|
HC CERVILENZ
|
Facility
|
IP
|
$174.10
|
|
| Hospital Charge Code |
27200171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.17 |
| Max. Negotiated Rate |
$156.69 |
| Rate for Payer: Aetna Commercial |
$147.99
|
| Rate for Payer: BCBS Trust/PPO |
$143.79
|
| Rate for Payer: BCN Commercial |
$143.79
|
| Rate for Payer: Cash Price |
$139.28
|
| Rate for Payer: Cofinity Commercial |
$149.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.28
|
| Rate for Payer: Healthscope Commercial |
$156.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.99
|
| Rate for Payer: Nomi Health Commercial |
$142.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.57
|
| Rate for Payer: PHP Commercial |
$147.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$151.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.21
|
| Rate for Payer: UHC Core |
$145.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.57
|
|
|
HC CERV OR VAG CA SCREEN PELVIC/BREAST EXAM
|
Facility
|
IP
|
$143.60
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
77000001
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$99.95 |
| Max. Negotiated Rate |
$129.24 |
| Rate for Payer: Aetna Commercial |
$122.06
|
| Rate for Payer: BCBS Trust/PPO |
$118.60
|
| Rate for Payer: BCN Commercial |
$118.60
|
| Rate for Payer: Cash Price |
$114.88
|
| Rate for Payer: Cofinity Commercial |
$123.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.88
|
| Rate for Payer: Healthscope Commercial |
$129.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.06
|
| Rate for Payer: Nomi Health Commercial |
$117.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.70
|
| Rate for Payer: PHP Commercial |
$122.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$124.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.37
|
| Rate for Payer: UHC Core |
$119.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.70
|
|
|
HC CERV OR VAG CA SCREEN PELVIC/BREAST EXAM
|
Facility
|
OP
|
$143.60
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
77000001
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$25.32 |
| Max. Negotiated Rate |
$129.24 |
| Rate for Payer: Aetna Commercial |
$122.06
|
| Rate for Payer: Aetna Medicare |
$37.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.88
|
| Rate for Payer: BCBS Complete |
$26.58
|
| Rate for Payer: BCBS MAPPO |
$35.90
|
| Rate for Payer: BCBS Trust/PPO |
$118.05
|
| Rate for Payer: BCN Commercial |
$118.05
|
| Rate for Payer: BCN Medicare Advantage |
$35.90
|
| Rate for Payer: Cash Price |
$114.88
|
| Rate for Payer: Cofinity Commercial |
$123.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$129.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.70
|
| Rate for Payer: Mclaren Medicaid |
$25.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.70
|
| Rate for Payer: Meridian Medicaid |
$26.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.06
|
| Rate for Payer: Nomi Health Commercial |
$117.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.70
|
| Rate for Payer: PACE Senior Care Partners |
$34.10
|
| Rate for Payer: PACE SWMI |
$35.90
|
| Rate for Payer: PHP Commercial |
$122.06
|
| Rate for Payer: PHP Medicare Advantage |
$35.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$124.93
|
| Rate for Payer: Priority Health Medicare |
$36.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.95
|
| Rate for Payer: Railroad Medicare Medicare |
$35.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.37
|
| Rate for Payer: UHC Core |
$119.91
|
| Rate for Payer: UHC Exchange |
$35.90
|
| Rate for Payer: UHC Medicaid |
$25.32
|
| Rate for Payer: UHC Medicare Advantage |
$35.90
|
| Rate for Payer: UHCCP Medicaid |
$25.32
|
| Rate for Payer: VA VA |
$35.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.70
|
|
|
HC CESIUM 137 PER SOURCE
|
Facility
|
OP
|
$793.26
|
|
| Hospital Charge Code |
34000001
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$139.85 |
| Max. Negotiated Rate |
$713.93 |
| Rate for Payer: Aetna Commercial |
$674.27
|
| Rate for Payer: Aetna Medicare |
$206.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$247.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$247.89
|
| Rate for Payer: BCBS Complete |
$146.83
|
| Rate for Payer: BCBS MAPPO |
$198.31
|
| Rate for Payer: BCBS Trust/PPO |
$652.14
|
| Rate for Payer: BCN Commercial |
$652.14
|
| Rate for Payer: BCN Medicare Advantage |
$198.31
|
| Rate for Payer: Cash Price |
$634.61
|
| Rate for Payer: Cofinity Commercial |
$682.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.31
|
| Rate for Payer: Healthscope Commercial |
$713.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.95
|
| Rate for Payer: Mclaren Medicaid |
$139.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.23
|
| Rate for Payer: Meridian Medicaid |
$146.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$218.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.27
|
| Rate for Payer: Nomi Health Commercial |
$650.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.95
|
| Rate for Payer: PACE Senior Care Partners |
$188.40
|
| Rate for Payer: PACE SWMI |
$198.31
|
| Rate for Payer: PHP Commercial |
$674.27
|
| Rate for Payer: PHP Medicare Advantage |
$198.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$690.14
|
| Rate for Payer: Priority Health Medicare |
$200.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$552.11
|
| Rate for Payer: Railroad Medicare Medicare |
$198.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.07
|
| Rate for Payer: UHC Core |
$662.37
|
| Rate for Payer: UHC Exchange |
$198.31
|
| Rate for Payer: UHC Medicaid |
$139.85
|
| Rate for Payer: UHC Medicare Advantage |
$198.31
|
| Rate for Payer: UHCCP Medicaid |
$139.85
|
| Rate for Payer: VA VA |
$198.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.95
|
|
|
HC CESIUM 137 PER SOURCE
|
Facility
|
IP
|
$793.26
|
|
| Hospital Charge Code |
34000001
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$552.11 |
| Max. Negotiated Rate |
$713.93 |
| Rate for Payer: Aetna Commercial |
$674.27
|
| Rate for Payer: BCBS Trust/PPO |
$655.15
|
| Rate for Payer: BCN Commercial |
$655.15
|
| Rate for Payer: Cash Price |
$634.61
|
| Rate for Payer: Cofinity Commercial |
$682.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.61
|
| Rate for Payer: Healthscope Commercial |
$713.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.27
|
| Rate for Payer: Nomi Health Commercial |
$650.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.95
|
| Rate for Payer: PHP Commercial |
$674.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$690.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$552.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.07
|
| Rate for Payer: UHC Core |
$662.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.95
|
|
|
HC CHAMBER HOLDING OPTI CHAMBER
|
Facility
|
OP
|
$22.77
|
|
| Hospital Charge Code |
27000044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.01 |
| Max. Negotiated Rate |
$20.49 |
| Rate for Payer: Aetna Commercial |
$19.35
|
| Rate for Payer: Aetna Medicare |
$5.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.12
|
| Rate for Payer: BCBS Complete |
$4.21
|
| Rate for Payer: BCBS MAPPO |
$5.69
|
| Rate for Payer: BCBS Trust/PPO |
$18.72
|
| Rate for Payer: BCN Commercial |
$18.72
|
| Rate for Payer: BCN Medicare Advantage |
$5.69
|
| Rate for Payer: Cash Price |
$18.22
|
| Rate for Payer: Cofinity Commercial |
$19.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.69
|
| Rate for Payer: Healthscope Commercial |
$20.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.08
|
| Rate for Payer: Mclaren Medicaid |
$4.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.98
|
| Rate for Payer: Meridian Medicaid |
$4.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.35
|
| Rate for Payer: Nomi Health Commercial |
$18.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.08
|
| Rate for Payer: PACE Senior Care Partners |
$5.41
|
| Rate for Payer: PACE SWMI |
$5.69
|
| Rate for Payer: PHP Commercial |
$19.35
|
| Rate for Payer: PHP Medicare Advantage |
$5.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.81
|
| Rate for Payer: Priority Health Medicare |
$5.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.85
|
| Rate for Payer: Railroad Medicare Medicare |
$5.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.04
|
| Rate for Payer: UHC Core |
$19.01
|
| Rate for Payer: UHC Exchange |
$5.69
|
| Rate for Payer: UHC Medicaid |
$4.01
|
| Rate for Payer: UHC Medicare Advantage |
$5.69
|
| Rate for Payer: UHCCP Medicaid |
$4.01
|
| Rate for Payer: VA VA |
$5.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.08
|
|
|
HC CHAMBER HOLDING OPTI CHAMBER
|
Facility
|
IP
|
$22.77
|
|
| Hospital Charge Code |
27000044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.85 |
| Max. Negotiated Rate |
$20.49 |
| Rate for Payer: Aetna Commercial |
$19.35
|
| Rate for Payer: BCBS Trust/PPO |
$18.81
|
| Rate for Payer: BCN Commercial |
$18.81
|
| Rate for Payer: Cash Price |
$18.22
|
| Rate for Payer: Cofinity Commercial |
$19.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.22
|
| Rate for Payer: Healthscope Commercial |
$20.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.35
|
| Rate for Payer: Nomi Health Commercial |
$18.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.08
|
| Rate for Payer: PHP Commercial |
$19.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.04
|
| Rate for Payer: UHC Core |
$19.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.08
|
|
|
HC CHANGE CYSTOSTOMY TUBE COMPLICATED
|
Facility
|
OP
|
$1,036.80
|
|
|
Service Code
|
CPT 51710
|
| Hospital Charge Code |
76100297
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$182.79 |
| Max. Negotiated Rate |
$933.12 |
| Rate for Payer: Aetna Commercial |
$881.28
|
| Rate for Payer: Aetna Medicare |
$269.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$324.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$324.00
|
| Rate for Payer: BCBS Complete |
$191.91
|
| Rate for Payer: BCBS MAPPO |
$259.20
|
| Rate for Payer: BCBS Trust/PPO |
$852.35
|
| Rate for Payer: BCN Commercial |
$852.35
|
| Rate for Payer: BCN Medicare Advantage |
$259.20
|
| Rate for Payer: Cash Price |
$829.44
|
| Rate for Payer: Cofinity Commercial |
$891.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$829.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.20
|
| Rate for Payer: Healthscope Commercial |
$933.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$777.60
|
| Rate for Payer: Mclaren Medicaid |
$182.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$272.16
|
| Rate for Payer: Meridian Medicaid |
$191.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$298.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$285.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$881.28
|
| Rate for Payer: Nomi Health Commercial |
$850.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$777.60
|
| Rate for Payer: PACE Senior Care Partners |
$246.24
|
| Rate for Payer: PACE SWMI |
$259.20
|
| Rate for Payer: PHP Commercial |
$881.28
|
| Rate for Payer: PHP Medicare Advantage |
$259.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$182.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$902.02
|
| Rate for Payer: Priority Health Medicare |
$261.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$721.61
|
| Rate for Payer: Railroad Medicare Medicare |
$259.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$912.38
|
| Rate for Payer: UHC Core |
$865.73
|
| Rate for Payer: UHC Exchange |
$259.20
|
| Rate for Payer: UHC Medicaid |
$182.79
|
| Rate for Payer: UHC Medicare Advantage |
$259.20
|
| Rate for Payer: UHCCP Medicaid |
$182.79
|
| Rate for Payer: VA VA |
$259.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$777.60
|
|
|
HC CHANGE CYSTOSTOMY TUBE COMPLICATED
|
Facility
|
IP
|
$1,036.80
|
|
|
Service Code
|
CPT 51710
|
| Hospital Charge Code |
76100297
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$721.61 |
| Max. Negotiated Rate |
$933.12 |
| Rate for Payer: Aetna Commercial |
$881.28
|
| Rate for Payer: BCBS Trust/PPO |
$856.29
|
| Rate for Payer: BCN Commercial |
$856.29
|
| Rate for Payer: Cash Price |
$829.44
|
| Rate for Payer: Cofinity Commercial |
$891.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$829.44
|
| Rate for Payer: Healthscope Commercial |
$933.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$777.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$881.28
|
| Rate for Payer: Nomi Health Commercial |
$850.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$777.60
|
| Rate for Payer: PHP Commercial |
$881.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$902.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$721.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$912.38
|
| Rate for Payer: UHC Core |
$865.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$777.60
|
|
|
HC CHANNEL RFA ENDO CATHETER
|
Facility
|
OP
|
$3,796.01
|
|
| Hospital Charge Code |
27200289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$669.24 |
| Max. Negotiated Rate |
$3,416.41 |
| Rate for Payer: Aetna Commercial |
$3,226.61
|
| Rate for Payer: Aetna Medicare |
$986.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,186.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,186.25
|
| Rate for Payer: BCBS Complete |
$702.64
|
| Rate for Payer: BCBS MAPPO |
$949.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,120.70
|
| Rate for Payer: BCN Commercial |
$3,120.70
|
| Rate for Payer: BCN Medicare Advantage |
$949.00
|
| Rate for Payer: Cash Price |
$3,036.81
|
| Rate for Payer: Cofinity Commercial |
$3,264.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,036.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$949.00
|
| Rate for Payer: Healthscope Commercial |
$3,416.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,847.01
|
| Rate for Payer: Mclaren Medicaid |
$669.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$996.45
|
| Rate for Payer: Meridian Medicaid |
$702.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,091.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,043.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,226.61
|
| Rate for Payer: Nomi Health Commercial |
$3,112.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,847.01
|
| Rate for Payer: PACE Senior Care Partners |
$901.55
|
| Rate for Payer: PACE SWMI |
$949.00
|
| Rate for Payer: PHP Commercial |
$3,226.61
|
| Rate for Payer: PHP Medicare Advantage |
$949.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$669.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,302.53
|
| Rate for Payer: Priority Health Medicare |
$958.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,642.02
|
| Rate for Payer: Railroad Medicare Medicare |
$949.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,340.49
|
| Rate for Payer: UHC Core |
$3,169.67
|
| Rate for Payer: UHC Exchange |
$949.00
|
| Rate for Payer: UHC Medicaid |
$669.24
|
| Rate for Payer: UHC Medicare Advantage |
$949.00
|
| Rate for Payer: UHCCP Medicaid |
$669.24
|
| Rate for Payer: VA VA |
$949.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,847.01
|
|
|
HC CHANNEL RFA ENDO CATHETER
|
Facility
|
IP
|
$3,796.01
|
|
| Hospital Charge Code |
27200289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,642.02 |
| Max. Negotiated Rate |
$3,416.41 |
| Rate for Payer: Aetna Commercial |
$3,226.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,135.12
|
| Rate for Payer: BCN Commercial |
$3,135.12
|
| Rate for Payer: Cash Price |
$3,036.81
|
| Rate for Payer: Cofinity Commercial |
$3,264.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,036.81
|
| Rate for Payer: Healthscope Commercial |
$3,416.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,847.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,226.61
|
| Rate for Payer: Nomi Health Commercial |
$3,112.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,847.01
|
| Rate for Payer: PHP Commercial |
$3,226.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,302.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,642.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,340.49
|
| Rate for Payer: UHC Core |
$3,169.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,847.01
|
|
|
HC CHEM CAUTERY GRANULATION TISSUE
|
Facility
|
IP
|
$302.67
|
|
|
Service Code
|
CPT 17250
|
| Hospital Charge Code |
76100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.66 |
| Max. Negotiated Rate |
$272.40 |
| Rate for Payer: Aetna Commercial |
$257.27
|
| Rate for Payer: BCBS Trust/PPO |
$249.98
|
| Rate for Payer: BCN Commercial |
$249.98
|
| Rate for Payer: Cash Price |
$242.14
|
| Rate for Payer: Cofinity Commercial |
$260.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.14
|
| Rate for Payer: Healthscope Commercial |
$272.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.27
|
| Rate for Payer: Nomi Health Commercial |
$248.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.00
|
| Rate for Payer: PHP Commercial |
$257.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$263.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.35
|
| Rate for Payer: UHC Core |
$252.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.00
|
|
|
HC CHEM CAUTERY GRANULATION TISSUE
|
Facility
|
OP
|
$302.67
|
|
|
Service Code
|
CPT 17250
|
| Hospital Charge Code |
76100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$53.36 |
| Max. Negotiated Rate |
$272.40 |
| Rate for Payer: Aetna Commercial |
$257.27
|
| Rate for Payer: Aetna Medicare |
$78.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.58
|
| Rate for Payer: BCBS Complete |
$56.02
|
| Rate for Payer: BCBS MAPPO |
$75.67
|
| Rate for Payer: BCBS Trust/PPO |
$248.83
|
| Rate for Payer: BCN Commercial |
$248.83
|
| Rate for Payer: BCN Medicare Advantage |
$75.67
|
| Rate for Payer: Cash Price |
$242.14
|
| Rate for Payer: Cofinity Commercial |
$260.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.67
|
| Rate for Payer: Healthscope Commercial |
$272.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.00
|
| Rate for Payer: Mclaren Medicaid |
$53.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.45
|
| Rate for Payer: Meridian Medicaid |
$56.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.27
|
| Rate for Payer: Nomi Health Commercial |
$248.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.00
|
| Rate for Payer: PACE Senior Care Partners |
$71.88
|
| Rate for Payer: PACE SWMI |
$75.67
|
| Rate for Payer: PHP Commercial |
$257.27
|
| Rate for Payer: PHP Medicare Advantage |
$75.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$263.32
|
| Rate for Payer: Priority Health Medicare |
$76.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$210.66
|
| Rate for Payer: Railroad Medicare Medicare |
$75.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.35
|
| Rate for Payer: UHC Core |
$252.73
|
| Rate for Payer: UHC Exchange |
$75.67
|
| Rate for Payer: UHC Medicaid |
$53.36
|
| Rate for Payer: UHC Medicare Advantage |
$75.67
|
| Rate for Payer: UHCCP Medicaid |
$53.36
|
| Rate for Payer: VA VA |
$75.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.00
|
|
|
HC CHEMO ADMIN INTO CNS
|
Facility
|
OP
|
$1,148.54
|
|
|
Service Code
|
CPT 96450
|
| Hospital Charge Code |
33100005
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$202.49 |
| Max. Negotiated Rate |
$1,033.69 |
| Rate for Payer: Aetna Commercial |
$976.26
|
| Rate for Payer: Aetna Medicare |
$298.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$358.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$358.92
|
| Rate for Payer: BCBS Complete |
$212.59
|
| Rate for Payer: BCBS MAPPO |
$287.13
|
| Rate for Payer: BCBS Trust/PPO |
$944.21
|
| Rate for Payer: BCN Commercial |
$944.21
|
| Rate for Payer: BCN Medicare Advantage |
$287.13
|
| Rate for Payer: Cash Price |
$918.83
|
| Rate for Payer: Cofinity Commercial |
$987.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.13
|
| Rate for Payer: Healthscope Commercial |
$1,033.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$861.40
|
| Rate for Payer: Mclaren Medicaid |
$202.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$301.49
|
| Rate for Payer: Meridian Medicaid |
$212.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$330.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$315.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$976.26
|
| Rate for Payer: Nomi Health Commercial |
$941.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$861.40
|
| Rate for Payer: PACE Senior Care Partners |
$272.78
|
| Rate for Payer: PACE SWMI |
$287.13
|
| Rate for Payer: PHP Commercial |
$976.26
|
| Rate for Payer: PHP Medicare Advantage |
$287.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$999.23
|
| Rate for Payer: Priority Health Medicare |
$290.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$799.38
|
| Rate for Payer: Railroad Medicare Medicare |
$287.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,010.72
|
| Rate for Payer: UHC Core |
$959.03
|
| Rate for Payer: UHC Exchange |
$287.13
|
| Rate for Payer: UHC Medicaid |
$202.49
|
| Rate for Payer: UHC Medicare Advantage |
$287.13
|
| Rate for Payer: UHCCP Medicaid |
$202.49
|
| Rate for Payer: VA VA |
$287.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$861.40
|
|
|
HC CHEMO ADMIN INTO CNS
|
Facility
|
IP
|
$1,148.54
|
|
|
Service Code
|
CPT 96450
|
| Hospital Charge Code |
33100005
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$799.38 |
| Max. Negotiated Rate |
$1,033.69 |
| Rate for Payer: Aetna Commercial |
$976.26
|
| Rate for Payer: BCBS Trust/PPO |
$948.58
|
| Rate for Payer: BCN Commercial |
$948.58
|
| Rate for Payer: Cash Price |
$918.83
|
| Rate for Payer: Cofinity Commercial |
$987.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.83
|
| Rate for Payer: Healthscope Commercial |
$1,033.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$861.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$976.26
|
| Rate for Payer: Nomi Health Commercial |
$941.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$861.40
|
| Rate for Payer: PHP Commercial |
$976.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$999.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$799.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,010.72
|
| Rate for Payer: UHC Core |
$959.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$861.40
|
|
|
HC CHEMODENERVATION INTERNAL ANAL SPHINCTER
|
Facility
|
IP
|
$3,267.32
|
|
|
Service Code
|
CPT 46505
|
| Hospital Charge Code |
76100384
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,274.05 |
| Max. Negotiated Rate |
$2,940.59 |
| Rate for Payer: Aetna Commercial |
$2,777.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,698.48
|
| Rate for Payer: BCN Commercial |
$2,698.48
|
| Rate for Payer: Cash Price |
$2,613.86
|
| Rate for Payer: Cofinity Commercial |
$2,809.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,613.86
|
| Rate for Payer: Healthscope Commercial |
$2,940.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,450.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,777.22
|
| Rate for Payer: Nomi Health Commercial |
$2,679.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,450.49
|
| Rate for Payer: PHP Commercial |
$2,777.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,842.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,274.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,875.24
|
| Rate for Payer: UHC Core |
$2,728.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,450.49
|
|
|
HC CHEMODENERVATION INTERNAL ANAL SPHINCTER
|
Facility
|
OP
|
$3,267.32
|
|
|
Service Code
|
CPT 46505
|
| Hospital Charge Code |
76100384
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$576.03 |
| Max. Negotiated Rate |
$2,940.59 |
| Rate for Payer: Aetna Commercial |
$2,777.22
|
| Rate for Payer: Aetna Medicare |
$849.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,021.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,021.04
|
| Rate for Payer: BCBS Complete |
$604.78
|
| Rate for Payer: BCBS MAPPO |
$816.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,686.06
|
| Rate for Payer: BCN Commercial |
$2,686.06
|
| Rate for Payer: BCN Medicare Advantage |
$816.83
|
| Rate for Payer: Cash Price |
$2,613.86
|
| Rate for Payer: Cofinity Commercial |
$2,809.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,613.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$816.83
|
| Rate for Payer: Healthscope Commercial |
$2,940.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,450.49
|
| Rate for Payer: Mclaren Medicaid |
$576.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$857.67
|
| Rate for Payer: Meridian Medicaid |
$604.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$939.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$898.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,777.22
|
| Rate for Payer: Nomi Health Commercial |
$2,679.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,450.49
|
| Rate for Payer: PACE Senior Care Partners |
$775.99
|
| Rate for Payer: PACE SWMI |
$816.83
|
| Rate for Payer: PHP Commercial |
$2,777.22
|
| Rate for Payer: PHP Medicare Advantage |
$816.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$576.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,842.57
|
| Rate for Payer: Priority Health Medicare |
$825.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,274.05
|
| Rate for Payer: Railroad Medicare Medicare |
$816.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,875.24
|
| Rate for Payer: UHC Core |
$2,728.21
|
| Rate for Payer: UHC Exchange |
$816.83
|
| Rate for Payer: UHC Medicaid |
$576.03
|
| Rate for Payer: UHC Medicare Advantage |
$816.83
|
| Rate for Payer: UHCCP Medicaid |
$576.03
|
| Rate for Payer: VA VA |
$816.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,450.49
|
|
|
HC CHEMODENERVATION TRUNK 6 OR > MUSCLES
|
Facility
|
IP
|
$1,995.07
|
|
|
Service Code
|
CPT 64647
|
| Hospital Charge Code |
36000374
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,388.57 |
| Max. Negotiated Rate |
$1,795.56 |
| Rate for Payer: Aetna Commercial |
$1,695.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,647.73
|
| Rate for Payer: BCN Commercial |
$1,647.73
|
| Rate for Payer: Cash Price |
$1,596.06
|
| Rate for Payer: Cofinity Commercial |
$1,715.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.06
|
| Rate for Payer: Healthscope Commercial |
$1,795.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.81
|
| Rate for Payer: Nomi Health Commercial |
$1,635.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,496.30
|
| Rate for Payer: PHP Commercial |
$1,695.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,735.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,388.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,755.66
|
| Rate for Payer: UHC Core |
$1,665.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.30
|
|
|
HC CHEMODENERVATION TRUNK 6 OR > MUSCLES
|
Facility
|
OP
|
$1,995.07
|
|
|
Service Code
|
CPT 64647
|
| Hospital Charge Code |
36000374
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$351.73 |
| Max. Negotiated Rate |
$1,795.56 |
| Rate for Payer: Aetna Commercial |
$1,695.81
|
| Rate for Payer: Aetna Medicare |
$518.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.46
|
| Rate for Payer: BCBS Complete |
$369.29
|
| Rate for Payer: BCBS MAPPO |
$498.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,640.15
|
| Rate for Payer: BCN Commercial |
$1,640.15
|
| Rate for Payer: BCN Medicare Advantage |
$498.77
|
| Rate for Payer: Cash Price |
$1,596.06
|
| Rate for Payer: Cofinity Commercial |
$1,715.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.77
|
| Rate for Payer: Healthscope Commercial |
$1,795.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.30
|
| Rate for Payer: Mclaren Medicaid |
$351.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.71
|
| Rate for Payer: Meridian Medicaid |
$369.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$548.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.81
|
| Rate for Payer: Nomi Health Commercial |
$1,635.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,496.30
|
| Rate for Payer: PACE Senior Care Partners |
$473.83
|
| Rate for Payer: PACE SWMI |
$498.77
|
| Rate for Payer: PHP Commercial |
$1,695.81
|
| Rate for Payer: PHP Medicare Advantage |
$498.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,735.71
|
| Rate for Payer: Priority Health Medicare |
$503.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,388.57
|
| Rate for Payer: Railroad Medicare Medicare |
$498.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,755.66
|
| Rate for Payer: UHC Core |
$1,665.88
|
| Rate for Payer: UHC Exchange |
$498.77
|
| Rate for Payer: UHC Medicaid |
$351.73
|
| Rate for Payer: UHC Medicare Advantage |
$498.77
|
| Rate for Payer: UHCCP Medicaid |
$351.73
|
| Rate for Payer: VA VA |
$498.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.30
|
|
|
HC CHEMODENERV SALIV GLANDS
|
Facility
|
IP
|
$393.93
|
|
|
Service Code
|
CPT 64611
|
| Hospital Charge Code |
76100210
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$274.18 |
| Max. Negotiated Rate |
$354.54 |
| Rate for Payer: Aetna Commercial |
$334.84
|
| Rate for Payer: BCBS Trust/PPO |
$325.35
|
| Rate for Payer: BCN Commercial |
$325.35
|
| Rate for Payer: Cash Price |
$315.14
|
| Rate for Payer: Cofinity Commercial |
$338.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.14
|
| Rate for Payer: Healthscope Commercial |
$354.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$334.84
|
| Rate for Payer: Nomi Health Commercial |
$323.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$295.45
|
| Rate for Payer: PHP Commercial |
$334.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$342.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.66
|
| Rate for Payer: UHC Core |
$328.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.45
|
|
|
HC CHEMODENERV SALIV GLANDS
|
Facility
|
OP
|
$393.93
|
|
|
Service Code
|
CPT 64611
|
| Hospital Charge Code |
76100210
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.45 |
| Max. Negotiated Rate |
$354.54 |
| Rate for Payer: Aetna Commercial |
$334.84
|
| Rate for Payer: Aetna Medicare |
$102.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.10
|
| Rate for Payer: BCBS Complete |
$72.92
|
| Rate for Payer: BCBS MAPPO |
$98.48
|
| Rate for Payer: BCBS Trust/PPO |
$323.85
|
| Rate for Payer: BCN Commercial |
$323.85
|
| Rate for Payer: BCN Medicare Advantage |
$98.48
|
| Rate for Payer: Cash Price |
$315.14
|
| Rate for Payer: Cofinity Commercial |
$338.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.48
|
| Rate for Payer: Healthscope Commercial |
$354.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.45
|
| Rate for Payer: Mclaren Medicaid |
$69.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.41
|
| Rate for Payer: Meridian Medicaid |
$72.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$334.84
|
| Rate for Payer: Nomi Health Commercial |
$323.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$295.45
|
| Rate for Payer: PACE Senior Care Partners |
$93.56
|
| Rate for Payer: PACE SWMI |
$98.48
|
| Rate for Payer: PHP Commercial |
$334.84
|
| Rate for Payer: PHP Medicare Advantage |
$98.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$342.72
|
| Rate for Payer: Priority Health Medicare |
$99.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.18
|
| Rate for Payer: Railroad Medicare Medicare |
$98.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.66
|
| Rate for Payer: UHC Core |
$328.93
|
| Rate for Payer: UHC Exchange |
$98.48
|
| Rate for Payer: UHC Medicaid |
$69.45
|
| Rate for Payer: UHC Medicare Advantage |
$98.48
|
| Rate for Payer: UHCCP Medicaid |
$69.45
|
| Rate for Payer: VA VA |
$98.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.45
|
|
|
HC CHEMODNRV EA ADD EXT 1-4 MUSC
|
Facility
|
OP
|
$710.37
|
|
|
Service Code
|
CPT 64643
|
| Hospital Charge Code |
36100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.24 |
| Max. Negotiated Rate |
$639.33 |
| Rate for Payer: Aetna Commercial |
$603.81
|
| Rate for Payer: Aetna Medicare |
$184.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.99
|
| Rate for Payer: BCBS Complete |
$131.49
|
| Rate for Payer: BCBS MAPPO |
$177.59
|
| Rate for Payer: BCBS Trust/PPO |
$584.00
|
| Rate for Payer: BCN Commercial |
$584.00
|
| Rate for Payer: BCN Medicare Advantage |
$177.59
|
| Rate for Payer: Cash Price |
$568.30
|
| Rate for Payer: Cofinity Commercial |
$610.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.59
|
| Rate for Payer: Healthscope Commercial |
$639.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$532.78
|
| Rate for Payer: Mclaren Medicaid |
$125.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.47
|
| Rate for Payer: Meridian Medicaid |
$131.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$195.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$603.81
|
| Rate for Payer: Nomi Health Commercial |
$582.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$532.78
|
| Rate for Payer: PACE Senior Care Partners |
$168.71
|
| Rate for Payer: PACE SWMI |
$177.59
|
| Rate for Payer: PHP Commercial |
$603.81
|
| Rate for Payer: PHP Medicare Advantage |
$177.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$618.02
|
| Rate for Payer: Priority Health Medicare |
$179.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$494.42
|
| Rate for Payer: Railroad Medicare Medicare |
$177.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.13
|
| Rate for Payer: UHC Core |
$593.16
|
| Rate for Payer: UHC Exchange |
$177.59
|
| Rate for Payer: UHC Medicaid |
$125.24
|
| Rate for Payer: UHC Medicare Advantage |
$177.59
|
| Rate for Payer: UHCCP Medicaid |
$125.24
|
| Rate for Payer: VA VA |
$177.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$532.78
|
|
|
HC CHEMODNRV EA ADD EXT 1-4 MUSC
|
Facility
|
IP
|
$710.37
|
|
|
Service Code
|
CPT 64643
|
| Hospital Charge Code |
36100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$494.42 |
| Max. Negotiated Rate |
$639.33 |
| Rate for Payer: Aetna Commercial |
$603.81
|
| Rate for Payer: BCBS Trust/PPO |
$586.69
|
| Rate for Payer: BCN Commercial |
$586.69
|
| Rate for Payer: Cash Price |
$568.30
|
| Rate for Payer: Cofinity Commercial |
$610.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.30
|
| Rate for Payer: Healthscope Commercial |
$639.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$532.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$603.81
|
| Rate for Payer: Nomi Health Commercial |
$582.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$532.78
|
| Rate for Payer: PHP Commercial |
$603.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$618.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$494.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.13
|
| Rate for Payer: UHC Core |
$593.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$532.78
|
|
|
HC CHEMODNRV EXT1-4 MUSC
|
Facility
|
OP
|
$684.81
|
|
|
Service Code
|
CPT 64642
|
| Hospital Charge Code |
36100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$120.73 |
| Max. Negotiated Rate |
$616.33 |
| Rate for Payer: Aetna Commercial |
$582.09
|
| Rate for Payer: Aetna Medicare |
$178.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$214.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$214.00
|
| Rate for Payer: BCBS Complete |
$126.76
|
| Rate for Payer: BCBS MAPPO |
$171.20
|
| Rate for Payer: BCBS Trust/PPO |
$562.98
|
| Rate for Payer: BCN Commercial |
$562.98
|
| Rate for Payer: BCN Medicare Advantage |
$171.20
|
| Rate for Payer: Cash Price |
$547.85
|
| Rate for Payer: Cofinity Commercial |
$588.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.20
|
| Rate for Payer: Healthscope Commercial |
$616.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$513.61
|
| Rate for Payer: Mclaren Medicaid |
$120.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.76
|
| Rate for Payer: Meridian Medicaid |
$126.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$196.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$188.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$582.09
|
| Rate for Payer: Nomi Health Commercial |
$561.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$513.61
|
| Rate for Payer: PACE Senior Care Partners |
$162.64
|
| Rate for Payer: PACE SWMI |
$171.20
|
| Rate for Payer: PHP Commercial |
$582.09
|
| Rate for Payer: PHP Medicare Advantage |
$171.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$595.78
|
| Rate for Payer: Priority Health Medicare |
$172.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$476.63
|
| Rate for Payer: Railroad Medicare Medicare |
$171.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$602.63
|
| Rate for Payer: UHC Core |
$571.82
|
| Rate for Payer: UHC Exchange |
$171.20
|
| Rate for Payer: UHC Medicaid |
$120.73
|
| Rate for Payer: UHC Medicare Advantage |
$171.20
|
| Rate for Payer: UHCCP Medicaid |
$120.73
|
| Rate for Payer: VA VA |
$171.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$513.61
|
|
|
HC CHEMODNRV EXT1-4 MUSC
|
Facility
|
IP
|
$684.81
|
|
|
Service Code
|
CPT 64642
|
| Hospital Charge Code |
36100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$476.63 |
| Max. Negotiated Rate |
$616.33 |
| Rate for Payer: Aetna Commercial |
$582.09
|
| Rate for Payer: BCBS Trust/PPO |
$565.58
|
| Rate for Payer: BCN Commercial |
$565.58
|
| Rate for Payer: Cash Price |
$547.85
|
| Rate for Payer: Cofinity Commercial |
$588.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.85
|
| Rate for Payer: Healthscope Commercial |
$616.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$513.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$582.09
|
| Rate for Payer: Nomi Health Commercial |
$561.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$513.61
|
| Rate for Payer: PHP Commercial |
$582.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$595.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$476.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$602.63
|
| Rate for Payer: UHC Core |
$571.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$513.61
|
|
