|
HC VASOPNEUMATIC TREATMENT
|
Facility
|
IP
|
$74.91
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
43000017
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$48.69 |
| Max. Negotiated Rate |
$67.42 |
| Rate for Payer: Aetna Commercial |
$63.67
|
| Rate for Payer: BCBS Trust/PPO |
$61.15
|
| Rate for Payer: BCN Commercial |
$57.89
|
| Rate for Payer: Cash Price |
$59.93
|
| Rate for Payer: Cofinity Commercial |
$64.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.93
|
| Rate for Payer: Healthscope Commercial |
$67.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.67
|
| Rate for Payer: Nomi Health Commercial |
$61.43
|
| Rate for Payer: PHP Commercial |
$63.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.69
|
| Rate for Payer: Priority Health HMO/PPO |
$65.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.92
|
| Rate for Payer: UHC Core |
$62.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.18
|
|
|
HC VDRL SPINAL FLUID
|
Facility
|
IP
|
$35.37
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200216
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: BCBS Trust/PPO |
$28.87
|
| Rate for Payer: BCN Commercial |
$27.33
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health HMO/PPO |
$30.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.13
|
| Rate for Payer: UHC Core |
$29.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC VDRL SPINAL FLUID
|
Facility
|
OP
|
$35.37
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200216
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna Medicare |
$9.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.05
|
| Rate for Payer: BCBS Complete |
$3.24
|
| Rate for Payer: BCBS MAPPO |
$8.84
|
| Rate for Payer: BCBS Trust/PPO |
$29.08
|
| Rate for Payer: BCN Commercial |
$27.50
|
| Rate for Payer: BCN Medicare Advantage |
$8.84
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.84
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Mclaren Medicaid |
$3.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.28
|
| Rate for Payer: Meridian Medicaid |
$3.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: PACE Senior Care Partners |
$8.40
|
| Rate for Payer: PACE SWMI |
$8.84
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: PHP Medicare Advantage |
$8.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health HMO/PPO |
$30.77
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.70
|
| Rate for Payer: Railroad Medicare Medicare |
$8.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.13
|
| Rate for Payer: UHC Core |
$29.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.84
|
| Rate for Payer: UHC Exchange |
$8.84
|
| Rate for Payer: UHC Medicare Advantage |
$8.84
|
| Rate for Payer: UHCCP Medicaid |
$3.09
|
| Rate for Payer: VA VA |
$8.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC VDRL TITER CSF
|
Facility
|
IP
|
$75.48
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
30200397
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.06 |
| Max. Negotiated Rate |
$67.93 |
| Rate for Payer: Aetna Commercial |
$64.16
|
| Rate for Payer: BCBS Trust/PPO |
$61.61
|
| Rate for Payer: BCN Commercial |
$58.33
|
| Rate for Payer: Cash Price |
$60.38
|
| Rate for Payer: Cofinity Commercial |
$64.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.38
|
| Rate for Payer: Healthscope Commercial |
$67.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.16
|
| Rate for Payer: Nomi Health Commercial |
$61.89
|
| Rate for Payer: PHP Commercial |
$64.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.06
|
| Rate for Payer: Priority Health HMO/PPO |
$65.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.42
|
| Rate for Payer: UHC Core |
$63.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.61
|
|
|
HC VDRL TITER CSF
|
Facility
|
OP
|
$75.48
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
30200397
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$67.93 |
| Rate for Payer: Aetna Commercial |
$64.16
|
| Rate for Payer: Aetna Medicare |
$19.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.59
|
| Rate for Payer: BCBS Complete |
$3.34
|
| Rate for Payer: BCBS MAPPO |
$18.87
|
| Rate for Payer: BCBS Trust/PPO |
$62.05
|
| Rate for Payer: BCN Commercial |
$58.69
|
| Rate for Payer: BCN Medicare Advantage |
$18.87
|
| Rate for Payer: Cash Price |
$60.38
|
| Rate for Payer: Cash Price |
$60.38
|
| Rate for Payer: Cofinity Commercial |
$64.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.87
|
| Rate for Payer: Healthscope Commercial |
$67.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.61
|
| Rate for Payer: Mclaren Medicaid |
$3.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.81
|
| Rate for Payer: Meridian Medicaid |
$3.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.16
|
| Rate for Payer: Nomi Health Commercial |
$61.89
|
| Rate for Payer: PACE Senior Care Partners |
$17.93
|
| Rate for Payer: PACE SWMI |
$18.87
|
| Rate for Payer: PHP Commercial |
$64.16
|
| Rate for Payer: PHP Medicare Advantage |
$18.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.06
|
| Rate for Payer: Priority Health HMO/PPO |
$65.67
|
| Rate for Payer: Priority Health Medicare |
$19.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.57
|
| Rate for Payer: Railroad Medicare Medicare |
$18.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.42
|
| Rate for Payer: UHC Core |
$63.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.87
|
| Rate for Payer: UHC Exchange |
$18.87
|
| Rate for Payer: UHC Medicare Advantage |
$18.87
|
| Rate for Payer: UHCCP Medicaid |
$3.18
|
| Rate for Payer: VA VA |
$18.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.61
|
|
|
HC VEDOLIZUMAB
|
Facility
|
OP
|
$166.26
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100671
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$149.63 |
| Rate for Payer: Aetna Commercial |
$141.32
|
| Rate for Payer: Aetna Medicare |
$43.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.96
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$41.56
|
| Rate for Payer: BCBS Trust/PPO |
$136.68
|
| Rate for Payer: BCN Commercial |
$129.27
|
| Rate for Payer: BCN Medicare Advantage |
$41.56
|
| Rate for Payer: Cash Price |
$133.01
|
| Rate for Payer: Cash Price |
$133.01
|
| Rate for Payer: Cofinity Commercial |
$142.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.56
|
| Rate for Payer: Healthscope Commercial |
$149.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.70
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.64
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.32
|
| Rate for Payer: Nomi Health Commercial |
$136.33
|
| Rate for Payer: PACE Senior Care Partners |
$39.49
|
| Rate for Payer: PACE SWMI |
$41.56
|
| Rate for Payer: PHP Commercial |
$141.32
|
| Rate for Payer: PHP Medicare Advantage |
$41.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.07
|
| Rate for Payer: Priority Health HMO/PPO |
$144.65
|
| Rate for Payer: Priority Health Medicare |
$41.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.39
|
| Rate for Payer: Railroad Medicare Medicare |
$41.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.31
|
| Rate for Payer: UHC Core |
$138.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.56
|
| Rate for Payer: UHC Exchange |
$41.56
|
| Rate for Payer: UHC Medicare Advantage |
$41.56
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$41.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.70
|
|
|
HC VEDOLIZUMAB
|
Facility
|
IP
|
$166.26
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100671
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$108.07 |
| Max. Negotiated Rate |
$149.63 |
| Rate for Payer: Aetna Commercial |
$141.32
|
| Rate for Payer: BCBS Trust/PPO |
$135.72
|
| Rate for Payer: BCN Commercial |
$128.49
|
| Rate for Payer: Cash Price |
$133.01
|
| Rate for Payer: Cofinity Commercial |
$142.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.01
|
| Rate for Payer: Healthscope Commercial |
$149.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.32
|
| Rate for Payer: Nomi Health Commercial |
$136.33
|
| Rate for Payer: PHP Commercial |
$141.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.07
|
| Rate for Payer: Priority Health HMO/PPO |
$144.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.31
|
| Rate for Payer: UHC Core |
$138.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.70
|
|
|
HC VEDOLIZUMAB, ANTIBODY
|
Facility
|
OP
|
$131.58
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
30100683
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.21 |
| Max. Negotiated Rate |
$118.42 |
| Rate for Payer: Aetna Commercial |
$111.84
|
| Rate for Payer: Aetna Medicare |
$34.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.12
|
| Rate for Payer: BCBS Complete |
$10.72
|
| Rate for Payer: BCBS MAPPO |
$32.90
|
| Rate for Payer: BCBS Trust/PPO |
$108.17
|
| Rate for Payer: BCN Commercial |
$102.30
|
| Rate for Payer: BCN Medicare Advantage |
$32.90
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cofinity Commercial |
$113.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.90
|
| Rate for Payer: Healthscope Commercial |
$118.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.68
|
| Rate for Payer: Mclaren Medicaid |
$10.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.54
|
| Rate for Payer: Meridian Medicaid |
$10.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.84
|
| Rate for Payer: Nomi Health Commercial |
$107.90
|
| Rate for Payer: PACE Senior Care Partners |
$31.25
|
| Rate for Payer: PACE SWMI |
$32.90
|
| Rate for Payer: PHP Commercial |
$111.84
|
| Rate for Payer: PHP Medicare Advantage |
$32.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.53
|
| Rate for Payer: Priority Health HMO/PPO |
$114.47
|
| Rate for Payer: Priority Health Medicare |
$33.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.16
|
| Rate for Payer: Railroad Medicare Medicare |
$32.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.79
|
| Rate for Payer: UHC Core |
$109.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.90
|
| Rate for Payer: UHC Exchange |
$32.90
|
| Rate for Payer: UHC Medicare Advantage |
$32.90
|
| Rate for Payer: UHCCP Medicaid |
$10.21
|
| Rate for Payer: VA VA |
$32.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.68
|
|
|
HC VEDOLIZUMAB, ANTIBODY
|
Facility
|
IP
|
$131.58
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
30100683
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$85.53 |
| Max. Negotiated Rate |
$118.42 |
| Rate for Payer: Aetna Commercial |
$111.84
|
| Rate for Payer: BCBS Trust/PPO |
$107.41
|
| Rate for Payer: BCN Commercial |
$101.69
|
| Rate for Payer: Cash Price |
$105.26
|
| Rate for Payer: Cofinity Commercial |
$113.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.26
|
| Rate for Payer: Healthscope Commercial |
$118.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.84
|
| Rate for Payer: Nomi Health Commercial |
$107.90
|
| Rate for Payer: PHP Commercial |
$111.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.53
|
| Rate for Payer: Priority Health HMO/PPO |
$114.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.79
|
| Rate for Payer: UHC Core |
$109.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.68
|
|
|
HC VEDOLIZUMAB CMPT
|
Facility
|
OP
|
$130.56
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100672
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.48 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: Aetna Medicare |
$33.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.80
|
| Rate for Payer: BCBS Complete |
$14.15
|
| Rate for Payer: BCBS MAPPO |
$32.64
|
| Rate for Payer: BCBS Trust/PPO |
$107.33
|
| Rate for Payer: BCN Commercial |
$101.51
|
| Rate for Payer: BCN Medicare Advantage |
$32.64
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.92
|
| Rate for Payer: Mclaren Medicaid |
$13.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.27
|
| Rate for Payer: Meridian Medicaid |
$14.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.98
|
| Rate for Payer: Nomi Health Commercial |
$107.06
|
| Rate for Payer: PACE Senior Care Partners |
$31.01
|
| Rate for Payer: PACE SWMI |
$32.64
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: PHP Medicare Advantage |
$32.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.86
|
| Rate for Payer: Priority Health HMO/PPO |
$113.59
|
| Rate for Payer: Priority Health Medicare |
$32.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.48
|
| Rate for Payer: Railroad Medicare Medicare |
$32.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.89
|
| Rate for Payer: UHC Core |
$109.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.64
|
| Rate for Payer: UHC Exchange |
$32.64
|
| Rate for Payer: UHC Medicare Advantage |
$32.64
|
| Rate for Payer: UHCCP Medicaid |
$13.48
|
| Rate for Payer: VA VA |
$32.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.92
|
|
|
HC VEDOLIZUMAB CMPT
|
Facility
|
IP
|
$130.56
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100672
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$84.86 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: BCBS Trust/PPO |
$106.58
|
| Rate for Payer: BCN Commercial |
$100.90
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.98
|
| Rate for Payer: Nomi Health Commercial |
$107.06
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.86
|
| Rate for Payer: Priority Health HMO/PPO |
$113.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.89
|
| Rate for Payer: UHC Core |
$109.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.92
|
|
|
HC VEDOLIZUMAB, S
|
Facility
|
OP
|
$248.88
|
|
|
Service Code
|
CPT 80280
|
| Hospital Charge Code |
30100706
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.89 |
| Max. Negotiated Rate |
$223.99 |
| Rate for Payer: Aetna Commercial |
$211.55
|
| Rate for Payer: Aetna Medicare |
$64.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.78
|
| Rate for Payer: BCBS Complete |
$29.28
|
| Rate for Payer: BCBS MAPPO |
$62.22
|
| Rate for Payer: BCBS Trust/PPO |
$204.60
|
| Rate for Payer: BCN Commercial |
$193.50
|
| Rate for Payer: BCN Medicare Advantage |
$62.22
|
| Rate for Payer: Cash Price |
$199.10
|
| Rate for Payer: Cash Price |
$199.10
|
| Rate for Payer: Cofinity Commercial |
$214.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.22
|
| Rate for Payer: Healthscope Commercial |
$223.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.66
|
| Rate for Payer: Mclaren Medicaid |
$27.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.33
|
| Rate for Payer: Meridian Medicaid |
$29.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.55
|
| Rate for Payer: Nomi Health Commercial |
$204.08
|
| Rate for Payer: PACE Senior Care Partners |
$59.11
|
| Rate for Payer: PACE SWMI |
$62.22
|
| Rate for Payer: PHP Commercial |
$211.55
|
| Rate for Payer: PHP Medicare Advantage |
$62.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.77
|
| Rate for Payer: Priority Health HMO/PPO |
$216.53
|
| Rate for Payer: Priority Health Medicare |
$62.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.75
|
| Rate for Payer: Railroad Medicare Medicare |
$62.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.01
|
| Rate for Payer: UHC Core |
$207.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.22
|
| Rate for Payer: UHC Exchange |
$62.22
|
| Rate for Payer: UHC Medicare Advantage |
$62.22
|
| Rate for Payer: UHCCP Medicaid |
$27.89
|
| Rate for Payer: VA VA |
$62.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.66
|
|
|
HC VEDOLIZUMAB, S
|
Facility
|
IP
|
$248.88
|
|
|
Service Code
|
CPT 80280
|
| Hospital Charge Code |
30100706
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$161.77 |
| Max. Negotiated Rate |
$223.99 |
| Rate for Payer: Aetna Commercial |
$211.55
|
| Rate for Payer: BCBS Trust/PPO |
$203.16
|
| Rate for Payer: BCN Commercial |
$192.33
|
| Rate for Payer: Cash Price |
$199.10
|
| Rate for Payer: Cofinity Commercial |
$214.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.10
|
| Rate for Payer: Healthscope Commercial |
$223.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.55
|
| Rate for Payer: Nomi Health Commercial |
$204.08
|
| Rate for Payer: PHP Commercial |
$211.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.77
|
| Rate for Payer: Priority Health HMO/PPO |
$216.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.01
|
| Rate for Payer: UHC Core |
$207.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.66
|
|
|
HC VEEG 12-26 HR UNMONITORED
|
Facility
|
IP
|
$1,021.26
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
74000027
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$663.82 |
| Max. Negotiated Rate |
$919.13 |
| Rate for Payer: Aetna Commercial |
$868.07
|
| Rate for Payer: BCBS Trust/PPO |
$833.65
|
| Rate for Payer: BCN Commercial |
$789.23
|
| Rate for Payer: Cash Price |
$817.01
|
| Rate for Payer: Cofinity Commercial |
$878.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.01
|
| Rate for Payer: Healthscope Commercial |
$919.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.07
|
| Rate for Payer: Nomi Health Commercial |
$837.43
|
| Rate for Payer: PHP Commercial |
$868.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.82
|
| Rate for Payer: Priority Health HMO/PPO |
$888.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$898.71
|
| Rate for Payer: UHC Core |
$852.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.94
|
|
|
HC VEEG 12-26 HR UNMONITORED
|
Facility
|
OP
|
$1,021.26
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
74000027
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$242.55 |
| Max. Negotiated Rate |
$919.13 |
| Rate for Payer: Aetna Commercial |
$868.07
|
| Rate for Payer: Aetna Medicare |
$265.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$319.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$319.14
|
| Rate for Payer: BCBS Complete |
$394.69
|
| Rate for Payer: BCBS MAPPO |
$255.32
|
| Rate for Payer: BCBS Trust/PPO |
$839.58
|
| Rate for Payer: BCN Commercial |
$794.03
|
| Rate for Payer: BCN Medicare Advantage |
$255.32
|
| Rate for Payer: Cash Price |
$817.01
|
| Rate for Payer: Cash Price |
$817.01
|
| Rate for Payer: Cofinity Commercial |
$878.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$817.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.32
|
| Rate for Payer: Healthscope Commercial |
$919.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.94
|
| Rate for Payer: Mclaren Medicaid |
$375.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$268.08
|
| Rate for Payer: Meridian Medicaid |
$394.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$293.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$868.07
|
| Rate for Payer: Nomi Health Commercial |
$837.43
|
| Rate for Payer: PACE Senior Care Partners |
$242.55
|
| Rate for Payer: PACE SWMI |
$255.32
|
| Rate for Payer: PHP Commercial |
$868.07
|
| Rate for Payer: PHP Medicare Advantage |
$255.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.82
|
| Rate for Payer: Priority Health HMO/PPO |
$888.50
|
| Rate for Payer: Priority Health Medicare |
$257.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$684.24
|
| Rate for Payer: Railroad Medicare Medicare |
$255.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$898.71
|
| Rate for Payer: UHC Core |
$852.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.32
|
| Rate for Payer: UHC Exchange |
$255.32
|
| Rate for Payer: UHC Medicare Advantage |
$255.32
|
| Rate for Payer: UHCCP Medicaid |
$375.87
|
| Rate for Payer: VA VA |
$255.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.94
|
|
|
HC VEEG 2-12 HR CONT MNTR
|
Facility
|
IP
|
$2,441.96
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
74000023
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,587.27 |
| Max. Negotiated Rate |
$2,197.76 |
| Rate for Payer: Aetna Commercial |
$2,075.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,993.37
|
| Rate for Payer: BCN Commercial |
$1,887.15
|
| Rate for Payer: Cash Price |
$1,953.57
|
| Rate for Payer: Cofinity Commercial |
$2,100.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,953.57
|
| Rate for Payer: Healthscope Commercial |
$2,197.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,831.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,075.67
|
| Rate for Payer: Nomi Health Commercial |
$2,002.41
|
| Rate for Payer: PHP Commercial |
$2,075.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.27
|
| Rate for Payer: Priority Health HMO/PPO |
$2,124.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,636.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,148.92
|
| Rate for Payer: UHC Core |
$2,039.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,831.47
|
|
|
HC VEEG 2-12 HR CONT MNTR
|
Facility
|
OP
|
$2,441.96
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
74000023
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$375.87 |
| Max. Negotiated Rate |
$2,197.76 |
| Rate for Payer: Aetna Commercial |
$2,075.67
|
| Rate for Payer: Aetna Medicare |
$634.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$763.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$763.11
|
| Rate for Payer: BCBS Complete |
$394.69
|
| Rate for Payer: BCBS MAPPO |
$610.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,007.54
|
| Rate for Payer: BCN Commercial |
$1,898.62
|
| Rate for Payer: BCN Medicare Advantage |
$610.49
|
| Rate for Payer: Cash Price |
$1,953.57
|
| Rate for Payer: Cash Price |
$1,953.57
|
| Rate for Payer: Cofinity Commercial |
$2,100.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,953.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$610.49
|
| Rate for Payer: Healthscope Commercial |
$2,197.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,831.47
|
| Rate for Payer: Mclaren Medicaid |
$375.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$641.01
|
| Rate for Payer: Meridian Medicaid |
$394.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$702.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,075.67
|
| Rate for Payer: Nomi Health Commercial |
$2,002.41
|
| Rate for Payer: PACE Senior Care Partners |
$579.97
|
| Rate for Payer: PACE SWMI |
$610.49
|
| Rate for Payer: PHP Commercial |
$2,075.67
|
| Rate for Payer: PHP Medicare Advantage |
$610.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.27
|
| Rate for Payer: Priority Health HMO/PPO |
$2,124.51
|
| Rate for Payer: Priority Health Medicare |
$616.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,636.11
|
| Rate for Payer: Railroad Medicare Medicare |
$610.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,148.92
|
| Rate for Payer: UHC Core |
$2,039.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$610.49
|
| Rate for Payer: UHC Exchange |
$610.49
|
| Rate for Payer: UHC Medicare Advantage |
$610.49
|
| Rate for Payer: UHCCP Medicaid |
$375.87
|
| Rate for Payer: VA VA |
$610.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,831.47
|
|
|
HC VEEG 2-12 HR INTMT MNTR
|
Facility
|
IP
|
$1,072.90
|
|
|
Service Code
|
CPT 95712
|
| Hospital Charge Code |
74000022
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$697.38 |
| Max. Negotiated Rate |
$965.61 |
| Rate for Payer: Aetna Commercial |
$911.96
|
| Rate for Payer: BCBS Trust/PPO |
$875.81
|
| Rate for Payer: BCN Commercial |
$829.14
|
| Rate for Payer: Cash Price |
$858.32
|
| Rate for Payer: Cofinity Commercial |
$922.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.32
|
| Rate for Payer: Healthscope Commercial |
$965.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$911.96
|
| Rate for Payer: Nomi Health Commercial |
$879.78
|
| Rate for Payer: PHP Commercial |
$911.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.38
|
| Rate for Payer: Priority Health HMO/PPO |
$933.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$718.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.15
|
| Rate for Payer: UHC Core |
$895.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.68
|
|
|
HC VEEG 2-12 HR INTMT MNTR
|
Facility
|
OP
|
$1,072.90
|
|
|
Service Code
|
CPT 95712
|
| Hospital Charge Code |
74000022
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$220.59 |
| Max. Negotiated Rate |
$965.61 |
| Rate for Payer: Aetna Commercial |
$911.96
|
| Rate for Payer: Aetna Medicare |
$278.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$335.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$335.28
|
| Rate for Payer: BCBS Complete |
$231.63
|
| Rate for Payer: BCBS MAPPO |
$268.22
|
| Rate for Payer: BCBS Trust/PPO |
$882.03
|
| Rate for Payer: BCN Commercial |
$834.18
|
| Rate for Payer: BCN Medicare Advantage |
$268.22
|
| Rate for Payer: Cash Price |
$858.32
|
| Rate for Payer: Cash Price |
$858.32
|
| Rate for Payer: Cofinity Commercial |
$922.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.22
|
| Rate for Payer: Healthscope Commercial |
$965.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.68
|
| Rate for Payer: Mclaren Medicaid |
$220.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.64
|
| Rate for Payer: Meridian Medicaid |
$231.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$911.96
|
| Rate for Payer: Nomi Health Commercial |
$879.78
|
| Rate for Payer: PACE Senior Care Partners |
$254.81
|
| Rate for Payer: PACE SWMI |
$268.22
|
| Rate for Payer: PHP Commercial |
$911.96
|
| Rate for Payer: PHP Medicare Advantage |
$268.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.38
|
| Rate for Payer: Priority Health HMO/PPO |
$933.42
|
| Rate for Payer: Priority Health Medicare |
$270.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$718.84
|
| Rate for Payer: Railroad Medicare Medicare |
$268.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$944.15
|
| Rate for Payer: UHC Core |
$895.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$268.22
|
| Rate for Payer: UHC Exchange |
$268.22
|
| Rate for Payer: UHC Medicare Advantage |
$268.22
|
| Rate for Payer: UHCCP Medicaid |
$220.59
|
| Rate for Payer: VA VA |
$268.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.68
|
|
|
HC VEEG 2-12 HR UNMONITORED
|
Facility
|
OP
|
$1,959.46
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
74000026
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$220.59 |
| Max. Negotiated Rate |
$1,763.51 |
| Rate for Payer: Aetna Commercial |
$1,665.54
|
| Rate for Payer: Aetna Medicare |
$509.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$612.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$612.33
|
| Rate for Payer: BCBS Complete |
$231.63
|
| Rate for Payer: BCBS MAPPO |
$489.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,610.87
|
| Rate for Payer: BCN Commercial |
$1,523.48
|
| Rate for Payer: BCN Medicare Advantage |
$489.86
|
| Rate for Payer: Cash Price |
$1,567.57
|
| Rate for Payer: Cash Price |
$1,567.57
|
| Rate for Payer: Cofinity Commercial |
$1,685.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.86
|
| Rate for Payer: Healthscope Commercial |
$1,763.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,469.60
|
| Rate for Payer: Mclaren Medicaid |
$220.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$514.36
|
| Rate for Payer: Meridian Medicaid |
$231.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$563.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.54
|
| Rate for Payer: Nomi Health Commercial |
$1,606.76
|
| Rate for Payer: PACE Senior Care Partners |
$465.37
|
| Rate for Payer: PACE SWMI |
$489.86
|
| Rate for Payer: PHP Commercial |
$1,665.54
|
| Rate for Payer: PHP Medicare Advantage |
$489.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$220.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,704.73
|
| Rate for Payer: Priority Health Medicare |
$494.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,312.84
|
| Rate for Payer: Railroad Medicare Medicare |
$489.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,724.32
|
| Rate for Payer: UHC Core |
$1,636.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.86
|
| Rate for Payer: UHC Exchange |
$489.86
|
| Rate for Payer: UHC Medicare Advantage |
$489.86
|
| Rate for Payer: UHCCP Medicaid |
$220.59
|
| Rate for Payer: VA VA |
$489.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,469.60
|
|
|
HC VEEG 2-12 HR UNMONITORED
|
Facility
|
IP
|
$1,959.46
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
74000026
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,273.65 |
| Max. Negotiated Rate |
$1,763.51 |
| Rate for Payer: Aetna Commercial |
$1,665.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,599.51
|
| Rate for Payer: BCN Commercial |
$1,514.27
|
| Rate for Payer: Cash Price |
$1,567.57
|
| Rate for Payer: Cofinity Commercial |
$1,685.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.57
|
| Rate for Payer: Healthscope Commercial |
$1,763.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,469.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.54
|
| Rate for Payer: Nomi Health Commercial |
$1,606.76
|
| Rate for Payer: PHP Commercial |
$1,665.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,704.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,312.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,724.32
|
| Rate for Payer: UHC Core |
$1,636.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,469.60
|
|
|
HC VEEG EA 12-26 HR CONT MNTR
|
Facility
|
IP
|
$4,552.18
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
74000025
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$2,958.92 |
| Max. Negotiated Rate |
$4,096.96 |
| Rate for Payer: Aetna Commercial |
$3,869.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,715.94
|
| Rate for Payer: BCN Commercial |
$3,517.92
|
| Rate for Payer: Cash Price |
$3,641.74
|
| Rate for Payer: Cofinity Commercial |
$3,914.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,641.74
|
| Rate for Payer: Healthscope Commercial |
$4,096.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,414.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,869.35
|
| Rate for Payer: Nomi Health Commercial |
$3,732.79
|
| Rate for Payer: PHP Commercial |
$3,869.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,958.92
|
| Rate for Payer: Priority Health HMO/PPO |
$3,960.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,049.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,005.92
|
| Rate for Payer: UHC Core |
$3,801.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,414.14
|
|
|
HC VEEG EA 12-26 HR CONT MNTR
|
Facility
|
OP
|
$4,552.18
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
74000025
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$720.70 |
| Max. Negotiated Rate |
$4,096.96 |
| Rate for Payer: Aetna Commercial |
$3,869.35
|
| Rate for Payer: Aetna Medicare |
$1,183.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,422.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,422.56
|
| Rate for Payer: BCBS Complete |
$756.79
|
| Rate for Payer: BCBS MAPPO |
$1,138.04
|
| Rate for Payer: BCBS Trust/PPO |
$3,742.35
|
| Rate for Payer: BCN Commercial |
$3,539.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,138.04
|
| Rate for Payer: Cash Price |
$3,641.74
|
| Rate for Payer: Cash Price |
$3,641.74
|
| Rate for Payer: Cofinity Commercial |
$3,914.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,641.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,138.04
|
| Rate for Payer: Healthscope Commercial |
$4,096.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,414.14
|
| Rate for Payer: Mclaren Medicaid |
$720.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,194.95
|
| Rate for Payer: Meridian Medicaid |
$756.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,308.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,869.35
|
| Rate for Payer: Nomi Health Commercial |
$3,732.79
|
| Rate for Payer: PACE Senior Care Partners |
$1,081.14
|
| Rate for Payer: PACE SWMI |
$1,138.04
|
| Rate for Payer: PHP Commercial |
$3,869.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,138.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$720.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,958.92
|
| Rate for Payer: Priority Health HMO/PPO |
$3,960.40
|
| Rate for Payer: Priority Health Medicare |
$1,149.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,049.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,138.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,005.92
|
| Rate for Payer: UHC Core |
$3,801.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,138.04
|
| Rate for Payer: UHC Exchange |
$1,138.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,138.04
|
| Rate for Payer: UHCCP Medicaid |
$720.70
|
| Rate for Payer: VA VA |
$1,138.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,414.14
|
|
|
HC VEEG EA 12-26 HR INTMT MNTR
|
Facility
|
OP
|
$2,421.79
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
74000024
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$375.87 |
| Max. Negotiated Rate |
$2,179.61 |
| Rate for Payer: Aetna Commercial |
$2,058.52
|
| Rate for Payer: Aetna Medicare |
$629.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$756.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$756.81
|
| Rate for Payer: BCBS Complete |
$394.69
|
| Rate for Payer: BCBS MAPPO |
$605.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,990.95
|
| Rate for Payer: BCN Commercial |
$1,882.94
|
| Rate for Payer: BCN Medicare Advantage |
$605.45
|
| Rate for Payer: Cash Price |
$1,937.43
|
| Rate for Payer: Cash Price |
$1,937.43
|
| Rate for Payer: Cofinity Commercial |
$2,082.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,937.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.45
|
| Rate for Payer: Healthscope Commercial |
$2,179.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,816.34
|
| Rate for Payer: Mclaren Medicaid |
$375.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$635.72
|
| Rate for Payer: Meridian Medicaid |
$394.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$696.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,058.52
|
| Rate for Payer: Nomi Health Commercial |
$1,985.87
|
| Rate for Payer: PACE Senior Care Partners |
$575.18
|
| Rate for Payer: PACE SWMI |
$605.45
|
| Rate for Payer: PHP Commercial |
$2,058.52
|
| Rate for Payer: PHP Medicare Advantage |
$605.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$375.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,574.16
|
| Rate for Payer: Priority Health HMO/PPO |
$2,106.96
|
| Rate for Payer: Priority Health Medicare |
$611.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,622.60
|
| Rate for Payer: Railroad Medicare Medicare |
$605.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,131.18
|
| Rate for Payer: UHC Core |
$2,022.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.45
|
| Rate for Payer: UHC Exchange |
$605.45
|
| Rate for Payer: UHC Medicare Advantage |
$605.45
|
| Rate for Payer: UHCCP Medicaid |
$375.87
|
| Rate for Payer: VA VA |
$605.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,816.34
|
|
|
HC VEEG EA 12-26 HR INTMT MNTR
|
Facility
|
IP
|
$2,421.79
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
74000024
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,574.16 |
| Max. Negotiated Rate |
$2,179.61 |
| Rate for Payer: Aetna Commercial |
$2,058.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,976.91
|
| Rate for Payer: BCN Commercial |
$1,871.56
|
| Rate for Payer: Cash Price |
$1,937.43
|
| Rate for Payer: Cofinity Commercial |
$2,082.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,937.43
|
| Rate for Payer: Healthscope Commercial |
$2,179.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,816.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,058.52
|
| Rate for Payer: Nomi Health Commercial |
$1,985.87
|
| Rate for Payer: PHP Commercial |
$2,058.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,574.16
|
| Rate for Payer: Priority Health HMO/PPO |
$2,106.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,622.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,131.18
|
| Rate for Payer: UHC Core |
$2,022.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,816.34
|
|
