|
HC ARRAY COMPARATIVE GENOMIC CMPT
|
Facility
|
OP
|
$1,440.95
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
31000061
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$254.04 |
| Max. Negotiated Rate |
$1,296.86 |
| Rate for Payer: Aetna Commercial |
$1,224.81
|
| Rate for Payer: Aetna Medicare |
$374.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$450.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$450.30
|
| Rate for Payer: BCBS Complete |
$266.72
|
| Rate for Payer: BCBS MAPPO |
$360.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,184.60
|
| Rate for Payer: BCN Commercial |
$1,184.60
|
| Rate for Payer: BCN Medicare Advantage |
$360.24
|
| Rate for Payer: Cash Price |
$1,152.76
|
| Rate for Payer: Cofinity Commercial |
$1,239.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,152.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.24
|
| Rate for Payer: Healthscope Commercial |
$1,296.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,080.71
|
| Rate for Payer: Mclaren Medicaid |
$254.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$378.25
|
| Rate for Payer: Meridian Medicaid |
$266.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$414.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$396.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,224.81
|
| Rate for Payer: Nomi Health Commercial |
$1,181.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.71
|
| Rate for Payer: PACE Senior Care Partners |
$342.23
|
| Rate for Payer: PACE SWMI |
$360.24
|
| Rate for Payer: PHP Commercial |
$1,224.81
|
| Rate for Payer: PHP Medicare Advantage |
$360.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,253.63
|
| Rate for Payer: Priority Health Medicare |
$363.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,002.90
|
| Rate for Payer: Railroad Medicare Medicare |
$360.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,268.04
|
| Rate for Payer: UHC Core |
$1,203.19
|
| Rate for Payer: UHC Exchange |
$360.24
|
| Rate for Payer: UHC Medicaid |
$254.04
|
| Rate for Payer: UHC Medicare Advantage |
$360.24
|
| Rate for Payer: UHCCP Medicaid |
$254.04
|
| Rate for Payer: VA VA |
$360.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,080.71
|
|
|
HC ARRAY COMPARATIVE GENOMIC CMPT
|
Facility
|
IP
|
$1,440.95
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
31000061
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,002.90 |
| Max. Negotiated Rate |
$1,296.86 |
| Rate for Payer: Aetna Commercial |
$1,224.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,190.08
|
| Rate for Payer: BCN Commercial |
$1,190.08
|
| Rate for Payer: Cash Price |
$1,152.76
|
| Rate for Payer: Cofinity Commercial |
$1,239.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,152.76
|
| Rate for Payer: Healthscope Commercial |
$1,296.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,080.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,224.81
|
| Rate for Payer: Nomi Health Commercial |
$1,181.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.71
|
| Rate for Payer: PHP Commercial |
$1,224.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,253.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,002.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,268.04
|
| Rate for Payer: UHC Core |
$1,203.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,080.71
|
|
|
HC ARSENIC
|
Facility
|
IP
|
$199.96
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$139.17 |
| Max. Negotiated Rate |
$179.96 |
| Rate for Payer: Aetna Commercial |
$169.97
|
| Rate for Payer: BCBS Trust/PPO |
$165.15
|
| Rate for Payer: BCN Commercial |
$165.15
|
| Rate for Payer: Cash Price |
$159.97
|
| Rate for Payer: Cofinity Commercial |
$171.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.97
|
| Rate for Payer: Healthscope Commercial |
$179.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.97
|
| Rate for Payer: Nomi Health Commercial |
$163.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.97
|
| Rate for Payer: PHP Commercial |
$169.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$173.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.96
|
| Rate for Payer: UHC Core |
$166.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.97
|
|
|
HC ARSENIC
|
Facility
|
OP
|
$199.96
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.25 |
| Max. Negotiated Rate |
$179.96 |
| Rate for Payer: Aetna Commercial |
$169.97
|
| Rate for Payer: Aetna Medicare |
$51.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.49
|
| Rate for Payer: BCBS Complete |
$37.01
|
| Rate for Payer: BCBS MAPPO |
$49.99
|
| Rate for Payer: BCBS Trust/PPO |
$164.39
|
| Rate for Payer: BCN Commercial |
$164.39
|
| Rate for Payer: BCN Medicare Advantage |
$49.99
|
| Rate for Payer: Cash Price |
$159.97
|
| Rate for Payer: Cofinity Commercial |
$171.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.99
|
| Rate for Payer: Healthscope Commercial |
$179.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.97
|
| Rate for Payer: Mclaren Medicaid |
$35.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.49
|
| Rate for Payer: Meridian Medicaid |
$37.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.97
|
| Rate for Payer: Nomi Health Commercial |
$163.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.97
|
| Rate for Payer: PACE Senior Care Partners |
$47.49
|
| Rate for Payer: PACE SWMI |
$49.99
|
| Rate for Payer: PHP Commercial |
$169.97
|
| Rate for Payer: PHP Medicare Advantage |
$49.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$173.97
|
| Rate for Payer: Priority Health Medicare |
$50.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.17
|
| Rate for Payer: Railroad Medicare Medicare |
$49.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.96
|
| Rate for Payer: UHC Core |
$166.97
|
| Rate for Payer: UHC Exchange |
$49.99
|
| Rate for Payer: UHC Medicaid |
$35.25
|
| Rate for Payer: UHC Medicare Advantage |
$49.99
|
| Rate for Payer: UHCCP Medicaid |
$35.25
|
| Rate for Payer: VA VA |
$49.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.97
|
|
|
HC ARSENIC 24HR U
|
Facility
|
IP
|
$116.52
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100679
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$81.10 |
| Max. Negotiated Rate |
$104.87 |
| Rate for Payer: Aetna Commercial |
$99.04
|
| Rate for Payer: BCBS Trust/PPO |
$96.23
|
| Rate for Payer: BCN Commercial |
$96.23
|
| Rate for Payer: Cash Price |
$93.22
|
| Rate for Payer: Cofinity Commercial |
$100.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.22
|
| Rate for Payer: Healthscope Commercial |
$104.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.04
|
| Rate for Payer: Nomi Health Commercial |
$95.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.39
|
| Rate for Payer: PHP Commercial |
$99.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.54
|
| Rate for Payer: UHC Core |
$97.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.39
|
|
|
HC ARSENIC 24HR U
|
Facility
|
OP
|
$116.52
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100679
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.54 |
| Max. Negotiated Rate |
$104.87 |
| Rate for Payer: Aetna Commercial |
$99.04
|
| Rate for Payer: Aetna Medicare |
$30.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.41
|
| Rate for Payer: BCBS Complete |
$21.57
|
| Rate for Payer: BCBS MAPPO |
$29.13
|
| Rate for Payer: BCBS Trust/PPO |
$95.79
|
| Rate for Payer: BCN Commercial |
$95.79
|
| Rate for Payer: BCN Medicare Advantage |
$29.13
|
| Rate for Payer: Cash Price |
$93.22
|
| Rate for Payer: Cofinity Commercial |
$100.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$104.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.39
|
| Rate for Payer: Mclaren Medicaid |
$20.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.59
|
| Rate for Payer: Meridian Medicaid |
$21.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.04
|
| Rate for Payer: Nomi Health Commercial |
$95.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.39
|
| Rate for Payer: PACE Senior Care Partners |
$27.67
|
| Rate for Payer: PACE SWMI |
$29.13
|
| Rate for Payer: PHP Commercial |
$99.04
|
| Rate for Payer: PHP Medicare Advantage |
$29.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.37
|
| Rate for Payer: Priority Health Medicare |
$29.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.10
|
| Rate for Payer: Railroad Medicare Medicare |
$29.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.54
|
| Rate for Payer: UHC Core |
$97.29
|
| Rate for Payer: UHC Exchange |
$29.13
|
| Rate for Payer: UHC Medicaid |
$20.54
|
| Rate for Payer: UHC Medicare Advantage |
$29.13
|
| Rate for Payer: UHCCP Medicaid |
$20.54
|
| Rate for Payer: VA VA |
$29.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.39
|
|
|
HC ARSENIC URINE
|
Facility
|
OP
|
$66.59
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.74 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare |
$17.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.81
|
| Rate for Payer: BCBS Complete |
$12.33
|
| Rate for Payer: BCBS MAPPO |
$16.65
|
| Rate for Payer: BCBS Trust/PPO |
$54.74
|
| Rate for Payer: BCN Commercial |
$54.74
|
| Rate for Payer: BCN Medicare Advantage |
$16.65
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Mclaren Medicaid |
$11.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.48
|
| Rate for Payer: Meridian Medicaid |
$12.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$54.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.94
|
| Rate for Payer: PACE Senior Care Partners |
$15.82
|
| Rate for Payer: PACE SWMI |
$16.65
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: PHP Medicare Advantage |
$16.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.93
|
| Rate for Payer: Priority Health Medicare |
$16.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.35
|
| Rate for Payer: Railroad Medicare Medicare |
$16.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.60
|
| Rate for Payer: UHC Core |
$55.60
|
| Rate for Payer: UHC Exchange |
$16.65
|
| Rate for Payer: UHC Medicaid |
$11.74
|
| Rate for Payer: UHC Medicare Advantage |
$16.65
|
| Rate for Payer: UHCCP Medicaid |
$11.74
|
| Rate for Payer: VA VA |
$16.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC ARSENIC URINE
|
Facility
|
IP
|
$66.59
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.35 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: BCBS Trust/PPO |
$55.00
|
| Rate for Payer: BCN Commercial |
$55.00
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$54.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.94
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.60
|
| Rate for Payer: UHC Core |
$55.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC ART CATH INSERT
|
Facility
|
IP
|
$461.76
|
|
| Hospital Charge Code |
45000029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$321.38 |
| Max. Negotiated Rate |
$415.58 |
| Rate for Payer: Aetna Commercial |
$392.50
|
| Rate for Payer: BCBS Trust/PPO |
$381.37
|
| Rate for Payer: BCN Commercial |
$381.37
|
| Rate for Payer: Cash Price |
$369.41
|
| Rate for Payer: Cofinity Commercial |
$397.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.41
|
| Rate for Payer: Healthscope Commercial |
$415.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$346.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.50
|
| Rate for Payer: Nomi Health Commercial |
$378.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.32
|
| Rate for Payer: PHP Commercial |
$392.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$401.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$321.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.35
|
| Rate for Payer: UHC Core |
$385.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$346.32
|
|
|
HC ART CATH INSERT
|
Facility
|
OP
|
$461.76
|
|
| Hospital Charge Code |
45000029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$81.41 |
| Max. Negotiated Rate |
$415.58 |
| Rate for Payer: Aetna Commercial |
$392.50
|
| Rate for Payer: Aetna Medicare |
$120.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$144.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$144.30
|
| Rate for Payer: BCBS Complete |
$85.47
|
| Rate for Payer: BCBS MAPPO |
$115.44
|
| Rate for Payer: BCBS Trust/PPO |
$379.61
|
| Rate for Payer: BCN Commercial |
$379.61
|
| Rate for Payer: BCN Medicare Advantage |
$115.44
|
| Rate for Payer: Cash Price |
$369.41
|
| Rate for Payer: Cofinity Commercial |
$397.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$369.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.44
|
| Rate for Payer: Healthscope Commercial |
$415.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$346.32
|
| Rate for Payer: Mclaren Medicaid |
$81.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.21
|
| Rate for Payer: Meridian Medicaid |
$85.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$126.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$392.50
|
| Rate for Payer: Nomi Health Commercial |
$378.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$346.32
|
| Rate for Payer: PACE Senior Care Partners |
$109.67
|
| Rate for Payer: PACE SWMI |
$115.44
|
| Rate for Payer: PHP Commercial |
$392.50
|
| Rate for Payer: PHP Medicare Advantage |
$115.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$401.73
|
| Rate for Payer: Priority Health Medicare |
$116.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$321.38
|
| Rate for Payer: Railroad Medicare Medicare |
$115.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.35
|
| Rate for Payer: UHC Core |
$385.57
|
| Rate for Payer: UHC Exchange |
$115.44
|
| Rate for Payer: UHC Medicaid |
$81.41
|
| Rate for Payer: UHC Medicare Advantage |
$115.44
|
| Rate for Payer: UHCCP Medicaid |
$81.41
|
| Rate for Payer: VA VA |
$115.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$346.32
|
|
|
HC ARTERIAL DUPLEX IMAG BIL LOWER EXTREMITY
|
Facility
|
OP
|
$1,619.87
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100007
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$285.58 |
| Max. Negotiated Rate |
$1,457.88 |
| Rate for Payer: Aetna Commercial |
$1,376.89
|
| Rate for Payer: Aetna Medicare |
$421.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.21
|
| Rate for Payer: BCBS Complete |
$299.84
|
| Rate for Payer: BCBS MAPPO |
$404.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,331.70
|
| Rate for Payer: BCN Commercial |
$1,331.70
|
| Rate for Payer: BCN Medicare Advantage |
$404.97
|
| Rate for Payer: Cash Price |
$1,295.90
|
| Rate for Payer: Cofinity Commercial |
$1,393.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,295.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.97
|
| Rate for Payer: Healthscope Commercial |
$1,457.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,214.90
|
| Rate for Payer: Mclaren Medicaid |
$285.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.22
|
| Rate for Payer: Meridian Medicaid |
$299.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,376.89
|
| Rate for Payer: Nomi Health Commercial |
$1,328.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,214.90
|
| Rate for Payer: PACE Senior Care Partners |
$384.72
|
| Rate for Payer: PACE SWMI |
$404.97
|
| Rate for Payer: PHP Commercial |
$1,376.89
|
| Rate for Payer: PHP Medicare Advantage |
$404.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$285.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,409.29
|
| Rate for Payer: Priority Health Medicare |
$409.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,127.43
|
| Rate for Payer: Railroad Medicare Medicare |
$404.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,425.49
|
| Rate for Payer: UHC Core |
$1,352.59
|
| Rate for Payer: UHC Exchange |
$404.97
|
| Rate for Payer: UHC Medicaid |
$285.58
|
| Rate for Payer: UHC Medicare Advantage |
$404.97
|
| Rate for Payer: UHCCP Medicaid |
$285.58
|
| Rate for Payer: VA VA |
$404.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,214.90
|
|
|
HC ARTERIAL DUPLEX IMAG BIL LOWER EXTREMITY
|
Facility
|
IP
|
$1,619.87
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100007
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$1,127.43 |
| Max. Negotiated Rate |
$1,457.88 |
| Rate for Payer: Aetna Commercial |
$1,376.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,337.85
|
| Rate for Payer: BCN Commercial |
$1,337.85
|
| Rate for Payer: Cash Price |
$1,295.90
|
| Rate for Payer: Cofinity Commercial |
$1,393.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,295.90
|
| Rate for Payer: Healthscope Commercial |
$1,457.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,214.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,376.89
|
| Rate for Payer: Nomi Health Commercial |
$1,328.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,214.90
|
| Rate for Payer: PHP Commercial |
$1,376.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,409.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,127.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,425.49
|
| Rate for Payer: UHC Core |
$1,352.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,214.90
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
IP
|
$1,335.07
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$929.21 |
| Max. Negotiated Rate |
$1,201.56 |
| Rate for Payer: Aetna Commercial |
$1,134.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,102.63
|
| Rate for Payer: BCN Commercial |
$1,102.63
|
| Rate for Payer: Cash Price |
$1,068.06
|
| Rate for Payer: Cofinity Commercial |
$1,148.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,068.06
|
| Rate for Payer: Healthscope Commercial |
$1,201.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,001.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,134.81
|
| Rate for Payer: Nomi Health Commercial |
$1,094.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,001.30
|
| Rate for Payer: PHP Commercial |
$1,134.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,161.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$929.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,174.86
|
| Rate for Payer: UHC Core |
$1,114.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,001.30
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
OP
|
$1,335.07
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$235.37 |
| Max. Negotiated Rate |
$1,201.56 |
| Rate for Payer: Aetna Commercial |
$1,134.81
|
| Rate for Payer: Aetna Medicare |
$347.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$417.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$417.21
|
| Rate for Payer: BCBS Complete |
$247.12
|
| Rate for Payer: BCBS MAPPO |
$333.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,097.56
|
| Rate for Payer: BCN Commercial |
$1,097.56
|
| Rate for Payer: BCN Medicare Advantage |
$333.77
|
| Rate for Payer: Cash Price |
$1,068.06
|
| Rate for Payer: Cofinity Commercial |
$1,148.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,068.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$333.77
|
| Rate for Payer: Healthscope Commercial |
$1,201.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,001.30
|
| Rate for Payer: Mclaren Medicaid |
$235.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$350.46
|
| Rate for Payer: Meridian Medicaid |
$247.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$383.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$367.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,134.81
|
| Rate for Payer: Nomi Health Commercial |
$1,094.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,001.30
|
| Rate for Payer: PACE Senior Care Partners |
$317.08
|
| Rate for Payer: PACE SWMI |
$333.77
|
| Rate for Payer: PHP Commercial |
$1,134.81
|
| Rate for Payer: PHP Medicare Advantage |
$333.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,161.51
|
| Rate for Payer: Priority Health Medicare |
$337.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$929.21
|
| Rate for Payer: Railroad Medicare Medicare |
$333.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,174.86
|
| Rate for Payer: UHC Core |
$1,114.78
|
| Rate for Payer: UHC Exchange |
$333.77
|
| Rate for Payer: UHC Medicaid |
$235.37
|
| Rate for Payer: UHC Medicare Advantage |
$333.77
|
| Rate for Payer: UHCCP Medicaid |
$235.37
|
| Rate for Payer: VA VA |
$333.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,001.30
|
|
|
HC ARTERIAL PUNCTURE
|
Facility
|
OP
|
$138.61
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$24.44 |
| Max. Negotiated Rate |
$124.75 |
| Rate for Payer: Aetna Commercial |
$117.82
|
| Rate for Payer: Aetna Medicare |
$36.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.32
|
| Rate for Payer: BCBS Complete |
$25.66
|
| Rate for Payer: BCBS MAPPO |
$34.65
|
| Rate for Payer: BCBS Trust/PPO |
$113.95
|
| Rate for Payer: BCN Commercial |
$113.95
|
| Rate for Payer: BCN Medicare Advantage |
$34.65
|
| Rate for Payer: Cash Price |
$110.89
|
| Rate for Payer: Cofinity Commercial |
$119.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.65
|
| Rate for Payer: Healthscope Commercial |
$124.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.96
|
| Rate for Payer: Mclaren Medicaid |
$24.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.39
|
| Rate for Payer: Meridian Medicaid |
$25.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.82
|
| Rate for Payer: Nomi Health Commercial |
$113.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.96
|
| Rate for Payer: PACE Senior Care Partners |
$32.92
|
| Rate for Payer: PACE SWMI |
$34.65
|
| Rate for Payer: PHP Commercial |
$117.82
|
| Rate for Payer: PHP Medicare Advantage |
$34.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$120.59
|
| Rate for Payer: Priority Health Medicare |
$35.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.47
|
| Rate for Payer: Railroad Medicare Medicare |
$34.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.98
|
| Rate for Payer: UHC Core |
$115.74
|
| Rate for Payer: UHC Exchange |
$34.65
|
| Rate for Payer: UHC Medicaid |
$24.44
|
| Rate for Payer: UHC Medicare Advantage |
$34.65
|
| Rate for Payer: UHCCP Medicaid |
$24.44
|
| Rate for Payer: VA VA |
$34.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.96
|
|
|
HC ARTERIAL PUNCTURE
|
Facility
|
IP
|
$138.61
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$96.47 |
| Max. Negotiated Rate |
$124.75 |
| Rate for Payer: Aetna Commercial |
$117.82
|
| Rate for Payer: BCBS Trust/PPO |
$114.48
|
| Rate for Payer: BCN Commercial |
$114.48
|
| Rate for Payer: Cash Price |
$110.89
|
| Rate for Payer: Cofinity Commercial |
$119.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.89
|
| Rate for Payer: Healthscope Commercial |
$124.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.82
|
| Rate for Payer: Nomi Health Commercial |
$113.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.96
|
| Rate for Payer: PHP Commercial |
$117.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$120.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.98
|
| Rate for Payer: UHC Core |
$115.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.96
|
|
|
HC ARTERIAL TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$5,211.17
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
36100371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,626.97 |
| Max. Negotiated Rate |
$4,690.05 |
| Rate for Payer: Aetna Commercial |
$4,429.49
|
| Rate for Payer: BCBS Trust/PPO |
$4,303.91
|
| Rate for Payer: BCN Commercial |
$4,303.91
|
| Rate for Payer: Cash Price |
$4,168.94
|
| Rate for Payer: Cofinity Commercial |
$4,481.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,168.94
|
| Rate for Payer: Healthscope Commercial |
$4,690.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,908.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,429.49
|
| Rate for Payer: Nomi Health Commercial |
$4,273.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,908.38
|
| Rate for Payer: PHP Commercial |
$4,429.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,533.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,626.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,585.83
|
| Rate for Payer: UHC Core |
$4,351.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,908.38
|
|
|
HC ARTERIAL TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$5,211.17
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
36100371
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$918.73 |
| Max. Negotiated Rate |
$4,690.05 |
| Rate for Payer: Aetna Commercial |
$4,429.49
|
| Rate for Payer: Aetna Medicare |
$1,354.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,628.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,628.49
|
| Rate for Payer: BCBS Complete |
$964.59
|
| Rate for Payer: BCBS MAPPO |
$1,302.79
|
| Rate for Payer: BCBS Trust/PPO |
$4,284.10
|
| Rate for Payer: BCN Commercial |
$4,284.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,302.79
|
| Rate for Payer: Cash Price |
$4,168.94
|
| Rate for Payer: Cofinity Commercial |
$4,481.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,168.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,302.79
|
| Rate for Payer: Healthscope Commercial |
$4,690.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,908.38
|
| Rate for Payer: Mclaren Medicaid |
$918.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,367.93
|
| Rate for Payer: Meridian Medicaid |
$964.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,498.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,433.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,429.49
|
| Rate for Payer: Nomi Health Commercial |
$4,273.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,908.38
|
| Rate for Payer: PACE Senior Care Partners |
$1,237.65
|
| Rate for Payer: PACE SWMI |
$1,302.79
|
| Rate for Payer: PHP Commercial |
$4,429.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,302.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$918.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,533.72
|
| Rate for Payer: Priority Health Medicare |
$1,315.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,626.97
|
| Rate for Payer: Railroad Medicare Medicare |
$1,302.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,585.83
|
| Rate for Payer: UHC Core |
$4,351.33
|
| Rate for Payer: UHC Exchange |
$1,302.79
|
| Rate for Payer: UHC Medicaid |
$918.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,302.79
|
| Rate for Payer: UHCCP Medicaid |
$918.73
|
| Rate for Payer: VA VA |
$1,302.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,908.38
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
IP
|
$881.24
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$613.34 |
| Max. Negotiated Rate |
$793.12 |
| Rate for Payer: Aetna Commercial |
$749.05
|
| Rate for Payer: BCBS Trust/PPO |
$727.82
|
| Rate for Payer: BCN Commercial |
$727.82
|
| Rate for Payer: Cash Price |
$704.99
|
| Rate for Payer: Cofinity Commercial |
$757.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$704.99
|
| Rate for Payer: Healthscope Commercial |
$793.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$660.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$749.05
|
| Rate for Payer: Nomi Health Commercial |
$722.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$660.93
|
| Rate for Payer: PHP Commercial |
$749.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$766.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$613.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$775.49
|
| Rate for Payer: UHC Core |
$735.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$660.93
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
OP
|
$881.24
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$155.36 |
| Max. Negotiated Rate |
$793.12 |
| Rate for Payer: Aetna Commercial |
$749.05
|
| Rate for Payer: Aetna Medicare |
$229.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$275.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$275.39
|
| Rate for Payer: BCBS Complete |
$163.12
|
| Rate for Payer: BCBS MAPPO |
$220.31
|
| Rate for Payer: BCBS Trust/PPO |
$724.47
|
| Rate for Payer: BCN Commercial |
$724.47
|
| Rate for Payer: BCN Medicare Advantage |
$220.31
|
| Rate for Payer: Cash Price |
$704.99
|
| Rate for Payer: Cofinity Commercial |
$757.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$704.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$220.31
|
| Rate for Payer: Healthscope Commercial |
$793.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$660.93
|
| Rate for Payer: Mclaren Medicaid |
$155.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$231.33
|
| Rate for Payer: Meridian Medicaid |
$163.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$253.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$242.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$749.05
|
| Rate for Payer: Nomi Health Commercial |
$722.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$660.93
|
| Rate for Payer: PACE Senior Care Partners |
$209.29
|
| Rate for Payer: PACE SWMI |
$220.31
|
| Rate for Payer: PHP Commercial |
$749.05
|
| Rate for Payer: PHP Medicare Advantage |
$220.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$766.68
|
| Rate for Payer: Priority Health Medicare |
$222.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$613.34
|
| Rate for Payer: Railroad Medicare Medicare |
$220.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$775.49
|
| Rate for Payer: UHC Core |
$735.84
|
| Rate for Payer: UHC Exchange |
$220.31
|
| Rate for Payer: UHC Medicaid |
$155.36
|
| Rate for Payer: UHC Medicare Advantage |
$220.31
|
| Rate for Payer: UHCCP Medicaid |
$155.36
|
| Rate for Payer: VA VA |
$220.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$660.93
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
OP
|
$739.09
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$130.30 |
| Max. Negotiated Rate |
$665.18 |
| Rate for Payer: Aetna Commercial |
$628.23
|
| Rate for Payer: Aetna Medicare |
$192.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$230.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$230.97
|
| Rate for Payer: BCBS Complete |
$136.81
|
| Rate for Payer: BCBS MAPPO |
$184.77
|
| Rate for Payer: BCBS Trust/PPO |
$607.61
|
| Rate for Payer: BCN Commercial |
$607.61
|
| Rate for Payer: BCN Medicare Advantage |
$184.77
|
| Rate for Payer: Cash Price |
$591.27
|
| Rate for Payer: Cofinity Commercial |
$635.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$591.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.77
|
| Rate for Payer: Healthscope Commercial |
$665.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$554.32
|
| Rate for Payer: Mclaren Medicaid |
$130.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.01
|
| Rate for Payer: Meridian Medicaid |
$136.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$203.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$628.23
|
| Rate for Payer: Nomi Health Commercial |
$606.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$554.32
|
| Rate for Payer: PACE Senior Care Partners |
$175.53
|
| Rate for Payer: PACE SWMI |
$184.77
|
| Rate for Payer: PHP Commercial |
$628.23
|
| Rate for Payer: PHP Medicare Advantage |
$184.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$643.01
|
| Rate for Payer: Priority Health Medicare |
$186.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$514.41
|
| Rate for Payer: Railroad Medicare Medicare |
$184.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$650.40
|
| Rate for Payer: UHC Core |
$617.14
|
| Rate for Payer: UHC Exchange |
$184.77
|
| Rate for Payer: UHC Medicaid |
$130.30
|
| Rate for Payer: UHC Medicare Advantage |
$184.77
|
| Rate for Payer: UHCCP Medicaid |
$130.30
|
| Rate for Payer: VA VA |
$184.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$554.32
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
IP
|
$739.09
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$514.41 |
| Max. Negotiated Rate |
$665.18 |
| Rate for Payer: Aetna Commercial |
$628.23
|
| Rate for Payer: BCBS Trust/PPO |
$610.41
|
| Rate for Payer: BCN Commercial |
$610.41
|
| Rate for Payer: Cash Price |
$591.27
|
| Rate for Payer: Cofinity Commercial |
$635.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$591.27
|
| Rate for Payer: Healthscope Commercial |
$665.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$554.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$628.23
|
| Rate for Payer: Nomi Health Commercial |
$606.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$554.32
|
| Rate for Payer: PHP Commercial |
$628.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$643.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$514.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$650.40
|
| Rate for Payer: UHC Core |
$617.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$554.32
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
IP
|
$961.35
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$669.10 |
| Max. Negotiated Rate |
$865.22 |
| Rate for Payer: Aetna Commercial |
$817.15
|
| Rate for Payer: BCBS Trust/PPO |
$793.98
|
| Rate for Payer: BCN Commercial |
$793.98
|
| Rate for Payer: Cash Price |
$769.08
|
| Rate for Payer: Cofinity Commercial |
$826.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.08
|
| Rate for Payer: Healthscope Commercial |
$865.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$721.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.15
|
| Rate for Payer: Nomi Health Commercial |
$788.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.01
|
| Rate for Payer: PHP Commercial |
$817.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$836.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$669.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$845.99
|
| Rate for Payer: UHC Core |
$802.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$721.01
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
OP
|
$961.35
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$169.49 |
| Max. Negotiated Rate |
$865.22 |
| Rate for Payer: Aetna Commercial |
$817.15
|
| Rate for Payer: Aetna Medicare |
$249.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$300.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$300.42
|
| Rate for Payer: BCBS Complete |
$177.95
|
| Rate for Payer: BCBS MAPPO |
$240.34
|
| Rate for Payer: BCBS Trust/PPO |
$790.33
|
| Rate for Payer: BCN Commercial |
$790.33
|
| Rate for Payer: BCN Medicare Advantage |
$240.34
|
| Rate for Payer: Cash Price |
$769.08
|
| Rate for Payer: Cofinity Commercial |
$826.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.34
|
| Rate for Payer: Healthscope Commercial |
$865.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$721.01
|
| Rate for Payer: Mclaren Medicaid |
$169.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.35
|
| Rate for Payer: Meridian Medicaid |
$177.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$276.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$264.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.15
|
| Rate for Payer: Nomi Health Commercial |
$788.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.01
|
| Rate for Payer: PACE Senior Care Partners |
$228.32
|
| Rate for Payer: PACE SWMI |
$240.34
|
| Rate for Payer: PHP Commercial |
$817.15
|
| Rate for Payer: PHP Medicare Advantage |
$240.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$836.37
|
| Rate for Payer: Priority Health Medicare |
$242.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$669.10
|
| Rate for Payer: Railroad Medicare Medicare |
$240.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$845.99
|
| Rate for Payer: UHC Core |
$802.73
|
| Rate for Payer: UHC Exchange |
$240.34
|
| Rate for Payer: UHC Medicaid |
$169.49
|
| Rate for Payer: UHC Medicare Advantage |
$240.34
|
| Rate for Payer: UHCCP Medicaid |
$169.49
|
| Rate for Payer: VA VA |
$240.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$721.01
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
OP
|
$806.28
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$142.15 |
| Max. Negotiated Rate |
$725.65 |
| Rate for Payer: Aetna Commercial |
$685.34
|
| Rate for Payer: Aetna Medicare |
$209.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.96
|
| Rate for Payer: BCBS Complete |
$149.24
|
| Rate for Payer: BCBS MAPPO |
$201.57
|
| Rate for Payer: BCBS Trust/PPO |
$662.84
|
| Rate for Payer: BCN Commercial |
$662.84
|
| Rate for Payer: BCN Medicare Advantage |
$201.57
|
| Rate for Payer: Cash Price |
$645.02
|
| Rate for Payer: Cofinity Commercial |
$693.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$645.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.57
|
| Rate for Payer: Healthscope Commercial |
$725.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$604.71
|
| Rate for Payer: Mclaren Medicaid |
$142.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.65
|
| Rate for Payer: Meridian Medicaid |
$149.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.34
|
| Rate for Payer: Nomi Health Commercial |
$661.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$604.71
|
| Rate for Payer: PACE Senior Care Partners |
$191.49
|
| Rate for Payer: PACE SWMI |
$201.57
|
| Rate for Payer: PHP Commercial |
$685.34
|
| Rate for Payer: PHP Medicare Advantage |
$201.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$142.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$701.46
|
| Rate for Payer: Priority Health Medicare |
$203.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$561.17
|
| Rate for Payer: Railroad Medicare Medicare |
$201.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$709.53
|
| Rate for Payer: UHC Core |
$673.24
|
| Rate for Payer: UHC Exchange |
$201.57
|
| Rate for Payer: UHC Medicaid |
$142.15
|
| Rate for Payer: UHC Medicare Advantage |
$201.57
|
| Rate for Payer: UHCCP Medicaid |
$142.15
|
| Rate for Payer: VA VA |
$201.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$604.71
|
|
