|
HC C-SECTION W/STERIL (OB SURGERY
|
Facility
|
OP
|
$3,753.17
|
|
| Hospital Charge Code |
36000025
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$661.68 |
| Max. Negotiated Rate |
$3,377.85 |
| Rate for Payer: Aetna Commercial |
$3,190.19
|
| Rate for Payer: Aetna Medicare |
$975.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,172.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,172.87
|
| Rate for Payer: BCBS Complete |
$694.71
|
| Rate for Payer: BCBS MAPPO |
$938.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,085.48
|
| Rate for Payer: BCN Commercial |
$3,085.48
|
| Rate for Payer: BCN Medicare Advantage |
$938.29
|
| Rate for Payer: Cash Price |
$3,002.54
|
| Rate for Payer: Cofinity Commercial |
$3,227.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,002.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$938.29
|
| Rate for Payer: Healthscope Commercial |
$3,377.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,814.88
|
| Rate for Payer: Mclaren Medicaid |
$661.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$985.21
|
| Rate for Payer: Meridian Medicaid |
$694.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,079.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,032.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,190.19
|
| Rate for Payer: Nomi Health Commercial |
$3,077.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,814.88
|
| Rate for Payer: PACE Senior Care Partners |
$891.38
|
| Rate for Payer: PACE SWMI |
$938.29
|
| Rate for Payer: PHP Commercial |
$3,190.19
|
| Rate for Payer: PHP Medicare Advantage |
$938.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$661.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,265.26
|
| Rate for Payer: Priority Health Medicare |
$947.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,612.21
|
| Rate for Payer: Railroad Medicare Medicare |
$938.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,302.79
|
| Rate for Payer: UHC Core |
$3,133.90
|
| Rate for Payer: UHC Exchange |
$938.29
|
| Rate for Payer: UHC Medicaid |
$661.68
|
| Rate for Payer: UHC Medicare Advantage |
$938.29
|
| Rate for Payer: UHCCP Medicaid |
$661.68
|
| Rate for Payer: VA VA |
$938.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,814.88
|
|
|
HC C-SECTION W/STERIL (OB SURGERY
|
Facility
|
IP
|
$3,753.17
|
|
| Hospital Charge Code |
36000025
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,612.21 |
| Max. Negotiated Rate |
$3,377.85 |
| Rate for Payer: Aetna Commercial |
$3,190.19
|
| Rate for Payer: BCBS Trust/PPO |
$3,099.74
|
| Rate for Payer: BCN Commercial |
$3,099.74
|
| Rate for Payer: Cash Price |
$3,002.54
|
| Rate for Payer: Cofinity Commercial |
$3,227.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,002.54
|
| Rate for Payer: Healthscope Commercial |
$3,377.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,814.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,190.19
|
| Rate for Payer: Nomi Health Commercial |
$3,077.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,814.88
|
| Rate for Payer: PHP Commercial |
$3,190.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,265.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,612.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,302.79
|
| Rate for Payer: UHC Core |
$3,133.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,814.88
|
|
|
HC CSF LACTATE
|
Facility
|
OP
|
$22.29
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$20.06 |
| Rate for Payer: Aetna Commercial |
$18.95
|
| Rate for Payer: Aetna Medicare |
$5.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.97
|
| Rate for Payer: BCBS Complete |
$4.13
|
| Rate for Payer: BCBS MAPPO |
$5.57
|
| Rate for Payer: BCBS Trust/PPO |
$18.32
|
| Rate for Payer: BCN Commercial |
$18.32
|
| Rate for Payer: BCN Medicare Advantage |
$5.57
|
| Rate for Payer: Cash Price |
$17.83
|
| Rate for Payer: Cofinity Commercial |
$19.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.57
|
| Rate for Payer: Healthscope Commercial |
$20.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.72
|
| Rate for Payer: Mclaren Medicaid |
$3.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.85
|
| Rate for Payer: Meridian Medicaid |
$4.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.95
|
| Rate for Payer: Nomi Health Commercial |
$18.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.72
|
| Rate for Payer: PACE Senior Care Partners |
$5.29
|
| Rate for Payer: PACE SWMI |
$5.57
|
| Rate for Payer: PHP Commercial |
$18.95
|
| Rate for Payer: PHP Medicare Advantage |
$5.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.39
|
| Rate for Payer: Priority Health Medicare |
$5.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.51
|
| Rate for Payer: Railroad Medicare Medicare |
$5.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.62
|
| Rate for Payer: UHC Core |
$18.61
|
| Rate for Payer: UHC Exchange |
$5.57
|
| Rate for Payer: UHC Medicaid |
$3.93
|
| Rate for Payer: UHC Medicare Advantage |
$5.57
|
| Rate for Payer: UHCCP Medicaid |
$3.93
|
| Rate for Payer: VA VA |
$5.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.72
|
|
|
HC CSF LACTATE
|
Facility
|
IP
|
$22.29
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.51 |
| Max. Negotiated Rate |
$20.06 |
| Rate for Payer: Aetna Commercial |
$18.95
|
| Rate for Payer: BCBS Trust/PPO |
$18.41
|
| Rate for Payer: BCN Commercial |
$18.41
|
| Rate for Payer: Cash Price |
$17.83
|
| Rate for Payer: Cofinity Commercial |
$19.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.83
|
| Rate for Payer: Healthscope Commercial |
$20.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.95
|
| Rate for Payer: Nomi Health Commercial |
$18.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.72
|
| Rate for Payer: PHP Commercial |
$18.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.62
|
| Rate for Payer: UHC Core |
$18.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.72
|
|
|
HC CSU OBSERVATION PER HOUR
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200016
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna Medicare |
$41.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.00
|
| Rate for Payer: BCBS Complete |
$29.62
|
| Rate for Payer: BCBS MAPPO |
$40.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.54
|
| Rate for Payer: BCN Commercial |
$131.54
|
| Rate for Payer: BCN Medicare Advantage |
$40.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Mclaren Medicaid |
$28.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.00
|
| Rate for Payer: Meridian Medicaid |
$29.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PACE Senior Care Partners |
$38.00
|
| Rate for Payer: PACE SWMI |
$40.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: PHP Medicare Advantage |
$40.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: Railroad Medicare Medicare |
$40.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: UHC Exchange |
$40.00
|
| Rate for Payer: UHC Medicaid |
$28.21
|
| Rate for Payer: UHC Medicare Advantage |
$40.00
|
| Rate for Payer: UHCCP Medicaid |
$850.00
|
| Rate for Payer: VA VA |
$40.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC CSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200016
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$111.36 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: BCBS Trust/PPO |
$132.14
|
| Rate for Payer: BCN Commercial |
$132.14
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC CSU R&B
|
Facility
|
IP
|
$7,454.86
|
|
| Hospital Charge Code |
21000002
|
|
Hospital Revenue Code
|
210
|
| Min. Negotiated Rate |
$1,819.25 |
| Max. Negotiated Rate |
$6,709.37 |
| Rate for Payer: Aetna Commercial |
$6,336.63
|
| 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 |
$6,156.97
|
| Rate for Payer: BCN Commercial |
$6,156.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,915.00
|
| Rate for Payer: Cash Price |
$5,963.89
|
| Rate for Payer: Cash Price |
$5,963.89
|
| Rate for Payer: Cofinity Commercial |
$6,411.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,963.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,915.00
|
| Rate for Payer: Healthscope Commercial |
$6,709.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,591.15
|
| 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 |
$6,336.63
|
| Rate for Payer: Nomi Health Commercial |
$6,112.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,591.15
|
| Rate for Payer: PACE Senior Care Partners |
$1,819.25
|
| Rate for Payer: PACE SWMI |
$1,915.00
|
| Rate for Payer: PHP Commercial |
$6,336.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,915.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,485.73
|
| Rate for Payer: Priority Health Medicare |
$1,934.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,188.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,915.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,560.28
|
| Rate for Payer: UHC Core |
$6,224.81
|
| 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 |
$5,591.15
|
|
|
HC CT ABDOMEN AND PELVIS W CON
|
Facility
|
OP
|
$3,783.83
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
35200027
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$667.09 |
| Max. Negotiated Rate |
$3,405.45 |
| Rate for Payer: Aetna Commercial |
$3,216.26
|
| Rate for Payer: Aetna Medicare |
$983.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,182.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,182.45
|
| Rate for Payer: BCBS Complete |
$700.39
|
| Rate for Payer: BCBS MAPPO |
$945.96
|
| Rate for Payer: BCBS Trust/PPO |
$3,110.69
|
| Rate for Payer: BCN Commercial |
$3,110.69
|
| Rate for Payer: BCN Medicare Advantage |
$945.96
|
| Rate for Payer: Cash Price |
$3,027.06
|
| Rate for Payer: Cofinity Commercial |
$3,254.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,027.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$945.96
|
| Rate for Payer: Healthscope Commercial |
$3,405.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,837.87
|
| Rate for Payer: Mclaren Medicaid |
$667.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$993.26
|
| Rate for Payer: Meridian Medicaid |
$700.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,087.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,040.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,216.26
|
| Rate for Payer: Nomi Health Commercial |
$3,102.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,837.87
|
| Rate for Payer: PACE Senior Care Partners |
$898.66
|
| Rate for Payer: PACE SWMI |
$945.96
|
| Rate for Payer: PHP Commercial |
$3,216.26
|
| Rate for Payer: PHP Medicare Advantage |
$945.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$667.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,291.93
|
| Rate for Payer: Priority Health Medicare |
$955.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,633.55
|
| Rate for Payer: Railroad Medicare Medicare |
$945.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,329.77
|
| Rate for Payer: UHC Core |
$3,159.50
|
| Rate for Payer: UHC Exchange |
$945.96
|
| Rate for Payer: UHC Medicaid |
$667.09
|
| Rate for Payer: UHC Medicare Advantage |
$945.96
|
| Rate for Payer: UHCCP Medicaid |
$667.09
|
| Rate for Payer: VA VA |
$945.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,837.87
|
|
|
HC CT ABDOMEN AND PELVIS W CON
|
Facility
|
IP
|
$3,783.83
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
35200027
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$2,633.55 |
| Max. Negotiated Rate |
$3,405.45 |
| Rate for Payer: Aetna Commercial |
$3,216.26
|
| Rate for Payer: BCBS Trust/PPO |
$3,125.07
|
| Rate for Payer: BCN Commercial |
$3,125.07
|
| Rate for Payer: Cash Price |
$3,027.06
|
| Rate for Payer: Cofinity Commercial |
$3,254.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,027.06
|
| Rate for Payer: Healthscope Commercial |
$3,405.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,837.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,216.26
|
| Rate for Payer: Nomi Health Commercial |
$3,102.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,837.87
|
| Rate for Payer: PHP Commercial |
$3,216.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,291.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,633.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,329.77
|
| Rate for Payer: UHC Core |
$3,159.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,837.87
|
|
|
HC CT ABDOMEN AND PELVIS WO CON
|
Facility
|
IP
|
$2,552.31
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
35200026
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,776.41 |
| Max. Negotiated Rate |
$2,297.08 |
| Rate for Payer: Aetna Commercial |
$2,169.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,107.95
|
| Rate for Payer: BCN Commercial |
$2,107.95
|
| Rate for Payer: Cash Price |
$2,041.85
|
| Rate for Payer: Cofinity Commercial |
$2,194.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,041.85
|
| Rate for Payer: Healthscope Commercial |
$2,297.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,914.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,169.46
|
| Rate for Payer: Nomi Health Commercial |
$2,092.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,914.23
|
| Rate for Payer: PHP Commercial |
$2,169.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,220.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,776.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,246.03
|
| Rate for Payer: UHC Core |
$2,131.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,914.23
|
|
|
HC CT ABDOMEN AND PELVIS WO CON
|
Facility
|
OP
|
$2,552.31
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
35200026
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$449.97 |
| Max. Negotiated Rate |
$2,297.08 |
| Rate for Payer: Aetna Commercial |
$2,169.46
|
| Rate for Payer: Aetna Medicare |
$663.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$797.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$797.60
|
| Rate for Payer: BCBS Complete |
$472.43
|
| Rate for Payer: BCBS MAPPO |
$638.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,098.25
|
| Rate for Payer: BCN Commercial |
$2,098.25
|
| Rate for Payer: BCN Medicare Advantage |
$638.08
|
| Rate for Payer: Cash Price |
$2,041.85
|
| Rate for Payer: Cofinity Commercial |
$2,194.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,041.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$638.08
|
| Rate for Payer: Healthscope Commercial |
$2,297.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,914.23
|
| Rate for Payer: Mclaren Medicaid |
$449.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$669.98
|
| Rate for Payer: Meridian Medicaid |
$472.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$733.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$701.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,169.46
|
| Rate for Payer: Nomi Health Commercial |
$2,092.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,914.23
|
| Rate for Payer: PACE Senior Care Partners |
$606.17
|
| Rate for Payer: PACE SWMI |
$638.08
|
| Rate for Payer: PHP Commercial |
$2,169.46
|
| Rate for Payer: PHP Medicare Advantage |
$638.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,220.51
|
| Rate for Payer: Priority Health Medicare |
$644.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,776.41
|
| Rate for Payer: Railroad Medicare Medicare |
$638.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,246.03
|
| Rate for Payer: UHC Core |
$2,131.18
|
| Rate for Payer: UHC Exchange |
$638.08
|
| Rate for Payer: UHC Medicaid |
$449.97
|
| Rate for Payer: UHC Medicare Advantage |
$638.08
|
| Rate for Payer: UHCCP Medicaid |
$449.97
|
| Rate for Payer: VA VA |
$638.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,914.23
|
|
|
HC CT ABDOMEN AND PELVIS WO W CON
|
Facility
|
IP
|
$4,522.30
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
35200028
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$3,147.52 |
| Max. Negotiated Rate |
$4,070.07 |
| Rate for Payer: Aetna Commercial |
$3,843.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,734.97
|
| Rate for Payer: BCN Commercial |
$3,734.97
|
| Rate for Payer: Cash Price |
$3,617.84
|
| Rate for Payer: Cofinity Commercial |
$3,889.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,617.84
|
| Rate for Payer: Healthscope Commercial |
$4,070.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,391.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,843.95
|
| Rate for Payer: Nomi Health Commercial |
$3,708.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,391.72
|
| Rate for Payer: PHP Commercial |
$3,843.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,934.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,147.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,979.62
|
| Rate for Payer: UHC Core |
$3,776.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,391.72
|
|
|
HC CT ABDOMEN AND PELVIS WO W CON
|
Facility
|
OP
|
$4,522.30
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
35200028
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$797.28 |
| Max. Negotiated Rate |
$4,070.07 |
| Rate for Payer: Aetna Commercial |
$3,843.95
|
| Rate for Payer: Aetna Medicare |
$1,175.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,413.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,413.22
|
| Rate for Payer: BCBS Complete |
$837.08
|
| Rate for Payer: BCBS MAPPO |
$1,130.58
|
| Rate for Payer: BCBS Trust/PPO |
$3,717.78
|
| Rate for Payer: BCN Commercial |
$3,717.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,130.58
|
| Rate for Payer: Cash Price |
$3,617.84
|
| Rate for Payer: Cofinity Commercial |
$3,889.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,617.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,130.58
|
| Rate for Payer: Healthscope Commercial |
$4,070.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,391.72
|
| Rate for Payer: Mclaren Medicaid |
$797.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,187.10
|
| Rate for Payer: Meridian Medicaid |
$837.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,300.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,243.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,843.95
|
| Rate for Payer: Nomi Health Commercial |
$3,708.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,391.72
|
| Rate for Payer: PACE Senior Care Partners |
$1,074.05
|
| Rate for Payer: PACE SWMI |
$1,130.58
|
| Rate for Payer: PHP Commercial |
$3,843.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,130.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$797.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,934.40
|
| Rate for Payer: Priority Health Medicare |
$1,141.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,147.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,130.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,979.62
|
| Rate for Payer: UHC Core |
$3,776.12
|
| Rate for Payer: UHC Exchange |
$1,130.58
|
| Rate for Payer: UHC Medicaid |
$797.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,130.58
|
| Rate for Payer: UHCCP Medicaid |
$797.28
|
| Rate for Payer: VA VA |
$1,130.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,391.72
|
|
|
HC CT ABDOMEN ANGIO
|
Facility
|
IP
|
$1,119.37
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
35200025
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$779.08 |
| Max. Negotiated Rate |
$1,007.43 |
| Rate for Payer: Aetna Commercial |
$951.46
|
| Rate for Payer: BCBS Trust/PPO |
$924.49
|
| Rate for Payer: BCN Commercial |
$924.49
|
| Rate for Payer: Cash Price |
$895.50
|
| Rate for Payer: Cofinity Commercial |
$962.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.50
|
| Rate for Payer: Healthscope Commercial |
$1,007.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$839.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.46
|
| Rate for Payer: Nomi Health Commercial |
$917.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$839.53
|
| Rate for Payer: PHP Commercial |
$951.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$973.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$779.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$985.05
|
| Rate for Payer: UHC Core |
$934.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$839.53
|
|
|
HC CT ABDOMEN ANGIO
|
Facility
|
OP
|
$1,119.37
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
35200025
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$197.34 |
| Max. Negotiated Rate |
$1,007.43 |
| Rate for Payer: Aetna Commercial |
$951.46
|
| Rate for Payer: Aetna Medicare |
$291.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$349.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$349.80
|
| Rate for Payer: BCBS Complete |
$207.20
|
| Rate for Payer: BCBS MAPPO |
$279.84
|
| Rate for Payer: BCBS Trust/PPO |
$920.23
|
| Rate for Payer: BCN Commercial |
$920.23
|
| Rate for Payer: BCN Medicare Advantage |
$279.84
|
| Rate for Payer: Cash Price |
$895.50
|
| Rate for Payer: Cofinity Commercial |
$962.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.84
|
| Rate for Payer: Healthscope Commercial |
$1,007.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$839.53
|
| Rate for Payer: Mclaren Medicaid |
$197.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.83
|
| Rate for Payer: Meridian Medicaid |
$207.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$321.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$307.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.46
|
| Rate for Payer: Nomi Health Commercial |
$917.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$839.53
|
| Rate for Payer: PACE Senior Care Partners |
$265.85
|
| Rate for Payer: PACE SWMI |
$279.84
|
| Rate for Payer: PHP Commercial |
$951.46
|
| Rate for Payer: PHP Medicare Advantage |
$279.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$973.85
|
| Rate for Payer: Priority Health Medicare |
$282.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$779.08
|
| Rate for Payer: Railroad Medicare Medicare |
$279.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$985.05
|
| Rate for Payer: UHC Core |
$934.67
|
| Rate for Payer: UHC Exchange |
$279.84
|
| Rate for Payer: UHC Medicaid |
$197.34
|
| Rate for Payer: UHC Medicare Advantage |
$279.84
|
| Rate for Payer: UHCCP Medicaid |
$197.34
|
| Rate for Payer: VA VA |
$279.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$839.53
|
|
|
HC CT ABDOMEN W CON
|
Facility
|
OP
|
$1,998.95
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
35200023
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$352.41 |
| Max. Negotiated Rate |
$1,799.06 |
| Rate for Payer: Aetna Commercial |
$1,699.11
|
| Rate for Payer: Aetna Medicare |
$519.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$624.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$624.67
|
| Rate for Payer: BCBS Complete |
$370.01
|
| Rate for Payer: BCBS MAPPO |
$499.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,643.34
|
| Rate for Payer: BCN Commercial |
$1,643.34
|
| Rate for Payer: BCN Medicare Advantage |
$499.74
|
| Rate for Payer: Cash Price |
$1,599.16
|
| Rate for Payer: Cofinity Commercial |
$1,719.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,599.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$499.74
|
| Rate for Payer: Healthscope Commercial |
$1,799.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,499.21
|
| Rate for Payer: Mclaren Medicaid |
$352.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$524.72
|
| Rate for Payer: Meridian Medicaid |
$370.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$574.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$549.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,699.11
|
| Rate for Payer: Nomi Health Commercial |
$1,639.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,499.21
|
| Rate for Payer: PACE Senior Care Partners |
$474.75
|
| Rate for Payer: PACE SWMI |
$499.74
|
| Rate for Payer: PHP Commercial |
$1,699.11
|
| Rate for Payer: PHP Medicare Advantage |
$499.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,739.09
|
| Rate for Payer: Priority Health Medicare |
$504.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,391.27
|
| Rate for Payer: Railroad Medicare Medicare |
$499.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,759.08
|
| Rate for Payer: UHC Core |
$1,669.12
|
| Rate for Payer: UHC Exchange |
$499.74
|
| Rate for Payer: UHC Medicaid |
$352.41
|
| Rate for Payer: UHC Medicare Advantage |
$499.74
|
| Rate for Payer: UHCCP Medicaid |
$352.41
|
| Rate for Payer: VA VA |
$499.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,499.21
|
|
|
HC CT ABDOMEN W CON
|
Facility
|
IP
|
$1,998.95
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
35200023
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,391.27 |
| Max. Negotiated Rate |
$1,799.06 |
| Rate for Payer: Aetna Commercial |
$1,699.11
|
| Rate for Payer: BCBS Trust/PPO |
$1,650.93
|
| Rate for Payer: BCN Commercial |
$1,650.93
|
| Rate for Payer: Cash Price |
$1,599.16
|
| Rate for Payer: Cofinity Commercial |
$1,719.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,599.16
|
| Rate for Payer: Healthscope Commercial |
$1,799.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,499.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,699.11
|
| Rate for Payer: Nomi Health Commercial |
$1,639.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,499.21
|
| Rate for Payer: PHP Commercial |
$1,699.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,739.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,391.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,759.08
|
| Rate for Payer: UHC Core |
$1,669.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,499.21
|
|
|
HC CT ABDOMEN WO CON
|
Facility
|
OP
|
$1,639.04
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
35200022
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$288.96 |
| Max. Negotiated Rate |
$1,475.14 |
| Rate for Payer: Aetna Commercial |
$1,393.18
|
| Rate for Payer: Aetna Medicare |
$426.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$512.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$512.20
|
| Rate for Payer: BCBS Complete |
$303.39
|
| Rate for Payer: BCBS MAPPO |
$409.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,347.45
|
| Rate for Payer: BCN Commercial |
$1,347.45
|
| Rate for Payer: BCN Medicare Advantage |
$409.76
|
| Rate for Payer: Cash Price |
$1,311.23
|
| Rate for Payer: Cofinity Commercial |
$1,409.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,311.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.76
|
| Rate for Payer: Healthscope Commercial |
$1,475.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,229.28
|
| Rate for Payer: Mclaren Medicaid |
$288.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$430.25
|
| Rate for Payer: Meridian Medicaid |
$303.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$471.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$450.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,393.18
|
| Rate for Payer: Nomi Health Commercial |
$1,344.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,229.28
|
| Rate for Payer: PACE Senior Care Partners |
$389.27
|
| Rate for Payer: PACE SWMI |
$409.76
|
| Rate for Payer: PHP Commercial |
$1,393.18
|
| Rate for Payer: PHP Medicare Advantage |
$409.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,425.96
|
| Rate for Payer: Priority Health Medicare |
$413.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,140.77
|
| Rate for Payer: Railroad Medicare Medicare |
$409.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,442.36
|
| Rate for Payer: UHC Core |
$1,368.60
|
| Rate for Payer: UHC Exchange |
$409.76
|
| Rate for Payer: UHC Medicaid |
$288.96
|
| Rate for Payer: UHC Medicare Advantage |
$409.76
|
| Rate for Payer: UHCCP Medicaid |
$288.96
|
| Rate for Payer: VA VA |
$409.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,229.28
|
|
|
HC CT ABDOMEN WO CON
|
Facility
|
IP
|
$1,639.04
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
35200022
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,140.77 |
| Max. Negotiated Rate |
$1,475.14 |
| Rate for Payer: Aetna Commercial |
$1,393.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,353.68
|
| Rate for Payer: BCN Commercial |
$1,353.68
|
| Rate for Payer: Cash Price |
$1,311.23
|
| Rate for Payer: Cofinity Commercial |
$1,409.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,311.23
|
| Rate for Payer: Healthscope Commercial |
$1,475.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,229.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,393.18
|
| Rate for Payer: Nomi Health Commercial |
$1,344.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,229.28
|
| Rate for Payer: PHP Commercial |
$1,393.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,425.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,140.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,442.36
|
| Rate for Payer: UHC Core |
$1,368.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,229.28
|
|
|
HC CT ABDOMEN WO W CON
|
Facility
|
OP
|
$2,502.70
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
35200024
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$441.23 |
| Max. Negotiated Rate |
$2,252.43 |
| Rate for Payer: Aetna Commercial |
$2,127.30
|
| Rate for Payer: Aetna Medicare |
$650.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$782.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$782.09
|
| Rate for Payer: BCBS Complete |
$463.25
|
| Rate for Payer: BCBS MAPPO |
$625.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,057.47
|
| Rate for Payer: BCN Commercial |
$2,057.47
|
| Rate for Payer: BCN Medicare Advantage |
$625.67
|
| Rate for Payer: Cash Price |
$2,002.16
|
| Rate for Payer: Cofinity Commercial |
$2,152.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,002.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.67
|
| Rate for Payer: Healthscope Commercial |
$2,252.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,877.03
|
| Rate for Payer: Mclaren Medicaid |
$441.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.96
|
| Rate for Payer: Meridian Medicaid |
$463.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$688.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,127.30
|
| Rate for Payer: Nomi Health Commercial |
$2,052.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,877.03
|
| Rate for Payer: PACE Senior Care Partners |
$594.39
|
| Rate for Payer: PACE SWMI |
$625.67
|
| Rate for Payer: PHP Commercial |
$2,127.30
|
| Rate for Payer: PHP Medicare Advantage |
$625.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$441.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,177.35
|
| Rate for Payer: Priority Health Medicare |
$631.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,741.88
|
| Rate for Payer: Railroad Medicare Medicare |
$625.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,202.38
|
| Rate for Payer: UHC Core |
$2,089.75
|
| Rate for Payer: UHC Exchange |
$625.67
|
| Rate for Payer: UHC Medicaid |
$441.23
|
| Rate for Payer: UHC Medicare Advantage |
$625.67
|
| Rate for Payer: UHCCP Medicaid |
$441.23
|
| Rate for Payer: VA VA |
$625.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,877.03
|
|
|
HC CT ABDOMEN WO W CON
|
Facility
|
IP
|
$2,502.70
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
35200024
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,741.88 |
| Max. Negotiated Rate |
$2,252.43 |
| Rate for Payer: Aetna Commercial |
$2,127.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,066.98
|
| Rate for Payer: BCN Commercial |
$2,066.98
|
| Rate for Payer: Cash Price |
$2,002.16
|
| Rate for Payer: Cofinity Commercial |
$2,152.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,002.16
|
| Rate for Payer: Healthscope Commercial |
$2,252.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,877.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,127.30
|
| Rate for Payer: Nomi Health Commercial |
$2,052.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,877.03
|
| Rate for Payer: PHP Commercial |
$2,127.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,177.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,741.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,202.38
|
| Rate for Payer: UHC Core |
$2,089.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,877.03
|
|
|
HC CT ABLATION PROCEDURE
|
Facility
|
OP
|
$1,156.81
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000030
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$203.95 |
| Max. Negotiated Rate |
$1,041.13 |
| Rate for Payer: Aetna Commercial |
$983.29
|
| Rate for Payer: Aetna Medicare |
$300.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.50
|
| Rate for Payer: BCBS Complete |
$214.13
|
| Rate for Payer: BCBS MAPPO |
$289.20
|
| Rate for Payer: BCBS Trust/PPO |
$951.01
|
| Rate for Payer: BCN Commercial |
$951.01
|
| Rate for Payer: BCN Medicare Advantage |
$289.20
|
| Rate for Payer: Cash Price |
$925.45
|
| Rate for Payer: Cofinity Commercial |
$994.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$925.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.20
|
| Rate for Payer: Healthscope Commercial |
$1,041.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$867.61
|
| Rate for Payer: Mclaren Medicaid |
$203.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.66
|
| Rate for Payer: Meridian Medicaid |
$214.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$318.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$983.29
|
| Rate for Payer: Nomi Health Commercial |
$948.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$867.61
|
| Rate for Payer: PACE Senior Care Partners |
$274.74
|
| Rate for Payer: PACE SWMI |
$289.20
|
| Rate for Payer: PHP Commercial |
$983.29
|
| Rate for Payer: PHP Medicare Advantage |
$289.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,006.42
|
| Rate for Payer: Priority Health Medicare |
$292.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$805.14
|
| Rate for Payer: Railroad Medicare Medicare |
$289.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,017.99
|
| Rate for Payer: UHC Core |
$965.94
|
| Rate for Payer: UHC Exchange |
$289.20
|
| Rate for Payer: UHC Medicaid |
$203.95
|
| Rate for Payer: UHC Medicare Advantage |
$289.20
|
| Rate for Payer: UHCCP Medicaid |
$203.95
|
| Rate for Payer: VA VA |
$289.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$867.61
|
|
|
HC CT ABLATION PROCEDURE
|
Facility
|
IP
|
$1,156.81
|
|
|
Service Code
|
CPT 77013
|
| Hospital Charge Code |
35000030
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$805.14 |
| Max. Negotiated Rate |
$1,041.13 |
| Rate for Payer: Aetna Commercial |
$983.29
|
| Rate for Payer: BCBS Trust/PPO |
$955.41
|
| Rate for Payer: BCN Commercial |
$955.41
|
| Rate for Payer: Cash Price |
$925.45
|
| Rate for Payer: Cofinity Commercial |
$994.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$925.45
|
| Rate for Payer: Healthscope Commercial |
$1,041.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$867.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$983.29
|
| Rate for Payer: Nomi Health Commercial |
$948.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$867.61
|
| Rate for Payer: PHP Commercial |
$983.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,006.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$805.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,017.99
|
| Rate for Payer: UHC Core |
$965.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$867.61
|
|
|
HC CTA HEAD/NECK W CONTRAST
|
Facility
|
IP
|
$2,187.00
|
|
|
Service Code
|
CPT 70471
|
| Hospital Charge Code |
35100012
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,522.15 |
| Max. Negotiated Rate |
$1,968.30 |
| Rate for Payer: Aetna Commercial |
$1,858.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,806.24
|
| Rate for Payer: BCN Commercial |
$1,806.24
|
| Rate for Payer: Cash Price |
$1,749.60
|
| Rate for Payer: Cofinity Commercial |
$1,880.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,749.60
|
| Rate for Payer: Healthscope Commercial |
$1,968.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,640.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,858.95
|
| Rate for Payer: Nomi Health Commercial |
$1,793.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,640.25
|
| Rate for Payer: PHP Commercial |
$1,858.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,902.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,522.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,924.56
|
| Rate for Payer: UHC Core |
$1,826.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,640.25
|
|
|
HC CTA HEAD/NECK W CONTRAST
|
Facility
|
OP
|
$2,187.00
|
|
|
Service Code
|
CPT 70471
|
| Hospital Charge Code |
35100012
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$385.57 |
| Max. Negotiated Rate |
$1,968.30 |
| Rate for Payer: Aetna Commercial |
$1,858.95
|
| Rate for Payer: Aetna Medicare |
$568.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$683.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$683.44
|
| Rate for Payer: BCBS Complete |
$404.81
|
| Rate for Payer: BCBS MAPPO |
$546.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,797.93
|
| Rate for Payer: BCN Commercial |
$1,797.93
|
| Rate for Payer: BCN Medicare Advantage |
$546.75
|
| Rate for Payer: Cash Price |
$1,749.60
|
| Rate for Payer: Cofinity Commercial |
$1,880.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,749.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.75
|
| Rate for Payer: Healthscope Commercial |
$1,968.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,640.25
|
| Rate for Payer: Mclaren Medicaid |
$385.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$574.09
|
| Rate for Payer: Meridian Medicaid |
$404.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$628.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$601.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,858.95
|
| Rate for Payer: Nomi Health Commercial |
$1,793.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,640.25
|
| Rate for Payer: PACE Senior Care Partners |
$519.41
|
| Rate for Payer: PACE SWMI |
$546.75
|
| Rate for Payer: PHP Commercial |
$1,858.95
|
| Rate for Payer: PHP Medicare Advantage |
$546.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,902.69
|
| Rate for Payer: Priority Health Medicare |
$552.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,522.15
|
| Rate for Payer: Railroad Medicare Medicare |
$546.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,924.56
|
| Rate for Payer: UHC Core |
$1,826.14
|
| Rate for Payer: UHC Exchange |
$546.75
|
| Rate for Payer: UHC Medicaid |
$385.57
|
| Rate for Payer: UHC Medicare Advantage |
$546.75
|
| Rate for Payer: UHCCP Medicaid |
$385.57
|
| Rate for Payer: VA VA |
$546.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,640.25
|
|
