|
HC BETA-2 MICROGLOBULIN
|
Facility
|
IP
|
$43.51
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
30100115
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.28 |
| Max. Negotiated Rate |
$39.16 |
| Rate for Payer: Aetna Commercial |
$36.98
|
| Rate for Payer: BCBS Trust/PPO |
$35.93
|
| Rate for Payer: BCN Commercial |
$35.93
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cofinity Commercial |
$37.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.81
|
| Rate for Payer: Healthscope Commercial |
$39.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.98
|
| Rate for Payer: Nomi Health Commercial |
$35.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.63
|
| Rate for Payer: PHP Commercial |
$36.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.29
|
| Rate for Payer: UHC Core |
$36.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.63
|
|
|
HC BETA HYDROXY BUTYRATE KETONE
|
Facility
|
OP
|
$28.98
|
|
|
Service Code
|
CPT 82010
|
| Hospital Charge Code |
30100068
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: Aetna Medicare |
$7.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.06
|
| Rate for Payer: BCBS Complete |
$5.36
|
| Rate for Payer: BCBS MAPPO |
$7.25
|
| Rate for Payer: BCBS Trust/PPO |
$23.82
|
| Rate for Payer: BCN Commercial |
$23.82
|
| Rate for Payer: BCN Medicare Advantage |
$7.25
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.25
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.73
|
| Rate for Payer: Mclaren Medicaid |
$5.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.61
|
| Rate for Payer: Meridian Medicaid |
$5.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PACE Senior Care Partners |
$6.88
|
| Rate for Payer: PACE SWMI |
$7.25
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: PHP Medicare Advantage |
$7.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.21
|
| Rate for Payer: Priority Health Medicare |
$7.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.17
|
| Rate for Payer: Railroad Medicare Medicare |
$7.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.50
|
| Rate for Payer: UHC Core |
$24.20
|
| Rate for Payer: UHC Exchange |
$7.25
|
| Rate for Payer: UHC Medicaid |
$5.11
|
| Rate for Payer: UHC Medicare Advantage |
$7.25
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: VA VA |
$7.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.73
|
|
|
HC BETA HYDROXY BUTYRATE KETONE
|
Facility
|
IP
|
$28.98
|
|
|
Service Code
|
CPT 82010
|
| Hospital Charge Code |
30100068
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.17 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: BCBS Trust/PPO |
$23.93
|
| Rate for Payer: BCN Commercial |
$23.93
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$23.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.50
|
| Rate for Payer: UHC Core |
$24.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.73
|
|
|
HC BILATERAL INJECT CARPAL TUNNEL
|
Facility
|
IP
|
$625.04
|
|
|
Service Code
|
CPT 20526
|
| Hospital Charge Code |
76100242
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$435.03 |
| Max. Negotiated Rate |
$562.54 |
| Rate for Payer: Aetna Commercial |
$531.28
|
| Rate for Payer: BCBS Trust/PPO |
$516.22
|
| Rate for Payer: BCN Commercial |
$516.22
|
| Rate for Payer: Cash Price |
$500.03
|
| Rate for Payer: Cofinity Commercial |
$537.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$500.03
|
| Rate for Payer: Healthscope Commercial |
$562.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$531.28
|
| Rate for Payer: Nomi Health Commercial |
$512.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.78
|
| Rate for Payer: PHP Commercial |
$531.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$435.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.04
|
| Rate for Payer: UHC Core |
$521.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.78
|
|
|
HC BILATERAL INJECT CARPAL TUNNEL
|
Facility
|
OP
|
$625.04
|
|
|
Service Code
|
CPT 20526
|
| Hospital Charge Code |
76100242
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$110.19 |
| Max. Negotiated Rate |
$562.54 |
| Rate for Payer: Aetna Commercial |
$531.28
|
| Rate for Payer: Aetna Medicare |
$162.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$195.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$195.32
|
| Rate for Payer: BCBS Complete |
$115.69
|
| Rate for Payer: BCBS MAPPO |
$156.26
|
| Rate for Payer: BCBS Trust/PPO |
$513.85
|
| Rate for Payer: BCN Commercial |
$513.85
|
| Rate for Payer: BCN Medicare Advantage |
$156.26
|
| Rate for Payer: Cash Price |
$500.03
|
| Rate for Payer: Cofinity Commercial |
$537.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$500.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.26
|
| Rate for Payer: Healthscope Commercial |
$562.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.78
|
| Rate for Payer: Mclaren Medicaid |
$110.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.07
|
| Rate for Payer: Meridian Medicaid |
$115.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$531.28
|
| Rate for Payer: Nomi Health Commercial |
$512.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$468.78
|
| Rate for Payer: PACE Senior Care Partners |
$148.45
|
| Rate for Payer: PACE SWMI |
$156.26
|
| Rate for Payer: PHP Commercial |
$531.28
|
| Rate for Payer: PHP Medicare Advantage |
$156.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$543.78
|
| Rate for Payer: Priority Health Medicare |
$157.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$435.03
|
| Rate for Payer: Railroad Medicare Medicare |
$156.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.04
|
| Rate for Payer: UHC Core |
$521.91
|
| Rate for Payer: UHC Exchange |
$156.26
|
| Rate for Payer: UHC Medicaid |
$110.19
|
| Rate for Payer: UHC Medicare Advantage |
$156.26
|
| Rate for Payer: UHCCP Medicaid |
$110.19
|
| Rate for Payer: VA VA |
$156.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.78
|
|
|
HC BILATERAL MULTILAYER COMP DSG BK
|
Facility
|
OP
|
$753.25
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100048
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$132.80 |
| Max. Negotiated Rate |
$677.92 |
| Rate for Payer: Aetna Commercial |
$640.26
|
| Rate for Payer: Aetna Medicare |
$195.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$235.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$235.39
|
| Rate for Payer: BCBS Complete |
$139.43
|
| Rate for Payer: BCBS MAPPO |
$188.31
|
| Rate for Payer: BCBS Trust/PPO |
$619.25
|
| Rate for Payer: BCN Commercial |
$619.25
|
| Rate for Payer: BCN Medicare Advantage |
$188.31
|
| Rate for Payer: Cash Price |
$602.60
|
| Rate for Payer: Cofinity Commercial |
$647.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$602.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.31
|
| Rate for Payer: Healthscope Commercial |
$677.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$564.94
|
| Rate for Payer: Mclaren Medicaid |
$132.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$197.73
|
| Rate for Payer: Meridian Medicaid |
$139.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$216.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$207.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$640.26
|
| Rate for Payer: Nomi Health Commercial |
$617.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$564.94
|
| Rate for Payer: PACE Senior Care Partners |
$178.90
|
| Rate for Payer: PACE SWMI |
$188.31
|
| Rate for Payer: PHP Commercial |
$640.26
|
| Rate for Payer: PHP Medicare Advantage |
$188.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$132.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$655.33
|
| Rate for Payer: Priority Health Medicare |
$190.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$524.26
|
| Rate for Payer: Railroad Medicare Medicare |
$188.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$662.86
|
| Rate for Payer: UHC Core |
$628.96
|
| Rate for Payer: UHC Exchange |
$188.31
|
| Rate for Payer: UHC Medicaid |
$132.80
|
| Rate for Payer: UHC Medicare Advantage |
$188.31
|
| Rate for Payer: UHCCP Medicaid |
$132.80
|
| Rate for Payer: VA VA |
$188.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$564.94
|
|
|
HC BILATERAL MULTILAYER COMP DSG BK
|
Facility
|
IP
|
$753.25
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100048
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$524.26 |
| Max. Negotiated Rate |
$677.92 |
| Rate for Payer: Aetna Commercial |
$640.26
|
| Rate for Payer: BCBS Trust/PPO |
$622.11
|
| Rate for Payer: BCN Commercial |
$622.11
|
| Rate for Payer: Cash Price |
$602.60
|
| Rate for Payer: Cofinity Commercial |
$647.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$602.60
|
| Rate for Payer: Healthscope Commercial |
$677.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$564.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$640.26
|
| Rate for Payer: Nomi Health Commercial |
$617.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$564.94
|
| Rate for Payer: PHP Commercial |
$640.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$655.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$524.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$662.86
|
| Rate for Payer: UHC Core |
$628.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$564.94
|
|
|
HC BILATERAL TOMOSYNTHESIS
|
Facility
|
IP
|
$128.15
|
|
|
Service Code
|
CPT 77062
|
| Hospital Charge Code |
32000300
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$89.19 |
| Max. Negotiated Rate |
$115.33 |
| Rate for Payer: Aetna Commercial |
$108.93
|
| Rate for Payer: BCBS Trust/PPO |
$105.84
|
| Rate for Payer: BCN Commercial |
$105.84
|
| Rate for Payer: Cash Price |
$102.52
|
| Rate for Payer: Cofinity Commercial |
$110.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.52
|
| Rate for Payer: Healthscope Commercial |
$115.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.93
|
| Rate for Payer: Nomi Health Commercial |
$105.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.11
|
| Rate for Payer: PHP Commercial |
$108.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$111.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.77
|
| Rate for Payer: UHC Core |
$107.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.11
|
|
|
HC BILATERAL TOMOSYNTHESIS
|
Facility
|
OP
|
$128.15
|
|
|
Service Code
|
CPT 77062
|
| Hospital Charge Code |
32000300
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$115.33 |
| Rate for Payer: Aetna Commercial |
$108.93
|
| Rate for Payer: Aetna Medicare |
$33.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.05
|
| Rate for Payer: BCBS Complete |
$23.72
|
| Rate for Payer: BCBS MAPPO |
$32.04
|
| Rate for Payer: BCBS Trust/PPO |
$105.35
|
| Rate for Payer: BCN Commercial |
$105.35
|
| Rate for Payer: BCN Medicare Advantage |
$32.04
|
| Rate for Payer: Cash Price |
$102.52
|
| Rate for Payer: Cofinity Commercial |
$110.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.04
|
| Rate for Payer: Healthscope Commercial |
$115.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.11
|
| Rate for Payer: Mclaren Medicaid |
$22.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.64
|
| Rate for Payer: Meridian Medicaid |
$23.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.93
|
| Rate for Payer: Nomi Health Commercial |
$105.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.11
|
| Rate for Payer: PACE Senior Care Partners |
$30.44
|
| Rate for Payer: PACE SWMI |
$32.04
|
| Rate for Payer: PHP Commercial |
$108.93
|
| Rate for Payer: PHP Medicare Advantage |
$32.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$111.49
|
| Rate for Payer: Priority Health Medicare |
$32.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.19
|
| Rate for Payer: Railroad Medicare Medicare |
$32.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.77
|
| Rate for Payer: UHC Core |
$107.01
|
| Rate for Payer: UHC Exchange |
$32.04
|
| Rate for Payer: UHC Medicaid |
$22.59
|
| Rate for Payer: UHC Medicare Advantage |
$32.04
|
| Rate for Payer: UHCCP Medicaid |
$22.59
|
| Rate for Payer: VA VA |
$32.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.11
|
|
|
HC BILATERAL UNNA BOOT
|
Facility
|
IP
|
$466.10
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
76100047
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$324.41 |
| Max. Negotiated Rate |
$419.49 |
| Rate for Payer: Aetna Commercial |
$396.19
|
| Rate for Payer: BCBS Trust/PPO |
$384.95
|
| Rate for Payer: BCN Commercial |
$384.95
|
| Rate for Payer: Cash Price |
$372.88
|
| Rate for Payer: Cofinity Commercial |
$400.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$372.88
|
| Rate for Payer: Healthscope Commercial |
$419.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$349.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$396.19
|
| Rate for Payer: Nomi Health Commercial |
$382.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$349.57
|
| Rate for Payer: PHP Commercial |
$396.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$405.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$324.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.17
|
| Rate for Payer: UHC Core |
$389.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$349.57
|
|
|
HC BILATERAL UNNA BOOT
|
Facility
|
OP
|
$466.10
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
76100047
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$419.49 |
| Rate for Payer: Aetna Commercial |
$396.19
|
| Rate for Payer: Aetna Medicare |
$121.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$145.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$145.66
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$116.53
|
| Rate for Payer: BCBS Trust/PPO |
$383.18
|
| Rate for Payer: BCN Commercial |
$383.18
|
| Rate for Payer: BCN Medicare Advantage |
$116.53
|
| Rate for Payer: Cash Price |
$372.88
|
| Rate for Payer: Cofinity Commercial |
$400.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$372.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.53
|
| Rate for Payer: Healthscope Commercial |
$419.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$349.57
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.35
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$134.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$128.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$396.19
|
| Rate for Payer: Nomi Health Commercial |
$382.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$349.57
|
| Rate for Payer: PACE Senior Care Partners |
$110.70
|
| Rate for Payer: PACE SWMI |
$116.53
|
| Rate for Payer: PHP Commercial |
$396.19
|
| Rate for Payer: PHP Medicare Advantage |
$116.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$405.51
|
| Rate for Payer: Priority Health Medicare |
$117.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$324.41
|
| Rate for Payer: Railroad Medicare Medicare |
$116.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.17
|
| Rate for Payer: UHC Core |
$389.19
|
| Rate for Payer: UHC Exchange |
$116.53
|
| Rate for Payer: UHC Medicaid |
$82.17
|
| Rate for Payer: UHC Medicare Advantage |
$116.53
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: VA VA |
$116.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$349.57
|
|
|
HC BILAT PERC IMPLANT NEUROSTIM ELTRD,SACRAL NERVE W/IMAG
|
Facility
|
IP
|
$14,773.12
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$10,282.09 |
| Max. Negotiated Rate |
$13,295.81 |
| Rate for Payer: Aetna Commercial |
$12,557.15
|
| Rate for Payer: BCBS Trust/PPO |
$12,201.12
|
| Rate for Payer: BCN Commercial |
$12,201.12
|
| Rate for Payer: Cash Price |
$11,818.50
|
| Rate for Payer: Cofinity Commercial |
$12,704.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,818.50
|
| Rate for Payer: Healthscope Commercial |
$13,295.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,079.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,557.15
|
| Rate for Payer: Nomi Health Commercial |
$12,113.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,079.84
|
| Rate for Payer: PHP Commercial |
$12,557.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12,852.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,282.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,000.35
|
| Rate for Payer: UHC Core |
$12,335.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,079.84
|
|
|
HC BILAT PERC IMPLANT NEUROSTIM ELTRD,SACRAL NERVE W/IMAG
|
Facility
|
OP
|
$14,773.12
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,604.50 |
| Max. Negotiated Rate |
$13,295.81 |
| Rate for Payer: Aetna Commercial |
$12,557.15
|
| Rate for Payer: Aetna Medicare |
$3,841.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,616.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,616.60
|
| Rate for Payer: BCBS Complete |
$2,734.50
|
| Rate for Payer: BCBS MAPPO |
$3,693.28
|
| Rate for Payer: BCBS Trust/PPO |
$12,144.98
|
| Rate for Payer: BCN Commercial |
$12,144.98
|
| Rate for Payer: BCN Medicare Advantage |
$3,693.28
|
| Rate for Payer: Cash Price |
$11,818.50
|
| Rate for Payer: Cofinity Commercial |
$12,704.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,818.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,693.28
|
| Rate for Payer: Healthscope Commercial |
$13,295.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,079.84
|
| Rate for Payer: Mclaren Medicaid |
$2,604.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,877.94
|
| Rate for Payer: Meridian Medicaid |
$2,734.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,247.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,062.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,557.15
|
| Rate for Payer: Nomi Health Commercial |
$12,113.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,079.84
|
| Rate for Payer: PACE Senior Care Partners |
$3,508.62
|
| Rate for Payer: PACE SWMI |
$3,693.28
|
| Rate for Payer: PHP Commercial |
$12,557.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,693.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,604.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12,852.61
|
| Rate for Payer: Priority Health Medicare |
$3,730.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,282.09
|
| Rate for Payer: Railroad Medicare Medicare |
$3,693.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,000.35
|
| Rate for Payer: UHC Core |
$12,335.56
|
| Rate for Payer: UHC Exchange |
$3,693.28
|
| Rate for Payer: UHC Medicaid |
$2,604.50
|
| Rate for Payer: UHC Medicare Advantage |
$3,693.28
|
| Rate for Payer: UHCCP Medicaid |
$2,604.50
|
| Rate for Payer: VA VA |
$3,693.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,079.84
|
|
|
HC BIL COMPLEX MULTILAYER COMP DSG
|
Facility
|
OP
|
$925.96
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100072
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$163.25 |
| Max. Negotiated Rate |
$833.36 |
| Rate for Payer: Aetna Commercial |
$787.07
|
| Rate for Payer: Aetna Medicare |
$240.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$289.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$289.36
|
| Rate for Payer: BCBS Complete |
$171.40
|
| Rate for Payer: BCBS MAPPO |
$231.49
|
| Rate for Payer: BCBS Trust/PPO |
$761.23
|
| Rate for Payer: BCN Commercial |
$761.23
|
| Rate for Payer: BCN Medicare Advantage |
$231.49
|
| Rate for Payer: Cash Price |
$740.77
|
| Rate for Payer: Cofinity Commercial |
$796.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$740.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.49
|
| Rate for Payer: Healthscope Commercial |
$833.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$694.47
|
| Rate for Payer: Mclaren Medicaid |
$163.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.06
|
| Rate for Payer: Meridian Medicaid |
$171.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$266.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$254.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.07
|
| Rate for Payer: Nomi Health Commercial |
$759.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.47
|
| Rate for Payer: PACE Senior Care Partners |
$219.92
|
| Rate for Payer: PACE SWMI |
$231.49
|
| Rate for Payer: PHP Commercial |
$787.07
|
| Rate for Payer: PHP Medicare Advantage |
$231.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$805.59
|
| Rate for Payer: Priority Health Medicare |
$233.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$644.47
|
| Rate for Payer: Railroad Medicare Medicare |
$231.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$814.84
|
| Rate for Payer: UHC Core |
$773.18
|
| Rate for Payer: UHC Exchange |
$231.49
|
| Rate for Payer: UHC Medicaid |
$163.25
|
| Rate for Payer: UHC Medicare Advantage |
$231.49
|
| Rate for Payer: UHCCP Medicaid |
$163.25
|
| Rate for Payer: VA VA |
$231.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$694.47
|
|
|
HC BIL COMPLEX MULTILAYER COMP DSG
|
Facility
|
IP
|
$925.96
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100072
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$644.47 |
| Max. Negotiated Rate |
$833.36 |
| Rate for Payer: Aetna Commercial |
$787.07
|
| Rate for Payer: BCBS Trust/PPO |
$764.75
|
| Rate for Payer: BCN Commercial |
$764.75
|
| Rate for Payer: Cash Price |
$740.77
|
| Rate for Payer: Cofinity Commercial |
$796.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$740.77
|
| Rate for Payer: Healthscope Commercial |
$833.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$694.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$787.07
|
| Rate for Payer: Nomi Health Commercial |
$759.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$694.47
|
| Rate for Payer: PHP Commercial |
$787.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$805.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$644.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$814.84
|
| Rate for Payer: UHC Core |
$773.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$694.47
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
IP
|
$3,316.28
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,308.13 |
| Max. Negotiated Rate |
$2,984.65 |
| Rate for Payer: Aetna Commercial |
$2,818.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,738.92
|
| Rate for Payer: BCN Commercial |
$2,738.92
|
| Rate for Payer: Cash Price |
$2,653.02
|
| Rate for Payer: Cofinity Commercial |
$2,852.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,653.02
|
| Rate for Payer: Healthscope Commercial |
$2,984.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,487.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,818.84
|
| Rate for Payer: Nomi Health Commercial |
$2,719.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,487.21
|
| Rate for Payer: PHP Commercial |
$2,818.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,885.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,308.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,918.33
|
| Rate for Payer: UHC Core |
$2,769.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,487.21
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
OP
|
$3,316.28
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$584.66 |
| Max. Negotiated Rate |
$2,984.65 |
| Rate for Payer: Aetna Commercial |
$2,818.84
|
| Rate for Payer: Aetna Medicare |
$862.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,036.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,036.34
|
| Rate for Payer: BCBS Complete |
$613.84
|
| Rate for Payer: BCBS MAPPO |
$829.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,726.31
|
| Rate for Payer: BCN Commercial |
$2,726.31
|
| Rate for Payer: BCN Medicare Advantage |
$829.07
|
| Rate for Payer: Cash Price |
$2,653.02
|
| Rate for Payer: Cofinity Commercial |
$2,852.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,653.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$829.07
|
| Rate for Payer: Healthscope Commercial |
$2,984.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,487.21
|
| Rate for Payer: Mclaren Medicaid |
$584.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$870.52
|
| Rate for Payer: Meridian Medicaid |
$613.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$953.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$911.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,818.84
|
| Rate for Payer: Nomi Health Commercial |
$2,719.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,487.21
|
| Rate for Payer: PACE Senior Care Partners |
$787.62
|
| Rate for Payer: PACE SWMI |
$829.07
|
| Rate for Payer: PHP Commercial |
$2,818.84
|
| Rate for Payer: PHP Medicare Advantage |
$829.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$584.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,885.16
|
| Rate for Payer: Priority Health Medicare |
$837.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,308.13
|
| Rate for Payer: Railroad Medicare Medicare |
$829.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,918.33
|
| Rate for Payer: UHC Core |
$2,769.09
|
| Rate for Payer: UHC Exchange |
$829.07
|
| Rate for Payer: UHC Medicaid |
$584.66
|
| Rate for Payer: UHC Medicare Advantage |
$829.07
|
| Rate for Payer: UHCCP Medicaid |
$584.66
|
| Rate for Payer: VA VA |
$829.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,487.21
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
IP
|
$3,158.15
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,198.07 |
| Max. Negotiated Rate |
$2,842.34 |
| Rate for Payer: Aetna Commercial |
$2,684.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,608.32
|
| Rate for Payer: BCN Commercial |
$2,608.32
|
| Rate for Payer: Cash Price |
$2,526.52
|
| Rate for Payer: Cofinity Commercial |
$2,716.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,526.52
|
| Rate for Payer: Healthscope Commercial |
$2,842.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,368.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.43
|
| Rate for Payer: Nomi Health Commercial |
$2,589.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,368.61
|
| Rate for Payer: PHP Commercial |
$2,684.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,747.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,198.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,779.17
|
| Rate for Payer: UHC Core |
$2,637.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,368.61
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
OP
|
$3,158.15
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$556.78 |
| Max. Negotiated Rate |
$2,842.34 |
| Rate for Payer: Aetna Commercial |
$2,684.43
|
| Rate for Payer: Aetna Medicare |
$821.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$986.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$986.92
|
| Rate for Payer: BCBS Complete |
$584.57
|
| Rate for Payer: BCBS MAPPO |
$789.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,596.32
|
| Rate for Payer: BCN Commercial |
$2,596.32
|
| Rate for Payer: BCN Medicare Advantage |
$789.54
|
| Rate for Payer: Cash Price |
$2,526.52
|
| Rate for Payer: Cofinity Commercial |
$2,716.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,526.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$789.54
|
| Rate for Payer: Healthscope Commercial |
$2,842.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,368.61
|
| Rate for Payer: Mclaren Medicaid |
$556.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$829.01
|
| Rate for Payer: Meridian Medicaid |
$584.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$907.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$868.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.43
|
| Rate for Payer: Nomi Health Commercial |
$2,589.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,368.61
|
| Rate for Payer: PACE Senior Care Partners |
$750.06
|
| Rate for Payer: PACE SWMI |
$789.54
|
| Rate for Payer: PHP Commercial |
$2,684.43
|
| Rate for Payer: PHP Medicare Advantage |
$789.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$556.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,747.59
|
| Rate for Payer: Priority Health Medicare |
$797.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,198.07
|
| Rate for Payer: Railroad Medicare Medicare |
$789.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,779.17
|
| Rate for Payer: UHC Core |
$2,637.06
|
| Rate for Payer: UHC Exchange |
$789.54
|
| Rate for Payer: UHC Medicaid |
$556.78
|
| Rate for Payer: UHC Medicare Advantage |
$789.54
|
| Rate for Payer: UHCCP Medicaid |
$556.78
|
| Rate for Payer: VA VA |
$789.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,368.61
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
IP
|
$3,158.15
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,198.07 |
| Max. Negotiated Rate |
$2,842.34 |
| Rate for Payer: Aetna Commercial |
$2,684.43
|
| Rate for Payer: BCBS Trust/PPO |
$2,608.32
|
| Rate for Payer: BCN Commercial |
$2,608.32
|
| Rate for Payer: Cash Price |
$2,526.52
|
| Rate for Payer: Cofinity Commercial |
$2,716.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,526.52
|
| Rate for Payer: Healthscope Commercial |
$2,842.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,368.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.43
|
| Rate for Payer: Nomi Health Commercial |
$2,589.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,368.61
|
| Rate for Payer: PHP Commercial |
$2,684.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,747.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,198.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,779.17
|
| Rate for Payer: UHC Core |
$2,637.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,368.61
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
OP
|
$3,158.15
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$556.78 |
| Max. Negotiated Rate |
$2,842.34 |
| Rate for Payer: Aetna Commercial |
$2,684.43
|
| Rate for Payer: Aetna Medicare |
$821.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$986.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$986.92
|
| Rate for Payer: BCBS Complete |
$584.57
|
| Rate for Payer: BCBS MAPPO |
$789.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,596.32
|
| Rate for Payer: BCN Commercial |
$2,596.32
|
| Rate for Payer: BCN Medicare Advantage |
$789.54
|
| Rate for Payer: Cash Price |
$2,526.52
|
| Rate for Payer: Cofinity Commercial |
$2,716.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,526.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$789.54
|
| Rate for Payer: Healthscope Commercial |
$2,842.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,368.61
|
| Rate for Payer: Mclaren Medicaid |
$556.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$829.01
|
| Rate for Payer: Meridian Medicaid |
$584.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$907.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$868.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,684.43
|
| Rate for Payer: Nomi Health Commercial |
$2,589.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,368.61
|
| Rate for Payer: PACE Senior Care Partners |
$750.06
|
| Rate for Payer: PACE SWMI |
$789.54
|
| Rate for Payer: PHP Commercial |
$2,684.43
|
| Rate for Payer: PHP Medicare Advantage |
$789.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$556.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,747.59
|
| Rate for Payer: Priority Health Medicare |
$797.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,198.07
|
| Rate for Payer: Railroad Medicare Medicare |
$789.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,779.17
|
| Rate for Payer: UHC Core |
$2,637.06
|
| Rate for Payer: UHC Exchange |
$789.54
|
| Rate for Payer: UHC Medicaid |
$556.78
|
| Rate for Payer: UHC Medicare Advantage |
$789.54
|
| Rate for Payer: UHCCP Medicaid |
$556.78
|
| Rate for Payer: VA VA |
$789.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,368.61
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC BILE BODY FLUID
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$6.95 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare |
$10.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.32
|
| Rate for Payer: BCBS Complete |
$7.30
|
| Rate for Payer: BCBS MAPPO |
$9.86
|
| Rate for Payer: BCBS Trust/PPO |
$32.42
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: BCN Medicare Advantage |
$9.86
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.86
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Mclaren Medicaid |
$6.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.35
|
| Rate for Payer: Meridian Medicaid |
$7.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Senior Care Partners |
$9.36
|
| Rate for Payer: PACE SWMI |
$9.86
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$9.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.30
|
| Rate for Payer: Priority Health Medicare |
$9.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.44
|
| Rate for Payer: Railroad Medicare Medicare |
$9.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.70
|
| Rate for Payer: UHC Core |
$32.92
|
| Rate for Payer: UHC Exchange |
$9.86
|
| Rate for Payer: UHC Medicaid |
$6.95
|
| Rate for Payer: UHC Medicare Advantage |
$9.86
|
| Rate for Payer: UHCCP Medicaid |
$6.95
|
| Rate for Payer: VA VA |
$9.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC BILE BODY FLUID
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: BCBS Trust/PPO |
$32.57
|
| Rate for Payer: BCN Commercial |
$32.57
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.70
|
| Rate for Payer: UHC Core |
$32.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
