|
HC GUIDING CATHETER LVL 3
|
Facility
|
OP
|
$330.88
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200061
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.58 |
| Max. Negotiated Rate |
$297.79 |
| Rate for Payer: Aetna Commercial |
$281.25
|
| Rate for Payer: Aetna Medicare |
$86.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.40
|
| Rate for Payer: BCBS Complete |
$132.35
|
| Rate for Payer: BCBS MAPPO |
$82.72
|
| Rate for Payer: BCBS Trust/PPO |
$257.26
|
| Rate for Payer: BCN Commercial |
$257.26
|
| Rate for Payer: BCN Medicare Advantage |
$82.72
|
| Rate for Payer: Cash Price |
$264.70
|
| Rate for Payer: Cofinity Commercial |
$284.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.72
|
| Rate for Payer: Healthscope Commercial |
$297.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$86.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$281.25
|
| Rate for Payer: PACE Senior Care Partners |
$78.58
|
| Rate for Payer: PACE SWMI |
$82.72
|
| Rate for Payer: PHP Commercial |
$281.25
|
| Rate for Payer: PHP Medicare Advantage |
$82.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.87
|
| Rate for Payer: Priority Health Medicare |
$82.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.80
|
| Rate for Payer: Railroad Medicare Medicare |
$82.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.17
|
| Rate for Payer: UHC Core |
$276.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.72
|
| Rate for Payer: UHC Medicare Advantage |
$85.20
|
| Rate for Payer: VA VA |
$82.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.16
|
|
|
HC GUIDING CATHETER LVL 3
|
Facility
|
IP
|
$330.88
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200061
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$201.80 |
| Max. Negotiated Rate |
$297.79 |
| Rate for Payer: Aetna Commercial |
$281.25
|
| Rate for Payer: BCBS Trust/PPO |
$255.70
|
| Rate for Payer: BCN Commercial |
$255.70
|
| Rate for Payer: Cash Price |
$264.70
|
| Rate for Payer: Cofinity Commercial |
$284.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.70
|
| Rate for Payer: Healthscope Commercial |
$297.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$281.25
|
| Rate for Payer: PHP Commercial |
$281.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$287.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.17
|
| Rate for Payer: UHC Core |
$276.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.16
|
|
|
HC GUIDING CATHETER LVL 35
|
Facility
|
IP
|
$3,522.11
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,148.13 |
| Max. Negotiated Rate |
$3,169.90 |
| Rate for Payer: Aetna Commercial |
$2,993.79
|
| Rate for Payer: BCBS Trust/PPO |
$2,721.89
|
| Rate for Payer: BCN Commercial |
$2,721.89
|
| Rate for Payer: Cash Price |
$2,817.69
|
| Rate for Payer: Cofinity Commercial |
$3,029.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,817.69
|
| Rate for Payer: Healthscope Commercial |
$3,169.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,641.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,993.79
|
| Rate for Payer: PHP Commercial |
$2,993.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,465.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,064.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,148.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,099.46
|
| Rate for Payer: UHC Core |
$2,940.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,641.58
|
|
|
HC GUIDING CATHETER LVL 35
|
Facility
|
OP
|
$3,522.11
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27800061
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$836.50 |
| Max. Negotiated Rate |
$3,169.90 |
| Rate for Payer: Aetna Commercial |
$2,993.79
|
| Rate for Payer: Aetna Medicare |
$915.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,100.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,100.66
|
| Rate for Payer: BCBS Complete |
$1,408.84
|
| Rate for Payer: BCBS MAPPO |
$880.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,738.44
|
| Rate for Payer: BCN Commercial |
$2,738.44
|
| Rate for Payer: BCN Medicare Advantage |
$880.53
|
| Rate for Payer: Cash Price |
$2,817.69
|
| Rate for Payer: Cofinity Commercial |
$3,029.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,817.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$880.53
|
| Rate for Payer: Healthscope Commercial |
$3,169.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,641.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$924.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,012.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,993.79
|
| Rate for Payer: PACE Senior Care Partners |
$836.50
|
| Rate for Payer: PACE SWMI |
$880.53
|
| Rate for Payer: PHP Commercial |
$2,993.79
|
| Rate for Payer: PHP Medicare Advantage |
$880.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,465.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,064.24
|
| Rate for Payer: Priority Health Medicare |
$880.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,148.13
|
| Rate for Payer: Railroad Medicare Medicare |
$880.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,099.46
|
| Rate for Payer: UHC Core |
$2,940.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$880.53
|
| Rate for Payer: UHC Medicare Advantage |
$906.94
|
| Rate for Payer: VA VA |
$880.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,641.58
|
|
|
HC GUIDING CATHETER LVL 4
|
Facility
|
IP
|
$480.90
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$293.30 |
| Max. Negotiated Rate |
$432.81 |
| Rate for Payer: Aetna Commercial |
$408.76
|
| Rate for Payer: BCBS Trust/PPO |
$371.64
|
| Rate for Payer: BCN Commercial |
$371.64
|
| Rate for Payer: Cash Price |
$384.72
|
| Rate for Payer: Cofinity Commercial |
$413.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.72
|
| Rate for Payer: Healthscope Commercial |
$432.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.76
|
| Rate for Payer: PHP Commercial |
$408.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.19
|
| Rate for Payer: UHC Core |
$401.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.68
|
|
|
HC GUIDING CATHETER LVL 4
|
Facility
|
OP
|
$480.90
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.21 |
| Max. Negotiated Rate |
$432.81 |
| Rate for Payer: Aetna Commercial |
$408.76
|
| Rate for Payer: Aetna Medicare |
$125.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.28
|
| Rate for Payer: BCBS Complete |
$192.36
|
| Rate for Payer: BCBS MAPPO |
$120.22
|
| Rate for Payer: BCBS Trust/PPO |
$373.90
|
| Rate for Payer: BCN Commercial |
$373.90
|
| Rate for Payer: BCN Medicare Advantage |
$120.22
|
| Rate for Payer: Cash Price |
$384.72
|
| Rate for Payer: Cofinity Commercial |
$413.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.22
|
| Rate for Payer: Healthscope Commercial |
$432.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.76
|
| Rate for Payer: PACE Senior Care Partners |
$114.21
|
| Rate for Payer: PACE SWMI |
$120.22
|
| Rate for Payer: PHP Commercial |
$408.76
|
| Rate for Payer: PHP Medicare Advantage |
$120.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.38
|
| Rate for Payer: Priority Health Medicare |
$120.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.30
|
| Rate for Payer: Railroad Medicare Medicare |
$120.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.19
|
| Rate for Payer: UHC Core |
$401.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.22
|
| Rate for Payer: UHC Medicare Advantage |
$123.83
|
| Rate for Payer: VA VA |
$120.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.68
|
|
|
HC GUIDING CATHETER LVL 42
|
Facility
|
IP
|
$4,295.53
|
|
| Hospital Charge Code |
27200130
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,619.84 |
| Max. Negotiated Rate |
$3,865.98 |
| Rate for Payer: Aetna Commercial |
$3,651.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,319.59
|
| Rate for Payer: BCN Commercial |
$3,319.59
|
| Rate for Payer: Cash Price |
$3,436.42
|
| Rate for Payer: Cofinity Commercial |
$3,694.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,436.42
|
| Rate for Payer: Healthscope Commercial |
$3,865.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,221.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,651.20
|
| Rate for Payer: PHP Commercial |
$3,651.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,006.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,737.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,619.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,780.07
|
| Rate for Payer: UHC Core |
$3,586.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,221.65
|
|
|
HC GUIDING CATHETER LVL 42
|
Facility
|
OP
|
$4,295.53
|
|
| Hospital Charge Code |
27200130
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,020.19 |
| Max. Negotiated Rate |
$3,865.98 |
| Rate for Payer: Aetna Commercial |
$3,651.20
|
| Rate for Payer: Aetna Medicare |
$1,116.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,342.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,342.35
|
| Rate for Payer: BCBS Complete |
$1,718.21
|
| Rate for Payer: BCBS MAPPO |
$1,073.88
|
| Rate for Payer: BCBS Trust/PPO |
$3,339.77
|
| Rate for Payer: BCN Commercial |
$3,339.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,073.88
|
| Rate for Payer: Cash Price |
$3,436.42
|
| Rate for Payer: Cofinity Commercial |
$3,694.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,436.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,073.88
|
| Rate for Payer: Healthscope Commercial |
$3,865.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,221.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,127.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,234.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,651.20
|
| Rate for Payer: PACE Senior Care Partners |
$1,020.19
|
| Rate for Payer: PACE SWMI |
$1,073.88
|
| Rate for Payer: PHP Commercial |
$3,651.20
|
| Rate for Payer: PHP Medicare Advantage |
$1,073.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,006.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,737.11
|
| Rate for Payer: Priority Health Medicare |
$1,073.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,619.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,073.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,780.07
|
| Rate for Payer: UHC Core |
$3,586.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,073.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,106.10
|
| Rate for Payer: VA VA |
$1,073.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,221.65
|
|
|
HC GUIDING CATHETER LVL 57
|
Facility
|
IP
|
$5,712.15
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200095
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,483.84 |
| Max. Negotiated Rate |
$5,140.94 |
| Rate for Payer: Aetna Commercial |
$4,855.33
|
| Rate for Payer: BCBS Trust/PPO |
$4,414.35
|
| Rate for Payer: BCN Commercial |
$4,414.35
|
| Rate for Payer: Cash Price |
$4,569.72
|
| Rate for Payer: Cofinity Commercial |
$4,912.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,569.72
|
| Rate for Payer: Healthscope Commercial |
$5,140.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,284.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,855.33
|
| Rate for Payer: PHP Commercial |
$4,855.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,998.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,969.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,483.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,026.69
|
| Rate for Payer: UHC Core |
$4,769.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,284.11
|
|
|
HC GUIDING CATHETER LVL 57
|
Facility
|
OP
|
$5,712.15
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
27200095
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,356.64 |
| Max. Negotiated Rate |
$5,140.94 |
| Rate for Payer: Aetna Commercial |
$4,855.33
|
| Rate for Payer: Aetna Medicare |
$1,485.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.05
|
| Rate for Payer: BCBS Complete |
$2,284.86
|
| Rate for Payer: BCBS MAPPO |
$1,428.04
|
| Rate for Payer: BCBS Trust/PPO |
$4,441.20
|
| Rate for Payer: BCN Commercial |
$4,441.20
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.04
|
| Rate for Payer: Cash Price |
$4,569.72
|
| Rate for Payer: Cofinity Commercial |
$4,912.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,569.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.04
|
| Rate for Payer: Healthscope Commercial |
$5,140.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,284.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,499.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,855.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,356.64
|
| Rate for Payer: PACE SWMI |
$1,428.04
|
| Rate for Payer: PHP Commercial |
$4,855.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,998.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,969.57
|
| Rate for Payer: Priority Health Medicare |
$1,428.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,483.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,026.69
|
| Rate for Payer: UHC Core |
$4,769.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,428.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,470.88
|
| Rate for Payer: VA VA |
$1,428.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,284.11
|
|
|
HC HAEMOPHILUS INFLUENZAE
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600269
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC HAEMOPHILUS INFLUENZAE
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600269
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB) PRP-T CONJUGATE, 4 DOSE IM
|
Facility
|
IP
|
$32.64
|
|
|
Service Code
|
CPT 90648
|
| Hospital Charge Code |
63600069
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.91 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Aetna Commercial |
$27.74
|
| Rate for Payer: BCBS Trust/PPO |
$25.22
|
| Rate for Payer: BCN Commercial |
$25.22
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$29.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.74
|
| Rate for Payer: PHP Commercial |
$27.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.72
|
| Rate for Payer: UHC Core |
$27.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.48
|
|
|
HC HAEMOPHILUS INFLUENZAE TYPE B VACCINE (HIB) PRP-T CONJUGATE, 4 DOSE IM
|
Facility
|
OP
|
$32.64
|
|
|
Service Code
|
CPT 90648
|
| Hospital Charge Code |
63600069
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.75 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Aetna Commercial |
$27.74
|
| Rate for Payer: Aetna Medicare |
$8.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.20
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: BCBS MAPPO |
$8.16
|
| Rate for Payer: BCBS Trust/PPO |
$25.38
|
| Rate for Payer: BCN Commercial |
$25.38
|
| Rate for Payer: BCN Medicare Advantage |
$8.16
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.16
|
| Rate for Payer: Healthscope Commercial |
$29.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.74
|
| Rate for Payer: PACE Senior Care Partners |
$7.75
|
| Rate for Payer: PACE SWMI |
$8.16
|
| Rate for Payer: PHP Commercial |
$27.74
|
| Rate for Payer: PHP Medicare Advantage |
$8.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.40
|
| Rate for Payer: Priority Health Medicare |
$8.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.91
|
| Rate for Payer: Railroad Medicare Medicare |
$8.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.72
|
| Rate for Payer: UHC Core |
$27.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.16
|
| Rate for Payer: UHC Medicare Advantage |
$8.40
|
| Rate for Payer: VA VA |
$8.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.48
|
|
|
HC HAI ESTABLISHED PATIENT LEVEL I
|
Facility
|
IP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000014
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$90.38 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: BCBS Trust/PPO |
$114.52
|
| Rate for Payer: BCN Commercial |
$114.52
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.96
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.41
|
| Rate for Payer: UHC Core |
$123.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
|
HC HAI ESTABLISHED PATIENT LEVEL I
|
Facility
|
OP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000014
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: Aetna Medicare |
$38.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.31
|
| Rate for Payer: BCBS Complete |
$59.28
|
| Rate for Payer: BCBS MAPPO |
$37.05
|
| Rate for Payer: BCBS Trust/PPO |
$115.22
|
| Rate for Payer: BCCCP Commercial |
$22.00
|
| Rate for Payer: BCN Commercial |
$115.22
|
| Rate for Payer: BCN Medicare Advantage |
$37.05
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.96
|
| Rate for Payer: PACE Senior Care Partners |
$35.20
|
| Rate for Payer: PACE SWMI |
$37.05
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: PHP Medicare Advantage |
$37.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.93
|
| Rate for Payer: Priority Health Medicare |
$37.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.38
|
| Rate for Payer: Railroad Medicare Medicare |
$37.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.41
|
| Rate for Payer: UHC Core |
$123.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.05
|
| Rate for Payer: UHC Medicare Advantage |
$38.16
|
| Rate for Payer: VA VA |
$37.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
|
HC HAI PICC FLUSH
|
Facility
|
IP
|
$134.71
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$82.16 |
| Max. Negotiated Rate |
$121.24 |
| Rate for Payer: Aetna Commercial |
$114.50
|
| Rate for Payer: BCBS Trust/PPO |
$104.10
|
| Rate for Payer: BCN Commercial |
$104.10
|
| Rate for Payer: Cash Price |
$107.77
|
| Rate for Payer: Cofinity Commercial |
$115.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.77
|
| Rate for Payer: Healthscope Commercial |
$121.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.50
|
| Rate for Payer: PHP Commercial |
$114.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.54
|
| Rate for Payer: UHC Core |
$112.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.03
|
|
|
HC HAI PICC FLUSH
|
Facility
|
OP
|
$134.71
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$121.24 |
| Rate for Payer: Aetna Commercial |
$114.50
|
| Rate for Payer: Aetna Medicare |
$35.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.10
|
| Rate for Payer: BCBS Complete |
$53.88
|
| Rate for Payer: BCBS MAPPO |
$33.68
|
| Rate for Payer: BCBS Trust/PPO |
$104.74
|
| Rate for Payer: BCCCP Commercial |
$22.00
|
| Rate for Payer: BCN Commercial |
$104.74
|
| Rate for Payer: BCN Medicare Advantage |
$33.68
|
| Rate for Payer: Cash Price |
$107.77
|
| Rate for Payer: Cash Price |
$107.77
|
| Rate for Payer: Cofinity Commercial |
$115.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.68
|
| Rate for Payer: Healthscope Commercial |
$121.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.50
|
| Rate for Payer: PACE Senior Care Partners |
$31.99
|
| Rate for Payer: PACE SWMI |
$33.68
|
| Rate for Payer: PHP Commercial |
$114.50
|
| Rate for Payer: PHP Medicare Advantage |
$33.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.20
|
| Rate for Payer: Priority Health Medicare |
$33.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.16
|
| Rate for Payer: Railroad Medicare Medicare |
$33.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.54
|
| Rate for Payer: UHC Core |
$112.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.68
|
| Rate for Payer: UHC Medicare Advantage |
$34.69
|
| Rate for Payer: VA VA |
$33.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.03
|
|
|
HC HAI PORTA CATH ACCESS
|
Facility
|
IP
|
$134.71
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000058
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$82.16 |
| Max. Negotiated Rate |
$121.24 |
| Rate for Payer: Aetna Commercial |
$114.50
|
| Rate for Payer: BCBS Trust/PPO |
$104.10
|
| Rate for Payer: BCN Commercial |
$104.10
|
| Rate for Payer: Cash Price |
$107.77
|
| Rate for Payer: Cofinity Commercial |
$115.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.77
|
| Rate for Payer: Healthscope Commercial |
$121.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.50
|
| Rate for Payer: PHP Commercial |
$114.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.54
|
| Rate for Payer: UHC Core |
$112.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.03
|
|
|
HC HAI PORTA CATH ACCESS
|
Facility
|
OP
|
$134.71
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000058
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$121.24 |
| Rate for Payer: Aetna Commercial |
$114.50
|
| Rate for Payer: Aetna Medicare |
$35.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.10
|
| Rate for Payer: BCBS Complete |
$53.88
|
| Rate for Payer: BCBS MAPPO |
$33.68
|
| Rate for Payer: BCBS Trust/PPO |
$104.74
|
| Rate for Payer: BCCCP Commercial |
$22.00
|
| Rate for Payer: BCN Commercial |
$104.74
|
| Rate for Payer: BCN Medicare Advantage |
$33.68
|
| Rate for Payer: Cash Price |
$107.77
|
| Rate for Payer: Cash Price |
$107.77
|
| Rate for Payer: Cofinity Commercial |
$115.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.68
|
| Rate for Payer: Healthscope Commercial |
$121.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.50
|
| Rate for Payer: PACE Senior Care Partners |
$31.99
|
| Rate for Payer: PACE SWMI |
$33.68
|
| Rate for Payer: PHP Commercial |
$114.50
|
| Rate for Payer: PHP Medicare Advantage |
$33.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.20
|
| Rate for Payer: Priority Health Medicare |
$33.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.16
|
| Rate for Payer: Railroad Medicare Medicare |
$33.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.54
|
| Rate for Payer: UHC Core |
$112.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.68
|
| Rate for Payer: UHC Medicare Advantage |
$34.69
|
| Rate for Payer: VA VA |
$33.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.03
|
|
|
HC HALOPERIDOL LEVEL
|
Facility
|
OP
|
$104.00
|
|
|
Service Code
|
CPT 80173
|
| Hospital Charge Code |
30100031
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.65 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: Aetna Commercial |
$88.40
|
| Rate for Payer: Aetna Medicare |
$27.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.50
|
| Rate for Payer: BCBS Complete |
$12.23
|
| Rate for Payer: BCBS MAPPO |
$26.00
|
| Rate for Payer: BCBS Trust/PPO |
$80.86
|
| Rate for Payer: BCN Commercial |
$80.86
|
| Rate for Payer: BCN Medicare Advantage |
$26.00
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$89.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.00
|
| Rate for Payer: Healthscope Commercial |
$93.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.00
|
| Rate for Payer: Mclaren Medicaid |
$11.65
|
| Rate for Payer: Meridian Medicaid |
$12.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.40
|
| Rate for Payer: PACE Senior Care Partners |
$24.70
|
| Rate for Payer: PACE SWMI |
$26.00
|
| Rate for Payer: PHP Commercial |
$88.40
|
| Rate for Payer: PHP Medicare Advantage |
$26.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.48
|
| Rate for Payer: Priority Health Medicare |
$26.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.43
|
| Rate for Payer: Railroad Medicare Medicare |
$26.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.52
|
| Rate for Payer: UHC Core |
$86.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.00
|
| Rate for Payer: UHC Medicare Advantage |
$26.78
|
| Rate for Payer: VA VA |
$26.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.00
|
|
|
HC HALOPERIDOL LEVEL
|
Facility
|
IP
|
$104.00
|
|
|
Service Code
|
CPT 80173
|
| Hospital Charge Code |
30100031
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.43 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: Aetna Commercial |
$88.40
|
| Rate for Payer: BCBS Trust/PPO |
$80.37
|
| Rate for Payer: BCN Commercial |
$80.37
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$89.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.20
|
| Rate for Payer: Healthscope Commercial |
$93.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.40
|
| Rate for Payer: PHP Commercial |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.52
|
| Rate for Payer: UHC Core |
$86.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.00
|
|
|
HC HALO RING APPLICATION
|
Facility
|
IP
|
$2,460.76
|
|
| Hospital Charge Code |
27000085
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,500.82 |
| Max. Negotiated Rate |
$2,214.68 |
| Rate for Payer: Aetna Commercial |
$2,091.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,901.68
|
| Rate for Payer: BCN Commercial |
$1,901.68
|
| Rate for Payer: Cash Price |
$1,968.61
|
| Rate for Payer: Cofinity Commercial |
$2,116.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,968.61
|
| Rate for Payer: Healthscope Commercial |
$2,214.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,845.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,091.65
|
| Rate for Payer: PHP Commercial |
$2,091.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,722.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,140.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,500.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,165.47
|
| Rate for Payer: UHC Core |
$2,054.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,845.57
|
|
|
HC HALO RING APPLICATION
|
Facility
|
OP
|
$2,460.76
|
|
| Hospital Charge Code |
27000085
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$584.43 |
| Max. Negotiated Rate |
$2,214.68 |
| Rate for Payer: Aetna Commercial |
$2,091.65
|
| Rate for Payer: Aetna Medicare |
$639.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.99
|
| Rate for Payer: BCBS Complete |
$984.30
|
| Rate for Payer: BCBS MAPPO |
$615.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,913.24
|
| Rate for Payer: BCN Commercial |
$1,913.24
|
| Rate for Payer: BCN Medicare Advantage |
$615.19
|
| Rate for Payer: Cash Price |
$1,968.61
|
| Rate for Payer: Cofinity Commercial |
$2,116.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,968.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.19
|
| Rate for Payer: Healthscope Commercial |
$2,214.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,845.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$707.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,091.65
|
| Rate for Payer: PACE Senior Care Partners |
$584.43
|
| Rate for Payer: PACE SWMI |
$615.19
|
| Rate for Payer: PHP Commercial |
$2,091.65
|
| Rate for Payer: PHP Medicare Advantage |
$615.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,722.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,140.86
|
| Rate for Payer: Priority Health Medicare |
$615.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,500.82
|
| Rate for Payer: Railroad Medicare Medicare |
$615.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,165.47
|
| Rate for Payer: UHC Core |
$2,054.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$615.19
|
| Rate for Payer: UHC Medicare Advantage |
$633.65
|
| Rate for Payer: VA VA |
$615.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,845.57
|
|
|
HC HALO RING & VEST
|
Facility
|
OP
|
$6,162.09
|
|
| Hospital Charge Code |
27000084
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,463.50 |
| Max. Negotiated Rate |
$5,545.88 |
| Rate for Payer: Aetna Commercial |
$5,237.78
|
| Rate for Payer: Aetna Medicare |
$1,602.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,925.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,925.65
|
| Rate for Payer: BCBS Complete |
$2,464.84
|
| Rate for Payer: BCBS MAPPO |
$1,540.52
|
| Rate for Payer: BCBS Trust/PPO |
$4,791.02
|
| Rate for Payer: BCN Commercial |
$4,791.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,540.52
|
| Rate for Payer: Cash Price |
$4,929.67
|
| Rate for Payer: Cofinity Commercial |
$5,299.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,929.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,540.52
|
| Rate for Payer: Healthscope Commercial |
$5,545.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,621.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,617.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,771.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,237.78
|
| Rate for Payer: PACE Senior Care Partners |
$1,463.50
|
| Rate for Payer: PACE SWMI |
$1,540.52
|
| Rate for Payer: PHP Commercial |
$5,237.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,540.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,313.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,361.02
|
| Rate for Payer: Priority Health Medicare |
$1,540.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,758.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,540.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,422.64
|
| Rate for Payer: UHC Core |
$5,145.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,540.52
|
| Rate for Payer: UHC Medicare Advantage |
$1,586.74
|
| Rate for Payer: VA VA |
$1,540.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,621.57
|
|
