|
HC 4X4 WAFER
|
Facility
|
OP
|
$24.51
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.82 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Aetna Commercial |
$20.83
|
| Rate for Payer: Aetna Medicare |
$6.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.66
|
| Rate for Payer: BCBS Complete |
$9.80
|
| Rate for Payer: BCBS MAPPO |
$6.13
|
| Rate for Payer: BCBS Trust/PPO |
$20.15
|
| Rate for Payer: BCN Commercial |
$19.06
|
| Rate for Payer: BCN Medicare Advantage |
$6.13
|
| Rate for Payer: Cash Price |
$19.61
|
| Rate for Payer: Cofinity Commercial |
$21.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.13
|
| Rate for Payer: Healthscope Commercial |
$22.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.83
|
| Rate for Payer: Nomi Health Commercial |
$20.10
|
| Rate for Payer: PACE Senior Care Partners |
$5.82
|
| Rate for Payer: PACE SWMI |
$6.13
|
| Rate for Payer: PHP Commercial |
$20.83
|
| Rate for Payer: PHP Medicare Advantage |
$6.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.93
|
| Rate for Payer: Priority Health HMO/PPO |
$21.32
|
| Rate for Payer: Priority Health Medicare |
$6.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.42
|
| Rate for Payer: Railroad Medicare Medicare |
$6.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.57
|
| Rate for Payer: UHC Core |
$20.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.13
|
| Rate for Payer: UHC Exchange |
$6.13
|
| Rate for Payer: UHC Medicare Advantage |
$6.13
|
| Rate for Payer: VA VA |
$6.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.38
|
|
|
HC 4X4 WAFER
|
Facility
|
IP
|
$24.51
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.93 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Aetna Commercial |
$20.83
|
| Rate for Payer: BCBS Trust/PPO |
$20.01
|
| Rate for Payer: BCN Commercial |
$18.94
|
| Rate for Payer: Cash Price |
$19.61
|
| Rate for Payer: Cofinity Commercial |
$21.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.61
|
| Rate for Payer: Healthscope Commercial |
$22.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.83
|
| Rate for Payer: Nomi Health Commercial |
$20.10
|
| Rate for Payer: PHP Commercial |
$20.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.93
|
| Rate for Payer: Priority Health HMO/PPO |
$21.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.57
|
| Rate for Payer: UHC Core |
$20.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.38
|
|
|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,126.57
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$732.27 |
| Max. Negotiated Rate |
$1,013.91 |
| Rate for Payer: Aetna Commercial |
$957.58
|
| Rate for Payer: BCBS Trust/PPO |
$919.62
|
| Rate for Payer: BCN Commercial |
$870.61
|
| Rate for Payer: Cash Price |
$901.26
|
| Rate for Payer: Cofinity Commercial |
$968.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$901.26
|
| Rate for Payer: Healthscope Commercial |
$1,013.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$957.58
|
| Rate for Payer: Nomi Health Commercial |
$923.79
|
| Rate for Payer: PHP Commercial |
$957.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.27
|
| Rate for Payer: Priority Health HMO/PPO |
$980.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$754.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$991.38
|
| Rate for Payer: UHC Core |
$940.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.93
|
|
|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,126.57
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$267.56 |
| Max. Negotiated Rate |
$1,013.91 |
| Rate for Payer: Aetna Commercial |
$957.58
|
| Rate for Payer: Aetna Medicare |
$292.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$352.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$352.05
|
| Rate for Payer: BCBS Complete |
$450.63
|
| Rate for Payer: BCBS MAPPO |
$281.64
|
| Rate for Payer: BCBS Trust/PPO |
$926.15
|
| Rate for Payer: BCN Commercial |
$875.91
|
| Rate for Payer: BCN Medicare Advantage |
$281.64
|
| Rate for Payer: Cash Price |
$901.26
|
| Rate for Payer: Cofinity Commercial |
$968.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$901.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$281.64
|
| Rate for Payer: Healthscope Commercial |
$1,013.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$295.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$323.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$957.58
|
| Rate for Payer: Nomi Health Commercial |
$923.79
|
| Rate for Payer: PACE Senior Care Partners |
$267.56
|
| Rate for Payer: PACE SWMI |
$281.64
|
| Rate for Payer: PHP Commercial |
$957.58
|
| Rate for Payer: PHP Medicare Advantage |
$281.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.27
|
| Rate for Payer: Priority Health HMO/PPO |
$980.12
|
| Rate for Payer: Priority Health Medicare |
$284.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$754.80
|
| Rate for Payer: Railroad Medicare Medicare |
$281.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$991.38
|
| Rate for Payer: UHC Core |
$940.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$281.64
|
| Rate for Payer: UHC Exchange |
$281.64
|
| Rate for Payer: UHC Medicare Advantage |
$281.64
|
| Rate for Payer: VA VA |
$281.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.93
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
OP
|
$976.26
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$231.86 |
| Max. Negotiated Rate |
$878.63 |
| Rate for Payer: Aetna Commercial |
$829.82
|
| Rate for Payer: Aetna Medicare |
$253.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$305.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$305.08
|
| Rate for Payer: BCBS Complete |
$390.50
|
| Rate for Payer: BCBS MAPPO |
$244.06
|
| Rate for Payer: BCBS Trust/PPO |
$802.58
|
| Rate for Payer: BCN Commercial |
$759.04
|
| Rate for Payer: BCN Medicare Advantage |
$244.06
|
| Rate for Payer: Cash Price |
$781.01
|
| Rate for Payer: Cofinity Commercial |
$839.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$781.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$244.06
|
| Rate for Payer: Healthscope Commercial |
$878.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$732.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$256.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$280.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.82
|
| Rate for Payer: Nomi Health Commercial |
$800.53
|
| Rate for Payer: PACE Senior Care Partners |
$231.86
|
| Rate for Payer: PACE SWMI |
$244.06
|
| Rate for Payer: PHP Commercial |
$829.82
|
| Rate for Payer: PHP Medicare Advantage |
$244.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.57
|
| Rate for Payer: Priority Health HMO/PPO |
$849.35
|
| Rate for Payer: Priority Health Medicare |
$246.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$654.09
|
| Rate for Payer: Railroad Medicare Medicare |
$244.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$859.11
|
| Rate for Payer: UHC Core |
$815.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$244.06
|
| Rate for Payer: UHC Exchange |
$244.06
|
| Rate for Payer: UHC Medicare Advantage |
$244.06
|
| Rate for Payer: VA VA |
$244.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$732.20
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
IP
|
$976.26
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$634.57 |
| Max. Negotiated Rate |
$878.63 |
| Rate for Payer: Aetna Commercial |
$829.82
|
| Rate for Payer: BCBS Trust/PPO |
$796.92
|
| Rate for Payer: BCN Commercial |
$754.45
|
| Rate for Payer: Cash Price |
$781.01
|
| Rate for Payer: Cofinity Commercial |
$839.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$781.01
|
| Rate for Payer: Healthscope Commercial |
$878.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$732.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.82
|
| Rate for Payer: Nomi Health Commercial |
$800.53
|
| Rate for Payer: PHP Commercial |
$829.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.57
|
| Rate for Payer: Priority Health HMO/PPO |
$849.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$654.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$859.11
|
| Rate for Payer: UHC Core |
$815.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$732.20
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
OP
|
$1,229.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$291.89 |
| Max. Negotiated Rate |
$1,106.10 |
| Rate for Payer: Aetna Commercial |
$1,044.65
|
| Rate for Payer: Aetna Medicare |
$319.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$384.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$384.06
|
| Rate for Payer: BCBS Complete |
$491.60
|
| Rate for Payer: BCBS MAPPO |
$307.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,010.36
|
| Rate for Payer: BCN Commercial |
$955.55
|
| Rate for Payer: BCN Medicare Advantage |
$307.25
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$1,056.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$983.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.25
|
| Rate for Payer: Healthscope Commercial |
$1,106.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$921.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$353.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.65
|
| Rate for Payer: Nomi Health Commercial |
$1,007.78
|
| Rate for Payer: PACE Senior Care Partners |
$291.89
|
| Rate for Payer: PACE SWMI |
$307.25
|
| Rate for Payer: PHP Commercial |
$1,044.65
|
| Rate for Payer: PHP Medicare Advantage |
$307.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,069.23
|
| Rate for Payer: Priority Health Medicare |
$310.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$823.43
|
| Rate for Payer: Railroad Medicare Medicare |
$307.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,081.52
|
| Rate for Payer: UHC Core |
$1,026.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$307.25
|
| Rate for Payer: UHC Exchange |
$307.25
|
| Rate for Payer: UHC Medicare Advantage |
$307.25
|
| Rate for Payer: VA VA |
$307.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$921.75
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
IP
|
$1,229.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$798.85 |
| Max. Negotiated Rate |
$1,106.10 |
| Rate for Payer: Aetna Commercial |
$1,044.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.23
|
| Rate for Payer: BCN Commercial |
$949.77
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$1,056.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$983.20
|
| Rate for Payer: Healthscope Commercial |
$1,106.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$921.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.65
|
| Rate for Payer: Nomi Health Commercial |
$1,007.78
|
| Rate for Payer: PHP Commercial |
$1,044.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,069.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$823.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,081.52
|
| Rate for Payer: UHC Core |
$1,026.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$921.75
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
IP
|
$1,065.01
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$692.26 |
| Max. Negotiated Rate |
$958.51 |
| Rate for Payer: Aetna Commercial |
$905.26
|
| Rate for Payer: BCBS Trust/PPO |
$869.37
|
| Rate for Payer: BCN Commercial |
$823.04
|
| Rate for Payer: Cash Price |
$852.01
|
| Rate for Payer: Cofinity Commercial |
$915.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.01
|
| Rate for Payer: Healthscope Commercial |
$958.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.26
|
| Rate for Payer: Nomi Health Commercial |
$873.31
|
| Rate for Payer: PHP Commercial |
$905.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.26
|
| Rate for Payer: Priority Health HMO/PPO |
$926.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$713.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$937.21
|
| Rate for Payer: UHC Core |
$889.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.76
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
OP
|
$1,065.01
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$252.94 |
| Max. Negotiated Rate |
$958.51 |
| Rate for Payer: Aetna Commercial |
$905.26
|
| Rate for Payer: Aetna Medicare |
$276.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$332.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$332.82
|
| Rate for Payer: BCBS Complete |
$426.00
|
| Rate for Payer: BCBS MAPPO |
$266.25
|
| Rate for Payer: BCBS Trust/PPO |
$875.54
|
| Rate for Payer: BCN Commercial |
$828.05
|
| Rate for Payer: BCN Medicare Advantage |
$266.25
|
| Rate for Payer: Cash Price |
$852.01
|
| Rate for Payer: Cofinity Commercial |
$915.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$266.25
|
| Rate for Payer: Healthscope Commercial |
$958.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$279.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$306.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.26
|
| Rate for Payer: Nomi Health Commercial |
$873.31
|
| Rate for Payer: PACE Senior Care Partners |
$252.94
|
| Rate for Payer: PACE SWMI |
$266.25
|
| Rate for Payer: PHP Commercial |
$905.26
|
| Rate for Payer: PHP Medicare Advantage |
$266.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.26
|
| Rate for Payer: Priority Health HMO/PPO |
$926.56
|
| Rate for Payer: Priority Health Medicare |
$268.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$713.56
|
| Rate for Payer: Railroad Medicare Medicare |
$266.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$937.21
|
| Rate for Payer: UHC Core |
$889.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$266.25
|
| Rate for Payer: UHC Exchange |
$266.25
|
| Rate for Payer: UHC Medicare Advantage |
$266.25
|
| Rate for Payer: VA VA |
$266.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.76
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,229.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$798.85 |
| Max. Negotiated Rate |
$1,106.10 |
| Rate for Payer: Aetna Commercial |
$1,044.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.23
|
| Rate for Payer: BCN Commercial |
$949.77
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$1,056.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$983.20
|
| Rate for Payer: Healthscope Commercial |
$1,106.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$921.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.65
|
| Rate for Payer: Nomi Health Commercial |
$1,007.78
|
| Rate for Payer: PHP Commercial |
$1,044.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,069.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$823.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,081.52
|
| Rate for Payer: UHC Core |
$1,026.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$921.75
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,229.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$291.89 |
| Max. Negotiated Rate |
$1,106.10 |
| Rate for Payer: Aetna Commercial |
$1,044.65
|
| Rate for Payer: Aetna Medicare |
$319.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$384.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$384.06
|
| Rate for Payer: BCBS Complete |
$491.60
|
| Rate for Payer: BCBS MAPPO |
$307.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,010.36
|
| Rate for Payer: BCN Commercial |
$955.55
|
| Rate for Payer: BCN Medicare Advantage |
$307.25
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$1,056.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$983.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.25
|
| Rate for Payer: Healthscope Commercial |
$1,106.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$921.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$322.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$353.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.65
|
| Rate for Payer: Nomi Health Commercial |
$1,007.78
|
| Rate for Payer: PACE Senior Care Partners |
$291.89
|
| Rate for Payer: PACE SWMI |
$307.25
|
| Rate for Payer: PHP Commercial |
$1,044.65
|
| Rate for Payer: PHP Medicare Advantage |
$307.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,069.23
|
| Rate for Payer: Priority Health Medicare |
$310.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$823.43
|
| Rate for Payer: Railroad Medicare Medicare |
$307.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,081.52
|
| Rate for Payer: UHC Core |
$1,026.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$307.25
|
| Rate for Payer: UHC Exchange |
$307.25
|
| Rate for Payer: UHC Medicare Advantage |
$307.25
|
| Rate for Payer: VA VA |
$307.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$921.75
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
OP
|
$1,065.01
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$252.94 |
| Max. Negotiated Rate |
$958.51 |
| Rate for Payer: Aetna Commercial |
$905.26
|
| Rate for Payer: Aetna Medicare |
$276.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$332.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$332.82
|
| Rate for Payer: BCBS Complete |
$426.00
|
| Rate for Payer: BCBS MAPPO |
$266.25
|
| Rate for Payer: BCBS Trust/PPO |
$875.54
|
| Rate for Payer: BCN Commercial |
$828.05
|
| Rate for Payer: BCN Medicare Advantage |
$266.25
|
| Rate for Payer: Cash Price |
$852.01
|
| Rate for Payer: Cofinity Commercial |
$915.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$266.25
|
| Rate for Payer: Healthscope Commercial |
$958.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$279.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$306.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.26
|
| Rate for Payer: Nomi Health Commercial |
$873.31
|
| Rate for Payer: PACE Senior Care Partners |
$252.94
|
| Rate for Payer: PACE SWMI |
$266.25
|
| Rate for Payer: PHP Commercial |
$905.26
|
| Rate for Payer: PHP Medicare Advantage |
$266.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.26
|
| Rate for Payer: Priority Health HMO/PPO |
$926.56
|
| Rate for Payer: Priority Health Medicare |
$268.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$713.56
|
| Rate for Payer: Railroad Medicare Medicare |
$266.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$937.21
|
| Rate for Payer: UHC Core |
$889.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$266.25
|
| Rate for Payer: UHC Exchange |
$266.25
|
| Rate for Payer: UHC Medicare Advantage |
$266.25
|
| Rate for Payer: VA VA |
$266.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.76
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
IP
|
$1,065.01
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$692.26 |
| Max. Negotiated Rate |
$958.51 |
| Rate for Payer: Aetna Commercial |
$905.26
|
| Rate for Payer: BCBS Trust/PPO |
$869.37
|
| Rate for Payer: BCN Commercial |
$823.04
|
| Rate for Payer: Cash Price |
$852.01
|
| Rate for Payer: Cofinity Commercial |
$915.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.01
|
| Rate for Payer: Healthscope Commercial |
$958.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.26
|
| Rate for Payer: Nomi Health Commercial |
$873.31
|
| Rate for Payer: PHP Commercial |
$905.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.26
|
| Rate for Payer: Priority Health HMO/PPO |
$926.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$713.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$937.21
|
| Rate for Payer: UHC Core |
$889.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.76
|
|
|
HC 8X8 WAFER
|
Facility
|
OP
|
$74.04
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.58 |
| Max. Negotiated Rate |
$66.64 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Medicare |
$19.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.14
|
| Rate for Payer: BCBS Complete |
$29.62
|
| Rate for Payer: BCBS MAPPO |
$18.51
|
| Rate for Payer: BCBS Trust/PPO |
$60.87
|
| Rate for Payer: BCN Commercial |
$57.57
|
| Rate for Payer: BCN Medicare Advantage |
$18.51
|
| Rate for Payer: Cash Price |
$59.23
|
| Rate for Payer: Cofinity Commercial |
$63.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.51
|
| Rate for Payer: Healthscope Commercial |
$66.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.93
|
| Rate for Payer: Nomi Health Commercial |
$60.71
|
| Rate for Payer: PACE Senior Care Partners |
$17.58
|
| Rate for Payer: PACE SWMI |
$18.51
|
| Rate for Payer: PHP Commercial |
$62.93
|
| Rate for Payer: PHP Medicare Advantage |
$18.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.13
|
| Rate for Payer: Priority Health HMO/PPO |
$64.41
|
| Rate for Payer: Priority Health Medicare |
$18.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.61
|
| Rate for Payer: Railroad Medicare Medicare |
$18.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.16
|
| Rate for Payer: UHC Core |
$61.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.51
|
| Rate for Payer: UHC Exchange |
$18.51
|
| Rate for Payer: UHC Medicare Advantage |
$18.51
|
| Rate for Payer: VA VA |
$18.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.53
|
|
|
HC 8X8 WAFER
|
Facility
|
IP
|
$74.04
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$48.13 |
| Max. Negotiated Rate |
$66.64 |
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: BCBS Trust/PPO |
$60.44
|
| Rate for Payer: BCN Commercial |
$57.22
|
| Rate for Payer: Cash Price |
$59.23
|
| Rate for Payer: Cofinity Commercial |
$63.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.23
|
| Rate for Payer: Healthscope Commercial |
$66.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.93
|
| Rate for Payer: Nomi Health Commercial |
$60.71
|
| Rate for Payer: PHP Commercial |
$62.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.13
|
| Rate for Payer: Priority Health HMO/PPO |
$64.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.16
|
| Rate for Payer: UHC Core |
$61.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.53
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
OP
|
$48.90
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.61 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: Aetna Medicare |
$12.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.28
|
| Rate for Payer: BCBS Complete |
$18.29
|
| Rate for Payer: BCBS MAPPO |
$12.22
|
| Rate for Payer: BCBS Trust/PPO |
$40.20
|
| Rate for Payer: BCN Commercial |
$38.02
|
| Rate for Payer: BCN Medicare Advantage |
$12.22
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.22
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.67
|
| Rate for Payer: Mclaren Medicaid |
$17.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.84
|
| Rate for Payer: Meridian Medicaid |
$18.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: PACE Senior Care Partners |
$11.61
|
| Rate for Payer: PACE SWMI |
$12.22
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: PHP Medicare Advantage |
$12.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.79
|
| Rate for Payer: Priority Health HMO/PPO |
$42.54
|
| Rate for Payer: Priority Health Medicare |
$12.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.76
|
| Rate for Payer: Railroad Medicare Medicare |
$12.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.03
|
| Rate for Payer: UHC Core |
$40.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.22
|
| Rate for Payer: UHC Exchange |
$12.22
|
| Rate for Payer: UHC Medicare Advantage |
$12.22
|
| Rate for Payer: UHCCP Medicaid |
$17.42
|
| Rate for Payer: VA VA |
$12.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.67
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.79 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: BCBS Trust/PPO |
$39.92
|
| Rate for Payer: BCN Commercial |
$37.79
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.79
|
| Rate for Payer: Priority Health HMO/PPO |
$42.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.03
|
| Rate for Payer: UHC Core |
$40.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.67
|
|
|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
IP
|
$21.42
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$17.49
|
| Rate for Payer: BCN Commercial |
$16.55
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.21
|
| Rate for Payer: Nomi Health Commercial |
$17.56
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.92
|
| Rate for Payer: Priority Health HMO/PPO |
$18.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.85
|
| Rate for Payer: UHC Core |
$17.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.07
|
|
|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
OP
|
$21.42
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.09 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna Medicare |
$5.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.69
|
| Rate for Payer: BCBS Complete |
$10.20
|
| Rate for Payer: BCBS MAPPO |
$5.36
|
| Rate for Payer: BCBS Trust/PPO |
$17.61
|
| Rate for Payer: BCN Commercial |
$16.65
|
| Rate for Payer: BCN Medicare Advantage |
$5.36
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.36
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.07
|
| Rate for Payer: Mclaren Medicaid |
$9.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.62
|
| Rate for Payer: Meridian Medicaid |
$10.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.21
|
| Rate for Payer: Nomi Health Commercial |
$17.56
|
| Rate for Payer: PACE Senior Care Partners |
$5.09
|
| Rate for Payer: PACE SWMI |
$5.36
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: PHP Medicare Advantage |
$5.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.92
|
| Rate for Payer: Priority Health HMO/PPO |
$18.64
|
| Rate for Payer: Priority Health Medicare |
$5.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.35
|
| Rate for Payer: Railroad Medicare Medicare |
$5.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.85
|
| Rate for Payer: UHC Core |
$17.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.36
|
| Rate for Payer: UHC Exchange |
$5.36
|
| Rate for Payer: UHC Medicare Advantage |
$5.36
|
| Rate for Payer: UHCCP Medicaid |
$9.72
|
| Rate for Payer: VA VA |
$5.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.07
|
|
|
HC ABDOMINAL HYSTERECT (OB SURGER
|
Facility
|
OP
|
$2,565.37
|
|
| Hospital Charge Code |
36000002
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$609.28 |
| Max. Negotiated Rate |
$2,308.83 |
| Rate for Payer: Aetna Commercial |
$2,180.56
|
| Rate for Payer: Aetna Medicare |
$667.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$801.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$801.68
|
| Rate for Payer: BCBS Complete |
$1,026.15
|
| Rate for Payer: BCBS MAPPO |
$641.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,108.99
|
| Rate for Payer: BCN Commercial |
$1,994.58
|
| Rate for Payer: BCN Medicare Advantage |
$641.34
|
| Rate for Payer: Cash Price |
$2,052.30
|
| Rate for Payer: Cofinity Commercial |
$2,206.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,052.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.34
|
| Rate for Payer: Healthscope Commercial |
$2,308.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,924.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$737.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,180.56
|
| Rate for Payer: Nomi Health Commercial |
$2,103.60
|
| Rate for Payer: PACE Senior Care Partners |
$609.28
|
| Rate for Payer: PACE SWMI |
$641.34
|
| Rate for Payer: PHP Commercial |
$2,180.56
|
| Rate for Payer: PHP Medicare Advantage |
$641.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,667.49
|
| Rate for Payer: Priority Health HMO/PPO |
$2,231.87
|
| Rate for Payer: Priority Health Medicare |
$647.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,718.80
|
| Rate for Payer: Railroad Medicare Medicare |
$641.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,257.53
|
| Rate for Payer: UHC Core |
$2,142.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$641.34
|
| Rate for Payer: UHC Exchange |
$641.34
|
| Rate for Payer: UHC Medicare Advantage |
$641.34
|
| Rate for Payer: VA VA |
$641.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,924.03
|
|
|
HC ABDOMINAL HYSTERECT (OB SURGER
|
Facility
|
IP
|
$2,565.37
|
|
| Hospital Charge Code |
36000002
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,667.49 |
| Max. Negotiated Rate |
$2,308.83 |
| Rate for Payer: Aetna Commercial |
$2,180.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,094.11
|
| Rate for Payer: BCN Commercial |
$1,982.52
|
| Rate for Payer: Cash Price |
$2,052.30
|
| Rate for Payer: Cofinity Commercial |
$2,206.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,052.30
|
| Rate for Payer: Healthscope Commercial |
$2,308.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,924.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,180.56
|
| Rate for Payer: Nomi Health Commercial |
$2,103.60
|
| Rate for Payer: PHP Commercial |
$2,180.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,667.49
|
| Rate for Payer: Priority Health HMO/PPO |
$2,231.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,718.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,257.53
|
| Rate for Payer: UHC Core |
$2,142.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,924.03
|
|
|
HC ABDOMINAL STERILIZE (OB SURGER
|
Facility
|
OP
|
$1,576.94
|
|
| Hospital Charge Code |
36000003
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$374.52 |
| Max. Negotiated Rate |
$1,419.25 |
| Rate for Payer: Aetna Commercial |
$1,340.40
|
| Rate for Payer: Aetna Medicare |
$410.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.79
|
| Rate for Payer: BCBS Complete |
$630.78
|
| Rate for Payer: BCBS MAPPO |
$394.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,296.40
|
| Rate for Payer: BCN Commercial |
$1,226.07
|
| Rate for Payer: BCN Medicare Advantage |
$394.24
|
| Rate for Payer: Cash Price |
$1,261.55
|
| Rate for Payer: Cofinity Commercial |
$1,356.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,261.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.24
|
| Rate for Payer: Healthscope Commercial |
$1,419.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,182.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$413.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$453.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,340.40
|
| Rate for Payer: Nomi Health Commercial |
$1,293.09
|
| Rate for Payer: PACE Senior Care Partners |
$374.52
|
| Rate for Payer: PACE SWMI |
$394.24
|
| Rate for Payer: PHP Commercial |
$1,340.40
|
| Rate for Payer: PHP Medicare Advantage |
$394.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.01
|
| Rate for Payer: Priority Health HMO/PPO |
$1,371.94
|
| Rate for Payer: Priority Health Medicare |
$398.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,056.55
|
| Rate for Payer: Railroad Medicare Medicare |
$394.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,387.71
|
| Rate for Payer: UHC Core |
$1,316.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.24
|
| Rate for Payer: UHC Exchange |
$394.24
|
| Rate for Payer: UHC Medicare Advantage |
$394.24
|
| Rate for Payer: VA VA |
$394.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,182.70
|
|
|
HC ABDOMINAL STERILIZE (OB SURGER
|
Facility
|
IP
|
$1,576.94
|
|
| Hospital Charge Code |
36000003
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,025.01 |
| Max. Negotiated Rate |
$1,419.25 |
| Rate for Payer: Aetna Commercial |
$1,340.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,287.26
|
| Rate for Payer: BCN Commercial |
$1,218.66
|
| Rate for Payer: Cash Price |
$1,261.55
|
| Rate for Payer: Cofinity Commercial |
$1,356.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,261.55
|
| Rate for Payer: Healthscope Commercial |
$1,419.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,182.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,340.40
|
| Rate for Payer: Nomi Health Commercial |
$1,293.09
|
| Rate for Payer: PHP Commercial |
$1,340.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,025.01
|
| Rate for Payer: Priority Health HMO/PPO |
$1,371.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,056.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,387.71
|
| Rate for Payer: UHC Core |
$1,316.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,182.70
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV BIL KNEE 3 OR MORE NRVS
|
Facility
|
OP
|
$4,024.27
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100603
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$955.76 |
| Max. Negotiated Rate |
$3,621.84 |
| Rate for Payer: Aetna Commercial |
$3,420.63
|
| Rate for Payer: Aetna Medicare |
$1,046.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,257.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,257.58
|
| Rate for Payer: BCBS Complete |
$1,482.54
|
| Rate for Payer: BCBS MAPPO |
$1,006.07
|
| Rate for Payer: BCBS Trust/PPO |
$3,308.35
|
| Rate for Payer: BCN Commercial |
$3,128.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,006.07
|
| Rate for Payer: Cash Price |
$3,219.42
|
| Rate for Payer: Cash Price |
$3,219.42
|
| Rate for Payer: Cofinity Commercial |
$3,460.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,219.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,006.07
|
| Rate for Payer: Healthscope Commercial |
$3,621.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,018.20
|
| Rate for Payer: Mclaren Medicaid |
$1,411.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,056.37
|
| Rate for Payer: Meridian Medicaid |
$1,482.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,156.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,420.63
|
| Rate for Payer: Nomi Health Commercial |
$3,299.90
|
| Rate for Payer: PACE Senior Care Partners |
$955.76
|
| Rate for Payer: PACE SWMI |
$1,006.07
|
| Rate for Payer: PHP Commercial |
$3,420.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,006.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,411.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,615.78
|
| Rate for Payer: Priority Health HMO/PPO |
$3,501.11
|
| Rate for Payer: Priority Health Medicare |
$1,016.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,696.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,006.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,541.36
|
| Rate for Payer: UHC Core |
$3,360.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,006.07
|
| Rate for Payer: UHC Exchange |
$1,006.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,006.07
|
| Rate for Payer: UHCCP Medicaid |
$1,411.85
|
| Rate for Payer: VA VA |
$1,006.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,018.20
|
|
