|
HC CRITIC AID 6.5 OZ
|
Facility
|
IP
|
$39.99
|
|
| Hospital Charge Code |
27100008
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.99 |
| Max. Negotiated Rate |
$35.99 |
| Rate for Payer: Aetna Commercial |
$33.99
|
| Rate for Payer: BCBS Trust/PPO |
$32.64
|
| Rate for Payer: BCN Commercial |
$30.90
|
| Rate for Payer: Cash Price |
$31.99
|
| Rate for Payer: Cofinity Commercial |
$34.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.99
|
| Rate for Payer: Healthscope Commercial |
$35.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.99
|
| Rate for Payer: Nomi Health Commercial |
$32.79
|
| Rate for Payer: PHP Commercial |
$33.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.99
|
| Rate for Payer: Priority Health HMO/PPO |
$34.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.19
|
| Rate for Payer: UHC Core |
$33.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.99
|
|
|
HC CRITICAL CARE R&B
|
Facility
|
IP
|
$6,337.46
|
|
| Hospital Charge Code |
20000001
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$4,119.35 |
| Max. Negotiated Rate |
$5,703.71 |
| Rate for Payer: Aetna Commercial |
$5,386.84
|
| Rate for Payer: BCBS Trust/PPO |
$5,173.27
|
| Rate for Payer: BCN Commercial |
$4,897.59
|
| Rate for Payer: Cash Price |
$5,069.97
|
| Rate for Payer: Cofinity Commercial |
$5,450.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,069.97
|
| Rate for Payer: Healthscope Commercial |
$5,703.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,753.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,386.84
|
| Rate for Payer: Nomi Health Commercial |
$5,196.72
|
| Rate for Payer: PHP Commercial |
$5,386.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,119.35
|
| Rate for Payer: Priority Health HMO/PPO |
$5,513.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,246.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,576.96
|
| Rate for Payer: UHC Core |
$5,291.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,753.10
|
|
|
HC CRMP 5 IGG WB
|
Facility
|
OP
|
$160.14
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100640
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.12 |
| Max. Negotiated Rate |
$144.13 |
| Rate for Payer: Aetna Commercial |
$136.12
|
| Rate for Payer: Aetna Medicare |
$41.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.04
|
| Rate for Payer: BCBS Complete |
$22.18
|
| Rate for Payer: BCBS MAPPO |
$40.03
|
| Rate for Payer: BCBS Trust/PPO |
$131.65
|
| Rate for Payer: BCN Commercial |
$124.51
|
| Rate for Payer: BCN Medicare Advantage |
$40.03
|
| Rate for Payer: Cash Price |
$128.11
|
| Rate for Payer: Cash Price |
$128.11
|
| Rate for Payer: Cofinity Commercial |
$137.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.03
|
| Rate for Payer: Healthscope Commercial |
$144.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.11
|
| Rate for Payer: Mclaren Medicaid |
$21.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.04
|
| Rate for Payer: Meridian Medicaid |
$22.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.12
|
| Rate for Payer: Nomi Health Commercial |
$131.31
|
| Rate for Payer: PACE Senior Care Partners |
$38.03
|
| Rate for Payer: PACE SWMI |
$40.03
|
| Rate for Payer: PHP Commercial |
$136.12
|
| Rate for Payer: PHP Medicare Advantage |
$40.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.09
|
| Rate for Payer: Priority Health HMO/PPO |
$139.32
|
| Rate for Payer: Priority Health Medicare |
$40.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.29
|
| Rate for Payer: Railroad Medicare Medicare |
$40.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.92
|
| Rate for Payer: UHC Core |
$133.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.03
|
| Rate for Payer: UHC Exchange |
$40.03
|
| Rate for Payer: UHC Medicare Advantage |
$40.03
|
| Rate for Payer: UHCCP Medicaid |
$21.12
|
| Rate for Payer: VA VA |
$40.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.11
|
|
|
HC CRMP 5 IGG WB
|
Facility
|
IP
|
$160.14
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100640
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$104.09 |
| Max. Negotiated Rate |
$144.13 |
| Rate for Payer: Aetna Commercial |
$136.12
|
| Rate for Payer: BCBS Trust/PPO |
$130.72
|
| Rate for Payer: BCN Commercial |
$123.76
|
| Rate for Payer: Cash Price |
$128.11
|
| Rate for Payer: Cofinity Commercial |
$137.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.11
|
| Rate for Payer: Healthscope Commercial |
$144.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.12
|
| Rate for Payer: Nomi Health Commercial |
$131.31
|
| Rate for Payer: PHP Commercial |
$136.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.09
|
| Rate for Payer: Priority Health HMO/PPO |
$139.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.92
|
| Rate for Payer: UHC Core |
$133.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.11
|
|
|
HC CRMP 5 IGG WESTERN BLOT
|
Facility
|
IP
|
$158.10
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200180
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$102.77 |
| Max. Negotiated Rate |
$142.29 |
| Rate for Payer: Aetna Commercial |
$134.38
|
| Rate for Payer: BCBS Trust/PPO |
$129.06
|
| Rate for Payer: BCN Commercial |
$122.18
|
| Rate for Payer: Cash Price |
$126.48
|
| Rate for Payer: Cofinity Commercial |
$135.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.48
|
| Rate for Payer: Healthscope Commercial |
$142.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.38
|
| Rate for Payer: Nomi Health Commercial |
$129.64
|
| Rate for Payer: PHP Commercial |
$134.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.77
|
| Rate for Payer: Priority Health HMO/PPO |
$137.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.13
|
| Rate for Payer: UHC Core |
$132.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.58
|
|
|
HC CRMP 5 IGG WESTERN BLOT
|
Facility
|
OP
|
$158.10
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200180
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$142.29 |
| Rate for Payer: Aetna Commercial |
$134.38
|
| Rate for Payer: Aetna Medicare |
$41.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.41
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$39.52
|
| Rate for Payer: BCBS Trust/PPO |
$129.97
|
| Rate for Payer: BCN Commercial |
$122.92
|
| Rate for Payer: BCN Medicare Advantage |
$39.52
|
| Rate for Payer: Cash Price |
$126.48
|
| Rate for Payer: Cash Price |
$126.48
|
| Rate for Payer: Cofinity Commercial |
$135.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.52
|
| Rate for Payer: Healthscope Commercial |
$142.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.58
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.50
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.38
|
| Rate for Payer: Nomi Health Commercial |
$129.64
|
| Rate for Payer: PACE Senior Care Partners |
$37.55
|
| Rate for Payer: PACE SWMI |
$39.52
|
| Rate for Payer: PHP Commercial |
$134.38
|
| Rate for Payer: PHP Medicare Advantage |
$39.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.77
|
| Rate for Payer: Priority Health HMO/PPO |
$137.55
|
| Rate for Payer: Priority Health Medicare |
$39.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.93
|
| Rate for Payer: Railroad Medicare Medicare |
$39.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.13
|
| Rate for Payer: UHC Core |
$132.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.52
|
| Rate for Payer: UHC Exchange |
$39.52
|
| Rate for Payer: UHC Medicare Advantage |
$39.52
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$39.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.58
|
|
|
HC CROSSMATCH COOMBS
|
Facility
|
OP
|
$184.62
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
30200352
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.85 |
| Max. Negotiated Rate |
$166.16 |
| Rate for Payer: Aetna Commercial |
$156.93
|
| Rate for Payer: Aetna Medicare |
$48.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.69
|
| Rate for Payer: BCBS Complete |
$130.10
|
| Rate for Payer: BCBS MAPPO |
$46.16
|
| Rate for Payer: BCBS Trust/PPO |
$151.78
|
| Rate for Payer: BCN Commercial |
$143.54
|
| Rate for Payer: BCN Medicare Advantage |
$46.16
|
| Rate for Payer: Cash Price |
$147.70
|
| Rate for Payer: Cash Price |
$147.70
|
| Rate for Payer: Cofinity Commercial |
$158.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.16
|
| Rate for Payer: Healthscope Commercial |
$166.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.47
|
| Rate for Payer: Mclaren Medicaid |
$123.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.46
|
| Rate for Payer: Meridian Medicaid |
$130.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.93
|
| Rate for Payer: Nomi Health Commercial |
$151.39
|
| Rate for Payer: PACE Senior Care Partners |
$43.85
|
| Rate for Payer: PACE SWMI |
$46.16
|
| Rate for Payer: PHP Commercial |
$156.93
|
| Rate for Payer: PHP Medicare Advantage |
$46.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.00
|
| Rate for Payer: Priority Health HMO/PPO |
$160.62
|
| Rate for Payer: Priority Health Medicare |
$46.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.70
|
| Rate for Payer: Railroad Medicare Medicare |
$46.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.47
|
| Rate for Payer: UHC Core |
$154.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.16
|
| Rate for Payer: UHC Exchange |
$46.16
|
| Rate for Payer: UHC Medicare Advantage |
$46.16
|
| Rate for Payer: UHCCP Medicaid |
$123.89
|
| Rate for Payer: VA VA |
$46.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.47
|
|
|
HC CROSSMATCH COOMBS
|
Facility
|
IP
|
$184.62
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
30200352
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$166.16 |
| Rate for Payer: Aetna Commercial |
$156.93
|
| Rate for Payer: BCBS Trust/PPO |
$150.71
|
| Rate for Payer: BCN Commercial |
$142.67
|
| Rate for Payer: Cash Price |
$147.70
|
| Rate for Payer: Cofinity Commercial |
$158.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.70
|
| Rate for Payer: Healthscope Commercial |
$166.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.93
|
| Rate for Payer: Nomi Health Commercial |
$151.39
|
| Rate for Payer: PHP Commercial |
$156.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.00
|
| Rate for Payer: Priority Health HMO/PPO |
$160.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.47
|
| Rate for Payer: UHC Core |
$154.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.47
|
|
|
HC CROSSMATCH ELECTRONIC
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
30200380
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$50.95
|
| Rate for Payer: BCN Commercial |
$48.24
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC CROSSMATCH ELECTRONIC
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
30200380
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.82 |
| Max. Negotiated Rate |
$130.10 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.51
|
| Rate for Payer: BCBS Complete |
$130.10
|
| Rate for Payer: BCBS MAPPO |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$48.53
|
| Rate for Payer: BCN Medicare Advantage |
$15.61
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.61
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Mclaren Medicaid |
$123.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$130.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE Senior Care Partners |
$14.82
|
| Rate for Payer: PACE SWMI |
$15.61
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.82
|
| Rate for Payer: Railroad Medicare Medicare |
$15.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.61
|
| Rate for Payer: UHC Exchange |
$15.61
|
| Rate for Payer: UHC Medicare Advantage |
$15.61
|
| Rate for Payer: UHCCP Medicaid |
$123.89
|
| Rate for Payer: VA VA |
$15.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC CROSSMATCH IMMED SPIN
|
Facility
|
IP
|
$91.87
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
30200351
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$59.72 |
| Max. Negotiated Rate |
$82.68 |
| Rate for Payer: Aetna Commercial |
$78.09
|
| Rate for Payer: BCBS Trust/PPO |
$74.99
|
| Rate for Payer: BCN Commercial |
$71.00
|
| Rate for Payer: Cash Price |
$73.50
|
| Rate for Payer: Cofinity Commercial |
$79.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.50
|
| Rate for Payer: Healthscope Commercial |
$82.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.09
|
| Rate for Payer: Nomi Health Commercial |
$75.33
|
| Rate for Payer: PHP Commercial |
$78.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.72
|
| Rate for Payer: Priority Health HMO/PPO |
$79.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.85
|
| Rate for Payer: UHC Core |
$76.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.90
|
|
|
HC CROSSMATCH IMMED SPIN
|
Facility
|
OP
|
$91.87
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
30200351
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.82 |
| Max. Negotiated Rate |
$130.10 |
| Rate for Payer: Aetna Commercial |
$78.09
|
| Rate for Payer: Aetna Medicare |
$23.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.71
|
| Rate for Payer: BCBS Complete |
$130.10
|
| Rate for Payer: BCBS MAPPO |
$22.97
|
| Rate for Payer: BCBS Trust/PPO |
$75.53
|
| Rate for Payer: BCN Commercial |
$71.43
|
| Rate for Payer: BCN Medicare Advantage |
$22.97
|
| Rate for Payer: Cash Price |
$73.50
|
| Rate for Payer: Cash Price |
$73.50
|
| Rate for Payer: Cofinity Commercial |
$79.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.97
|
| Rate for Payer: Healthscope Commercial |
$82.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.90
|
| Rate for Payer: Mclaren Medicaid |
$123.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.12
|
| Rate for Payer: Meridian Medicaid |
$130.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.09
|
| Rate for Payer: Nomi Health Commercial |
$75.33
|
| Rate for Payer: PACE Senior Care Partners |
$21.82
|
| Rate for Payer: PACE SWMI |
$22.97
|
| Rate for Payer: PHP Commercial |
$78.09
|
| Rate for Payer: PHP Medicare Advantage |
$22.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.72
|
| Rate for Payer: Priority Health HMO/PPO |
$79.93
|
| Rate for Payer: Priority Health Medicare |
$23.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.55
|
| Rate for Payer: Railroad Medicare Medicare |
$22.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.85
|
| Rate for Payer: UHC Core |
$76.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.97
|
| Rate for Payer: UHC Exchange |
$22.97
|
| Rate for Payer: UHC Medicare Advantage |
$22.97
|
| Rate for Payer: UHCCP Medicaid |
$123.89
|
| Rate for Payer: VA VA |
$22.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.90
|
|
|
HC CROSSMATCH PREWARM
|
Facility
|
OP
|
$233.07
|
|
|
Service Code
|
CPT 86921
|
| Hospital Charge Code |
30200491
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$55.35 |
| Max. Negotiated Rate |
$209.76 |
| Rate for Payer: Aetna Commercial |
$198.11
|
| Rate for Payer: Aetna Medicare |
$60.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.83
|
| Rate for Payer: BCBS Complete |
$130.10
|
| Rate for Payer: BCBS MAPPO |
$58.27
|
| Rate for Payer: BCBS Trust/PPO |
$191.61
|
| Rate for Payer: BCN Commercial |
$181.21
|
| Rate for Payer: BCN Medicare Advantage |
$58.27
|
| Rate for Payer: Cash Price |
$186.46
|
| Rate for Payer: Cash Price |
$186.46
|
| Rate for Payer: Cofinity Commercial |
$200.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.27
|
| Rate for Payer: Healthscope Commercial |
$209.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.80
|
| Rate for Payer: Mclaren Medicaid |
$123.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.18
|
| Rate for Payer: Meridian Medicaid |
$130.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.11
|
| Rate for Payer: Nomi Health Commercial |
$191.12
|
| Rate for Payer: PACE Senior Care Partners |
$55.35
|
| Rate for Payer: PACE SWMI |
$58.27
|
| Rate for Payer: PHP Commercial |
$198.11
|
| Rate for Payer: PHP Medicare Advantage |
$58.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.50
|
| Rate for Payer: Priority Health HMO/PPO |
$202.77
|
| Rate for Payer: Priority Health Medicare |
$58.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.16
|
| Rate for Payer: Railroad Medicare Medicare |
$58.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.10
|
| Rate for Payer: UHC Core |
$194.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.27
|
| Rate for Payer: UHC Exchange |
$58.27
|
| Rate for Payer: UHC Medicare Advantage |
$58.27
|
| Rate for Payer: UHCCP Medicaid |
$123.89
|
| Rate for Payer: VA VA |
$58.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.80
|
|
|
HC CROSSMATCH PREWARM
|
Facility
|
IP
|
$233.07
|
|
|
Service Code
|
CPT 86921
|
| Hospital Charge Code |
30200491
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$151.50 |
| Max. Negotiated Rate |
$209.76 |
| Rate for Payer: Aetna Commercial |
$198.11
|
| Rate for Payer: BCBS Trust/PPO |
$190.26
|
| Rate for Payer: BCN Commercial |
$180.12
|
| Rate for Payer: Cash Price |
$186.46
|
| Rate for Payer: Cofinity Commercial |
$200.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.46
|
| Rate for Payer: Healthscope Commercial |
$209.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.11
|
| Rate for Payer: Nomi Health Commercial |
$191.12
|
| Rate for Payer: PHP Commercial |
$198.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.50
|
| Rate for Payer: Priority Health HMO/PPO |
$202.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.10
|
| Rate for Payer: UHC Core |
$194.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.80
|
|
|
HC CRP HIGH SENSITIVITY CARDIAC RISK
|
Facility
|
OP
|
$92.21
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
30200138
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$82.99 |
| Rate for Payer: Aetna Commercial |
$78.38
|
| Rate for Payer: Aetna Medicare |
$23.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.82
|
| Rate for Payer: BCBS Complete |
$9.83
|
| Rate for Payer: BCBS MAPPO |
$23.05
|
| Rate for Payer: BCBS Trust/PPO |
$75.81
|
| Rate for Payer: BCN Commercial |
$71.69
|
| Rate for Payer: BCN Medicare Advantage |
$23.05
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cofinity Commercial |
$79.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.05
|
| Rate for Payer: Healthscope Commercial |
$82.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.16
|
| Rate for Payer: Mclaren Medicaid |
$9.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.21
|
| Rate for Payer: Meridian Medicaid |
$9.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.38
|
| Rate for Payer: Nomi Health Commercial |
$75.61
|
| Rate for Payer: PACE Senior Care Partners |
$21.90
|
| Rate for Payer: PACE SWMI |
$23.05
|
| Rate for Payer: PHP Commercial |
$78.38
|
| Rate for Payer: PHP Medicare Advantage |
$23.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.94
|
| Rate for Payer: Priority Health HMO/PPO |
$80.22
|
| Rate for Payer: Priority Health Medicare |
$23.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.78
|
| Rate for Payer: Railroad Medicare Medicare |
$23.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.14
|
| Rate for Payer: UHC Core |
$77.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.05
|
| Rate for Payer: UHC Exchange |
$23.05
|
| Rate for Payer: UHC Medicare Advantage |
$23.05
|
| Rate for Payer: UHCCP Medicaid |
$9.36
|
| Rate for Payer: VA VA |
$23.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.16
|
|
|
HC CRP HIGH SENSITIVITY CARDIAC RISK
|
Facility
|
IP
|
$92.21
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
30200138
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$59.94 |
| Max. Negotiated Rate |
$82.99 |
| Rate for Payer: Aetna Commercial |
$78.38
|
| Rate for Payer: BCBS Trust/PPO |
$75.27
|
| Rate for Payer: BCN Commercial |
$71.26
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cofinity Commercial |
$79.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.77
|
| Rate for Payer: Healthscope Commercial |
$82.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.38
|
| Rate for Payer: Nomi Health Commercial |
$75.61
|
| Rate for Payer: PHP Commercial |
$78.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.94
|
| Rate for Payer: Priority Health HMO/PPO |
$80.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.14
|
| Rate for Payer: UHC Core |
$77.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.16
|
|
|
HC CRP-SF
|
Facility
|
IP
|
$29.97
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.48 |
| Max. Negotiated Rate |
$26.97 |
| Rate for Payer: Aetna Commercial |
$25.47
|
| Rate for Payer: BCBS Trust/PPO |
$24.46
|
| Rate for Payer: BCN Commercial |
$23.16
|
| Rate for Payer: Cash Price |
$23.98
|
| Rate for Payer: Cofinity Commercial |
$25.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.98
|
| Rate for Payer: Healthscope Commercial |
$26.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.47
|
| Rate for Payer: Nomi Health Commercial |
$24.58
|
| Rate for Payer: PHP Commercial |
$25.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.48
|
| Rate for Payer: Priority Health HMO/PPO |
$26.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.37
|
| Rate for Payer: UHC Core |
$25.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.48
|
|
|
HC CRP-SF
|
Facility
|
OP
|
$29.97
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$26.97 |
| Rate for Payer: Aetna Commercial |
$25.47
|
| Rate for Payer: Aetna Medicare |
$7.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.37
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$7.49
|
| Rate for Payer: BCBS Trust/PPO |
$24.64
|
| Rate for Payer: BCN Commercial |
$23.30
|
| Rate for Payer: BCN Medicare Advantage |
$7.49
|
| Rate for Payer: Cash Price |
$23.98
|
| Rate for Payer: Cash Price |
$23.98
|
| Rate for Payer: Cofinity Commercial |
$25.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.49
|
| Rate for Payer: Healthscope Commercial |
$26.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.48
|
| Rate for Payer: Mclaren Medicaid |
$3.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.87
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.47
|
| Rate for Payer: Nomi Health Commercial |
$24.58
|
| Rate for Payer: PACE Senior Care Partners |
$7.12
|
| Rate for Payer: PACE SWMI |
$7.49
|
| Rate for Payer: PHP Commercial |
$25.47
|
| Rate for Payer: PHP Medicare Advantage |
$7.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.48
|
| Rate for Payer: Priority Health HMO/PPO |
$26.07
|
| Rate for Payer: Priority Health Medicare |
$7.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.08
|
| Rate for Payer: Railroad Medicare Medicare |
$7.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.37
|
| Rate for Payer: UHC Core |
$25.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.49
|
| Rate for Payer: UHC Exchange |
$7.49
|
| Rate for Payer: UHC Medicare Advantage |
$7.49
|
| Rate for Payer: UHCCP Medicaid |
$3.75
|
| Rate for Payer: VA VA |
$7.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.48
|
|
|
HC CRRT INITIAL
|
Facility
|
IP
|
$714.00
|
|
| Hospital Charge Code |
27000607
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$464.10 |
| Max. Negotiated Rate |
$642.60 |
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: BCBS Trust/PPO |
$582.84
|
| Rate for Payer: BCN Commercial |
$551.78
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$606.90
|
| Rate for Payer: Nomi Health Commercial |
$585.48
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO |
$621.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$478.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.32
|
| Rate for Payer: UHC Core |
$596.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
|
|
HC CRRT INITIAL
|
Facility
|
OP
|
$714.00
|
|
| Hospital Charge Code |
27000607
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$169.57 |
| Max. Negotiated Rate |
$642.60 |
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: Aetna Medicare |
$185.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$223.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$223.12
|
| Rate for Payer: BCBS Complete |
$285.60
|
| Rate for Payer: BCBS MAPPO |
$178.50
|
| Rate for Payer: BCBS Trust/PPO |
$586.98
|
| Rate for Payer: BCN Commercial |
$555.13
|
| Rate for Payer: BCN Medicare Advantage |
$178.50
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.50
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$606.90
|
| Rate for Payer: Nomi Health Commercial |
$585.48
|
| Rate for Payer: PACE Senior Care Partners |
$169.57
|
| Rate for Payer: PACE SWMI |
$178.50
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: PHP Medicare Advantage |
$178.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health HMO/PPO |
$621.18
|
| Rate for Payer: Priority Health Medicare |
$180.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$478.38
|
| Rate for Payer: Railroad Medicare Medicare |
$178.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$628.32
|
| Rate for Payer: UHC Core |
$596.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$178.50
|
| Rate for Payer: UHC Exchange |
$178.50
|
| Rate for Payer: UHC Medicare Advantage |
$178.50
|
| Rate for Payer: VA VA |
$178.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
|
|
HC CRRT INITIATION/REINITIATION
|
Facility
|
IP
|
$1,135.08
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
88000001
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$737.80 |
| Max. Negotiated Rate |
$1,021.57 |
| Rate for Payer: Aetna Commercial |
$964.82
|
| Rate for Payer: BCBS Trust/PPO |
$926.57
|
| Rate for Payer: BCN Commercial |
$877.19
|
| Rate for Payer: Cash Price |
$908.06
|
| Rate for Payer: Cofinity Commercial |
$976.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.06
|
| Rate for Payer: Healthscope Commercial |
$1,021.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$964.82
|
| Rate for Payer: Nomi Health Commercial |
$930.77
|
| Rate for Payer: PHP Commercial |
$964.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.80
|
| Rate for Payer: Priority Health HMO/PPO |
$987.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$760.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$998.87
|
| Rate for Payer: UHC Core |
$947.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.31
|
|
|
HC CRRT INITIATION/REINITIATION
|
Facility
|
OP
|
$1,135.08
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
88000001
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$269.58 |
| Max. Negotiated Rate |
$1,021.57 |
| Rate for Payer: Aetna Commercial |
$964.82
|
| Rate for Payer: Aetna Medicare |
$295.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$354.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$354.71
|
| Rate for Payer: BCBS Complete |
$323.28
|
| Rate for Payer: BCBS MAPPO |
$283.77
|
| Rate for Payer: BCBS Trust/PPO |
$933.15
|
| Rate for Payer: BCN Commercial |
$882.52
|
| Rate for Payer: BCN Medicare Advantage |
$283.77
|
| Rate for Payer: Cash Price |
$908.06
|
| Rate for Payer: Cash Price |
$908.06
|
| Rate for Payer: Cofinity Commercial |
$976.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$283.77
|
| Rate for Payer: Healthscope Commercial |
$1,021.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.31
|
| Rate for Payer: Mclaren Medicaid |
$307.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$297.96
|
| Rate for Payer: Meridian Medicaid |
$323.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$326.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$964.82
|
| Rate for Payer: Nomi Health Commercial |
$930.77
|
| Rate for Payer: PACE Senior Care Partners |
$269.58
|
| Rate for Payer: PACE SWMI |
$283.77
|
| Rate for Payer: PHP Commercial |
$964.82
|
| Rate for Payer: PHP Medicare Advantage |
$283.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.80
|
| Rate for Payer: Priority Health HMO/PPO |
$987.52
|
| Rate for Payer: Priority Health Medicare |
$286.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$760.50
|
| Rate for Payer: Railroad Medicare Medicare |
$283.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$998.87
|
| Rate for Payer: UHC Core |
$947.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$283.77
|
| Rate for Payer: UHC Exchange |
$283.77
|
| Rate for Payer: UHC Medicare Advantage |
$283.77
|
| Rate for Payer: UHCCP Medicaid |
$307.87
|
| Rate for Payer: VA VA |
$283.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.31
|
|
|
HC CRRT MONITOR FEE
|
Facility
|
OP
|
$127.50
|
|
| Hospital Charge Code |
27000609
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.28 |
| Max. Negotiated Rate |
$114.75 |
| Rate for Payer: Aetna Commercial |
$108.38
|
| Rate for Payer: Aetna Medicare |
$33.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.84
|
| Rate for Payer: BCBS Complete |
$51.00
|
| Rate for Payer: BCBS MAPPO |
$31.88
|
| Rate for Payer: BCBS Trust/PPO |
$104.82
|
| Rate for Payer: BCN Commercial |
$99.13
|
| Rate for Payer: BCN Medicare Advantage |
$31.88
|
| Rate for Payer: Cash Price |
$102.00
|
| Rate for Payer: Cofinity Commercial |
$109.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.88
|
| Rate for Payer: Healthscope Commercial |
$114.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.38
|
| Rate for Payer: Nomi Health Commercial |
$104.55
|
| Rate for Payer: PACE Senior Care Partners |
$30.28
|
| Rate for Payer: PACE SWMI |
$31.88
|
| Rate for Payer: PHP Commercial |
$108.38
|
| Rate for Payer: PHP Medicare Advantage |
$31.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.88
|
| Rate for Payer: Priority Health HMO/PPO |
$110.92
|
| Rate for Payer: Priority Health Medicare |
$32.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.42
|
| Rate for Payer: Railroad Medicare Medicare |
$31.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.20
|
| Rate for Payer: UHC Core |
$106.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.88
|
| Rate for Payer: UHC Exchange |
$31.88
|
| Rate for Payer: UHC Medicare Advantage |
$31.88
|
| Rate for Payer: VA VA |
$31.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.62
|
|
|
HC CRRT MONITOR FEE
|
Facility
|
IP
|
$127.50
|
|
| Hospital Charge Code |
27000609
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$82.88 |
| Max. Negotiated Rate |
$114.75 |
| Rate for Payer: Aetna Commercial |
$108.38
|
| Rate for Payer: BCBS Trust/PPO |
$104.08
|
| Rate for Payer: BCN Commercial |
$98.53
|
| Rate for Payer: Cash Price |
$102.00
|
| Rate for Payer: Cofinity Commercial |
$109.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.00
|
| Rate for Payer: Healthscope Commercial |
$114.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.38
|
| Rate for Payer: Nomi Health Commercial |
$104.55
|
| Rate for Payer: PHP Commercial |
$108.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.88
|
| Rate for Payer: Priority Health HMO/PPO |
$110.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.20
|
| Rate for Payer: UHC Core |
$106.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.62
|
|
|
HC CRRT MONITORING PER HOUR
|
Facility
|
OP
|
$416.84
|
|
| Hospital Charge Code |
88000002
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$375.16 |
| Rate for Payer: Aetna Commercial |
$354.31
|
| Rate for Payer: Aetna Medicare |
$108.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.26
|
| Rate for Payer: BCBS Complete |
$166.74
|
| Rate for Payer: BCBS MAPPO |
$104.21
|
| Rate for Payer: BCBS Trust/PPO |
$342.68
|
| Rate for Payer: BCN Commercial |
$324.09
|
| Rate for Payer: BCN Medicare Advantage |
$104.21
|
| Rate for Payer: Cash Price |
$333.47
|
| Rate for Payer: Cofinity Commercial |
$358.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.21
|
| Rate for Payer: Healthscope Commercial |
$375.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.31
|
| Rate for Payer: Nomi Health Commercial |
$341.81
|
| Rate for Payer: PACE Senior Care Partners |
$99.00
|
| Rate for Payer: PACE SWMI |
$104.21
|
| Rate for Payer: PHP Commercial |
$354.31
|
| Rate for Payer: PHP Medicare Advantage |
$104.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$270.95
|
| Rate for Payer: Priority Health HMO/PPO |
$362.65
|
| Rate for Payer: Priority Health Medicare |
$105.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$279.28
|
| Rate for Payer: Railroad Medicare Medicare |
$104.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.82
|
| Rate for Payer: UHC Core |
$348.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.21
|
| Rate for Payer: UHC Exchange |
$104.21
|
| Rate for Payer: UHC Medicare Advantage |
$104.21
|
| Rate for Payer: VA VA |
$104.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.63
|
|
