|
HC CERV OR VAG CA SCREEN PELVIC/BREAST EXAM
|
Facility
|
OP
|
$140.78
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
77000001
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$33.44 |
| Max. Negotiated Rate |
$126.70 |
| Rate for Payer: Aetna Commercial |
$119.66
|
| Rate for Payer: Aetna Medicare |
$36.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.99
|
| Rate for Payer: BCBS Complete |
$68.81
|
| Rate for Payer: BCBS MAPPO |
$35.20
|
| Rate for Payer: BCBS Trust/PPO |
$115.74
|
| Rate for Payer: BCN Commercial |
$109.46
|
| Rate for Payer: BCN Medicare Advantage |
$35.20
|
| Rate for Payer: Cash Price |
$112.62
|
| Rate for Payer: Cash Price |
$112.62
|
| Rate for Payer: Cofinity Commercial |
$121.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.20
|
| Rate for Payer: Healthscope Commercial |
$126.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.58
|
| Rate for Payer: Mclaren Medicaid |
$65.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.95
|
| Rate for Payer: Meridian Medicaid |
$68.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.66
|
| Rate for Payer: Nomi Health Commercial |
$115.44
|
| Rate for Payer: PACE Senior Care Partners |
$33.44
|
| Rate for Payer: PACE SWMI |
$35.20
|
| Rate for Payer: PHP Commercial |
$119.66
|
| Rate for Payer: PHP Medicare Advantage |
$35.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.51
|
| Rate for Payer: Priority Health HMO/PPO |
$122.48
|
| Rate for Payer: Priority Health Medicare |
$35.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.32
|
| Rate for Payer: Railroad Medicare Medicare |
$35.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.89
|
| Rate for Payer: UHC Core |
$117.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.20
|
| Rate for Payer: UHC Exchange |
$35.20
|
| Rate for Payer: UHC Medicare Advantage |
$35.20
|
| Rate for Payer: UHCCP Medicaid |
$65.53
|
| Rate for Payer: VA VA |
$35.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.58
|
|
|
HC CERV OR VAG CA SCREEN PELVIC/BREAST EXAM
|
Facility
|
IP
|
$140.78
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
77000001
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$91.51 |
| Max. Negotiated Rate |
$126.70 |
| Rate for Payer: Aetna Commercial |
$119.66
|
| Rate for Payer: BCBS Trust/PPO |
$114.92
|
| Rate for Payer: BCN Commercial |
$108.79
|
| Rate for Payer: Cash Price |
$112.62
|
| Rate for Payer: Cofinity Commercial |
$121.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.62
|
| Rate for Payer: Healthscope Commercial |
$126.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.66
|
| Rate for Payer: Nomi Health Commercial |
$115.44
|
| Rate for Payer: PHP Commercial |
$119.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.51
|
| Rate for Payer: Priority Health HMO/PPO |
$122.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.89
|
| Rate for Payer: UHC Core |
$117.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.58
|
|
|
HC CESIUM 137 PER SOURCE
|
Facility
|
OP
|
$777.71
|
|
| Hospital Charge Code |
34000001
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$184.71 |
| Max. Negotiated Rate |
$699.94 |
| Rate for Payer: Aetna Commercial |
$661.05
|
| Rate for Payer: Aetna Medicare |
$202.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.03
|
| Rate for Payer: BCBS Complete |
$311.08
|
| Rate for Payer: BCBS MAPPO |
$194.43
|
| Rate for Payer: BCBS Trust/PPO |
$639.36
|
| Rate for Payer: BCN Commercial |
$604.67
|
| Rate for Payer: BCN Medicare Advantage |
$194.43
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cofinity Commercial |
$668.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.43
|
| Rate for Payer: Healthscope Commercial |
$699.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.05
|
| Rate for Payer: Nomi Health Commercial |
$637.72
|
| Rate for Payer: PACE Senior Care Partners |
$184.71
|
| Rate for Payer: PACE SWMI |
$194.43
|
| Rate for Payer: PHP Commercial |
$661.05
|
| Rate for Payer: PHP Medicare Advantage |
$194.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: Priority Health HMO/PPO |
$676.61
|
| Rate for Payer: Priority Health Medicare |
$196.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$521.07
|
| Rate for Payer: Railroad Medicare Medicare |
$194.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$684.38
|
| Rate for Payer: UHC Core |
$649.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.43
|
| Rate for Payer: UHC Exchange |
$194.43
|
| Rate for Payer: UHC Medicare Advantage |
$194.43
|
| Rate for Payer: VA VA |
$194.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.28
|
|
|
HC CESIUM 137 PER SOURCE
|
Facility
|
IP
|
$777.71
|
|
| Hospital Charge Code |
34000001
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$505.51 |
| Max. Negotiated Rate |
$699.94 |
| Rate for Payer: Aetna Commercial |
$661.05
|
| Rate for Payer: BCBS Trust/PPO |
$634.84
|
| Rate for Payer: BCN Commercial |
$601.01
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cofinity Commercial |
$668.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.17
|
| Rate for Payer: Healthscope Commercial |
$699.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.05
|
| Rate for Payer: Nomi Health Commercial |
$637.72
|
| Rate for Payer: PHP Commercial |
$661.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: Priority Health HMO/PPO |
$676.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$521.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$684.38
|
| Rate for Payer: UHC Core |
$649.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.28
|
|
|
HC CHAMBER HOLDING OPTI CHAMBER
|
Facility
|
IP
|
$22.32
|
|
| Hospital Charge Code |
27000044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.51 |
| Max. Negotiated Rate |
$20.09 |
| Rate for Payer: Aetna Commercial |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$18.22
|
| Rate for Payer: BCN Commercial |
$17.25
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Cofinity Commercial |
$19.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.86
|
| Rate for Payer: Healthscope Commercial |
$20.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.97
|
| Rate for Payer: Nomi Health Commercial |
$18.30
|
| Rate for Payer: PHP Commercial |
$18.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.51
|
| Rate for Payer: Priority Health HMO/PPO |
$19.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.64
|
| Rate for Payer: UHC Core |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.74
|
|
|
HC CHAMBER HOLDING OPTI CHAMBER
|
Facility
|
OP
|
$22.32
|
|
| Hospital Charge Code |
27000044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$20.09 |
| Rate for Payer: Aetna Commercial |
$18.97
|
| Rate for Payer: Aetna Medicare |
$5.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.98
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$5.58
|
| Rate for Payer: BCBS Trust/PPO |
$18.35
|
| Rate for Payer: BCN Commercial |
$17.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.58
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Cofinity Commercial |
$19.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.58
|
| Rate for Payer: Healthscope Commercial |
$20.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.97
|
| Rate for Payer: Nomi Health Commercial |
$18.30
|
| Rate for Payer: PACE Senior Care Partners |
$5.30
|
| Rate for Payer: PACE SWMI |
$5.58
|
| Rate for Payer: PHP Commercial |
$18.97
|
| Rate for Payer: PHP Medicare Advantage |
$5.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.51
|
| Rate for Payer: Priority Health HMO/PPO |
$19.42
|
| Rate for Payer: Priority Health Medicare |
$5.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.95
|
| Rate for Payer: Railroad Medicare Medicare |
$5.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.64
|
| Rate for Payer: UHC Core |
$18.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.58
|
| Rate for Payer: UHC Exchange |
$5.58
|
| Rate for Payer: UHC Medicare Advantage |
$5.58
|
| Rate for Payer: VA VA |
$5.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.74
|
|
|
HC CHANGE CYSTOSTOMY TUBE COMPLICATED
|
Facility
|
OP
|
$1,016.47
|
|
|
Service Code
|
CPT 51710
|
| Hospital Charge Code |
76100297
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$241.41 |
| Max. Negotiated Rate |
$914.82 |
| Rate for Payer: Aetna Commercial |
$864.00
|
| Rate for Payer: Aetna Medicare |
$264.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$317.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$317.65
|
| Rate for Payer: BCBS Complete |
$496.49
|
| Rate for Payer: BCBS MAPPO |
$254.12
|
| Rate for Payer: BCBS Trust/PPO |
$835.64
|
| Rate for Payer: BCN Commercial |
$790.31
|
| Rate for Payer: BCN Medicare Advantage |
$254.12
|
| Rate for Payer: Cash Price |
$813.18
|
| Rate for Payer: Cash Price |
$813.18
|
| Rate for Payer: Cofinity Commercial |
$874.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$813.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.12
|
| Rate for Payer: Healthscope Commercial |
$914.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$762.35
|
| Rate for Payer: Mclaren Medicaid |
$472.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$266.82
|
| Rate for Payer: Meridian Medicaid |
$496.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$292.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$864.00
|
| Rate for Payer: Nomi Health Commercial |
$833.51
|
| Rate for Payer: PACE Senior Care Partners |
$241.41
|
| Rate for Payer: PACE SWMI |
$254.12
|
| Rate for Payer: PHP Commercial |
$864.00
|
| Rate for Payer: PHP Medicare Advantage |
$254.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$660.71
|
| Rate for Payer: Priority Health HMO/PPO |
$884.33
|
| Rate for Payer: Priority Health Medicare |
$256.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$681.03
|
| Rate for Payer: Railroad Medicare Medicare |
$254.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$894.49
|
| Rate for Payer: UHC Core |
$848.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$254.12
|
| Rate for Payer: UHC Exchange |
$254.12
|
| Rate for Payer: UHC Medicare Advantage |
$254.12
|
| Rate for Payer: UHCCP Medicaid |
$472.82
|
| Rate for Payer: VA VA |
$254.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$762.35
|
|
|
HC CHANGE CYSTOSTOMY TUBE COMPLICATED
|
Facility
|
IP
|
$1,016.47
|
|
|
Service Code
|
CPT 51710
|
| Hospital Charge Code |
76100297
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$660.71 |
| Max. Negotiated Rate |
$914.82 |
| Rate for Payer: Aetna Commercial |
$864.00
|
| Rate for Payer: BCBS Trust/PPO |
$829.74
|
| Rate for Payer: BCN Commercial |
$785.53
|
| Rate for Payer: Cash Price |
$813.18
|
| Rate for Payer: Cofinity Commercial |
$874.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$813.18
|
| Rate for Payer: Healthscope Commercial |
$914.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$762.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$864.00
|
| Rate for Payer: Nomi Health Commercial |
$833.51
|
| Rate for Payer: PHP Commercial |
$864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$660.71
|
| Rate for Payer: Priority Health HMO/PPO |
$884.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$681.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$894.49
|
| Rate for Payer: UHC Core |
$848.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$762.35
|
|
|
HC CHANNEL RFA ENDO CATHETER
|
Facility
|
OP
|
$3,721.58
|
|
| Hospital Charge Code |
27200289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$883.88 |
| Max. Negotiated Rate |
$3,349.42 |
| Rate for Payer: Aetna Commercial |
$3,163.34
|
| Rate for Payer: Aetna Medicare |
$967.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,162.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,162.99
|
| Rate for Payer: BCBS Complete |
$1,488.63
|
| Rate for Payer: BCBS MAPPO |
$930.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,059.51
|
| Rate for Payer: BCN Commercial |
$2,893.53
|
| Rate for Payer: BCN Medicare Advantage |
$930.40
|
| Rate for Payer: Cash Price |
$2,977.26
|
| Rate for Payer: Cofinity Commercial |
$3,200.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,977.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$930.40
|
| Rate for Payer: Healthscope Commercial |
$3,349.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,791.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$976.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,069.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,163.34
|
| Rate for Payer: Nomi Health Commercial |
$3,051.70
|
| Rate for Payer: PACE Senior Care Partners |
$883.88
|
| Rate for Payer: PACE SWMI |
$930.40
|
| Rate for Payer: PHP Commercial |
$3,163.34
|
| Rate for Payer: PHP Medicare Advantage |
$930.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,419.03
|
| Rate for Payer: Priority Health HMO/PPO |
$3,237.77
|
| Rate for Payer: Priority Health Medicare |
$939.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,493.46
|
| Rate for Payer: Railroad Medicare Medicare |
$930.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,274.99
|
| Rate for Payer: UHC Core |
$3,107.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$930.40
|
| Rate for Payer: UHC Exchange |
$930.40
|
| Rate for Payer: UHC Medicare Advantage |
$930.40
|
| Rate for Payer: VA VA |
$930.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,791.18
|
|
|
HC CHANNEL RFA ENDO CATHETER
|
Facility
|
IP
|
$3,721.58
|
|
| Hospital Charge Code |
27200289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,419.03 |
| Max. Negotiated Rate |
$3,349.42 |
| Rate for Payer: Aetna Commercial |
$3,163.34
|
| Rate for Payer: BCBS Trust/PPO |
$3,037.93
|
| Rate for Payer: BCN Commercial |
$2,876.04
|
| Rate for Payer: Cash Price |
$2,977.26
|
| Rate for Payer: Cofinity Commercial |
$3,200.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,977.26
|
| Rate for Payer: Healthscope Commercial |
$3,349.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,791.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,163.34
|
| Rate for Payer: Nomi Health Commercial |
$3,051.70
|
| Rate for Payer: PHP Commercial |
$3,163.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,419.03
|
| Rate for Payer: Priority Health HMO/PPO |
$3,237.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,493.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,274.99
|
| Rate for Payer: UHC Core |
$3,107.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,791.18
|
|
|
HC CHEM CAUTERY GRANULATION TISSUE
|
Facility
|
IP
|
$296.74
|
|
|
Service Code
|
CPT 17250
|
| Hospital Charge Code |
76100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$192.88 |
| Max. Negotiated Rate |
$267.07 |
| Rate for Payer: Aetna Commercial |
$252.23
|
| Rate for Payer: BCBS Trust/PPO |
$242.23
|
| Rate for Payer: BCN Commercial |
$229.32
|
| Rate for Payer: Cash Price |
$237.39
|
| Rate for Payer: Cofinity Commercial |
$255.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.39
|
| Rate for Payer: Healthscope Commercial |
$267.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.23
|
| Rate for Payer: Nomi Health Commercial |
$243.33
|
| Rate for Payer: PHP Commercial |
$252.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.88
|
| Rate for Payer: Priority Health HMO/PPO |
$258.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.13
|
| Rate for Payer: UHC Core |
$247.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.56
|
|
|
HC CHEM CAUTERY GRANULATION TISSUE
|
Facility
|
OP
|
$296.74
|
|
|
Service Code
|
CPT 17250
|
| Hospital Charge Code |
76100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$70.48 |
| Max. Negotiated Rate |
$267.07 |
| Rate for Payer: Aetna Commercial |
$252.23
|
| Rate for Payer: Aetna Medicare |
$77.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$92.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$92.73
|
| Rate for Payer: BCBS Complete |
$147.80
|
| Rate for Payer: BCBS MAPPO |
$74.18
|
| Rate for Payer: BCBS Trust/PPO |
$243.95
|
| Rate for Payer: BCN Commercial |
$230.72
|
| Rate for Payer: BCN Medicare Advantage |
$74.18
|
| Rate for Payer: Cash Price |
$237.39
|
| Rate for Payer: Cash Price |
$237.39
|
| Rate for Payer: Cofinity Commercial |
$255.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.18
|
| Rate for Payer: Healthscope Commercial |
$267.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.56
|
| Rate for Payer: Mclaren Medicaid |
$140.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.89
|
| Rate for Payer: Meridian Medicaid |
$147.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.23
|
| Rate for Payer: Nomi Health Commercial |
$243.33
|
| Rate for Payer: PACE Senior Care Partners |
$70.48
|
| Rate for Payer: PACE SWMI |
$74.18
|
| Rate for Payer: PHP Commercial |
$252.23
|
| Rate for Payer: PHP Medicare Advantage |
$74.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.88
|
| Rate for Payer: Priority Health HMO/PPO |
$258.16
|
| Rate for Payer: Priority Health Medicare |
$74.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.82
|
| Rate for Payer: Railroad Medicare Medicare |
$74.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.13
|
| Rate for Payer: UHC Core |
$247.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.18
|
| Rate for Payer: UHC Exchange |
$74.18
|
| Rate for Payer: UHC Medicare Advantage |
$74.18
|
| Rate for Payer: UHCCP Medicaid |
$140.75
|
| Rate for Payer: VA VA |
$74.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.56
|
|
|
HC CHEMO ADMIN INTO CNS
|
Facility
|
OP
|
$1,126.02
|
|
|
Service Code
|
CPT 96450
|
| Hospital Charge Code |
33100005
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$234.96 |
| Max. Negotiated Rate |
$1,013.42 |
| Rate for Payer: Aetna Commercial |
$957.12
|
| Rate for Payer: Aetna Medicare |
$292.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$351.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$351.88
|
| Rate for Payer: BCBS Complete |
$246.72
|
| Rate for Payer: BCBS MAPPO |
$281.50
|
| Rate for Payer: BCBS Trust/PPO |
$925.70
|
| Rate for Payer: BCN Commercial |
$875.48
|
| Rate for Payer: BCN Medicare Advantage |
$281.50
|
| Rate for Payer: Cash Price |
$900.82
|
| Rate for Payer: Cash Price |
$900.82
|
| Rate for Payer: Cofinity Commercial |
$968.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$281.50
|
| Rate for Payer: Healthscope Commercial |
$1,013.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.52
|
| Rate for Payer: Mclaren Medicaid |
$234.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$295.58
|
| Rate for Payer: Meridian Medicaid |
$246.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$323.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$957.12
|
| Rate for Payer: Nomi Health Commercial |
$923.34
|
| Rate for Payer: PACE Senior Care Partners |
$267.43
|
| Rate for Payer: PACE SWMI |
$281.50
|
| Rate for Payer: PHP Commercial |
$957.12
|
| Rate for Payer: PHP Medicare Advantage |
$281.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.91
|
| Rate for Payer: Priority Health HMO/PPO |
$979.64
|
| Rate for Payer: Priority Health Medicare |
$284.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$754.43
|
| Rate for Payer: Railroad Medicare Medicare |
$281.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$990.90
|
| Rate for Payer: UHC Core |
$940.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$281.50
|
| Rate for Payer: UHC Exchange |
$281.50
|
| Rate for Payer: UHC Medicare Advantage |
$281.50
|
| Rate for Payer: UHCCP Medicaid |
$234.96
|
| Rate for Payer: VA VA |
$281.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.52
|
|
|
HC CHEMO ADMIN INTO CNS
|
Facility
|
IP
|
$1,126.02
|
|
|
Service Code
|
CPT 96450
|
| Hospital Charge Code |
33100005
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$731.91 |
| Max. Negotiated Rate |
$1,013.42 |
| Rate for Payer: Aetna Commercial |
$957.12
|
| Rate for Payer: BCBS Trust/PPO |
$919.17
|
| Rate for Payer: BCN Commercial |
$870.19
|
| Rate for Payer: Cash Price |
$900.82
|
| Rate for Payer: Cofinity Commercial |
$968.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.82
|
| Rate for Payer: Healthscope Commercial |
$1,013.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$957.12
|
| Rate for Payer: Nomi Health Commercial |
$923.34
|
| Rate for Payer: PHP Commercial |
$957.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.91
|
| Rate for Payer: Priority Health HMO/PPO |
$979.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$754.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$990.90
|
| Rate for Payer: UHC Core |
$940.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.52
|
|
|
HC CHEMODENERVATION INTERNAL ANAL SPHINCTER
|
Facility
|
IP
|
$3,203.25
|
|
|
Service Code
|
CPT 46505
|
| Hospital Charge Code |
76100384
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,082.11 |
| Max. Negotiated Rate |
$2,882.92 |
| Rate for Payer: Aetna Commercial |
$2,722.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,614.81
|
| Rate for Payer: BCN Commercial |
$2,475.47
|
| Rate for Payer: Cash Price |
$2,562.60
|
| Rate for Payer: Cofinity Commercial |
$2,754.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,562.60
|
| Rate for Payer: Healthscope Commercial |
$2,882.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,402.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,722.76
|
| Rate for Payer: Nomi Health Commercial |
$2,626.66
|
| Rate for Payer: PHP Commercial |
$2,722.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,082.11
|
| Rate for Payer: Priority Health HMO/PPO |
$2,786.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,146.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,818.86
|
| Rate for Payer: UHC Core |
$2,674.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,402.44
|
|
|
HC CHEMODENERVATION INTERNAL ANAL SPHINCTER
|
Facility
|
OP
|
$3,203.25
|
|
|
Service Code
|
CPT 46505
|
| Hospital Charge Code |
76100384
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$760.77 |
| Max. Negotiated Rate |
$2,882.92 |
| Rate for Payer: Aetna Commercial |
$2,722.76
|
| Rate for Payer: Aetna Medicare |
$832.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,001.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,001.02
|
| Rate for Payer: BCBS Complete |
$877.06
|
| Rate for Payer: BCBS MAPPO |
$800.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,633.39
|
| Rate for Payer: BCN Commercial |
$2,490.53
|
| Rate for Payer: BCN Medicare Advantage |
$800.81
|
| Rate for Payer: Cash Price |
$2,562.60
|
| Rate for Payer: Cash Price |
$2,562.60
|
| Rate for Payer: Cofinity Commercial |
$2,754.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,562.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$800.81
|
| Rate for Payer: Healthscope Commercial |
$2,882.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,402.44
|
| Rate for Payer: Mclaren Medicaid |
$835.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$840.85
|
| Rate for Payer: Meridian Medicaid |
$877.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$920.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,722.76
|
| Rate for Payer: Nomi Health Commercial |
$2,626.66
|
| Rate for Payer: PACE Senior Care Partners |
$760.77
|
| Rate for Payer: PACE SWMI |
$800.81
|
| Rate for Payer: PHP Commercial |
$2,722.76
|
| Rate for Payer: PHP Medicare Advantage |
$800.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$835.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,082.11
|
| Rate for Payer: Priority Health HMO/PPO |
$2,786.83
|
| Rate for Payer: Priority Health Medicare |
$808.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,146.18
|
| Rate for Payer: Railroad Medicare Medicare |
$800.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,818.86
|
| Rate for Payer: UHC Core |
$2,674.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$800.81
|
| Rate for Payer: UHC Exchange |
$800.81
|
| Rate for Payer: UHC Medicare Advantage |
$800.81
|
| Rate for Payer: UHCCP Medicaid |
$835.24
|
| Rate for Payer: VA VA |
$800.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,402.44
|
|
|
HC CHEMODENERVATION TRUNK 6 OR > MUSCLES
|
Facility
|
IP
|
$1,955.95
|
|
|
Service Code
|
CPT 64647
|
| Hospital Charge Code |
36000374
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,271.37 |
| Max. Negotiated Rate |
$1,760.36 |
| Rate for Payer: Aetna Commercial |
$1,662.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,596.64
|
| Rate for Payer: BCN Commercial |
$1,511.56
|
| Rate for Payer: Cash Price |
$1,564.76
|
| Rate for Payer: Cofinity Commercial |
$1,682.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,564.76
|
| Rate for Payer: Healthscope Commercial |
$1,760.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,466.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,662.56
|
| Rate for Payer: Nomi Health Commercial |
$1,603.88
|
| Rate for Payer: PHP Commercial |
$1,662.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,271.37
|
| Rate for Payer: Priority Health HMO/PPO |
$1,701.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,310.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,721.24
|
| Rate for Payer: UHC Core |
$1,633.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,466.96
|
|
|
HC CHEMODENERVATION TRUNK 6 OR > MUSCLES
|
Facility
|
OP
|
$1,955.95
|
|
|
Service Code
|
CPT 64647
|
| Hospital Charge Code |
36000374
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$464.54 |
| Max. Negotiated Rate |
$1,760.36 |
| Rate for Payer: Aetna Commercial |
$1,662.56
|
| Rate for Payer: Aetna Medicare |
$508.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.23
|
| Rate for Payer: BCBS Complete |
$515.13
|
| Rate for Payer: BCBS MAPPO |
$488.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,607.99
|
| Rate for Payer: BCN Commercial |
$1,520.75
|
| Rate for Payer: BCN Medicare Advantage |
$488.99
|
| Rate for Payer: Cash Price |
$1,564.76
|
| Rate for Payer: Cash Price |
$1,564.76
|
| Rate for Payer: Cofinity Commercial |
$1,682.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,564.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$488.99
|
| Rate for Payer: Healthscope Commercial |
$1,760.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,466.96
|
| Rate for Payer: Mclaren Medicaid |
$490.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$513.44
|
| Rate for Payer: Meridian Medicaid |
$515.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,662.56
|
| Rate for Payer: Nomi Health Commercial |
$1,603.88
|
| Rate for Payer: PACE Senior Care Partners |
$464.54
|
| Rate for Payer: PACE SWMI |
$488.99
|
| Rate for Payer: PHP Commercial |
$1,662.56
|
| Rate for Payer: PHP Medicare Advantage |
$488.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,271.37
|
| Rate for Payer: Priority Health HMO/PPO |
$1,701.68
|
| Rate for Payer: Priority Health Medicare |
$493.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,310.49
|
| Rate for Payer: Railroad Medicare Medicare |
$488.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,721.24
|
| Rate for Payer: UHC Core |
$1,633.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$488.99
|
| Rate for Payer: UHC Exchange |
$488.99
|
| Rate for Payer: UHC Medicare Advantage |
$488.99
|
| Rate for Payer: UHCCP Medicaid |
$490.57
|
| Rate for Payer: VA VA |
$488.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,466.96
|
|
|
HC CHEMODENERV SALIV GLANDS
|
Facility
|
OP
|
$386.21
|
|
|
Service Code
|
CPT 64611
|
| Hospital Charge Code |
76100210
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$91.72 |
| Max. Negotiated Rate |
$347.59 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare |
$100.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$120.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$120.69
|
| Rate for Payer: BCBS Complete |
$219.58
|
| Rate for Payer: BCBS MAPPO |
$96.55
|
| Rate for Payer: BCBS Trust/PPO |
$317.50
|
| Rate for Payer: BCN Commercial |
$300.28
|
| Rate for Payer: BCN Medicare Advantage |
$96.55
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cofinity Commercial |
$332.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.55
|
| Rate for Payer: Healthscope Commercial |
$347.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.66
|
| Rate for Payer: Mclaren Medicaid |
$209.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.38
|
| Rate for Payer: Meridian Medicaid |
$219.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.28
|
| Rate for Payer: Nomi Health Commercial |
$316.69
|
| Rate for Payer: PACE Senior Care Partners |
$91.72
|
| Rate for Payer: PACE SWMI |
$96.55
|
| Rate for Payer: PHP Commercial |
$328.28
|
| Rate for Payer: PHP Medicare Advantage |
$96.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.04
|
| Rate for Payer: Priority Health HMO/PPO |
$336.00
|
| Rate for Payer: Priority Health Medicare |
$97.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$258.76
|
| Rate for Payer: Railroad Medicare Medicare |
$96.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.86
|
| Rate for Payer: UHC Core |
$322.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.55
|
| Rate for Payer: UHC Exchange |
$96.55
|
| Rate for Payer: UHC Medicare Advantage |
$96.55
|
| Rate for Payer: UHCCP Medicaid |
$209.11
|
| Rate for Payer: VA VA |
$96.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.66
|
|
|
HC CHEMODENERV SALIV GLANDS
|
Facility
|
IP
|
$386.21
|
|
|
Service Code
|
CPT 64611
|
| Hospital Charge Code |
76100210
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$251.04 |
| Max. Negotiated Rate |
$347.59 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: BCBS Trust/PPO |
$315.26
|
| Rate for Payer: BCN Commercial |
$298.46
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cofinity Commercial |
$332.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.97
|
| Rate for Payer: Healthscope Commercial |
$347.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.28
|
| Rate for Payer: Nomi Health Commercial |
$316.69
|
| Rate for Payer: PHP Commercial |
$328.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.04
|
| Rate for Payer: Priority Health HMO/PPO |
$336.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$258.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.86
|
| Rate for Payer: UHC Core |
$322.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.66
|
|
|
HC CHEMODNRV EA ADD EXT 1-4 MUSC
|
Facility
|
IP
|
$696.44
|
|
|
Service Code
|
CPT 64643
|
| Hospital Charge Code |
36100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$452.69 |
| Max. Negotiated Rate |
$626.80 |
| Rate for Payer: Aetna Commercial |
$591.97
|
| Rate for Payer: BCBS Trust/PPO |
$568.50
|
| Rate for Payer: BCN Commercial |
$538.21
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cofinity Commercial |
$598.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.15
|
| Rate for Payer: Healthscope Commercial |
$626.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$591.97
|
| Rate for Payer: Nomi Health Commercial |
$571.08
|
| Rate for Payer: PHP Commercial |
$591.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.69
|
| Rate for Payer: Priority Health HMO/PPO |
$605.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$466.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$612.87
|
| Rate for Payer: UHC Core |
$581.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.33
|
|
|
HC CHEMODNRV EA ADD EXT 1-4 MUSC
|
Facility
|
OP
|
$696.44
|
|
|
Service Code
|
CPT 64643
|
| Hospital Charge Code |
36100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$165.40 |
| Max. Negotiated Rate |
$626.80 |
| Rate for Payer: Aetna Commercial |
$591.97
|
| Rate for Payer: Aetna Medicare |
$181.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.64
|
| Rate for Payer: BCBS Complete |
$278.58
|
| Rate for Payer: BCBS MAPPO |
$174.11
|
| Rate for Payer: BCBS Trust/PPO |
$572.54
|
| Rate for Payer: BCN Commercial |
$541.48
|
| Rate for Payer: BCN Medicare Advantage |
$174.11
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cofinity Commercial |
$598.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.11
|
| Rate for Payer: Healthscope Commercial |
$626.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$591.97
|
| Rate for Payer: Nomi Health Commercial |
$571.08
|
| Rate for Payer: PACE Senior Care Partners |
$165.40
|
| Rate for Payer: PACE SWMI |
$174.11
|
| Rate for Payer: PHP Commercial |
$591.97
|
| Rate for Payer: PHP Medicare Advantage |
$174.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.69
|
| Rate for Payer: Priority Health HMO/PPO |
$605.90
|
| Rate for Payer: Priority Health Medicare |
$175.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$466.61
|
| Rate for Payer: Railroad Medicare Medicare |
$174.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$612.87
|
| Rate for Payer: UHC Core |
$581.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.11
|
| Rate for Payer: UHC Exchange |
$174.11
|
| Rate for Payer: UHC Medicare Advantage |
$174.11
|
| Rate for Payer: VA VA |
$174.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.33
|
|
|
HC CHEMODNRV EXT1-4 MUSC
|
Facility
|
OP
|
$671.38
|
|
|
Service Code
|
CPT 64642
|
| Hospital Charge Code |
36100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.45 |
| Max. Negotiated Rate |
$604.24 |
| Rate for Payer: Aetna Commercial |
$570.67
|
| Rate for Payer: Aetna Medicare |
$174.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.81
|
| Rate for Payer: BCBS Complete |
$515.13
|
| Rate for Payer: BCBS MAPPO |
$167.84
|
| Rate for Payer: BCBS Trust/PPO |
$551.94
|
| Rate for Payer: BCN Commercial |
$522.00
|
| Rate for Payer: BCN Medicare Advantage |
$167.84
|
| Rate for Payer: Cash Price |
$537.10
|
| Rate for Payer: Cash Price |
$537.10
|
| Rate for Payer: Cofinity Commercial |
$577.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.84
|
| Rate for Payer: Healthscope Commercial |
$604.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.54
|
| Rate for Payer: Mclaren Medicaid |
$490.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.24
|
| Rate for Payer: Meridian Medicaid |
$515.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.67
|
| Rate for Payer: Nomi Health Commercial |
$550.53
|
| Rate for Payer: PACE Senior Care Partners |
$159.45
|
| Rate for Payer: PACE SWMI |
$167.84
|
| Rate for Payer: PHP Commercial |
$570.67
|
| Rate for Payer: PHP Medicare Advantage |
$167.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.40
|
| Rate for Payer: Priority Health HMO/PPO |
$584.10
|
| Rate for Payer: Priority Health Medicare |
$169.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$449.82
|
| Rate for Payer: Railroad Medicare Medicare |
$167.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$590.81
|
| Rate for Payer: UHC Core |
$560.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.84
|
| Rate for Payer: UHC Exchange |
$167.84
|
| Rate for Payer: UHC Medicare Advantage |
$167.84
|
| Rate for Payer: UHCCP Medicaid |
$490.57
|
| Rate for Payer: VA VA |
$167.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.54
|
|
|
HC CHEMODNRV EXT1-4 MUSC
|
Facility
|
IP
|
$671.38
|
|
|
Service Code
|
CPT 64642
|
| Hospital Charge Code |
36100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$436.40 |
| Max. Negotiated Rate |
$604.24 |
| Rate for Payer: Aetna Commercial |
$570.67
|
| Rate for Payer: BCBS Trust/PPO |
$548.05
|
| Rate for Payer: BCN Commercial |
$518.84
|
| Rate for Payer: Cash Price |
$537.10
|
| Rate for Payer: Cofinity Commercial |
$577.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.10
|
| Rate for Payer: Healthscope Commercial |
$604.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.67
|
| Rate for Payer: Nomi Health Commercial |
$550.53
|
| Rate for Payer: PHP Commercial |
$570.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.40
|
| Rate for Payer: Priority Health HMO/PPO |
$584.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$449.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$590.81
|
| Rate for Payer: UHC Core |
$560.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.54
|
|
|
HC CHEMODNRV EXTREMITY 5/< MUSCLES
|
Facility
|
IP
|
$115.59
|
|
|
Service Code
|
CPT 64645
|
| Hospital Charge Code |
36100550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$75.13 |
| Max. Negotiated Rate |
$104.03 |
| Rate for Payer: Aetna Commercial |
$98.25
|
| Rate for Payer: BCBS Trust/PPO |
$94.36
|
| Rate for Payer: BCN Commercial |
$89.33
|
| Rate for Payer: Cash Price |
$92.47
|
| Rate for Payer: Cofinity Commercial |
$99.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.47
|
| Rate for Payer: Healthscope Commercial |
$104.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.25
|
| Rate for Payer: Nomi Health Commercial |
$94.78
|
| Rate for Payer: PHP Commercial |
$98.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.13
|
| Rate for Payer: Priority Health HMO/PPO |
$100.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.72
|
| Rate for Payer: UHC Core |
$96.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.69
|
|
