|
HC BDIAL F8A
|
Facility
|
OP
|
$65.64
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500091
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$59.08 |
| Rate for Payer: Aetna Commercial |
$55.79
|
| Rate for Payer: Aetna Medicare |
$17.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.51
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCBS MAPPO |
$16.41
|
| Rate for Payer: BCBS Trust/PPO |
$51.04
|
| Rate for Payer: BCN Commercial |
$51.04
|
| Rate for Payer: BCN Medicare Advantage |
$16.41
|
| Rate for Payer: Cash Price |
$52.51
|
| Rate for Payer: Cash Price |
$52.51
|
| Rate for Payer: Cofinity Commercial |
$56.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.41
|
| Rate for Payer: Healthscope Commercial |
$59.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.23
|
| Rate for Payer: Mclaren Medicaid |
$13.21
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.79
|
| Rate for Payer: PACE Senior Care Partners |
$15.59
|
| Rate for Payer: PACE SWMI |
$16.41
|
| Rate for Payer: PHP Commercial |
$55.79
|
| Rate for Payer: PHP Medicare Advantage |
$16.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.11
|
| Rate for Payer: Priority Health Medicare |
$16.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.03
|
| Rate for Payer: Railroad Medicare Medicare |
$16.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.76
|
| Rate for Payer: UHC Core |
$54.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.41
|
| Rate for Payer: UHC Medicare Advantage |
$16.90
|
| Rate for Payer: VA VA |
$16.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.23
|
|
|
HC BDIAL FIBC
|
Facility
|
IP
|
$34.68
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500090
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$21.15 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$29.48
|
| Rate for Payer: BCBS Trust/PPO |
$26.80
|
| Rate for Payer: BCN Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cofinity Commercial |
$29.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.74
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.48
|
| Rate for Payer: PHP Commercial |
$29.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.52
|
| Rate for Payer: UHC Core |
$28.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.01
|
|
|
HC BDIAL FIBC
|
Facility
|
OP
|
$34.68
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500090
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.17 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna Commercial |
$29.48
|
| Rate for Payer: Aetna Medicare |
$9.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.84
|
| Rate for Payer: BCBS Complete |
$7.53
|
| Rate for Payer: BCBS MAPPO |
$8.67
|
| Rate for Payer: BCBS Trust/PPO |
$26.96
|
| Rate for Payer: BCN Commercial |
$26.96
|
| Rate for Payer: BCN Medicare Advantage |
$8.67
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cofinity Commercial |
$29.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.67
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.01
|
| Rate for Payer: Mclaren Medicaid |
$7.17
|
| Rate for Payer: Meridian Medicaid |
$7.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.48
|
| Rate for Payer: PACE Senior Care Partners |
$8.24
|
| Rate for Payer: PACE SWMI |
$8.67
|
| Rate for Payer: PHP Commercial |
$29.48
|
| Rate for Payer: PHP Medicare Advantage |
$8.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.17
|
| Rate for Payer: Priority Health Medicare |
$8.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.15
|
| Rate for Payer: Railroad Medicare Medicare |
$8.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.52
|
| Rate for Payer: UHC Core |
$28.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.67
|
| Rate for Payer: UHC Medicare Advantage |
$8.93
|
| Rate for Payer: VA VA |
$8.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.01
|
|
|
HC BDIAL FXIII
|
Facility
|
OP
|
$34.48
|
|
|
Service Code
|
CPT 85291
|
| Hospital Charge Code |
30500094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: BCBS Complete |
$7.06
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$26.81
|
| Rate for Payer: BCN Commercial |
$26.81
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Mclaren Medicaid |
$6.72
|
| Rate for Payer: Meridian Medicaid |
$7.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PACE Senior Care Partners |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
| Rate for Payer: UHC Core |
$28.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$8.88
|
| Rate for Payer: VA VA |
$8.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC BDIAL FXIII
|
Facility
|
IP
|
$34.48
|
|
|
Service Code
|
CPT 85291
|
| Hospital Charge Code |
30500094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$21.03 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: BCBS Trust/PPO |
$26.65
|
| Rate for Payer: BCN Commercial |
$26.65
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
| Rate for Payer: UHC Core |
$28.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC BDIAL PTIN
|
Facility
|
OP
|
$28.56
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500095
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$25.70 |
| Rate for Payer: Aetna Commercial |
$24.28
|
| Rate for Payer: Aetna Medicare |
$7.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.92
|
| Rate for Payer: BCBS Complete |
$3.32
|
| Rate for Payer: BCBS MAPPO |
$7.14
|
| Rate for Payer: BCBS Trust/PPO |
$22.21
|
| Rate for Payer: BCN Commercial |
$22.21
|
| Rate for Payer: BCN Medicare Advantage |
$7.14
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$24.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.14
|
| Rate for Payer: Healthscope Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.42
|
| Rate for Payer: Mclaren Medicaid |
$3.17
|
| Rate for Payer: Meridian Medicaid |
$3.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.28
|
| Rate for Payer: PACE Senior Care Partners |
$6.78
|
| Rate for Payer: PACE SWMI |
$7.14
|
| Rate for Payer: PHP Commercial |
$24.28
|
| Rate for Payer: PHP Medicare Advantage |
$7.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.85
|
| Rate for Payer: Priority Health Medicare |
$7.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.42
|
| Rate for Payer: Railroad Medicare Medicare |
$7.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.13
|
| Rate for Payer: UHC Core |
$23.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.14
|
| Rate for Payer: UHC Medicare Advantage |
$7.35
|
| Rate for Payer: VA VA |
$7.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.42
|
|
|
HC BDIAL PTIN
|
Facility
|
IP
|
$28.56
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500095
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$25.70 |
| Rate for Payer: Aetna Commercial |
$24.28
|
| Rate for Payer: BCBS Trust/PPO |
$22.07
|
| Rate for Payer: BCN Commercial |
$22.07
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$24.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.85
|
| Rate for Payer: Healthscope Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.28
|
| Rate for Payer: PHP Commercial |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.13
|
| Rate for Payer: UHC Core |
$23.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.42
|
|
|
HC BDIAL SFM
|
Facility
|
OP
|
$245.08
|
|
|
Service Code
|
CPT 85366
|
| Hospital Charge Code |
30500089
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.21 |
| Max. Negotiated Rate |
$220.57 |
| Rate for Payer: Aetna Commercial |
$208.32
|
| Rate for Payer: Aetna Medicare |
$63.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.59
|
| Rate for Payer: BCBS Complete |
$62.35
|
| Rate for Payer: BCBS MAPPO |
$61.27
|
| Rate for Payer: BCBS Trust/PPO |
$190.55
|
| Rate for Payer: BCN Commercial |
$190.55
|
| Rate for Payer: BCN Medicare Advantage |
$61.27
|
| Rate for Payer: Cash Price |
$196.06
|
| Rate for Payer: Cash Price |
$196.06
|
| Rate for Payer: Cofinity Commercial |
$210.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.27
|
| Rate for Payer: Healthscope Commercial |
$220.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.81
|
| Rate for Payer: Mclaren Medicaid |
$59.38
|
| Rate for Payer: Meridian Medicaid |
$62.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$64.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.32
|
| Rate for Payer: PACE Senior Care Partners |
$58.21
|
| Rate for Payer: PACE SWMI |
$61.27
|
| Rate for Payer: PHP Commercial |
$208.32
|
| Rate for Payer: PHP Medicare Advantage |
$61.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.22
|
| Rate for Payer: Priority Health Medicare |
$61.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.47
|
| Rate for Payer: Railroad Medicare Medicare |
$61.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.67
|
| Rate for Payer: UHC Core |
$204.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.27
|
| Rate for Payer: UHC Medicare Advantage |
$63.11
|
| Rate for Payer: VA VA |
$61.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.81
|
|
|
HC BDIAL SFM
|
Facility
|
IP
|
$245.08
|
|
|
Service Code
|
CPT 85366
|
| Hospital Charge Code |
30500089
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$149.47 |
| Max. Negotiated Rate |
$220.57 |
| Rate for Payer: Aetna Commercial |
$208.32
|
| Rate for Payer: BCBS Trust/PPO |
$189.40
|
| Rate for Payer: BCN Commercial |
$189.40
|
| Rate for Payer: Cash Price |
$196.06
|
| Rate for Payer: Cofinity Commercial |
$210.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.06
|
| Rate for Payer: Healthscope Commercial |
$220.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.32
|
| Rate for Payer: PHP Commercial |
$208.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.67
|
| Rate for Payer: UHC Core |
$204.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.81
|
|
|
HC BDIAL TT
|
Facility
|
OP
|
$24.61
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
30500087
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.26 |
| Max. Negotiated Rate |
$22.15 |
| Rate for Payer: Aetna Commercial |
$20.92
|
| Rate for Payer: Aetna Medicare |
$6.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.69
|
| Rate for Payer: BCBS Complete |
$4.47
|
| Rate for Payer: BCBS MAPPO |
$6.15
|
| Rate for Payer: BCBS Trust/PPO |
$19.13
|
| Rate for Payer: BCN Commercial |
$19.13
|
| Rate for Payer: BCN Medicare Advantage |
$6.15
|
| Rate for Payer: Cash Price |
$19.69
|
| Rate for Payer: Cash Price |
$19.69
|
| Rate for Payer: Cofinity Commercial |
$21.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.15
|
| Rate for Payer: Healthscope Commercial |
$22.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.46
|
| Rate for Payer: Mclaren Medicaid |
$4.26
|
| Rate for Payer: Meridian Medicaid |
$4.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.84
|
| Rate for Payer: PACE SWMI |
$6.15
|
| Rate for Payer: PHP Commercial |
$20.92
|
| Rate for Payer: PHP Medicare Advantage |
$6.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.41
|
| Rate for Payer: Priority Health Medicare |
$6.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.66
|
| Rate for Payer: UHC Core |
$20.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.15
|
| Rate for Payer: UHC Medicare Advantage |
$6.34
|
| Rate for Payer: VA VA |
$6.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.46
|
|
|
HC BDIAL TT
|
Facility
|
IP
|
$24.61
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
30500087
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.01 |
| Max. Negotiated Rate |
$22.15 |
| Rate for Payer: Aetna Commercial |
$20.92
|
| Rate for Payer: BCBS Trust/PPO |
$19.02
|
| Rate for Payer: BCN Commercial |
$19.02
|
| Rate for Payer: Cash Price |
$19.69
|
| Rate for Payer: Cofinity Commercial |
$21.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.69
|
| Rate for Payer: Healthscope Commercial |
$22.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.92
|
| Rate for Payer: PHP Commercial |
$20.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.66
|
| Rate for Payer: UHC Core |
$20.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.46
|
|
|
HC BDIAL VWAG
|
Facility
|
IP
|
$82.68
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500092
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$50.43 |
| Max. Negotiated Rate |
$74.41 |
| Rate for Payer: Aetna Commercial |
$70.28
|
| Rate for Payer: BCBS Trust/PPO |
$63.90
|
| Rate for Payer: BCN Commercial |
$63.90
|
| Rate for Payer: Cash Price |
$66.14
|
| Rate for Payer: Cofinity Commercial |
$71.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.14
|
| Rate for Payer: Healthscope Commercial |
$74.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.28
|
| Rate for Payer: PHP Commercial |
$70.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.76
|
| Rate for Payer: UHC Core |
$69.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.01
|
|
|
HC BDIAL VWAG
|
Facility
|
OP
|
$82.68
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500092
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.93 |
| Max. Negotiated Rate |
$74.41 |
| Rate for Payer: Aetna Commercial |
$70.28
|
| Rate for Payer: Aetna Medicare |
$21.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.84
|
| Rate for Payer: BCBS Complete |
$17.78
|
| Rate for Payer: BCBS MAPPO |
$20.67
|
| Rate for Payer: BCBS Trust/PPO |
$64.28
|
| Rate for Payer: BCN Commercial |
$64.28
|
| Rate for Payer: BCN Medicare Advantage |
$20.67
|
| Rate for Payer: Cash Price |
$66.14
|
| Rate for Payer: Cash Price |
$66.14
|
| Rate for Payer: Cofinity Commercial |
$71.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.67
|
| Rate for Payer: Healthscope Commercial |
$74.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.01
|
| Rate for Payer: Mclaren Medicaid |
$16.93
|
| Rate for Payer: Meridian Medicaid |
$17.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.28
|
| Rate for Payer: PACE Senior Care Partners |
$19.64
|
| Rate for Payer: PACE SWMI |
$20.67
|
| Rate for Payer: PHP Commercial |
$70.28
|
| Rate for Payer: PHP Medicare Advantage |
$20.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.93
|
| Rate for Payer: Priority Health Medicare |
$20.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.43
|
| Rate for Payer: Railroad Medicare Medicare |
$20.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.76
|
| Rate for Payer: UHC Core |
$69.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.67
|
| Rate for Payer: UHC Medicare Advantage |
$21.29
|
| Rate for Payer: VA VA |
$20.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.01
|
|
|
HC BDIAL VWFX
|
Facility
|
OP
|
$99.02
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500093
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.77 |
| Max. Negotiated Rate |
$89.12 |
| Rate for Payer: Aetna Commercial |
$84.17
|
| Rate for Payer: Aetna Medicare |
$25.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.94
|
| Rate for Payer: BCBS Complete |
$23.91
|
| Rate for Payer: BCBS MAPPO |
$24.76
|
| Rate for Payer: BCBS Trust/PPO |
$76.99
|
| Rate for Payer: BCN Commercial |
$76.99
|
| Rate for Payer: BCN Medicare Advantage |
$24.76
|
| Rate for Payer: Cash Price |
$79.22
|
| Rate for Payer: Cash Price |
$79.22
|
| Rate for Payer: Cofinity Commercial |
$85.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.76
|
| Rate for Payer: Healthscope Commercial |
$89.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.26
|
| Rate for Payer: Mclaren Medicaid |
$22.77
|
| Rate for Payer: Meridian Medicaid |
$23.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.17
|
| Rate for Payer: PACE Senior Care Partners |
$23.52
|
| Rate for Payer: PACE SWMI |
$24.76
|
| Rate for Payer: PHP Commercial |
$84.17
|
| Rate for Payer: PHP Medicare Advantage |
$24.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.15
|
| Rate for Payer: Priority Health Medicare |
$24.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.39
|
| Rate for Payer: Railroad Medicare Medicare |
$24.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.14
|
| Rate for Payer: UHC Core |
$82.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.76
|
| Rate for Payer: UHC Medicare Advantage |
$25.50
|
| Rate for Payer: VA VA |
$24.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.26
|
|
|
HC BDIAL VWFX
|
Facility
|
IP
|
$99.02
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500093
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$60.39 |
| Max. Negotiated Rate |
$89.12 |
| Rate for Payer: Aetna Commercial |
$84.17
|
| Rate for Payer: BCBS Trust/PPO |
$76.52
|
| Rate for Payer: BCN Commercial |
$76.52
|
| Rate for Payer: Cash Price |
$79.22
|
| Rate for Payer: Cofinity Commercial |
$85.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.22
|
| Rate for Payer: Healthscope Commercial |
$89.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.17
|
| Rate for Payer: PHP Commercial |
$84.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.14
|
| Rate for Payer: UHC Core |
$82.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.26
|
|
|
HC BEDSIDE/SIMPLE SPIROMETRY
|
Facility
|
IP
|
$234.56
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000001
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$143.06 |
| Max. Negotiated Rate |
$211.10 |
| Rate for Payer: Aetna Commercial |
$199.38
|
| Rate for Payer: BCBS Trust/PPO |
$181.27
|
| Rate for Payer: BCN Commercial |
$181.27
|
| Rate for Payer: Cash Price |
$187.65
|
| Rate for Payer: Cofinity Commercial |
$201.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.65
|
| Rate for Payer: Healthscope Commercial |
$211.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$199.38
|
| Rate for Payer: PHP Commercial |
$199.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$143.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.41
|
| Rate for Payer: UHC Core |
$195.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.92
|
|
|
HC BEDSIDE/SIMPLE SPIROMETRY
|
Facility
|
OP
|
$234.56
|
|
|
Service Code
|
CPT 94010
|
| Hospital Charge Code |
46000001
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$55.71 |
| Max. Negotiated Rate |
$211.10 |
| Rate for Payer: Aetna Commercial |
$199.38
|
| Rate for Payer: Aetna Medicare |
$60.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.30
|
| Rate for Payer: BCBS Complete |
$107.59
|
| Rate for Payer: BCBS MAPPO |
$58.64
|
| Rate for Payer: BCBS Trust/PPO |
$182.37
|
| Rate for Payer: BCN Commercial |
$182.37
|
| Rate for Payer: BCN Medicare Advantage |
$58.64
|
| Rate for Payer: Cash Price |
$187.65
|
| Rate for Payer: Cash Price |
$187.65
|
| Rate for Payer: Cofinity Commercial |
$201.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.64
|
| Rate for Payer: Healthscope Commercial |
$211.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.92
|
| Rate for Payer: Mclaren Medicaid |
$102.47
|
| Rate for Payer: Meridian Medicaid |
$107.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$199.38
|
| Rate for Payer: PACE Senior Care Partners |
$55.71
|
| Rate for Payer: PACE SWMI |
$58.64
|
| Rate for Payer: PHP Commercial |
$199.38
|
| Rate for Payer: PHP Medicare Advantage |
$58.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$102.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.07
|
| Rate for Payer: Priority Health Medicare |
$58.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$143.06
|
| Rate for Payer: Railroad Medicare Medicare |
$58.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.41
|
| Rate for Payer: UHC Core |
$195.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.64
|
| Rate for Payer: UHC Medicare Advantage |
$60.40
|
| Rate for Payer: VA VA |
$58.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.92
|
|
|
HC BEDSIDE URINE PREG TEST
|
Facility
|
OP
|
$28.56
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30000000
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.35 |
| Max. Negotiated Rate |
$25.70 |
| Rate for Payer: Aetna Commercial |
$24.28
|
| Rate for Payer: Aetna Medicare |
$7.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.92
|
| Rate for Payer: BCBS Complete |
$6.67
|
| Rate for Payer: BCBS MAPPO |
$7.14
|
| Rate for Payer: BCBS Trust/PPO |
$22.21
|
| Rate for Payer: BCCCP Commercial |
$8.61
|
| Rate for Payer: BCN Commercial |
$22.21
|
| Rate for Payer: BCN Medicare Advantage |
$7.14
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$24.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.14
|
| Rate for Payer: Healthscope Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.42
|
| Rate for Payer: Mclaren Medicaid |
$6.35
|
| Rate for Payer: Meridian Medicaid |
$6.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.28
|
| Rate for Payer: PACE Senior Care Partners |
$6.78
|
| Rate for Payer: PACE SWMI |
$7.14
|
| Rate for Payer: PHP Commercial |
$24.28
|
| Rate for Payer: PHP Medicare Advantage |
$7.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.85
|
| Rate for Payer: Priority Health Medicare |
$7.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.42
|
| Rate for Payer: Railroad Medicare Medicare |
$7.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.13
|
| Rate for Payer: UHC Core |
$23.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.14
|
| Rate for Payer: UHC Medicare Advantage |
$7.35
|
| Rate for Payer: VA VA |
$7.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.42
|
|
|
HC BEDSIDE URINE PREG TEST
|
Facility
|
IP
|
$28.56
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30000000
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$25.70 |
| Rate for Payer: Aetna Commercial |
$24.28
|
| Rate for Payer: BCBS Trust/PPO |
$22.07
|
| Rate for Payer: BCN Commercial |
$22.07
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$24.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.85
|
| Rate for Payer: Healthscope Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.28
|
| Rate for Payer: PHP Commercial |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.13
|
| Rate for Payer: UHC Core |
$23.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.42
|
|
|
HC BEECH IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200074
|
|
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
|
|
|
HC BEECH IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200074
|
|
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 BENCE JONES PROTEIN
|
Facility
|
IP
|
$165.80
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200197
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$101.12 |
| Max. Negotiated Rate |
$149.22 |
| Rate for Payer: Aetna Commercial |
$140.93
|
| Rate for Payer: BCBS Trust/PPO |
$128.13
|
| Rate for Payer: BCN Commercial |
$128.13
|
| Rate for Payer: Cash Price |
$132.64
|
| Rate for Payer: Cofinity Commercial |
$142.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.64
|
| Rate for Payer: Healthscope Commercial |
$149.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$140.93
|
| Rate for Payer: PHP Commercial |
$140.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.90
|
| Rate for Payer: UHC Core |
$138.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.35
|
|
|
HC BENCE JONES PROTEIN
|
Facility
|
OP
|
$165.80
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200197
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.66 |
| Max. Negotiated Rate |
$149.22 |
| Rate for Payer: Aetna Commercial |
$140.93
|
| Rate for Payer: Aetna Medicare |
$43.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.81
|
| Rate for Payer: BCBS Complete |
$22.74
|
| Rate for Payer: BCBS MAPPO |
$41.45
|
| Rate for Payer: BCBS Trust/PPO |
$128.91
|
| Rate for Payer: BCN Commercial |
$128.91
|
| Rate for Payer: BCN Medicare Advantage |
$41.45
|
| Rate for Payer: Cash Price |
$132.64
|
| Rate for Payer: Cash Price |
$132.64
|
| Rate for Payer: Cofinity Commercial |
$142.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.45
|
| Rate for Payer: Healthscope Commercial |
$149.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.35
|
| Rate for Payer: Mclaren Medicaid |
$21.66
|
| Rate for Payer: Meridian Medicaid |
$22.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$140.93
|
| Rate for Payer: PACE Senior Care Partners |
$39.38
|
| Rate for Payer: PACE SWMI |
$41.45
|
| Rate for Payer: PHP Commercial |
$140.93
|
| Rate for Payer: PHP Medicare Advantage |
$41.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.25
|
| Rate for Payer: Priority Health Medicare |
$41.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.12
|
| Rate for Payer: Railroad Medicare Medicare |
$41.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.90
|
| Rate for Payer: UHC Core |
$138.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.45
|
| Rate for Payer: UHC Medicare Advantage |
$42.69
|
| Rate for Payer: VA VA |
$41.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.35
|
|
|
HC BENIGN HYPERKERATOTIC 2-4 LESIONS
|
Facility
|
IP
|
$272.49
|
|
|
Service Code
|
CPT 11056
|
| Hospital Charge Code |
76100039
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$166.19 |
| Max. Negotiated Rate |
$245.24 |
| Rate for Payer: Aetna Commercial |
$231.62
|
| Rate for Payer: BCBS Trust/PPO |
$210.58
|
| Rate for Payer: BCN Commercial |
$210.58
|
| Rate for Payer: Cash Price |
$217.99
|
| Rate for Payer: Cofinity Commercial |
$234.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.99
|
| Rate for Payer: Healthscope Commercial |
$245.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$231.62
|
| Rate for Payer: PHP Commercial |
$231.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.79
|
| Rate for Payer: UHC Core |
$227.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.37
|
|
|
HC BENIGN HYPERKERATOTIC 2-4 LESIONS
|
Facility
|
OP
|
$272.49
|
|
|
Service Code
|
CPT 11056
|
| Hospital Charge Code |
76100039
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.72 |
| Max. Negotiated Rate |
$245.24 |
| Rate for Payer: Aetna Commercial |
$231.62
|
| Rate for Payer: Aetna Medicare |
$70.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.15
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$68.12
|
| Rate for Payer: BCBS Trust/PPO |
$211.86
|
| Rate for Payer: BCN Commercial |
$211.86
|
| Rate for Payer: BCN Medicare Advantage |
$68.12
|
| Rate for Payer: Cash Price |
$217.99
|
| Rate for Payer: Cash Price |
$217.99
|
| Rate for Payer: Cofinity Commercial |
$234.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.12
|
| Rate for Payer: Healthscope Commercial |
$245.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.37
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$71.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$231.62
|
| Rate for Payer: PACE Senior Care Partners |
$64.72
|
| Rate for Payer: PACE SWMI |
$68.12
|
| Rate for Payer: PHP Commercial |
$231.62
|
| Rate for Payer: PHP Medicare Advantage |
$68.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.07
|
| Rate for Payer: Priority Health Medicare |
$68.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.19
|
| Rate for Payer: Railroad Medicare Medicare |
$68.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.79
|
| Rate for Payer: UHC Core |
$227.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.12
|
| Rate for Payer: UHC Medicare Advantage |
$70.17
|
| Rate for Payer: VA VA |
$68.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.37
|
|
