|
HC CHEMODNRV EXTREMITY 5/< MUSCLES
|
Facility
|
OP
|
$117.90
|
|
|
Service Code
|
CPT 64645
|
| Hospital Charge Code |
36100550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$20.79 |
| Max. Negotiated Rate |
$106.11 |
| Rate for Payer: Aetna Commercial |
$100.22
|
| Rate for Payer: Aetna Medicare |
$30.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.84
|
| Rate for Payer: BCBS Complete |
$21.82
|
| Rate for Payer: BCBS MAPPO |
$29.48
|
| Rate for Payer: BCBS Trust/PPO |
$96.93
|
| Rate for Payer: BCN Commercial |
$96.93
|
| Rate for Payer: BCN Medicare Advantage |
$29.48
|
| Rate for Payer: Cash Price |
$94.32
|
| Rate for Payer: Cofinity Commercial |
$101.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.48
|
| Rate for Payer: Healthscope Commercial |
$106.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.42
|
| Rate for Payer: Mclaren Medicaid |
$20.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.95
|
| Rate for Payer: Meridian Medicaid |
$21.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.22
|
| Rate for Payer: Nomi Health Commercial |
$96.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.42
|
| Rate for Payer: PACE Senior Care Partners |
$28.00
|
| Rate for Payer: PACE SWMI |
$29.48
|
| Rate for Payer: PHP Commercial |
$100.22
|
| Rate for Payer: PHP Medicare Advantage |
$29.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.57
|
| Rate for Payer: Priority Health Medicare |
$29.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.06
|
| Rate for Payer: Railroad Medicare Medicare |
$29.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.75
|
| Rate for Payer: UHC Core |
$98.45
|
| Rate for Payer: UHC Exchange |
$29.48
|
| Rate for Payer: UHC Medicaid |
$20.79
|
| Rate for Payer: UHC Medicare Advantage |
$29.48
|
| Rate for Payer: UHCCP Medicaid |
$20.79
|
| Rate for Payer: VA VA |
$29.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.42
|
|
|
HC CHEMODNRV EXTREMITY 5/< MUSCLES
|
Facility
|
IP
|
$117.90
|
|
|
Service Code
|
CPT 64645
|
| Hospital Charge Code |
36100550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$82.06 |
| Max. Negotiated Rate |
$106.11 |
| Rate for Payer: Aetna Commercial |
$100.22
|
| Rate for Payer: BCBS Trust/PPO |
$97.37
|
| Rate for Payer: BCN Commercial |
$97.37
|
| Rate for Payer: Cash Price |
$94.32
|
| Rate for Payer: Cofinity Commercial |
$101.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.32
|
| Rate for Payer: Healthscope Commercial |
$106.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.22
|
| Rate for Payer: Nomi Health Commercial |
$96.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.42
|
| Rate for Payer: PHP Commercial |
$100.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.75
|
| Rate for Payer: UHC Core |
$98.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.42
|
|
|
HC CHEMODNRV EXTREMITY 5 OR MORE MUSCLES
|
Facility
|
IP
|
$538.03
|
|
|
Service Code
|
CPT 64644
|
| Hospital Charge Code |
36100547
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$374.47 |
| Max. Negotiated Rate |
$484.23 |
| Rate for Payer: Aetna Commercial |
$457.33
|
| Rate for Payer: BCBS Trust/PPO |
$444.36
|
| Rate for Payer: BCN Commercial |
$444.36
|
| Rate for Payer: Cash Price |
$430.42
|
| Rate for Payer: Cofinity Commercial |
$462.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.42
|
| Rate for Payer: Healthscope Commercial |
$484.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$403.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.33
|
| Rate for Payer: Nomi Health Commercial |
$441.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.52
|
| Rate for Payer: PHP Commercial |
$457.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$468.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$374.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.47
|
| Rate for Payer: UHC Core |
$449.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$403.52
|
|
|
HC CHEMODNRV EXTREMITY 5 OR MORE MUSCLES
|
Facility
|
OP
|
$538.03
|
|
|
Service Code
|
CPT 64644
|
| Hospital Charge Code |
36100547
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$94.85 |
| Max. Negotiated Rate |
$484.23 |
| Rate for Payer: Aetna Commercial |
$457.33
|
| Rate for Payer: Aetna Medicare |
$139.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$168.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$168.13
|
| Rate for Payer: BCBS Complete |
$99.59
|
| Rate for Payer: BCBS MAPPO |
$134.51
|
| Rate for Payer: BCBS Trust/PPO |
$442.31
|
| Rate for Payer: BCN Commercial |
$442.31
|
| Rate for Payer: BCN Medicare Advantage |
$134.51
|
| Rate for Payer: Cash Price |
$430.42
|
| Rate for Payer: Cofinity Commercial |
$462.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.51
|
| Rate for Payer: Healthscope Commercial |
$484.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$403.52
|
| Rate for Payer: Mclaren Medicaid |
$94.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.23
|
| Rate for Payer: Meridian Medicaid |
$99.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$154.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.33
|
| Rate for Payer: Nomi Health Commercial |
$441.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.52
|
| Rate for Payer: PACE Senior Care Partners |
$127.78
|
| Rate for Payer: PACE SWMI |
$134.51
|
| Rate for Payer: PHP Commercial |
$457.33
|
| Rate for Payer: PHP Medicare Advantage |
$134.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$468.09
|
| Rate for Payer: Priority Health Medicare |
$135.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$374.47
|
| Rate for Payer: Railroad Medicare Medicare |
$134.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.47
|
| Rate for Payer: UHC Core |
$449.26
|
| Rate for Payer: UHC Exchange |
$134.51
|
| Rate for Payer: UHC Medicaid |
$94.85
|
| Rate for Payer: UHC Medicare Advantage |
$134.51
|
| Rate for Payer: UHCCP Medicaid |
$94.85
|
| Rate for Payer: VA VA |
$134.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$403.52
|
|
|
HC CHEMODNRV MUSC FACIAL
|
Facility
|
OP
|
$552.83
|
|
|
Service Code
|
CPT 64612
|
| Hospital Charge Code |
36100472
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.46 |
| Max. Negotiated Rate |
$497.55 |
| Rate for Payer: Aetna Commercial |
$469.91
|
| Rate for Payer: Aetna Medicare |
$143.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.76
|
| Rate for Payer: BCBS Complete |
$102.33
|
| Rate for Payer: BCBS MAPPO |
$138.21
|
| Rate for Payer: BCBS Trust/PPO |
$454.48
|
| Rate for Payer: BCN Commercial |
$454.48
|
| Rate for Payer: BCN Medicare Advantage |
$138.21
|
| Rate for Payer: Cash Price |
$442.26
|
| Rate for Payer: Cofinity Commercial |
$475.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.21
|
| Rate for Payer: Healthscope Commercial |
$497.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$414.62
|
| Rate for Payer: Mclaren Medicaid |
$97.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.12
|
| Rate for Payer: Meridian Medicaid |
$102.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$158.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$469.91
|
| Rate for Payer: Nomi Health Commercial |
$453.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$414.62
|
| Rate for Payer: PACE Senior Care Partners |
$131.30
|
| Rate for Payer: PACE SWMI |
$138.21
|
| Rate for Payer: PHP Commercial |
$469.91
|
| Rate for Payer: PHP Medicare Advantage |
$138.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$480.96
|
| Rate for Payer: Priority Health Medicare |
$139.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.77
|
| Rate for Payer: Railroad Medicare Medicare |
$138.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$486.49
|
| Rate for Payer: UHC Core |
$461.61
|
| Rate for Payer: UHC Exchange |
$138.21
|
| Rate for Payer: UHC Medicaid |
$97.46
|
| Rate for Payer: UHC Medicare Advantage |
$138.21
|
| Rate for Payer: UHCCP Medicaid |
$97.46
|
| Rate for Payer: VA VA |
$138.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$414.62
|
|
|
HC CHEMODNRV MUSC FACIAL
|
Facility
|
IP
|
$552.83
|
|
|
Service Code
|
CPT 64612
|
| Hospital Charge Code |
36100472
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$384.77 |
| Max. Negotiated Rate |
$497.55 |
| Rate for Payer: Aetna Commercial |
$469.91
|
| Rate for Payer: BCBS Trust/PPO |
$456.58
|
| Rate for Payer: BCN Commercial |
$456.58
|
| Rate for Payer: Cash Price |
$442.26
|
| Rate for Payer: Cofinity Commercial |
$475.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.26
|
| Rate for Payer: Healthscope Commercial |
$497.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$414.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$469.91
|
| Rate for Payer: Nomi Health Commercial |
$453.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$414.62
|
| Rate for Payer: PHP Commercial |
$469.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$480.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$384.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$486.49
|
| Rate for Payer: UHC Core |
$461.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$414.62
|
|
|
HC CHEMODNRV MUSC FACIAL BIL
|
Facility
|
IP
|
$675.67
|
|
|
Service Code
|
CPT 64612
|
| Hospital Charge Code |
36100473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$470.27 |
| Max. Negotiated Rate |
$608.10 |
| Rate for Payer: Aetna Commercial |
$574.32
|
| Rate for Payer: BCBS Trust/PPO |
$558.04
|
| Rate for Payer: BCN Commercial |
$558.04
|
| Rate for Payer: Cash Price |
$540.54
|
| Rate for Payer: Cofinity Commercial |
$581.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.54
|
| Rate for Payer: Healthscope Commercial |
$608.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$506.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.32
|
| Rate for Payer: Nomi Health Commercial |
$554.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.75
|
| Rate for Payer: PHP Commercial |
$574.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$587.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$470.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$594.59
|
| Rate for Payer: UHC Core |
$564.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$506.75
|
|
|
HC CHEMODNRV MUSC FACIAL BIL
|
Facility
|
OP
|
$675.67
|
|
|
Service Code
|
CPT 64612
|
| Hospital Charge Code |
36100473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$119.12 |
| Max. Negotiated Rate |
$608.10 |
| Rate for Payer: Aetna Commercial |
$574.32
|
| Rate for Payer: Aetna Medicare |
$175.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$211.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$211.15
|
| Rate for Payer: BCBS Complete |
$125.07
|
| Rate for Payer: BCBS MAPPO |
$168.92
|
| Rate for Payer: BCBS Trust/PPO |
$555.47
|
| Rate for Payer: BCN Commercial |
$555.47
|
| Rate for Payer: BCN Medicare Advantage |
$168.92
|
| Rate for Payer: Cash Price |
$540.54
|
| Rate for Payer: Cofinity Commercial |
$581.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.92
|
| Rate for Payer: Healthscope Commercial |
$608.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$506.75
|
| Rate for Payer: Mclaren Medicaid |
$119.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$177.36
|
| Rate for Payer: Meridian Medicaid |
$125.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$194.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$185.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.32
|
| Rate for Payer: Nomi Health Commercial |
$554.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.75
|
| Rate for Payer: PACE Senior Care Partners |
$160.47
|
| Rate for Payer: PACE SWMI |
$168.92
|
| Rate for Payer: PHP Commercial |
$574.32
|
| Rate for Payer: PHP Medicare Advantage |
$168.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$587.83
|
| Rate for Payer: Priority Health Medicare |
$170.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$470.27
|
| Rate for Payer: Railroad Medicare Medicare |
$168.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$594.59
|
| Rate for Payer: UHC Core |
$564.18
|
| Rate for Payer: UHC Exchange |
$168.92
|
| Rate for Payer: UHC Medicaid |
$119.12
|
| Rate for Payer: UHC Medicare Advantage |
$168.92
|
| Rate for Payer: UHCCP Medicaid |
$119.12
|
| Rate for Payer: VA VA |
$168.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$506.75
|
|
|
HC CHEMODNRV MUSC MIGRAINE BIL
|
Facility
|
OP
|
$245.14
|
|
|
Service Code
|
CPT 64615
|
| Hospital Charge Code |
36100548
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.22 |
| Max. Negotiated Rate |
$220.63 |
| Rate for Payer: Aetna Commercial |
$208.37
|
| Rate for Payer: Aetna Medicare |
$63.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.61
|
| Rate for Payer: BCBS Complete |
$45.38
|
| Rate for Payer: BCBS MAPPO |
$61.28
|
| Rate for Payer: BCBS Trust/PPO |
$201.53
|
| Rate for Payer: BCN Commercial |
$201.53
|
| Rate for Payer: BCN Medicare Advantage |
$61.28
|
| Rate for Payer: Cash Price |
$196.11
|
| Rate for Payer: Cofinity Commercial |
$210.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.28
|
| Rate for Payer: Healthscope Commercial |
$220.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.85
|
| Rate for Payer: Mclaren Medicaid |
$43.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.35
|
| Rate for Payer: Meridian Medicaid |
$45.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.37
|
| Rate for Payer: Nomi Health Commercial |
$201.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.85
|
| Rate for Payer: PACE Senior Care Partners |
$58.22
|
| Rate for Payer: PACE SWMI |
$61.28
|
| Rate for Payer: PHP Commercial |
$208.37
|
| Rate for Payer: PHP Medicare Advantage |
$61.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$213.27
|
| Rate for Payer: Priority Health Medicare |
$61.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.62
|
| Rate for Payer: Railroad Medicare Medicare |
$61.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.72
|
| Rate for Payer: UHC Core |
$204.69
|
| Rate for Payer: UHC Exchange |
$61.28
|
| Rate for Payer: UHC Medicaid |
$43.22
|
| Rate for Payer: UHC Medicare Advantage |
$61.28
|
| Rate for Payer: UHCCP Medicaid |
$43.22
|
| Rate for Payer: VA VA |
$61.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.85
|
|
|
HC CHEMODNRV MUSC MIGRAINE BIL
|
Facility
|
IP
|
$245.14
|
|
|
Service Code
|
CPT 64615
|
| Hospital Charge Code |
36100548
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$170.62 |
| Max. Negotiated Rate |
$220.63 |
| Rate for Payer: Aetna Commercial |
$208.37
|
| Rate for Payer: BCBS Trust/PPO |
$202.46
|
| Rate for Payer: BCN Commercial |
$202.46
|
| Rate for Payer: Cash Price |
$196.11
|
| Rate for Payer: Cofinity Commercial |
$210.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.11
|
| Rate for Payer: Healthscope Commercial |
$220.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.37
|
| Rate for Payer: Nomi Health Commercial |
$201.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.85
|
| Rate for Payer: PHP Commercial |
$208.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$213.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.72
|
| Rate for Payer: UHC Core |
$204.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.85
|
|
|
HC CHEMODNRV MUSC NECK
|
Facility
|
OP
|
$457.39
|
|
|
Service Code
|
CPT 64616
|
| Hospital Charge Code |
36100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$80.64 |
| Max. Negotiated Rate |
$411.65 |
| Rate for Payer: Aetna Commercial |
$388.78
|
| Rate for Payer: Aetna Medicare |
$118.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$142.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$142.93
|
| Rate for Payer: BCBS Complete |
$84.66
|
| Rate for Payer: BCBS MAPPO |
$114.35
|
| Rate for Payer: BCBS Trust/PPO |
$376.02
|
| Rate for Payer: BCN Commercial |
$376.02
|
| Rate for Payer: BCN Medicare Advantage |
$114.35
|
| Rate for Payer: Cash Price |
$365.91
|
| Rate for Payer: Cofinity Commercial |
$393.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.35
|
| Rate for Payer: Healthscope Commercial |
$411.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$343.04
|
| Rate for Payer: Mclaren Medicaid |
$80.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.06
|
| Rate for Payer: Meridian Medicaid |
$84.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$131.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$125.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.78
|
| Rate for Payer: Nomi Health Commercial |
$375.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$343.04
|
| Rate for Payer: PACE Senior Care Partners |
$108.63
|
| Rate for Payer: PACE SWMI |
$114.35
|
| Rate for Payer: PHP Commercial |
$388.78
|
| Rate for Payer: PHP Medicare Advantage |
$114.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$397.93
|
| Rate for Payer: Priority Health Medicare |
$115.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.34
|
| Rate for Payer: Railroad Medicare Medicare |
$114.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402.50
|
| Rate for Payer: UHC Core |
$381.92
|
| Rate for Payer: UHC Exchange |
$114.35
|
| Rate for Payer: UHC Medicaid |
$80.64
|
| Rate for Payer: UHC Medicare Advantage |
$114.35
|
| Rate for Payer: UHCCP Medicaid |
$80.64
|
| Rate for Payer: VA VA |
$114.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$343.04
|
|
|
HC CHEMODNRV MUSC NECK
|
Facility
|
IP
|
$457.39
|
|
|
Service Code
|
CPT 64616
|
| Hospital Charge Code |
36100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$318.34 |
| Max. Negotiated Rate |
$411.65 |
| Rate for Payer: Aetna Commercial |
$388.78
|
| Rate for Payer: BCBS Trust/PPO |
$377.76
|
| Rate for Payer: BCN Commercial |
$377.76
|
| Rate for Payer: Cash Price |
$365.91
|
| Rate for Payer: Cofinity Commercial |
$393.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.91
|
| Rate for Payer: Healthscope Commercial |
$411.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$343.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.78
|
| Rate for Payer: Nomi Health Commercial |
$375.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$343.04
|
| Rate for Payer: PHP Commercial |
$388.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$397.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$318.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402.50
|
| Rate for Payer: UHC Core |
$381.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$343.04
|
|
|
HC CHEMODNRV TRUNK MUSC 1-5 MUSC
|
Facility
|
OP
|
$710.37
|
|
|
Service Code
|
CPT 64646
|
| Hospital Charge Code |
36100453
|
|
Hospital Revenue Code
|
361
|
| 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 TRUNK MUSC 1-5 MUSC
|
Facility
|
IP
|
$710.37
|
|
|
Service Code
|
CPT 64646
|
| Hospital Charge Code |
36100453
|
|
Hospital Revenue Code
|
361
|
| 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 CHEMO INFUSION CONCURRENT
|
Facility
|
OP
|
$201.63
|
|
|
Service Code
|
CPT 96549
|
| Hospital Charge Code |
33500011
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$35.55 |
| Max. Negotiated Rate |
$181.47 |
| Rate for Payer: Aetna Commercial |
$171.39
|
| Rate for Payer: Aetna Medicare |
$52.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.01
|
| Rate for Payer: BCBS Complete |
$37.32
|
| Rate for Payer: BCBS MAPPO |
$50.41
|
| Rate for Payer: BCBS Trust/PPO |
$165.76
|
| Rate for Payer: BCN Commercial |
$165.76
|
| Rate for Payer: BCN Medicare Advantage |
$50.41
|
| Rate for Payer: Cash Price |
$161.30
|
| Rate for Payer: Cofinity Commercial |
$173.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.41
|
| Rate for Payer: Healthscope Commercial |
$181.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.22
|
| Rate for Payer: Mclaren Medicaid |
$35.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.93
|
| Rate for Payer: Meridian Medicaid |
$37.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.39
|
| Rate for Payer: Nomi Health Commercial |
$165.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.22
|
| Rate for Payer: PACE Senior Care Partners |
$47.89
|
| Rate for Payer: PACE SWMI |
$50.41
|
| Rate for Payer: PHP Commercial |
$171.39
|
| Rate for Payer: PHP Medicare Advantage |
$50.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$175.42
|
| Rate for Payer: Priority Health Medicare |
$50.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.33
|
| Rate for Payer: Railroad Medicare Medicare |
$50.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.43
|
| Rate for Payer: UHC Core |
$168.36
|
| Rate for Payer: UHC Exchange |
$50.41
|
| Rate for Payer: UHC Medicaid |
$35.55
|
| Rate for Payer: UHC Medicare Advantage |
$50.41
|
| Rate for Payer: UHCCP Medicaid |
$35.55
|
| Rate for Payer: VA VA |
$50.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.22
|
|
|
HC CHEMO INFUSION CONCURRENT
|
Facility
|
IP
|
$201.63
|
|
|
Service Code
|
CPT 96549
|
| Hospital Charge Code |
33500011
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$140.33 |
| Max. Negotiated Rate |
$181.47 |
| Rate for Payer: Aetna Commercial |
$171.39
|
| Rate for Payer: BCBS Trust/PPO |
$166.53
|
| Rate for Payer: BCN Commercial |
$166.53
|
| Rate for Payer: Cash Price |
$161.30
|
| Rate for Payer: Cofinity Commercial |
$173.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.30
|
| Rate for Payer: Healthscope Commercial |
$181.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.39
|
| Rate for Payer: Nomi Health Commercial |
$165.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.22
|
| Rate for Payer: PHP Commercial |
$171.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$175.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.43
|
| Rate for Payer: UHC Core |
$168.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.22
|
|
|
HC CHEMO INFUSION EACH ADDL HR
|
Facility
|
IP
|
$267.37
|
|
|
Service Code
|
CPT 96415
|
| Hospital Charge Code |
33500002
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$186.09 |
| Max. Negotiated Rate |
$240.63 |
| Rate for Payer: Aetna Commercial |
$227.26
|
| Rate for Payer: BCBS Trust/PPO |
$220.82
|
| Rate for Payer: BCN Commercial |
$220.82
|
| Rate for Payer: Cash Price |
$213.90
|
| Rate for Payer: Cofinity Commercial |
$229.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.90
|
| Rate for Payer: Healthscope Commercial |
$240.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.26
|
| Rate for Payer: Nomi Health Commercial |
$219.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.53
|
| Rate for Payer: PHP Commercial |
$227.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$232.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.29
|
| Rate for Payer: UHC Core |
$223.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.53
|
|
|
HC CHEMO INFUSION EACH ADDL HR
|
Facility
|
OP
|
$267.37
|
|
|
Service Code
|
CPT 96415
|
| Hospital Charge Code |
33500002
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$47.14 |
| Max. Negotiated Rate |
$240.63 |
| Rate for Payer: Aetna Commercial |
$227.26
|
| Rate for Payer: Aetna Medicare |
$69.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.55
|
| Rate for Payer: BCBS Complete |
$49.49
|
| Rate for Payer: BCBS MAPPO |
$66.84
|
| Rate for Payer: BCBS Trust/PPO |
$219.80
|
| Rate for Payer: BCN Commercial |
$219.80
|
| Rate for Payer: BCN Medicare Advantage |
$66.84
|
| Rate for Payer: Cash Price |
$213.90
|
| Rate for Payer: Cofinity Commercial |
$229.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.84
|
| Rate for Payer: Healthscope Commercial |
$240.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.53
|
| Rate for Payer: Mclaren Medicaid |
$47.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.18
|
| Rate for Payer: Meridian Medicaid |
$49.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.26
|
| Rate for Payer: Nomi Health Commercial |
$219.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.53
|
| Rate for Payer: PACE Senior Care Partners |
$63.50
|
| Rate for Payer: PACE SWMI |
$66.84
|
| Rate for Payer: PHP Commercial |
$227.26
|
| Rate for Payer: PHP Medicare Advantage |
$66.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$232.61
|
| Rate for Payer: Priority Health Medicare |
$67.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.09
|
| Rate for Payer: Railroad Medicare Medicare |
$66.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$235.29
|
| Rate for Payer: UHC Core |
$223.25
|
| Rate for Payer: UHC Exchange |
$66.84
|
| Rate for Payer: UHC Medicaid |
$47.14
|
| Rate for Payer: UHC Medicare Advantage |
$66.84
|
| Rate for Payer: UHCCP Medicaid |
$47.14
|
| Rate for Payer: VA VA |
$66.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.53
|
|
|
HC CHEMO INFUSION FIRST HR
|
Facility
|
OP
|
$993.45
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
33500001
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$175.15 |
| Max. Negotiated Rate |
$894.11 |
| Rate for Payer: Aetna Commercial |
$844.43
|
| Rate for Payer: Aetna Medicare |
$258.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$310.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$310.45
|
| Rate for Payer: BCBS Complete |
$183.89
|
| Rate for Payer: BCBS MAPPO |
$248.36
|
| Rate for Payer: BCBS Trust/PPO |
$816.72
|
| Rate for Payer: BCN Commercial |
$816.72
|
| Rate for Payer: BCN Medicare Advantage |
$248.36
|
| Rate for Payer: Cash Price |
$794.76
|
| Rate for Payer: Cofinity Commercial |
$854.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$794.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.36
|
| Rate for Payer: Healthscope Commercial |
$894.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$745.09
|
| Rate for Payer: Mclaren Medicaid |
$175.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$260.78
|
| Rate for Payer: Meridian Medicaid |
$183.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$285.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$844.43
|
| Rate for Payer: Nomi Health Commercial |
$814.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$745.09
|
| Rate for Payer: PACE Senior Care Partners |
$235.94
|
| Rate for Payer: PACE SWMI |
$248.36
|
| Rate for Payer: PHP Commercial |
$844.43
|
| Rate for Payer: PHP Medicare Advantage |
$248.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$175.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$864.30
|
| Rate for Payer: Priority Health Medicare |
$250.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$691.44
|
| Rate for Payer: Railroad Medicare Medicare |
$248.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$874.24
|
| Rate for Payer: UHC Core |
$829.53
|
| Rate for Payer: UHC Exchange |
$248.36
|
| Rate for Payer: UHC Medicaid |
$175.15
|
| Rate for Payer: UHC Medicare Advantage |
$248.36
|
| Rate for Payer: UHCCP Medicaid |
$175.15
|
| Rate for Payer: VA VA |
$248.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$745.09
|
|
|
HC CHEMO INFUSION FIRST HR
|
Facility
|
IP
|
$993.45
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
33500001
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$691.44 |
| Max. Negotiated Rate |
$894.11 |
| Rate for Payer: Aetna Commercial |
$844.43
|
| Rate for Payer: BCBS Trust/PPO |
$820.49
|
| Rate for Payer: BCN Commercial |
$820.49
|
| Rate for Payer: Cash Price |
$794.76
|
| Rate for Payer: Cofinity Commercial |
$854.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$794.76
|
| Rate for Payer: Healthscope Commercial |
$894.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$745.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$844.43
|
| Rate for Payer: Nomi Health Commercial |
$814.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$745.09
|
| Rate for Payer: PHP Commercial |
$844.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$864.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$691.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$874.24
|
| Rate for Payer: UHC Core |
$829.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$745.09
|
|
|
HC CHEMO INFUSION VIA PUMP
|
Facility
|
OP
|
$900.20
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
33500003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$158.71 |
| Max. Negotiated Rate |
$810.18 |
| Rate for Payer: Aetna Commercial |
$765.17
|
| Rate for Payer: Aetna Medicare |
$234.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$281.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$281.31
|
| Rate for Payer: BCBS Complete |
$166.63
|
| Rate for Payer: BCBS MAPPO |
$225.05
|
| Rate for Payer: BCBS Trust/PPO |
$740.05
|
| Rate for Payer: BCN Commercial |
$740.05
|
| Rate for Payer: BCN Medicare Advantage |
$225.05
|
| Rate for Payer: Cash Price |
$720.16
|
| Rate for Payer: Cofinity Commercial |
$774.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.05
|
| Rate for Payer: Healthscope Commercial |
$810.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$675.15
|
| Rate for Payer: Mclaren Medicaid |
$158.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.30
|
| Rate for Payer: Meridian Medicaid |
$166.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$258.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$247.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$765.17
|
| Rate for Payer: Nomi Health Commercial |
$738.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$675.15
|
| Rate for Payer: PACE Senior Care Partners |
$213.80
|
| Rate for Payer: PACE SWMI |
$225.05
|
| Rate for Payer: PHP Commercial |
$765.17
|
| Rate for Payer: PHP Medicare Advantage |
$225.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$783.17
|
| Rate for Payer: Priority Health Medicare |
$227.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$626.54
|
| Rate for Payer: Railroad Medicare Medicare |
$225.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$792.18
|
| Rate for Payer: UHC Core |
$751.67
|
| Rate for Payer: UHC Exchange |
$225.05
|
| Rate for Payer: UHC Medicaid |
$158.71
|
| Rate for Payer: UHC Medicare Advantage |
$225.05
|
| Rate for Payer: UHCCP Medicaid |
$158.71
|
| Rate for Payer: VA VA |
$225.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$675.15
|
|
|
HC CHEMO INFUSION VIA PUMP
|
Facility
|
IP
|
$900.20
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
33500003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$626.54 |
| Max. Negotiated Rate |
$810.18 |
| Rate for Payer: Aetna Commercial |
$765.17
|
| Rate for Payer: BCBS Trust/PPO |
$743.48
|
| Rate for Payer: BCN Commercial |
$743.48
|
| Rate for Payer: Cash Price |
$720.16
|
| Rate for Payer: Cofinity Commercial |
$774.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.16
|
| Rate for Payer: Healthscope Commercial |
$810.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$675.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$765.17
|
| Rate for Payer: Nomi Health Commercial |
$738.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$675.15
|
| Rate for Payer: PHP Commercial |
$765.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$783.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$626.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$792.18
|
| Rate for Payer: UHC Core |
$751.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$675.15
|
|
|
HC CHEMO INFUS SEQUENTIAL UP TO 1 HR
|
Facility
|
OP
|
$449.04
|
|
|
Service Code
|
CPT 96417
|
| Hospital Charge Code |
33500004
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$79.17 |
| Max. Negotiated Rate |
$404.14 |
| Rate for Payer: Aetna Commercial |
$381.68
|
| Rate for Payer: Aetna Medicare |
$116.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$140.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$140.32
|
| Rate for Payer: BCBS Complete |
$83.12
|
| Rate for Payer: BCBS MAPPO |
$112.26
|
| Rate for Payer: BCBS Trust/PPO |
$369.16
|
| Rate for Payer: BCN Commercial |
$369.16
|
| Rate for Payer: BCN Medicare Advantage |
$112.26
|
| Rate for Payer: Cash Price |
$359.23
|
| Rate for Payer: Cofinity Commercial |
$386.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.26
|
| Rate for Payer: Healthscope Commercial |
$404.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$336.78
|
| Rate for Payer: Mclaren Medicaid |
$79.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.87
|
| Rate for Payer: Meridian Medicaid |
$83.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$381.68
|
| Rate for Payer: Nomi Health Commercial |
$368.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$336.78
|
| Rate for Payer: PACE Senior Care Partners |
$106.65
|
| Rate for Payer: PACE SWMI |
$112.26
|
| Rate for Payer: PHP Commercial |
$381.68
|
| Rate for Payer: PHP Medicare Advantage |
$112.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$390.66
|
| Rate for Payer: Priority Health Medicare |
$113.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$312.53
|
| Rate for Payer: Railroad Medicare Medicare |
$112.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.16
|
| Rate for Payer: UHC Core |
$374.95
|
| Rate for Payer: UHC Exchange |
$112.26
|
| Rate for Payer: UHC Medicaid |
$79.17
|
| Rate for Payer: UHC Medicare Advantage |
$112.26
|
| Rate for Payer: UHCCP Medicaid |
$79.17
|
| Rate for Payer: VA VA |
$112.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$336.78
|
|
|
HC CHEMO INFUS SEQUENTIAL UP TO 1 HR
|
Facility
|
IP
|
$449.04
|
|
|
Service Code
|
CPT 96417
|
| Hospital Charge Code |
33500004
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$312.53 |
| Max. Negotiated Rate |
$404.14 |
| Rate for Payer: Aetna Commercial |
$381.68
|
| Rate for Payer: BCBS Trust/PPO |
$370.86
|
| Rate for Payer: BCN Commercial |
$370.86
|
| Rate for Payer: Cash Price |
$359.23
|
| Rate for Payer: Cofinity Commercial |
$386.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.23
|
| Rate for Payer: Healthscope Commercial |
$404.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$336.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$381.68
|
| Rate for Payer: Nomi Health Commercial |
$368.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$336.78
|
| Rate for Payer: PHP Commercial |
$381.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$390.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$312.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.16
|
| Rate for Payer: UHC Core |
$374.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$336.78
|
|
|
HC CHEMO INTO PERITONEAL CAVITY VIA PORT
|
Facility
|
IP
|
$447.42
|
|
|
Service Code
|
CPT 96446
|
| Hospital Charge Code |
33500007
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$311.40 |
| Max. Negotiated Rate |
$402.68 |
| Rate for Payer: Aetna Commercial |
$380.31
|
| Rate for Payer: BCBS Trust/PPO |
$369.52
|
| Rate for Payer: BCN Commercial |
$369.52
|
| Rate for Payer: Cash Price |
$357.94
|
| Rate for Payer: Cofinity Commercial |
$384.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.94
|
| Rate for Payer: Healthscope Commercial |
$402.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.31
|
| Rate for Payer: Nomi Health Commercial |
$366.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.56
|
| Rate for Payer: PHP Commercial |
$380.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$389.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.73
|
| Rate for Payer: UHC Core |
$373.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.56
|
|
