|
HC AUTOLOGOUS UNIT
|
Facility
|
IP
|
$809.10
|
|
|
Service Code
|
HCPCS P9021
|
| Hospital Charge Code |
39000040
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$493.47 |
| Max. Negotiated Rate |
$728.19 |
| Rate for Payer: Aetna Commercial |
$687.74
|
| Rate for Payer: BCBS Trust/PPO |
$625.27
|
| Rate for Payer: BCN Commercial |
$625.27
|
| Rate for Payer: Cash Price |
$647.28
|
| Rate for Payer: Cofinity Commercial |
$695.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$647.28
|
| Rate for Payer: Healthscope Commercial |
$728.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$606.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$687.74
|
| Rate for Payer: PHP Commercial |
$687.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$703.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$493.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$712.01
|
| Rate for Payer: UHC Core |
$675.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$606.82
|
|
|
HC AUTONOMIC FUNC ADRENERGIC
|
Facility
|
IP
|
$177.97
|
|
|
Service Code
|
CPT 95922
|
| Hospital Charge Code |
92000007
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$108.54 |
| Max. Negotiated Rate |
$160.17 |
| Rate for Payer: Aetna Commercial |
$151.27
|
| Rate for Payer: BCBS Trust/PPO |
$137.54
|
| Rate for Payer: BCN Commercial |
$137.54
|
| Rate for Payer: Cash Price |
$142.38
|
| Rate for Payer: Cofinity Commercial |
$153.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.38
|
| Rate for Payer: Healthscope Commercial |
$160.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$151.27
|
| Rate for Payer: PHP Commercial |
$151.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.61
|
| Rate for Payer: UHC Core |
$148.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.48
|
|
|
HC AUTONOMIC FUNC ADRENERGIC
|
Facility
|
OP
|
$177.97
|
|
|
Service Code
|
CPT 95922
|
| Hospital Charge Code |
92000007
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$42.27 |
| Max. Negotiated Rate |
$160.17 |
| Rate for Payer: Aetna Commercial |
$151.27
|
| Rate for Payer: Aetna Medicare |
$46.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.62
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$44.49
|
| Rate for Payer: BCBS Trust/PPO |
$138.37
|
| Rate for Payer: BCN Commercial |
$138.37
|
| Rate for Payer: BCN Medicare Advantage |
$44.49
|
| Rate for Payer: Cash Price |
$142.38
|
| Rate for Payer: Cash Price |
$142.38
|
| Rate for Payer: Cofinity Commercial |
$153.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.49
|
| Rate for Payer: Healthscope Commercial |
$160.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.48
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$46.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$151.27
|
| Rate for Payer: PACE Senior Care Partners |
$42.27
|
| Rate for Payer: PACE SWMI |
$44.49
|
| Rate for Payer: PHP Commercial |
$151.27
|
| Rate for Payer: PHP Medicare Advantage |
$44.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.83
|
| Rate for Payer: Priority Health Medicare |
$44.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.54
|
| Rate for Payer: Railroad Medicare Medicare |
$44.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.61
|
| Rate for Payer: UHC Core |
$148.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.49
|
| Rate for Payer: UHC Medicare Advantage |
$45.83
|
| Rate for Payer: VA VA |
$44.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.48
|
|
|
HC AUTONOMIC FUNC CARDIO INNERVAT
|
Facility
|
IP
|
$355.93
|
|
|
Service Code
|
CPT 95921
|
| Hospital Charge Code |
92000006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$217.08 |
| Max. Negotiated Rate |
$320.34 |
| Rate for Payer: Aetna Commercial |
$302.54
|
| Rate for Payer: BCBS Trust/PPO |
$275.06
|
| Rate for Payer: BCN Commercial |
$275.06
|
| Rate for Payer: Cash Price |
$284.74
|
| Rate for Payer: Cofinity Commercial |
$306.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.74
|
| Rate for Payer: Healthscope Commercial |
$320.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$302.54
|
| Rate for Payer: PHP Commercial |
$302.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$309.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.22
|
| Rate for Payer: UHC Core |
$297.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.95
|
|
|
HC AUTONOMIC FUNC CARDIO INNERVAT
|
Facility
|
OP
|
$355.93
|
|
|
Service Code
|
CPT 95921
|
| Hospital Charge Code |
92000006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$84.53 |
| Max. Negotiated Rate |
$320.34 |
| Rate for Payer: Aetna Commercial |
$302.54
|
| Rate for Payer: Aetna Medicare |
$92.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.23
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$88.98
|
| Rate for Payer: BCBS Trust/PPO |
$276.74
|
| Rate for Payer: BCN Commercial |
$276.74
|
| Rate for Payer: BCN Medicare Advantage |
$88.98
|
| Rate for Payer: Cash Price |
$284.74
|
| Rate for Payer: Cash Price |
$284.74
|
| Rate for Payer: Cofinity Commercial |
$306.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.98
|
| Rate for Payer: Healthscope Commercial |
$320.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.95
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$93.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$302.54
|
| Rate for Payer: PACE Senior Care Partners |
$84.53
|
| Rate for Payer: PACE SWMI |
$88.98
|
| Rate for Payer: PHP Commercial |
$302.54
|
| Rate for Payer: PHP Medicare Advantage |
$88.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$309.66
|
| Rate for Payer: Priority Health Medicare |
$88.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.08
|
| Rate for Payer: Railroad Medicare Medicare |
$88.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.22
|
| Rate for Payer: UHC Core |
$297.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.98
|
| Rate for Payer: UHC Medicare Advantage |
$91.65
|
| Rate for Payer: VA VA |
$88.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.95
|
|
|
HC AUTONOMIC FUNC QSART
|
Facility
|
OP
|
$355.93
|
|
|
Service Code
|
CPT 95923
|
| Hospital Charge Code |
92000008
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$83.80 |
| Max. Negotiated Rate |
$320.34 |
| Rate for Payer: Aetna Commercial |
$302.54
|
| Rate for Payer: Aetna Medicare |
$92.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.23
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$88.98
|
| Rate for Payer: BCBS Trust/PPO |
$276.74
|
| Rate for Payer: BCN Commercial |
$276.74
|
| Rate for Payer: BCN Medicare Advantage |
$88.98
|
| Rate for Payer: Cash Price |
$284.74
|
| Rate for Payer: Cash Price |
$284.74
|
| Rate for Payer: Cofinity Commercial |
$306.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.98
|
| Rate for Payer: Healthscope Commercial |
$320.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.95
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$93.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$302.54
|
| Rate for Payer: PACE Senior Care Partners |
$84.53
|
| Rate for Payer: PACE SWMI |
$88.98
|
| Rate for Payer: PHP Commercial |
$302.54
|
| Rate for Payer: PHP Medicare Advantage |
$88.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$309.66
|
| Rate for Payer: Priority Health Medicare |
$88.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.08
|
| Rate for Payer: Railroad Medicare Medicare |
$88.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.22
|
| Rate for Payer: UHC Core |
$297.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.98
|
| Rate for Payer: UHC Medicare Advantage |
$91.65
|
| Rate for Payer: VA VA |
$88.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.95
|
|
|
HC AUTONOMIC FUNC QSART
|
Facility
|
IP
|
$355.93
|
|
|
Service Code
|
CPT 95923
|
| Hospital Charge Code |
92000008
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$217.08 |
| Max. Negotiated Rate |
$320.34 |
| Rate for Payer: Aetna Commercial |
$302.54
|
| Rate for Payer: BCBS Trust/PPO |
$275.06
|
| Rate for Payer: BCN Commercial |
$275.06
|
| Rate for Payer: Cash Price |
$284.74
|
| Rate for Payer: Cofinity Commercial |
$306.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.74
|
| Rate for Payer: Healthscope Commercial |
$320.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$302.54
|
| Rate for Payer: PHP Commercial |
$302.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$309.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.22
|
| Rate for Payer: UHC Core |
$297.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.95
|
|
|
HC AUTONOMIC W/O QSART
|
Facility
|
IP
|
$508.47
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
92000012
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$310.12 |
| Max. Negotiated Rate |
$457.62 |
| Rate for Payer: Aetna Commercial |
$432.20
|
| Rate for Payer: BCBS Trust/PPO |
$392.95
|
| Rate for Payer: BCN Commercial |
$392.95
|
| Rate for Payer: Cash Price |
$406.78
|
| Rate for Payer: Cofinity Commercial |
$437.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.78
|
| Rate for Payer: Healthscope Commercial |
$457.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$432.20
|
| Rate for Payer: PHP Commercial |
$432.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$355.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$442.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.45
|
| Rate for Payer: UHC Core |
$424.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.35
|
|
|
HC AUTONOMIC W/O QSART
|
Facility
|
OP
|
$508.47
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
92000012
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$120.76 |
| Max. Negotiated Rate |
$457.62 |
| Rate for Payer: Aetna Commercial |
$432.20
|
| Rate for Payer: Aetna Medicare |
$132.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$158.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$158.90
|
| Rate for Payer: BCBS Complete |
$216.20
|
| Rate for Payer: BCBS MAPPO |
$127.12
|
| Rate for Payer: BCBS Trust/PPO |
$395.34
|
| Rate for Payer: BCN Commercial |
$395.34
|
| Rate for Payer: BCN Medicare Advantage |
$127.12
|
| Rate for Payer: Cash Price |
$406.78
|
| Rate for Payer: Cash Price |
$406.78
|
| Rate for Payer: Cofinity Commercial |
$437.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.12
|
| Rate for Payer: Healthscope Commercial |
$457.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.35
|
| Rate for Payer: Mclaren Medicaid |
$205.90
|
| Rate for Payer: Meridian Medicaid |
$216.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$133.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$432.20
|
| Rate for Payer: PACE Senior Care Partners |
$120.76
|
| Rate for Payer: PACE SWMI |
$127.12
|
| Rate for Payer: PHP Commercial |
$432.20
|
| Rate for Payer: PHP Medicare Advantage |
$127.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$355.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$442.37
|
| Rate for Payer: Priority Health Medicare |
$127.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$310.12
|
| Rate for Payer: Railroad Medicare Medicare |
$127.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.45
|
| Rate for Payer: UHC Core |
$424.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.12
|
| Rate for Payer: UHC Medicare Advantage |
$130.93
|
| Rate for Payer: VA VA |
$127.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.35
|
|
|
HC AVULSION OF NAIL PLATE
|
Facility
|
IP
|
$311.34
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
76100045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$189.89 |
| Max. Negotiated Rate |
$280.21 |
| Rate for Payer: Aetna Commercial |
$264.64
|
| Rate for Payer: BCBS Trust/PPO |
$240.60
|
| Rate for Payer: BCN Commercial |
$240.60
|
| Rate for Payer: Cash Price |
$249.07
|
| Rate for Payer: Cofinity Commercial |
$267.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.07
|
| Rate for Payer: Healthscope Commercial |
$280.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$264.64
|
| Rate for Payer: PHP Commercial |
$264.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$270.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.98
|
| Rate for Payer: UHC Core |
$259.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.50
|
|
|
HC AVULSION OF NAIL PLATE
|
Facility
|
OP
|
$311.34
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
76100045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$73.94 |
| Max. Negotiated Rate |
$280.21 |
| Rate for Payer: Aetna Commercial |
$264.64
|
| Rate for Payer: Aetna Medicare |
$80.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$97.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$97.29
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$77.84
|
| Rate for Payer: BCBS Trust/PPO |
$242.07
|
| Rate for Payer: BCN Commercial |
$242.07
|
| Rate for Payer: BCN Medicare Advantage |
$77.84
|
| Rate for Payer: Cash Price |
$249.07
|
| Rate for Payer: Cash Price |
$249.07
|
| Rate for Payer: Cofinity Commercial |
$267.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.84
|
| Rate for Payer: Healthscope Commercial |
$280.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.50
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$81.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$264.64
|
| Rate for Payer: PACE Senior Care Partners |
$73.94
|
| Rate for Payer: PACE SWMI |
$77.84
|
| Rate for Payer: PHP Commercial |
$264.64
|
| Rate for Payer: PHP Medicare Advantage |
$77.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$270.87
|
| Rate for Payer: Priority Health Medicare |
$77.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$189.89
|
| Rate for Payer: Railroad Medicare Medicare |
$77.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.98
|
| Rate for Payer: UHC Core |
$259.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.84
|
| Rate for Payer: UHC Medicare Advantage |
$80.17
|
| Rate for Payer: VA VA |
$77.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.50
|
|
|
HC BACITRACIN 1 OZ
|
Facility
|
OP
|
$7.97
|
|
| Hospital Charge Code |
27100006
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$1.89 |
| Max. Negotiated Rate |
$7.17 |
| Rate for Payer: Aetna Commercial |
$6.77
|
| Rate for Payer: Aetna Medicare |
$2.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.49
|
| Rate for Payer: BCBS Complete |
$3.19
|
| Rate for Payer: BCBS MAPPO |
$1.99
|
| Rate for Payer: BCBS Trust/PPO |
$6.20
|
| Rate for Payer: BCN Commercial |
$6.20
|
| Rate for Payer: BCN Medicare Advantage |
$1.99
|
| Rate for Payer: Cash Price |
$6.38
|
| Rate for Payer: Cofinity Commercial |
$6.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.99
|
| Rate for Payer: Healthscope Commercial |
$7.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6.77
|
| Rate for Payer: PACE Senior Care Partners |
$1.89
|
| Rate for Payer: PACE SWMI |
$1.99
|
| Rate for Payer: PHP Commercial |
$6.77
|
| Rate for Payer: PHP Medicare Advantage |
$1.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.93
|
| Rate for Payer: Priority Health Medicare |
$1.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.01
|
| Rate for Payer: UHC Core |
$6.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.99
|
| Rate for Payer: UHC Medicare Advantage |
$2.05
|
| Rate for Payer: VA VA |
$1.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.98
|
|
|
HC BACITRACIN 1 OZ
|
Facility
|
IP
|
$7.97
|
|
| Hospital Charge Code |
27100006
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.86 |
| Max. Negotiated Rate |
$7.17 |
| Rate for Payer: Aetna Commercial |
$6.77
|
| Rate for Payer: BCBS Trust/PPO |
$6.16
|
| Rate for Payer: BCN Commercial |
$6.16
|
| Rate for Payer: Cash Price |
$6.38
|
| Rate for Payer: Cofinity Commercial |
$6.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$7.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6.77
|
| Rate for Payer: PHP Commercial |
$6.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.01
|
| Rate for Payer: UHC Core |
$6.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.98
|
|
|
HC BACITRACIN 4 OZ
|
Facility
|
OP
|
$30.37
|
|
| Hospital Charge Code |
27100007
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.21 |
| Max. Negotiated Rate |
$27.33 |
| Rate for Payer: Aetna Commercial |
$25.81
|
| Rate for Payer: Aetna Medicare |
$7.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.49
|
| Rate for Payer: BCBS Complete |
$12.15
|
| Rate for Payer: BCBS MAPPO |
$7.59
|
| Rate for Payer: BCBS Trust/PPO |
$23.61
|
| Rate for Payer: BCN Commercial |
$23.61
|
| Rate for Payer: BCN Medicare Advantage |
$7.59
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cofinity Commercial |
$26.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.59
|
| Rate for Payer: Healthscope Commercial |
$27.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.81
|
| Rate for Payer: PACE Senior Care Partners |
$7.21
|
| Rate for Payer: PACE SWMI |
$7.59
|
| Rate for Payer: PHP Commercial |
$25.81
|
| Rate for Payer: PHP Medicare Advantage |
$7.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.42
|
| Rate for Payer: Priority Health Medicare |
$7.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.52
|
| Rate for Payer: Railroad Medicare Medicare |
$7.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.73
|
| Rate for Payer: UHC Core |
$25.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.59
|
| Rate for Payer: UHC Medicare Advantage |
$7.82
|
| Rate for Payer: VA VA |
$7.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.78
|
|
|
HC BACITRACIN 4 OZ
|
Facility
|
IP
|
$30.37
|
|
| Hospital Charge Code |
27100007
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$18.52 |
| Max. Negotiated Rate |
$27.33 |
| Rate for Payer: Aetna Commercial |
$25.81
|
| Rate for Payer: BCBS Trust/PPO |
$23.47
|
| Rate for Payer: BCN Commercial |
$23.47
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cofinity Commercial |
$26.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.30
|
| Rate for Payer: Healthscope Commercial |
$27.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.81
|
| Rate for Payer: PHP Commercial |
$25.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.73
|
| Rate for Payer: UHC Core |
$25.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.78
|
|
|
HC BACK SCREEN
|
Facility
|
IP
|
$51.00
|
|
| Hospital Charge Code |
42000047
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC BACK SCREEN
|
Facility
|
OP
|
$51.00
|
|
| Hospital Charge Code |
42000047
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC BACK SCREEN, VBISD
|
Facility
|
IP
|
$68.34
|
|
| Hospital Charge Code |
43000014
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$41.68 |
| Max. Negotiated Rate |
$61.51 |
| Rate for Payer: Aetna Commercial |
$58.09
|
| Rate for Payer: BCBS Trust/PPO |
$52.81
|
| Rate for Payer: BCN Commercial |
$52.81
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$58.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Healthscope Commercial |
$61.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.09
|
| Rate for Payer: PHP Commercial |
$58.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.14
|
| Rate for Payer: UHC Core |
$57.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.26
|
|
|
HC BACK SCREEN, VBISD
|
Facility
|
OP
|
$68.34
|
|
| Hospital Charge Code |
43000014
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$16.23 |
| Max. Negotiated Rate |
$61.51 |
| Rate for Payer: Aetna Commercial |
$58.09
|
| Rate for Payer: Aetna Medicare |
$17.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.36
|
| Rate for Payer: BCBS Complete |
$27.34
|
| Rate for Payer: BCBS MAPPO |
$17.08
|
| Rate for Payer: BCBS Trust/PPO |
$53.13
|
| Rate for Payer: BCN Commercial |
$53.13
|
| Rate for Payer: BCN Medicare Advantage |
$17.08
|
| Rate for Payer: Cash Price |
$54.67
|
| Rate for Payer: Cofinity Commercial |
$58.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.08
|
| Rate for Payer: Healthscope Commercial |
$61.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.09
|
| Rate for Payer: PACE Senior Care Partners |
$16.23
|
| Rate for Payer: PACE SWMI |
$17.08
|
| Rate for Payer: PHP Commercial |
$58.09
|
| Rate for Payer: PHP Medicare Advantage |
$17.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.46
|
| Rate for Payer: Priority Health Medicare |
$17.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.68
|
| Rate for Payer: Railroad Medicare Medicare |
$17.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.14
|
| Rate for Payer: UHC Core |
$57.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.08
|
| Rate for Payer: UHC Medicare Advantage |
$17.60
|
| Rate for Payer: VA VA |
$17.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.26
|
|
|
HC BACTERIAL VAGINOSIS PANEL
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
CPT 0352U
|
| Hospital Charge Code |
30600337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$91.48 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: BCBS Trust/PPO |
$115.92
|
| Rate for Payer: BCN Commercial |
$115.92
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.50
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.00
|
| Rate for Payer: UHC Core |
$125.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HC BACTERIAL VAGINOSIS PANEL
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
CPT 0352U
|
| Hospital Charge Code |
30600337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.62 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna Medicare |
$39.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.88
|
| Rate for Payer: BCBS Complete |
$110.52
|
| Rate for Payer: BCBS MAPPO |
$37.50
|
| Rate for Payer: BCBS Trust/PPO |
$116.62
|
| Rate for Payer: BCN Commercial |
$116.62
|
| Rate for Payer: BCN Medicare Advantage |
$37.50
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.50
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Mclaren Medicaid |
$105.26
|
| Rate for Payer: Meridian Medicaid |
$110.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.50
|
| Rate for Payer: PACE Senior Care Partners |
$35.62
|
| Rate for Payer: PACE SWMI |
$37.50
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: PHP Medicare Advantage |
$37.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.50
|
| Rate for Payer: Priority Health Medicare |
$37.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.48
|
| Rate for Payer: Railroad Medicare Medicare |
$37.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.00
|
| Rate for Payer: UHC Core |
$125.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.50
|
| Rate for Payer: UHC Medicare Advantage |
$38.62
|
| Rate for Payer: VA VA |
$37.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HC BAG BLOOD TRANSFER
|
Facility
|
OP
|
$8.70
|
|
| Hospital Charge Code |
27000161
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.07 |
| Max. Negotiated Rate |
$7.83 |
| Rate for Payer: Aetna Commercial |
$7.40
|
| Rate for Payer: Aetna Medicare |
$2.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.72
|
| Rate for Payer: BCBS Complete |
$3.48
|
| Rate for Payer: BCBS MAPPO |
$2.18
|
| Rate for Payer: BCBS Trust/PPO |
$6.76
|
| Rate for Payer: BCN Commercial |
$6.76
|
| Rate for Payer: BCN Medicare Advantage |
$2.18
|
| Rate for Payer: Cash Price |
$6.96
|
| Rate for Payer: Cofinity Commercial |
$7.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.18
|
| Rate for Payer: Healthscope Commercial |
$7.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7.40
|
| Rate for Payer: PACE Senior Care Partners |
$2.07
|
| Rate for Payer: PACE SWMI |
$2.18
|
| Rate for Payer: PHP Commercial |
$7.40
|
| Rate for Payer: PHP Medicare Advantage |
$2.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.57
|
| Rate for Payer: Priority Health Medicare |
$2.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.31
|
| Rate for Payer: Railroad Medicare Medicare |
$2.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.66
|
| Rate for Payer: UHC Core |
$7.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.18
|
| Rate for Payer: UHC Medicare Advantage |
$2.24
|
| Rate for Payer: VA VA |
$2.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.52
|
|
|
HC BAG BLOOD TRANSFER
|
Facility
|
IP
|
$8.70
|
|
| Hospital Charge Code |
27000161
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.31 |
| Max. Negotiated Rate |
$7.83 |
| Rate for Payer: Aetna Commercial |
$7.40
|
| Rate for Payer: BCBS Trust/PPO |
$6.72
|
| Rate for Payer: BCN Commercial |
$6.72
|
| Rate for Payer: Cash Price |
$6.96
|
| Rate for Payer: Cofinity Commercial |
$7.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.96
|
| Rate for Payer: Healthscope Commercial |
$7.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7.40
|
| Rate for Payer: PHP Commercial |
$7.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.66
|
| Rate for Payer: UHC Core |
$7.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.52
|
|
|
HC BAG WASTE
|
Facility
|
OP
|
$63.00
|
|
| Hospital Charge Code |
27000670
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.96 |
| Max. Negotiated Rate |
$56.70 |
| Rate for Payer: Aetna Commercial |
$53.55
|
| Rate for Payer: Aetna Medicare |
$16.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.69
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCBS MAPPO |
$15.75
|
| Rate for Payer: BCBS Trust/PPO |
$48.98
|
| Rate for Payer: BCN Commercial |
$48.98
|
| Rate for Payer: BCN Medicare Advantage |
$15.75
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$54.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.75
|
| Rate for Payer: Healthscope Commercial |
$56.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$53.55
|
| Rate for Payer: PACE Senior Care Partners |
$14.96
|
| Rate for Payer: PACE SWMI |
$15.75
|
| Rate for Payer: PHP Commercial |
$53.55
|
| Rate for Payer: PHP Medicare Advantage |
$15.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.81
|
| Rate for Payer: Priority Health Medicare |
$15.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.42
|
| Rate for Payer: Railroad Medicare Medicare |
$15.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.44
|
| Rate for Payer: UHC Core |
$52.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.75
|
| Rate for Payer: UHC Medicare Advantage |
$16.22
|
| Rate for Payer: VA VA |
$15.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.25
|
|
|
HC BAG WASTE
|
Facility
|
IP
|
$63.00
|
|
| Hospital Charge Code |
27000670
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.42 |
| Max. Negotiated Rate |
$56.70 |
| Rate for Payer: Aetna Commercial |
$53.55
|
| Rate for Payer: BCBS Trust/PPO |
$48.69
|
| Rate for Payer: BCN Commercial |
$48.69
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$54.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.40
|
| Rate for Payer: Healthscope Commercial |
$56.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$53.55
|
| Rate for Payer: PHP Commercial |
$53.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.44
|
| Rate for Payer: UHC Core |
$52.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.25
|
|
