|
HC ACB NEW PT LEVEL 4
|
Facility
|
OP
|
$874.52
|
|
|
Service Code
|
CPT 99204
|
| Hospital Charge Code |
51000103
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$107.15 |
| Max. Negotiated Rate |
$787.07 |
| Rate for Payer: Aetna Commercial |
$743.34
|
| Rate for Payer: Aetna Medicare |
$227.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$273.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$273.29
|
| Rate for Payer: BCBS Complete |
$349.81
|
| Rate for Payer: BCBS MAPPO |
$218.63
|
| Rate for Payer: BCBS Trust/PPO |
$679.94
|
| Rate for Payer: BCCCP Commercial |
$107.15
|
| Rate for Payer: BCN Commercial |
$679.94
|
| Rate for Payer: BCN Medicare Advantage |
$218.63
|
| Rate for Payer: Cash Price |
$699.62
|
| Rate for Payer: Cash Price |
$699.62
|
| Rate for Payer: Cofinity Commercial |
$752.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.63
|
| Rate for Payer: Healthscope Commercial |
$787.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$655.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$229.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$251.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$743.34
|
| Rate for Payer: PACE Senior Care Partners |
$207.70
|
| Rate for Payer: PACE SWMI |
$218.63
|
| Rate for Payer: PHP Commercial |
$743.34
|
| Rate for Payer: PHP Medicare Advantage |
$218.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.83
|
| Rate for Payer: Priority Health Medicare |
$218.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$533.37
|
| Rate for Payer: Railroad Medicare Medicare |
$218.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.58
|
| Rate for Payer: UHC Core |
$730.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.63
|
| Rate for Payer: UHC Medicare Advantage |
$225.19
|
| Rate for Payer: VA VA |
$218.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$655.89
|
|
|
HC ACB NEW PT LEVEL 4
|
Facility
|
IP
|
$874.52
|
|
|
Service Code
|
CPT 99204
|
| Hospital Charge Code |
51000103
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$533.37 |
| Max. Negotiated Rate |
$787.07 |
| Rate for Payer: Aetna Commercial |
$743.34
|
| Rate for Payer: BCBS Trust/PPO |
$675.83
|
| Rate for Payer: BCN Commercial |
$675.83
|
| Rate for Payer: Cash Price |
$699.62
|
| Rate for Payer: Cofinity Commercial |
$752.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.62
|
| Rate for Payer: Healthscope Commercial |
$787.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$655.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$743.34
|
| Rate for Payer: PHP Commercial |
$743.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$533.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.58
|
| Rate for Payer: UHC Core |
$730.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$655.89
|
|
|
HC ACB NEW PT LEVEL 5
|
Facility
|
IP
|
$1,042.88
|
|
|
Service Code
|
CPT 99205
|
| Hospital Charge Code |
51000104
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$636.05 |
| Max. Negotiated Rate |
$938.59 |
| Rate for Payer: Aetna Commercial |
$886.45
|
| Rate for Payer: BCBS Trust/PPO |
$805.94
|
| Rate for Payer: BCN Commercial |
$805.94
|
| Rate for Payer: Cash Price |
$834.30
|
| Rate for Payer: Cofinity Commercial |
$896.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$834.30
|
| Rate for Payer: Healthscope Commercial |
$938.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$782.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$886.45
|
| Rate for Payer: PHP Commercial |
$886.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$907.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$636.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$917.73
|
| Rate for Payer: UHC Core |
$870.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$782.16
|
|
|
HC ACB NEW PT LEVEL 5
|
Facility
|
OP
|
$1,042.88
|
|
|
Service Code
|
CPT 99205
|
| Hospital Charge Code |
51000104
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$107.15 |
| Max. Negotiated Rate |
$938.59 |
| Rate for Payer: Aetna Commercial |
$886.45
|
| Rate for Payer: Aetna Medicare |
$271.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.90
|
| Rate for Payer: BCBS Complete |
$417.15
|
| Rate for Payer: BCBS MAPPO |
$260.72
|
| Rate for Payer: BCBS Trust/PPO |
$810.84
|
| Rate for Payer: BCCCP Commercial |
$107.15
|
| Rate for Payer: BCN Commercial |
$810.84
|
| Rate for Payer: BCN Medicare Advantage |
$260.72
|
| Rate for Payer: Cash Price |
$834.30
|
| Rate for Payer: Cash Price |
$834.30
|
| Rate for Payer: Cofinity Commercial |
$896.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$834.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.72
|
| Rate for Payer: Healthscope Commercial |
$938.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$782.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$273.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$886.45
|
| Rate for Payer: PACE Senior Care Partners |
$247.68
|
| Rate for Payer: PACE SWMI |
$260.72
|
| Rate for Payer: PHP Commercial |
$886.45
|
| Rate for Payer: PHP Medicare Advantage |
$260.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$907.31
|
| Rate for Payer: Priority Health Medicare |
$260.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$636.05
|
| Rate for Payer: Railroad Medicare Medicare |
$260.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$917.73
|
| Rate for Payer: UHC Core |
$870.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.72
|
| Rate for Payer: UHC Medicare Advantage |
$268.54
|
| Rate for Payer: VA VA |
$260.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$782.16
|
|
|
HC ACCESS AORTA
|
Facility
|
IP
|
$3,843.44
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
36100105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,344.11 |
| Max. Negotiated Rate |
$3,459.10 |
| Rate for Payer: Aetna Commercial |
$3,266.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,970.21
|
| Rate for Payer: BCN Commercial |
$2,970.21
|
| Rate for Payer: Cash Price |
$3,074.75
|
| Rate for Payer: Cofinity Commercial |
$3,305.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.75
|
| Rate for Payer: Healthscope Commercial |
$3,459.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,882.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,266.92
|
| Rate for Payer: PHP Commercial |
$3,266.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,690.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,343.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,344.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,382.23
|
| Rate for Payer: UHC Core |
$3,209.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,882.58
|
|
|
HC ACCESS AORTA
|
Facility
|
OP
|
$3,843.44
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
36100105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$912.82 |
| Max. Negotiated Rate |
$3,459.10 |
| Rate for Payer: Aetna Commercial |
$3,266.92
|
| Rate for Payer: Aetna Medicare |
$999.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,201.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,201.08
|
| Rate for Payer: BCBS Complete |
$1,537.38
|
| Rate for Payer: BCBS MAPPO |
$960.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,988.27
|
| Rate for Payer: BCN Commercial |
$2,988.27
|
| Rate for Payer: BCN Medicare Advantage |
$960.86
|
| Rate for Payer: Cash Price |
$3,074.75
|
| Rate for Payer: Cofinity Commercial |
$3,305.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$960.86
|
| Rate for Payer: Healthscope Commercial |
$3,459.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,882.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,008.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,104.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,266.92
|
| Rate for Payer: PACE Senior Care Partners |
$912.82
|
| Rate for Payer: PACE SWMI |
$960.86
|
| Rate for Payer: PHP Commercial |
$3,266.92
|
| Rate for Payer: PHP Medicare Advantage |
$960.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,690.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,343.79
|
| Rate for Payer: Priority Health Medicare |
$960.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,344.11
|
| Rate for Payer: Railroad Medicare Medicare |
$960.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,382.23
|
| Rate for Payer: UHC Core |
$3,209.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$960.86
|
| Rate for Payer: UHC Medicare Advantage |
$989.69
|
| Rate for Payer: VA VA |
$960.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,882.58
|
|
|
HC ACCESS EXTREMITY ARTERY
|
Facility
|
OP
|
$491.10
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
36100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.64 |
| Max. Negotiated Rate |
$441.99 |
| Rate for Payer: Aetna Commercial |
$417.44
|
| Rate for Payer: Aetna Medicare |
$127.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.47
|
| Rate for Payer: BCBS Complete |
$196.44
|
| Rate for Payer: BCBS MAPPO |
$122.78
|
| Rate for Payer: BCBS Trust/PPO |
$381.83
|
| Rate for Payer: BCN Commercial |
$381.83
|
| Rate for Payer: BCN Medicare Advantage |
$122.78
|
| Rate for Payer: Cash Price |
$392.88
|
| Rate for Payer: Cofinity Commercial |
$422.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.78
|
| Rate for Payer: Healthscope Commercial |
$441.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$368.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$417.44
|
| Rate for Payer: PACE Senior Care Partners |
$116.64
|
| Rate for Payer: PACE SWMI |
$122.78
|
| Rate for Payer: PHP Commercial |
$417.44
|
| Rate for Payer: PHP Medicare Advantage |
$122.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$427.26
|
| Rate for Payer: Priority Health Medicare |
$122.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$299.52
|
| Rate for Payer: Railroad Medicare Medicare |
$122.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$432.17
|
| Rate for Payer: UHC Core |
$410.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.78
|
| Rate for Payer: UHC Medicare Advantage |
$126.46
|
| Rate for Payer: VA VA |
$122.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$368.32
|
|
|
HC ACCESS EXTREMITY ARTERY
|
Facility
|
IP
|
$491.10
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
36100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$299.52 |
| Max. Negotiated Rate |
$441.99 |
| Rate for Payer: Aetna Commercial |
$417.44
|
| Rate for Payer: BCBS Trust/PPO |
$379.52
|
| Rate for Payer: BCN Commercial |
$379.52
|
| Rate for Payer: Cash Price |
$392.88
|
| Rate for Payer: Cofinity Commercial |
$422.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.88
|
| Rate for Payer: Healthscope Commercial |
$441.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$368.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$417.44
|
| Rate for Payer: PHP Commercial |
$417.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$427.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$299.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$432.17
|
| Rate for Payer: UHC Core |
$410.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$368.32
|
|
|
HC ACCESS MAIN PULMONARY
|
Facility
|
OP
|
$419.20
|
|
|
Service Code
|
CPT 36013
|
| Hospital Charge Code |
36100099
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$99.56 |
| Max. Negotiated Rate |
$377.28 |
| Rate for Payer: Aetna Commercial |
$356.32
|
| Rate for Payer: Aetna Medicare |
$108.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$131.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$131.00
|
| Rate for Payer: BCBS Complete |
$167.68
|
| Rate for Payer: BCBS MAPPO |
$104.80
|
| Rate for Payer: BCBS Trust/PPO |
$325.93
|
| Rate for Payer: BCN Commercial |
$325.93
|
| Rate for Payer: BCN Medicare Advantage |
$104.80
|
| Rate for Payer: Cash Price |
$335.36
|
| Rate for Payer: Cofinity Commercial |
$360.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.80
|
| Rate for Payer: Healthscope Commercial |
$377.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$110.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$120.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$356.32
|
| Rate for Payer: PACE Senior Care Partners |
$99.56
|
| Rate for Payer: PACE SWMI |
$104.80
|
| Rate for Payer: PHP Commercial |
$356.32
|
| Rate for Payer: PHP Medicare Advantage |
$104.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$364.70
|
| Rate for Payer: Priority Health Medicare |
$104.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$255.67
|
| Rate for Payer: Railroad Medicare Medicare |
$104.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$368.90
|
| Rate for Payer: UHC Core |
$350.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.80
|
| Rate for Payer: UHC Medicare Advantage |
$107.94
|
| Rate for Payer: VA VA |
$104.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.40
|
|
|
HC ACCESS MAIN PULMONARY
|
Facility
|
IP
|
$419.20
|
|
|
Service Code
|
CPT 36013
|
| Hospital Charge Code |
36100099
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$255.67 |
| Max. Negotiated Rate |
$377.28 |
| Rate for Payer: Aetna Commercial |
$356.32
|
| Rate for Payer: BCBS Trust/PPO |
$323.96
|
| Rate for Payer: BCN Commercial |
$323.96
|
| Rate for Payer: Cash Price |
$335.36
|
| Rate for Payer: Cofinity Commercial |
$360.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.36
|
| Rate for Payer: Healthscope Commercial |
$377.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$356.32
|
| Rate for Payer: PHP Commercial |
$356.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$364.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$255.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$368.90
|
| Rate for Payer: UHC Core |
$350.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.40
|
|
|
HC ACCESS VEIN
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
36100093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$232.43 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: BCBS Trust/PPO |
$294.51
|
| Rate for Payer: BCN Commercial |
$294.51
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.36
|
| Rate for Payer: UHC Core |
$318.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC ACCESS VEIN
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
36100093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$90.51 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna Medicare |
$99.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.09
|
| Rate for Payer: BCBS Complete |
$152.44
|
| Rate for Payer: BCBS MAPPO |
$95.27
|
| Rate for Payer: BCBS Trust/PPO |
$296.30
|
| Rate for Payer: BCN Commercial |
$296.30
|
| Rate for Payer: BCN Medicare Advantage |
$95.27
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.27
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PACE Senior Care Partners |
$90.51
|
| Rate for Payer: PACE SWMI |
$95.27
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: PHP Medicare Advantage |
$95.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.55
|
| Rate for Payer: Priority Health Medicare |
$95.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.43
|
| Rate for Payer: Railroad Medicare Medicare |
$95.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.36
|
| Rate for Payer: UHC Core |
$318.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.27
|
| Rate for Payer: UHC Medicare Advantage |
$98.13
|
| Rate for Payer: VA VA |
$95.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC ACCESS VEIN ORGAN BLOOD SAMPLING
|
Facility
|
IP
|
$1,048.38
|
|
|
Service Code
|
CPT 36500
|
| Hospital Charge Code |
36100118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.41 |
| Max. Negotiated Rate |
$943.54 |
| Rate for Payer: Aetna Commercial |
$891.12
|
| Rate for Payer: BCBS Trust/PPO |
$810.19
|
| Rate for Payer: BCN Commercial |
$810.19
|
| Rate for Payer: Cash Price |
$838.70
|
| Rate for Payer: Cofinity Commercial |
$901.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$838.70
|
| Rate for Payer: Healthscope Commercial |
$943.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$786.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$891.12
|
| Rate for Payer: PHP Commercial |
$891.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$912.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$639.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$922.57
|
| Rate for Payer: UHC Core |
$875.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$786.28
|
|
|
HC ACCESS VEIN ORGAN BLOOD SAMPLING
|
Facility
|
OP
|
$1,048.38
|
|
|
Service Code
|
CPT 36500
|
| Hospital Charge Code |
36100118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$248.99 |
| Max. Negotiated Rate |
$943.54 |
| Rate for Payer: Aetna Commercial |
$891.12
|
| Rate for Payer: Aetna Medicare |
$272.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$327.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$327.62
|
| Rate for Payer: BCBS Complete |
$419.35
|
| Rate for Payer: BCBS MAPPO |
$262.10
|
| Rate for Payer: BCBS Trust/PPO |
$815.12
|
| Rate for Payer: BCN Commercial |
$815.12
|
| Rate for Payer: BCN Medicare Advantage |
$262.10
|
| Rate for Payer: Cash Price |
$838.70
|
| Rate for Payer: Cofinity Commercial |
$901.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$838.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$262.10
|
| Rate for Payer: Healthscope Commercial |
$943.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$786.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$275.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$301.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$891.12
|
| Rate for Payer: PACE Senior Care Partners |
$248.99
|
| Rate for Payer: PACE SWMI |
$262.10
|
| Rate for Payer: PHP Commercial |
$891.12
|
| Rate for Payer: PHP Medicare Advantage |
$262.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$912.09
|
| Rate for Payer: Priority Health Medicare |
$262.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$639.41
|
| Rate for Payer: Railroad Medicare Medicare |
$262.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$922.57
|
| Rate for Payer: UHC Core |
$875.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$262.10
|
| Rate for Payer: UHC Medicare Advantage |
$269.96
|
| Rate for Payer: VA VA |
$262.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$786.28
|
|
|
HC ACCESS VENA CAVA
|
Facility
|
IP
|
$3,067.24
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
36100096
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,870.71 |
| Max. Negotiated Rate |
$2,760.52 |
| Rate for Payer: Aetna Commercial |
$2,607.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,370.36
|
| Rate for Payer: BCN Commercial |
$2,370.36
|
| Rate for Payer: Cash Price |
$2,453.79
|
| Rate for Payer: Cofinity Commercial |
$2,637.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,453.79
|
| Rate for Payer: Healthscope Commercial |
$2,760.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,300.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,607.15
|
| Rate for Payer: PHP Commercial |
$2,607.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,147.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,668.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,870.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,699.17
|
| Rate for Payer: UHC Core |
$2,561.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,300.43
|
|
|
HC ACCESS VENA CAVA
|
Facility
|
OP
|
$3,067.24
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
36100096
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$728.47 |
| Max. Negotiated Rate |
$2,760.52 |
| Rate for Payer: Aetna Commercial |
$2,607.15
|
| Rate for Payer: Aetna Medicare |
$797.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$958.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$958.51
|
| Rate for Payer: BCBS Complete |
$1,226.90
|
| Rate for Payer: BCBS MAPPO |
$766.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,384.78
|
| Rate for Payer: BCN Commercial |
$2,384.78
|
| Rate for Payer: BCN Medicare Advantage |
$766.81
|
| Rate for Payer: Cash Price |
$2,453.79
|
| Rate for Payer: Cofinity Commercial |
$2,637.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,453.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$766.81
|
| Rate for Payer: Healthscope Commercial |
$2,760.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,300.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$805.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$881.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,607.15
|
| Rate for Payer: PACE Senior Care Partners |
$728.47
|
| Rate for Payer: PACE SWMI |
$766.81
|
| Rate for Payer: PHP Commercial |
$2,607.15
|
| Rate for Payer: PHP Medicare Advantage |
$766.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,147.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,668.50
|
| Rate for Payer: Priority Health Medicare |
$766.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,870.71
|
| Rate for Payer: Railroad Medicare Medicare |
$766.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,699.17
|
| Rate for Payer: UHC Core |
$2,561.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$766.81
|
| Rate for Payer: UHC Medicare Advantage |
$789.81
|
| Rate for Payer: VA VA |
$766.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,300.43
|
|
|
HC ACCESS WINDOW
|
Facility
|
IP
|
$38.17
|
|
| Hospital Charge Code |
27000624
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.28 |
| Max. Negotiated Rate |
$34.35 |
| Rate for Payer: Aetna Commercial |
$32.44
|
| Rate for Payer: BCBS Trust/PPO |
$29.50
|
| Rate for Payer: BCN Commercial |
$29.50
|
| Rate for Payer: Cash Price |
$30.54
|
| Rate for Payer: Cofinity Commercial |
$32.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.54
|
| Rate for Payer: Healthscope Commercial |
$34.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.44
|
| Rate for Payer: PHP Commercial |
$32.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.59
|
| Rate for Payer: UHC Core |
$31.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.63
|
|
|
HC ACCESS WINDOW
|
Facility
|
OP
|
$38.17
|
|
| Hospital Charge Code |
27000624
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.07 |
| Max. Negotiated Rate |
$34.35 |
| Rate for Payer: Aetna Commercial |
$32.44
|
| Rate for Payer: Aetna Medicare |
$9.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.93
|
| Rate for Payer: BCBS Complete |
$15.27
|
| Rate for Payer: BCBS MAPPO |
$9.54
|
| Rate for Payer: BCBS Trust/PPO |
$29.68
|
| Rate for Payer: BCN Commercial |
$29.68
|
| Rate for Payer: BCN Medicare Advantage |
$9.54
|
| Rate for Payer: Cash Price |
$30.54
|
| Rate for Payer: Cofinity Commercial |
$32.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.54
|
| Rate for Payer: Healthscope Commercial |
$34.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.44
|
| Rate for Payer: PACE Senior Care Partners |
$9.07
|
| Rate for Payer: PACE SWMI |
$9.54
|
| Rate for Payer: PHP Commercial |
$32.44
|
| Rate for Payer: PHP Medicare Advantage |
$9.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.21
|
| Rate for Payer: Priority Health Medicare |
$9.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.28
|
| Rate for Payer: Railroad Medicare Medicare |
$9.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.59
|
| Rate for Payer: UHC Core |
$31.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.54
|
| Rate for Payer: UHC Medicare Advantage |
$9.83
|
| Rate for Payer: VA VA |
$9.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.63
|
|
|
HC ACCUNET EMBOLIC PROTECTION
|
Facility
|
OP
|
$3,932.93
|
|
| Hospital Charge Code |
27200110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$934.07 |
| Max. Negotiated Rate |
$3,539.64 |
| Rate for Payer: Aetna Commercial |
$3,342.99
|
| Rate for Payer: Aetna Medicare |
$1,022.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,229.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,229.04
|
| Rate for Payer: BCBS Complete |
$1,573.17
|
| Rate for Payer: BCBS MAPPO |
$983.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,057.85
|
| Rate for Payer: BCN Commercial |
$3,057.85
|
| Rate for Payer: BCN Medicare Advantage |
$983.23
|
| Rate for Payer: Cash Price |
$3,146.34
|
| Rate for Payer: Cofinity Commercial |
$3,382.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,146.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$983.23
|
| Rate for Payer: Healthscope Commercial |
$3,539.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,949.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,032.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,130.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,342.99
|
| Rate for Payer: PACE Senior Care Partners |
$934.07
|
| Rate for Payer: PACE SWMI |
$983.23
|
| Rate for Payer: PHP Commercial |
$3,342.99
|
| Rate for Payer: PHP Medicare Advantage |
$983.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,753.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,421.65
|
| Rate for Payer: Priority Health Medicare |
$983.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,398.69
|
| Rate for Payer: Railroad Medicare Medicare |
$983.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,460.98
|
| Rate for Payer: UHC Core |
$3,284.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$983.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,012.73
|
| Rate for Payer: VA VA |
$983.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,949.70
|
|
|
HC ACCUNET EMBOLIC PROTECTION
|
Facility
|
IP
|
$3,932.93
|
|
| Hospital Charge Code |
27200110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,398.69 |
| Max. Negotiated Rate |
$3,539.64 |
| Rate for Payer: Aetna Commercial |
$3,342.99
|
| Rate for Payer: BCBS Trust/PPO |
$3,039.37
|
| Rate for Payer: BCN Commercial |
$3,039.37
|
| Rate for Payer: Cash Price |
$3,146.34
|
| Rate for Payer: Cofinity Commercial |
$3,382.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,146.34
|
| Rate for Payer: Healthscope Commercial |
$3,539.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,949.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,342.99
|
| Rate for Payer: PHP Commercial |
$3,342.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,753.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,421.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,398.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,460.98
|
| Rate for Payer: UHC Core |
$3,284.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,949.70
|
|
|
HC ACETAMINOPHEN LVL.
|
Facility
|
OP
|
$126.58
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100648
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.06 |
| Max. Negotiated Rate |
$113.92 |
| Rate for Payer: Aetna Commercial |
$107.59
|
| Rate for Payer: Aetna Medicare |
$32.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.56
|
| Rate for Payer: BCBS Complete |
$48.15
|
| Rate for Payer: BCBS MAPPO |
$31.64
|
| Rate for Payer: BCBS Trust/PPO |
$98.42
|
| Rate for Payer: BCN Commercial |
$98.42
|
| Rate for Payer: BCN Medicare Advantage |
$31.64
|
| Rate for Payer: Cash Price |
$101.26
|
| Rate for Payer: Cash Price |
$101.26
|
| Rate for Payer: Cofinity Commercial |
$108.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.64
|
| Rate for Payer: Healthscope Commercial |
$113.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.94
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$48.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$107.59
|
| Rate for Payer: PACE Senior Care Partners |
$30.06
|
| Rate for Payer: PACE SWMI |
$31.64
|
| Rate for Payer: PHP Commercial |
$107.59
|
| Rate for Payer: PHP Medicare Advantage |
$31.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.12
|
| Rate for Payer: Priority Health Medicare |
$31.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.20
|
| Rate for Payer: Railroad Medicare Medicare |
$31.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.39
|
| Rate for Payer: UHC Core |
$105.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.64
|
| Rate for Payer: UHC Medicare Advantage |
$32.59
|
| Rate for Payer: VA VA |
$31.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.94
|
|
|
HC ACETAMINOPHEN LVL.
|
Facility
|
IP
|
$126.58
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100648
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$77.20 |
| Max. Negotiated Rate |
$113.92 |
| Rate for Payer: Aetna Commercial |
$107.59
|
| Rate for Payer: BCBS Trust/PPO |
$97.82
|
| Rate for Payer: BCN Commercial |
$97.82
|
| Rate for Payer: Cash Price |
$101.26
|
| Rate for Payer: Cofinity Commercial |
$108.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.26
|
| Rate for Payer: Healthscope Commercial |
$113.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$107.59
|
| Rate for Payer: PHP Commercial |
$107.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.39
|
| Rate for Payer: UHC Core |
$105.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.94
|
|
|
HC ACETOMINOPHEN THERAPEUTIC DRUG ASSAY
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 80143
|
| Hospital Charge Code |
30100729
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.88 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$31.53
|
| Rate for Payer: BCN Commercial |
$31.53
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC ACETOMINOPHEN THERAPEUTIC DRUG ASSAY
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 80143
|
| Hospital Charge Code |
30100729
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.69 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$14.44
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$31.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$14.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.51
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC ACETYLCHOLINE RECEPTOR AB
|
Facility
|
OP
|
$75.48
|
|
|
Service Code
|
CPT 86041
|
| Hospital Charge Code |
30100254
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.93 |
| 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 |
$30.19
|
| Rate for Payer: BCBS MAPPO |
$18.87
|
| Rate for Payer: BCBS Trust/PPO |
$58.69
|
| 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: 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: Meridian Wellcare - Medicare Advantage |
$19.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.16
|
| 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 Cigna Priority Health |
$52.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.67
|
| Rate for Payer: Priority Health Medicare |
$18.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.04
|
| 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 Medicare Advantage |
$19.44
|
| Rate for Payer: VA VA |
$18.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.61
|
|
