|
HC COMP BURN GARM STMP CLS STRCH
|
Facility
|
IP
|
$12.73
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
98300053
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$11.46 |
| Rate for Payer: Aetna Commercial |
$10.82
|
| Rate for Payer: BCBS Trust/PPO |
$10.51
|
| Rate for Payer: BCN Commercial |
$10.51
|
| Rate for Payer: Cash Price |
$10.18
|
| Rate for Payer: Cofinity Commercial |
$10.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$11.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.82
|
| Rate for Payer: Nomi Health Commercial |
$10.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.55
|
| Rate for Payer: PHP Commercial |
$10.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.20
|
| Rate for Payer: UHC Core |
$10.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.55
|
|
|
HC COMP BURN GARM STOCKING TO KNE
|
Facility
|
IP
|
$72.83
|
|
|
Service Code
|
HCPCS A6507
|
| Hospital Charge Code |
98300054
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$50.69 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: BCBS Trust/PPO |
$60.15
|
| Rate for Payer: BCN Commercial |
$60.15
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.09
|
| Rate for Payer: UHC Core |
$60.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC COMP BURN GARM STOCKING TO KNE
|
Facility
|
OP
|
$72.83
|
|
|
Service Code
|
HCPCS A6507
|
| Hospital Charge Code |
98300054
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.84 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: Aetna Medicare |
$18.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.76
|
| Rate for Payer: BCBS Complete |
$13.48
|
| Rate for Payer: BCBS MAPPO |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$59.87
|
| Rate for Payer: BCN Commercial |
$59.87
|
| Rate for Payer: BCN Medicare Advantage |
$18.21
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.21
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: Mclaren Medicaid |
$12.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.12
|
| Rate for Payer: Meridian Medicaid |
$13.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PACE Senior Care Partners |
$17.30
|
| Rate for Payer: PACE SWMI |
$18.21
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: PHP Medicare Advantage |
$18.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.36
|
| Rate for Payer: Priority Health Medicare |
$18.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.69
|
| Rate for Payer: Railroad Medicare Medicare |
$18.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.09
|
| Rate for Payer: UHC Core |
$60.81
|
| Rate for Payer: UHC Exchange |
$18.21
|
| Rate for Payer: UHC Medicaid |
$12.84
|
| Rate for Payer: UHC Medicare Advantage |
$18.21
|
| Rate for Payer: UHCCP Medicaid |
$12.84
|
| Rate for Payer: VA VA |
$18.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC COMP BURN GARM STOCKING TO THI
|
Facility
|
IP
|
$95.72
|
|
|
Service Code
|
HCPCS A6508
|
| Hospital Charge Code |
98300055
|
|
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 STOCKING TO THI
|
Facility
|
OP
|
$95.72
|
|
|
Service Code
|
HCPCS A6508
|
| Hospital Charge Code |
98300055
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.88 |
| Max. Negotiated Rate |
$86.15 |
| Rate for Payer: Aetna Commercial |
$81.36
|
| Rate for Payer: Aetna Medicare |
$24.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.91
|
| Rate for Payer: BCBS Complete |
$17.72
|
| Rate for Payer: BCBS MAPPO |
$23.93
|
| Rate for Payer: BCBS Trust/PPO |
$78.69
|
| Rate for Payer: BCN Commercial |
$78.69
|
| Rate for Payer: BCN Medicare Advantage |
$23.93
|
| 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: Health Alliance Plan Medicare Advantage |
$23.93
|
| Rate for Payer: Healthscope Commercial |
$86.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.79
|
| Rate for Payer: Mclaren Medicaid |
$16.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.13
|
| Rate for Payer: Meridian Medicaid |
$17.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.32
|
| 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: PACE Senior Care Partners |
$22.73
|
| Rate for Payer: PACE SWMI |
$23.93
|
| Rate for Payer: PHP Commercial |
$81.36
|
| Rate for Payer: PHP Medicare Advantage |
$23.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.28
|
| Rate for Payer: Priority Health Medicare |
$24.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.62
|
| Rate for Payer: Railroad Medicare Medicare |
$23.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.23
|
| Rate for Payer: UHC Core |
$79.93
|
| Rate for Payer: UHC Exchange |
$23.93
|
| Rate for Payer: UHC Medicaid |
$16.88
|
| Rate for Payer: UHC Medicare Advantage |
$23.93
|
| Rate for Payer: UHCCP Medicaid |
$16.88
|
| Rate for Payer: VA VA |
$23.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.79
|
|
|
HC COMP BURN GARM STOCK-KNEE/NO F
|
Facility
|
OP
|
$64.50
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300056
|
|
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 STOCK-KNEE/NO F
|
Facility
|
IP
|
$64.50
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300056
|
|
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 STRETCH INSERT
|
Facility
|
IP
|
$12.73
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
98300057
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$11.46 |
| Rate for Payer: Aetna Commercial |
$10.82
|
| Rate for Payer: BCBS Trust/PPO |
$10.51
|
| Rate for Payer: BCN Commercial |
$10.51
|
| Rate for Payer: Cash Price |
$10.18
|
| Rate for Payer: Cofinity Commercial |
$10.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$11.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.82
|
| Rate for Payer: Nomi Health Commercial |
$10.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.55
|
| Rate for Payer: PHP Commercial |
$10.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.20
|
| Rate for Payer: UHC Core |
$10.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.55
|
|
|
HC COMP BURN GARM STRETCH INSERT
|
Facility
|
OP
|
$12.73
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
98300057
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.24 |
| Max. Negotiated Rate |
$11.46 |
| Rate for Payer: Aetna Commercial |
$10.82
|
| Rate for Payer: Aetna Medicare |
$3.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.98
|
| Rate for Payer: BCBS Complete |
$2.36
|
| Rate for Payer: BCBS MAPPO |
$3.18
|
| Rate for Payer: BCBS Trust/PPO |
$10.47
|
| Rate for Payer: BCN Commercial |
$10.47
|
| Rate for Payer: BCN Medicare Advantage |
$3.18
|
| Rate for Payer: Cash Price |
$10.18
|
| Rate for Payer: Cofinity Commercial |
$10.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.18
|
| Rate for Payer: Healthscope Commercial |
$11.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.55
|
| Rate for Payer: Mclaren Medicaid |
$2.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.34
|
| Rate for Payer: Meridian Medicaid |
$2.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.82
|
| Rate for Payer: Nomi Health Commercial |
$10.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.55
|
| Rate for Payer: PACE Senior Care Partners |
$3.02
|
| Rate for Payer: PACE SWMI |
$3.18
|
| Rate for Payer: PHP Commercial |
$10.82
|
| Rate for Payer: PHP Medicare Advantage |
$3.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11.08
|
| Rate for Payer: Priority Health Medicare |
$3.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.86
|
| Rate for Payer: Railroad Medicare Medicare |
$3.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.20
|
| Rate for Payer: UHC Core |
$10.63
|
| Rate for Payer: UHC Exchange |
$3.18
|
| Rate for Payer: UHC Medicaid |
$2.24
|
| Rate for Payer: UHC Medicare Advantage |
$3.18
|
| Rate for Payer: UHCCP Medicaid |
$2.24
|
| Rate for Payer: VA VA |
$3.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.55
|
|
|
HC COMP BURN GARM SUEDE/LEATHER G
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
HCPCS A9900
|
| Hospital Charge Code |
98300058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$32.59 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: BCBS Trust/PPO |
$38.67
|
| Rate for Payer: BCN Commercial |
$38.67
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC COMP BURN GARM SUEDE/LEATHER G
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
HCPCS A9900
|
| Hospital Charge Code |
98300058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.63
|
| Rate for Payer: BCBS Complete |
$8.67
|
| Rate for Payer: BCBS MAPPO |
$11.71
|
| Rate for Payer: BCBS Trust/PPO |
$38.49
|
| Rate for Payer: BCN Commercial |
$38.49
|
| Rate for Payer: BCN Medicare Advantage |
$11.71
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.71
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$8.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.29
|
| Rate for Payer: Meridian Medicaid |
$8.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PACE Senior Care Partners |
$11.12
|
| Rate for Payer: PACE SWMI |
$11.71
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: Railroad Medicare Medicare |
$11.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: UHC Exchange |
$11.71
|
| Rate for Payer: UHC Medicaid |
$8.25
|
| Rate for Payer: UHC Medicare Advantage |
$11.71
|
| Rate for Payer: UHCCP Medicaid |
$8.25
|
| Rate for Payer: VA VA |
$11.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC COMP BURN GARM SUIT SLVD ABV K
|
Facility
|
IP
|
$395.35
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300059
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$275.16 |
| Max. Negotiated Rate |
$355.81 |
| Rate for Payer: Aetna Commercial |
$336.05
|
| Rate for Payer: BCBS Trust/PPO |
$326.52
|
| Rate for Payer: BCN Commercial |
$326.52
|
| Rate for Payer: Cash Price |
$316.28
|
| Rate for Payer: Cofinity Commercial |
$340.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.28
|
| Rate for Payer: Healthscope Commercial |
$355.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$296.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.05
|
| Rate for Payer: Nomi Health Commercial |
$324.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$296.51
|
| Rate for Payer: PHP Commercial |
$336.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$343.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$347.91
|
| Rate for Payer: UHC Core |
$330.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$296.51
|
|
|
HC COMP BURN GARM SUIT SLVD ABV K
|
Facility
|
OP
|
$395.35
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300059
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$69.70 |
| Max. Negotiated Rate |
$355.81 |
| Rate for Payer: Aetna Commercial |
$336.05
|
| Rate for Payer: Aetna Medicare |
$102.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.55
|
| Rate for Payer: BCBS Complete |
$73.18
|
| Rate for Payer: BCBS MAPPO |
$98.84
|
| Rate for Payer: BCBS Trust/PPO |
$325.02
|
| Rate for Payer: BCN Commercial |
$325.02
|
| Rate for Payer: BCN Medicare Advantage |
$98.84
|
| Rate for Payer: Cash Price |
$316.28
|
| Rate for Payer: Cofinity Commercial |
$340.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.84
|
| Rate for Payer: Healthscope Commercial |
$355.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$296.51
|
| Rate for Payer: Mclaren Medicaid |
$69.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.78
|
| Rate for Payer: Meridian Medicaid |
$73.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.05
|
| Rate for Payer: Nomi Health Commercial |
$324.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$296.51
|
| Rate for Payer: PACE Senior Care Partners |
$93.90
|
| Rate for Payer: PACE SWMI |
$98.84
|
| Rate for Payer: PHP Commercial |
$336.05
|
| Rate for Payer: PHP Medicare Advantage |
$98.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$343.95
|
| Rate for Payer: Priority Health Medicare |
$99.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.16
|
| Rate for Payer: Railroad Medicare Medicare |
$98.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$347.91
|
| Rate for Payer: UHC Core |
$330.12
|
| Rate for Payer: UHC Exchange |
$98.84
|
| Rate for Payer: UHC Medicaid |
$69.70
|
| Rate for Payer: UHC Medicare Advantage |
$98.84
|
| Rate for Payer: UHCCP Medicaid |
$69.70
|
| Rate for Payer: VA VA |
$98.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$296.51
|
|
|
HC COMP BURN GARM SUIT SLVD TWO LEGS
|
Facility
|
OP
|
$501.47
|
|
|
Service Code
|
HCPCS A6501
|
| Hospital Charge Code |
98300060
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$88.41 |
| Max. Negotiated Rate |
$451.32 |
| Rate for Payer: Aetna Commercial |
$426.25
|
| Rate for Payer: Aetna Medicare |
$130.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.71
|
| Rate for Payer: BCBS Complete |
$92.82
|
| Rate for Payer: BCBS MAPPO |
$125.37
|
| Rate for Payer: BCBS Trust/PPO |
$412.26
|
| Rate for Payer: BCN Commercial |
$412.26
|
| Rate for Payer: BCN Medicare Advantage |
$125.37
|
| Rate for Payer: Cash Price |
$401.18
|
| Rate for Payer: Cofinity Commercial |
$431.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$401.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.37
|
| Rate for Payer: Healthscope Commercial |
$451.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$376.10
|
| Rate for Payer: Mclaren Medicaid |
$88.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.64
|
| Rate for Payer: Meridian Medicaid |
$92.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$426.25
|
| Rate for Payer: Nomi Health Commercial |
$411.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$376.10
|
| Rate for Payer: PACE Senior Care Partners |
$119.10
|
| Rate for Payer: PACE SWMI |
$125.37
|
| Rate for Payer: PHP Commercial |
$426.25
|
| Rate for Payer: PHP Medicare Advantage |
$125.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$436.28
|
| Rate for Payer: Priority Health Medicare |
$126.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$349.02
|
| Rate for Payer: Railroad Medicare Medicare |
$125.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.29
|
| Rate for Payer: UHC Core |
$418.73
|
| Rate for Payer: UHC Exchange |
$125.37
|
| Rate for Payer: UHC Medicaid |
$88.41
|
| Rate for Payer: UHC Medicare Advantage |
$125.37
|
| Rate for Payer: UHCCP Medicaid |
$88.41
|
| Rate for Payer: VA VA |
$125.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$376.10
|
|
|
HC COMP BURN GARM SUIT SLVD TWO LEGS
|
Facility
|
IP
|
$501.47
|
|
|
Service Code
|
HCPCS A6501
|
| Hospital Charge Code |
98300060
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$349.02 |
| Max. Negotiated Rate |
$451.32 |
| Rate for Payer: Aetna Commercial |
$426.25
|
| Rate for Payer: BCBS Trust/PPO |
$414.16
|
| Rate for Payer: BCN Commercial |
$414.16
|
| Rate for Payer: Cash Price |
$401.18
|
| Rate for Payer: Cofinity Commercial |
$431.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$401.18
|
| Rate for Payer: Healthscope Commercial |
$451.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$376.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$426.25
|
| Rate for Payer: Nomi Health Commercial |
$411.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$376.10
|
| Rate for Payer: PHP Commercial |
$426.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$436.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$349.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.29
|
| Rate for Payer: UHC Core |
$418.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$376.10
|
|
|
HC COMP BURN GARM SUIT SLVLS ABV
|
Facility
|
OP
|
$326.69
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300061
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$294.02 |
| Rate for Payer: Aetna Commercial |
$277.69
|
| Rate for Payer: Aetna Medicare |
$84.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.09
|
| Rate for Payer: BCBS Complete |
$60.47
|
| Rate for Payer: BCBS MAPPO |
$81.67
|
| Rate for Payer: BCBS Trust/PPO |
$268.57
|
| Rate for Payer: BCN Commercial |
$268.57
|
| Rate for Payer: BCN Medicare Advantage |
$81.67
|
| Rate for Payer: Cash Price |
$261.35
|
| Rate for Payer: Cofinity Commercial |
$280.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.67
|
| Rate for Payer: Healthscope Commercial |
$294.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$245.02
|
| Rate for Payer: Mclaren Medicaid |
$57.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.76
|
| Rate for Payer: Meridian Medicaid |
$60.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$89.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.69
|
| Rate for Payer: Nomi Health Commercial |
$267.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.02
|
| Rate for Payer: PACE Senior Care Partners |
$77.59
|
| Rate for Payer: PACE SWMI |
$81.67
|
| Rate for Payer: PHP Commercial |
$277.69
|
| Rate for Payer: PHP Medicare Advantage |
$81.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$284.22
|
| Rate for Payer: Priority Health Medicare |
$82.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.38
|
| Rate for Payer: Railroad Medicare Medicare |
$81.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.49
|
| Rate for Payer: UHC Core |
$272.79
|
| Rate for Payer: UHC Exchange |
$81.67
|
| Rate for Payer: UHC Medicaid |
$57.60
|
| Rate for Payer: UHC Medicare Advantage |
$81.67
|
| Rate for Payer: UHCCP Medicaid |
$57.60
|
| Rate for Payer: VA VA |
$81.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$245.02
|
|
|
HC COMP BURN GARM SUIT SLVLS ABV
|
Facility
|
IP
|
$326.69
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300061
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$227.38 |
| Max. Negotiated Rate |
$294.02 |
| Rate for Payer: Aetna Commercial |
$277.69
|
| Rate for Payer: BCBS Trust/PPO |
$269.81
|
| Rate for Payer: BCN Commercial |
$269.81
|
| Rate for Payer: Cash Price |
$261.35
|
| Rate for Payer: Cofinity Commercial |
$280.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.35
|
| Rate for Payer: Healthscope Commercial |
$294.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$245.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.69
|
| Rate for Payer: Nomi Health Commercial |
$267.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.02
|
| Rate for Payer: PHP Commercial |
$277.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$284.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.49
|
| Rate for Payer: UHC Core |
$272.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$245.02
|
|
|
HC COMP BURN GARM SUIT SLVLS-TWO LEGS
|
Facility
|
OP
|
$382.87
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300062
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$67.50 |
| Max. Negotiated Rate |
$344.58 |
| Rate for Payer: Aetna Commercial |
$325.44
|
| Rate for Payer: Aetna Medicare |
$99.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.65
|
| Rate for Payer: BCBS Complete |
$70.87
|
| Rate for Payer: BCBS MAPPO |
$95.72
|
| Rate for Payer: BCBS Trust/PPO |
$314.76
|
| Rate for Payer: BCN Commercial |
$314.76
|
| Rate for Payer: BCN Medicare Advantage |
$95.72
|
| Rate for Payer: Cash Price |
$306.30
|
| Rate for Payer: Cofinity Commercial |
$329.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$344.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.15
|
| Rate for Payer: Mclaren Medicaid |
$67.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.50
|
| Rate for Payer: Meridian Medicaid |
$70.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.44
|
| Rate for Payer: Nomi Health Commercial |
$313.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.15
|
| Rate for Payer: PACE Senior Care Partners |
$90.93
|
| Rate for Payer: PACE SWMI |
$95.72
|
| Rate for Payer: PHP Commercial |
$325.44
|
| Rate for Payer: PHP Medicare Advantage |
$95.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$333.10
|
| Rate for Payer: Priority Health Medicare |
$96.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.48
|
| Rate for Payer: Railroad Medicare Medicare |
$95.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.93
|
| Rate for Payer: UHC Core |
$319.70
|
| Rate for Payer: UHC Exchange |
$95.72
|
| Rate for Payer: UHC Medicaid |
$67.50
|
| Rate for Payer: UHC Medicare Advantage |
$95.72
|
| Rate for Payer: UHCCP Medicaid |
$67.50
|
| Rate for Payer: VA VA |
$95.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.15
|
|
|
HC COMP BURN GARM SUIT SLVLS-TWO LEGS
|
Facility
|
IP
|
$382.87
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300062
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$266.48 |
| Max. Negotiated Rate |
$344.58 |
| Rate for Payer: Aetna Commercial |
$325.44
|
| Rate for Payer: BCBS Trust/PPO |
$316.21
|
| Rate for Payer: BCN Commercial |
$316.21
|
| Rate for Payer: Cash Price |
$306.30
|
| Rate for Payer: Cofinity Commercial |
$329.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.30
|
| Rate for Payer: Healthscope Commercial |
$344.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.44
|
| Rate for Payer: Nomi Health Commercial |
$313.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.15
|
| Rate for Payer: PHP Commercial |
$325.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$333.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.93
|
| Rate for Payer: UHC Core |
$319.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.15
|
|
|
HC COMP BURN GARM SUSPENDERS ATTA
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
HCPCS A9900
|
| Hospital Charge Code |
98300063
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.63
|
| Rate for Payer: BCBS Complete |
$8.67
|
| Rate for Payer: BCBS MAPPO |
$11.71
|
| Rate for Payer: BCBS Trust/PPO |
$38.49
|
| Rate for Payer: BCN Commercial |
$38.49
|
| Rate for Payer: BCN Medicare Advantage |
$11.71
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.71
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$8.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.29
|
| Rate for Payer: Meridian Medicaid |
$8.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PACE Senior Care Partners |
$11.12
|
| Rate for Payer: PACE SWMI |
$11.71
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: Railroad Medicare Medicare |
$11.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: UHC Exchange |
$11.71
|
| Rate for Payer: UHC Medicaid |
$8.25
|
| Rate for Payer: UHC Medicare Advantage |
$11.71
|
| Rate for Payer: UHCCP Medicaid |
$8.25
|
| Rate for Payer: VA VA |
$11.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC COMP BURN GARM SUSPENDERS ATTA
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
HCPCS A9900
|
| Hospital Charge Code |
98300063
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$32.59 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: BCBS Trust/PPO |
$38.67
|
| Rate for Payer: BCN Commercial |
$38.67
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC COMP BURN GARM SUSPENDERS REMO
|
Facility
|
OP
|
$12.48
|
|
|
Service Code
|
HCPCS A9900
|
| Hospital Charge Code |
98300064
|
|
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 SUSPENDERS REMO
|
Facility
|
IP
|
$12.48
|
|
|
Service Code
|
HCPCS A9900
|
| Hospital Charge Code |
98300064
|
|
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 TWO LEGS PREGNA
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300065
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$181.03 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: BCBS Trust/PPO |
$214.82
|
| Rate for Payer: BCN Commercial |
$214.82
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.07
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC COMP BURN GARM TWO LEGS PREGNA
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300065
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.86 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna Medicare |
$67.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.28
|
| Rate for Payer: BCBS Complete |
$48.14
|
| Rate for Payer: BCBS MAPPO |
$65.03
|
| Rate for Payer: BCBS Trust/PPO |
$213.83
|
| Rate for Payer: BCN Commercial |
$213.83
|
| Rate for Payer: BCN Medicare Advantage |
$65.03
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.03
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.28
|
| Rate for Payer: Meridian Medicaid |
$48.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.07
|
| Rate for Payer: PACE Senior Care Partners |
$61.77
|
| Rate for Payer: PACE SWMI |
$65.03
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: PHP Medicare Advantage |
$65.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.29
|
| Rate for Payer: Priority Health Medicare |
$65.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.03
|
| Rate for Payer: Railroad Medicare Medicare |
$65.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: UHC Exchange |
$65.03
|
| Rate for Payer: UHC Medicaid |
$45.86
|
| Rate for Payer: UHC Medicare Advantage |
$65.03
|
| Rate for Payer: UHCCP Medicaid |
$45.86
|
| Rate for Payer: VA VA |
$65.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
