|
HC CHEMODNRV MUSC NECK
|
Facility
|
OP
|
$448.42
|
|
|
Service Code
|
CPT 64616
|
| Hospital Charge Code |
36100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$106.50 |
| Max. Negotiated Rate |
$403.58 |
| Rate for Payer: Aetna Commercial |
$381.16
|
| Rate for Payer: Aetna Medicare |
$116.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$140.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$140.13
|
| Rate for Payer: BCBS Complete |
$224.11
|
| Rate for Payer: BCBS MAPPO |
$112.11
|
| Rate for Payer: BCBS Trust/PPO |
$368.65
|
| Rate for Payer: BCN Commercial |
$348.65
|
| Rate for Payer: BCN Medicare Advantage |
$112.11
|
| Rate for Payer: Cash Price |
$358.74
|
| Rate for Payer: Cash Price |
$358.74
|
| Rate for Payer: Cofinity Commercial |
$385.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.11
|
| Rate for Payer: Healthscope Commercial |
$403.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$336.31
|
| Rate for Payer: Mclaren Medicaid |
$213.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.71
|
| Rate for Payer: Meridian Medicaid |
$224.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$381.16
|
| Rate for Payer: Nomi Health Commercial |
$367.70
|
| Rate for Payer: PACE Senior Care Partners |
$106.50
|
| Rate for Payer: PACE SWMI |
$112.11
|
| Rate for Payer: PHP Commercial |
$381.16
|
| Rate for Payer: PHP Medicare Advantage |
$112.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.47
|
| Rate for Payer: Priority Health HMO/PPO |
$390.13
|
| Rate for Payer: Priority Health Medicare |
$113.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$300.44
|
| Rate for Payer: Railroad Medicare Medicare |
$112.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$394.61
|
| Rate for Payer: UHC Core |
$374.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.11
|
| Rate for Payer: UHC Exchange |
$112.11
|
| Rate for Payer: UHC Medicare Advantage |
$112.11
|
| Rate for Payer: UHCCP Medicaid |
$213.42
|
| Rate for Payer: VA VA |
$112.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$336.31
|
|
|
HC CHEMODNRV MUSC NECK
|
Facility
|
IP
|
$448.42
|
|
|
Service Code
|
CPT 64616
|
| Hospital Charge Code |
36100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$291.47 |
| Max. Negotiated Rate |
$403.58 |
| Rate for Payer: Aetna Commercial |
$381.16
|
| Rate for Payer: BCBS Trust/PPO |
$366.05
|
| Rate for Payer: BCN Commercial |
$346.54
|
| Rate for Payer: Cash Price |
$358.74
|
| Rate for Payer: Cofinity Commercial |
$385.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.74
|
| Rate for Payer: Healthscope Commercial |
$403.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$336.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$381.16
|
| Rate for Payer: Nomi Health Commercial |
$367.70
|
| Rate for Payer: PHP Commercial |
$381.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.47
|
| Rate for Payer: Priority Health HMO/PPO |
$390.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$300.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$394.61
|
| Rate for Payer: UHC Core |
$374.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$336.31
|
|
|
HC CHEMODNRV TRUNK MUSC 1-5 MUSC
|
Facility
|
OP
|
$696.44
|
|
|
Service Code
|
CPT 64646
|
| Hospital Charge Code |
36100453
|
|
Hospital Revenue Code
|
361
|
| 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 |
$525.76
|
| 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: 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: Mclaren Medicaid |
$500.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.82
|
| Rate for Payer: Meridian Medicaid |
$525.76
|
| 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 Choice Medicaid |
$500.69
|
| 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: UHCCP Medicaid |
$500.69
|
| Rate for Payer: VA VA |
$174.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.33
|
|
|
HC CHEMODNRV TRUNK MUSC 1-5 MUSC
|
Facility
|
IP
|
$696.44
|
|
|
Service Code
|
CPT 64646
|
| Hospital Charge Code |
36100453
|
|
Hospital Revenue Code
|
361
|
| 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 CHEMO INFUSION CONCURRENT
|
Facility
|
IP
|
$197.68
|
|
|
Service Code
|
CPT 96549
|
| Hospital Charge Code |
33500011
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$128.49 |
| Max. Negotiated Rate |
$177.91 |
| Rate for Payer: Aetna Commercial |
$168.03
|
| Rate for Payer: BCBS Trust/PPO |
$161.37
|
| Rate for Payer: BCN Commercial |
$152.77
|
| Rate for Payer: Cash Price |
$158.14
|
| Rate for Payer: Cofinity Commercial |
$170.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.14
|
| Rate for Payer: Healthscope Commercial |
$177.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.03
|
| Rate for Payer: Nomi Health Commercial |
$162.10
|
| Rate for Payer: PHP Commercial |
$168.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.49
|
| Rate for Payer: Priority Health HMO/PPO |
$171.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.96
|
| Rate for Payer: UHC Core |
$165.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.26
|
|
|
HC CHEMO INFUSION CONCURRENT
|
Facility
|
OP
|
$197.68
|
|
|
Service Code
|
CPT 96549
|
| Hospital Charge Code |
33500011
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$33.36 |
| Max. Negotiated Rate |
$177.91 |
| Rate for Payer: Aetna Commercial |
$168.03
|
| Rate for Payer: Aetna Medicare |
$51.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.77
|
| Rate for Payer: BCBS Complete |
$35.03
|
| Rate for Payer: BCBS MAPPO |
$49.42
|
| Rate for Payer: BCBS Trust/PPO |
$162.51
|
| Rate for Payer: BCN Commercial |
$153.70
|
| Rate for Payer: BCN Medicare Advantage |
$49.42
|
| Rate for Payer: Cash Price |
$158.14
|
| Rate for Payer: Cash Price |
$158.14
|
| Rate for Payer: Cofinity Commercial |
$170.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.42
|
| Rate for Payer: Healthscope Commercial |
$177.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.26
|
| Rate for Payer: Mclaren Medicaid |
$33.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.89
|
| Rate for Payer: Meridian Medicaid |
$35.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.03
|
| Rate for Payer: Nomi Health Commercial |
$162.10
|
| Rate for Payer: PACE Senior Care Partners |
$46.95
|
| Rate for Payer: PACE SWMI |
$49.42
|
| Rate for Payer: PHP Commercial |
$168.03
|
| Rate for Payer: PHP Medicare Advantage |
$49.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.49
|
| Rate for Payer: Priority Health HMO/PPO |
$171.98
|
| Rate for Payer: Priority Health Medicare |
$49.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.45
|
| Rate for Payer: Railroad Medicare Medicare |
$49.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.96
|
| Rate for Payer: UHC Core |
$165.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.42
|
| Rate for Payer: UHC Exchange |
$49.42
|
| Rate for Payer: UHC Medicare Advantage |
$49.42
|
| Rate for Payer: UHCCP Medicaid |
$33.36
|
| Rate for Payer: VA VA |
$49.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.26
|
|
|
HC CHEMO INFUSION EACH ADDL HR
|
Facility
|
OP
|
$262.13
|
|
|
Service Code
|
CPT 96415
|
| Hospital Charge Code |
33500002
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$51.46 |
| Max. Negotiated Rate |
$235.92 |
| Rate for Payer: Aetna Commercial |
$222.81
|
| Rate for Payer: Aetna Medicare |
$68.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.92
|
| Rate for Payer: BCBS Complete |
$54.03
|
| Rate for Payer: BCBS MAPPO |
$65.53
|
| Rate for Payer: BCBS Trust/PPO |
$215.50
|
| Rate for Payer: BCN Commercial |
$203.81
|
| Rate for Payer: BCN Medicare Advantage |
$65.53
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Cofinity Commercial |
$225.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.53
|
| Rate for Payer: Healthscope Commercial |
$235.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.60
|
| Rate for Payer: Mclaren Medicaid |
$51.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.81
|
| Rate for Payer: Meridian Medicaid |
$54.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.81
|
| Rate for Payer: Nomi Health Commercial |
$214.95
|
| Rate for Payer: PACE Senior Care Partners |
$62.26
|
| Rate for Payer: PACE SWMI |
$65.53
|
| Rate for Payer: PHP Commercial |
$222.81
|
| Rate for Payer: PHP Medicare Advantage |
$65.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.38
|
| Rate for Payer: Priority Health HMO/PPO |
$228.05
|
| Rate for Payer: Priority Health Medicare |
$66.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.63
|
| Rate for Payer: Railroad Medicare Medicare |
$65.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.67
|
| Rate for Payer: UHC Core |
$218.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.53
|
| Rate for Payer: UHC Exchange |
$65.53
|
| Rate for Payer: UHC Medicare Advantage |
$65.53
|
| Rate for Payer: UHCCP Medicaid |
$51.46
|
| Rate for Payer: VA VA |
$65.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.60
|
|
|
HC CHEMO INFUSION EACH ADDL HR
|
Facility
|
IP
|
$262.13
|
|
|
Service Code
|
CPT 96415
|
| Hospital Charge Code |
33500002
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$170.38 |
| Max. Negotiated Rate |
$235.92 |
| Rate for Payer: Aetna Commercial |
$222.81
|
| Rate for Payer: BCBS Trust/PPO |
$213.98
|
| Rate for Payer: BCN Commercial |
$202.57
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Cofinity Commercial |
$225.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.70
|
| Rate for Payer: Healthscope Commercial |
$235.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.81
|
| Rate for Payer: Nomi Health Commercial |
$214.95
|
| Rate for Payer: PHP Commercial |
$222.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.38
|
| Rate for Payer: Priority Health HMO/PPO |
$228.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.67
|
| Rate for Payer: UHC Core |
$218.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.60
|
|
|
HC CHEMO INFUSION FIRST HR
|
Facility
|
IP
|
$973.97
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
33500001
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$633.08 |
| Max. Negotiated Rate |
$876.57 |
| Rate for Payer: Aetna Commercial |
$827.87
|
| Rate for Payer: BCBS Trust/PPO |
$795.05
|
| Rate for Payer: BCN Commercial |
$752.68
|
| Rate for Payer: Cash Price |
$779.18
|
| Rate for Payer: Cofinity Commercial |
$837.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$779.18
|
| Rate for Payer: Healthscope Commercial |
$876.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$730.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$827.87
|
| Rate for Payer: Nomi Health Commercial |
$798.66
|
| Rate for Payer: PHP Commercial |
$827.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.08
|
| Rate for Payer: Priority Health HMO/PPO |
$847.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$652.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$857.09
|
| Rate for Payer: UHC Core |
$813.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$730.48
|
|
|
HC CHEMO INFUSION FIRST HR
|
Facility
|
OP
|
$973.97
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
33500001
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$231.32 |
| Max. Negotiated Rate |
$876.57 |
| Rate for Payer: Aetna Commercial |
$827.87
|
| Rate for Payer: Aetna Medicare |
$253.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$304.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$304.37
|
| Rate for Payer: BCBS Complete |
$251.82
|
| Rate for Payer: BCBS MAPPO |
$243.49
|
| Rate for Payer: BCBS Trust/PPO |
$800.70
|
| Rate for Payer: BCN Commercial |
$757.26
|
| Rate for Payer: BCN Medicare Advantage |
$243.49
|
| Rate for Payer: Cash Price |
$779.18
|
| Rate for Payer: Cash Price |
$779.18
|
| Rate for Payer: Cofinity Commercial |
$837.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$779.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$243.49
|
| Rate for Payer: Healthscope Commercial |
$876.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$730.48
|
| Rate for Payer: Mclaren Medicaid |
$239.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$255.67
|
| Rate for Payer: Meridian Medicaid |
$251.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$280.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$827.87
|
| Rate for Payer: Nomi Health Commercial |
$798.66
|
| Rate for Payer: PACE Senior Care Partners |
$231.32
|
| Rate for Payer: PACE SWMI |
$243.49
|
| Rate for Payer: PHP Commercial |
$827.87
|
| Rate for Payer: PHP Medicare Advantage |
$243.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.08
|
| Rate for Payer: Priority Health HMO/PPO |
$847.35
|
| Rate for Payer: Priority Health Medicare |
$245.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$652.56
|
| Rate for Payer: Railroad Medicare Medicare |
$243.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$857.09
|
| Rate for Payer: UHC Core |
$813.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$243.49
|
| Rate for Payer: UHC Exchange |
$243.49
|
| Rate for Payer: UHC Medicare Advantage |
$243.49
|
| Rate for Payer: UHCCP Medicaid |
$239.81
|
| Rate for Payer: VA VA |
$243.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$730.48
|
|
|
HC CHEMO INFUSION VIA PUMP
|
Facility
|
IP
|
$882.55
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
33500003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$573.66 |
| Max. Negotiated Rate |
$794.29 |
| Rate for Payer: Aetna Commercial |
$750.17
|
| Rate for Payer: BCBS Trust/PPO |
$720.43
|
| Rate for Payer: BCN Commercial |
$682.03
|
| Rate for Payer: Cash Price |
$706.04
|
| Rate for Payer: Cofinity Commercial |
$758.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$706.04
|
| Rate for Payer: Healthscope Commercial |
$794.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$661.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$750.17
|
| Rate for Payer: Nomi Health Commercial |
$723.69
|
| Rate for Payer: PHP Commercial |
$750.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.66
|
| Rate for Payer: Priority Health HMO/PPO |
$767.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$591.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$776.64
|
| Rate for Payer: UHC Core |
$736.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$661.91
|
|
|
HC CHEMO INFUSION VIA PUMP
|
Facility
|
OP
|
$882.55
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
33500003
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$209.61 |
| Max. Negotiated Rate |
$794.29 |
| Rate for Payer: Aetna Commercial |
$750.17
|
| Rate for Payer: Aetna Medicare |
$229.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$275.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$275.80
|
| Rate for Payer: BCBS Complete |
$251.82
|
| Rate for Payer: BCBS MAPPO |
$220.64
|
| Rate for Payer: BCBS Trust/PPO |
$725.54
|
| Rate for Payer: BCN Commercial |
$686.18
|
| Rate for Payer: BCN Medicare Advantage |
$220.64
|
| Rate for Payer: Cash Price |
$706.04
|
| Rate for Payer: Cash Price |
$706.04
|
| Rate for Payer: Cofinity Commercial |
$758.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$706.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$220.64
|
| Rate for Payer: Healthscope Commercial |
$794.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$661.91
|
| Rate for Payer: Mclaren Medicaid |
$239.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$231.67
|
| Rate for Payer: Meridian Medicaid |
$251.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$253.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$750.17
|
| Rate for Payer: Nomi Health Commercial |
$723.69
|
| Rate for Payer: PACE Senior Care Partners |
$209.61
|
| Rate for Payer: PACE SWMI |
$220.64
|
| Rate for Payer: PHP Commercial |
$750.17
|
| Rate for Payer: PHP Medicare Advantage |
$220.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.66
|
| Rate for Payer: Priority Health HMO/PPO |
$767.82
|
| Rate for Payer: Priority Health Medicare |
$222.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$591.31
|
| Rate for Payer: Railroad Medicare Medicare |
$220.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$776.64
|
| Rate for Payer: UHC Core |
$736.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$220.64
|
| Rate for Payer: UHC Exchange |
$220.64
|
| Rate for Payer: UHC Medicare Advantage |
$220.64
|
| Rate for Payer: UHCCP Medicaid |
$239.81
|
| Rate for Payer: VA VA |
$220.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$661.91
|
|
|
HC CHEMO INFUS SEQUENTIAL UP TO 1 HR
|
Facility
|
IP
|
$440.24
|
|
|
Service Code
|
CPT 96417
|
| Hospital Charge Code |
33500004
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$286.16 |
| Max. Negotiated Rate |
$396.22 |
| Rate for Payer: Aetna Commercial |
$374.20
|
| Rate for Payer: BCBS Trust/PPO |
$359.37
|
| Rate for Payer: BCN Commercial |
$340.22
|
| Rate for Payer: Cash Price |
$352.19
|
| Rate for Payer: Cofinity Commercial |
$378.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.19
|
| Rate for Payer: Healthscope Commercial |
$396.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.20
|
| Rate for Payer: Nomi Health Commercial |
$361.00
|
| Rate for Payer: PHP Commercial |
$374.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.16
|
| Rate for Payer: Priority Health HMO/PPO |
$383.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.41
|
| Rate for Payer: UHC Core |
$367.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.18
|
|
|
HC CHEMO INFUS SEQUENTIAL UP TO 1 HR
|
Facility
|
OP
|
$440.24
|
|
|
Service Code
|
CPT 96417
|
| Hospital Charge Code |
33500004
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$51.46 |
| Max. Negotiated Rate |
$396.22 |
| Rate for Payer: Aetna Commercial |
$374.20
|
| Rate for Payer: Aetna Medicare |
$114.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.57
|
| Rate for Payer: BCBS Complete |
$54.03
|
| Rate for Payer: BCBS MAPPO |
$110.06
|
| Rate for Payer: BCBS Trust/PPO |
$361.92
|
| Rate for Payer: BCN Commercial |
$342.29
|
| Rate for Payer: BCN Medicare Advantage |
$110.06
|
| Rate for Payer: Cash Price |
$352.19
|
| Rate for Payer: Cash Price |
$352.19
|
| Rate for Payer: Cofinity Commercial |
$378.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.06
|
| Rate for Payer: Healthscope Commercial |
$396.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.18
|
| Rate for Payer: Mclaren Medicaid |
$51.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.56
|
| Rate for Payer: Meridian Medicaid |
$54.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.20
|
| Rate for Payer: Nomi Health Commercial |
$361.00
|
| Rate for Payer: PACE Senior Care Partners |
$104.56
|
| Rate for Payer: PACE SWMI |
$110.06
|
| Rate for Payer: PHP Commercial |
$374.20
|
| Rate for Payer: PHP Medicare Advantage |
$110.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.16
|
| Rate for Payer: Priority Health HMO/PPO |
$383.01
|
| Rate for Payer: Priority Health Medicare |
$111.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.96
|
| Rate for Payer: Railroad Medicare Medicare |
$110.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.41
|
| Rate for Payer: UHC Core |
$367.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.06
|
| Rate for Payer: UHC Exchange |
$110.06
|
| Rate for Payer: UHC Medicare Advantage |
$110.06
|
| Rate for Payer: UHCCP Medicaid |
$51.46
|
| Rate for Payer: VA VA |
$110.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.18
|
|
|
HC CHEMO INTO PERITONEAL CAVITY VIA PORT
|
Facility
|
OP
|
$438.65
|
|
|
Service Code
|
CPT 96446
|
| Hospital Charge Code |
33500007
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$104.18 |
| Max. Negotiated Rate |
$394.79 |
| Rate for Payer: Aetna Commercial |
$372.85
|
| Rate for Payer: Aetna Medicare |
$114.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.08
|
| Rate for Payer: BCBS Complete |
$251.82
|
| Rate for Payer: BCBS MAPPO |
$109.66
|
| Rate for Payer: BCBS Trust/PPO |
$360.61
|
| Rate for Payer: BCN Commercial |
$341.05
|
| Rate for Payer: BCN Medicare Advantage |
$109.66
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$377.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.66
|
| Rate for Payer: Healthscope Commercial |
$394.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.99
|
| Rate for Payer: Mclaren Medicaid |
$239.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.15
|
| Rate for Payer: Meridian Medicaid |
$251.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: Nomi Health Commercial |
$359.69
|
| Rate for Payer: PACE Senior Care Partners |
$104.18
|
| Rate for Payer: PACE SWMI |
$109.66
|
| Rate for Payer: PHP Commercial |
$372.85
|
| Rate for Payer: PHP Medicare Advantage |
$109.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: Priority Health HMO/PPO |
$381.63
|
| Rate for Payer: Priority Health Medicare |
$110.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.90
|
| Rate for Payer: Railroad Medicare Medicare |
$109.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.01
|
| Rate for Payer: UHC Core |
$366.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.66
|
| Rate for Payer: UHC Exchange |
$109.66
|
| Rate for Payer: UHC Medicare Advantage |
$109.66
|
| Rate for Payer: UHCCP Medicaid |
$239.81
|
| Rate for Payer: VA VA |
$109.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.99
|
|
|
HC CHEMO INTO PERITONEAL CAVITY VIA PORT
|
Facility
|
IP
|
$438.65
|
|
|
Service Code
|
CPT 96446
|
| Hospital Charge Code |
33500007
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$285.12 |
| Max. Negotiated Rate |
$394.79 |
| Rate for Payer: Aetna Commercial |
$372.85
|
| Rate for Payer: BCBS Trust/PPO |
$358.07
|
| Rate for Payer: BCN Commercial |
$338.99
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$377.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Healthscope Commercial |
$394.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: Nomi Health Commercial |
$359.69
|
| Rate for Payer: PHP Commercial |
$372.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: Priority Health HMO/PPO |
$381.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.01
|
| Rate for Payer: UHC Core |
$366.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.99
|
|
|
HC CHEMO INTO PLEURA W THORACENTESIS
|
Facility
|
OP
|
$438.65
|
|
|
Service Code
|
CPT 96440
|
| Hospital Charge Code |
33500006
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$104.18 |
| Max. Negotiated Rate |
$394.79 |
| Rate for Payer: Aetna Commercial |
$372.85
|
| Rate for Payer: Aetna Medicare |
$114.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.08
|
| Rate for Payer: BCBS Complete |
$251.82
|
| Rate for Payer: BCBS MAPPO |
$109.66
|
| Rate for Payer: BCBS Trust/PPO |
$360.61
|
| Rate for Payer: BCN Commercial |
$341.05
|
| Rate for Payer: BCN Medicare Advantage |
$109.66
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$377.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.66
|
| Rate for Payer: Healthscope Commercial |
$394.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.99
|
| Rate for Payer: Mclaren Medicaid |
$239.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.15
|
| Rate for Payer: Meridian Medicaid |
$251.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: Nomi Health Commercial |
$359.69
|
| Rate for Payer: PACE Senior Care Partners |
$104.18
|
| Rate for Payer: PACE SWMI |
$109.66
|
| Rate for Payer: PHP Commercial |
$372.85
|
| Rate for Payer: PHP Medicare Advantage |
$109.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: Priority Health HMO/PPO |
$381.63
|
| Rate for Payer: Priority Health Medicare |
$110.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.90
|
| Rate for Payer: Railroad Medicare Medicare |
$109.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.01
|
| Rate for Payer: UHC Core |
$366.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.66
|
| Rate for Payer: UHC Exchange |
$109.66
|
| Rate for Payer: UHC Medicare Advantage |
$109.66
|
| Rate for Payer: UHCCP Medicaid |
$239.81
|
| Rate for Payer: VA VA |
$109.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.99
|
|
|
HC CHEMO INTO PLEURA W THORACENTESIS
|
Facility
|
IP
|
$438.65
|
|
|
Service Code
|
CPT 96440
|
| Hospital Charge Code |
33500006
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$285.12 |
| Max. Negotiated Rate |
$394.79 |
| Rate for Payer: Aetna Commercial |
$372.85
|
| Rate for Payer: BCBS Trust/PPO |
$358.07
|
| Rate for Payer: BCN Commercial |
$338.99
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$377.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Healthscope Commercial |
$394.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: Nomi Health Commercial |
$359.69
|
| Rate for Payer: PHP Commercial |
$372.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: Priority Health HMO/PPO |
$381.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$293.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.01
|
| Rate for Payer: UHC Core |
$366.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.99
|
|
|
HC CHEST TUBE PROCEDURE
|
Facility
|
OP
|
$1,560.60
|
|
| Hospital Charge Code |
45000035
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$370.64 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna Commercial |
$1,326.51
|
| Rate for Payer: Aetna Medicare |
$405.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.69
|
| Rate for Payer: BCBS Complete |
$624.24
|
| Rate for Payer: BCBS MAPPO |
$390.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,282.97
|
| Rate for Payer: BCN Commercial |
$1,213.37
|
| Rate for Payer: BCN Medicare Advantage |
$390.15
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Commercial |
$1,342.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.15
|
| Rate for Payer: Healthscope Commercial |
$1,404.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,170.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Nomi Health Commercial |
$1,279.69
|
| Rate for Payer: PACE Senior Care Partners |
$370.64
|
| Rate for Payer: PACE SWMI |
$390.15
|
| Rate for Payer: PHP Commercial |
$1,326.51
|
| Rate for Payer: PHP Medicare Advantage |
$390.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.39
|
| Rate for Payer: Priority Health HMO/PPO |
$1,357.72
|
| Rate for Payer: Priority Health Medicare |
$394.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,045.60
|
| Rate for Payer: Railroad Medicare Medicare |
$390.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,373.33
|
| Rate for Payer: UHC Core |
$1,303.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.15
|
| Rate for Payer: UHC Exchange |
$390.15
|
| Rate for Payer: UHC Medicare Advantage |
$390.15
|
| Rate for Payer: VA VA |
$390.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,170.45
|
|
|
HC CHEST TUBE PROCEDURE
|
Facility
|
IP
|
$1,560.60
|
|
| Hospital Charge Code |
45000035
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,014.39 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna Commercial |
$1,326.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,273.92
|
| Rate for Payer: BCN Commercial |
$1,206.03
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Commercial |
$1,342.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Healthscope Commercial |
$1,404.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,170.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Nomi Health Commercial |
$1,279.69
|
| Rate for Payer: PHP Commercial |
$1,326.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.39
|
| Rate for Payer: Priority Health HMO/PPO |
$1,357.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,045.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,373.33
|
| Rate for Payer: UHC Core |
$1,303.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,170.45
|
|
|
HC CHICKEN FEATHERS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200078
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CHICKEN FEATHERS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200078
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CHILDBIRTH EDUCATION
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
HCPCS S9442
|
| Hospital Charge Code |
94200005
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$27.30 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Aetna Commercial |
$35.70
|
| Rate for Payer: BCBS Trust/PPO |
$34.28
|
| Rate for Payer: BCN Commercial |
$32.46
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$36.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.60
|
| Rate for Payer: Healthscope Commercial |
$37.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.70
|
| Rate for Payer: Nomi Health Commercial |
$34.44
|
| Rate for Payer: PHP Commercial |
$35.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health HMO/PPO |
$36.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.96
|
| Rate for Payer: UHC Core |
$35.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.50
|
|
|
HC CHILDBIRTH EDUCATION
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
HCPCS S9442
|
| Hospital Charge Code |
94200005
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$9.97 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Aetna Commercial |
$35.70
|
| Rate for Payer: Aetna Medicare |
$10.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.12
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS MAPPO |
$10.50
|
| Rate for Payer: BCBS Trust/PPO |
$34.53
|
| Rate for Payer: BCN Commercial |
$32.66
|
| Rate for Payer: BCN Medicare Advantage |
$10.50
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$36.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.50
|
| Rate for Payer: Healthscope Commercial |
$37.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.70
|
| Rate for Payer: Nomi Health Commercial |
$34.44
|
| Rate for Payer: PACE Senior Care Partners |
$9.97
|
| Rate for Payer: PACE SWMI |
$10.50
|
| Rate for Payer: PHP Commercial |
$35.70
|
| Rate for Payer: PHP Medicare Advantage |
$10.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health HMO/PPO |
$36.54
|
| Rate for Payer: Priority Health Medicare |
$10.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.14
|
| Rate for Payer: Railroad Medicare Medicare |
$10.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.96
|
| Rate for Payer: UHC Core |
$35.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.50
|
| Rate for Payer: UHC Exchange |
$10.50
|
| Rate for Payer: UHC Medicare Advantage |
$10.50
|
| Rate for Payer: VA VA |
$10.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.50
|
|
|
HC CHILDHOOD ALLERGEN PROFILE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200120
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
