|
HC CRITIC AID 6.5 OZ
|
Facility
|
IP
|
$40.79
|
|
| Hospital Charge Code |
27100008
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$28.39 |
| Max. Negotiated Rate |
$36.71 |
| Rate for Payer: Aetna Commercial |
$34.67
|
| Rate for Payer: BCBS Trust/PPO |
$33.69
|
| Rate for Payer: BCN Commercial |
$33.69
|
| Rate for Payer: Cash Price |
$32.63
|
| Rate for Payer: Cofinity Commercial |
$35.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.63
|
| Rate for Payer: Healthscope Commercial |
$36.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.67
|
| Rate for Payer: Nomi Health Commercial |
$33.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.59
|
| Rate for Payer: PHP Commercial |
$34.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.59
|
|
|
HC CRITIC AID 6.5 OZ
|
Facility
|
OP
|
$40.79
|
|
| Hospital Charge Code |
27100008
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.19 |
| Max. Negotiated Rate |
$36.71 |
| Rate for Payer: Aetna Commercial |
$34.67
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$7.55
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$33.53
|
| Rate for Payer: BCN Commercial |
$33.53
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.63
|
| Rate for Payer: Cofinity Commercial |
$35.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.59
|
| Rate for Payer: Mclaren Medicaid |
$7.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: Meridian Medicaid |
$7.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.67
|
| Rate for Payer: Nomi Health Commercial |
$33.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.59
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.67
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.49
|
| Rate for Payer: Priority Health Medicare |
$10.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.39
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.06
|
| Rate for Payer: UHC Exchange |
$10.20
|
| Rate for Payer: UHC Medicaid |
$7.19
|
| Rate for Payer: UHC Medicare Advantage |
$10.20
|
| Rate for Payer: UHCCP Medicaid |
$7.19
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.59
|
|
|
HC CRITICAL CARE R&B
|
Facility
|
IP
|
$6,464.21
|
|
| Hospital Charge Code |
20000001
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$1,819.25 |
| Max. Negotiated Rate |
$5,817.79 |
| Rate for Payer: Aetna Commercial |
$5,494.58
|
| Rate for Payer: Aetna Medicare |
$1,991.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,393.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,393.75
|
| Rate for Payer: BCBS MAPPO |
$1,915.00
|
| Rate for Payer: BCBS Trust/PPO |
$5,338.79
|
| Rate for Payer: BCN Commercial |
$5,338.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,915.00
|
| Rate for Payer: Cash Price |
$5,171.37
|
| Rate for Payer: Cash Price |
$5,171.37
|
| Rate for Payer: Cofinity Commercial |
$5,559.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,171.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,915.00
|
| Rate for Payer: Healthscope Commercial |
$5,817.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,848.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,010.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,202.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,106.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,494.58
|
| Rate for Payer: Nomi Health Commercial |
$5,300.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,848.16
|
| Rate for Payer: PACE Senior Care Partners |
$1,819.25
|
| Rate for Payer: PACE SWMI |
$1,915.00
|
| Rate for Payer: PHP Commercial |
$5,494.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,915.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,623.86
|
| Rate for Payer: Priority Health Medicare |
$1,934.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,499.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,915.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,688.50
|
| Rate for Payer: UHC Core |
$5,397.62
|
| Rate for Payer: UHC Exchange |
$1,915.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,915.00
|
| Rate for Payer: VA VA |
$1,915.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,848.16
|
|
|
HC CRMP 5 IGG WB
|
Facility
|
OP
|
$163.34
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100640
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.80 |
| Max. Negotiated Rate |
$147.01 |
| Rate for Payer: Aetna Commercial |
$138.84
|
| Rate for Payer: Aetna Medicare |
$42.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.04
|
| Rate for Payer: BCBS Complete |
$30.23
|
| Rate for Payer: BCBS MAPPO |
$40.84
|
| Rate for Payer: BCBS Trust/PPO |
$134.28
|
| Rate for Payer: BCN Commercial |
$134.28
|
| Rate for Payer: BCN Medicare Advantage |
$40.84
|
| Rate for Payer: Cash Price |
$130.67
|
| Rate for Payer: Cofinity Commercial |
$140.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.84
|
| Rate for Payer: Healthscope Commercial |
$147.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.50
|
| Rate for Payer: Mclaren Medicaid |
$28.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.88
|
| Rate for Payer: Meridian Medicaid |
$30.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.84
|
| Rate for Payer: Nomi Health Commercial |
$133.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.50
|
| Rate for Payer: PACE Senior Care Partners |
$38.79
|
| Rate for Payer: PACE SWMI |
$40.84
|
| Rate for Payer: PHP Commercial |
$138.84
|
| Rate for Payer: PHP Medicare Advantage |
$40.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$142.11
|
| Rate for Payer: Priority Health Medicare |
$41.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.68
|
| Rate for Payer: Railroad Medicare Medicare |
$40.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.74
|
| Rate for Payer: UHC Core |
$136.39
|
| Rate for Payer: UHC Exchange |
$40.84
|
| Rate for Payer: UHC Medicaid |
$28.80
|
| Rate for Payer: UHC Medicare Advantage |
$40.84
|
| Rate for Payer: UHCCP Medicaid |
$28.80
|
| Rate for Payer: VA VA |
$40.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.50
|
|
|
HC CRMP 5 IGG WB
|
Facility
|
IP
|
$163.34
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100640
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$113.68 |
| Max. Negotiated Rate |
$147.01 |
| Rate for Payer: Aetna Commercial |
$138.84
|
| Rate for Payer: BCBS Trust/PPO |
$134.90
|
| Rate for Payer: BCN Commercial |
$134.90
|
| Rate for Payer: Cash Price |
$130.67
|
| Rate for Payer: Cofinity Commercial |
$140.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.67
|
| Rate for Payer: Healthscope Commercial |
$147.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.84
|
| Rate for Payer: Nomi Health Commercial |
$133.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.50
|
| Rate for Payer: PHP Commercial |
$138.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$142.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.74
|
| Rate for Payer: UHC Core |
$136.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.50
|
|
|
HC CRMP 5 IGG WESTERN BLOT
|
Facility
|
IP
|
$161.26
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200180
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$112.24 |
| Max. Negotiated Rate |
$145.13 |
| Rate for Payer: Aetna Commercial |
$137.07
|
| Rate for Payer: BCBS Trust/PPO |
$133.18
|
| Rate for Payer: BCN Commercial |
$133.18
|
| Rate for Payer: Cash Price |
$129.01
|
| Rate for Payer: Cofinity Commercial |
$138.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.01
|
| Rate for Payer: Healthscope Commercial |
$145.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.07
|
| Rate for Payer: Nomi Health Commercial |
$132.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.94
|
| Rate for Payer: PHP Commercial |
$137.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$140.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.91
|
| Rate for Payer: UHC Core |
$134.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.94
|
|
|
HC CRMP 5 IGG WESTERN BLOT
|
Facility
|
OP
|
$161.26
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200180
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.43 |
| Max. Negotiated Rate |
$145.13 |
| Rate for Payer: Aetna Commercial |
$137.07
|
| Rate for Payer: Aetna Medicare |
$41.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.39
|
| Rate for Payer: BCBS Complete |
$29.85
|
| Rate for Payer: BCBS MAPPO |
$40.31
|
| Rate for Payer: BCBS Trust/PPO |
$132.57
|
| Rate for Payer: BCN Commercial |
$132.57
|
| Rate for Payer: BCN Medicare Advantage |
$40.31
|
| Rate for Payer: Cash Price |
$129.01
|
| Rate for Payer: Cofinity Commercial |
$138.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.31
|
| Rate for Payer: Healthscope Commercial |
$145.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.94
|
| Rate for Payer: Mclaren Medicaid |
$28.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.33
|
| Rate for Payer: Meridian Medicaid |
$29.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.07
|
| Rate for Payer: Nomi Health Commercial |
$132.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.94
|
| Rate for Payer: PACE Senior Care Partners |
$38.30
|
| Rate for Payer: PACE SWMI |
$40.31
|
| Rate for Payer: PHP Commercial |
$137.07
|
| Rate for Payer: PHP Medicare Advantage |
$40.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$140.30
|
| Rate for Payer: Priority Health Medicare |
$40.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.24
|
| Rate for Payer: Railroad Medicare Medicare |
$40.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.91
|
| Rate for Payer: UHC Core |
$134.65
|
| Rate for Payer: UHC Exchange |
$40.31
|
| Rate for Payer: UHC Medicaid |
$28.43
|
| Rate for Payer: UHC Medicare Advantage |
$40.31
|
| Rate for Payer: UHCCP Medicaid |
$28.43
|
| Rate for Payer: VA VA |
$40.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.94
|
|
|
HC CROSSMATCH COOMBS
|
Facility
|
IP
|
$188.31
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
30200352
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$131.06 |
| Max. Negotiated Rate |
$169.48 |
| Rate for Payer: Aetna Commercial |
$160.06
|
| Rate for Payer: BCBS Trust/PPO |
$155.53
|
| Rate for Payer: BCN Commercial |
$155.53
|
| Rate for Payer: Cash Price |
$150.65
|
| Rate for Payer: Cofinity Commercial |
$161.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.65
|
| Rate for Payer: Healthscope Commercial |
$169.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.06
|
| Rate for Payer: Nomi Health Commercial |
$154.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.23
|
| Rate for Payer: PHP Commercial |
$160.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$163.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.71
|
| Rate for Payer: UHC Core |
$157.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.23
|
|
|
HC CROSSMATCH COOMBS
|
Facility
|
OP
|
$188.31
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
30200352
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.20 |
| Max. Negotiated Rate |
$169.48 |
| Rate for Payer: Aetna Commercial |
$160.06
|
| Rate for Payer: Aetna Medicare |
$48.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.85
|
| Rate for Payer: BCBS Complete |
$34.86
|
| Rate for Payer: BCBS MAPPO |
$47.08
|
| Rate for Payer: BCBS Trust/PPO |
$154.81
|
| Rate for Payer: BCN Commercial |
$154.81
|
| Rate for Payer: BCN Medicare Advantage |
$47.08
|
| Rate for Payer: Cash Price |
$150.65
|
| Rate for Payer: Cofinity Commercial |
$161.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.08
|
| Rate for Payer: Healthscope Commercial |
$169.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.23
|
| Rate for Payer: Mclaren Medicaid |
$33.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.43
|
| Rate for Payer: Meridian Medicaid |
$34.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.06
|
| Rate for Payer: Nomi Health Commercial |
$154.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.23
|
| Rate for Payer: PACE Senior Care Partners |
$44.72
|
| Rate for Payer: PACE SWMI |
$47.08
|
| Rate for Payer: PHP Commercial |
$160.06
|
| Rate for Payer: PHP Medicare Advantage |
$47.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$163.83
|
| Rate for Payer: Priority Health Medicare |
$47.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$131.06
|
| Rate for Payer: Railroad Medicare Medicare |
$47.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.71
|
| Rate for Payer: UHC Core |
$157.24
|
| Rate for Payer: UHC Exchange |
$47.08
|
| Rate for Payer: UHC Medicaid |
$33.20
|
| Rate for Payer: UHC Medicare Advantage |
$47.08
|
| Rate for Payer: UHCCP Medicaid |
$33.20
|
| Rate for Payer: VA VA |
$47.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.23
|
|
|
HC CROSSMATCH ELECTRONIC
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
30200380
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.31 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: BCBS Trust/PPO |
$52.59
|
| Rate for Payer: BCN Commercial |
$52.59
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.03
|
| Rate for Payer: UHC Core |
$53.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC CROSSMATCH ELECTRONIC
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
30200380
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.23 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna Medicare |
$16.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.90
|
| Rate for Payer: BCBS Complete |
$11.79
|
| Rate for Payer: BCBS MAPPO |
$15.92
|
| Rate for Payer: BCBS Trust/PPO |
$52.34
|
| Rate for Payer: BCN Commercial |
$52.34
|
| Rate for Payer: BCN Medicare Advantage |
$15.92
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.92
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$11.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.71
|
| Rate for Payer: Meridian Medicaid |
$11.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Senior Care Partners |
$15.12
|
| Rate for Payer: PACE SWMI |
$15.92
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: PHP Medicare Advantage |
$15.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.39
|
| Rate for Payer: Priority Health Medicare |
$16.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.31
|
| Rate for Payer: Railroad Medicare Medicare |
$15.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.03
|
| Rate for Payer: UHC Core |
$53.16
|
| Rate for Payer: UHC Exchange |
$15.92
|
| Rate for Payer: UHC Medicaid |
$11.23
|
| Rate for Payer: UHC Medicare Advantage |
$15.92
|
| Rate for Payer: UHCCP Medicaid |
$11.23
|
| Rate for Payer: VA VA |
$15.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC CROSSMATCH IMMED SPIN
|
Facility
|
IP
|
$93.71
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
30200351
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$65.22 |
| Max. Negotiated Rate |
$84.34 |
| Rate for Payer: Aetna Commercial |
$79.65
|
| Rate for Payer: BCBS Trust/PPO |
$77.40
|
| Rate for Payer: BCN Commercial |
$77.40
|
| Rate for Payer: Cash Price |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$80.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.97
|
| Rate for Payer: Healthscope Commercial |
$84.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.65
|
| Rate for Payer: Nomi Health Commercial |
$76.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.28
|
| Rate for Payer: PHP Commercial |
$79.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.46
|
| Rate for Payer: UHC Core |
$78.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.28
|
|
|
HC CROSSMATCH IMMED SPIN
|
Facility
|
OP
|
$93.71
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
30200351
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.52 |
| Max. Negotiated Rate |
$84.34 |
| Rate for Payer: Aetna Commercial |
$79.65
|
| Rate for Payer: Aetna Medicare |
$24.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.28
|
| Rate for Payer: BCBS Complete |
$17.35
|
| Rate for Payer: BCBS MAPPO |
$23.43
|
| Rate for Payer: BCBS Trust/PPO |
$77.04
|
| Rate for Payer: BCN Commercial |
$77.04
|
| Rate for Payer: BCN Medicare Advantage |
$23.43
|
| Rate for Payer: Cash Price |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$80.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.43
|
| Rate for Payer: Healthscope Commercial |
$84.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.28
|
| Rate for Payer: Mclaren Medicaid |
$16.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.60
|
| Rate for Payer: Meridian Medicaid |
$17.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.65
|
| Rate for Payer: Nomi Health Commercial |
$76.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.28
|
| Rate for Payer: PACE Senior Care Partners |
$22.26
|
| Rate for Payer: PACE SWMI |
$23.43
|
| Rate for Payer: PHP Commercial |
$79.65
|
| Rate for Payer: PHP Medicare Advantage |
$23.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.53
|
| Rate for Payer: Priority Health Medicare |
$23.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.22
|
| Rate for Payer: Railroad Medicare Medicare |
$23.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.46
|
| Rate for Payer: UHC Core |
$78.25
|
| Rate for Payer: UHC Exchange |
$23.43
|
| Rate for Payer: UHC Medicaid |
$16.52
|
| Rate for Payer: UHC Medicare Advantage |
$23.43
|
| Rate for Payer: UHCCP Medicaid |
$16.52
|
| Rate for Payer: VA VA |
$23.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.28
|
|
|
HC CROSSMATCH PREWARM
|
Facility
|
OP
|
$237.73
|
|
|
Service Code
|
CPT 86921
|
| Hospital Charge Code |
30200491
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$41.91 |
| Max. Negotiated Rate |
$213.96 |
| Rate for Payer: Aetna Commercial |
$202.07
|
| Rate for Payer: Aetna Medicare |
$61.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.29
|
| Rate for Payer: BCBS Complete |
$44.00
|
| Rate for Payer: BCBS MAPPO |
$59.43
|
| Rate for Payer: BCBS Trust/PPO |
$195.44
|
| Rate for Payer: BCN Commercial |
$195.44
|
| Rate for Payer: BCN Medicare Advantage |
$59.43
|
| Rate for Payer: Cash Price |
$190.18
|
| Rate for Payer: Cofinity Commercial |
$204.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.43
|
| Rate for Payer: Healthscope Commercial |
$213.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.30
|
| Rate for Payer: Mclaren Medicaid |
$41.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.40
|
| Rate for Payer: Meridian Medicaid |
$44.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.07
|
| Rate for Payer: Nomi Health Commercial |
$194.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.30
|
| Rate for Payer: PACE Senior Care Partners |
$56.46
|
| Rate for Payer: PACE SWMI |
$59.43
|
| Rate for Payer: PHP Commercial |
$202.07
|
| Rate for Payer: PHP Medicare Advantage |
$59.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$206.83
|
| Rate for Payer: Priority Health Medicare |
$60.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.46
|
| Rate for Payer: Railroad Medicare Medicare |
$59.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.20
|
| Rate for Payer: UHC Core |
$198.50
|
| Rate for Payer: UHC Exchange |
$59.43
|
| Rate for Payer: UHC Medicaid |
$41.91
|
| Rate for Payer: UHC Medicare Advantage |
$59.43
|
| Rate for Payer: UHCCP Medicaid |
$41.91
|
| Rate for Payer: VA VA |
$59.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.30
|
|
|
HC CROSSMATCH PREWARM
|
Facility
|
IP
|
$237.73
|
|
|
Service Code
|
CPT 86921
|
| Hospital Charge Code |
30200491
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$165.46 |
| Max. Negotiated Rate |
$213.96 |
| Rate for Payer: Aetna Commercial |
$202.07
|
| Rate for Payer: BCBS Trust/PPO |
$196.34
|
| Rate for Payer: BCN Commercial |
$196.34
|
| Rate for Payer: Cash Price |
$190.18
|
| Rate for Payer: Cofinity Commercial |
$204.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.18
|
| Rate for Payer: Healthscope Commercial |
$213.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.07
|
| Rate for Payer: Nomi Health Commercial |
$194.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.30
|
| Rate for Payer: PHP Commercial |
$202.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$206.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.20
|
| Rate for Payer: UHC Core |
$198.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.30
|
|
|
HC CRP HIGH SENSITIVITY CARDIAC RISK
|
Facility
|
IP
|
$94.05
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
30200138
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$65.46 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: BCBS Trust/PPO |
$77.68
|
| Rate for Payer: BCN Commercial |
$77.68
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Nomi Health Commercial |
$77.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.54
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.76
|
| Rate for Payer: UHC Core |
$78.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC CRP HIGH SENSITIVITY CARDIAC RISK
|
Facility
|
OP
|
$94.05
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
30200138
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.58 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: Aetna Medicare |
$24.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.39
|
| Rate for Payer: BCBS Complete |
$17.41
|
| Rate for Payer: BCBS MAPPO |
$23.51
|
| Rate for Payer: BCBS Trust/PPO |
$77.32
|
| Rate for Payer: BCN Commercial |
$77.32
|
| Rate for Payer: BCN Medicare Advantage |
$23.51
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.51
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Mclaren Medicaid |
$16.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.69
|
| Rate for Payer: Meridian Medicaid |
$17.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Nomi Health Commercial |
$77.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.54
|
| Rate for Payer: PACE Senior Care Partners |
$22.34
|
| Rate for Payer: PACE SWMI |
$23.51
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: PHP Medicare Advantage |
$23.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.82
|
| Rate for Payer: Priority Health Medicare |
$23.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.46
|
| Rate for Payer: Railroad Medicare Medicare |
$23.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.76
|
| Rate for Payer: UHC Core |
$78.53
|
| Rate for Payer: UHC Exchange |
$23.51
|
| Rate for Payer: UHC Medicaid |
$16.58
|
| Rate for Payer: UHC Medicare Advantage |
$23.51
|
| Rate for Payer: UHCCP Medicaid |
$16.58
|
| Rate for Payer: VA VA |
$23.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC CRP-SF
|
Facility
|
OP
|
$30.57
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$27.51 |
| Rate for Payer: Aetna Commercial |
$25.98
|
| Rate for Payer: Aetna Medicare |
$7.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.55
|
| Rate for Payer: BCBS Complete |
$5.66
|
| Rate for Payer: BCBS MAPPO |
$7.64
|
| Rate for Payer: BCBS Trust/PPO |
$25.13
|
| Rate for Payer: BCN Commercial |
$25.13
|
| Rate for Payer: BCN Medicare Advantage |
$7.64
|
| Rate for Payer: Cash Price |
$24.46
|
| Rate for Payer: Cofinity Commercial |
$26.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.64
|
| Rate for Payer: Healthscope Commercial |
$27.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.93
|
| Rate for Payer: Mclaren Medicaid |
$5.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.02
|
| Rate for Payer: Meridian Medicaid |
$5.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.98
|
| Rate for Payer: Nomi Health Commercial |
$25.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.93
|
| Rate for Payer: PACE Senior Care Partners |
$7.26
|
| Rate for Payer: PACE SWMI |
$7.64
|
| Rate for Payer: PHP Commercial |
$25.98
|
| Rate for Payer: PHP Medicare Advantage |
$7.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.60
|
| Rate for Payer: Priority Health Medicare |
$7.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.28
|
| Rate for Payer: Railroad Medicare Medicare |
$7.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.90
|
| Rate for Payer: UHC Core |
$25.53
|
| Rate for Payer: UHC Exchange |
$7.64
|
| Rate for Payer: UHC Medicaid |
$5.39
|
| Rate for Payer: UHC Medicare Advantage |
$7.64
|
| Rate for Payer: UHCCP Medicaid |
$5.39
|
| Rate for Payer: VA VA |
$7.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.93
|
|
|
HC CRP-SF
|
Facility
|
IP
|
$30.57
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.28 |
| Max. Negotiated Rate |
$27.51 |
| Rate for Payer: Aetna Commercial |
$25.98
|
| Rate for Payer: BCBS Trust/PPO |
$25.25
|
| Rate for Payer: BCN Commercial |
$25.25
|
| Rate for Payer: Cash Price |
$24.46
|
| Rate for Payer: Cofinity Commercial |
$26.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.46
|
| Rate for Payer: Healthscope Commercial |
$27.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.98
|
| Rate for Payer: Nomi Health Commercial |
$25.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.93
|
| Rate for Payer: PHP Commercial |
$25.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.90
|
| Rate for Payer: UHC Core |
$25.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.93
|
|
|
HC CRRT INITIAL
|
Facility
|
IP
|
$728.28
|
|
| Hospital Charge Code |
27000607
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$506.88 |
| Max. Negotiated Rate |
$655.45 |
| Rate for Payer: Aetna Commercial |
$619.04
|
| Rate for Payer: BCBS Trust/PPO |
$601.49
|
| Rate for Payer: BCN Commercial |
$601.49
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cofinity Commercial |
$626.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.62
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.04
|
| Rate for Payer: Nomi Health Commercial |
$597.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.21
|
| Rate for Payer: PHP Commercial |
$619.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$633.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$506.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$640.89
|
| Rate for Payer: UHC Core |
$608.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.21
|
|
|
HC CRRT INITIAL
|
Facility
|
OP
|
$728.28
|
|
| Hospital Charge Code |
27000607
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$128.40 |
| Max. Negotiated Rate |
$655.45 |
| Rate for Payer: Aetna Commercial |
$619.04
|
| Rate for Payer: Aetna Medicare |
$189.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$227.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$227.59
|
| Rate for Payer: BCBS Complete |
$134.80
|
| Rate for Payer: BCBS MAPPO |
$182.07
|
| Rate for Payer: BCBS Trust/PPO |
$598.72
|
| Rate for Payer: BCN Commercial |
$598.72
|
| Rate for Payer: BCN Medicare Advantage |
$182.07
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cofinity Commercial |
$626.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.07
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.21
|
| Rate for Payer: Mclaren Medicaid |
$128.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.17
|
| Rate for Payer: Meridian Medicaid |
$134.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$209.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$200.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.04
|
| Rate for Payer: Nomi Health Commercial |
$597.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.21
|
| Rate for Payer: PACE Senior Care Partners |
$172.97
|
| Rate for Payer: PACE SWMI |
$182.07
|
| Rate for Payer: PHP Commercial |
$619.04
|
| Rate for Payer: PHP Medicare Advantage |
$182.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$633.60
|
| Rate for Payer: Priority Health Medicare |
$183.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$506.88
|
| Rate for Payer: Railroad Medicare Medicare |
$182.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$640.89
|
| Rate for Payer: UHC Core |
$608.11
|
| Rate for Payer: UHC Exchange |
$182.07
|
| Rate for Payer: UHC Medicaid |
$128.40
|
| Rate for Payer: UHC Medicare Advantage |
$182.07
|
| Rate for Payer: UHCCP Medicaid |
$128.40
|
| Rate for Payer: VA VA |
$182.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.21
|
|
|
HC CRRT INITIATION/REINITIATION
|
Facility
|
IP
|
$1,157.78
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
88000001
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$805.81 |
| Max. Negotiated Rate |
$1,042.00 |
| Rate for Payer: Aetna Commercial |
$984.11
|
| Rate for Payer: BCBS Trust/PPO |
$956.21
|
| Rate for Payer: BCN Commercial |
$956.21
|
| Rate for Payer: Cash Price |
$926.22
|
| Rate for Payer: Cofinity Commercial |
$995.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$926.22
|
| Rate for Payer: Healthscope Commercial |
$1,042.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$868.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$984.11
|
| Rate for Payer: Nomi Health Commercial |
$949.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$868.34
|
| Rate for Payer: PHP Commercial |
$984.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,007.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$805.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,018.85
|
| Rate for Payer: UHC Core |
$966.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$868.34
|
|
|
HC CRRT INITIATION/REINITIATION
|
Facility
|
OP
|
$1,157.78
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
88000001
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$204.12 |
| Max. Negotiated Rate |
$1,042.00 |
| Rate for Payer: Aetna Commercial |
$984.11
|
| Rate for Payer: Aetna Medicare |
$301.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.81
|
| Rate for Payer: BCBS Complete |
$214.31
|
| Rate for Payer: BCBS MAPPO |
$289.44
|
| Rate for Payer: BCBS Trust/PPO |
$951.81
|
| Rate for Payer: BCN Commercial |
$951.81
|
| Rate for Payer: BCN Medicare Advantage |
$289.44
|
| Rate for Payer: Cash Price |
$926.22
|
| Rate for Payer: Cofinity Commercial |
$995.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$926.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.44
|
| Rate for Payer: Healthscope Commercial |
$1,042.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$868.34
|
| Rate for Payer: Mclaren Medicaid |
$204.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.92
|
| Rate for Payer: Meridian Medicaid |
$214.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$318.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$984.11
|
| Rate for Payer: Nomi Health Commercial |
$949.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$868.34
|
| Rate for Payer: PACE Senior Care Partners |
$274.97
|
| Rate for Payer: PACE SWMI |
$289.44
|
| Rate for Payer: PHP Commercial |
$984.11
|
| Rate for Payer: PHP Medicare Advantage |
$289.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$204.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,007.27
|
| Rate for Payer: Priority Health Medicare |
$292.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$805.81
|
| Rate for Payer: Railroad Medicare Medicare |
$289.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,018.85
|
| Rate for Payer: UHC Core |
$966.75
|
| Rate for Payer: UHC Exchange |
$289.44
|
| Rate for Payer: UHC Medicaid |
$204.12
|
| Rate for Payer: UHC Medicare Advantage |
$289.44
|
| Rate for Payer: UHCCP Medicaid |
$204.12
|
| Rate for Payer: VA VA |
$289.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$868.34
|
|
|
HC CRRT MONITOR FEE
|
Facility
|
OP
|
$130.05
|
|
| Hospital Charge Code |
27000609
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.93 |
| Max. Negotiated Rate |
$117.05 |
| Rate for Payer: Aetna Commercial |
$110.54
|
| Rate for Payer: Aetna Medicare |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.64
|
| Rate for Payer: BCBS Complete |
$24.07
|
| Rate for Payer: BCBS MAPPO |
$32.51
|
| Rate for Payer: BCBS Trust/PPO |
$106.91
|
| Rate for Payer: BCN Commercial |
$106.91
|
| Rate for Payer: BCN Medicare Advantage |
$32.51
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Commercial |
$111.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.51
|
| Rate for Payer: Healthscope Commercial |
$117.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.54
|
| Rate for Payer: Mclaren Medicaid |
$22.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.14
|
| Rate for Payer: Meridian Medicaid |
$24.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: Nomi Health Commercial |
$106.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.54
|
| Rate for Payer: PACE Senior Care Partners |
$30.89
|
| Rate for Payer: PACE SWMI |
$32.51
|
| Rate for Payer: PHP Commercial |
$110.54
|
| Rate for Payer: PHP Medicare Advantage |
$32.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.14
|
| Rate for Payer: Priority Health Medicare |
$32.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.51
|
| Rate for Payer: Railroad Medicare Medicare |
$32.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.44
|
| Rate for Payer: UHC Core |
$108.59
|
| Rate for Payer: UHC Exchange |
$32.51
|
| Rate for Payer: UHC Medicaid |
$22.93
|
| Rate for Payer: UHC Medicare Advantage |
$32.51
|
| Rate for Payer: UHCCP Medicaid |
$22.93
|
| Rate for Payer: VA VA |
$32.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.54
|
|
|
HC CRRT MONITOR FEE
|
Facility
|
IP
|
$130.05
|
|
| Hospital Charge Code |
27000609
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$90.51 |
| Max. Negotiated Rate |
$117.05 |
| Rate for Payer: Aetna Commercial |
$110.54
|
| Rate for Payer: BCBS Trust/PPO |
$107.41
|
| Rate for Payer: BCN Commercial |
$107.41
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Commercial |
$111.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Healthscope Commercial |
$117.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: Nomi Health Commercial |
$106.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.54
|
| Rate for Payer: PHP Commercial |
$110.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.44
|
| Rate for Payer: UHC Core |
$108.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.54
|
|
