|
HC CRITIC AID 6.5 OZ
|
Facility
|
IP
|
$39.21
|
|
| Hospital Charge Code |
27100008
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$23.91 |
| Max. Negotiated Rate |
$35.29 |
| Rate for Payer: Aetna Commercial |
$33.33
|
| Rate for Payer: BCBS Trust/PPO |
$30.30
|
| Rate for Payer: BCN Commercial |
$30.30
|
| Rate for Payer: Cash Price |
$31.37
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.37
|
| Rate for Payer: Healthscope Commercial |
$35.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.33
|
| Rate for Payer: PHP Commercial |
$33.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.50
|
| Rate for Payer: UHC Core |
$32.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.41
|
|
|
HC CRITIC AID 6.5 OZ
|
Facility
|
OP
|
$39.21
|
|
| Hospital Charge Code |
27100008
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.31 |
| Max. Negotiated Rate |
$35.29 |
| Rate for Payer: Aetna Commercial |
$33.33
|
| Rate for Payer: Aetna Medicare |
$10.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.25
|
| Rate for Payer: BCBS Complete |
$15.68
|
| Rate for Payer: BCBS MAPPO |
$9.80
|
| Rate for Payer: BCBS Trust/PPO |
$30.49
|
| Rate for Payer: BCN Commercial |
$30.49
|
| Rate for Payer: BCN Medicare Advantage |
$9.80
|
| Rate for Payer: Cash Price |
$31.37
|
| Rate for Payer: Cofinity Commercial |
$33.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.80
|
| Rate for Payer: Healthscope Commercial |
$35.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.33
|
| Rate for Payer: PACE Senior Care Partners |
$9.31
|
| Rate for Payer: PACE SWMI |
$9.80
|
| Rate for Payer: PHP Commercial |
$33.33
|
| Rate for Payer: PHP Medicare Advantage |
$9.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.11
|
| Rate for Payer: Priority Health Medicare |
$9.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.91
|
| Rate for Payer: Railroad Medicare Medicare |
$9.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.50
|
| Rate for Payer: UHC Core |
$32.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.80
|
| Rate for Payer: UHC Medicare Advantage |
$10.10
|
| Rate for Payer: VA VA |
$9.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.41
|
|
|
HC CRITICAL CARE R&B
|
Facility
|
IP
|
$6,213.20
|
|
| Hospital Charge Code |
20000001
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$1,577.95 |
| Max. Negotiated Rate |
$166,100.00 |
| Rate for Payer: Aetna Commercial |
$5,281.22
|
| Rate for Payer: Aetna Medicare |
$1,727.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,076.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,076.25
|
| Rate for Payer: BCBS MAPPO |
$1,661.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,801.56
|
| Rate for Payer: BCN Commercial |
$4,801.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,661.00
|
| Rate for Payer: Cash Price |
$4,970.56
|
| Rate for Payer: Cash Price |
$4,970.56
|
| Rate for Payer: Cash Price |
$4,970.56
|
| Rate for Payer: Cofinity Commercial |
$5,343.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,970.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,661.00
|
| Rate for Payer: Healthscope Commercial |
$5,591.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,659.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,744.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,910.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,281.22
|
| Rate for Payer: PACE Senior Care Partners |
$1,577.95
|
| Rate for Payer: PACE SWMI |
$1,661.00
|
| Rate for Payer: PHP Commercial |
$5,281.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,661.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,349.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,405.48
|
| Rate for Payer: Priority Health Medicare |
$1,661.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,789.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,661.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,467.62
|
| Rate for Payer: UHC Core |
$5,188.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$166,100.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,710.83
|
| Rate for Payer: VA VA |
$1,661.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,659.90
|
|
|
HC CRMP 5 IGG WB
|
Facility
|
IP
|
$157.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100640
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$95.75 |
| Max. Negotiated Rate |
$141.30 |
| Rate for Payer: Aetna Commercial |
$133.45
|
| Rate for Payer: BCBS Trust/PPO |
$121.33
|
| Rate for Payer: BCN Commercial |
$121.33
|
| Rate for Payer: Cash Price |
$125.60
|
| Rate for Payer: Cofinity Commercial |
$135.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.60
|
| Rate for Payer: Healthscope Commercial |
$141.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.45
|
| Rate for Payer: PHP Commercial |
$133.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.16
|
| Rate for Payer: UHC Core |
$131.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.75
|
|
|
HC CRMP 5 IGG WB
|
Facility
|
OP
|
$157.00
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100640
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.56 |
| Max. Negotiated Rate |
$141.30 |
| Rate for Payer: Aetna Commercial |
$133.45
|
| Rate for Payer: Aetna Medicare |
$40.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.06
|
| Rate for Payer: BCBS Complete |
$22.63
|
| Rate for Payer: BCBS MAPPO |
$39.25
|
| Rate for Payer: BCBS Trust/PPO |
$122.07
|
| Rate for Payer: BCN Commercial |
$122.07
|
| Rate for Payer: BCN Medicare Advantage |
$39.25
|
| Rate for Payer: Cash Price |
$125.60
|
| Rate for Payer: Cash Price |
$125.60
|
| Rate for Payer: Cofinity Commercial |
$135.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.25
|
| Rate for Payer: Healthscope Commercial |
$141.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.75
|
| Rate for Payer: Mclaren Medicaid |
$21.56
|
| Rate for Payer: Meridian Medicaid |
$22.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.45
|
| Rate for Payer: PACE Senior Care Partners |
$37.29
|
| Rate for Payer: PACE SWMI |
$39.25
|
| Rate for Payer: PHP Commercial |
$133.45
|
| Rate for Payer: PHP Medicare Advantage |
$39.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.59
|
| Rate for Payer: Priority Health Medicare |
$39.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.75
|
| Rate for Payer: Railroad Medicare Medicare |
$39.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.16
|
| Rate for Payer: UHC Core |
$131.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.25
|
| Rate for Payer: UHC Medicare Advantage |
$40.43
|
| Rate for Payer: VA VA |
$39.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.75
|
|
|
HC CRMP 5 IGG WESTERN BLOT
|
Facility
|
OP
|
$155.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200180
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$139.50 |
| Rate for Payer: Aetna Commercial |
$131.75
|
| Rate for Payer: Aetna Medicare |
$40.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.44
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$38.75
|
| Rate for Payer: BCBS Trust/PPO |
$120.51
|
| Rate for Payer: BCN Commercial |
$120.51
|
| Rate for Payer: BCN Medicare Advantage |
$38.75
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cofinity Commercial |
$133.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.75
|
| Rate for Payer: Healthscope Commercial |
$139.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.25
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$131.75
|
| Rate for Payer: PACE Senior Care Partners |
$36.81
|
| Rate for Payer: PACE SWMI |
$38.75
|
| Rate for Payer: PHP Commercial |
$131.75
|
| Rate for Payer: PHP Medicare Advantage |
$38.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.85
|
| Rate for Payer: Priority Health Medicare |
$38.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.53
|
| Rate for Payer: Railroad Medicare Medicare |
$38.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.40
|
| Rate for Payer: UHC Core |
$129.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.75
|
| Rate for Payer: UHC Medicare Advantage |
$39.91
|
| Rate for Payer: VA VA |
$38.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.25
|
|
|
HC CRMP 5 IGG WESTERN BLOT
|
Facility
|
IP
|
$155.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200180
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$94.53 |
| Max. Negotiated Rate |
$139.50 |
| Rate for Payer: Aetna Commercial |
$131.75
|
| Rate for Payer: BCBS Trust/PPO |
$119.78
|
| Rate for Payer: BCN Commercial |
$119.78
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cofinity Commercial |
$133.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.00
|
| Rate for Payer: Healthscope Commercial |
$139.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$131.75
|
| Rate for Payer: PHP Commercial |
$131.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.40
|
| Rate for Payer: UHC Core |
$129.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.25
|
|
|
HC CROSSMATCH COOMBS
|
Facility
|
OP
|
$181.00
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
30200352
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$42.99 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna Commercial |
$153.85
|
| Rate for Payer: Aetna Medicare |
$47.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.56
|
| Rate for Payer: BCBS Complete |
$117.65
|
| Rate for Payer: BCBS MAPPO |
$45.25
|
| Rate for Payer: BCBS Trust/PPO |
$140.73
|
| Rate for Payer: BCN Commercial |
$140.73
|
| Rate for Payer: BCN Medicare Advantage |
$45.25
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$155.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.25
|
| Rate for Payer: Healthscope Commercial |
$162.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.75
|
| Rate for Payer: Mclaren Medicaid |
$112.04
|
| Rate for Payer: Meridian Medicaid |
$117.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.85
|
| Rate for Payer: PACE Senior Care Partners |
$42.99
|
| Rate for Payer: PACE SWMI |
$45.25
|
| Rate for Payer: PHP Commercial |
$153.85
|
| Rate for Payer: PHP Medicare Advantage |
$45.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.47
|
| Rate for Payer: Priority Health Medicare |
$45.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.39
|
| Rate for Payer: Railroad Medicare Medicare |
$45.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.28
|
| Rate for Payer: UHC Core |
$151.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.25
|
| Rate for Payer: UHC Medicare Advantage |
$46.61
|
| Rate for Payer: VA VA |
$45.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.75
|
|
|
HC CROSSMATCH COOMBS
|
Facility
|
IP
|
$181.00
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
30200352
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$110.39 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna Commercial |
$153.85
|
| Rate for Payer: BCBS Trust/PPO |
$139.88
|
| Rate for Payer: BCN Commercial |
$139.88
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$155.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.80
|
| Rate for Payer: Healthscope Commercial |
$162.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.85
|
| Rate for Payer: PHP Commercial |
$153.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.28
|
| Rate for Payer: UHC Core |
$151.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.75
|
|
|
HC CROSSMATCH ELECTRONIC
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
30200380
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.54 |
| Max. Negotiated Rate |
$117.65 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$117.65
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.58
|
| Rate for Payer: BCN Commercial |
$47.58
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$112.04
|
| Rate for Payer: Meridian Medicaid |
$117.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.76
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC CROSSMATCH ELECTRONIC
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
30200380
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.33 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$47.30
|
| Rate for Payer: BCN Commercial |
$47.30
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.86
|
| Rate for Payer: UHC Core |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC CROSSMATCH IMMED SPIN
|
Facility
|
OP
|
$90.07
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
30200351
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.39 |
| Max. Negotiated Rate |
$117.65 |
| Rate for Payer: Aetna Commercial |
$76.56
|
| Rate for Payer: Aetna Medicare |
$23.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.15
|
| Rate for Payer: BCBS Complete |
$117.65
|
| Rate for Payer: BCBS MAPPO |
$22.52
|
| Rate for Payer: BCBS Trust/PPO |
$70.03
|
| Rate for Payer: BCN Commercial |
$70.03
|
| Rate for Payer: BCN Medicare Advantage |
$22.52
|
| Rate for Payer: Cash Price |
$72.06
|
| Rate for Payer: Cash Price |
$72.06
|
| Rate for Payer: Cofinity Commercial |
$77.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.52
|
| Rate for Payer: Healthscope Commercial |
$81.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.55
|
| Rate for Payer: Mclaren Medicaid |
$112.04
|
| Rate for Payer: Meridian Medicaid |
$117.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.56
|
| Rate for Payer: PACE Senior Care Partners |
$21.39
|
| Rate for Payer: PACE SWMI |
$22.52
|
| Rate for Payer: PHP Commercial |
$76.56
|
| Rate for Payer: PHP Medicare Advantage |
$22.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.36
|
| Rate for Payer: Priority Health Medicare |
$22.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.93
|
| Rate for Payer: Railroad Medicare Medicare |
$22.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.26
|
| Rate for Payer: UHC Core |
$75.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.52
|
| Rate for Payer: UHC Medicare Advantage |
$23.19
|
| Rate for Payer: VA VA |
$22.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.55
|
|
|
HC CROSSMATCH IMMED SPIN
|
Facility
|
IP
|
$90.07
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
30200351
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$54.93 |
| Max. Negotiated Rate |
$81.06 |
| Rate for Payer: Aetna Commercial |
$76.56
|
| Rate for Payer: BCBS Trust/PPO |
$69.61
|
| Rate for Payer: BCN Commercial |
$69.61
|
| Rate for Payer: Cash Price |
$72.06
|
| Rate for Payer: Cofinity Commercial |
$77.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.06
|
| Rate for Payer: Healthscope Commercial |
$81.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.56
|
| Rate for Payer: PHP Commercial |
$76.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.26
|
| Rate for Payer: UHC Core |
$75.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.55
|
|
|
HC CROSSMATCH PREWARM
|
Facility
|
IP
|
$228.50
|
|
|
Service Code
|
CPT 86921
|
| Hospital Charge Code |
30200491
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$139.36 |
| Max. Negotiated Rate |
$205.65 |
| Rate for Payer: Aetna Commercial |
$194.22
|
| Rate for Payer: BCBS Trust/PPO |
$176.58
|
| Rate for Payer: BCN Commercial |
$176.58
|
| Rate for Payer: Cash Price |
$182.80
|
| Rate for Payer: Cofinity Commercial |
$196.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.80
|
| Rate for Payer: Healthscope Commercial |
$205.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$194.22
|
| Rate for Payer: PHP Commercial |
$194.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.08
|
| Rate for Payer: UHC Core |
$190.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.38
|
|
|
HC CROSSMATCH PREWARM
|
Facility
|
OP
|
$228.50
|
|
|
Service Code
|
CPT 86921
|
| Hospital Charge Code |
30200491
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$54.27 |
| Max. Negotiated Rate |
$205.65 |
| Rate for Payer: Aetna Commercial |
$194.22
|
| Rate for Payer: Aetna Medicare |
$59.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.41
|
| Rate for Payer: BCBS Complete |
$117.65
|
| Rate for Payer: BCBS MAPPO |
$57.12
|
| Rate for Payer: BCBS Trust/PPO |
$177.66
|
| Rate for Payer: BCN Commercial |
$177.66
|
| Rate for Payer: BCN Medicare Advantage |
$57.12
|
| Rate for Payer: Cash Price |
$182.80
|
| Rate for Payer: Cash Price |
$182.80
|
| Rate for Payer: Cofinity Commercial |
$196.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$205.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.38
|
| Rate for Payer: Mclaren Medicaid |
$112.04
|
| Rate for Payer: Meridian Medicaid |
$117.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$59.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$194.22
|
| Rate for Payer: PACE Senior Care Partners |
$54.27
|
| Rate for Payer: PACE SWMI |
$57.12
|
| Rate for Payer: PHP Commercial |
$194.22
|
| Rate for Payer: PHP Medicare Advantage |
$57.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.80
|
| Rate for Payer: Priority Health Medicare |
$57.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$139.36
|
| Rate for Payer: Railroad Medicare Medicare |
$57.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.08
|
| Rate for Payer: UHC Core |
$190.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.12
|
| Rate for Payer: UHC Medicare Advantage |
$58.84
|
| Rate for Payer: VA VA |
$57.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.38
|
|
|
HC CRP HIGH SENSITIVITY CARDIAC RISK
|
Facility
|
IP
|
$90.40
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
30200138
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$55.13 |
| Max. Negotiated Rate |
$81.36 |
| Rate for Payer: Aetna Commercial |
$76.84
|
| Rate for Payer: BCBS Trust/PPO |
$69.86
|
| Rate for Payer: BCN Commercial |
$69.86
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cofinity Commercial |
$77.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.32
|
| Rate for Payer: Healthscope Commercial |
$81.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.84
|
| Rate for Payer: PHP Commercial |
$76.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.55
|
| Rate for Payer: UHC Core |
$75.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.80
|
|
|
HC CRP HIGH SENSITIVITY CARDIAC RISK
|
Facility
|
OP
|
$90.40
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
30200138
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.56 |
| Max. Negotiated Rate |
$81.36 |
| Rate for Payer: Aetna Commercial |
$76.84
|
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.25
|
| Rate for Payer: BCBS Complete |
$10.03
|
| Rate for Payer: BCBS MAPPO |
$22.60
|
| Rate for Payer: BCBS Trust/PPO |
$70.29
|
| Rate for Payer: BCN Commercial |
$70.29
|
| Rate for Payer: BCN Medicare Advantage |
$22.60
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cofinity Commercial |
$77.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.60
|
| Rate for Payer: Healthscope Commercial |
$81.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.80
|
| Rate for Payer: Mclaren Medicaid |
$9.56
|
| Rate for Payer: Meridian Medicaid |
$10.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.84
|
| Rate for Payer: PACE Senior Care Partners |
$21.47
|
| Rate for Payer: PACE SWMI |
$22.60
|
| Rate for Payer: PHP Commercial |
$76.84
|
| Rate for Payer: PHP Medicare Advantage |
$22.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.65
|
| Rate for Payer: Priority Health Medicare |
$22.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.13
|
| Rate for Payer: Railroad Medicare Medicare |
$22.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.55
|
| Rate for Payer: UHC Core |
$75.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.60
|
| Rate for Payer: UHC Medicare Advantage |
$23.28
|
| Rate for Payer: VA VA |
$22.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.80
|
|
|
HC CRP-SF
|
Facility
|
OP
|
$29.38
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$26.44 |
| Rate for Payer: Aetna Commercial |
$24.97
|
| Rate for Payer: Aetna Medicare |
$7.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.18
|
| Rate for Payer: BCBS Complete |
$4.01
|
| Rate for Payer: BCBS MAPPO |
$7.34
|
| Rate for Payer: BCBS Trust/PPO |
$22.84
|
| Rate for Payer: BCN Commercial |
$22.84
|
| Rate for Payer: BCN Medicare Advantage |
$7.34
|
| Rate for Payer: Cash Price |
$23.50
|
| Rate for Payer: Cash Price |
$23.50
|
| Rate for Payer: Cofinity Commercial |
$25.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.34
|
| Rate for Payer: Healthscope Commercial |
$26.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.04
|
| Rate for Payer: Mclaren Medicaid |
$3.82
|
| Rate for Payer: Meridian Medicaid |
$4.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.97
|
| Rate for Payer: PACE Senior Care Partners |
$6.98
|
| Rate for Payer: PACE SWMI |
$7.34
|
| Rate for Payer: PHP Commercial |
$24.97
|
| Rate for Payer: PHP Medicare Advantage |
$7.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.56
|
| Rate for Payer: Priority Health Medicare |
$7.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.92
|
| Rate for Payer: Railroad Medicare Medicare |
$7.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.85
|
| Rate for Payer: UHC Core |
$24.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.34
|
| Rate for Payer: UHC Medicare Advantage |
$7.57
|
| Rate for Payer: VA VA |
$7.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.04
|
|
|
HC CRP-SF
|
Facility
|
IP
|
$29.38
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.92 |
| Max. Negotiated Rate |
$26.44 |
| Rate for Payer: Aetna Commercial |
$24.97
|
| Rate for Payer: BCBS Trust/PPO |
$22.70
|
| Rate for Payer: BCN Commercial |
$22.70
|
| Rate for Payer: Cash Price |
$23.50
|
| Rate for Payer: Cofinity Commercial |
$25.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.50
|
| Rate for Payer: Healthscope Commercial |
$26.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.97
|
| Rate for Payer: PHP Commercial |
$24.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.85
|
| Rate for Payer: UHC Core |
$24.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.04
|
|
|
HC CRRT INITIAL
|
Facility
|
OP
|
$700.00
|
|
| Hospital Charge Code |
27000607
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$166.25 |
| Max. Negotiated Rate |
$630.00 |
| Rate for Payer: Aetna Commercial |
$595.00
|
| Rate for Payer: Aetna Medicare |
$182.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.75
|
| Rate for Payer: BCBS Complete |
$280.00
|
| Rate for Payer: BCBS MAPPO |
$175.00
|
| Rate for Payer: BCBS Trust/PPO |
$544.25
|
| Rate for Payer: BCN Commercial |
$544.25
|
| Rate for Payer: BCN Medicare Advantage |
$175.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cofinity Commercial |
$602.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.00
|
| Rate for Payer: Healthscope Commercial |
$630.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$183.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$595.00
|
| Rate for Payer: PACE Senior Care Partners |
$166.25
|
| Rate for Payer: PACE SWMI |
$175.00
|
| Rate for Payer: PHP Commercial |
$595.00
|
| Rate for Payer: PHP Medicare Advantage |
$175.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$609.00
|
| Rate for Payer: Priority Health Medicare |
$175.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.93
|
| Rate for Payer: Railroad Medicare Medicare |
$175.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.00
|
| Rate for Payer: UHC Core |
$584.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.00
|
| Rate for Payer: UHC Medicare Advantage |
$180.25
|
| Rate for Payer: VA VA |
$175.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.00
|
|
|
HC CRRT INITIAL
|
Facility
|
IP
|
$700.00
|
|
| Hospital Charge Code |
27000607
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$426.93 |
| Max. Negotiated Rate |
$630.00 |
| Rate for Payer: Aetna Commercial |
$595.00
|
| Rate for Payer: BCBS Trust/PPO |
$540.96
|
| Rate for Payer: BCN Commercial |
$540.96
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cofinity Commercial |
$602.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.00
|
| Rate for Payer: Healthscope Commercial |
$630.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$595.00
|
| Rate for Payer: PHP Commercial |
$595.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$609.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$426.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.00
|
| Rate for Payer: UHC Core |
$584.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.00
|
|
|
HC CRRT INITIATION/REINITIATION
|
Facility
|
IP
|
$1,112.82
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
88000001
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$678.71 |
| Max. Negotiated Rate |
$1,001.54 |
| Rate for Payer: Aetna Commercial |
$945.90
|
| Rate for Payer: BCBS Trust/PPO |
$859.99
|
| Rate for Payer: BCN Commercial |
$859.99
|
| Rate for Payer: Cash Price |
$890.26
|
| Rate for Payer: Cofinity Commercial |
$957.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$890.26
|
| Rate for Payer: Healthscope Commercial |
$1,001.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$834.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$945.90
|
| Rate for Payer: PHP Commercial |
$945.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$968.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$678.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$979.28
|
| Rate for Payer: UHC Core |
$929.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$834.62
|
|
|
HC CRRT INITIATION/REINITIATION
|
Facility
|
OP
|
$1,112.82
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
88000001
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$264.29 |
| Max. Negotiated Rate |
$1,001.54 |
| Rate for Payer: Aetna Commercial |
$945.90
|
| Rate for Payer: Aetna Medicare |
$289.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$347.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$347.76
|
| Rate for Payer: BCBS Complete |
$305.07
|
| Rate for Payer: BCBS MAPPO |
$278.20
|
| Rate for Payer: BCBS Trust/PPO |
$865.22
|
| Rate for Payer: BCN Commercial |
$865.22
|
| Rate for Payer: BCN Medicare Advantage |
$278.20
|
| Rate for Payer: Cash Price |
$890.26
|
| Rate for Payer: Cash Price |
$890.26
|
| Rate for Payer: Cofinity Commercial |
$957.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$890.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.20
|
| Rate for Payer: Healthscope Commercial |
$1,001.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$834.62
|
| Rate for Payer: Mclaren Medicaid |
$290.54
|
| Rate for Payer: Meridian Medicaid |
$305.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$319.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$945.90
|
| Rate for Payer: PACE Senior Care Partners |
$264.29
|
| Rate for Payer: PACE SWMI |
$278.20
|
| Rate for Payer: PHP Commercial |
$945.90
|
| Rate for Payer: PHP Medicare Advantage |
$278.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$290.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$968.15
|
| Rate for Payer: Priority Health Medicare |
$278.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$678.71
|
| Rate for Payer: Railroad Medicare Medicare |
$278.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$979.28
|
| Rate for Payer: UHC Core |
$929.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$278.20
|
| Rate for Payer: UHC Medicare Advantage |
$286.55
|
| Rate for Payer: VA VA |
$278.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$834.62
|
|
|
HC CRRT MONITOR FEE
|
Facility
|
IP
|
$125.00
|
|
| Hospital Charge Code |
27000609
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$76.24 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: BCBS Trust/PPO |
$96.60
|
| Rate for Payer: BCN Commercial |
$96.60
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.25
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.00
|
| Rate for Payer: UHC Core |
$104.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.75
|
|
|
HC CRRT MONITOR FEE
|
Facility
|
OP
|
$125.00
|
|
| Hospital Charge Code |
27000609
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$29.69 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: Aetna Medicare |
$32.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.06
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS MAPPO |
$31.25
|
| Rate for Payer: BCBS Trust/PPO |
$97.19
|
| Rate for Payer: BCN Commercial |
$97.19
|
| Rate for Payer: BCN Medicare Advantage |
$31.25
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.25
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.25
|
| Rate for Payer: PACE Senior Care Partners |
$29.69
|
| Rate for Payer: PACE SWMI |
$31.25
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: PHP Medicare Advantage |
$31.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.75
|
| Rate for Payer: Priority Health Medicare |
$31.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.24
|
| Rate for Payer: Railroad Medicare Medicare |
$31.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.00
|
| Rate for Payer: UHC Core |
$104.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.25
|
| Rate for Payer: UHC Medicare Advantage |
$32.19
|
| Rate for Payer: VA VA |
$31.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.75
|
|
