|
HC COMMON REED IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200080
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC COMM WORK REINTEGRATION EA 15 MIN
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
42000031
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$17.43 |
| 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 |
$18.30
|
| Rate for Payer: BCBS MAPPO |
$24.71
|
| Rate for Payer: BCBS Trust/PPO |
$81.26
|
| Rate for Payer: BCN Commercial |
$81.26
|
| Rate for Payer: BCN Medicare Advantage |
$24.71
|
| 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 |
$17.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.95
|
| Rate for Payer: Meridian Medicaid |
$18.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| 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 |
$17.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Medicare |
$24.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.79
|
| 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 Exchange |
$24.71
|
| Rate for Payer: UHC Medicaid |
$17.43
|
| Rate for Payer: UHC Medicare Advantage |
$24.71
|
| Rate for Payer: UHCCP Medicaid |
$17.43
|
| Rate for Payer: VA VA |
$24.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC COMM WORK REINTEGRATION EA 15 MIN
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
42000031
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$68.79 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: BCBS Trust/PPO |
$81.63
|
| Rate for Payer: BCN Commercial |
$81.63
|
| 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: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.79
|
| 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 COMPARTMENT PRESSURE CHECK
|
Facility
|
OP
|
$671.79
|
|
| Hospital Charge Code |
27000045
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$118.44 |
| Max. Negotiated Rate |
$604.61 |
| Rate for Payer: Aetna Commercial |
$571.02
|
| Rate for Payer: Aetna Medicare |
$174.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.93
|
| Rate for Payer: BCBS Complete |
$124.35
|
| Rate for Payer: BCBS MAPPO |
$167.95
|
| Rate for Payer: BCBS Trust/PPO |
$552.28
|
| Rate for Payer: BCN Commercial |
$552.28
|
| Rate for Payer: BCN Medicare Advantage |
$167.95
|
| Rate for Payer: Cash Price |
$537.43
|
| Rate for Payer: Cofinity Commercial |
$577.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.95
|
| Rate for Payer: Healthscope Commercial |
$604.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.84
|
| Rate for Payer: Mclaren Medicaid |
$118.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.34
|
| Rate for Payer: Meridian Medicaid |
$124.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$571.02
|
| Rate for Payer: Nomi Health Commercial |
$550.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$503.84
|
| Rate for Payer: PACE Senior Care Partners |
$159.55
|
| Rate for Payer: PACE SWMI |
$167.95
|
| Rate for Payer: PHP Commercial |
$571.02
|
| Rate for Payer: PHP Medicare Advantage |
$167.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$584.46
|
| Rate for Payer: Priority Health Medicare |
$169.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$467.57
|
| Rate for Payer: Railroad Medicare Medicare |
$167.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$591.18
|
| Rate for Payer: UHC Core |
$560.94
|
| Rate for Payer: UHC Exchange |
$167.95
|
| Rate for Payer: UHC Medicaid |
$118.44
|
| Rate for Payer: UHC Medicare Advantage |
$167.95
|
| Rate for Payer: UHCCP Medicaid |
$118.44
|
| Rate for Payer: VA VA |
$167.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.84
|
|
|
HC COMPARTMENT PRESSURE CHECK
|
Facility
|
IP
|
$671.79
|
|
| Hospital Charge Code |
27000045
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$467.57 |
| Max. Negotiated Rate |
$604.61 |
| Rate for Payer: Aetna Commercial |
$571.02
|
| Rate for Payer: BCBS Trust/PPO |
$554.83
|
| Rate for Payer: BCN Commercial |
$554.83
|
| Rate for Payer: Cash Price |
$537.43
|
| Rate for Payer: Cofinity Commercial |
$577.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.43
|
| Rate for Payer: Healthscope Commercial |
$604.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$571.02
|
| Rate for Payer: Nomi Health Commercial |
$550.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$503.84
|
| Rate for Payer: PHP Commercial |
$571.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$584.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$467.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$591.18
|
| Rate for Payer: UHC Core |
$560.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.84
|
|
|
HC COMP BURN GARM 2 LEGS-WAIST
|
Facility
|
IP
|
$243.45
|
|
|
Service Code
|
HCPCS A6511
|
| Hospital Charge Code |
98300142
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$169.44 |
| Max. Negotiated Rate |
$219.10 |
| Rate for Payer: Aetna Commercial |
$206.93
|
| Rate for Payer: BCBS Trust/PPO |
$201.07
|
| Rate for Payer: BCN Commercial |
$201.07
|
| Rate for Payer: Cash Price |
$194.76
|
| Rate for Payer: Cofinity Commercial |
$209.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.76
|
| Rate for Payer: Healthscope Commercial |
$219.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.93
|
| Rate for Payer: Nomi Health Commercial |
$199.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.59
|
| Rate for Payer: PHP Commercial |
$206.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$211.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.24
|
| Rate for Payer: UHC Core |
$203.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.59
|
|
|
HC COMP BURN GARM 2 LEGS-WAIST
|
Facility
|
OP
|
$243.45
|
|
|
Service Code
|
HCPCS A6511
|
| Hospital Charge Code |
98300142
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$42.92 |
| Max. Negotiated Rate |
$219.10 |
| Rate for Payer: Aetna Commercial |
$206.93
|
| Rate for Payer: Aetna Medicare |
$63.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.08
|
| Rate for Payer: BCBS Complete |
$45.06
|
| Rate for Payer: BCBS MAPPO |
$60.86
|
| Rate for Payer: BCBS Trust/PPO |
$200.14
|
| Rate for Payer: BCN Commercial |
$200.14
|
| Rate for Payer: BCN Medicare Advantage |
$60.86
|
| Rate for Payer: Cash Price |
$194.76
|
| Rate for Payer: Cofinity Commercial |
$209.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.86
|
| Rate for Payer: Healthscope Commercial |
$219.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.59
|
| Rate for Payer: Mclaren Medicaid |
$42.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.91
|
| Rate for Payer: Meridian Medicaid |
$45.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$66.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.93
|
| Rate for Payer: Nomi Health Commercial |
$199.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.59
|
| Rate for Payer: PACE Senior Care Partners |
$57.82
|
| Rate for Payer: PACE SWMI |
$60.86
|
| Rate for Payer: PHP Commercial |
$206.93
|
| Rate for Payer: PHP Medicare Advantage |
$60.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$211.80
|
| Rate for Payer: Priority Health Medicare |
$61.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.44
|
| Rate for Payer: Railroad Medicare Medicare |
$60.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.24
|
| Rate for Payer: UHC Core |
$203.28
|
| Rate for Payer: UHC Exchange |
$60.86
|
| Rate for Payer: UHC Medicaid |
$42.92
|
| Rate for Payer: UHC Medicare Advantage |
$60.86
|
| Rate for Payer: UHCCP Medicaid |
$42.92
|
| Rate for Payer: VA VA |
$60.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.59
|
|
|
HC COMP BURN GARM 2 OR MORE FAB/C
|
Facility
|
IP
|
$12.48
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.69 |
| Max. Negotiated Rate |
$11.23 |
| Rate for Payer: Aetna Commercial |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$10.31
|
| Rate for Payer: BCN Commercial |
$10.31
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$10.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$11.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: Nomi Health Commercial |
$10.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.36
|
| Rate for Payer: PHP Commercial |
$10.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.98
|
| Rate for Payer: UHC Core |
$10.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.36
|
|
|
HC COMP BURN GARM 2 OR MORE FAB/C
|
Facility
|
OP
|
$12.48
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$11.23 |
| Rate for Payer: Aetna Commercial |
$10.61
|
| Rate for Payer: Aetna Medicare |
$3.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.90
|
| Rate for Payer: BCBS Complete |
$2.31
|
| Rate for Payer: BCBS MAPPO |
$3.12
|
| Rate for Payer: BCBS Trust/PPO |
$10.26
|
| Rate for Payer: BCN Commercial |
$10.26
|
| Rate for Payer: BCN Medicare Advantage |
$3.12
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$10.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.12
|
| Rate for Payer: Healthscope Commercial |
$11.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.36
|
| Rate for Payer: Mclaren Medicaid |
$2.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.28
|
| Rate for Payer: Meridian Medicaid |
$2.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: Nomi Health Commercial |
$10.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.36
|
| Rate for Payer: PACE Senior Care Partners |
$2.96
|
| Rate for Payer: PACE SWMI |
$3.12
|
| Rate for Payer: PHP Commercial |
$10.61
|
| Rate for Payer: PHP Medicare Advantage |
$3.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.86
|
| Rate for Payer: Priority Health Medicare |
$3.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.69
|
| Rate for Payer: Railroad Medicare Medicare |
$3.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.98
|
| Rate for Payer: UHC Core |
$10.42
|
| Rate for Payer: UHC Exchange |
$3.12
|
| Rate for Payer: UHC Medicaid |
$2.20
|
| Rate for Payer: UHC Medicare Advantage |
$3.12
|
| Rate for Payer: UHCCP Medicaid |
$2.20
|
| Rate for Payer: VA VA |
$3.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.36
|
|
|
HC COMP BURN GARM ABD REINFOR DBL
|
Facility
|
OP
|
$16.65
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300144
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$14.98 |
| Rate for Payer: Aetna Commercial |
$14.15
|
| Rate for Payer: Aetna Medicare |
$4.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.20
|
| Rate for Payer: BCBS Complete |
$3.08
|
| Rate for Payer: BCBS MAPPO |
$4.16
|
| Rate for Payer: BCBS Trust/PPO |
$13.69
|
| Rate for Payer: BCN Commercial |
$13.69
|
| Rate for Payer: BCN Medicare Advantage |
$4.16
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cofinity Commercial |
$14.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.16
|
| Rate for Payer: Healthscope Commercial |
$14.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.49
|
| Rate for Payer: Mclaren Medicaid |
$2.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.37
|
| Rate for Payer: Meridian Medicaid |
$3.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.15
|
| Rate for Payer: Nomi Health Commercial |
$13.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.49
|
| Rate for Payer: PACE Senior Care Partners |
$3.95
|
| Rate for Payer: PACE SWMI |
$4.16
|
| Rate for Payer: PHP Commercial |
$14.15
|
| Rate for Payer: PHP Medicare Advantage |
$4.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.49
|
| Rate for Payer: Priority Health Medicare |
$4.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.59
|
| Rate for Payer: Railroad Medicare Medicare |
$4.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.65
|
| Rate for Payer: UHC Core |
$13.90
|
| Rate for Payer: UHC Exchange |
$4.16
|
| Rate for Payer: UHC Medicaid |
$2.94
|
| Rate for Payer: UHC Medicare Advantage |
$4.16
|
| Rate for Payer: UHCCP Medicaid |
$2.94
|
| Rate for Payer: VA VA |
$4.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.49
|
|
|
HC COMP BURN GARM ABD REINFOR DBL
|
Facility
|
IP
|
$16.65
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300144
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.59 |
| Max. Negotiated Rate |
$14.98 |
| Rate for Payer: Aetna Commercial |
$14.15
|
| Rate for Payer: BCBS Trust/PPO |
$13.75
|
| Rate for Payer: BCN Commercial |
$13.75
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cofinity Commercial |
$14.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$14.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.15
|
| Rate for Payer: Nomi Health Commercial |
$13.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.49
|
| Rate for Payer: PHP Commercial |
$14.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.65
|
| Rate for Payer: UHC Core |
$13.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.49
|
|
|
HC COMP BURN GARM ANKLET
|
Facility
|
IP
|
$64.50
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$44.89 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: BCBS Trust/PPO |
$53.27
|
| Rate for Payer: BCN Commercial |
$53.27
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.76
|
| Rate for Payer: UHC Core |
$53.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
|
HC COMP BURN GARM ANKLET
|
Facility
|
OP
|
$64.50
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.37 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: Aetna Medicare |
$16.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.16
|
| Rate for Payer: BCBS Complete |
$11.94
|
| Rate for Payer: BCBS MAPPO |
$16.12
|
| Rate for Payer: BCBS Trust/PPO |
$53.03
|
| Rate for Payer: BCN Commercial |
$53.03
|
| Rate for Payer: BCN Medicare Advantage |
$16.12
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.12
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: Mclaren Medicaid |
$11.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.93
|
| Rate for Payer: Meridian Medicaid |
$11.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Nomi Health Commercial |
$52.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: PACE Senior Care Partners |
$15.32
|
| Rate for Payer: PACE SWMI |
$16.12
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: PHP Medicare Advantage |
$16.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.12
|
| Rate for Payer: Priority Health Medicare |
$16.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.89
|
| Rate for Payer: Railroad Medicare Medicare |
$16.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.76
|
| Rate for Payer: UHC Core |
$53.86
|
| Rate for Payer: UHC Exchange |
$16.12
|
| Rate for Payer: UHC Medicaid |
$11.37
|
| Rate for Payer: UHC Medicare Advantage |
$16.12
|
| Rate for Payer: UHCCP Medicaid |
$11.37
|
| Rate for Payer: VA VA |
$16.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
|
HC COMP BURN GARM BDY BRF SLVD LE
|
Facility
|
OP
|
$345.41
|
|
|
Service Code
|
HCPCS A6510
|
| Hospital Charge Code |
98300146
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$60.90 |
| Max. Negotiated Rate |
$310.87 |
| Rate for Payer: Aetna Commercial |
$293.60
|
| Rate for Payer: Aetna Medicare |
$89.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.94
|
| Rate for Payer: BCBS Complete |
$63.94
|
| Rate for Payer: BCBS MAPPO |
$86.35
|
| Rate for Payer: BCBS Trust/PPO |
$283.96
|
| Rate for Payer: BCN Commercial |
$283.96
|
| Rate for Payer: BCN Medicare Advantage |
$86.35
|
| Rate for Payer: Cash Price |
$276.33
|
| Rate for Payer: Cofinity Commercial |
$297.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.35
|
| Rate for Payer: Healthscope Commercial |
$310.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.06
|
| Rate for Payer: Mclaren Medicaid |
$60.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.67
|
| Rate for Payer: Meridian Medicaid |
$63.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.60
|
| Rate for Payer: Nomi Health Commercial |
$283.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.06
|
| Rate for Payer: PACE Senior Care Partners |
$82.03
|
| Rate for Payer: PACE SWMI |
$86.35
|
| Rate for Payer: PHP Commercial |
$293.60
|
| Rate for Payer: PHP Medicare Advantage |
$86.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$300.51
|
| Rate for Payer: Priority Health Medicare |
$87.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.41
|
| Rate for Payer: Railroad Medicare Medicare |
$86.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.96
|
| Rate for Payer: UHC Core |
$288.42
|
| Rate for Payer: UHC Exchange |
$86.35
|
| Rate for Payer: UHC Medicaid |
$60.90
|
| Rate for Payer: UHC Medicare Advantage |
$86.35
|
| Rate for Payer: UHCCP Medicaid |
$60.90
|
| Rate for Payer: VA VA |
$86.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.06
|
|
|
HC COMP BURN GARM BDY BRF SLVD LE
|
Facility
|
IP
|
$345.41
|
|
|
Service Code
|
HCPCS A6510
|
| Hospital Charge Code |
98300146
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$240.41 |
| Max. Negotiated Rate |
$310.87 |
| Rate for Payer: Aetna Commercial |
$293.60
|
| Rate for Payer: BCBS Trust/PPO |
$285.27
|
| Rate for Payer: BCN Commercial |
$285.27
|
| Rate for Payer: Cash Price |
$276.33
|
| Rate for Payer: Cofinity Commercial |
$297.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.33
|
| Rate for Payer: Healthscope Commercial |
$310.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.60
|
| Rate for Payer: Nomi Health Commercial |
$283.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.06
|
| Rate for Payer: PHP Commercial |
$293.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$300.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.96
|
| Rate for Payer: UHC Core |
$288.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.06
|
|
|
HC COMP BURN GARM BELLY BAND
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300147
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.34 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$7.70
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$34.22
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$7.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$7.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.97
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicaid |
$7.34
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$7.34
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC COMP BURN GARM BELLY BAND
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300147
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$34.37
|
| Rate for Payer: BCN Commercial |
$34.37
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC COMP BURN GARM BODY BRF SLEEVE
|
Facility
|
OP
|
$245.53
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300148
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$43.29 |
| Max. Negotiated Rate |
$220.98 |
| Rate for Payer: Aetna Commercial |
$208.70
|
| Rate for Payer: Aetna Medicare |
$63.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.73
|
| Rate for Payer: BCBS Complete |
$45.45
|
| Rate for Payer: BCBS MAPPO |
$61.38
|
| Rate for Payer: BCBS Trust/PPO |
$201.85
|
| Rate for Payer: BCN Commercial |
$201.85
|
| Rate for Payer: BCN Medicare Advantage |
$61.38
|
| Rate for Payer: Cash Price |
$196.42
|
| Rate for Payer: Cofinity Commercial |
$211.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.38
|
| Rate for Payer: Healthscope Commercial |
$220.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.15
|
| Rate for Payer: Mclaren Medicaid |
$43.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.45
|
| Rate for Payer: Meridian Medicaid |
$45.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.70
|
| Rate for Payer: Nomi Health Commercial |
$201.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.15
|
| Rate for Payer: PACE Senior Care Partners |
$58.31
|
| Rate for Payer: PACE SWMI |
$61.38
|
| Rate for Payer: PHP Commercial |
$208.70
|
| Rate for Payer: PHP Medicare Advantage |
$61.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$213.61
|
| Rate for Payer: Priority Health Medicare |
$62.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.89
|
| Rate for Payer: Railroad Medicare Medicare |
$61.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.07
|
| Rate for Payer: UHC Core |
$205.02
|
| Rate for Payer: UHC Exchange |
$61.38
|
| Rate for Payer: UHC Medicaid |
$43.29
|
| Rate for Payer: UHC Medicare Advantage |
$61.38
|
| Rate for Payer: UHCCP Medicaid |
$43.29
|
| Rate for Payer: VA VA |
$61.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.15
|
|
|
HC COMP BURN GARM BODY BRF SLEEVE
|
Facility
|
IP
|
$245.53
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300148
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$170.89 |
| Max. Negotiated Rate |
$220.98 |
| Rate for Payer: Aetna Commercial |
$208.70
|
| Rate for Payer: BCBS Trust/PPO |
$202.78
|
| Rate for Payer: BCN Commercial |
$202.78
|
| Rate for Payer: Cash Price |
$196.42
|
| Rate for Payer: Cofinity Commercial |
$211.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.42
|
| Rate for Payer: Healthscope Commercial |
$220.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.70
|
| Rate for Payer: Nomi Health Commercial |
$201.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.15
|
| Rate for Payer: PHP Commercial |
$208.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$213.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.07
|
| Rate for Payer: UHC Core |
$205.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.15
|
|
|
HC COMP BURN GARM BRF 2 LEGS ABV
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300149
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$108.62 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: BCBS Trust/PPO |
$128.89
|
| Rate for Payer: BCN Commercial |
$128.89
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC COMP BURN GARM BRF 2 LEGS ABV
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300149
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.51 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$40.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.77
|
| Rate for Payer: BCBS Complete |
$28.89
|
| Rate for Payer: BCBS MAPPO |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$128.30
|
| Rate for Payer: BCN Commercial |
$128.30
|
| Rate for Payer: BCN Medicare Advantage |
$39.02
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.02
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Mclaren Medicaid |
$27.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.97
|
| Rate for Payer: Meridian Medicaid |
$28.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PACE Senior Care Partners |
$37.06
|
| Rate for Payer: PACE SWMI |
$39.02
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: PHP Medicare Advantage |
$39.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Medicare |
$39.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.62
|
| Rate for Payer: Railroad Medicare Medicare |
$39.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: UHC Exchange |
$39.02
|
| Rate for Payer: UHC Medicaid |
$27.51
|
| Rate for Payer: UHC Medicare Advantage |
$39.02
|
| Rate for Payer: UHCCP Medicaid |
$27.51
|
| Rate for Payer: VA VA |
$39.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC COMP BURN GARM BRF&CHAP,LG-MID
|
Facility
|
OP
|
$137.33
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300150
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.21 |
| Max. Negotiated Rate |
$123.60 |
| Rate for Payer: Aetna Commercial |
$116.73
|
| Rate for Payer: Aetna Medicare |
$35.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.92
|
| Rate for Payer: BCBS Complete |
$25.42
|
| Rate for Payer: BCBS MAPPO |
$34.33
|
| Rate for Payer: BCBS Trust/PPO |
$112.90
|
| Rate for Payer: BCN Commercial |
$112.90
|
| Rate for Payer: BCN Medicare Advantage |
$34.33
|
| Rate for Payer: Cash Price |
$109.86
|
| Rate for Payer: Cofinity Commercial |
$118.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.33
|
| Rate for Payer: Healthscope Commercial |
$123.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.00
|
| Rate for Payer: Mclaren Medicaid |
$24.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.05
|
| Rate for Payer: Meridian Medicaid |
$25.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.73
|
| Rate for Payer: Nomi Health Commercial |
$112.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.00
|
| Rate for Payer: PACE Senior Care Partners |
$32.62
|
| Rate for Payer: PACE SWMI |
$34.33
|
| Rate for Payer: PHP Commercial |
$116.73
|
| Rate for Payer: PHP Medicare Advantage |
$34.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$119.48
|
| Rate for Payer: Priority Health Medicare |
$34.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.58
|
| Rate for Payer: Railroad Medicare Medicare |
$34.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.85
|
| Rate for Payer: UHC Core |
$114.67
|
| Rate for Payer: UHC Exchange |
$34.33
|
| Rate for Payer: UHC Medicaid |
$24.21
|
| Rate for Payer: UHC Medicare Advantage |
$34.33
|
| Rate for Payer: UHCCP Medicaid |
$24.21
|
| Rate for Payer: VA VA |
$34.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.00
|
|
|
HC COMP BURN GARM BRF&CHAP,LG-MID
|
Facility
|
IP
|
$137.33
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300150
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$95.58 |
| Max. Negotiated Rate |
$123.60 |
| Rate for Payer: Aetna Commercial |
$116.73
|
| Rate for Payer: BCBS Trust/PPO |
$113.42
|
| Rate for Payer: BCN Commercial |
$113.42
|
| Rate for Payer: Cash Price |
$109.86
|
| Rate for Payer: Cofinity Commercial |
$118.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.86
|
| Rate for Payer: Healthscope Commercial |
$123.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.73
|
| Rate for Payer: Nomi Health Commercial |
$112.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.00
|
| Rate for Payer: PHP Commercial |
$116.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$119.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.85
|
| Rate for Payer: UHC Core |
$114.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.00
|
|
|
HC COMP BURN GARM BRIEF
|
Facility
|
OP
|
$137.33
|
|
|
Service Code
|
HCPCS A6511
|
| Hospital Charge Code |
98300151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.21 |
| Max. Negotiated Rate |
$123.60 |
| Rate for Payer: Aetna Commercial |
$116.73
|
| Rate for Payer: Aetna Medicare |
$35.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.92
|
| Rate for Payer: BCBS Complete |
$25.42
|
| Rate for Payer: BCBS MAPPO |
$34.33
|
| Rate for Payer: BCBS Trust/PPO |
$112.90
|
| Rate for Payer: BCN Commercial |
$112.90
|
| Rate for Payer: BCN Medicare Advantage |
$34.33
|
| Rate for Payer: Cash Price |
$109.86
|
| Rate for Payer: Cofinity Commercial |
$118.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.33
|
| Rate for Payer: Healthscope Commercial |
$123.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.00
|
| Rate for Payer: Mclaren Medicaid |
$24.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.05
|
| Rate for Payer: Meridian Medicaid |
$25.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.73
|
| Rate for Payer: Nomi Health Commercial |
$112.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.00
|
| Rate for Payer: PACE Senior Care Partners |
$32.62
|
| Rate for Payer: PACE SWMI |
$34.33
|
| Rate for Payer: PHP Commercial |
$116.73
|
| Rate for Payer: PHP Medicare Advantage |
$34.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$119.48
|
| Rate for Payer: Priority Health Medicare |
$34.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.58
|
| Rate for Payer: Railroad Medicare Medicare |
$34.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.85
|
| Rate for Payer: UHC Core |
$114.67
|
| Rate for Payer: UHC Exchange |
$34.33
|
| Rate for Payer: UHC Medicaid |
$24.21
|
| Rate for Payer: UHC Medicare Advantage |
$34.33
|
| Rate for Payer: UHCCP Medicaid |
$24.21
|
| Rate for Payer: VA VA |
$34.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.00
|
|
|
HC COMP BURN GARM BRIEF
|
Facility
|
IP
|
$137.33
|
|
|
Service Code
|
HCPCS A6511
|
| Hospital Charge Code |
98300151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$95.58 |
| Max. Negotiated Rate |
$123.60 |
| Rate for Payer: Aetna Commercial |
$116.73
|
| Rate for Payer: BCBS Trust/PPO |
$113.42
|
| Rate for Payer: BCN Commercial |
$113.42
|
| Rate for Payer: Cash Price |
$109.86
|
| Rate for Payer: Cofinity Commercial |
$118.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.86
|
| Rate for Payer: Healthscope Commercial |
$123.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.73
|
| Rate for Payer: Nomi Health Commercial |
$112.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.00
|
| Rate for Payer: PHP Commercial |
$116.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$119.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.85
|
| Rate for Payer: UHC Core |
$114.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.00
|
|
