|
HC ADMIN TOCILIZUMAB COVID 19 2ND DOSE
|
Facility
|
OP
|
$524.28
|
|
|
Service Code
|
HCPCS M0250
|
| Hospital Charge Code |
77100045
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$124.52 |
| Max. Negotiated Rate |
$471.85 |
| Rate for Payer: Aetna Commercial |
$445.64
|
| Rate for Payer: Aetna Medicare |
$136.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$163.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$163.84
|
| Rate for Payer: BCBS Complete |
$325.67
|
| Rate for Payer: BCBS MAPPO |
$131.07
|
| Rate for Payer: BCBS Trust/PPO |
$407.63
|
| Rate for Payer: BCN Commercial |
$407.63
|
| Rate for Payer: BCN Medicare Advantage |
$131.07
|
| Rate for Payer: Cash Price |
$419.42
|
| Rate for Payer: Cash Price |
$419.42
|
| Rate for Payer: Cofinity Commercial |
$450.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.07
|
| Rate for Payer: Healthscope Commercial |
$471.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.21
|
| Rate for Payer: Mclaren Medicaid |
$310.17
|
| Rate for Payer: Meridian Medicaid |
$325.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$150.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$445.64
|
| Rate for Payer: PACE Senior Care Partners |
$124.52
|
| Rate for Payer: PACE SWMI |
$131.07
|
| Rate for Payer: PHP Commercial |
$445.64
|
| Rate for Payer: PHP Medicare Advantage |
$131.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$310.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.12
|
| Rate for Payer: Priority Health Medicare |
$131.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$319.76
|
| Rate for Payer: Railroad Medicare Medicare |
$131.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.37
|
| Rate for Payer: UHC Core |
$437.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.07
|
| Rate for Payer: UHC Medicare Advantage |
$135.00
|
| Rate for Payer: VA VA |
$131.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.21
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 2ND DOSE
|
Facility
|
IP
|
$524.28
|
|
|
Service Code
|
HCPCS M0250
|
| Hospital Charge Code |
77100045
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$319.76 |
| Max. Negotiated Rate |
$471.85 |
| Rate for Payer: Aetna Commercial |
$445.64
|
| Rate for Payer: BCBS Trust/PPO |
$405.16
|
| Rate for Payer: BCN Commercial |
$405.16
|
| Rate for Payer: Cash Price |
$419.42
|
| Rate for Payer: Cofinity Commercial |
$450.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.42
|
| Rate for Payer: Healthscope Commercial |
$471.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$445.64
|
| Rate for Payer: PHP Commercial |
$445.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$319.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.37
|
| Rate for Payer: UHC Core |
$437.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.21
|
|
|
HC ADMN SARSCOV2 VACC 1 DOSE
|
Facility
|
OP
|
$83.04
|
|
|
Service Code
|
CPT 90480
|
| Hospital Charge Code |
77100064
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$19.72 |
| Max. Negotiated Rate |
$74.74 |
| Rate for Payer: Aetna Commercial |
$70.58
|
| Rate for Payer: Aetna Medicare |
$21.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.95
|
| Rate for Payer: BCBS Complete |
$30.01
|
| Rate for Payer: BCBS MAPPO |
$20.76
|
| Rate for Payer: BCBS Trust/PPO |
$64.56
|
| Rate for Payer: BCN Commercial |
$64.56
|
| Rate for Payer: BCN Medicare Advantage |
$20.76
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cofinity Commercial |
$71.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.76
|
| Rate for Payer: Healthscope Commercial |
$74.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.28
|
| Rate for Payer: Mclaren Medicaid |
$28.58
|
| Rate for Payer: Meridian Medicaid |
$30.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.58
|
| Rate for Payer: PACE Senior Care Partners |
$19.72
|
| Rate for Payer: PACE SWMI |
$20.76
|
| Rate for Payer: PHP Commercial |
$70.58
|
| Rate for Payer: PHP Medicare Advantage |
$20.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.24
|
| Rate for Payer: Priority Health Medicare |
$20.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.65
|
| Rate for Payer: Railroad Medicare Medicare |
$20.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.08
|
| Rate for Payer: UHC Core |
$69.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.76
|
| Rate for Payer: UHC Medicare Advantage |
$21.38
|
| Rate for Payer: VA VA |
$20.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.28
|
|
|
HC ADMN SARSCOV2 VACC 1 DOSE
|
Facility
|
IP
|
$83.04
|
|
|
Service Code
|
CPT 90480
|
| Hospital Charge Code |
77100064
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$50.65 |
| Max. Negotiated Rate |
$74.74 |
| Rate for Payer: Aetna Commercial |
$70.58
|
| Rate for Payer: BCBS Trust/PPO |
$64.17
|
| Rate for Payer: BCN Commercial |
$64.17
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cofinity Commercial |
$71.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.43
|
| Rate for Payer: Healthscope Commercial |
$74.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.58
|
| Rate for Payer: PHP Commercial |
$70.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.08
|
| Rate for Payer: UHC Core |
$69.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.28
|
|
|
HC ADMU OBSERVATION PER HOUR
|
Facility
|
IP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200020
|
|
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 ADMU OBSERVATION PER HOUR
|
Facility
|
OP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200020
|
|
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 ADRENOCORTICOTROPIC HORMONE
|
Facility
|
IP
|
$60.50
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
30100071
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.90 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Aetna Commercial |
$51.42
|
| Rate for Payer: BCBS Trust/PPO |
$46.75
|
| Rate for Payer: BCN Commercial |
$46.75
|
| Rate for Payer: Cash Price |
$48.40
|
| Rate for Payer: Cofinity Commercial |
$52.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.40
|
| Rate for Payer: Healthscope Commercial |
$54.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.42
|
| Rate for Payer: PHP Commercial |
$51.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.24
|
| Rate for Payer: UHC Core |
$50.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.38
|
|
|
HC ADRENOCORTICOTROPIC HORMONE
|
Facility
|
OP
|
$60.50
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
30100071
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.37 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Aetna Commercial |
$51.42
|
| Rate for Payer: Aetna Medicare |
$15.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.91
|
| Rate for Payer: BCBS Complete |
$29.93
|
| Rate for Payer: BCBS MAPPO |
$15.12
|
| Rate for Payer: BCBS Trust/PPO |
$47.04
|
| Rate for Payer: BCN Commercial |
$47.04
|
| Rate for Payer: BCN Medicare Advantage |
$15.12
|
| Rate for Payer: Cash Price |
$48.40
|
| Rate for Payer: Cash Price |
$48.40
|
| Rate for Payer: Cofinity Commercial |
$52.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.12
|
| Rate for Payer: Healthscope Commercial |
$54.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.38
|
| Rate for Payer: Mclaren Medicaid |
$28.50
|
| Rate for Payer: Meridian Medicaid |
$29.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.42
|
| Rate for Payer: PACE Senior Care Partners |
$14.37
|
| Rate for Payer: PACE SWMI |
$15.12
|
| Rate for Payer: PHP Commercial |
$51.42
|
| Rate for Payer: PHP Medicare Advantage |
$15.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.64
|
| Rate for Payer: Priority Health Medicare |
$15.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.90
|
| Rate for Payer: Railroad Medicare Medicare |
$15.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.24
|
| Rate for Payer: UHC Core |
$50.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.12
|
| Rate for Payer: UHC Medicare Advantage |
$15.58
|
| Rate for Payer: VA VA |
$15.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.38
|
|
|
HC ADULTERANT SURVEY URINE
|
Facility
|
IP
|
$15.00
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700010
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$9.15 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Aetna Commercial |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$11.59
|
| Rate for Payer: BCN Commercial |
$11.59
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$12.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.00
|
| Rate for Payer: Healthscope Commercial |
$13.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.75
|
| Rate for Payer: PHP Commercial |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.20
|
| Rate for Payer: UHC Core |
$12.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.25
|
|
|
HC ADULTERANT SURVEY URINE
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700010
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Aetna Commercial |
$12.75
|
| Rate for Payer: Aetna Medicare |
$3.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.69
|
| Rate for Payer: BCBS Complete |
$1.68
|
| Rate for Payer: BCBS MAPPO |
$3.75
|
| Rate for Payer: BCBS Trust/PPO |
$11.66
|
| Rate for Payer: BCN Commercial |
$11.66
|
| Rate for Payer: BCN Medicare Advantage |
$3.75
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$12.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.75
|
| Rate for Payer: Healthscope Commercial |
$13.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.25
|
| Rate for Payer: Mclaren Medicaid |
$1.60
|
| Rate for Payer: Meridian Medicaid |
$1.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.75
|
| Rate for Payer: PACE Senior Care Partners |
$3.56
|
| Rate for Payer: PACE SWMI |
$3.75
|
| Rate for Payer: PHP Commercial |
$12.75
|
| Rate for Payer: PHP Medicare Advantage |
$3.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.05
|
| Rate for Payer: Priority Health Medicare |
$3.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.15
|
| Rate for Payer: Railroad Medicare Medicare |
$3.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.20
|
| Rate for Payer: UHC Core |
$12.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.75
|
| Rate for Payer: UHC Medicare Advantage |
$3.86
|
| Rate for Payer: VA VA |
$3.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.25
|
|
|
HC ADVANCE CARE PLANNING EA ADDL 30 MIN
|
Facility
|
OP
|
$32.64
|
|
|
Service Code
|
CPT 99498
|
| Hospital Charge Code |
51000091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.75 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Aetna Commercial |
$27.74
|
| Rate for Payer: Aetna Medicare |
$8.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.20
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: BCBS MAPPO |
$8.16
|
| Rate for Payer: BCBS Trust/PPO |
$25.38
|
| Rate for Payer: BCN Commercial |
$25.38
|
| Rate for Payer: BCN Medicare Advantage |
$8.16
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.16
|
| Rate for Payer: Healthscope Commercial |
$29.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.74
|
| Rate for Payer: PACE Senior Care Partners |
$7.75
|
| Rate for Payer: PACE SWMI |
$8.16
|
| Rate for Payer: PHP Commercial |
$27.74
|
| Rate for Payer: PHP Medicare Advantage |
$8.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.40
|
| Rate for Payer: Priority Health Medicare |
$8.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.91
|
| Rate for Payer: Railroad Medicare Medicare |
$8.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.72
|
| Rate for Payer: UHC Core |
$27.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.16
|
| Rate for Payer: UHC Medicare Advantage |
$8.40
|
| Rate for Payer: VA VA |
$8.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.48
|
|
|
HC ADVANCE CARE PLANNING EA ADDL 30 MIN
|
Facility
|
IP
|
$32.64
|
|
|
Service Code
|
CPT 99498
|
| Hospital Charge Code |
51000091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Aetna Commercial |
$27.74
|
| Rate for Payer: BCBS Trust/PPO |
$25.22
|
| Rate for Payer: BCN Commercial |
$25.22
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$29.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.74
|
| Rate for Payer: PHP Commercial |
$27.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.72
|
| Rate for Payer: UHC Core |
$27.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.48
|
|
|
HC ADVANCE CARE PLANNING FIRST 30 MIN
|
Facility
|
OP
|
$32.64
|
|
|
Service Code
|
CPT 99497
|
| Hospital Charge Code |
51000090
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.75 |
| Max. Negotiated Rate |
$61.40 |
| Rate for Payer: Aetna Commercial |
$27.74
|
| Rate for Payer: Aetna Medicare |
$8.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.20
|
| Rate for Payer: BCBS Complete |
$61.40
|
| Rate for Payer: BCBS MAPPO |
$8.16
|
| Rate for Payer: BCBS Trust/PPO |
$25.38
|
| Rate for Payer: BCN Commercial |
$25.38
|
| Rate for Payer: BCN Medicare Advantage |
$8.16
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.16
|
| Rate for Payer: Healthscope Commercial |
$29.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.48
|
| Rate for Payer: Mclaren Medicaid |
$58.47
|
| Rate for Payer: Meridian Medicaid |
$61.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.74
|
| Rate for Payer: PACE Senior Care Partners |
$7.75
|
| Rate for Payer: PACE SWMI |
$8.16
|
| Rate for Payer: PHP Commercial |
$27.74
|
| Rate for Payer: PHP Medicare Advantage |
$8.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.40
|
| Rate for Payer: Priority Health Medicare |
$8.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.91
|
| Rate for Payer: Railroad Medicare Medicare |
$8.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.72
|
| Rate for Payer: UHC Core |
$27.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.16
|
| Rate for Payer: UHC Medicare Advantage |
$8.40
|
| Rate for Payer: VA VA |
$8.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.48
|
|
|
HC ADVANCE CARE PLANNING FIRST 30 MIN
|
Facility
|
IP
|
$32.64
|
|
|
Service Code
|
CPT 99497
|
| Hospital Charge Code |
51000090
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Aetna Commercial |
$27.74
|
| Rate for Payer: BCBS Trust/PPO |
$25.22
|
| Rate for Payer: BCN Commercial |
$25.22
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$29.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.74
|
| Rate for Payer: PHP Commercial |
$27.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.72
|
| Rate for Payer: UHC Core |
$27.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.48
|
|
|
HC AEP HEARING STATUS DETER BROADBAND STIMULI I&R
|
Facility
|
IP
|
$158.00
|
|
|
Service Code
|
CPT 92651
|
| Hospital Charge Code |
76100497
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$96.36 |
| Max. Negotiated Rate |
$142.20 |
| Rate for Payer: Aetna Commercial |
$134.30
|
| Rate for Payer: BCBS Trust/PPO |
$122.10
|
| Rate for Payer: BCN Commercial |
$122.10
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$135.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.40
|
| Rate for Payer: Healthscope Commercial |
$142.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.30
|
| Rate for Payer: PHP Commercial |
$134.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.04
|
| Rate for Payer: UHC Core |
$131.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.50
|
|
|
HC AEP HEARING STATUS DETER BROADBAND STIMULI I&R
|
Facility
|
OP
|
$158.00
|
|
|
Service Code
|
CPT 92651
|
| Hospital Charge Code |
76100497
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$37.52 |
| Max. Negotiated Rate |
$216.20 |
| Rate for Payer: Aetna Commercial |
$134.30
|
| Rate for Payer: Aetna Medicare |
$41.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.38
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$39.50
|
| Rate for Payer: BCBS Trust/PPO |
$122.84
|
| Rate for Payer: BCN Commercial |
$122.84
|
| Rate for Payer: BCN Medicare Advantage |
$39.50
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$135.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.50
|
| Rate for Payer: Healthscope Commercial |
$142.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.50
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.30
|
| Rate for Payer: PACE Senior Care Partners |
$37.52
|
| Rate for Payer: PACE SWMI |
$39.50
|
| Rate for Payer: PHP Commercial |
$134.30
|
| Rate for Payer: PHP Medicare Advantage |
$39.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.46
|
| Rate for Payer: Priority Health Medicare |
$39.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.36
|
| Rate for Payer: Railroad Medicare Medicare |
$39.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.04
|
| Rate for Payer: UHC Core |
$131.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.50
|
| Rate for Payer: UHC Medicare Advantage |
$40.68
|
| Rate for Payer: VA VA |
$39.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.50
|
|
|
HC AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R
|
Facility
|
IP
|
$281.00
|
|
|
Service Code
|
CPT 92652
|
| Hospital Charge Code |
47100401
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$171.38 |
| Max. Negotiated Rate |
$252.90 |
| Rate for Payer: Aetna Commercial |
$238.85
|
| Rate for Payer: BCBS Trust/PPO |
$217.16
|
| Rate for Payer: BCN Commercial |
$217.16
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cofinity Commercial |
$241.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.80
|
| Rate for Payer: Healthscope Commercial |
$252.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$238.85
|
| Rate for Payer: PHP Commercial |
$238.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$244.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$171.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.28
|
| Rate for Payer: UHC Core |
$234.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.75
|
|
|
HC AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R
|
Facility
|
OP
|
$281.00
|
|
|
Service Code
|
CPT 92652
|
| Hospital Charge Code |
47100401
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$66.74 |
| Max. Negotiated Rate |
$252.90 |
| Rate for Payer: Aetna Commercial |
$238.85
|
| Rate for Payer: Aetna Medicare |
$73.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.81
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$70.25
|
| Rate for Payer: BCBS Trust/PPO |
$218.48
|
| Rate for Payer: BCN Commercial |
$218.48
|
| Rate for Payer: BCN Medicare Advantage |
$70.25
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cofinity Commercial |
$241.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.25
|
| Rate for Payer: Healthscope Commercial |
$252.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.75
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$73.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$238.85
|
| Rate for Payer: PACE Senior Care Partners |
$66.74
|
| Rate for Payer: PACE SWMI |
$70.25
|
| Rate for Payer: PHP Commercial |
$238.85
|
| Rate for Payer: PHP Medicare Advantage |
$70.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$244.47
|
| Rate for Payer: Priority Health Medicare |
$70.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$171.38
|
| Rate for Payer: Railroad Medicare Medicare |
$70.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.28
|
| Rate for Payer: UHC Core |
$234.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.25
|
| Rate for Payer: UHC Medicare Advantage |
$72.36
|
| Rate for Payer: VA VA |
$70.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.75
|
|
|
HC AEROBIKA
|
Facility
|
IP
|
$147.32
|
|
| Hospital Charge Code |
27000612
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$89.85 |
| Max. Negotiated Rate |
$132.59 |
| Rate for Payer: Aetna Commercial |
$125.22
|
| Rate for Payer: BCBS Trust/PPO |
$113.85
|
| Rate for Payer: BCN Commercial |
$113.85
|
| Rate for Payer: Cash Price |
$117.86
|
| Rate for Payer: Cofinity Commercial |
$126.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.86
|
| Rate for Payer: Healthscope Commercial |
$132.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.22
|
| Rate for Payer: PHP Commercial |
$125.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.64
|
| Rate for Payer: UHC Core |
$123.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.49
|
|
|
HC AEROBIKA
|
Facility
|
OP
|
$147.32
|
|
| Hospital Charge Code |
27000612
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$34.99 |
| Max. Negotiated Rate |
$132.59 |
| Rate for Payer: Aetna Commercial |
$125.22
|
| Rate for Payer: Aetna Medicare |
$38.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.04
|
| Rate for Payer: BCBS Complete |
$58.93
|
| Rate for Payer: BCBS MAPPO |
$36.83
|
| Rate for Payer: BCBS Trust/PPO |
$114.54
|
| Rate for Payer: BCN Commercial |
$114.54
|
| Rate for Payer: BCN Medicare Advantage |
$36.83
|
| Rate for Payer: Cash Price |
$117.86
|
| Rate for Payer: Cofinity Commercial |
$126.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.83
|
| Rate for Payer: Healthscope Commercial |
$132.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.22
|
| Rate for Payer: PACE Senior Care Partners |
$34.99
|
| Rate for Payer: PACE SWMI |
$36.83
|
| Rate for Payer: PHP Commercial |
$125.22
|
| Rate for Payer: PHP Medicare Advantage |
$36.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.17
|
| Rate for Payer: Priority Health Medicare |
$36.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.85
|
| Rate for Payer: Railroad Medicare Medicare |
$36.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.64
|
| Rate for Payer: UHC Core |
$123.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.83
|
| Rate for Payer: UHC Medicare Advantage |
$37.93
|
| Rate for Payer: VA VA |
$36.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.49
|
|
|
HC AERONEB SUPPLY
|
Facility
|
IP
|
$163.93
|
|
| Hospital Charge Code |
27000465
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$99.98 |
| Max. Negotiated Rate |
$147.54 |
| Rate for Payer: Aetna Commercial |
$139.34
|
| Rate for Payer: BCBS Trust/PPO |
$126.69
|
| Rate for Payer: BCN Commercial |
$126.69
|
| Rate for Payer: Cash Price |
$131.14
|
| Rate for Payer: Cofinity Commercial |
$140.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.14
|
| Rate for Payer: Healthscope Commercial |
$147.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$139.34
|
| Rate for Payer: PHP Commercial |
$139.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.26
|
| Rate for Payer: UHC Core |
$136.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.95
|
|
|
HC AERONEB SUPPLY
|
Facility
|
OP
|
$163.93
|
|
| Hospital Charge Code |
27000465
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.93 |
| Max. Negotiated Rate |
$147.54 |
| Rate for Payer: Aetna Commercial |
$139.34
|
| Rate for Payer: Aetna Medicare |
$42.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.23
|
| Rate for Payer: BCBS Complete |
$65.57
|
| Rate for Payer: BCBS MAPPO |
$40.98
|
| Rate for Payer: BCBS Trust/PPO |
$127.46
|
| Rate for Payer: BCN Commercial |
$127.46
|
| Rate for Payer: BCN Medicare Advantage |
$40.98
|
| Rate for Payer: Cash Price |
$131.14
|
| Rate for Payer: Cofinity Commercial |
$140.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.98
|
| Rate for Payer: Healthscope Commercial |
$147.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$139.34
|
| Rate for Payer: PACE Senior Care Partners |
$38.93
|
| Rate for Payer: PACE SWMI |
$40.98
|
| Rate for Payer: PHP Commercial |
$139.34
|
| Rate for Payer: PHP Medicare Advantage |
$40.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.62
|
| Rate for Payer: Priority Health Medicare |
$40.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.98
|
| Rate for Payer: Railroad Medicare Medicare |
$40.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.26
|
| Rate for Payer: UHC Core |
$136.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.98
|
| Rate for Payer: UHC Medicare Advantage |
$42.21
|
| Rate for Payer: VA VA |
$40.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.95
|
|
|
HC AEROSOLIZED MEDICATION
|
Facility
|
OP
|
$146.74
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000012
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$34.85 |
| Max. Negotiated Rate |
$146.91 |
| Rate for Payer: Aetna Commercial |
$124.73
|
| Rate for Payer: Aetna Medicare |
$38.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.86
|
| Rate for Payer: BCBS Complete |
$146.91
|
| Rate for Payer: BCBS MAPPO |
$36.68
|
| Rate for Payer: BCBS Trust/PPO |
$114.09
|
| Rate for Payer: BCN Commercial |
$114.09
|
| Rate for Payer: BCN Medicare Advantage |
$36.68
|
| Rate for Payer: Cash Price |
$117.39
|
| Rate for Payer: Cash Price |
$117.39
|
| Rate for Payer: Cofinity Commercial |
$126.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.68
|
| Rate for Payer: Healthscope Commercial |
$132.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.06
|
| Rate for Payer: Mclaren Medicaid |
$139.92
|
| Rate for Payer: Meridian Medicaid |
$146.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.73
|
| Rate for Payer: PACE Senior Care Partners |
$34.85
|
| Rate for Payer: PACE SWMI |
$36.68
|
| Rate for Payer: PHP Commercial |
$124.73
|
| Rate for Payer: PHP Medicare Advantage |
$36.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.66
|
| Rate for Payer: Priority Health Medicare |
$36.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.50
|
| Rate for Payer: Railroad Medicare Medicare |
$36.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.13
|
| Rate for Payer: UHC Core |
$122.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.68
|
| Rate for Payer: UHC Medicare Advantage |
$37.79
|
| Rate for Payer: VA VA |
$36.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.06
|
|
|
HC AEROSOLIZED MEDICATION
|
Facility
|
IP
|
$146.74
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000012
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$89.50 |
| Max. Negotiated Rate |
$132.07 |
| Rate for Payer: Aetna Commercial |
$124.73
|
| Rate for Payer: BCBS Trust/PPO |
$113.40
|
| Rate for Payer: BCN Commercial |
$113.40
|
| Rate for Payer: Cash Price |
$117.39
|
| Rate for Payer: Cofinity Commercial |
$126.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.39
|
| Rate for Payer: Healthscope Commercial |
$132.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.73
|
| Rate for Payer: PHP Commercial |
$124.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.13
|
| Rate for Payer: UHC Core |
$122.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.06
|
|
|
HC AFB CULTURE
|
Facility
|
IP
|
$89.40
|
|
|
Service Code
|
CPT 87116
|
| Hospital Charge Code |
30600089
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$54.53 |
| Max. Negotiated Rate |
$80.46 |
| Rate for Payer: Aetna Commercial |
$75.99
|
| Rate for Payer: BCBS Trust/PPO |
$69.09
|
| Rate for Payer: BCN Commercial |
$69.09
|
| Rate for Payer: Cash Price |
$71.52
|
| Rate for Payer: Cofinity Commercial |
$76.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.52
|
| Rate for Payer: Healthscope Commercial |
$80.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.99
|
| Rate for Payer: PHP Commercial |
$75.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$77.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.67
|
| Rate for Payer: UHC Core |
$74.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.05
|
|
