|
HC CHEMODNRV MUSC FACIAL
|
Facility
|
IP
|
$531.36
|
|
|
Service Code
|
CPT 64612
|
| Hospital Charge Code |
36100472
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$324.08 |
| Max. Negotiated Rate |
$478.22 |
| Rate for Payer: Aetna Commercial |
$451.66
|
| Rate for Payer: BCBS Trust/PPO |
$410.64
|
| Rate for Payer: BCN Commercial |
$410.64
|
| Rate for Payer: Cash Price |
$425.09
|
| Rate for Payer: Cofinity Commercial |
$456.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.09
|
| Rate for Payer: Healthscope Commercial |
$478.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$451.66
|
| Rate for Payer: PHP Commercial |
$451.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$462.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$324.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.60
|
| Rate for Payer: UHC Core |
$443.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.52
|
|
|
HC CHEMODNRV MUSC FACIAL BIL
|
Facility
|
OP
|
$649.43
|
|
|
Service Code
|
CPT 64612
|
| Hospital Charge Code |
36100473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$154.24 |
| Max. Negotiated Rate |
$584.49 |
| Rate for Payer: Aetna Commercial |
$552.02
|
| Rate for Payer: Aetna Medicare |
$168.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.95
|
| Rate for Payer: BCBS Complete |
$204.01
|
| Rate for Payer: BCBS MAPPO |
$162.36
|
| Rate for Payer: BCBS Trust/PPO |
$504.93
|
| Rate for Payer: BCN Commercial |
$504.93
|
| Rate for Payer: BCN Medicare Advantage |
$162.36
|
| Rate for Payer: Cash Price |
$519.54
|
| Rate for Payer: Cash Price |
$519.54
|
| Rate for Payer: Cofinity Commercial |
$558.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$519.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.36
|
| Rate for Payer: Healthscope Commercial |
$584.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.07
|
| Rate for Payer: Mclaren Medicaid |
$194.29
|
| Rate for Payer: Meridian Medicaid |
$204.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$170.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.02
|
| Rate for Payer: PACE Senior Care Partners |
$154.24
|
| Rate for Payer: PACE SWMI |
$162.36
|
| Rate for Payer: PHP Commercial |
$552.02
|
| Rate for Payer: PHP Medicare Advantage |
$162.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$454.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$565.00
|
| Rate for Payer: Priority Health Medicare |
$162.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$396.09
|
| Rate for Payer: Railroad Medicare Medicare |
$162.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$571.50
|
| Rate for Payer: UHC Core |
$542.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.36
|
| Rate for Payer: UHC Medicare Advantage |
$167.23
|
| Rate for Payer: VA VA |
$162.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.07
|
|
|
HC CHEMODNRV MUSC FACIAL BIL
|
Facility
|
IP
|
$649.43
|
|
|
Service Code
|
CPT 64612
|
| Hospital Charge Code |
36100473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$396.09 |
| Max. Negotiated Rate |
$584.49 |
| Rate for Payer: Aetna Commercial |
$552.02
|
| Rate for Payer: BCBS Trust/PPO |
$501.88
|
| Rate for Payer: BCN Commercial |
$501.88
|
| Rate for Payer: Cash Price |
$519.54
|
| Rate for Payer: Cofinity Commercial |
$558.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$519.54
|
| Rate for Payer: Healthscope Commercial |
$584.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.02
|
| Rate for Payer: PHP Commercial |
$552.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$454.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$565.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$396.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$571.50
|
| Rate for Payer: UHC Core |
$542.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.07
|
|
|
HC CHEMODNRV MUSC MIGRAINE BIL
|
Facility
|
OP
|
$235.62
|
|
|
Service Code
|
CPT 64615
|
| Hospital Charge Code |
36100548
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.96 |
| Max. Negotiated Rate |
$212.06 |
| Rate for Payer: Aetna Commercial |
$200.28
|
| Rate for Payer: Aetna Medicare |
$61.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.63
|
| Rate for Payer: BCBS Complete |
$204.01
|
| Rate for Payer: BCBS MAPPO |
$58.90
|
| Rate for Payer: BCBS Trust/PPO |
$183.19
|
| Rate for Payer: BCN Commercial |
$183.19
|
| Rate for Payer: BCN Medicare Advantage |
$58.90
|
| Rate for Payer: Cash Price |
$188.50
|
| Rate for Payer: Cash Price |
$188.50
|
| Rate for Payer: Cofinity Commercial |
$202.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.90
|
| Rate for Payer: Healthscope Commercial |
$212.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.72
|
| Rate for Payer: Mclaren Medicaid |
$194.29
|
| Rate for Payer: Meridian Medicaid |
$204.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$200.28
|
| Rate for Payer: PACE Senior Care Partners |
$55.96
|
| Rate for Payer: PACE SWMI |
$58.90
|
| Rate for Payer: PHP Commercial |
$200.28
|
| Rate for Payer: PHP Medicare Advantage |
$58.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.99
|
| Rate for Payer: Priority Health Medicare |
$58.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$143.70
|
| Rate for Payer: Railroad Medicare Medicare |
$58.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.35
|
| Rate for Payer: UHC Core |
$196.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.90
|
| Rate for Payer: UHC Medicare Advantage |
$60.67
|
| Rate for Payer: VA VA |
$58.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.72
|
|
|
HC CHEMODNRV MUSC MIGRAINE BIL
|
Facility
|
IP
|
$235.62
|
|
|
Service Code
|
CPT 64615
|
| Hospital Charge Code |
36100548
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$143.70 |
| Max. Negotiated Rate |
$212.06 |
| Rate for Payer: Aetna Commercial |
$200.28
|
| Rate for Payer: BCBS Trust/PPO |
$182.09
|
| Rate for Payer: BCN Commercial |
$182.09
|
| Rate for Payer: Cash Price |
$188.50
|
| Rate for Payer: Cofinity Commercial |
$202.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.50
|
| Rate for Payer: Healthscope Commercial |
$212.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$200.28
|
| Rate for Payer: PHP Commercial |
$200.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$143.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.35
|
| Rate for Payer: UHC Core |
$196.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.72
|
|
|
HC CHEMODNRV MUSC NECK
|
Facility
|
IP
|
$439.63
|
|
|
Service Code
|
CPT 64616
|
| Hospital Charge Code |
36100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$268.13 |
| Max. Negotiated Rate |
$395.67 |
| Rate for Payer: Aetna Commercial |
$373.69
|
| Rate for Payer: BCBS Trust/PPO |
$339.75
|
| Rate for Payer: BCN Commercial |
$339.75
|
| Rate for Payer: Cash Price |
$351.70
|
| Rate for Payer: Cofinity Commercial |
$378.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.70
|
| Rate for Payer: Healthscope Commercial |
$395.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$373.69
|
| Rate for Payer: PHP Commercial |
$373.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$382.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.87
|
| Rate for Payer: UHC Core |
$367.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.72
|
|
|
HC CHEMODNRV MUSC NECK
|
Facility
|
OP
|
$439.63
|
|
|
Service Code
|
CPT 64616
|
| Hospital Charge Code |
36100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.41 |
| Max. Negotiated Rate |
$395.67 |
| Rate for Payer: Aetna Commercial |
$373.69
|
| Rate for Payer: Aetna Medicare |
$114.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.38
|
| Rate for Payer: BCBS Complete |
$204.01
|
| Rate for Payer: BCBS MAPPO |
$109.91
|
| Rate for Payer: BCBS Trust/PPO |
$341.81
|
| Rate for Payer: BCN Commercial |
$341.81
|
| Rate for Payer: BCN Medicare Advantage |
$109.91
|
| Rate for Payer: Cash Price |
$351.70
|
| Rate for Payer: Cash Price |
$351.70
|
| Rate for Payer: Cofinity Commercial |
$378.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$351.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.91
|
| Rate for Payer: Healthscope Commercial |
$395.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$329.72
|
| Rate for Payer: Mclaren Medicaid |
$194.29
|
| Rate for Payer: Meridian Medicaid |
$204.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$115.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$373.69
|
| Rate for Payer: PACE Senior Care Partners |
$104.41
|
| Rate for Payer: PACE SWMI |
$109.91
|
| Rate for Payer: PHP Commercial |
$373.69
|
| Rate for Payer: PHP Medicare Advantage |
$109.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$382.48
|
| Rate for Payer: Priority Health Medicare |
$109.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.13
|
| Rate for Payer: Railroad Medicare Medicare |
$109.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.87
|
| Rate for Payer: UHC Core |
$367.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.91
|
| Rate for Payer: UHC Medicare Advantage |
$113.20
|
| Rate for Payer: VA VA |
$109.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$329.72
|
|
|
HC CHEMODNRV TRUNK MUSC 1-5 MUSC
|
Facility
|
IP
|
$682.78
|
|
|
Service Code
|
CPT 64646
|
| Hospital Charge Code |
36100453
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$416.43 |
| Max. Negotiated Rate |
$614.50 |
| Rate for Payer: Aetna Commercial |
$580.36
|
| Rate for Payer: BCBS Trust/PPO |
$527.65
|
| Rate for Payer: BCN Commercial |
$527.65
|
| Rate for Payer: Cash Price |
$546.22
|
| Rate for Payer: Cofinity Commercial |
$587.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.22
|
| Rate for Payer: Healthscope Commercial |
$614.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$512.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$580.36
|
| Rate for Payer: PHP Commercial |
$580.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$594.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$416.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$600.85
|
| Rate for Payer: UHC Core |
$570.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$512.08
|
|
|
HC CHEMODNRV TRUNK MUSC 1-5 MUSC
|
Facility
|
OP
|
$682.78
|
|
|
Service Code
|
CPT 64646
|
| Hospital Charge Code |
36100453
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$162.16 |
| Max. Negotiated Rate |
$614.50 |
| Rate for Payer: Aetna Commercial |
$580.36
|
| Rate for Payer: Aetna Medicare |
$177.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$213.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$213.37
|
| Rate for Payer: BCBS Complete |
$476.33
|
| Rate for Payer: BCBS MAPPO |
$170.70
|
| Rate for Payer: BCBS Trust/PPO |
$530.86
|
| Rate for Payer: BCN Commercial |
$530.86
|
| Rate for Payer: BCN Medicare Advantage |
$170.70
|
| Rate for Payer: Cash Price |
$546.22
|
| Rate for Payer: Cash Price |
$546.22
|
| Rate for Payer: Cofinity Commercial |
$587.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.70
|
| Rate for Payer: Healthscope Commercial |
$614.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$512.08
|
| Rate for Payer: Mclaren Medicaid |
$453.65
|
| Rate for Payer: Meridian Medicaid |
$476.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$179.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$196.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$580.36
|
| Rate for Payer: PACE Senior Care Partners |
$162.16
|
| Rate for Payer: PACE SWMI |
$170.70
|
| Rate for Payer: PHP Commercial |
$580.36
|
| Rate for Payer: PHP Medicare Advantage |
$170.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$594.02
|
| Rate for Payer: Priority Health Medicare |
$170.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$416.43
|
| Rate for Payer: Railroad Medicare Medicare |
$170.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$600.85
|
| Rate for Payer: UHC Core |
$570.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.70
|
| Rate for Payer: UHC Medicare Advantage |
$175.82
|
| Rate for Payer: VA VA |
$170.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$512.08
|
|
|
HC CHEMO INFUSION CONCURRENT
|
Facility
|
IP
|
$193.80
|
|
|
Service Code
|
CPT 96549
|
| Hospital Charge Code |
33500011
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$118.20 |
| Max. Negotiated Rate |
$174.42 |
| Rate for Payer: Aetna Commercial |
$164.73
|
| Rate for Payer: BCBS Trust/PPO |
$149.77
|
| Rate for Payer: BCN Commercial |
$149.77
|
| Rate for Payer: Cash Price |
$155.04
|
| Rate for Payer: Cofinity Commercial |
$166.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.04
|
| Rate for Payer: Healthscope Commercial |
$174.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.73
|
| Rate for Payer: PHP Commercial |
$164.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.54
|
| Rate for Payer: UHC Core |
$161.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.35
|
|
|
HC CHEMO INFUSION CONCURRENT
|
Facility
|
OP
|
$193.80
|
|
|
Service Code
|
CPT 96549
|
| Hospital Charge Code |
33500011
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$31.16 |
| Max. Negotiated Rate |
$174.42 |
| Rate for Payer: Aetna Commercial |
$164.73
|
| Rate for Payer: Aetna Medicare |
$50.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.56
|
| Rate for Payer: BCBS Complete |
$32.72
|
| Rate for Payer: BCBS MAPPO |
$48.45
|
| Rate for Payer: BCBS Trust/PPO |
$150.68
|
| Rate for Payer: BCN Commercial |
$150.68
|
| Rate for Payer: BCN Medicare Advantage |
$48.45
|
| Rate for Payer: Cash Price |
$155.04
|
| Rate for Payer: Cash Price |
$155.04
|
| Rate for Payer: Cofinity Commercial |
$166.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.45
|
| Rate for Payer: Healthscope Commercial |
$174.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.35
|
| Rate for Payer: Mclaren Medicaid |
$31.16
|
| Rate for Payer: Meridian Medicaid |
$32.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.73
|
| Rate for Payer: PACE Senior Care Partners |
$46.03
|
| Rate for Payer: PACE SWMI |
$48.45
|
| Rate for Payer: PHP Commercial |
$164.73
|
| Rate for Payer: PHP Medicare Advantage |
$48.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.61
|
| Rate for Payer: Priority Health Medicare |
$48.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.20
|
| Rate for Payer: Railroad Medicare Medicare |
$48.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.54
|
| Rate for Payer: UHC Core |
$161.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.45
|
| Rate for Payer: UHC Medicare Advantage |
$49.90
|
| Rate for Payer: VA VA |
$48.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.35
|
|
|
HC CHEMO INFUSION EACH ADDL HR
|
Facility
|
IP
|
$238.30
|
|
|
Service Code
|
CPT 96415
|
| Hospital Charge Code |
33500002
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$145.34 |
| Max. Negotiated Rate |
$214.47 |
| Rate for Payer: Aetna Commercial |
$202.56
|
| Rate for Payer: BCBS Trust/PPO |
$184.16
|
| Rate for Payer: BCN Commercial |
$184.16
|
| Rate for Payer: Cash Price |
$190.64
|
| Rate for Payer: Cofinity Commercial |
$204.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.64
|
| Rate for Payer: Healthscope Commercial |
$214.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$202.56
|
| Rate for Payer: PHP Commercial |
$202.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.70
|
| Rate for Payer: UHC Core |
$198.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.72
|
|
|
HC CHEMO INFUSION EACH ADDL HR
|
Facility
|
OP
|
$238.30
|
|
|
Service Code
|
CPT 96415
|
| Hospital Charge Code |
33500002
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$46.21 |
| Max. Negotiated Rate |
$214.47 |
| Rate for Payer: Aetna Commercial |
$202.56
|
| Rate for Payer: Aetna Medicare |
$61.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.47
|
| Rate for Payer: BCBS Complete |
$48.52
|
| Rate for Payer: BCBS MAPPO |
$59.58
|
| Rate for Payer: BCBS Trust/PPO |
$185.28
|
| Rate for Payer: BCN Commercial |
$185.28
|
| Rate for Payer: BCN Medicare Advantage |
$59.58
|
| Rate for Payer: Cash Price |
$190.64
|
| Rate for Payer: Cash Price |
$190.64
|
| Rate for Payer: Cofinity Commercial |
$204.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.58
|
| Rate for Payer: Healthscope Commercial |
$214.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.72
|
| Rate for Payer: Mclaren Medicaid |
$46.21
|
| Rate for Payer: Meridian Medicaid |
$48.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$62.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$202.56
|
| Rate for Payer: PACE Senior Care Partners |
$56.60
|
| Rate for Payer: PACE SWMI |
$59.58
|
| Rate for Payer: PHP Commercial |
$202.56
|
| Rate for Payer: PHP Medicare Advantage |
$59.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.32
|
| Rate for Payer: Priority Health Medicare |
$59.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.34
|
| Rate for Payer: Railroad Medicare Medicare |
$59.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.70
|
| Rate for Payer: UHC Core |
$198.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.58
|
| Rate for Payer: UHC Medicare Advantage |
$61.36
|
| Rate for Payer: VA VA |
$59.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.72
|
|
|
HC CHEMO INFUSION FIRST HR
|
Facility
|
IP
|
$885.43
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
33500001
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$540.02 |
| Max. Negotiated Rate |
$796.89 |
| Rate for Payer: Aetna Commercial |
$752.62
|
| Rate for Payer: BCBS Trust/PPO |
$684.26
|
| Rate for Payer: BCN Commercial |
$684.26
|
| Rate for Payer: Cash Price |
$708.34
|
| Rate for Payer: Cofinity Commercial |
$761.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$708.34
|
| Rate for Payer: Healthscope Commercial |
$796.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$664.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$752.62
|
| Rate for Payer: PHP Commercial |
$752.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$619.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$770.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$540.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$779.18
|
| Rate for Payer: UHC Core |
$739.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$664.07
|
|
|
HC CHEMO INFUSION FIRST HR
|
Facility
|
OP
|
$885.43
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
33500001
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$210.29 |
| Max. Negotiated Rate |
$796.89 |
| Rate for Payer: Aetna Commercial |
$752.62
|
| Rate for Payer: Aetna Medicare |
$230.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$276.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$276.70
|
| Rate for Payer: BCBS Complete |
$233.27
|
| Rate for Payer: BCBS MAPPO |
$221.36
|
| Rate for Payer: BCBS Trust/PPO |
$688.42
|
| Rate for Payer: BCN Commercial |
$688.42
|
| Rate for Payer: BCN Medicare Advantage |
$221.36
|
| Rate for Payer: Cash Price |
$708.34
|
| Rate for Payer: Cash Price |
$708.34
|
| Rate for Payer: Cofinity Commercial |
$761.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$708.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.36
|
| Rate for Payer: Healthscope Commercial |
$796.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$664.07
|
| Rate for Payer: Mclaren Medicaid |
$222.16
|
| Rate for Payer: Meridian Medicaid |
$233.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$232.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$752.62
|
| Rate for Payer: PACE Senior Care Partners |
$210.29
|
| Rate for Payer: PACE SWMI |
$221.36
|
| Rate for Payer: PHP Commercial |
$752.62
|
| Rate for Payer: PHP Medicare Advantage |
$221.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$619.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$770.32
|
| Rate for Payer: Priority Health Medicare |
$221.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$540.02
|
| Rate for Payer: Railroad Medicare Medicare |
$221.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$779.18
|
| Rate for Payer: UHC Core |
$739.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$221.36
|
| Rate for Payer: UHC Medicare Advantage |
$228.00
|
| Rate for Payer: VA VA |
$221.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$664.07
|
|
|
HC CHEMO INFUSION VIA PUMP
|
Facility
|
OP
|
$802.32
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
33500003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$190.55 |
| Max. Negotiated Rate |
$722.09 |
| Rate for Payer: Aetna Commercial |
$681.97
|
| Rate for Payer: Aetna Medicare |
$208.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$250.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$250.72
|
| Rate for Payer: BCBS Complete |
$233.27
|
| Rate for Payer: BCBS MAPPO |
$200.58
|
| Rate for Payer: BCBS Trust/PPO |
$623.80
|
| Rate for Payer: BCN Commercial |
$623.80
|
| Rate for Payer: BCN Medicare Advantage |
$200.58
|
| Rate for Payer: Cash Price |
$641.86
|
| Rate for Payer: Cash Price |
$641.86
|
| Rate for Payer: Cofinity Commercial |
$690.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.58
|
| Rate for Payer: Healthscope Commercial |
$722.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$601.74
|
| Rate for Payer: Mclaren Medicaid |
$222.16
|
| Rate for Payer: Meridian Medicaid |
$233.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$210.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$230.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$681.97
|
| Rate for Payer: PACE Senior Care Partners |
$190.55
|
| Rate for Payer: PACE SWMI |
$200.58
|
| Rate for Payer: PHP Commercial |
$681.97
|
| Rate for Payer: PHP Medicare Advantage |
$200.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$698.02
|
| Rate for Payer: Priority Health Medicare |
$200.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$489.33
|
| Rate for Payer: Railroad Medicare Medicare |
$200.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$706.04
|
| Rate for Payer: UHC Core |
$669.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.58
|
| Rate for Payer: UHC Medicare Advantage |
$206.60
|
| Rate for Payer: VA VA |
$200.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$601.74
|
|
|
HC CHEMO INFUSION VIA PUMP
|
Facility
|
IP
|
$802.32
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
33500003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$489.33 |
| Max. Negotiated Rate |
$722.09 |
| Rate for Payer: Aetna Commercial |
$681.97
|
| Rate for Payer: BCBS Trust/PPO |
$620.03
|
| Rate for Payer: BCN Commercial |
$620.03
|
| Rate for Payer: Cash Price |
$641.86
|
| Rate for Payer: Cofinity Commercial |
$690.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.86
|
| Rate for Payer: Healthscope Commercial |
$722.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$601.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$681.97
|
| Rate for Payer: PHP Commercial |
$681.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$561.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$698.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$489.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$706.04
|
| Rate for Payer: UHC Core |
$669.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$601.74
|
|
|
HC CHEMO INFUS SEQUENTIAL UP TO 1 HR
|
Facility
|
OP
|
$400.22
|
|
|
Service Code
|
CPT 96417
|
| Hospital Charge Code |
33500004
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$46.21 |
| Max. Negotiated Rate |
$360.20 |
| Rate for Payer: Aetna Commercial |
$340.19
|
| Rate for Payer: Aetna Medicare |
$104.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$125.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$125.07
|
| Rate for Payer: BCBS Complete |
$48.52
|
| Rate for Payer: BCBS MAPPO |
$100.06
|
| Rate for Payer: BCBS Trust/PPO |
$311.17
|
| Rate for Payer: BCN Commercial |
$311.17
|
| Rate for Payer: BCN Medicare Advantage |
$100.06
|
| Rate for Payer: Cash Price |
$320.18
|
| Rate for Payer: Cash Price |
$320.18
|
| Rate for Payer: Cofinity Commercial |
$344.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.06
|
| Rate for Payer: Healthscope Commercial |
$360.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.16
|
| Rate for Payer: Mclaren Medicaid |
$46.21
|
| Rate for Payer: Meridian Medicaid |
$48.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$105.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.19
|
| Rate for Payer: PACE Senior Care Partners |
$95.05
|
| Rate for Payer: PACE SWMI |
$100.06
|
| Rate for Payer: PHP Commercial |
$340.19
|
| Rate for Payer: PHP Medicare Advantage |
$100.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.19
|
| Rate for Payer: Priority Health Medicare |
$100.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.09
|
| Rate for Payer: Railroad Medicare Medicare |
$100.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.19
|
| Rate for Payer: UHC Core |
$334.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.06
|
| Rate for Payer: UHC Medicare Advantage |
$103.06
|
| Rate for Payer: VA VA |
$100.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.16
|
|
|
HC CHEMO INFUS SEQUENTIAL UP TO 1 HR
|
Facility
|
IP
|
$400.22
|
|
|
Service Code
|
CPT 96417
|
| Hospital Charge Code |
33500004
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$244.09 |
| Max. Negotiated Rate |
$360.20 |
| Rate for Payer: Aetna Commercial |
$340.19
|
| Rate for Payer: BCBS Trust/PPO |
$309.29
|
| Rate for Payer: BCN Commercial |
$309.29
|
| Rate for Payer: Cash Price |
$320.18
|
| Rate for Payer: Cofinity Commercial |
$344.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.18
|
| Rate for Payer: Healthscope Commercial |
$360.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.19
|
| Rate for Payer: PHP Commercial |
$340.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$348.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.19
|
| Rate for Payer: UHC Core |
$334.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.16
|
|
|
HC CHEMO INTO PERITONEAL CAVITY VIA PORT
|
Facility
|
OP
|
$430.05
|
|
|
Service Code
|
CPT 96446
|
| Hospital Charge Code |
33500007
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$102.14 |
| Max. Negotiated Rate |
$387.04 |
| Rate for Payer: Aetna Commercial |
$365.54
|
| Rate for Payer: Aetna Commercial |
$297.67
|
| Rate for Payer: Aetna Medicare |
$91.05
|
| Rate for Payer: Aetna Medicare |
$111.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.44
|
| Rate for Payer: BCBS Complete |
$233.27
|
| Rate for Payer: BCBS Complete |
$233.27
|
| Rate for Payer: BCBS MAPPO |
$87.55
|
| Rate for Payer: BCBS MAPPO |
$107.51
|
| Rate for Payer: BCBS Trust/PPO |
$272.28
|
| Rate for Payer: BCBS Trust/PPO |
$334.36
|
| Rate for Payer: BCN Commercial |
$334.36
|
| Rate for Payer: BCN Commercial |
$272.28
|
| Rate for Payer: BCN Medicare Advantage |
$107.51
|
| Rate for Payer: BCN Medicare Advantage |
$87.55
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Cofinity Commercial |
$369.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.51
|
| Rate for Payer: Healthscope Commercial |
$387.04
|
| Rate for Payer: Healthscope Commercial |
$315.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.54
|
| Rate for Payer: Mclaren Medicaid |
$222.16
|
| Rate for Payer: Mclaren Medicaid |
$222.16
|
| Rate for Payer: Meridian Medicaid |
$233.27
|
| Rate for Payer: Meridian Medicaid |
$233.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.54
|
| Rate for Payer: PACE Senior Care Partners |
$102.14
|
| Rate for Payer: PACE Senior Care Partners |
$83.17
|
| Rate for Payer: PACE SWMI |
$87.55
|
| Rate for Payer: PACE SWMI |
$107.51
|
| Rate for Payer: PHP Commercial |
$365.54
|
| Rate for Payer: PHP Commercial |
$297.67
|
| Rate for Payer: PHP Medicare Advantage |
$107.51
|
| Rate for Payer: PHP Medicare Advantage |
$87.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$374.14
|
| Rate for Payer: Priority Health Medicare |
$87.55
|
| Rate for Payer: Priority Health Medicare |
$107.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.59
|
| Rate for Payer: Railroad Medicare Medicare |
$107.51
|
| Rate for Payer: Railroad Medicare Medicare |
$87.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.44
|
| Rate for Payer: UHC Core |
$292.42
|
| Rate for Payer: UHC Core |
$359.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.51
|
| Rate for Payer: UHC Medicare Advantage |
$110.74
|
| Rate for Payer: UHC Medicare Advantage |
$90.18
|
| Rate for Payer: VA VA |
$87.55
|
| Rate for Payer: VA VA |
$107.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.65
|
|
|
HC CHEMO INTO PERITONEAL CAVITY VIA PORT
|
Facility
|
IP
|
$430.05
|
|
|
Service Code
|
CPT 96446
|
| Hospital Charge Code |
33500007
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$262.29 |
| Max. Negotiated Rate |
$387.04 |
| Rate for Payer: Aetna Commercial |
$365.54
|
| Rate for Payer: Aetna Commercial |
$297.67
|
| Rate for Payer: BCBS Trust/PPO |
$270.63
|
| Rate for Payer: BCBS Trust/PPO |
$332.34
|
| Rate for Payer: BCN Commercial |
$332.34
|
| Rate for Payer: BCN Commercial |
$270.63
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Cofinity Commercial |
$369.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Healthscope Commercial |
$387.04
|
| Rate for Payer: Healthscope Commercial |
$315.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: PHP Commercial |
$297.67
|
| Rate for Payer: PHP Commercial |
$365.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$374.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.44
|
| Rate for Payer: UHC Core |
$292.42
|
| Rate for Payer: UHC Core |
$359.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.54
|
|
|
HC CHEMO INTO PLEURA W THORACENTESIS
|
Facility
|
OP
|
$350.20
|
|
|
Service Code
|
CPT 96440
|
| Hospital Charge Code |
33500006
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$83.17 |
| Max. Negotiated Rate |
$315.18 |
| Rate for Payer: Aetna Commercial |
$297.67
|
| Rate for Payer: Aetna Commercial |
$365.54
|
| Rate for Payer: Aetna Medicare |
$111.81
|
| Rate for Payer: Aetna Medicare |
$91.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.39
|
| Rate for Payer: BCBS Complete |
$233.27
|
| Rate for Payer: BCBS Complete |
$233.27
|
| Rate for Payer: BCBS MAPPO |
$107.51
|
| Rate for Payer: BCBS MAPPO |
$87.55
|
| Rate for Payer: BCBS Trust/PPO |
$334.36
|
| Rate for Payer: BCBS Trust/PPO |
$272.28
|
| Rate for Payer: BCN Commercial |
$272.28
|
| Rate for Payer: BCN Commercial |
$334.36
|
| Rate for Payer: BCN Medicare Advantage |
$87.55
|
| Rate for Payer: BCN Medicare Advantage |
$107.51
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Cofinity Commercial |
$369.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.51
|
| Rate for Payer: Healthscope Commercial |
$315.18
|
| Rate for Payer: Healthscope Commercial |
$387.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.65
|
| Rate for Payer: Mclaren Medicaid |
$222.16
|
| Rate for Payer: Mclaren Medicaid |
$222.16
|
| Rate for Payer: Meridian Medicaid |
$233.27
|
| Rate for Payer: Meridian Medicaid |
$233.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: PACE Senior Care Partners |
$83.17
|
| Rate for Payer: PACE Senior Care Partners |
$102.14
|
| Rate for Payer: PACE SWMI |
$87.55
|
| Rate for Payer: PACE SWMI |
$107.51
|
| Rate for Payer: PHP Commercial |
$365.54
|
| Rate for Payer: PHP Commercial |
$297.67
|
| Rate for Payer: PHP Medicare Advantage |
$87.55
|
| Rate for Payer: PHP Medicare Advantage |
$107.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$374.14
|
| Rate for Payer: Priority Health Medicare |
$87.55
|
| Rate for Payer: Priority Health Medicare |
$107.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.59
|
| Rate for Payer: Railroad Medicare Medicare |
$107.51
|
| Rate for Payer: Railroad Medicare Medicare |
$87.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.18
|
| Rate for Payer: UHC Core |
$359.09
|
| Rate for Payer: UHC Core |
$292.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.55
|
| Rate for Payer: UHC Medicare Advantage |
$110.74
|
| Rate for Payer: UHC Medicare Advantage |
$90.18
|
| Rate for Payer: VA VA |
$87.55
|
| Rate for Payer: VA VA |
$107.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.65
|
|
|
HC CHEMO INTO PLEURA W THORACENTESIS
|
Facility
|
IP
|
$350.20
|
|
|
Service Code
|
CPT 96440
|
| Hospital Charge Code |
33500006
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$213.59 |
| Max. Negotiated Rate |
$315.18 |
| Rate for Payer: Aetna Commercial |
$297.67
|
| Rate for Payer: Aetna Commercial |
$365.54
|
| Rate for Payer: BCBS Trust/PPO |
$332.34
|
| Rate for Payer: BCBS Trust/PPO |
$270.63
|
| Rate for Payer: BCN Commercial |
$270.63
|
| Rate for Payer: BCN Commercial |
$332.34
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Cofinity Commercial |
$369.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Healthscope Commercial |
$387.04
|
| Rate for Payer: Healthscope Commercial |
$315.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.54
|
| Rate for Payer: PHP Commercial |
$297.67
|
| Rate for Payer: PHP Commercial |
$365.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$374.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.18
|
| Rate for Payer: UHC Core |
$292.42
|
| Rate for Payer: UHC Core |
$359.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.65
|
|
|
HC CHEST TUBE PROCEDURE
|
Facility
|
IP
|
$1,530.00
|
|
| Hospital Charge Code |
45000035
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$933.15 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.38
|
| Rate for Payer: BCN Commercial |
$1,182.38
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,331.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$933.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,346.40
|
| Rate for Payer: UHC Core |
$1,277.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC CHEST TUBE PROCEDURE
|
Facility
|
OP
|
$1,530.00
|
|
| Hospital Charge Code |
45000035
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.38 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna Medicare |
$397.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$478.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$478.12
|
| Rate for Payer: BCBS Complete |
$612.00
|
| Rate for Payer: BCBS MAPPO |
$382.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,189.58
|
| Rate for Payer: BCN Commercial |
$1,189.58
|
| Rate for Payer: BCN Medicare Advantage |
$382.50
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.50
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$401.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$439.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PACE Senior Care Partners |
$363.38
|
| Rate for Payer: PACE SWMI |
$382.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: PHP Medicare Advantage |
$382.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,331.10
|
| Rate for Payer: Priority Health Medicare |
$382.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$933.15
|
| Rate for Payer: Railroad Medicare Medicare |
$382.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,346.40
|
| Rate for Payer: UHC Core |
$1,277.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.50
|
| Rate for Payer: UHC Medicare Advantage |
$393.98
|
| Rate for Payer: VA VA |
$382.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
