|
HC APPLY LC SKIN SUB ADDL 25 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
OP
|
$696.66
|
|
|
Service Code
|
HCPCS 15272
|
| Hospital Charge Code |
76100050
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$165.46 |
| Max. Negotiated Rate |
$626.99 |
| Rate for Payer: Aetna Commercial |
$592.16
|
| Rate for Payer: Aetna Medicare |
$181.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.71
|
| Rate for Payer: BCBS Complete |
$278.66
|
| Rate for Payer: BCBS MAPPO |
$174.16
|
| Rate for Payer: BCBS Trust/PPO |
$541.65
|
| Rate for Payer: BCN Commercial |
$541.65
|
| Rate for Payer: BCN Medicare Advantage |
$174.16
|
| Rate for Payer: Cash Price |
$557.33
|
| Rate for Payer: Cofinity Commercial |
$599.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.16
|
| Rate for Payer: Healthscope Commercial |
$626.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$182.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$592.16
|
| Rate for Payer: PACE Senior Care Partners |
$165.46
|
| Rate for Payer: PACE SWMI |
$174.16
|
| Rate for Payer: PHP Commercial |
$592.16
|
| Rate for Payer: PHP Medicare Advantage |
$174.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.09
|
| Rate for Payer: Priority Health Medicare |
$174.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$424.89
|
| Rate for Payer: Railroad Medicare Medicare |
$174.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.06
|
| Rate for Payer: UHC Core |
$581.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.16
|
| Rate for Payer: UHC Medicare Advantage |
$179.39
|
| Rate for Payer: VA VA |
$174.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.50
|
|
|
HC APPLY LC SKIN SUB ADDL 25 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
IP
|
$696.66
|
|
|
Service Code
|
HCPCS 15272
|
| Hospital Charge Code |
76100050
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$424.89 |
| Max. Negotiated Rate |
$626.99 |
| Rate for Payer: Aetna Commercial |
$592.16
|
| Rate for Payer: BCBS Trust/PPO |
$538.38
|
| Rate for Payer: BCN Commercial |
$538.38
|
| Rate for Payer: Cash Price |
$557.33
|
| Rate for Payer: Cofinity Commercial |
$599.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.33
|
| Rate for Payer: Healthscope Commercial |
$626.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$592.16
|
| Rate for Payer: PHP Commercial |
$592.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$606.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$424.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$613.06
|
| Rate for Payer: UHC Core |
$581.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.50
|
|
|
HC APPLY SPLINT/CAST COMPLEX
|
Facility
|
IP
|
$322.41
|
|
| Hospital Charge Code |
45000027
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$196.64 |
| Max. Negotiated Rate |
$290.17 |
| Rate for Payer: Aetna Commercial |
$274.05
|
| Rate for Payer: BCBS Trust/PPO |
$249.16
|
| Rate for Payer: BCN Commercial |
$249.16
|
| Rate for Payer: Cash Price |
$257.93
|
| Rate for Payer: Cofinity Commercial |
$277.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.93
|
| Rate for Payer: Healthscope Commercial |
$290.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$274.05
|
| Rate for Payer: PHP Commercial |
$274.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$280.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.72
|
| Rate for Payer: UHC Core |
$269.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.81
|
|
|
HC APPLY SPLINT/CAST COMPLEX
|
Facility
|
OP
|
$322.41
|
|
| Hospital Charge Code |
45000027
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$76.57 |
| Max. Negotiated Rate |
$290.17 |
| Rate for Payer: Aetna Commercial |
$274.05
|
| Rate for Payer: Aetna Medicare |
$83.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.75
|
| Rate for Payer: BCBS Complete |
$128.96
|
| Rate for Payer: BCBS MAPPO |
$80.60
|
| Rate for Payer: BCBS Trust/PPO |
$250.67
|
| Rate for Payer: BCN Commercial |
$250.67
|
| Rate for Payer: BCN Medicare Advantage |
$80.60
|
| Rate for Payer: Cash Price |
$257.93
|
| Rate for Payer: Cofinity Commercial |
$277.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.60
|
| Rate for Payer: Healthscope Commercial |
$290.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$274.05
|
| Rate for Payer: PACE Senior Care Partners |
$76.57
|
| Rate for Payer: PACE SWMI |
$80.60
|
| Rate for Payer: PHP Commercial |
$274.05
|
| Rate for Payer: PHP Medicare Advantage |
$80.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$280.50
|
| Rate for Payer: Priority Health Medicare |
$80.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$196.64
|
| Rate for Payer: Railroad Medicare Medicare |
$80.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.72
|
| Rate for Payer: UHC Core |
$269.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.60
|
| Rate for Payer: UHC Medicare Advantage |
$83.02
|
| Rate for Payer: VA VA |
$80.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.81
|
|
|
HC APPLY SPLINT/CAST SIMPLE
|
Facility
|
OP
|
$193.15
|
|
| Hospital Charge Code |
45000028
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$45.87 |
| Max. Negotiated Rate |
$173.84 |
| Rate for Payer: Aetna Commercial |
$164.18
|
| Rate for Payer: Aetna Medicare |
$50.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.36
|
| Rate for Payer: BCBS Complete |
$77.26
|
| Rate for Payer: BCBS MAPPO |
$48.29
|
| Rate for Payer: BCBS Trust/PPO |
$150.17
|
| Rate for Payer: BCN Commercial |
$150.17
|
| Rate for Payer: BCN Medicare Advantage |
$48.29
|
| Rate for Payer: Cash Price |
$154.52
|
| Rate for Payer: Cofinity Commercial |
$166.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.29
|
| Rate for Payer: Healthscope Commercial |
$173.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.18
|
| Rate for Payer: PACE Senior Care Partners |
$45.87
|
| Rate for Payer: PACE SWMI |
$48.29
|
| Rate for Payer: PHP Commercial |
$164.18
|
| Rate for Payer: PHP Medicare Advantage |
$48.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.04
|
| Rate for Payer: Priority Health Medicare |
$48.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.80
|
| Rate for Payer: Railroad Medicare Medicare |
$48.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.97
|
| Rate for Payer: UHC Core |
$161.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.29
|
| Rate for Payer: UHC Medicare Advantage |
$49.74
|
| Rate for Payer: VA VA |
$48.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.86
|
|
|
HC APPLY SPLINT/CAST SIMPLE
|
Facility
|
IP
|
$193.15
|
|
| Hospital Charge Code |
45000028
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$117.80 |
| Max. Negotiated Rate |
$173.84 |
| Rate for Payer: Aetna Commercial |
$164.18
|
| Rate for Payer: BCBS Trust/PPO |
$149.27
|
| Rate for Payer: BCN Commercial |
$149.27
|
| Rate for Payer: Cash Price |
$154.52
|
| Rate for Payer: Cofinity Commercial |
$166.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.52
|
| Rate for Payer: Healthscope Commercial |
$173.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.18
|
| Rate for Payer: PHP Commercial |
$164.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.97
|
| Rate for Payer: UHC Core |
$161.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.86
|
|
|
HC APT DOWNEY TEST
|
Facility
|
OP
|
$90.40
|
|
|
Service Code
|
CPT 83033
|
| Hospital Charge Code |
30100237
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.90 |
| Max. Negotiated Rate |
$81.36 |
| Rate for Payer: Aetna Commercial |
$76.84
|
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.25
|
| Rate for Payer: BCBS Complete |
$6.20
|
| Rate for Payer: BCBS MAPPO |
$22.60
|
| Rate for Payer: BCBS Trust/PPO |
$70.29
|
| Rate for Payer: BCN Commercial |
$70.29
|
| Rate for Payer: BCN Medicare Advantage |
$22.60
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cofinity Commercial |
$77.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.60
|
| Rate for Payer: Healthscope Commercial |
$81.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.80
|
| Rate for Payer: Mclaren Medicaid |
$5.90
|
| Rate for Payer: Meridian Medicaid |
$6.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.84
|
| Rate for Payer: PACE Senior Care Partners |
$21.47
|
| Rate for Payer: PACE SWMI |
$22.60
|
| Rate for Payer: PHP Commercial |
$76.84
|
| Rate for Payer: PHP Medicare Advantage |
$22.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.65
|
| Rate for Payer: Priority Health Medicare |
$22.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.13
|
| Rate for Payer: Railroad Medicare Medicare |
$22.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.55
|
| Rate for Payer: UHC Core |
$75.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.60
|
| Rate for Payer: UHC Medicare Advantage |
$23.28
|
| Rate for Payer: VA VA |
$22.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.80
|
|
|
HC APT DOWNEY TEST
|
Facility
|
IP
|
$90.40
|
|
|
Service Code
|
CPT 83033
|
| Hospital Charge Code |
30100237
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.13 |
| Max. Negotiated Rate |
$81.36 |
| Rate for Payer: Aetna Commercial |
$76.84
|
| Rate for Payer: BCBS Trust/PPO |
$69.86
|
| Rate for Payer: BCN Commercial |
$69.86
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cofinity Commercial |
$77.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.32
|
| Rate for Payer: Healthscope Commercial |
$81.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.84
|
| Rate for Payer: PHP Commercial |
$76.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.55
|
| Rate for Payer: UHC Core |
$75.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.80
|
|
|
HC APTT
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500063
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC APTT
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500063
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$4.66
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$4.44
|
| Rate for Payer: Meridian Medicaid |
$4.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC APTT MIXING STUDY
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 85732
|
| Hospital Charge Code |
30500064
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$59.77 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Aetna Commercial |
$83.30
|
| Rate for Payer: BCBS Trust/PPO |
$75.73
|
| Rate for Payer: BCN Commercial |
$75.73
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cofinity Commercial |
$84.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.40
|
| Rate for Payer: Healthscope Commercial |
$88.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$83.30
|
| Rate for Payer: PHP Commercial |
$83.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.24
|
| Rate for Payer: UHC Core |
$81.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.50
|
|
|
HC APTT MIXING STUDY
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 85732
|
| Hospital Charge Code |
30500064
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.77 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Aetna Commercial |
$83.30
|
| Rate for Payer: Aetna Medicare |
$25.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.62
|
| Rate for Payer: BCBS Complete |
$5.01
|
| Rate for Payer: BCBS MAPPO |
$24.50
|
| Rate for Payer: BCBS Trust/PPO |
$76.20
|
| Rate for Payer: BCN Commercial |
$76.20
|
| Rate for Payer: BCN Medicare Advantage |
$24.50
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cofinity Commercial |
$84.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.50
|
| Rate for Payer: Healthscope Commercial |
$88.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.50
|
| Rate for Payer: Mclaren Medicaid |
$4.77
|
| Rate for Payer: Meridian Medicaid |
$5.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$83.30
|
| Rate for Payer: PACE Senior Care Partners |
$23.28
|
| Rate for Payer: PACE SWMI |
$24.50
|
| Rate for Payer: PHP Commercial |
$83.30
|
| Rate for Payer: PHP Medicare Advantage |
$24.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.26
|
| Rate for Payer: Priority Health Medicare |
$24.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.77
|
| Rate for Payer: Railroad Medicare Medicare |
$24.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.24
|
| Rate for Payer: UHC Core |
$81.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.50
|
| Rate for Payer: UHC Medicare Advantage |
$25.24
|
| Rate for Payer: VA VA |
$24.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.50
|
|
|
HC AQUATIC THERAPY EA 15 MIN
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 97113
|
| Hospital Charge Code |
42000022
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.69
|
| Rate for Payer: BCBS Complete |
$36.72
|
| Rate for Payer: BCBS MAPPO |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$71.37
|
| Rate for Payer: BCN Commercial |
$71.37
|
| Rate for Payer: BCN Medicare Advantage |
$22.95
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.95
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.03
|
| Rate for Payer: PACE Senior Care Partners |
$21.80
|
| Rate for Payer: PACE SWMI |
$22.95
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Medicare Advantage |
$22.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.87
|
| Rate for Payer: Priority Health Medicare |
$22.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.99
|
| Rate for Payer: Railroad Medicare Medicare |
$22.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.95
|
| Rate for Payer: UHC Medicare Advantage |
$23.64
|
| Rate for Payer: VA VA |
$22.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC AQUATIC THERAPY EA 15 MIN
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 97113
|
| Hospital Charge Code |
42000022
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$55.99 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: BCBS Trust/PPO |
$70.94
|
| Rate for Payer: BCN Commercial |
$70.94
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.03
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$79.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC ARBOVIRUS CALIF CMPT
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200388
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$10.22
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$9.73
|
| Rate for Payer: Meridian Medicaid |
$10.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC ARBOVIRUS CALIF CMPT
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200388
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC ARBOVIRUS E EQUINE CMPT
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
30200389
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC ARBOVIRUS E EQUINE CMPT
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
30200389
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$10.22
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$9.73
|
| Rate for Payer: Meridian Medicaid |
$10.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC ARBOVIRUS IGG/IGM PNL, CSF
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200387
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$10.22
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$9.73
|
| Rate for Payer: Meridian Medicaid |
$10.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC ARBOVIRUS IGG/IGM PNL, CSF
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200387
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC ARBOVIRUS T LOUIS CMPT
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200390
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC ARBOVIRUS T LOUIS CMPT
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200390
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$10.22
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$9.73
|
| Rate for Payer: Meridian Medicaid |
$10.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC ARBOVIRUS W EQUINE CMPT
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$10.22
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$9.73
|
| Rate for Payer: Meridian Medicaid |
$10.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC ARBOVIRUS W EQUINE CMPT
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC ARCTIC SUN TORSO/LEG PADS
|
Facility
|
IP
|
$2,530.24
|
|
| Hospital Charge Code |
27000610
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,543.19 |
| Max. Negotiated Rate |
$2,277.22 |
| Rate for Payer: Aetna Commercial |
$2,150.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,955.37
|
| Rate for Payer: BCN Commercial |
$1,955.37
|
| Rate for Payer: Cash Price |
$2,024.19
|
| Rate for Payer: Cofinity Commercial |
$2,176.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,024.19
|
| Rate for Payer: Healthscope Commercial |
$2,277.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,897.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,150.70
|
| Rate for Payer: PHP Commercial |
$2,150.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,771.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,201.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,543.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,226.61
|
| Rate for Payer: UHC Core |
$2,112.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,897.68
|
|
