HC AFB CULTURE
|
Facility
|
OP
|
$89.40
|
|
Service Code
|
CPT 87116
|
Hospital Charge Code |
30600089
|
Hospital Revenue Code
|
306
|
Min. Negotiated Rate |
$7.97 |
Max. Negotiated Rate |
$80.46 |
Rate for Payer: Aetna Commercial |
$75.99
|
Rate for Payer: Aetna Medicare |
$23.24
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.94
|
Rate for Payer: Amish Plain Church Group Commercial |
$27.94
|
Rate for Payer: BCBS Complete |
$8.37
|
Rate for Payer: BCBS MAPPO |
$22.35
|
Rate for Payer: BCBS Trust/PPO |
$69.51
|
Rate for Payer: BCN Commercial |
$69.51
|
Rate for Payer: BCN Medicare Advantage |
$22.35
|
Rate for Payer: Cash Price |
$71.52
|
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: Health Alliance Plan Medicare Advantage |
$22.35
|
Rate for Payer: Healthscope Commercial |
$80.46
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.05
|
Rate for Payer: Mclaren Medicaid |
$7.97
|
Rate for Payer: Meridian Medicaid |
$8.37
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.47
|
Rate for Payer: MI Amish Medical Board Commercial |
$25.70
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.99
|
Rate for Payer: PACE Senior Care Partners |
$21.23
|
Rate for Payer: PACE SWMI |
$22.35
|
Rate for Payer: PHP Commercial |
$75.99
|
Rate for Payer: PHP Medicare Advantage |
$22.35
|
Rate for Payer: Priority Health Choice Medicaid |
$7.97
|
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 Medicare |
$22.35
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$54.53
|
Rate for Payer: Railroad Medicare Medicare |
$22.35
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$78.67
|
Rate for Payer: UHC Core |
$74.65
|
Rate for Payer: UHC Dual Complete DSNP |
$22.35
|
Rate for Payer: UHC Medicare Advantage |
$23.02
|
Rate for Payer: VA VA |
$22.35
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.05
|
|
HC AFB SMEAR
|
Facility
|
OP
|
$57.50
|
|
Service Code
|
CPT 87206
|
Hospital Charge Code |
30600105
|
Hospital Revenue Code
|
306
|
Min. Negotiated Rate |
$3.98 |
Max. Negotiated Rate |
$51.75 |
Rate for Payer: Aetna Commercial |
$48.88
|
Rate for Payer: Aetna Medicare |
$14.95
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.97
|
Rate for Payer: Amish Plain Church Group Commercial |
$17.97
|
Rate for Payer: BCBS Complete |
$4.18
|
Rate for Payer: BCBS MAPPO |
$14.38
|
Rate for Payer: BCBS Trust/PPO |
$44.71
|
Rate for Payer: BCN Commercial |
$44.71
|
Rate for Payer: BCN Medicare Advantage |
$14.38
|
Rate for Payer: Cash Price |
$46.00
|
Rate for Payer: Cash Price |
$46.00
|
Rate for Payer: Cofinity Commercial |
$49.45
|
Rate for Payer: Encore Health Key Benefits Commercial |
$46.00
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.38
|
Rate for Payer: Healthscope Commercial |
$51.75
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.12
|
Rate for Payer: Mclaren Medicaid |
$3.98
|
Rate for Payer: Meridian Medicaid |
$4.18
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.09
|
Rate for Payer: MI Amish Medical Board Commercial |
$16.53
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.88
|
Rate for Payer: PACE Senior Care Partners |
$13.66
|
Rate for Payer: PACE SWMI |
$14.38
|
Rate for Payer: PHP Commercial |
$48.88
|
Rate for Payer: PHP Medicare Advantage |
$14.38
|
Rate for Payer: Priority Health Choice Medicaid |
$3.98
|
Rate for Payer: Priority Health Cigna Priority Health |
$40.25
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.02
|
Rate for Payer: Priority Health Medicare |
$14.38
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$35.07
|
Rate for Payer: Railroad Medicare Medicare |
$14.38
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$50.60
|
Rate for Payer: UHC Core |
$48.01
|
Rate for Payer: UHC Dual Complete DSNP |
$14.38
|
Rate for Payer: UHC Medicare Advantage |
$14.81
|
Rate for Payer: VA VA |
$14.38
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.12
|
|
HC AFB SMEAR
|
Facility
|
IP
|
$57.50
|
|
Service Code
|
CPT 87206
|
Hospital Charge Code |
30600105
|
Hospital Revenue Code
|
306
|
Min. Negotiated Rate |
$35.07 |
Max. Negotiated Rate |
$51.75 |
Rate for Payer: Aetna Commercial |
$48.88
|
Rate for Payer: BCBS Trust/PPO |
$44.44
|
Rate for Payer: BCN Commercial |
$44.44
|
Rate for Payer: Cash Price |
$46.00
|
Rate for Payer: Cofinity Commercial |
$49.45
|
Rate for Payer: Encore Health Key Benefits Commercial |
$46.00
|
Rate for Payer: Healthscope Commercial |
$51.75
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.12
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.88
|
Rate for Payer: PHP Commercial |
$48.88
|
Rate for Payer: Priority Health Cigna Priority Health |
$40.25
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.02
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$35.07
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$50.60
|
Rate for Payer: UHC Core |
$48.01
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.12
|
|
HC AFFINITY 1.5 X 1.5 PER SQ CM
|
Facility
|
OP
|
$706.86
|
|
Service Code
|
HCPCS Q4159
|
Hospital Charge Code |
63600124
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$167.88 |
Max. Negotiated Rate |
$636.17 |
Rate for Payer: Aetna Commercial |
$600.83
|
Rate for Payer: Aetna Medicare |
$183.78
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.89
|
Rate for Payer: Amish Plain Church Group Commercial |
$220.89
|
Rate for Payer: BCBS Complete |
$282.74
|
Rate for Payer: BCBS MAPPO |
$176.72
|
Rate for Payer: BCBS Trust/PPO |
$549.58
|
Rate for Payer: BCN Commercial |
$549.58
|
Rate for Payer: BCN Medicare Advantage |
$176.72
|
Rate for Payer: Cash Price |
$565.49
|
Rate for Payer: Cofinity Commercial |
$607.90
|
Rate for Payer: Encore Health Key Benefits Commercial |
$565.49
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.72
|
Rate for Payer: Healthscope Commercial |
$636.17
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$530.14
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$185.55
|
Rate for Payer: MI Amish Medical Board Commercial |
$203.22
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$600.83
|
Rate for Payer: PACE Senior Care Partners |
$167.88
|
Rate for Payer: PACE SWMI |
$176.72
|
Rate for Payer: PHP Commercial |
$600.83
|
Rate for Payer: PHP Medicare Advantage |
$176.72
|
Rate for Payer: Priority Health Cigna Priority Health |
$494.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$614.97
|
Rate for Payer: Priority Health Medicare |
$176.72
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$431.11
|
Rate for Payer: Railroad Medicare Medicare |
$176.72
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$622.04
|
Rate for Payer: UHC Core |
$590.23
|
Rate for Payer: UHC Dual Complete DSNP |
$176.72
|
Rate for Payer: UHC Medicare Advantage |
$182.02
|
Rate for Payer: VA VA |
$176.72
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$530.14
|
|
HC AFFINITY 1.5 X 1.5 PER SQ CM
|
Facility
|
IP
|
$706.86
|
|
Service Code
|
HCPCS Q4159
|
Hospital Charge Code |
63600124
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$431.11 |
Max. Negotiated Rate |
$636.17 |
Rate for Payer: Aetna Commercial |
$600.83
|
Rate for Payer: BCBS Trust/PPO |
$546.26
|
Rate for Payer: BCN Commercial |
$546.26
|
Rate for Payer: Cash Price |
$565.49
|
Rate for Payer: Cofinity Commercial |
$607.90
|
Rate for Payer: Encore Health Key Benefits Commercial |
$565.49
|
Rate for Payer: Healthscope Commercial |
$636.17
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$530.14
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$600.83
|
Rate for Payer: PHP Commercial |
$600.83
|
Rate for Payer: Priority Health Cigna Priority Health |
$494.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$614.97
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$431.11
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$622.04
|
Rate for Payer: UHC Core |
$590.23
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$530.14
|
|
HC AFFINITY 2.5 X 2.5 PER SQ CM
|
Facility
|
IP
|
$426.26
|
|
Service Code
|
HCPCS Q4159
|
Hospital Charge Code |
63600125
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$259.98 |
Max. Negotiated Rate |
$383.63 |
Rate for Payer: Aetna Commercial |
$362.32
|
Rate for Payer: BCBS Trust/PPO |
$329.41
|
Rate for Payer: BCN Commercial |
$329.41
|
Rate for Payer: Cash Price |
$341.01
|
Rate for Payer: Cofinity Commercial |
$366.58
|
Rate for Payer: Encore Health Key Benefits Commercial |
$341.01
|
Rate for Payer: Healthscope Commercial |
$383.63
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$319.70
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$362.32
|
Rate for Payer: PHP Commercial |
$362.32
|
Rate for Payer: Priority Health Cigna Priority Health |
$298.38
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$370.85
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$259.98
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$375.11
|
Rate for Payer: UHC Core |
$355.93
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$319.70
|
|
HC AFFINITY 2.5 X 2.5 PER SQ CM
|
Facility
|
OP
|
$426.26
|
|
Service Code
|
HCPCS Q4159
|
Hospital Charge Code |
63600125
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$101.24 |
Max. Negotiated Rate |
$383.63 |
Rate for Payer: Aetna Commercial |
$362.32
|
Rate for Payer: Aetna Medicare |
$110.83
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$133.21
|
Rate for Payer: Amish Plain Church Group Commercial |
$133.21
|
Rate for Payer: BCBS Complete |
$170.50
|
Rate for Payer: BCBS MAPPO |
$106.56
|
Rate for Payer: BCBS Trust/PPO |
$331.42
|
Rate for Payer: BCN Commercial |
$331.42
|
Rate for Payer: BCN Medicare Advantage |
$106.56
|
Rate for Payer: Cash Price |
$341.01
|
Rate for Payer: Cofinity Commercial |
$366.58
|
Rate for Payer: Encore Health Key Benefits Commercial |
$341.01
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.56
|
Rate for Payer: Healthscope Commercial |
$383.63
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$319.70
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$111.89
|
Rate for Payer: MI Amish Medical Board Commercial |
$122.55
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$362.32
|
Rate for Payer: PACE Senior Care Partners |
$101.24
|
Rate for Payer: PACE SWMI |
$106.56
|
Rate for Payer: PHP Commercial |
$362.32
|
Rate for Payer: PHP Medicare Advantage |
$106.56
|
Rate for Payer: Priority Health Cigna Priority Health |
$298.38
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$370.85
|
Rate for Payer: Priority Health Medicare |
$106.56
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$259.98
|
Rate for Payer: Railroad Medicare Medicare |
$106.56
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$375.11
|
Rate for Payer: UHC Core |
$355.93
|
Rate for Payer: UHC Dual Complete DSNP |
$106.56
|
Rate for Payer: UHC Medicare Advantage |
$109.76
|
Rate for Payer: VA VA |
$106.56
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$319.70
|
|
HC AFP SINGLE MARKER SCRN,MS
|
Facility
|
OP
|
$47.94
|
|
Service Code
|
CPT 82105
|
Hospital Charge Code |
30100622
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$11.39 |
Max. Negotiated Rate |
$43.15 |
Rate for Payer: Aetna Commercial |
$40.75
|
Rate for Payer: Aetna Medicare |
$12.46
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
Rate for Payer: BCBS Complete |
$13.00
|
Rate for Payer: BCBS MAPPO |
$11.98
|
Rate for Payer: BCBS Trust/PPO |
$37.27
|
Rate for Payer: BCN Commercial |
$37.27
|
Rate for Payer: BCN Medicare Advantage |
$11.98
|
Rate for Payer: Cash Price |
$38.35
|
Rate for Payer: Cash Price |
$38.35
|
Rate for Payer: Cofinity Commercial |
$41.23
|
Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
Rate for Payer: Healthscope Commercial |
$43.15
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
Rate for Payer: Mclaren Medicaid |
$12.38
|
Rate for Payer: Meridian Medicaid |
$13.00
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.58
|
Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.75
|
Rate for Payer: PACE Senior Care Partners |
$11.39
|
Rate for Payer: PACE SWMI |
$11.98
|
Rate for Payer: PHP Commercial |
$40.75
|
Rate for Payer: PHP Medicare Advantage |
$11.98
|
Rate for Payer: Priority Health Choice Medicaid |
$12.38
|
Rate for Payer: Priority Health Cigna Priority Health |
$33.56
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.71
|
Rate for Payer: Priority Health Medicare |
$11.98
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$29.24
|
Rate for Payer: Railroad Medicare Medicare |
$11.98
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
Rate for Payer: UHC Core |
$40.03
|
Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
Rate for Payer: UHC Medicare Advantage |
$12.34
|
Rate for Payer: VA VA |
$11.98
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
HC AFP SINGLE MARKER SCRN,MS
|
Facility
|
IP
|
$47.94
|
|
Service Code
|
CPT 82105
|
Hospital Charge Code |
30100622
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$29.24 |
Max. Negotiated Rate |
$43.15 |
Rate for Payer: Aetna Commercial |
$40.75
|
Rate for Payer: BCBS Trust/PPO |
$37.05
|
Rate for Payer: BCN Commercial |
$37.05
|
Rate for Payer: Cash Price |
$38.35
|
Rate for Payer: Cofinity Commercial |
$41.23
|
Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
Rate for Payer: Healthscope Commercial |
$43.15
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.75
|
Rate for Payer: PHP Commercial |
$40.75
|
Rate for Payer: Priority Health Cigna Priority Health |
$33.56
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.71
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$29.24
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$42.19
|
Rate for Payer: UHC Core |
$40.03
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
HC AFTER HOURS ACCESS
|
Facility
|
OP
|
$20.00
|
|
Service Code
|
CPT 99050
|
Hospital Charge Code |
98300006
|
Hospital Revenue Code
|
983
|
Min. Negotiated Rate |
$4.75 |
Max. Negotiated Rate |
$18.00 |
Rate for Payer: Aetna Commercial |
$17.00
|
Rate for Payer: Aetna Medicare |
$5.20
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.25
|
Rate for Payer: Amish Plain Church Group Commercial |
$6.25
|
Rate for Payer: BCBS Complete |
$8.00
|
Rate for Payer: BCBS MAPPO |
$5.00
|
Rate for Payer: BCBS Trust/PPO |
$15.55
|
Rate for Payer: BCN Commercial |
$15.55
|
Rate for Payer: BCN Medicare Advantage |
$5.00
|
Rate for Payer: Cash Price |
$16.00
|
Rate for Payer: Cofinity Commercial |
$17.20
|
Rate for Payer: Encore Health Key Benefits Commercial |
$16.00
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.00
|
Rate for Payer: Healthscope Commercial |
$18.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.00
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.25
|
Rate for Payer: MI Amish Medical Board Commercial |
$5.75
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.00
|
Rate for Payer: PACE Senior Care Partners |
$4.75
|
Rate for Payer: PACE SWMI |
$5.00
|
Rate for Payer: PHP Commercial |
$17.00
|
Rate for Payer: PHP Medicare Advantage |
$5.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$14.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.40
|
Rate for Payer: Priority Health Medicare |
$5.00
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$12.20
|
Rate for Payer: Railroad Medicare Medicare |
$5.00
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$17.60
|
Rate for Payer: UHC Core |
$16.70
|
Rate for Payer: UHC Dual Complete DSNP |
$5.00
|
Rate for Payer: UHC Medicare Advantage |
$5.15
|
Rate for Payer: VA VA |
$5.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.00
|
|
HC AFTER HOURS ACCESS
|
Facility
|
IP
|
$20.00
|
|
Service Code
|
CPT 99050
|
Hospital Charge Code |
98300006
|
Hospital Revenue Code
|
983
|
Min. Negotiated Rate |
$12.20 |
Max. Negotiated Rate |
$18.00 |
Rate for Payer: Aetna Commercial |
$17.00
|
Rate for Payer: BCBS Trust/PPO |
$15.46
|
Rate for Payer: BCN Commercial |
$15.46
|
Rate for Payer: Cash Price |
$16.00
|
Rate for Payer: Cofinity Commercial |
$17.20
|
Rate for Payer: Encore Health Key Benefits Commercial |
$16.00
|
Rate for Payer: Healthscope Commercial |
$18.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.00
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.00
|
Rate for Payer: PHP Commercial |
$17.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$14.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.40
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$12.20
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$17.60
|
Rate for Payer: UHC Core |
$16.70
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.00
|
|
HC ALBUMIN SERUM
|
Facility
|
OP
|
$37.90
|
|
Service Code
|
CPT 82040
|
Hospital Charge Code |
30100072
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$3.65 |
Max. Negotiated Rate |
$34.11 |
Rate for Payer: Aetna Commercial |
$32.22
|
Rate for Payer: Aetna Medicare |
$9.85
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.84
|
Rate for Payer: Amish Plain Church Group Commercial |
$11.84
|
Rate for Payer: BCBS Complete |
$3.84
|
Rate for Payer: BCBS MAPPO |
$9.48
|
Rate for Payer: BCBS Trust/PPO |
$29.47
|
Rate for Payer: BCN Commercial |
$29.47
|
Rate for Payer: BCN Medicare Advantage |
$9.48
|
Rate for Payer: Cash Price |
$30.32
|
Rate for Payer: Cash Price |
$30.32
|
Rate for Payer: Cofinity Commercial |
$32.59
|
Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.48
|
Rate for Payer: Healthscope Commercial |
$34.11
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
Rate for Payer: Mclaren Medicaid |
$3.65
|
Rate for Payer: Meridian Medicaid |
$3.84
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.95
|
Rate for Payer: MI Amish Medical Board Commercial |
$10.90
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
Rate for Payer: PACE Senior Care Partners |
$9.00
|
Rate for Payer: PACE SWMI |
$9.48
|
Rate for Payer: PHP Commercial |
$32.22
|
Rate for Payer: PHP Medicare Advantage |
$9.48
|
Rate for Payer: Priority Health Choice Medicaid |
$3.65
|
Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
Rate for Payer: Priority Health Medicare |
$9.48
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
Rate for Payer: Railroad Medicare Medicare |
$9.48
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
Rate for Payer: UHC Core |
$31.65
|
Rate for Payer: UHC Dual Complete DSNP |
$9.48
|
Rate for Payer: UHC Medicare Advantage |
$9.76
|
Rate for Payer: VA VA |
$9.48
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
HC ALBUMIN SERUM
|
Facility
|
IP
|
$37.90
|
|
Service Code
|
CPT 82040
|
Hospital Charge Code |
30100072
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$23.12 |
Max. Negotiated Rate |
$34.11 |
Rate for Payer: Aetna Commercial |
$32.22
|
Rate for Payer: BCBS Trust/PPO |
$29.29
|
Rate for Payer: BCN Commercial |
$29.29
|
Rate for Payer: Cash Price |
$30.32
|
Rate for Payer: Cofinity Commercial |
$32.59
|
Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
Rate for Payer: Healthscope Commercial |
$34.11
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
Rate for Payer: PHP Commercial |
$32.22
|
Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
Rate for Payer: UHC Core |
$31.65
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
HC ALBUMIN URINE OR OTHER SOURCE
|
Facility
|
OP
|
$40.49
|
|
Service Code
|
CPT 82042
|
Hospital Charge Code |
30100663
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$5.74 |
Max. Negotiated Rate |
$36.44 |
Rate for Payer: Aetna Commercial |
$34.42
|
Rate for Payer: Aetna Medicare |
$10.53
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.65
|
Rate for Payer: Amish Plain Church Group Commercial |
$12.65
|
Rate for Payer: BCBS Complete |
$6.03
|
Rate for Payer: BCBS MAPPO |
$10.12
|
Rate for Payer: BCBS Trust/PPO |
$31.48
|
Rate for Payer: BCN Commercial |
$31.48
|
Rate for Payer: BCN Medicare Advantage |
$10.12
|
Rate for Payer: Cash Price |
$32.39
|
Rate for Payer: Cash Price |
$32.39
|
Rate for Payer: Cofinity Commercial |
$34.82
|
Rate for Payer: Encore Health Key Benefits Commercial |
$32.39
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.12
|
Rate for Payer: Healthscope Commercial |
$36.44
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.37
|
Rate for Payer: Mclaren Medicaid |
$5.74
|
Rate for Payer: Meridian Medicaid |
$6.03
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.63
|
Rate for Payer: MI Amish Medical Board Commercial |
$11.64
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.42
|
Rate for Payer: PACE Senior Care Partners |
$9.62
|
Rate for Payer: PACE SWMI |
$10.12
|
Rate for Payer: PHP Commercial |
$34.42
|
Rate for Payer: PHP Medicare Advantage |
$10.12
|
Rate for Payer: Priority Health Choice Medicaid |
$5.74
|
Rate for Payer: Priority Health Cigna Priority Health |
$28.34
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.23
|
Rate for Payer: Priority Health Medicare |
$10.12
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$24.69
|
Rate for Payer: Railroad Medicare Medicare |
$10.12
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$35.63
|
Rate for Payer: UHC Core |
$33.81
|
Rate for Payer: UHC Dual Complete DSNP |
$10.12
|
Rate for Payer: UHC Medicare Advantage |
$10.43
|
Rate for Payer: VA VA |
$10.12
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.37
|
|
HC ALBUMIN URINE OR OTHER SOURCE
|
Facility
|
IP
|
$40.49
|
|
Service Code
|
CPT 82042
|
Hospital Charge Code |
30100663
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$24.69 |
Max. Negotiated Rate |
$36.44 |
Rate for Payer: Aetna Commercial |
$34.42
|
Rate for Payer: BCBS Trust/PPO |
$31.29
|
Rate for Payer: BCN Commercial |
$31.29
|
Rate for Payer: Cash Price |
$32.39
|
Rate for Payer: Cofinity Commercial |
$34.82
|
Rate for Payer: Encore Health Key Benefits Commercial |
$32.39
|
Rate for Payer: Healthscope Commercial |
$36.44
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.37
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.42
|
Rate for Payer: PHP Commercial |
$34.42
|
Rate for Payer: Priority Health Cigna Priority Health |
$28.34
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.23
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$24.69
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$35.63
|
Rate for Payer: UHC Core |
$33.81
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.37
|
|
HC ALBUTEROL, INHALATION SOLUTION, UNIT DOSE 1MG
|
Facility
|
OP
|
$6.12
|
|
Service Code
|
CPT J7613
|
Hospital Charge Code |
63600110
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$1.45 |
Max. Negotiated Rate |
$5.51 |
Rate for Payer: Aetna Commercial |
$5.20
|
Rate for Payer: Aetna Medicare |
$1.59
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.91
|
Rate for Payer: Amish Plain Church Group Commercial |
$1.91
|
Rate for Payer: BCBS Complete |
$2.45
|
Rate for Payer: BCBS MAPPO |
$1.53
|
Rate for Payer: BCBS Trust/PPO |
$4.76
|
Rate for Payer: BCN Commercial |
$4.76
|
Rate for Payer: BCN Medicare Advantage |
$1.53
|
Rate for Payer: Cash Price |
$4.90
|
Rate for Payer: Cofinity Commercial |
$5.26
|
Rate for Payer: Encore Health Key Benefits Commercial |
$4.90
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.53
|
Rate for Payer: Healthscope Commercial |
$5.51
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.59
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1.61
|
Rate for Payer: MI Amish Medical Board Commercial |
$1.76
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.20
|
Rate for Payer: PACE Senior Care Partners |
$1.45
|
Rate for Payer: PACE SWMI |
$1.53
|
Rate for Payer: PHP Commercial |
$5.20
|
Rate for Payer: PHP Medicare Advantage |
$1.53
|
Rate for Payer: Priority Health Cigna Priority Health |
$4.28
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.32
|
Rate for Payer: Priority Health Medicare |
$1.53
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$3.73
|
Rate for Payer: Railroad Medicare Medicare |
$1.53
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$5.39
|
Rate for Payer: UHC Core |
$5.11
|
Rate for Payer: UHC Dual Complete DSNP |
$1.53
|
Rate for Payer: UHC Medicare Advantage |
$1.58
|
Rate for Payer: VA VA |
$1.53
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.59
|
|
HC ALBUTEROL, INHALATION SOLUTION, UNIT DOSE 1MG
|
Facility
|
IP
|
$6.12
|
|
Service Code
|
CPT J7613
|
Hospital Charge Code |
63600110
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$3.73 |
Max. Negotiated Rate |
$5.51 |
Rate for Payer: Aetna Commercial |
$5.20
|
Rate for Payer: BCBS Trust/PPO |
$4.73
|
Rate for Payer: BCN Commercial |
$4.73
|
Rate for Payer: Cash Price |
$4.90
|
Rate for Payer: Cofinity Commercial |
$5.26
|
Rate for Payer: Encore Health Key Benefits Commercial |
$4.90
|
Rate for Payer: Healthscope Commercial |
$5.51
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.59
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.20
|
Rate for Payer: PHP Commercial |
$5.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$4.28
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.32
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$3.73
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$5.39
|
Rate for Payer: UHC Core |
$5.11
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.59
|
|
HC ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG
|
Facility
|
IP
|
$4.08
|
|
Service Code
|
CPT J7620
|
Hospital Charge Code |
63600111
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$2.49 |
Max. Negotiated Rate |
$3.67 |
Rate for Payer: Aetna Commercial |
$3.47
|
Rate for Payer: BCBS Trust/PPO |
$3.15
|
Rate for Payer: BCN Commercial |
$3.15
|
Rate for Payer: Cash Price |
$3.26
|
Rate for Payer: Cofinity Commercial |
$3.51
|
Rate for Payer: Encore Health Key Benefits Commercial |
$3.26
|
Rate for Payer: Healthscope Commercial |
$3.67
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.06
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.47
|
Rate for Payer: PHP Commercial |
$3.47
|
Rate for Payer: Priority Health Cigna Priority Health |
$2.86
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.55
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2.49
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$3.59
|
Rate for Payer: UHC Core |
$3.41
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.06
|
|
HC ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG
|
Facility
|
OP
|
$4.08
|
|
Service Code
|
CPT J7620
|
Hospital Charge Code |
63600111
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.97 |
Max. Negotiated Rate |
$3.67 |
Rate for Payer: Aetna Commercial |
$3.47
|
Rate for Payer: Aetna Medicare |
$1.06
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.28
|
Rate for Payer: Amish Plain Church Group Commercial |
$1.28
|
Rate for Payer: BCBS Complete |
$1.63
|
Rate for Payer: BCBS MAPPO |
$1.02
|
Rate for Payer: BCBS Trust/PPO |
$3.17
|
Rate for Payer: BCN Commercial |
$3.17
|
Rate for Payer: BCN Medicare Advantage |
$1.02
|
Rate for Payer: Cash Price |
$3.26
|
Rate for Payer: Cofinity Commercial |
$3.51
|
Rate for Payer: Encore Health Key Benefits Commercial |
$3.26
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.02
|
Rate for Payer: Healthscope Commercial |
$3.67
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.06
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1.07
|
Rate for Payer: MI Amish Medical Board Commercial |
$1.17
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.47
|
Rate for Payer: PACE Senior Care Partners |
$0.97
|
Rate for Payer: PACE SWMI |
$1.02
|
Rate for Payer: PHP Commercial |
$3.47
|
Rate for Payer: PHP Medicare Advantage |
$1.02
|
Rate for Payer: Priority Health Cigna Priority Health |
$2.86
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.55
|
Rate for Payer: Priority Health Medicare |
$1.02
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2.49
|
Rate for Payer: Railroad Medicare Medicare |
$1.02
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$3.59
|
Rate for Payer: UHC Core |
$3.41
|
Rate for Payer: UHC Dual Complete DSNP |
$1.02
|
Rate for Payer: UHC Medicare Advantage |
$1.05
|
Rate for Payer: VA VA |
$1.02
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.06
|
|
HC ALCOHOL ETHANOL LVL.
|
Facility
|
IP
|
$123.41
|
|
Service Code
|
CPT 80307
|
Hospital Charge Code |
30100651
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$75.27 |
Max. Negotiated Rate |
$111.07 |
Rate for Payer: Aetna Commercial |
$104.90
|
Rate for Payer: BCBS Trust/PPO |
$95.37
|
Rate for Payer: BCN Commercial |
$95.37
|
Rate for Payer: Cash Price |
$98.73
|
Rate for Payer: Cofinity Commercial |
$106.13
|
Rate for Payer: Encore Health Key Benefits Commercial |
$98.73
|
Rate for Payer: Healthscope Commercial |
$111.07
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.56
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.90
|
Rate for Payer: PHP Commercial |
$104.90
|
Rate for Payer: Priority Health Cigna Priority Health |
$86.39
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.37
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$75.27
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$108.60
|
Rate for Payer: UHC Core |
$103.05
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.56
|
|
HC ALCOHOL ETHANOL LVL.
|
Facility
|
OP
|
$123.41
|
|
Service Code
|
CPT 80307
|
Hospital Charge Code |
30100651
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$29.31 |
Max. Negotiated Rate |
$111.07 |
Rate for Payer: Aetna Commercial |
$104.90
|
Rate for Payer: Aetna Medicare |
$32.09
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.57
|
Rate for Payer: Amish Plain Church Group Commercial |
$38.57
|
Rate for Payer: BCBS Complete |
$48.15
|
Rate for Payer: BCBS MAPPO |
$30.85
|
Rate for Payer: BCBS Trust/PPO |
$95.95
|
Rate for Payer: BCN Commercial |
$95.95
|
Rate for Payer: BCN Medicare Advantage |
$30.85
|
Rate for Payer: Cash Price |
$98.73
|
Rate for Payer: Cash Price |
$98.73
|
Rate for Payer: Cofinity Commercial |
$106.13
|
Rate for Payer: Encore Health Key Benefits Commercial |
$98.73
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.85
|
Rate for Payer: Healthscope Commercial |
$111.07
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.56
|
Rate for Payer: Mclaren Medicaid |
$45.86
|
Rate for Payer: Meridian Medicaid |
$48.15
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.40
|
Rate for Payer: MI Amish Medical Board Commercial |
$35.48
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.90
|
Rate for Payer: PACE Senior Care Partners |
$29.31
|
Rate for Payer: PACE SWMI |
$30.85
|
Rate for Payer: PHP Commercial |
$104.90
|
Rate for Payer: PHP Medicare Advantage |
$30.85
|
Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
Rate for Payer: Priority Health Cigna Priority Health |
$86.39
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.37
|
Rate for Payer: Priority Health Medicare |
$30.85
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$75.27
|
Rate for Payer: Railroad Medicare Medicare |
$30.85
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$108.60
|
Rate for Payer: UHC Core |
$103.05
|
Rate for Payer: UHC Dual Complete DSNP |
$30.85
|
Rate for Payer: UHC Medicare Advantage |
$31.78
|
Rate for Payer: VA VA |
$30.85
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.56
|
|
HC ALCOHOL ETHANOL LVL REFLEX
|
Facility
|
OP
|
$65.00
|
|
Service Code
|
CPT 80320
|
Hospital Charge Code |
30100617
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$15.44 |
Max. Negotiated Rate |
$58.50 |
Rate for Payer: Aetna Commercial |
$55.25
|
Rate for Payer: Aetna Medicare |
$16.90
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.31
|
Rate for Payer: Amish Plain Church Group Commercial |
$20.31
|
Rate for Payer: BCBS Complete |
$26.00
|
Rate for Payer: BCBS MAPPO |
$16.25
|
Rate for Payer: BCBS Trust/PPO |
$50.54
|
Rate for Payer: BCN Commercial |
$50.54
|
Rate for Payer: BCN Medicare Advantage |
$16.25
|
Rate for Payer: Cash Price |
$52.00
|
Rate for Payer: Cofinity Commercial |
$55.90
|
Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.25
|
Rate for Payer: Healthscope Commercial |
$58.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.06
|
Rate for Payer: MI Amish Medical Board Commercial |
$18.69
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
Rate for Payer: PACE Senior Care Partners |
$15.44
|
Rate for Payer: PACE SWMI |
$16.25
|
Rate for Payer: PHP Commercial |
$55.25
|
Rate for Payer: PHP Medicare Advantage |
$16.25
|
Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.55
|
Rate for Payer: Priority Health Medicare |
$16.25
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$39.64
|
Rate for Payer: Railroad Medicare Medicare |
$16.25
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$57.20
|
Rate for Payer: UHC Core |
$54.28
|
Rate for Payer: UHC Dual Complete DSNP |
$16.25
|
Rate for Payer: UHC Medicare Advantage |
$16.74
|
Rate for Payer: VA VA |
$16.25
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
HC ALCOHOL ETHANOL LVL REFLEX
|
Facility
|
IP
|
$65.00
|
|
Service Code
|
CPT 80320
|
Hospital Charge Code |
30100617
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$39.64 |
Max. Negotiated Rate |
$58.50 |
Rate for Payer: Aetna Commercial |
$55.25
|
Rate for Payer: BCBS Trust/PPO |
$50.23
|
Rate for Payer: BCN Commercial |
$50.23
|
Rate for Payer: Cash Price |
$52.00
|
Rate for Payer: Cofinity Commercial |
$55.90
|
Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
Rate for Payer: Healthscope Commercial |
$58.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
Rate for Payer: PHP Commercial |
$55.25
|
Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.55
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$39.64
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$57.20
|
Rate for Payer: UHC Core |
$54.28
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
HC ALDER IGE
|
Facility
|
IP
|
$24.89
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
30200071
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$15.18 |
Max. Negotiated Rate |
$22.40 |
Rate for Payer: Aetna Commercial |
$21.16
|
Rate for Payer: BCBS Trust/PPO |
$19.23
|
Rate for Payer: BCN Commercial |
$19.23
|
Rate for Payer: Cash Price |
$19.91
|
Rate for Payer: Cofinity Commercial |
$21.41
|
Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
Rate for Payer: Healthscope Commercial |
$22.40
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
Rate for Payer: PHP Commercial |
$21.16
|
Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
Rate for Payer: UHC Core |
$20.78
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
HC ALDER IGE
|
Facility
|
OP
|
$24.89
|
|
Service Code
|
CPT 86003
|
Hospital Charge Code |
30200071
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$3.85 |
Max. Negotiated Rate |
$22.40 |
Rate for Payer: Aetna Commercial |
$21.16
|
Rate for Payer: Aetna Medicare |
$6.47
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
Rate for Payer: BCBS Complete |
$4.04
|
Rate for Payer: BCBS MAPPO |
$6.22
|
Rate for Payer: BCBS Trust/PPO |
$19.35
|
Rate for Payer: BCN Commercial |
$19.35
|
Rate for Payer: BCN Medicare Advantage |
$6.22
|
Rate for Payer: Cash Price |
$19.91
|
Rate for Payer: Cash Price |
$19.91
|
Rate for Payer: Cofinity Commercial |
$21.41
|
Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
Rate for Payer: Healthscope Commercial |
$22.40
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
Rate for Payer: Mclaren Medicaid |
$3.85
|
Rate for Payer: Meridian Medicaid |
$4.04
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
Rate for Payer: PACE Senior Care Partners |
$5.91
|
Rate for Payer: PACE SWMI |
$6.22
|
Rate for Payer: PHP Commercial |
$21.16
|
Rate for Payer: PHP Medicare Advantage |
$6.22
|
Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
Rate for Payer: Priority Health Medicare |
$6.22
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
Rate for Payer: Railroad Medicare Medicare |
$6.22
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
Rate for Payer: UHC Core |
$20.78
|
Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
Rate for Payer: UHC Medicare Advantage |
$6.41
|
Rate for Payer: VA VA |
$6.22
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|