|
HC COMP BURN GARM GAUNTLET TO AXI
|
Facility
|
IP
|
$95.72
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300027
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$66.62 |
| Max. Negotiated Rate |
$86.15 |
| Rate for Payer: Aetna Commercial |
$81.36
|
| Rate for Payer: BCBS Trust/PPO |
$79.06
|
| Rate for Payer: BCN Commercial |
$79.06
|
| Rate for Payer: Cash Price |
$76.58
|
| Rate for Payer: Cofinity Commercial |
$82.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.58
|
| Rate for Payer: Healthscope Commercial |
$86.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.36
|
| Rate for Payer: Nomi Health Commercial |
$78.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.79
|
| Rate for Payer: PHP Commercial |
$81.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.23
|
| Rate for Payer: UHC Core |
$79.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.79
|
|
|
HC COMP BURN GARM GAUNTLET TO WRI
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300028
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna Medicare |
$9.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.38
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$9.10
|
| Rate for Payer: BCBS Trust/PPO |
$29.93
|
| Rate for Payer: BCN Commercial |
$29.93
|
| Rate for Payer: BCN Medicare Advantage |
$9.10
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.10
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.56
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.31
|
| Rate for Payer: PACE Senior Care Partners |
$8.65
|
| Rate for Payer: PACE SWMI |
$9.10
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: PHP Medicare Advantage |
$9.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.68
|
| Rate for Payer: Priority Health Medicare |
$9.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.34
|
| Rate for Payer: Railroad Medicare Medicare |
$9.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.04
|
| Rate for Payer: UHC Core |
$30.40
|
| Rate for Payer: UHC Exchange |
$9.10
|
| Rate for Payer: UHC Medicaid |
$6.42
|
| Rate for Payer: UHC Medicare Advantage |
$9.10
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: VA VA |
$9.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC COMP BURN GARM GAUNTLET TO WRI
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300028
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$25.34 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: BCBS Trust/PPO |
$30.07
|
| Rate for Payer: BCN Commercial |
$30.07
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$29.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.31
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.04
|
| Rate for Payer: UHC Core |
$30.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC COMP BURN GARM GLOVE-ELBOW
|
Facility
|
OP
|
$166.46
|
|
|
Service Code
|
HCPCS A6505
|
| Hospital Charge Code |
98300030
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$29.35 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: Aetna Medicare |
$43.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.02
|
| Rate for Payer: BCBS Complete |
$30.81
|
| Rate for Payer: BCBS MAPPO |
$41.62
|
| Rate for Payer: BCBS Trust/PPO |
$136.85
|
| Rate for Payer: BCN Commercial |
$136.85
|
| Rate for Payer: BCN Medicare Advantage |
$41.62
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.84
|
| Rate for Payer: Mclaren Medicaid |
$29.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.70
|
| Rate for Payer: Meridian Medicaid |
$30.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$136.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.84
|
| Rate for Payer: PACE Senior Care Partners |
$39.53
|
| Rate for Payer: PACE SWMI |
$41.62
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: PHP Medicare Advantage |
$41.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$144.82
|
| Rate for Payer: Priority Health Medicare |
$42.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.86
|
| Rate for Payer: Railroad Medicare Medicare |
$41.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.48
|
| Rate for Payer: UHC Core |
$138.99
|
| Rate for Payer: UHC Exchange |
$41.62
|
| Rate for Payer: UHC Medicaid |
$29.35
|
| Rate for Payer: UHC Medicare Advantage |
$41.62
|
| Rate for Payer: UHCCP Medicaid |
$29.35
|
| Rate for Payer: VA VA |
$41.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.84
|
|
|
HC COMP BURN GARM GLOVE-ELBOW
|
Facility
|
IP
|
$166.46
|
|
|
Service Code
|
HCPCS A6505
|
| Hospital Charge Code |
98300030
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$115.86 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: BCBS Trust/PPO |
$137.48
|
| Rate for Payer: BCN Commercial |
$137.48
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$136.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.84
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$144.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.48
|
| Rate for Payer: UHC Core |
$138.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.84
|
|
|
HC COMP BURN GARM GLOVE TO AXILLA
|
Facility
|
IP
|
$183.11
|
|
|
Service Code
|
HCPCS A6506
|
| Hospital Charge Code |
98300029
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$127.44 |
| Max. Negotiated Rate |
$164.80 |
| Rate for Payer: Aetna Commercial |
$155.64
|
| Rate for Payer: BCBS Trust/PPO |
$151.23
|
| Rate for Payer: BCN Commercial |
$151.23
|
| Rate for Payer: Cash Price |
$146.49
|
| Rate for Payer: Cofinity Commercial |
$157.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.49
|
| Rate for Payer: Healthscope Commercial |
$164.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.64
|
| Rate for Payer: Nomi Health Commercial |
$150.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$137.33
|
| Rate for Payer: PHP Commercial |
$155.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$159.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.14
|
| Rate for Payer: UHC Core |
$152.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.33
|
|
|
HC COMP BURN GARM GLOVE TO AXILLA
|
Facility
|
OP
|
$183.11
|
|
|
Service Code
|
HCPCS A6506
|
| Hospital Charge Code |
98300029
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$32.28 |
| Max. Negotiated Rate |
$164.80 |
| Rate for Payer: Aetna Commercial |
$155.64
|
| Rate for Payer: Aetna Medicare |
$47.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.22
|
| Rate for Payer: BCBS Complete |
$33.89
|
| Rate for Payer: BCBS MAPPO |
$45.78
|
| Rate for Payer: BCBS Trust/PPO |
$150.53
|
| Rate for Payer: BCN Commercial |
$150.53
|
| Rate for Payer: BCN Medicare Advantage |
$45.78
|
| Rate for Payer: Cash Price |
$146.49
|
| Rate for Payer: Cofinity Commercial |
$157.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$164.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.33
|
| Rate for Payer: Mclaren Medicaid |
$32.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.07
|
| Rate for Payer: Meridian Medicaid |
$33.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$50.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.64
|
| Rate for Payer: Nomi Health Commercial |
$150.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$137.33
|
| Rate for Payer: PACE Senior Care Partners |
$43.49
|
| Rate for Payer: PACE SWMI |
$45.78
|
| Rate for Payer: PHP Commercial |
$155.64
|
| Rate for Payer: PHP Medicare Advantage |
$45.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$159.31
|
| Rate for Payer: Priority Health Medicare |
$46.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.44
|
| Rate for Payer: Railroad Medicare Medicare |
$45.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.14
|
| Rate for Payer: UHC Core |
$152.90
|
| Rate for Payer: UHC Exchange |
$45.78
|
| Rate for Payer: UHC Medicaid |
$32.28
|
| Rate for Payer: UHC Medicare Advantage |
$45.78
|
| Rate for Payer: UHCCP Medicaid |
$32.28
|
| Rate for Payer: VA VA |
$45.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.33
|
|
|
HC COMP BURN GARM GLOVE-WRIST
|
Facility
|
OP
|
$114.44
|
|
|
Service Code
|
HCPCS A6504
|
| Hospital Charge Code |
98300031
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.18 |
| Max. Negotiated Rate |
$103.00 |
| Rate for Payer: Aetna Commercial |
$97.27
|
| Rate for Payer: Aetna Medicare |
$29.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.76
|
| Rate for Payer: BCBS Complete |
$21.18
|
| Rate for Payer: BCBS MAPPO |
$28.61
|
| Rate for Payer: BCBS Trust/PPO |
$94.08
|
| Rate for Payer: BCN Commercial |
$94.08
|
| Rate for Payer: BCN Medicare Advantage |
$28.61
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Commercial |
$98.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.61
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.83
|
| Rate for Payer: Mclaren Medicaid |
$20.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.04
|
| Rate for Payer: Meridian Medicaid |
$21.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Nomi Health Commercial |
$93.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.83
|
| Rate for Payer: PACE Senior Care Partners |
$27.18
|
| Rate for Payer: PACE SWMI |
$28.61
|
| Rate for Payer: PHP Commercial |
$97.27
|
| Rate for Payer: PHP Medicare Advantage |
$28.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.56
|
| Rate for Payer: Priority Health Medicare |
$28.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.65
|
| Rate for Payer: Railroad Medicare Medicare |
$28.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.71
|
| Rate for Payer: UHC Core |
$95.56
|
| Rate for Payer: UHC Exchange |
$28.61
|
| Rate for Payer: UHC Medicaid |
$20.18
|
| Rate for Payer: UHC Medicare Advantage |
$28.61
|
| Rate for Payer: UHCCP Medicaid |
$20.18
|
| Rate for Payer: VA VA |
$28.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.83
|
|
|
HC COMP BURN GARM GLOVE-WRIST
|
Facility
|
IP
|
$114.44
|
|
|
Service Code
|
HCPCS A6504
|
| Hospital Charge Code |
98300031
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$79.65 |
| Max. Negotiated Rate |
$103.00 |
| Rate for Payer: Aetna Commercial |
$97.27
|
| Rate for Payer: BCBS Trust/PPO |
$94.52
|
| Rate for Payer: BCN Commercial |
$94.52
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Commercial |
$98.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Nomi Health Commercial |
$93.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.83
|
| Rate for Payer: PHP Commercial |
$97.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.71
|
| Rate for Payer: UHC Core |
$95.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.83
|
|
|
HC COMP BURN GARM HEAD BAND
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300032
|
|
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 HEAD BAND
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300032
|
|
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 HOOK&LOOP SNAP
|
Facility
|
OP
|
$14.57
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300033
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$13.11 |
| Rate for Payer: Aetna Commercial |
$12.38
|
| Rate for Payer: Aetna Medicare |
$3.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.55
|
| Rate for Payer: BCBS Complete |
$2.70
|
| Rate for Payer: BCBS MAPPO |
$3.64
|
| Rate for Payer: BCBS Trust/PPO |
$11.98
|
| Rate for Payer: BCN Commercial |
$11.98
|
| Rate for Payer: BCN Medicare Advantage |
$3.64
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cofinity Commercial |
$12.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.64
|
| Rate for Payer: Healthscope Commercial |
$13.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.93
|
| Rate for Payer: Mclaren Medicaid |
$2.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.82
|
| Rate for Payer: Meridian Medicaid |
$2.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.38
|
| Rate for Payer: Nomi Health Commercial |
$11.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.93
|
| Rate for Payer: PACE Senior Care Partners |
$3.46
|
| Rate for Payer: PACE SWMI |
$3.64
|
| Rate for Payer: PHP Commercial |
$12.38
|
| Rate for Payer: PHP Medicare Advantage |
$3.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.68
|
| Rate for Payer: Priority Health Medicare |
$3.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.82
|
| Rate for Payer: UHC Core |
$12.17
|
| Rate for Payer: UHC Exchange |
$3.64
|
| Rate for Payer: UHC Medicaid |
$2.57
|
| Rate for Payer: UHC Medicare Advantage |
$3.64
|
| Rate for Payer: UHCCP Medicaid |
$2.57
|
| Rate for Payer: VA VA |
$3.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.93
|
|
|
HC COMP BURN GARM HOOK&LOOP SNAP
|
Facility
|
IP
|
$14.57
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300033
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.14 |
| Max. Negotiated Rate |
$13.11 |
| Rate for Payer: Aetna Commercial |
$12.38
|
| Rate for Payer: BCBS Trust/PPO |
$12.03
|
| Rate for Payer: BCN Commercial |
$12.03
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cofinity Commercial |
$12.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.66
|
| Rate for Payer: Healthscope Commercial |
$13.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.38
|
| Rate for Payer: Nomi Health Commercial |
$11.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.93
|
| Rate for Payer: PHP Commercial |
$12.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.82
|
| Rate for Payer: UHC Core |
$12.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.93
|
|
|
HC COMP BURN GARM HOOK&LOOP TAB S
|
Facility
|
OP
|
$8.32
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300034
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.47 |
| Max. Negotiated Rate |
$7.49 |
| Rate for Payer: Aetna Commercial |
$7.07
|
| Rate for Payer: Aetna Medicare |
$2.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.60
|
| Rate for Payer: BCBS Complete |
$1.54
|
| Rate for Payer: BCBS MAPPO |
$2.08
|
| Rate for Payer: BCBS Trust/PPO |
$6.84
|
| Rate for Payer: BCN Commercial |
$6.84
|
| Rate for Payer: BCN Medicare Advantage |
$2.08
|
| Rate for Payer: Cash Price |
$6.66
|
| Rate for Payer: Cofinity Commercial |
$7.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.08
|
| Rate for Payer: Healthscope Commercial |
$7.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.24
|
| Rate for Payer: Mclaren Medicaid |
$1.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.18
|
| Rate for Payer: Meridian Medicaid |
$1.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.07
|
| Rate for Payer: Nomi Health Commercial |
$6.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.24
|
| Rate for Payer: PACE Senior Care Partners |
$1.98
|
| Rate for Payer: PACE SWMI |
$2.08
|
| Rate for Payer: PHP Commercial |
$7.07
|
| Rate for Payer: PHP Medicare Advantage |
$2.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.24
|
| Rate for Payer: Priority Health Medicare |
$2.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.79
|
| Rate for Payer: Railroad Medicare Medicare |
$2.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.32
|
| Rate for Payer: UHC Core |
$6.95
|
| Rate for Payer: UHC Exchange |
$2.08
|
| Rate for Payer: UHC Medicaid |
$1.47
|
| Rate for Payer: UHC Medicare Advantage |
$2.08
|
| Rate for Payer: UHCCP Medicaid |
$1.47
|
| Rate for Payer: VA VA |
$2.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.24
|
|
|
HC COMP BURN GARM HOOK&LOOP TAB S
|
Facility
|
IP
|
$8.32
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300034
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$7.49 |
| Rate for Payer: Aetna Commercial |
$7.07
|
| Rate for Payer: BCBS Trust/PPO |
$6.87
|
| Rate for Payer: BCN Commercial |
$6.87
|
| Rate for Payer: Cash Price |
$6.66
|
| Rate for Payer: Cofinity Commercial |
$7.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.66
|
| Rate for Payer: Healthscope Commercial |
$7.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.07
|
| Rate for Payer: Nomi Health Commercial |
$6.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.24
|
| Rate for Payer: PHP Commercial |
$7.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.32
|
| Rate for Payer: UHC Core |
$6.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.24
|
|
|
HC COMP BURN GARM LEG&CHAP TO WAI
|
Facility
|
OP
|
$216.40
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300036
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.15 |
| Max. Negotiated Rate |
$194.76 |
| Rate for Payer: Aetna Commercial |
$183.94
|
| Rate for Payer: Aetna Medicare |
$56.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.62
|
| Rate for Payer: BCBS Complete |
$40.06
|
| Rate for Payer: BCBS MAPPO |
$54.10
|
| Rate for Payer: BCBS Trust/PPO |
$177.90
|
| Rate for Payer: BCN Commercial |
$177.90
|
| Rate for Payer: BCN Medicare Advantage |
$54.10
|
| Rate for Payer: Cash Price |
$173.12
|
| Rate for Payer: Cofinity Commercial |
$186.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$194.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.30
|
| Rate for Payer: Mclaren Medicaid |
$38.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.80
|
| Rate for Payer: Meridian Medicaid |
$40.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.94
|
| Rate for Payer: Nomi Health Commercial |
$177.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.30
|
| Rate for Payer: PACE Senior Care Partners |
$51.40
|
| Rate for Payer: PACE SWMI |
$54.10
|
| Rate for Payer: PHP Commercial |
$183.94
|
| Rate for Payer: PHP Medicare Advantage |
$54.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$188.27
|
| Rate for Payer: Priority Health Medicare |
$54.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.61
|
| Rate for Payer: Railroad Medicare Medicare |
$54.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.43
|
| Rate for Payer: UHC Core |
$180.69
|
| Rate for Payer: UHC Exchange |
$54.10
|
| Rate for Payer: UHC Medicaid |
$38.15
|
| Rate for Payer: UHC Medicare Advantage |
$54.10
|
| Rate for Payer: UHCCP Medicaid |
$38.15
|
| Rate for Payer: VA VA |
$54.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.30
|
|
|
HC COMP BURN GARM LEG&CHAP TO WAI
|
Facility
|
IP
|
$216.40
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300036
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$150.61 |
| Max. Negotiated Rate |
$194.76 |
| Rate for Payer: Aetna Commercial |
$183.94
|
| Rate for Payer: BCBS Trust/PPO |
$178.72
|
| Rate for Payer: BCN Commercial |
$178.72
|
| Rate for Payer: Cash Price |
$173.12
|
| Rate for Payer: Cofinity Commercial |
$186.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.12
|
| Rate for Payer: Healthscope Commercial |
$194.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.94
|
| Rate for Payer: Nomi Health Commercial |
$177.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.30
|
| Rate for Payer: PHP Commercial |
$183.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$188.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.43
|
| Rate for Payer: UHC Core |
$180.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.30
|
|
|
HC COMP BURN GARM LEG & PANTY
|
Facility
|
OP
|
$230.97
|
|
|
Service Code
|
HCPCS A6511
|
| Hospital Charge Code |
98300035
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.72 |
| Max. Negotiated Rate |
$207.87 |
| Rate for Payer: Aetna Commercial |
$196.32
|
| Rate for Payer: Aetna Medicare |
$60.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.18
|
| Rate for Payer: BCBS Complete |
$42.75
|
| Rate for Payer: BCBS MAPPO |
$57.74
|
| Rate for Payer: BCBS Trust/PPO |
$189.88
|
| Rate for Payer: BCN Commercial |
$189.88
|
| Rate for Payer: BCN Medicare Advantage |
$57.74
|
| Rate for Payer: Cash Price |
$184.78
|
| Rate for Payer: Cofinity Commercial |
$198.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.74
|
| Rate for Payer: Healthscope Commercial |
$207.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.23
|
| Rate for Payer: Mclaren Medicaid |
$40.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.63
|
| Rate for Payer: Meridian Medicaid |
$42.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.32
|
| Rate for Payer: Nomi Health Commercial |
$189.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.23
|
| Rate for Payer: PACE Senior Care Partners |
$54.86
|
| Rate for Payer: PACE SWMI |
$57.74
|
| Rate for Payer: PHP Commercial |
$196.32
|
| Rate for Payer: PHP Medicare Advantage |
$57.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$200.94
|
| Rate for Payer: Priority Health Medicare |
$58.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.76
|
| Rate for Payer: Railroad Medicare Medicare |
$57.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.25
|
| Rate for Payer: UHC Core |
$192.86
|
| Rate for Payer: UHC Exchange |
$57.74
|
| Rate for Payer: UHC Medicaid |
$40.72
|
| Rate for Payer: UHC Medicare Advantage |
$57.74
|
| Rate for Payer: UHCCP Medicaid |
$40.72
|
| Rate for Payer: VA VA |
$57.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.23
|
|
|
HC COMP BURN GARM LEG & PANTY
|
Facility
|
IP
|
$230.97
|
|
|
Service Code
|
HCPCS A6511
|
| Hospital Charge Code |
98300035
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$160.76 |
| Max. Negotiated Rate |
$207.87 |
| Rate for Payer: Aetna Commercial |
$196.32
|
| Rate for Payer: BCBS Trust/PPO |
$190.76
|
| Rate for Payer: BCN Commercial |
$190.76
|
| Rate for Payer: Cash Price |
$184.78
|
| Rate for Payer: Cofinity Commercial |
$198.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.78
|
| Rate for Payer: Healthscope Commercial |
$207.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.32
|
| Rate for Payer: Nomi Health Commercial |
$189.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.23
|
| Rate for Payer: PHP Commercial |
$196.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$200.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.25
|
| Rate for Payer: UHC Core |
$192.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.23
|
|
|
HC COMP BURN GARM LINING,POCKET,F
|
Facility
|
OP
|
$12.48
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300037
|
|
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 LINING,POCKET,F
|
Facility
|
IP
|
$12.48
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300037
|
|
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 MITTEN TO WRIST
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300038
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.47 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$18.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.11
|
| Rate for Payer: BCBS Complete |
$13.10
|
| Rate for Payer: BCBS MAPPO |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$58.16
|
| Rate for Payer: BCN Commercial |
$58.16
|
| Rate for Payer: BCN Medicare Advantage |
$17.69
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.69
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Mclaren Medicaid |
$12.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.57
|
| Rate for Payer: Meridian Medicaid |
$13.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PACE Senior Care Partners |
$16.80
|
| Rate for Payer: PACE SWMI |
$17.69
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: PHP Medicare Advantage |
$17.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Medicare |
$17.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.24
|
| Rate for Payer: Railroad Medicare Medicare |
$17.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: UHC Exchange |
$17.69
|
| Rate for Payer: UHC Medicaid |
$12.47
|
| Rate for Payer: UHC Medicare Advantage |
$17.69
|
| Rate for Payer: UHCCP Medicaid |
$12.47
|
| Rate for Payer: VA VA |
$17.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC COMP BURN GARM MITTEN TO WRIST
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300038
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$49.24 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: BCBS Trust/PPO |
$58.43
|
| Rate for Payer: BCN Commercial |
$58.43
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC COMP BURN GARM POCKET & PAD CO
|
Facility
|
OP
|
$14.57
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$13.11 |
| Rate for Payer: Aetna Commercial |
$12.38
|
| Rate for Payer: Aetna Medicare |
$3.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.55
|
| Rate for Payer: BCBS Complete |
$2.70
|
| Rate for Payer: BCBS MAPPO |
$3.64
|
| Rate for Payer: BCBS Trust/PPO |
$11.98
|
| Rate for Payer: BCN Commercial |
$11.98
|
| Rate for Payer: BCN Medicare Advantage |
$3.64
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cofinity Commercial |
$12.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.64
|
| Rate for Payer: Healthscope Commercial |
$13.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.93
|
| Rate for Payer: Mclaren Medicaid |
$2.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.82
|
| Rate for Payer: Meridian Medicaid |
$2.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.38
|
| Rate for Payer: Nomi Health Commercial |
$11.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.93
|
| Rate for Payer: PACE Senior Care Partners |
$3.46
|
| Rate for Payer: PACE SWMI |
$3.64
|
| Rate for Payer: PHP Commercial |
$12.38
|
| Rate for Payer: PHP Medicare Advantage |
$3.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.68
|
| Rate for Payer: Priority Health Medicare |
$3.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.82
|
| Rate for Payer: UHC Core |
$12.17
|
| Rate for Payer: UHC Exchange |
$3.64
|
| Rate for Payer: UHC Medicaid |
$2.57
|
| Rate for Payer: UHC Medicare Advantage |
$3.64
|
| Rate for Payer: UHCCP Medicaid |
$2.57
|
| Rate for Payer: VA VA |
$3.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.93
|
|
|
HC COMP BURN GARM POCKET & PAD CO
|
Facility
|
IP
|
$14.57
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.14 |
| Max. Negotiated Rate |
$13.11 |
| Rate for Payer: Aetna Commercial |
$12.38
|
| Rate for Payer: BCBS Trust/PPO |
$12.03
|
| Rate for Payer: BCN Commercial |
$12.03
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cofinity Commercial |
$12.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.66
|
| Rate for Payer: Healthscope Commercial |
$13.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.38
|
| Rate for Payer: Nomi Health Commercial |
$11.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.93
|
| Rate for Payer: PHP Commercial |
$12.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.82
|
| Rate for Payer: UHC Core |
$12.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.93
|
|
