|
HC ACNE SURGERY
|
Facility
|
OP
|
$272.69
|
|
|
Service Code
|
CPT 10040
|
| Hospital Charge Code |
76100282
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.76 |
| Max. Negotiated Rate |
$245.42 |
| Rate for Payer: Aetna Commercial |
$231.79
|
| Rate for Payer: Aetna Medicare |
$70.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.22
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$68.17
|
| Rate for Payer: BCBS Trust/PPO |
$224.18
|
| Rate for Payer: BCN Commercial |
$212.02
|
| Rate for Payer: BCN Medicare Advantage |
$68.17
|
| Rate for Payer: Cash Price |
$218.15
|
| Rate for Payer: Cash Price |
$218.15
|
| Rate for Payer: Cofinity Commercial |
$234.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.17
|
| Rate for Payer: Healthscope Commercial |
$245.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.52
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.58
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.79
|
| Rate for Payer: Nomi Health Commercial |
$223.61
|
| Rate for Payer: PACE Senior Care Partners |
$64.76
|
| Rate for Payer: PACE SWMI |
$68.17
|
| Rate for Payer: PHP Commercial |
$231.79
|
| Rate for Payer: PHP Medicare Advantage |
$68.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.25
|
| Rate for Payer: Priority Health HMO/PPO |
$237.24
|
| Rate for Payer: Priority Health Medicare |
$68.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.70
|
| Rate for Payer: Railroad Medicare Medicare |
$68.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.97
|
| Rate for Payer: UHC Core |
$227.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.17
|
| Rate for Payer: UHC Exchange |
$68.17
|
| Rate for Payer: UHC Medicare Advantage |
$68.17
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$68.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.52
|
|
|
HC ACOUSTIC IMMITANCE TESTING
|
Facility
|
IP
|
$148.92
|
|
|
Service Code
|
CPT 92570
|
| Hospital Charge Code |
76100509
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$134.03 |
| Rate for Payer: Aetna Commercial |
$126.58
|
| Rate for Payer: BCBS Trust/PPO |
$121.56
|
| Rate for Payer: BCN Commercial |
$115.09
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$128.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Healthscope Commercial |
$134.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$122.11
|
| Rate for Payer: PHP Commercial |
$126.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: Priority Health HMO/PPO |
$129.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.05
|
| Rate for Payer: UHC Core |
$124.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.69
|
|
|
HC ACOUSTIC IMMITANCE TESTING
|
Facility
|
OP
|
$148.92
|
|
|
Service Code
|
CPT 92570
|
| Hospital Charge Code |
76100509
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$35.37 |
| Max. Negotiated Rate |
$134.03 |
| Rate for Payer: Aetna Commercial |
$126.58
|
| Rate for Payer: Aetna Medicare |
$38.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.54
|
| Rate for Payer: BCBS Complete |
$118.78
|
| Rate for Payer: BCBS MAPPO |
$37.23
|
| Rate for Payer: BCBS Trust/PPO |
$122.43
|
| Rate for Payer: BCN Commercial |
$115.79
|
| Rate for Payer: BCN Medicare Advantage |
$37.23
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$128.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.23
|
| Rate for Payer: Healthscope Commercial |
$134.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.69
|
| Rate for Payer: Mclaren Medicaid |
$113.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.09
|
| Rate for Payer: Meridian Medicaid |
$118.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$122.11
|
| Rate for Payer: PACE Senior Care Partners |
$35.37
|
| Rate for Payer: PACE SWMI |
$37.23
|
| Rate for Payer: PHP Commercial |
$126.58
|
| Rate for Payer: PHP Medicare Advantage |
$37.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: Priority Health HMO/PPO |
$129.56
|
| Rate for Payer: Priority Health Medicare |
$37.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.78
|
| Rate for Payer: Railroad Medicare Medicare |
$37.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.05
|
| Rate for Payer: UHC Core |
$124.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.23
|
| Rate for Payer: UHC Exchange |
$37.23
|
| Rate for Payer: UHC Medicare Advantage |
$37.23
|
| Rate for Payer: UHCCP Medicaid |
$113.12
|
| Rate for Payer: VA VA |
$37.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.69
|
|
|
HC ACTIGRAPHY
|
Facility
|
IP
|
$275.56
|
|
|
Service Code
|
CPT 95803
|
| Hospital Charge Code |
92000016
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$179.11 |
| Max. Negotiated Rate |
$248.00 |
| Rate for Payer: Aetna Commercial |
$234.23
|
| Rate for Payer: BCBS Trust/PPO |
$224.94
|
| Rate for Payer: BCN Commercial |
$212.95
|
| Rate for Payer: Cash Price |
$220.45
|
| Rate for Payer: Cofinity Commercial |
$236.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.45
|
| Rate for Payer: Healthscope Commercial |
$248.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.23
|
| Rate for Payer: Nomi Health Commercial |
$225.96
|
| Rate for Payer: PHP Commercial |
$234.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.11
|
| Rate for Payer: Priority Health HMO/PPO |
$239.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.49
|
| Rate for Payer: UHC Core |
$230.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.67
|
|
|
HC ACTIGRAPHY
|
Facility
|
OP
|
$275.56
|
|
|
Service Code
|
CPT 95803
|
| Hospital Charge Code |
92000016
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$42.95 |
| Max. Negotiated Rate |
$248.00 |
| Rate for Payer: Aetna Commercial |
$234.23
|
| Rate for Payer: Aetna Medicare |
$71.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.11
|
| Rate for Payer: BCBS Complete |
$45.10
|
| Rate for Payer: BCBS MAPPO |
$68.89
|
| Rate for Payer: BCBS Trust/PPO |
$226.54
|
| Rate for Payer: BCN Commercial |
$214.25
|
| Rate for Payer: BCN Medicare Advantage |
$68.89
|
| Rate for Payer: Cash Price |
$220.45
|
| Rate for Payer: Cash Price |
$220.45
|
| Rate for Payer: Cofinity Commercial |
$236.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.89
|
| Rate for Payer: Healthscope Commercial |
$248.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.67
|
| Rate for Payer: Mclaren Medicaid |
$42.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.33
|
| Rate for Payer: Meridian Medicaid |
$45.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.23
|
| Rate for Payer: Nomi Health Commercial |
$225.96
|
| Rate for Payer: PACE Senior Care Partners |
$65.45
|
| Rate for Payer: PACE SWMI |
$68.89
|
| Rate for Payer: PHP Commercial |
$234.23
|
| Rate for Payer: PHP Medicare Advantage |
$68.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.11
|
| Rate for Payer: Priority Health HMO/PPO |
$239.74
|
| Rate for Payer: Priority Health Medicare |
$69.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.63
|
| Rate for Payer: Railroad Medicare Medicare |
$68.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.49
|
| Rate for Payer: UHC Core |
$230.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.89
|
| Rate for Payer: UHC Exchange |
$68.89
|
| Rate for Payer: UHC Medicare Advantage |
$68.89
|
| Rate for Payer: UHCCP Medicaid |
$42.95
|
| Rate for Payer: VA VA |
$68.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.67
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE
|
Facility
|
OP
|
$92.60
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500040
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$83.34 |
| Rate for Payer: Aetna Commercial |
$78.71
|
| Rate for Payer: Aetna Medicare |
$24.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.94
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$23.15
|
| Rate for Payer: BCBS Trust/PPO |
$76.13
|
| Rate for Payer: BCN Commercial |
$72.00
|
| Rate for Payer: BCN Medicare Advantage |
$23.15
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cofinity Commercial |
$79.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.15
|
| Rate for Payer: Healthscope Commercial |
$83.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.45
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.31
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.71
|
| Rate for Payer: Nomi Health Commercial |
$75.93
|
| Rate for Payer: PACE Senior Care Partners |
$21.99
|
| Rate for Payer: PACE SWMI |
$23.15
|
| Rate for Payer: PHP Commercial |
$78.71
|
| Rate for Payer: PHP Medicare Advantage |
$23.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.19
|
| Rate for Payer: Priority Health HMO/PPO |
$80.56
|
| Rate for Payer: Priority Health Medicare |
$23.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.04
|
| Rate for Payer: Railroad Medicare Medicare |
$23.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.49
|
| Rate for Payer: UHC Core |
$77.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.15
|
| Rate for Payer: UHC Exchange |
$23.15
|
| Rate for Payer: UHC Medicare Advantage |
$23.15
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: VA VA |
$23.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.45
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE
|
Facility
|
IP
|
$92.60
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500040
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$60.19 |
| Max. Negotiated Rate |
$83.34 |
| Rate for Payer: Aetna Commercial |
$78.71
|
| Rate for Payer: BCBS Trust/PPO |
$75.59
|
| Rate for Payer: BCN Commercial |
$71.56
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cofinity Commercial |
$79.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.08
|
| Rate for Payer: Healthscope Commercial |
$83.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.71
|
| Rate for Payer: Nomi Health Commercial |
$75.93
|
| Rate for Payer: PHP Commercial |
$78.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.19
|
| Rate for Payer: Priority Health HMO/PPO |
$80.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.49
|
| Rate for Payer: UHC Core |
$77.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.45
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE.
|
Facility
|
OP
|
$66.59
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500084
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare |
$17.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.81
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$16.65
|
| Rate for Payer: BCBS Trust/PPO |
$54.74
|
| Rate for Payer: BCN Commercial |
$51.77
|
| Rate for Payer: BCN Medicare Advantage |
$16.65
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.48
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$54.60
|
| Rate for Payer: PACE Senior Care Partners |
$15.82
|
| Rate for Payer: PACE SWMI |
$16.65
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: PHP Medicare Advantage |
$16.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.28
|
| Rate for Payer: Priority Health HMO/PPO |
$57.93
|
| Rate for Payer: Priority Health Medicare |
$16.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.62
|
| Rate for Payer: Railroad Medicare Medicare |
$16.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.60
|
| Rate for Payer: UHC Core |
$55.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.65
|
| Rate for Payer: UHC Exchange |
$16.65
|
| Rate for Payer: UHC Medicare Advantage |
$16.65
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: VA VA |
$16.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE.
|
Facility
|
IP
|
$66.59
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500084
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$43.28 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: BCBS Trust/PPO |
$54.36
|
| Rate for Payer: BCN Commercial |
$51.46
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$54.60
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.28
|
| Rate for Payer: Priority Health HMO/PPO |
$57.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.60
|
| Rate for Payer: UHC Core |
$55.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC ACUNAV CATHETER
|
Facility
|
IP
|
$5,722.20
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,719.43 |
| Max. Negotiated Rate |
$5,149.98 |
| Rate for Payer: Aetna Commercial |
$4,863.87
|
| Rate for Payer: BCBS Trust/PPO |
$4,671.03
|
| Rate for Payer: BCN Commercial |
$4,422.12
|
| Rate for Payer: Cash Price |
$4,577.76
|
| Rate for Payer: Cofinity Commercial |
$4,921.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,577.76
|
| Rate for Payer: Healthscope Commercial |
$5,149.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,291.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,863.87
|
| Rate for Payer: Nomi Health Commercial |
$4,692.20
|
| Rate for Payer: PHP Commercial |
$4,863.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,719.43
|
| Rate for Payer: Priority Health HMO/PPO |
$4,978.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,833.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,035.54
|
| Rate for Payer: UHC Core |
$4,778.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,291.65
|
|
|
HC ACUNAV CATHETER
|
Facility
|
OP
|
$5,722.20
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,359.02 |
| Max. Negotiated Rate |
$5,149.98 |
| Rate for Payer: Aetna Commercial |
$4,863.87
|
| Rate for Payer: Aetna Medicare |
$1,487.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,788.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,788.19
|
| Rate for Payer: BCBS Complete |
$2,288.88
|
| Rate for Payer: BCBS MAPPO |
$1,430.55
|
| Rate for Payer: BCBS Trust/PPO |
$4,704.22
|
| Rate for Payer: BCN Commercial |
$4,449.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,430.55
|
| Rate for Payer: Cash Price |
$4,577.76
|
| Rate for Payer: Cofinity Commercial |
$4,921.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,577.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,430.55
|
| Rate for Payer: Healthscope Commercial |
$5,149.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,291.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,502.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,645.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,863.87
|
| Rate for Payer: Nomi Health Commercial |
$4,692.20
|
| Rate for Payer: PACE Senior Care Partners |
$1,359.02
|
| Rate for Payer: PACE SWMI |
$1,430.55
|
| Rate for Payer: PHP Commercial |
$4,863.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,430.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,719.43
|
| Rate for Payer: Priority Health HMO/PPO |
$4,978.31
|
| Rate for Payer: Priority Health Medicare |
$1,444.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,833.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,430.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,035.54
|
| Rate for Payer: UHC Core |
$4,778.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,430.55
|
| Rate for Payer: UHC Exchange |
$1,430.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,430.55
|
| Rate for Payer: VA VA |
$1,430.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,291.65
|
|
|
HC ACU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200003
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$34.46 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna Medicare |
$37.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.34
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: BCBS MAPPO |
$36.27
|
| Rate for Payer: BCBS Trust/PPO |
$119.27
|
| Rate for Payer: BCN Commercial |
$112.80
|
| Rate for Payer: BCN Medicare Advantage |
$36.27
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.27
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: PACE Senior Care Partners |
$34.46
|
| Rate for Payer: PACE SWMI |
$36.27
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: PHP Medicare Advantage |
$36.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO |
$126.22
|
| Rate for Payer: Priority Health Medicare |
$36.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.20
|
| Rate for Payer: Railroad Medicare Medicare |
$36.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.67
|
| Rate for Payer: UHC Core |
$121.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.27
|
| Rate for Payer: UHC Exchange |
$36.27
|
| Rate for Payer: UHC Medicare Advantage |
$36.27
|
| Rate for Payer: VA VA |
$36.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC ACU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200003
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: BCBS Trust/PPO |
$118.43
|
| Rate for Payer: BCN Commercial |
$112.12
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: Nomi Health Commercial |
$118.97
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO |
$126.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.67
|
| Rate for Payer: UHC Core |
$121.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC ACU OBS OVERFLOW PER HOUR
|
Facility
|
OP
|
$137.02
|
|
| Hospital Charge Code |
76900001
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$32.54 |
| Max. Negotiated Rate |
$123.32 |
| Rate for Payer: Aetna Commercial |
$116.47
|
| Rate for Payer: Aetna Medicare |
$35.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.82
|
| Rate for Payer: BCBS Complete |
$54.81
|
| Rate for Payer: BCBS MAPPO |
$34.26
|
| Rate for Payer: BCBS Trust/PPO |
$112.64
|
| Rate for Payer: BCN Commercial |
$106.53
|
| Rate for Payer: BCN Medicare Advantage |
$34.26
|
| Rate for Payer: Cash Price |
$109.62
|
| Rate for Payer: Cofinity Commercial |
$117.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.26
|
| Rate for Payer: Healthscope Commercial |
$123.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.47
|
| Rate for Payer: Nomi Health Commercial |
$112.36
|
| Rate for Payer: PACE Senior Care Partners |
$32.54
|
| Rate for Payer: PACE SWMI |
$34.26
|
| Rate for Payer: PHP Commercial |
$116.47
|
| Rate for Payer: PHP Medicare Advantage |
$34.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.06
|
| Rate for Payer: Priority Health HMO/PPO |
$119.21
|
| Rate for Payer: Priority Health Medicare |
$34.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.80
|
| Rate for Payer: Railroad Medicare Medicare |
$34.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.58
|
| Rate for Payer: UHC Core |
$114.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.26
|
| Rate for Payer: UHC Exchange |
$34.26
|
| Rate for Payer: UHC Medicare Advantage |
$34.26
|
| Rate for Payer: VA VA |
$34.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.77
|
|
|
HC ACU OBS OVERFLOW PER HOUR
|
Facility
|
IP
|
$137.02
|
|
| Hospital Charge Code |
76900001
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$89.06 |
| Max. Negotiated Rate |
$123.32 |
| Rate for Payer: Aetna Commercial |
$116.47
|
| Rate for Payer: BCBS Trust/PPO |
$111.85
|
| Rate for Payer: BCN Commercial |
$105.89
|
| Rate for Payer: Cash Price |
$109.62
|
| Rate for Payer: Cofinity Commercial |
$117.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.62
|
| Rate for Payer: Healthscope Commercial |
$123.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.47
|
| Rate for Payer: Nomi Health Commercial |
$112.36
|
| Rate for Payer: PHP Commercial |
$116.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.06
|
| Rate for Payer: Priority Health HMO/PPO |
$119.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.58
|
| Rate for Payer: UHC Core |
$114.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.77
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH
|
Facility
|
OP
|
$37.74
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100023
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$8.96 |
| Max. Negotiated Rate |
$33.97 |
| Rate for Payer: Aetna Commercial |
$32.08
|
| Rate for Payer: Aetna Medicare |
$9.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.79
|
| Rate for Payer: BCBS Complete |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCBS Trust/PPO |
$31.03
|
| Rate for Payer: BCN Commercial |
$29.34
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$32.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Healthscope Commercial |
$33.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.30
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.08
|
| Rate for Payer: Nomi Health Commercial |
$30.95
|
| Rate for Payer: PACE Senior Care Partners |
$8.96
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Commercial |
$32.08
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO |
$32.83
|
| Rate for Payer: Priority Health Medicare |
$9.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.29
|
| Rate for Payer: Railroad Medicare Medicare |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.21
|
| Rate for Payer: UHC Core |
$31.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.44
|
| Rate for Payer: UHC Exchange |
$9.44
|
| Rate for Payer: UHC Medicare Advantage |
$9.44
|
| Rate for Payer: UHCCP Medicaid |
$15.49
|
| Rate for Payer: VA VA |
$9.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.30
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH
|
Facility
|
IP
|
$37.74
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100023
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$24.53 |
| Max. Negotiated Rate |
$33.97 |
| Rate for Payer: Aetna Commercial |
$32.08
|
| Rate for Payer: BCBS Trust/PPO |
$30.81
|
| Rate for Payer: BCN Commercial |
$29.17
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$32.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Healthscope Commercial |
$33.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.08
|
| Rate for Payer: Nomi Health Commercial |
$30.95
|
| Rate for Payer: PHP Commercial |
$32.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO |
$32.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.21
|
| Rate for Payer: UHC Core |
$31.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.30
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100024
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$64.25 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: BCBS Trust/PPO |
$80.68
|
| Rate for Payer: BCN Commercial |
$76.38
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100024
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$25.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.89
|
| Rate for Payer: BCBS Complete |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$24.71
|
| Rate for Payer: BCBS Trust/PPO |
$81.26
|
| Rate for Payer: BCN Commercial |
$76.85
|
| Rate for Payer: BCN Medicare Advantage |
$24.71
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.71
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.95
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: PACE Senior Care Partners |
$23.47
|
| Rate for Payer: PACE SWMI |
$24.71
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: PHP Medicare Advantage |
$24.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Medicare |
$24.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.22
|
| Rate for Payer: Railroad Medicare Medicare |
$24.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.71
|
| Rate for Payer: UHC Exchange |
$24.71
|
| Rate for Payer: UHC Medicare Advantage |
$24.71
|
| Rate for Payer: UHCCP Medicaid |
$15.49
|
| Rate for Payer: VA VA |
$24.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT2
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31100026
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: BCBS Trust/PPO |
$74.94
|
| Rate for Payer: BCN Commercial |
$70.94
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT2
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31100026
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.69
|
| Rate for Payer: BCBS Complete |
$38.86
|
| Rate for Payer: BCBS MAPPO |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$75.47
|
| Rate for Payer: BCN Commercial |
$71.37
|
| Rate for Payer: BCN Medicare Advantage |
$22.95
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.95
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$37.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.10
|
| Rate for Payer: Meridian Medicaid |
$38.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PACE Senior Care Partners |
$21.80
|
| Rate for Payer: PACE SWMI |
$22.95
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Medicare Advantage |
$22.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Medicare |
$23.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: Railroad Medicare Medicare |
$22.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.95
|
| Rate for Payer: UHC Exchange |
$22.95
|
| Rate for Payer: UHC Medicare Advantage |
$22.95
|
| Rate for Payer: UHCCP Medicaid |
$37.01
|
| Rate for Payer: VA VA |
$22.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC ACUTE RENAL DIALYSIS
|
Facility
|
OP
|
$785.70
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
82000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$186.60 |
| Max. Negotiated Rate |
$707.13 |
| Rate for Payer: Aetna Commercial |
$667.85
|
| Rate for Payer: Aetna Medicare |
$204.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$245.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$245.53
|
| Rate for Payer: BCBS Complete |
$531.23
|
| Rate for Payer: BCBS MAPPO |
$196.43
|
| Rate for Payer: BCBS Trust/PPO |
$645.92
|
| Rate for Payer: BCN Commercial |
$610.88
|
| Rate for Payer: BCN Medicare Advantage |
$196.43
|
| Rate for Payer: Cash Price |
$628.56
|
| Rate for Payer: Cash Price |
$628.56
|
| Rate for Payer: Cofinity Commercial |
$675.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.43
|
| Rate for Payer: Healthscope Commercial |
$707.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$589.27
|
| Rate for Payer: Mclaren Medicaid |
$505.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.25
|
| Rate for Payer: Meridian Medicaid |
$531.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$225.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$667.85
|
| Rate for Payer: Nomi Health Commercial |
$644.27
|
| Rate for Payer: PACE Senior Care Partners |
$186.60
|
| Rate for Payer: PACE SWMI |
$196.43
|
| Rate for Payer: PHP Commercial |
$667.85
|
| Rate for Payer: PHP Medicare Advantage |
$196.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.70
|
| Rate for Payer: Priority Health HMO/PPO |
$683.56
|
| Rate for Payer: Priority Health Medicare |
$198.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$526.42
|
| Rate for Payer: Railroad Medicare Medicare |
$196.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$691.42
|
| Rate for Payer: UHC Core |
$656.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.43
|
| Rate for Payer: UHC Exchange |
$196.43
|
| Rate for Payer: UHC Medicare Advantage |
$196.43
|
| Rate for Payer: UHCCP Medicaid |
$505.90
|
| Rate for Payer: VA VA |
$196.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$589.27
|
|
|
HC ACUTE RENAL DIALYSIS
|
Facility
|
IP
|
$785.70
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
82000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$510.70 |
| Max. Negotiated Rate |
$707.13 |
| Rate for Payer: Aetna Commercial |
$667.85
|
| Rate for Payer: BCBS Trust/PPO |
$641.37
|
| Rate for Payer: BCN Commercial |
$607.19
|
| Rate for Payer: Cash Price |
$628.56
|
| Rate for Payer: Cofinity Commercial |
$675.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.56
|
| Rate for Payer: Healthscope Commercial |
$707.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$589.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$667.85
|
| Rate for Payer: Nomi Health Commercial |
$644.27
|
| Rate for Payer: PHP Commercial |
$667.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.70
|
| Rate for Payer: Priority Health HMO/PPO |
$683.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$526.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$691.42
|
| Rate for Payer: UHC Core |
$656.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$589.27
|
|
|
HC ACYLCARNITINES
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 82017
|
| Hospital Charge Code |
30100070
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.20 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$12.81
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$62.89
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$12.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: Meridian Medicaid |
$12.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Exchange |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.12
|
| Rate for Payer: UHCCP Medicaid |
$12.20
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC ACYLCARNITINES
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 82017
|
| Hospital Charge Code |
30100070
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.73 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: BCBS Trust/PPO |
$62.45
|
| Rate for Payer: BCN Commercial |
$59.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
