUMAB CMPT
|
Facility
|
IP
|
$133.17
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100672
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$92.69 |
| Max. Negotiated Rate |
$119.85 |
| Rate for Payer: Aetna Commercial |
$113.19
|
| Rate for Payer: BCBS Trust/PPO |
$109.99
|
| Rate for Payer: BCN Commercial |
$109.99
|
| Rate for Payer: Cash Price |
$106.54
|
| Rate for Payer: Cofinity Commercial |
$114.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.54
|
| Rate for Payer: Healthscope Commercial |
$119.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.19
|
| Rate for Payer: Nomi Health Commercial |
$109.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.88
|
| Rate for Payer: PHP Commercial |
$113.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$115.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.19
|
| Rate for Payer: UHC Core |
$111.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.88
|
|
|
HC VEDOLIZUMAB CMPT
|
Facility
|
OP
|
$133.17
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100672
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.48 |
| Max. Negotiated Rate |
$119.85 |
| Rate for Payer: Aetna Commercial |
$113.19
|
| Rate for Payer: Aetna Medicare |
$34.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.62
|
| Rate for Payer: BCBS Complete |
$24.65
|
| Rate for Payer: BCBS MAPPO |
$33.29
|
| Rate for Payer: BCBS Trust/PPO |
$109.48
|
| Rate for Payer: BCN Commercial |
$109.48
|
| Rate for Payer: BCN Medicare Advantage |
$33.29
|
| Rate for Payer: Cash Price |
$106.54
|
| Rate for Payer: Cofinity Commercial |
$114.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.29
|
| Rate for Payer: Healthscope Commercial |
$119.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.88
|
| Rate for Payer: Mclaren Medicaid |
$23.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.96
|
| Rate for Payer: Meridian Medicaid |
$24.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.19
|
| Rate for Payer: Nomi Health Commercial |
$109.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.88
|
| Rate for Payer: PACE Senior Care Partners |
$31.63
|
| Rate for Payer: PACE SWMI |
$33.29
|
| Rate for Payer: PHP Commercial |
$113.19
|
| Rate for Payer: PHP Medicare Advantage |
$33.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$115.86
|
| Rate for Payer: Priority Health Medicare |
$33.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.69
|
| Rate for Payer: Railroad Medicare Medicare |
$33.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.19
|
| Rate for Payer: UHC Core |
$111.20
|
| Rate for Payer: UHC Exchange |
$33.29
|
| Rate for Payer: UHC Medicaid |
$23.48
|
| Rate for Payer: UHC Medicare Advantage |
$33.29
|
| Rate for Payer: UHCCP Medicaid |
$23.48
|
| Rate for Payer: VA VA |
$33.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.88
|
|
|
HC VEDOLIZUMAB, S
|
Facility
|
IP
|
$253.86
|
|
|
Service Code
|
CPT 80280
|
| Hospital Charge Code |
30100706
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$176.69 |
| Max. Negotiated Rate |
$228.47 |
| Rate for Payer: Aetna Commercial |
$215.78
|
| Rate for Payer: BCBS Trust/PPO |
$209.66
|
| Rate for Payer: BCN Commercial |
$209.66
|
| Rate for Payer: Cash Price |
$203.09
|
| Rate for Payer: Cofinity Commercial |
$218.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.09
|
| Rate for Payer: Healthscope Commercial |
$228.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.78
|
| Rate for Payer: Nomi Health Commercial |
$208.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.40
|
| Rate for Payer: PHP Commercial |
$215.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$220.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.40
|
| Rate for Payer: UHC Core |
$211.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.40
|
|
|
HC VEDOLIZUMAB, S
|
Facility
|
OP
|
$253.86
|
|
|
Service Code
|
CPT 80280
|
| Hospital Charge Code |
30100706
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.76 |
| Max. Negotiated Rate |
$228.47 |
| Rate for Payer: Aetna Commercial |
$215.78
|
| Rate for Payer: Aetna Medicare |
$66.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.33
|
| Rate for Payer: BCBS Complete |
$46.99
|
| Rate for Payer: BCBS MAPPO |
$63.47
|
| Rate for Payer: BCBS Trust/PPO |
$208.70
|
| Rate for Payer: BCN Commercial |
$208.70
|
| Rate for Payer: BCN Medicare Advantage |
$63.47
|
| Rate for Payer: Cash Price |
$203.09
|
| Rate for Payer: Cofinity Commercial |
$218.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.47
|
| Rate for Payer: Healthscope Commercial |
$228.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.40
|
| Rate for Payer: Mclaren Medicaid |
$44.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.64
|
| Rate for Payer: Meridian Medicaid |
$46.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.78
|
| Rate for Payer: Nomi Health Commercial |
$208.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.40
|
| Rate for Payer: PACE Senior Care Partners |
$60.29
|
| Rate for Payer: PACE SWMI |
$63.47
|
| Rate for Payer: PHP Commercial |
$215.78
|
| Rate for Payer: PHP Medicare Advantage |
$63.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$220.86
|
| Rate for Payer: Priority Health Medicare |
$64.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.69
|
| Rate for Payer: Railroad Medicare Medicare |
$63.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.40
|
| Rate for Payer: UHC Core |
$211.97
|
| Rate for Payer: UHC Exchange |
$63.47
|
| Rate for Payer: UHC Medicaid |
$44.76
|
| Rate for Payer: UHC Medicare Advantage |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$44.76
|
| Rate for Payer: VA VA |
$63.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.40
|
|
|
HC VEEG 12-26 HR UNMONITORED
|
Facility
|
IP
|
$1,041.69
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
74000027
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$725.02 |
| Max. Negotiated Rate |
$937.52 |
| Rate for Payer: Aetna Commercial |
$885.44
|
| Rate for Payer: BCBS Trust/PPO |
$860.33
|
| Rate for Payer: BCN Commercial |
$860.33
|
| Rate for Payer: Cash Price |
$833.35
|
| Rate for Payer: Cofinity Commercial |
$895.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$833.35
|
| Rate for Payer: Healthscope Commercial |
$937.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$781.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.44
|
| Rate for Payer: Nomi Health Commercial |
$854.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$781.27
|
| Rate for Payer: PHP Commercial |
$885.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$906.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$725.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$916.69
|
| Rate for Payer: UHC Core |
$869.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$781.27
|
|
|
HC VEEG 12-26 HR UNMONITORED
|
Facility
|
OP
|
$1,041.69
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
74000027
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$183.65 |
| Max. Negotiated Rate |
$937.52 |
| Rate for Payer: Aetna Commercial |
$885.44
|
| Rate for Payer: Aetna Medicare |
$270.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.53
|
| Rate for Payer: BCBS Complete |
$192.82
|
| Rate for Payer: BCBS MAPPO |
$260.42
|
| Rate for Payer: BCBS Trust/PPO |
$856.37
|
| Rate for Payer: BCN Commercial |
$856.37
|
| Rate for Payer: BCN Medicare Advantage |
$260.42
|
| Rate for Payer: Cash Price |
$833.35
|
| Rate for Payer: Cofinity Commercial |
$895.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$833.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.42
|
| Rate for Payer: Healthscope Commercial |
$937.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$781.27
|
| Rate for Payer: Mclaren Medicaid |
$183.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.44
|
| Rate for Payer: Meridian Medicaid |
$192.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$286.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.44
|
| Rate for Payer: Nomi Health Commercial |
$854.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$781.27
|
| Rate for Payer: PACE Senior Care Partners |
$247.40
|
| Rate for Payer: PACE SWMI |
$260.42
|
| Rate for Payer: PHP Commercial |
$885.44
|
| Rate for Payer: PHP Medicare Advantage |
$260.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$906.27
|
| Rate for Payer: Priority Health Medicare |
$263.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$725.02
|
| Rate for Payer: Railroad Medicare Medicare |
$260.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$916.69
|
| Rate for Payer: UHC Core |
$869.81
|
| Rate for Payer: UHC Exchange |
$260.42
|
| Rate for Payer: UHC Medicaid |
$183.65
|
| Rate for Payer: UHC Medicare Advantage |
$260.42
|
| Rate for Payer: UHCCP Medicaid |
$183.65
|
| Rate for Payer: VA VA |
$260.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$781.27
|
|
|
HC VEEG 2-12 HR CONT MNTR
|
Facility
|
IP
|
$2,490.80
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
74000023
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,733.60 |
| Max. Negotiated Rate |
$2,241.72 |
| Rate for Payer: Aetna Commercial |
$2,117.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,057.15
|
| Rate for Payer: BCN Commercial |
$2,057.15
|
| Rate for Payer: Cash Price |
$1,992.64
|
| Rate for Payer: Cofinity Commercial |
$2,142.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,992.64
|
| Rate for Payer: Healthscope Commercial |
$2,241.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,868.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,117.18
|
| Rate for Payer: Nomi Health Commercial |
$2,042.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,868.10
|
| Rate for Payer: PHP Commercial |
$2,117.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,167.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,733.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,191.90
|
| Rate for Payer: UHC Core |
$2,079.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,868.10
|
|
|
HC VEEG 2-12 HR CONT MNTR
|
Facility
|
OP
|
$2,490.80
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
74000023
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$439.13 |
| Max. Negotiated Rate |
$2,241.72 |
| Rate for Payer: Aetna Commercial |
$2,117.18
|
| Rate for Payer: Aetna Medicare |
$647.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$778.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$778.38
|
| Rate for Payer: BCBS Complete |
$461.05
|
| Rate for Payer: BCBS MAPPO |
$622.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,047.69
|
| Rate for Payer: BCN Commercial |
$2,047.69
|
| Rate for Payer: BCN Medicare Advantage |
$622.70
|
| Rate for Payer: Cash Price |
$1,992.64
|
| Rate for Payer: Cofinity Commercial |
$2,142.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,992.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$622.70
|
| Rate for Payer: Healthscope Commercial |
$2,241.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,868.10
|
| Rate for Payer: Mclaren Medicaid |
$439.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$653.84
|
| Rate for Payer: Meridian Medicaid |
$461.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$716.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$684.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,117.18
|
| Rate for Payer: Nomi Health Commercial |
$2,042.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,868.10
|
| Rate for Payer: PACE Senior Care Partners |
$591.57
|
| Rate for Payer: PACE SWMI |
$622.70
|
| Rate for Payer: PHP Commercial |
$2,117.18
|
| Rate for Payer: PHP Medicare Advantage |
$622.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$439.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,167.00
|
| Rate for Payer: Priority Health Medicare |
$628.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,733.60
|
| Rate for Payer: Railroad Medicare Medicare |
$622.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,191.90
|
| Rate for Payer: UHC Core |
$2,079.82
|
| Rate for Payer: UHC Exchange |
$622.70
|
| Rate for Payer: UHC Medicaid |
$439.13
|
| Rate for Payer: UHC Medicare Advantage |
$622.70
|
| Rate for Payer: UHCCP Medicaid |
$439.13
|
| Rate for Payer: VA VA |
$622.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,868.10
|
|
|
HC VEEG 2-12 HR INTMT MNTR
|
Facility
|
OP
|
$1,094.36
|
|
|
Service Code
|
CPT 95712
|
| Hospital Charge Code |
74000022
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$192.94 |
| Max. Negotiated Rate |
$984.92 |
| Rate for Payer: Aetna Commercial |
$930.21
|
| Rate for Payer: Aetna Medicare |
$284.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$341.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$341.99
|
| Rate for Payer: BCBS Complete |
$202.57
|
| Rate for Payer: BCBS MAPPO |
$273.59
|
| Rate for Payer: BCBS Trust/PPO |
$899.67
|
| Rate for Payer: BCN Commercial |
$899.67
|
| Rate for Payer: BCN Medicare Advantage |
$273.59
|
| Rate for Payer: Cash Price |
$875.49
|
| Rate for Payer: Cofinity Commercial |
$941.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$875.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.59
|
| Rate for Payer: Healthscope Commercial |
$984.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$820.77
|
| Rate for Payer: Mclaren Medicaid |
$192.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$287.27
|
| Rate for Payer: Meridian Medicaid |
$202.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$314.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$300.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.21
|
| Rate for Payer: Nomi Health Commercial |
$897.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$820.77
|
| Rate for Payer: PACE Senior Care Partners |
$259.91
|
| Rate for Payer: PACE SWMI |
$273.59
|
| Rate for Payer: PHP Commercial |
$930.21
|
| Rate for Payer: PHP Medicare Advantage |
$273.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$192.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$952.09
|
| Rate for Payer: Priority Health Medicare |
$276.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$761.67
|
| Rate for Payer: Railroad Medicare Medicare |
$273.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$963.04
|
| Rate for Payer: UHC Core |
$913.79
|
| Rate for Payer: UHC Exchange |
$273.59
|
| Rate for Payer: UHC Medicaid |
$192.94
|
| Rate for Payer: UHC Medicare Advantage |
$273.59
|
| Rate for Payer: UHCCP Medicaid |
$192.94
|
| Rate for Payer: VA VA |
$273.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$820.77
|
|
|
HC VEEG 2-12 HR INTMT MNTR
|
Facility
|
IP
|
$1,094.36
|
|
|
Service Code
|
CPT 95712
|
| Hospital Charge Code |
74000022
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$761.67 |
| Max. Negotiated Rate |
$984.92 |
| Rate for Payer: Aetna Commercial |
$930.21
|
| Rate for Payer: BCBS Trust/PPO |
$903.83
|
| Rate for Payer: BCN Commercial |
$903.83
|
| Rate for Payer: Cash Price |
$875.49
|
| Rate for Payer: Cofinity Commercial |
$941.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$875.49
|
| Rate for Payer: Healthscope Commercial |
$984.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$820.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.21
|
| Rate for Payer: Nomi Health Commercial |
$897.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$820.77
|
| Rate for Payer: PHP Commercial |
$930.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$952.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$761.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$963.04
|
| Rate for Payer: UHC Core |
$913.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$820.77
|
|
|
HC VEEG 2-12 HR UNMONITORED
|
Facility
|
IP
|
$1,998.65
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
74000026
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,391.06 |
| Max. Negotiated Rate |
$1,798.79 |
| Rate for Payer: Aetna Commercial |
$1,698.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,650.69
|
| Rate for Payer: BCN Commercial |
$1,650.69
|
| Rate for Payer: Cash Price |
$1,598.92
|
| Rate for Payer: Cofinity Commercial |
$1,718.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,598.92
|
| Rate for Payer: Healthscope Commercial |
$1,798.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,498.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,698.85
|
| Rate for Payer: Nomi Health Commercial |
$1,638.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,498.99
|
| Rate for Payer: PHP Commercial |
$1,698.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,738.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,391.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,758.81
|
| Rate for Payer: UHC Core |
$1,668.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,498.99
|
|
|
HC VEEG 2-12 HR UNMONITORED
|
Facility
|
OP
|
$1,998.65
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
74000026
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$352.36 |
| Max. Negotiated Rate |
$1,798.79 |
| Rate for Payer: Aetna Commercial |
$1,698.85
|
| Rate for Payer: Aetna Medicare |
$519.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$624.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$624.58
|
| Rate for Payer: BCBS Complete |
$369.95
|
| Rate for Payer: BCBS MAPPO |
$499.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,643.09
|
| Rate for Payer: BCN Commercial |
$1,643.09
|
| Rate for Payer: BCN Medicare Advantage |
$499.66
|
| Rate for Payer: Cash Price |
$1,598.92
|
| Rate for Payer: Cofinity Commercial |
$1,718.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,598.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$499.66
|
| Rate for Payer: Healthscope Commercial |
$1,798.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,498.99
|
| Rate for Payer: Mclaren Medicaid |
$352.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$524.65
|
| Rate for Payer: Meridian Medicaid |
$369.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$574.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$549.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,698.85
|
| Rate for Payer: Nomi Health Commercial |
$1,638.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,498.99
|
| Rate for Payer: PACE Senior Care Partners |
$474.68
|
| Rate for Payer: PACE SWMI |
$499.66
|
| Rate for Payer: PHP Commercial |
$1,698.85
|
| Rate for Payer: PHP Medicare Advantage |
$499.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,738.83
|
| Rate for Payer: Priority Health Medicare |
$504.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,391.06
|
| Rate for Payer: Railroad Medicare Medicare |
$499.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,758.81
|
| Rate for Payer: UHC Core |
$1,668.87
|
| Rate for Payer: UHC Exchange |
$499.66
|
| Rate for Payer: UHC Medicaid |
$352.36
|
| Rate for Payer: UHC Medicare Advantage |
$499.66
|
| Rate for Payer: UHCCP Medicaid |
$352.36
|
| Rate for Payer: VA VA |
$499.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,498.99
|
|
|
HC VEEG EA 12-26 HR CONT MNTR
|
Facility
|
OP
|
$4,643.22
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
74000025
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$818.60 |
| Max. Negotiated Rate |
$4,178.90 |
| Rate for Payer: Aetna Commercial |
$3,946.74
|
| Rate for Payer: Aetna Medicare |
$1,207.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,451.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,451.01
|
| Rate for Payer: BCBS Complete |
$859.46
|
| Rate for Payer: BCBS MAPPO |
$1,160.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,817.19
|
| Rate for Payer: BCN Commercial |
$3,817.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,160.81
|
| Rate for Payer: Cash Price |
$3,714.58
|
| Rate for Payer: Cofinity Commercial |
$3,993.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,714.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,160.81
|
| Rate for Payer: Healthscope Commercial |
$4,178.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,482.41
|
| Rate for Payer: Mclaren Medicaid |
$818.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,218.85
|
| Rate for Payer: Meridian Medicaid |
$859.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,334.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,276.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,946.74
|
| Rate for Payer: Nomi Health Commercial |
$3,807.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,482.41
|
| Rate for Payer: PACE Senior Care Partners |
$1,102.76
|
| Rate for Payer: PACE SWMI |
$1,160.81
|
| Rate for Payer: PHP Commercial |
$3,946.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,160.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$818.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,039.60
|
| Rate for Payer: Priority Health Medicare |
$1,172.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,231.68
|
| Rate for Payer: Railroad Medicare Medicare |
$1,160.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,086.03
|
| Rate for Payer: UHC Core |
$3,877.09
|
| Rate for Payer: UHC Exchange |
$1,160.81
|
| Rate for Payer: UHC Medicaid |
$818.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,160.81
|
| Rate for Payer: UHCCP Medicaid |
$818.60
|
| Rate for Payer: VA VA |
$1,160.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,482.41
|
|
|
HC VEEG EA 12-26 HR CONT MNTR
|
Facility
|
IP
|
$4,643.22
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
74000025
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$3,231.68 |
| Max. Negotiated Rate |
$4,178.90 |
| Rate for Payer: Aetna Commercial |
$3,946.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,834.84
|
| Rate for Payer: BCN Commercial |
$3,834.84
|
| Rate for Payer: Cash Price |
$3,714.58
|
| Rate for Payer: Cofinity Commercial |
$3,993.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,714.58
|
| Rate for Payer: Healthscope Commercial |
$4,178.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,482.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,946.74
|
| Rate for Payer: Nomi Health Commercial |
$3,807.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,482.41
|
| Rate for Payer: PHP Commercial |
$3,946.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,039.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,231.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,086.03
|
| Rate for Payer: UHC Core |
$3,877.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,482.41
|
|
|
HC VEEG EA 12-26 HR INTMT MNTR
|
Facility
|
IP
|
$2,470.23
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
74000024
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,719.28 |
| Max. Negotiated Rate |
$2,223.21 |
| Rate for Payer: Aetna Commercial |
$2,099.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,040.16
|
| Rate for Payer: BCN Commercial |
$2,040.16
|
| Rate for Payer: Cash Price |
$1,976.18
|
| Rate for Payer: Cofinity Commercial |
$2,124.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,976.18
|
| Rate for Payer: Healthscope Commercial |
$2,223.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,852.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,099.70
|
| Rate for Payer: Nomi Health Commercial |
$2,025.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,852.67
|
| Rate for Payer: PHP Commercial |
$2,099.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,149.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,719.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,173.80
|
| Rate for Payer: UHC Core |
$2,062.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,852.67
|
|
|
HC VEEG EA 12-26 HR INTMT MNTR
|
Facility
|
OP
|
$2,470.23
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
74000024
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$435.50 |
| Max. Negotiated Rate |
$2,223.21 |
| Rate for Payer: Aetna Commercial |
$2,099.70
|
| Rate for Payer: Aetna Medicare |
$642.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$771.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$771.95
|
| Rate for Payer: BCBS Complete |
$457.24
|
| Rate for Payer: BCBS MAPPO |
$617.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,030.78
|
| Rate for Payer: BCN Commercial |
$2,030.78
|
| Rate for Payer: BCN Medicare Advantage |
$617.56
|
| Rate for Payer: Cash Price |
$1,976.18
|
| Rate for Payer: Cofinity Commercial |
$2,124.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,976.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$617.56
|
| Rate for Payer: Healthscope Commercial |
$2,223.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,852.67
|
| Rate for Payer: Mclaren Medicaid |
$435.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$648.44
|
| Rate for Payer: Meridian Medicaid |
$457.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$710.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$679.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,099.70
|
| Rate for Payer: Nomi Health Commercial |
$2,025.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,852.67
|
| Rate for Payer: PACE Senior Care Partners |
$586.68
|
| Rate for Payer: PACE SWMI |
$617.56
|
| Rate for Payer: PHP Commercial |
$2,099.70
|
| Rate for Payer: PHP Medicare Advantage |
$617.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,149.10
|
| Rate for Payer: Priority Health Medicare |
$623.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,719.28
|
| Rate for Payer: Railroad Medicare Medicare |
$617.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,173.80
|
| Rate for Payer: UHC Core |
$2,062.64
|
| Rate for Payer: UHC Exchange |
$617.56
|
| Rate for Payer: UHC Medicaid |
$435.50
|
| Rate for Payer: UHC Medicare Advantage |
$617.56
|
| Rate for Payer: UHCCP Medicaid |
$435.50
|
| Rate for Payer: VA VA |
$617.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,852.67
|
|
|
HC VEIN MAPPING BILATERAL LOWER
|
Facility
|
OP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100024
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$253.32 |
| Max. Negotiated Rate |
$1,293.17 |
| Rate for Payer: Aetna Commercial |
$1,221.33
|
| Rate for Payer: Aetna Medicare |
$373.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$449.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$449.02
|
| Rate for Payer: BCBS Complete |
$265.96
|
| Rate for Payer: BCBS MAPPO |
$359.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,181.24
|
| Rate for Payer: BCN Commercial |
$1,181.24
|
| Rate for Payer: BCN Medicare Advantage |
$359.21
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Commercial |
$1,235.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.21
|
| Rate for Payer: Healthscope Commercial |
$1,293.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,077.64
|
| Rate for Payer: Mclaren Medicaid |
$253.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$377.18
|
| Rate for Payer: Meridian Medicaid |
$265.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$413.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$395.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$1,178.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: PACE Senior Care Partners |
$341.25
|
| Rate for Payer: PACE SWMI |
$359.21
|
| Rate for Payer: PHP Commercial |
$1,221.33
|
| Rate for Payer: PHP Medicare Advantage |
$359.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,250.07
|
| Rate for Payer: Priority Health Medicare |
$362.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,000.05
|
| Rate for Payer: Railroad Medicare Medicare |
$359.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,264.44
|
| Rate for Payer: UHC Core |
$1,199.78
|
| Rate for Payer: UHC Exchange |
$359.21
|
| Rate for Payer: UHC Medicaid |
$253.32
|
| Rate for Payer: UHC Medicare Advantage |
$359.21
|
| Rate for Payer: UHCCP Medicaid |
$253.32
|
| Rate for Payer: VA VA |
$359.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,077.64
|
|
|
HC VEIN MAPPING BILATERAL LOWER
|
Facility
|
IP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100024
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,000.05 |
| Max. Negotiated Rate |
$1,293.17 |
| Rate for Payer: Aetna Commercial |
$1,221.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,186.70
|
| Rate for Payer: BCN Commercial |
$1,186.70
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Commercial |
$1,235.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Healthscope Commercial |
$1,293.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,077.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$1,178.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: PHP Commercial |
$1,221.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,250.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,000.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,264.44
|
| Rate for Payer: UHC Core |
$1,199.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,077.64
|
|
|
HC VEIN MAPPING BILATERAL UPPER
|
Facility
|
OP
|
$1,436.86
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100025
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$253.32 |
| Max. Negotiated Rate |
$1,293.17 |
| Rate for Payer: Aetna Commercial |
$1,221.33
|
| Rate for Payer: Aetna Medicare |
$373.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$449.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$449.02
|
| Rate for Payer: BCBS Complete |
$265.96
|
| Rate for Payer: BCBS MAPPO |
$359.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,181.24
|
| Rate for Payer: BCN Commercial |
$1,181.24
|
| Rate for Payer: BCN Medicare Advantage |
$359.21
|
| Rate for Payer: Cash Price |
$1,149.49
|
| Rate for Payer: Cofinity Commercial |
$1,235.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,149.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.21
|
| Rate for Payer: Healthscope Commercial |
$1,293.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,077.64
|
| Rate for Payer: Mclaren Medicaid |
$253.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$377.18
|
| Rate for Payer: Meridian Medicaid |
$265.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$413.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$395.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,221.33
|
| Rate for Payer: Nomi Health Commercial |
$1,178.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,077.64
|
| Rate for Payer: PACE Senior Care Partners |
$341.25
|
| Rate for Payer: PACE SWMI |
$359.21
|
| Rate for Payer: PHP Commercial |
$1,221.33
|
| Rate for Payer: PHP Medicare Advantage |
$359.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,250.07
|
| Rate for Payer: Priority Health Medicare |
$362.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,000.05
|
| Rate for Payer: Railroad Medicare Medicare |
$359.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,264.44
|
| Rate for Payer: UHC Core |
$1,199.78
|
| Rate for Payer: UHC Exchange |
$359.21
|
| Rate for Payer: UHC Medicaid |
$253.32
|
| Rate for Payer: UHC Medicare Advantage |
$359.21
|
| Rate for Payer: UHCCP Medicaid |
$253.32
|
| Rate for Payer: VA VA |
$359.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,077.64
|
|
