|
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
|
|
|
HC ACETYLCHOLINESTERASE AMNIOTIC
|
Facility
|
OP
|
$106.48
|
|
|
Service Code
|
CPT 82013
|
| Hospital Charge Code |
30100069
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.07 |
| Max. Negotiated Rate |
$95.83 |
| Rate for Payer: Aetna Commercial |
$90.51
|
| Rate for Payer: Aetna Medicare |
$27.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.28
|
| Rate for Payer: BCBS Complete |
$9.52
|
| Rate for Payer: BCBS MAPPO |
$26.62
|
| Rate for Payer: BCBS Trust/PPO |
$82.79
|
| Rate for Payer: BCN Commercial |
$82.79
|
| Rate for Payer: BCN Medicare Advantage |
$26.62
|
| Rate for Payer: Cash Price |
$85.18
|
| Rate for Payer: Cash Price |
$85.18
|
| Rate for Payer: Cofinity Commercial |
$91.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.62
|
| Rate for Payer: Healthscope Commercial |
$95.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.86
|
| Rate for Payer: Mclaren Medicaid |
$9.07
|
| Rate for Payer: Meridian Medicaid |
$9.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.51
|
| Rate for Payer: PACE Senior Care Partners |
$25.29
|
| Rate for Payer: PACE SWMI |
$26.62
|
| Rate for Payer: PHP Commercial |
$90.51
|
| Rate for Payer: PHP Medicare Advantage |
$26.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.64
|
| Rate for Payer: Priority Health Medicare |
$26.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.94
|
| Rate for Payer: Railroad Medicare Medicare |
$26.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.70
|
| Rate for Payer: UHC Core |
$88.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.62
|
| Rate for Payer: UHC Medicare Advantage |
$27.42
|
| Rate for Payer: VA VA |
$26.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.86
|
|
|
HC ACETYLCHOLINESTERASE AMNIOTIC
|
Facility
|
IP
|
$106.48
|
|
|
Service Code
|
CPT 82013
|
| Hospital Charge Code |
30100069
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.94 |
| Max. Negotiated Rate |
$95.83 |
| Rate for Payer: Aetna Commercial |
$90.51
|
| Rate for Payer: BCBS Trust/PPO |
$82.29
|
| Rate for Payer: BCN Commercial |
$82.29
|
| Rate for Payer: Cash Price |
$85.18
|
| Rate for Payer: Cofinity Commercial |
$91.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.18
|
| Rate for Payer: Healthscope Commercial |
$95.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.51
|
| Rate for Payer: PHP Commercial |
$90.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.70
|
| Rate for Payer: UHC Core |
$88.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.86
|
|
|
HC ACH RECEPTOR MUSCLE MOD AB
|
Facility
|
IP
|
$96.90
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30000061
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$59.10 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: BCBS Trust/PPO |
$74.88
|
| Rate for Payer: BCN Commercial |
$74.88
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.36
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.27
|
| Rate for Payer: UHC Core |
$80.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.68
|
|
|
HC ACH RECEPTOR MUSCLE MOD AB
|
Facility
|
OP
|
$96.90
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30000061
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: Aetna Medicare |
$25.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.28
|
| Rate for Payer: BCBS Complete |
$14.26
|
| Rate for Payer: BCBS MAPPO |
$24.22
|
| Rate for Payer: BCBS Trust/PPO |
$75.34
|
| Rate for Payer: BCN Commercial |
$75.34
|
| Rate for Payer: BCN Medicare Advantage |
$24.22
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.22
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.68
|
| Rate for Payer: Mclaren Medicaid |
$13.58
|
| Rate for Payer: Meridian Medicaid |
$14.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.36
|
| Rate for Payer: PACE Senior Care Partners |
$23.01
|
| Rate for Payer: PACE SWMI |
$24.22
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: PHP Medicare Advantage |
$24.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.30
|
| Rate for Payer: Priority Health Medicare |
$24.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.10
|
| Rate for Payer: Railroad Medicare Medicare |
$24.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.27
|
| Rate for Payer: UHC Core |
$80.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.22
|
| Rate for Payer: UHC Medicare Advantage |
$24.95
|
| Rate for Payer: VA VA |
$24.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.68
|
|
|
HC ACHR GANGLIONIC NEURONAL AB
|
Facility
|
OP
|
$87.72
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100606
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$78.95 |
| Rate for Payer: Aetna Commercial |
$74.56
|
| Rate for Payer: Aetna Medicare |
$22.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.41
|
| Rate for Payer: BCBS Complete |
$14.26
|
| Rate for Payer: BCBS MAPPO |
$21.93
|
| Rate for Payer: BCBS Trust/PPO |
$68.20
|
| Rate for Payer: BCN Commercial |
$68.20
|
| Rate for Payer: BCN Medicare Advantage |
$21.93
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cofinity Commercial |
$75.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.93
|
| Rate for Payer: Healthscope Commercial |
$78.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.79
|
| Rate for Payer: Mclaren Medicaid |
$13.58
|
| Rate for Payer: Meridian Medicaid |
$14.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.56
|
| Rate for Payer: PACE Senior Care Partners |
$20.83
|
| Rate for Payer: PACE SWMI |
$21.93
|
| Rate for Payer: PHP Commercial |
$74.56
|
| Rate for Payer: PHP Medicare Advantage |
$21.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.32
|
| Rate for Payer: Priority Health Medicare |
$21.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.50
|
| Rate for Payer: Railroad Medicare Medicare |
$21.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.19
|
| Rate for Payer: UHC Core |
$73.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.93
|
| Rate for Payer: UHC Medicare Advantage |
$22.59
|
| Rate for Payer: VA VA |
$21.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.79
|
|
|
HC ACHR GANGLIONIC NEURONAL AB
|
Facility
|
IP
|
$87.72
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100606
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.50 |
| Max. Negotiated Rate |
$78.95 |
| Rate for Payer: Aetna Commercial |
$74.56
|
| Rate for Payer: BCBS Trust/PPO |
$67.79
|
| Rate for Payer: BCN Commercial |
$67.79
|
| Rate for Payer: Cash Price |
$70.18
|
| Rate for Payer: Cofinity Commercial |
$75.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.18
|
| Rate for Payer: Healthscope Commercial |
$78.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.56
|
| Rate for Payer: PHP Commercial |
$74.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.19
|
| Rate for Payer: UHC Core |
$73.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.79
|
|
|
HC ACNE SURGERY
|
Facility
|
OP
|
$267.34
|
|
|
Service Code
|
CPT 10040
|
| Hospital Charge Code |
76100282
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$63.49 |
| Max. Negotiated Rate |
$240.61 |
| Rate for Payer: Aetna Commercial |
$227.24
|
| Rate for Payer: Aetna Medicare |
$69.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.54
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$66.84
|
| Rate for Payer: BCBS Trust/PPO |
$207.86
|
| Rate for Payer: BCN Commercial |
$207.86
|
| Rate for Payer: BCN Medicare Advantage |
$66.84
|
| Rate for Payer: Cash Price |
$213.87
|
| Rate for Payer: Cash Price |
$213.87
|
| Rate for Payer: Cofinity Commercial |
$229.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.84
|
| Rate for Payer: Healthscope Commercial |
$240.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.50
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$70.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$227.24
|
| Rate for Payer: PACE Senior Care Partners |
$63.49
|
| Rate for Payer: PACE SWMI |
$66.84
|
| Rate for Payer: PHP Commercial |
$227.24
|
| Rate for Payer: PHP Medicare Advantage |
$66.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.59
|
| Rate for Payer: Priority Health Medicare |
$66.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$163.05
|
| Rate for Payer: Railroad Medicare Medicare |
$66.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.26
|
| Rate for Payer: UHC Core |
$223.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.84
|
| Rate for Payer: UHC Medicare Advantage |
$68.84
|
| Rate for Payer: VA VA |
$66.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.50
|
|
|
HC ACNE SURGERY
|
Facility
|
IP
|
$267.34
|
|
|
Service Code
|
CPT 10040
|
| Hospital Charge Code |
76100282
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$163.05 |
| Max. Negotiated Rate |
$240.61 |
| Rate for Payer: Aetna Commercial |
$227.24
|
| Rate for Payer: BCBS Trust/PPO |
$206.60
|
| Rate for Payer: BCN Commercial |
$206.60
|
| Rate for Payer: Cash Price |
$213.87
|
| Rate for Payer: Cofinity Commercial |
$229.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.87
|
| Rate for Payer: Healthscope Commercial |
$240.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$227.24
|
| Rate for Payer: PHP Commercial |
$227.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$232.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$163.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.26
|
| Rate for Payer: UHC Core |
$223.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.50
|
|
|
HC ACOUSTIC IMMITANCE TESTING
|
Facility
|
OP
|
$146.00
|
|
|
Service Code
|
CPT 92570
|
| Hospital Charge Code |
76100509
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$34.68 |
| Max. Negotiated Rate |
$131.40 |
| Rate for Payer: Aetna Commercial |
$124.10
|
| Rate for Payer: Aetna Medicare |
$37.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.62
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$36.50
|
| Rate for Payer: BCBS Trust/PPO |
$113.52
|
| Rate for Payer: BCN Commercial |
$113.52
|
| Rate for Payer: BCN Medicare Advantage |
$36.50
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$125.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.50
|
| Rate for Payer: Healthscope Commercial |
$131.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.50
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.10
|
| Rate for Payer: PACE Senior Care Partners |
$34.68
|
| Rate for Payer: PACE SWMI |
$36.50
|
| Rate for Payer: PHP Commercial |
$124.10
|
| Rate for Payer: PHP Medicare Advantage |
$36.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.02
|
| Rate for Payer: Priority Health Medicare |
$36.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.05
|
| Rate for Payer: Railroad Medicare Medicare |
$36.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.48
|
| Rate for Payer: UHC Core |
$121.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.50
|
| Rate for Payer: UHC Medicare Advantage |
$37.60
|
| Rate for Payer: VA VA |
$36.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.50
|
|
|
HC ACOUSTIC IMMITANCE TESTING
|
Facility
|
IP
|
$146.00
|
|
|
Service Code
|
CPT 92570
|
| Hospital Charge Code |
76100509
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$89.05 |
| Max. Negotiated Rate |
$131.40 |
| Rate for Payer: Aetna Commercial |
$124.10
|
| Rate for Payer: BCBS Trust/PPO |
$112.83
|
| Rate for Payer: BCN Commercial |
$112.83
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$125.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.80
|
| Rate for Payer: Healthscope Commercial |
$131.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.10
|
| Rate for Payer: PHP Commercial |
$124.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.48
|
| Rate for Payer: UHC Core |
$121.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.50
|
|
|
HC ACTIGRAPHY
|
Facility
|
IP
|
$270.16
|
|
|
Service Code
|
CPT 95803
|
| Hospital Charge Code |
92000016
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$164.77 |
| Max. Negotiated Rate |
$243.14 |
| Rate for Payer: Aetna Commercial |
$229.64
|
| Rate for Payer: BCBS Trust/PPO |
$208.78
|
| Rate for Payer: BCN Commercial |
$208.78
|
| Rate for Payer: Cash Price |
$216.13
|
| Rate for Payer: Cofinity Commercial |
$232.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.13
|
| Rate for Payer: Healthscope Commercial |
$243.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.64
|
| Rate for Payer: PHP Commercial |
$229.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.74
|
| Rate for Payer: UHC Core |
$225.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.62
|
|
|
HC ACTIGRAPHY
|
Facility
|
OP
|
$270.16
|
|
|
Service Code
|
CPT 95803
|
| Hospital Charge Code |
92000016
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$40.13 |
| Max. Negotiated Rate |
$243.14 |
| Rate for Payer: Aetna Commercial |
$229.64
|
| Rate for Payer: Aetna Medicare |
$70.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.42
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$67.54
|
| Rate for Payer: BCBS Trust/PPO |
$210.05
|
| Rate for Payer: BCN Commercial |
$210.05
|
| Rate for Payer: BCN Medicare Advantage |
$67.54
|
| Rate for Payer: Cash Price |
$216.13
|
| Rate for Payer: Cash Price |
$216.13
|
| Rate for Payer: Cofinity Commercial |
$232.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.54
|
| Rate for Payer: Healthscope Commercial |
$243.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.62
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$70.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.64
|
| Rate for Payer: PACE Senior Care Partners |
$64.16
|
| Rate for Payer: PACE SWMI |
$67.54
|
| Rate for Payer: PHP Commercial |
$229.64
|
| Rate for Payer: PHP Medicare Advantage |
$67.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.04
|
| Rate for Payer: Priority Health Medicare |
$67.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.77
|
| Rate for Payer: Railroad Medicare Medicare |
$67.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.74
|
| Rate for Payer: UHC Core |
$225.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.54
|
| Rate for Payer: UHC Medicare Advantage |
$69.57
|
| Rate for Payer: VA VA |
$67.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.62
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE
|
Facility
|
OP
|
$90.78
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500040
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.31 |
| Max. Negotiated Rate |
$81.70 |
| Rate for Payer: Aetna Commercial |
$77.16
|
| Rate for Payer: Aetna Medicare |
$23.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.37
|
| Rate for Payer: BCBS Complete |
$11.87
|
| Rate for Payer: BCBS MAPPO |
$22.70
|
| Rate for Payer: BCBS Trust/PPO |
$70.58
|
| Rate for Payer: BCN Commercial |
$70.58
|
| Rate for Payer: BCN Medicare Advantage |
$22.70
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$78.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.70
|
| Rate for Payer: Healthscope Commercial |
$81.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.08
|
| Rate for Payer: Mclaren Medicaid |
$11.31
|
| Rate for Payer: Meridian Medicaid |
$11.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$77.16
|
| Rate for Payer: PACE Senior Care Partners |
$21.56
|
| Rate for Payer: PACE SWMI |
$22.70
|
| Rate for Payer: PHP Commercial |
$77.16
|
| Rate for Payer: PHP Medicare Advantage |
$22.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.98
|
| Rate for Payer: Priority Health Medicare |
$22.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.37
|
| Rate for Payer: Railroad Medicare Medicare |
$22.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.89
|
| Rate for Payer: UHC Core |
$75.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.70
|
| Rate for Payer: UHC Medicare Advantage |
$23.38
|
| Rate for Payer: VA VA |
$22.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.08
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE
|
Facility
|
IP
|
$90.78
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500040
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$55.37 |
| Max. Negotiated Rate |
$81.70 |
| Rate for Payer: Aetna Commercial |
$77.16
|
| Rate for Payer: BCBS Trust/PPO |
$70.15
|
| Rate for Payer: BCN Commercial |
$70.15
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$78.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Healthscope Commercial |
$81.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$77.16
|
| Rate for Payer: PHP Commercial |
$77.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.89
|
| Rate for Payer: UHC Core |
$75.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.08
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE.
|
Facility
|
OP
|
$65.28
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500084
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.31 |
| Max. Negotiated Rate |
$58.75 |
| Rate for Payer: Aetna Commercial |
$55.49
|
| Rate for Payer: Aetna Medicare |
$16.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.40
|
| Rate for Payer: BCBS Complete |
$11.87
|
| Rate for Payer: BCBS MAPPO |
$16.32
|
| Rate for Payer: BCBS Trust/PPO |
$50.76
|
| Rate for Payer: BCN Commercial |
$50.76
|
| Rate for Payer: BCN Medicare Advantage |
$16.32
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cofinity Commercial |
$56.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$58.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.96
|
| Rate for Payer: Mclaren Medicaid |
$11.31
|
| Rate for Payer: Meridian Medicaid |
$11.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.49
|
| Rate for Payer: PACE Senior Care Partners |
$15.50
|
| Rate for Payer: PACE SWMI |
$16.32
|
| Rate for Payer: PHP Commercial |
$55.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.79
|
| Rate for Payer: Priority Health Medicare |
$16.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.81
|
| Rate for Payer: Railroad Medicare Medicare |
$16.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.45
|
| Rate for Payer: UHC Core |
$54.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.32
|
| Rate for Payer: UHC Medicare Advantage |
$16.81
|
| Rate for Payer: VA VA |
$16.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.96
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE.
|
Facility
|
IP
|
$65.28
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500084
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$39.81 |
| Max. Negotiated Rate |
$58.75 |
| Rate for Payer: Aetna Commercial |
$55.49
|
| Rate for Payer: BCBS Trust/PPO |
$50.45
|
| Rate for Payer: BCN Commercial |
$50.45
|
| Rate for Payer: Cash Price |
$52.22
|
| Rate for Payer: Cofinity Commercial |
$56.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.22
|
| Rate for Payer: Healthscope Commercial |
$58.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.49
|
| Rate for Payer: PHP Commercial |
$55.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.45
|
| Rate for Payer: UHC Core |
$54.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.96
|
|
|
HC ACT TEST
|
Facility
|
IP
|
$75.13
|
|
| Hospital Charge Code |
62200001
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.82 |
| Max. Negotiated Rate |
$67.62 |
| Rate for Payer: Aetna Commercial |
$63.86
|
| Rate for Payer: BCBS Trust/PPO |
$58.06
|
| Rate for Payer: BCN Commercial |
$58.06
|
| Rate for Payer: Cash Price |
$60.10
|
| Rate for Payer: Cofinity Commercial |
$64.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.10
|
| Rate for Payer: Healthscope Commercial |
$67.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.86
|
| Rate for Payer: PHP Commercial |
$63.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.11
|
| Rate for Payer: UHC Core |
$62.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.35
|
|
|
HC ACT TEST
|
Facility
|
OP
|
$75.13
|
|
| Hospital Charge Code |
62200001
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.84 |
| Max. Negotiated Rate |
$67.62 |
| Rate for Payer: Aetna Commercial |
$63.86
|
| Rate for Payer: Aetna Medicare |
$19.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.48
|
| Rate for Payer: BCBS Complete |
$30.05
|
| Rate for Payer: BCBS MAPPO |
$18.78
|
| Rate for Payer: BCBS Trust/PPO |
$58.41
|
| Rate for Payer: BCN Commercial |
$58.41
|
| Rate for Payer: BCN Medicare Advantage |
$18.78
|
| Rate for Payer: Cash Price |
$60.10
|
| Rate for Payer: Cofinity Commercial |
$64.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.78
|
| Rate for Payer: Healthscope Commercial |
$67.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.86
|
| Rate for Payer: PACE Senior Care Partners |
$17.84
|
| Rate for Payer: PACE SWMI |
$18.78
|
| Rate for Payer: PHP Commercial |
$63.86
|
| Rate for Payer: PHP Medicare Advantage |
$18.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.36
|
| Rate for Payer: Priority Health Medicare |
$18.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.82
|
| Rate for Payer: Railroad Medicare Medicare |
$18.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.11
|
| Rate for Payer: UHC Core |
$62.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.78
|
| Rate for Payer: UHC Medicare Advantage |
$19.35
|
| Rate for Payer: VA VA |
$18.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.35
|
|
|
HC ACUNAV CATHETER
|
Facility
|
IP
|
$5,610.00
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,421.54 |
| Max. Negotiated Rate |
$5,049.00 |
| Rate for Payer: Aetna Commercial |
$4,768.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,335.41
|
| Rate for Payer: BCN Commercial |
$4,335.41
|
| Rate for Payer: Cash Price |
$4,488.00
|
| Rate for Payer: Cofinity Commercial |
$4,824.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,488.00
|
| Rate for Payer: Healthscope Commercial |
$5,049.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,207.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,768.50
|
| Rate for Payer: PHP Commercial |
$4,768.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,927.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,880.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,421.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,936.80
|
| Rate for Payer: UHC Core |
$4,684.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,207.50
|
|
|
HC ACUNAV CATHETER
|
Facility
|
OP
|
$5,610.00
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,332.38 |
| Max. Negotiated Rate |
$5,049.00 |
| Rate for Payer: Aetna Commercial |
$4,768.50
|
| Rate for Payer: Aetna Medicare |
$1,458.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,753.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,753.12
|
| Rate for Payer: BCBS Complete |
$2,244.00
|
| Rate for Payer: BCBS MAPPO |
$1,402.50
|
| Rate for Payer: BCBS Trust/PPO |
$4,361.78
|
| Rate for Payer: BCN Commercial |
$4,361.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,402.50
|
| Rate for Payer: Cash Price |
$4,488.00
|
| Rate for Payer: Cofinity Commercial |
$4,824.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,488.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,402.50
|
| Rate for Payer: Healthscope Commercial |
$5,049.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,207.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,472.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,612.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,768.50
|
| Rate for Payer: PACE Senior Care Partners |
$1,332.38
|
| Rate for Payer: PACE SWMI |
$1,402.50
|
| Rate for Payer: PHP Commercial |
$4,768.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,402.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,927.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,880.70
|
| Rate for Payer: Priority Health Medicare |
$1,402.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,421.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,402.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,936.80
|
| Rate for Payer: UHC Core |
$4,684.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,402.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,444.58
|
| Rate for Payer: VA VA |
$1,402.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,207.50
|
|
|
HC ACU OBSERVATION PER HOUR
|
Facility
|
OP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200003
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$31.90 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna Medicare |
$34.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.98
|
| Rate for Payer: BCBS Complete |
$53.73
|
| Rate for Payer: BCBS MAPPO |
$33.58
|
| Rate for Payer: BCBS Trust/PPO |
$104.44
|
| Rate for Payer: BCN Commercial |
$104.44
|
| Rate for Payer: BCN Medicare Advantage |
$33.58
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.58
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PACE Senior Care Partners |
$31.90
|
| Rate for Payer: PACE SWMI |
$33.58
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: PHP Medicare Advantage |
$33.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.87
|
| Rate for Payer: Priority Health Medicare |
$33.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.93
|
| Rate for Payer: Railroad Medicare Medicare |
$33.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.21
|
| Rate for Payer: UHC Core |
$112.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.58
|
| Rate for Payer: UHC Medicare Advantage |
$34.59
|
| Rate for Payer: VA VA |
$33.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC ACU OBSERVATION PER HOUR
|
Facility
|
IP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200003
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$81.93 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: BCBS Trust/PPO |
$103.81
|
| Rate for Payer: BCN Commercial |
$103.81
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.21
|
| Rate for Payer: UHC Core |
$112.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC ACU OBS OVERFLOW PER HOUR
|
Facility
|
IP
|
$134.33
|
|
| Hospital Charge Code |
76900001
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$81.93 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: BCBS Trust/PPO |
$103.81
|
| Rate for Payer: BCN Commercial |
$103.81
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.21
|
| Rate for Payer: UHC Core |
$112.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC ACU OBS OVERFLOW PER HOUR
|
Facility
|
OP
|
$134.33
|
|
| Hospital Charge Code |
76900001
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$31.90 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna Medicare |
$34.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.98
|
| Rate for Payer: BCBS Complete |
$53.73
|
| Rate for Payer: BCBS MAPPO |
$33.58
|
| Rate for Payer: BCBS Trust/PPO |
$104.44
|
| Rate for Payer: BCN Commercial |
$104.44
|
| Rate for Payer: BCN Medicare Advantage |
$33.58
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.58
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PACE Senior Care Partners |
$31.90
|
| Rate for Payer: PACE SWMI |
$33.58
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: PHP Medicare Advantage |
$33.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.87
|
| Rate for Payer: Priority Health Medicare |
$33.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.93
|
| Rate for Payer: Railroad Medicare Medicare |
$33.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.21
|
| Rate for Payer: UHC Core |
$112.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.58
|
| Rate for Payer: UHC Medicare Advantage |
$34.59
|
| Rate for Payer: VA VA |
$33.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
