|
HC THYROID IMAGING W VASC FLOW
|
Facility
|
IP
|
$583.41
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
34100075
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$379.22 |
| Max. Negotiated Rate |
$525.07 |
| Rate for Payer: Aetna Commercial |
$495.90
|
| Rate for Payer: BCBS Trust/PPO |
$476.24
|
| Rate for Payer: BCN Commercial |
$450.86
|
| Rate for Payer: Cash Price |
$466.73
|
| Rate for Payer: Cofinity Commercial |
$501.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.73
|
| Rate for Payer: Healthscope Commercial |
$525.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.90
|
| Rate for Payer: Nomi Health Commercial |
$478.40
|
| Rate for Payer: PHP Commercial |
$495.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.22
|
| Rate for Payer: Priority Health HMO/PPO |
$507.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.40
|
| Rate for Payer: UHC Core |
$487.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.56
|
|
|
HC THYROID IMAG W VASC FLOW SNGL OR MULTI
|
Facility
|
OP
|
$1,225.64
|
|
|
Service Code
|
CPT 78014
|
| Hospital Charge Code |
34100076
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$290.52 |
| Max. Negotiated Rate |
$1,103.08 |
| Rate for Payer: Aetna Commercial |
$1,041.79
|
| Rate for Payer: Aetna Medicare |
$318.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$383.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$383.01
|
| Rate for Payer: BCBS Complete |
$305.07
|
| Rate for Payer: BCBS MAPPO |
$306.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,007.60
|
| Rate for Payer: BCN Commercial |
$952.94
|
| Rate for Payer: BCN Medicare Advantage |
$306.41
|
| Rate for Payer: Cash Price |
$980.51
|
| Rate for Payer: Cash Price |
$980.51
|
| Rate for Payer: Cofinity Commercial |
$1,054.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$980.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.41
|
| Rate for Payer: Healthscope Commercial |
$1,103.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.23
|
| Rate for Payer: Mclaren Medicaid |
$290.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.73
|
| Rate for Payer: Meridian Medicaid |
$305.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$352.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.79
|
| Rate for Payer: Nomi Health Commercial |
$1,005.02
|
| Rate for Payer: PACE Senior Care Partners |
$291.09
|
| Rate for Payer: PACE SWMI |
$306.41
|
| Rate for Payer: PHP Commercial |
$1,041.79
|
| Rate for Payer: PHP Medicare Advantage |
$306.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.67
|
| Rate for Payer: Priority Health HMO/PPO |
$1,066.31
|
| Rate for Payer: Priority Health Medicare |
$309.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$821.18
|
| Rate for Payer: Railroad Medicare Medicare |
$306.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,078.56
|
| Rate for Payer: UHC Core |
$1,023.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.41
|
| Rate for Payer: UHC Exchange |
$306.41
|
| Rate for Payer: UHC Medicare Advantage |
$306.41
|
| Rate for Payer: UHCCP Medicaid |
$290.52
|
| Rate for Payer: VA VA |
$306.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.23
|
|
|
HC THYROID IMAG W VASC FLOW SNGL OR MULTI
|
Facility
|
IP
|
$1,225.64
|
|
|
Service Code
|
CPT 78014
|
| Hospital Charge Code |
34100076
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$796.67 |
| Max. Negotiated Rate |
$1,103.08 |
| Rate for Payer: Aetna Commercial |
$1,041.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,000.49
|
| Rate for Payer: BCN Commercial |
$947.17
|
| Rate for Payer: Cash Price |
$980.51
|
| Rate for Payer: Cofinity Commercial |
$1,054.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$980.51
|
| Rate for Payer: Healthscope Commercial |
$1,103.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.79
|
| Rate for Payer: Nomi Health Commercial |
$1,005.02
|
| Rate for Payer: PHP Commercial |
$1,041.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.67
|
| Rate for Payer: Priority Health HMO/PPO |
$1,066.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$821.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,078.56
|
| Rate for Payer: UHC Core |
$1,023.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.23
|
|
|
HC THYROID PEROXIDASE ANTIBODY
|
Facility
|
OP
|
$85.58
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200209
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.52 |
| Max. Negotiated Rate |
$77.02 |
| Rate for Payer: Aetna Commercial |
$72.74
|
| Rate for Payer: Aetna Medicare |
$22.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.74
|
| Rate for Payer: BCBS Complete |
$11.05
|
| Rate for Payer: BCBS MAPPO |
$21.39
|
| Rate for Payer: BCBS Trust/PPO |
$70.36
|
| Rate for Payer: BCN Commercial |
$66.54
|
| Rate for Payer: BCN Medicare Advantage |
$21.39
|
| Rate for Payer: Cash Price |
$68.46
|
| Rate for Payer: Cash Price |
$68.46
|
| Rate for Payer: Cofinity Commercial |
$73.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.39
|
| Rate for Payer: Healthscope Commercial |
$77.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.19
|
| Rate for Payer: Mclaren Medicaid |
$10.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.46
|
| Rate for Payer: Meridian Medicaid |
$11.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.74
|
| Rate for Payer: Nomi Health Commercial |
$70.18
|
| Rate for Payer: PACE Senior Care Partners |
$20.33
|
| Rate for Payer: PACE SWMI |
$21.39
|
| Rate for Payer: PHP Commercial |
$72.74
|
| Rate for Payer: PHP Medicare Advantage |
$21.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.63
|
| Rate for Payer: Priority Health HMO/PPO |
$74.45
|
| Rate for Payer: Priority Health Medicare |
$21.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.34
|
| Rate for Payer: Railroad Medicare Medicare |
$21.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.31
|
| Rate for Payer: UHC Core |
$71.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.39
|
| Rate for Payer: UHC Exchange |
$21.39
|
| Rate for Payer: UHC Medicare Advantage |
$21.39
|
| Rate for Payer: UHCCP Medicaid |
$10.52
|
| Rate for Payer: VA VA |
$21.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.19
|
|
|
HC THYROID PEROXIDASE ANTIBODY
|
Facility
|
IP
|
$85.58
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200209
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$55.63 |
| Max. Negotiated Rate |
$77.02 |
| Rate for Payer: Aetna Commercial |
$72.74
|
| Rate for Payer: BCBS Trust/PPO |
$69.86
|
| Rate for Payer: BCN Commercial |
$66.14
|
| Rate for Payer: Cash Price |
$68.46
|
| Rate for Payer: Cofinity Commercial |
$73.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.46
|
| Rate for Payer: Healthscope Commercial |
$77.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.74
|
| Rate for Payer: Nomi Health Commercial |
$70.18
|
| Rate for Payer: PHP Commercial |
$72.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.63
|
| Rate for Payer: Priority Health HMO/PPO |
$74.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.31
|
| Rate for Payer: UHC Core |
$71.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.19
|
|
|
HC THYROID STIMULATING IMMUNOGLOB
|
Facility
|
OP
|
$85.63
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
30100439
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.34 |
| Max. Negotiated Rate |
$77.07 |
| Rate for Payer: Aetna Commercial |
$72.79
|
| Rate for Payer: Aetna Medicare |
$22.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.76
|
| Rate for Payer: BCBS Complete |
$38.61
|
| Rate for Payer: BCBS MAPPO |
$21.41
|
| Rate for Payer: BCBS Trust/PPO |
$70.40
|
| Rate for Payer: BCN Commercial |
$66.58
|
| Rate for Payer: BCN Medicare Advantage |
$21.41
|
| Rate for Payer: Cash Price |
$68.50
|
| Rate for Payer: Cash Price |
$68.50
|
| Rate for Payer: Cofinity Commercial |
$73.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.41
|
| Rate for Payer: Healthscope Commercial |
$77.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.22
|
| Rate for Payer: Mclaren Medicaid |
$36.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.48
|
| Rate for Payer: Meridian Medicaid |
$38.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.79
|
| Rate for Payer: Nomi Health Commercial |
$70.22
|
| Rate for Payer: PACE Senior Care Partners |
$20.34
|
| Rate for Payer: PACE SWMI |
$21.41
|
| Rate for Payer: PHP Commercial |
$72.79
|
| Rate for Payer: PHP Medicare Advantage |
$21.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.66
|
| Rate for Payer: Priority Health HMO/PPO |
$74.50
|
| Rate for Payer: Priority Health Medicare |
$21.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.37
|
| Rate for Payer: Railroad Medicare Medicare |
$21.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.35
|
| Rate for Payer: UHC Core |
$71.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.41
|
| Rate for Payer: UHC Exchange |
$21.41
|
| Rate for Payer: UHC Medicare Advantage |
$21.41
|
| Rate for Payer: UHCCP Medicaid |
$36.77
|
| Rate for Payer: VA VA |
$21.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.22
|
|
|
HC THYROID STIMULATING IMMUNOGLOB
|
Facility
|
IP
|
$85.63
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
30100439
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.66 |
| Max. Negotiated Rate |
$77.07 |
| Rate for Payer: Aetna Commercial |
$72.79
|
| Rate for Payer: BCBS Trust/PPO |
$69.90
|
| Rate for Payer: BCN Commercial |
$66.17
|
| Rate for Payer: Cash Price |
$68.50
|
| Rate for Payer: Cofinity Commercial |
$73.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.50
|
| Rate for Payer: Healthscope Commercial |
$77.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.79
|
| Rate for Payer: Nomi Health Commercial |
$70.22
|
| Rate for Payer: PHP Commercial |
$72.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.66
|
| Rate for Payer: Priority Health HMO/PPO |
$74.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.35
|
| Rate for Payer: UHC Core |
$71.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.22
|
|
|
HC THYROID TC 99M PER STUDY
|
Facility
|
OP
|
$143.20
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300021
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$34.01 |
| Max. Negotiated Rate |
$128.88 |
| Rate for Payer: Aetna Commercial |
$121.72
|
| Rate for Payer: Aetna Medicare |
$37.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.75
|
| Rate for Payer: BCBS Complete |
$57.28
|
| Rate for Payer: BCBS MAPPO |
$35.80
|
| Rate for Payer: BCBS Trust/PPO |
$117.72
|
| Rate for Payer: BCN Commercial |
$111.34
|
| Rate for Payer: BCN Medicare Advantage |
$35.80
|
| Rate for Payer: Cash Price |
$114.56
|
| Rate for Payer: Cofinity Commercial |
$123.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.80
|
| Rate for Payer: Healthscope Commercial |
$128.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.72
|
| Rate for Payer: Nomi Health Commercial |
$117.42
|
| Rate for Payer: PACE Senior Care Partners |
$34.01
|
| Rate for Payer: PACE SWMI |
$35.80
|
| Rate for Payer: PHP Commercial |
$121.72
|
| Rate for Payer: PHP Medicare Advantage |
$35.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.08
|
| Rate for Payer: Priority Health HMO/PPO |
$124.58
|
| Rate for Payer: Priority Health Medicare |
$36.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.94
|
| Rate for Payer: Railroad Medicare Medicare |
$35.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.02
|
| Rate for Payer: UHC Core |
$119.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.80
|
| Rate for Payer: UHC Exchange |
$35.80
|
| Rate for Payer: UHC Medicare Advantage |
$35.80
|
| Rate for Payer: VA VA |
$35.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.40
|
|
|
HC THYROID TC 99M PER STUDY
|
Facility
|
IP
|
$143.20
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300021
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$93.08 |
| Max. Negotiated Rate |
$128.88 |
| Rate for Payer: Aetna Commercial |
$121.72
|
| Rate for Payer: BCBS Trust/PPO |
$116.89
|
| Rate for Payer: BCN Commercial |
$110.66
|
| Rate for Payer: Cash Price |
$114.56
|
| Rate for Payer: Cofinity Commercial |
$123.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.56
|
| Rate for Payer: Healthscope Commercial |
$128.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.72
|
| Rate for Payer: Nomi Health Commercial |
$117.42
|
| Rate for Payer: PHP Commercial |
$121.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.08
|
| Rate for Payer: Priority Health HMO/PPO |
$124.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.02
|
| Rate for Payer: UHC Core |
$119.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.40
|
|
|
HC THYROID UPTK SNGL OR MULTI DETER
|
Facility
|
IP
|
$1,056.63
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
34100074
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$686.81 |
| Max. Negotiated Rate |
$950.97 |
| Rate for Payer: Aetna Commercial |
$898.14
|
| Rate for Payer: BCBS Trust/PPO |
$862.53
|
| Rate for Payer: BCN Commercial |
$816.56
|
| Rate for Payer: Cash Price |
$845.30
|
| Rate for Payer: Cofinity Commercial |
$908.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$845.30
|
| Rate for Payer: Healthscope Commercial |
$950.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$792.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$898.14
|
| Rate for Payer: Nomi Health Commercial |
$866.44
|
| Rate for Payer: PHP Commercial |
$898.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$686.81
|
| Rate for Payer: Priority Health HMO/PPO |
$919.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$707.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$929.83
|
| Rate for Payer: UHC Core |
$882.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$792.47
|
|
|
HC THYROID UPTK SNGL OR MULTI DETER
|
Facility
|
OP
|
$1,056.63
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
34100074
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$250.95 |
| Max. Negotiated Rate |
$950.97 |
| Rate for Payer: Aetna Commercial |
$898.14
|
| Rate for Payer: Aetna Medicare |
$274.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$330.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$330.20
|
| Rate for Payer: BCBS Complete |
$305.07
|
| Rate for Payer: BCBS MAPPO |
$264.16
|
| Rate for Payer: BCBS Trust/PPO |
$868.66
|
| Rate for Payer: BCN Commercial |
$821.53
|
| Rate for Payer: BCN Medicare Advantage |
$264.16
|
| Rate for Payer: Cash Price |
$845.30
|
| Rate for Payer: Cash Price |
$845.30
|
| Rate for Payer: Cofinity Commercial |
$908.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$845.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$264.16
|
| Rate for Payer: Healthscope Commercial |
$950.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$792.47
|
| Rate for Payer: Mclaren Medicaid |
$290.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$277.37
|
| Rate for Payer: Meridian Medicaid |
$305.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$303.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$898.14
|
| Rate for Payer: Nomi Health Commercial |
$866.44
|
| Rate for Payer: PACE Senior Care Partners |
$250.95
|
| Rate for Payer: PACE SWMI |
$264.16
|
| Rate for Payer: PHP Commercial |
$898.14
|
| Rate for Payer: PHP Medicare Advantage |
$264.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$686.81
|
| Rate for Payer: Priority Health HMO/PPO |
$919.27
|
| Rate for Payer: Priority Health Medicare |
$266.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$707.94
|
| Rate for Payer: Railroad Medicare Medicare |
$264.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$929.83
|
| Rate for Payer: UHC Core |
$882.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$264.16
|
| Rate for Payer: UHC Exchange |
$264.16
|
| Rate for Payer: UHC Medicare Advantage |
$264.16
|
| Rate for Payer: UHCCP Medicaid |
$290.52
|
| Rate for Payer: VA VA |
$264.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$792.47
|
|
|
HC THYROXINE BINDING GLOBULIN
|
Facility
|
OP
|
$66.40
|
|
|
Service Code
|
CPT 84442
|
| Hospital Charge Code |
30100437
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.69 |
| Max. Negotiated Rate |
$59.76 |
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: Aetna Medicare |
$17.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.75
|
| Rate for Payer: BCBS Complete |
$11.22
|
| Rate for Payer: BCBS MAPPO |
$16.60
|
| Rate for Payer: BCBS Trust/PPO |
$54.59
|
| Rate for Payer: BCN Commercial |
$51.63
|
| Rate for Payer: BCN Medicare Advantage |
$16.60
|
| Rate for Payer: Cash Price |
$53.12
|
| Rate for Payer: Cash Price |
$53.12
|
| Rate for Payer: Cofinity Commercial |
$57.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.60
|
| Rate for Payer: Healthscope Commercial |
$59.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.80
|
| Rate for Payer: Mclaren Medicaid |
$10.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.43
|
| Rate for Payer: Meridian Medicaid |
$11.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.44
|
| Rate for Payer: Nomi Health Commercial |
$54.45
|
| Rate for Payer: PACE Senior Care Partners |
$15.77
|
| Rate for Payer: PACE SWMI |
$16.60
|
| Rate for Payer: PHP Commercial |
$56.44
|
| Rate for Payer: PHP Medicare Advantage |
$16.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.16
|
| Rate for Payer: Priority Health HMO/PPO |
$57.77
|
| Rate for Payer: Priority Health Medicare |
$16.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.49
|
| Rate for Payer: Railroad Medicare Medicare |
$16.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.43
|
| Rate for Payer: UHC Core |
$55.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.60
|
| Rate for Payer: UHC Exchange |
$16.60
|
| Rate for Payer: UHC Medicare Advantage |
$16.60
|
| Rate for Payer: UHCCP Medicaid |
$10.69
|
| Rate for Payer: VA VA |
$16.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.80
|
|
|
HC THYROXINE BINDING GLOBULIN
|
Facility
|
IP
|
$66.40
|
|
|
Service Code
|
CPT 84442
|
| Hospital Charge Code |
30100437
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.16 |
| Max. Negotiated Rate |
$59.76 |
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: BCBS Trust/PPO |
$54.20
|
| Rate for Payer: BCN Commercial |
$51.31
|
| Rate for Payer: Cash Price |
$53.12
|
| Rate for Payer: Cofinity Commercial |
$57.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.12
|
| Rate for Payer: Healthscope Commercial |
$59.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.44
|
| Rate for Payer: Nomi Health Commercial |
$54.45
|
| Rate for Payer: PHP Commercial |
$56.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.16
|
| Rate for Payer: Priority Health HMO/PPO |
$57.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.43
|
| Rate for Payer: UHC Core |
$55.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.80
|
|
|
HC THYROXINE FREE T4
|
Facility
|
IP
|
$115.26
|
|
|
Service Code
|
CPT 84439
|
| Hospital Charge Code |
30100436
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$74.92 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: BCBS Trust/PPO |
$94.09
|
| Rate for Payer: BCN Commercial |
$89.07
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: Nomi Health Commercial |
$94.51
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health HMO/PPO |
$100.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.43
|
| Rate for Payer: UHC Core |
$96.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC THYROXINE FREE T4
|
Facility
|
OP
|
$115.26
|
|
|
Service Code
|
CPT 84439
|
| Hospital Charge Code |
30100436
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: Aetna Medicare |
$29.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: BCBS Complete |
$6.85
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$94.76
|
| Rate for Payer: BCN Commercial |
$89.61
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Mclaren Medicaid |
$6.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$6.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: Nomi Health Commercial |
$94.51
|
| Rate for Payer: PACE Senior Care Partners |
$27.37
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health HMO/PPO |
$100.28
|
| Rate for Payer: Priority Health Medicare |
$29.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.22
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.43
|
| Rate for Payer: UHC Core |
$96.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.82
|
| Rate for Payer: UHC Exchange |
$28.82
|
| Rate for Payer: UHC Medicare Advantage |
$28.82
|
| Rate for Payer: UHCCP Medicaid |
$6.52
|
| Rate for Payer: VA VA |
$28.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC TIAGABINE LEVEL
|
Facility
|
IP
|
$115.93
|
|
|
Service Code
|
CPT 80199
|
| Hospital Charge Code |
30100058
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$75.35 |
| Max. Negotiated Rate |
$104.34 |
| Rate for Payer: Aetna Commercial |
$98.54
|
| Rate for Payer: BCBS Trust/PPO |
$94.63
|
| Rate for Payer: BCN Commercial |
$89.59
|
| Rate for Payer: Cash Price |
$92.74
|
| Rate for Payer: Cofinity Commercial |
$99.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.74
|
| Rate for Payer: Healthscope Commercial |
$104.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.54
|
| Rate for Payer: Nomi Health Commercial |
$95.06
|
| Rate for Payer: PHP Commercial |
$98.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.35
|
| Rate for Payer: Priority Health HMO/PPO |
$100.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.02
|
| Rate for Payer: UHC Core |
$96.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.95
|
|
|
HC TIAGABINE LEVEL
|
Facility
|
OP
|
$115.93
|
|
|
Service Code
|
CPT 80199
|
| Hospital Charge Code |
30100058
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$104.34 |
| Rate for Payer: Aetna Commercial |
$98.54
|
| Rate for Payer: Aetna Medicare |
$30.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.23
|
| Rate for Payer: BCBS Complete |
$20.58
|
| Rate for Payer: BCBS MAPPO |
$28.98
|
| Rate for Payer: BCBS Trust/PPO |
$95.31
|
| Rate for Payer: BCN Commercial |
$90.14
|
| Rate for Payer: BCN Medicare Advantage |
$28.98
|
| Rate for Payer: Cash Price |
$92.74
|
| Rate for Payer: Cash Price |
$92.74
|
| Rate for Payer: Cofinity Commercial |
$99.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.98
|
| Rate for Payer: Healthscope Commercial |
$104.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.95
|
| Rate for Payer: Mclaren Medicaid |
$19.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.43
|
| Rate for Payer: Meridian Medicaid |
$20.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.54
|
| Rate for Payer: Nomi Health Commercial |
$95.06
|
| Rate for Payer: PACE Senior Care Partners |
$27.53
|
| Rate for Payer: PACE SWMI |
$28.98
|
| Rate for Payer: PHP Commercial |
$98.54
|
| Rate for Payer: PHP Medicare Advantage |
$28.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.35
|
| Rate for Payer: Priority Health HMO/PPO |
$100.86
|
| Rate for Payer: Priority Health Medicare |
$29.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.67
|
| Rate for Payer: Railroad Medicare Medicare |
$28.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.02
|
| Rate for Payer: UHC Core |
$96.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.98
|
| Rate for Payer: UHC Exchange |
$28.98
|
| Rate for Payer: UHC Medicare Advantage |
$28.98
|
| Rate for Payer: UHCCP Medicaid |
$19.60
|
| Rate for Payer: VA VA |
$28.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.95
|
|
|
HC TIER 1 MAJOR TRAUMA RESUSCITATION
|
Facility
|
OP
|
$6,022.01
|
|
| Hospital Charge Code |
68100001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$1,430.23 |
| Max. Negotiated Rate |
$5,419.81 |
| Rate for Payer: Aetna Commercial |
$5,118.71
|
| Rate for Payer: Aetna Medicare |
$1,565.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,881.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,881.88
|
| Rate for Payer: BCBS Complete |
$2,408.80
|
| Rate for Payer: BCBS MAPPO |
$1,505.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,950.69
|
| Rate for Payer: BCN Commercial |
$4,682.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,505.50
|
| Rate for Payer: Cash Price |
$4,817.61
|
| Rate for Payer: Cofinity Commercial |
$5,178.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,817.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,505.50
|
| Rate for Payer: Healthscope Commercial |
$5,419.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,516.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,580.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,731.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,118.71
|
| Rate for Payer: Nomi Health Commercial |
$4,938.05
|
| Rate for Payer: PACE Senior Care Partners |
$1,430.23
|
| Rate for Payer: PACE SWMI |
$1,505.50
|
| Rate for Payer: PHP Commercial |
$5,118.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,505.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,914.31
|
| Rate for Payer: Priority Health HMO/PPO |
$5,239.15
|
| Rate for Payer: Priority Health Medicare |
$1,520.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,034.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,505.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,299.37
|
| Rate for Payer: UHC Core |
$5,028.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,505.50
|
| Rate for Payer: UHC Exchange |
$1,505.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,505.50
|
| Rate for Payer: VA VA |
$1,505.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,516.51
|
|
|
HC TIER 1 MAJOR TRAUMA RESUSCITATION
|
Facility
|
IP
|
$6,022.01
|
|
| Hospital Charge Code |
68100001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$3,914.31 |
| Max. Negotiated Rate |
$5,419.81 |
| Rate for Payer: Aetna Commercial |
$5,118.71
|
| Rate for Payer: BCBS Trust/PPO |
$4,915.77
|
| Rate for Payer: BCN Commercial |
$4,653.81
|
| Rate for Payer: Cash Price |
$4,817.61
|
| Rate for Payer: Cofinity Commercial |
$5,178.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,817.61
|
| Rate for Payer: Healthscope Commercial |
$5,419.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,516.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,118.71
|
| Rate for Payer: Nomi Health Commercial |
$4,938.05
|
| Rate for Payer: PHP Commercial |
$5,118.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,914.31
|
| Rate for Payer: Priority Health HMO/PPO |
$5,239.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,034.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,299.37
|
| Rate for Payer: UHC Core |
$5,028.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,516.51
|
|
|
HC TIER 2 TRAUMA RESUSCITATION
|
Facility
|
OP
|
$4,592.66
|
|
| Hospital Charge Code |
68200001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$1,090.76 |
| Max. Negotiated Rate |
$4,133.39 |
| Rate for Payer: Aetna Commercial |
$3,903.76
|
| Rate for Payer: Aetna Medicare |
$1,194.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,435.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,435.21
|
| Rate for Payer: BCBS Complete |
$1,837.06
|
| Rate for Payer: BCBS MAPPO |
$1,148.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,775.63
|
| Rate for Payer: BCN Commercial |
$3,570.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,148.16
|
| Rate for Payer: Cash Price |
$3,674.13
|
| Rate for Payer: Cofinity Commercial |
$3,949.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,674.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,148.16
|
| Rate for Payer: Healthscope Commercial |
$4,133.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,444.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,205.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,320.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,903.76
|
| Rate for Payer: Nomi Health Commercial |
$3,765.98
|
| Rate for Payer: PACE Senior Care Partners |
$1,090.76
|
| Rate for Payer: PACE SWMI |
$1,148.16
|
| Rate for Payer: PHP Commercial |
$3,903.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,148.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,985.23
|
| Rate for Payer: Priority Health HMO/PPO |
$3,995.61
|
| Rate for Payer: Priority Health Medicare |
$1,159.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,077.08
|
| Rate for Payer: Railroad Medicare Medicare |
$1,148.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,041.54
|
| Rate for Payer: UHC Core |
$3,834.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,148.16
|
| Rate for Payer: UHC Exchange |
$1,148.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,148.16
|
| Rate for Payer: VA VA |
$1,148.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,444.49
|
|
|
HC TIER 2 TRAUMA RESUSCITATION
|
Facility
|
IP
|
$4,592.66
|
|
| Hospital Charge Code |
68200001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$2,985.23 |
| Max. Negotiated Rate |
$4,133.39 |
| Rate for Payer: Aetna Commercial |
$3,903.76
|
| Rate for Payer: BCBS Trust/PPO |
$3,748.99
|
| Rate for Payer: BCN Commercial |
$3,549.21
|
| Rate for Payer: Cash Price |
$3,674.13
|
| Rate for Payer: Cofinity Commercial |
$3,949.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,674.13
|
| Rate for Payer: Healthscope Commercial |
$4,133.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,444.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,903.76
|
| Rate for Payer: Nomi Health Commercial |
$3,765.98
|
| Rate for Payer: PHP Commercial |
$3,903.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,985.23
|
| Rate for Payer: Priority Health HMO/PPO |
$3,995.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,077.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,041.54
|
| Rate for Payer: UHC Core |
$3,834.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,444.49
|
|
|
HC TIER 3 TRAUMA CONSULT
|
Facility
|
OP
|
$3,503.03
|
|
| Hospital Charge Code |
68100002
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$831.97 |
| Max. Negotiated Rate |
$3,152.73 |
| Rate for Payer: Aetna Commercial |
$2,977.58
|
| Rate for Payer: Aetna Medicare |
$910.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,094.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,094.70
|
| Rate for Payer: BCBS Complete |
$1,401.21
|
| Rate for Payer: BCBS MAPPO |
$875.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,879.84
|
| Rate for Payer: BCN Commercial |
$2,723.61
|
| Rate for Payer: BCN Medicare Advantage |
$875.76
|
| Rate for Payer: Cash Price |
$2,802.42
|
| Rate for Payer: Cofinity Commercial |
$3,012.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,802.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$875.76
|
| Rate for Payer: Healthscope Commercial |
$3,152.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,627.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$919.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,007.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,977.58
|
| Rate for Payer: Nomi Health Commercial |
$2,872.48
|
| Rate for Payer: PACE Senior Care Partners |
$831.97
|
| Rate for Payer: PACE SWMI |
$875.76
|
| Rate for Payer: PHP Commercial |
$2,977.58
|
| Rate for Payer: PHP Medicare Advantage |
$875.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,276.97
|
| Rate for Payer: Priority Health HMO/PPO |
$3,047.64
|
| Rate for Payer: Priority Health Medicare |
$884.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,347.03
|
| Rate for Payer: Railroad Medicare Medicare |
$875.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,082.67
|
| Rate for Payer: UHC Core |
$2,925.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$875.76
|
| Rate for Payer: UHC Exchange |
$875.76
|
| Rate for Payer: UHC Medicare Advantage |
$875.76
|
| Rate for Payer: VA VA |
$875.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,627.27
|
|
|
HC TIER 3 TRAUMA CONSULT
|
Facility
|
IP
|
$3,503.03
|
|
| Hospital Charge Code |
68100002
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$2,276.97 |
| Max. Negotiated Rate |
$3,152.73 |
| Rate for Payer: Aetna Commercial |
$2,977.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,859.52
|
| Rate for Payer: BCN Commercial |
$2,707.14
|
| Rate for Payer: Cash Price |
$2,802.42
|
| Rate for Payer: Cofinity Commercial |
$3,012.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,802.42
|
| Rate for Payer: Healthscope Commercial |
$3,152.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,627.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,977.58
|
| Rate for Payer: Nomi Health Commercial |
$2,872.48
|
| Rate for Payer: PHP Commercial |
$2,977.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,276.97
|
| Rate for Payer: Priority Health HMO/PPO |
$3,047.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,347.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,082.67
|
| Rate for Payer: UHC Core |
$2,925.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,627.27
|
|
|
HC TIER 4 TRAUMA CONSULT
|
Facility
|
IP
|
$2,672.79
|
|
| Hospital Charge Code |
68100003
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$1,737.31 |
| Max. Negotiated Rate |
$2,405.51 |
| Rate for Payer: Aetna Commercial |
$2,271.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,181.80
|
| Rate for Payer: BCN Commercial |
$2,065.53
|
| Rate for Payer: Cash Price |
$2,138.23
|
| Rate for Payer: Cofinity Commercial |
$2,298.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,138.23
|
| Rate for Payer: Healthscope Commercial |
$2,405.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,004.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,271.87
|
| Rate for Payer: Nomi Health Commercial |
$2,191.69
|
| Rate for Payer: PHP Commercial |
$2,271.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,737.31
|
| Rate for Payer: Priority Health HMO/PPO |
$2,325.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,790.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,352.06
|
| Rate for Payer: UHC Core |
$2,231.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,004.59
|
|
|
HC TIER 4 TRAUMA CONSULT
|
Facility
|
OP
|
$2,672.79
|
|
| Hospital Charge Code |
68100003
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$634.79 |
| Max. Negotiated Rate |
$2,405.51 |
| Rate for Payer: Aetna Commercial |
$2,271.87
|
| Rate for Payer: Aetna Medicare |
$694.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$835.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$835.25
|
| Rate for Payer: BCBS Complete |
$1,069.12
|
| Rate for Payer: BCBS MAPPO |
$668.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,197.30
|
| Rate for Payer: BCN Commercial |
$2,078.09
|
| Rate for Payer: BCN Medicare Advantage |
$668.20
|
| Rate for Payer: Cash Price |
$2,138.23
|
| Rate for Payer: Cofinity Commercial |
$2,298.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,138.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$668.20
|
| Rate for Payer: Healthscope Commercial |
$2,405.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,004.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$701.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$768.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,271.87
|
| Rate for Payer: Nomi Health Commercial |
$2,191.69
|
| Rate for Payer: PACE Senior Care Partners |
$634.79
|
| Rate for Payer: PACE SWMI |
$668.20
|
| Rate for Payer: PHP Commercial |
$2,271.87
|
| Rate for Payer: PHP Medicare Advantage |
$668.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,737.31
|
| Rate for Payer: Priority Health HMO/PPO |
$2,325.33
|
| Rate for Payer: Priority Health Medicare |
$674.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,790.77
|
| Rate for Payer: Railroad Medicare Medicare |
$668.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,352.06
|
| Rate for Payer: UHC Core |
$2,231.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$668.20
|
| Rate for Payer: UHC Exchange |
$668.20
|
| Rate for Payer: UHC Medicare Advantage |
$668.20
|
| Rate for Payer: VA VA |
$668.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,004.59
|
|
