|
HC ER CRITICAL CARE EA ADDL 30 MIN
|
Facility
|
IP
|
$958.04
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
45000081
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$666.80 |
| Max. Negotiated Rate |
$862.24 |
| Rate for Payer: Aetna Commercial |
$814.33
|
| Rate for Payer: BCBS Trust/PPO |
$791.25
|
| Rate for Payer: BCN Commercial |
$791.25
|
| Rate for Payer: Cash Price |
$766.43
|
| Rate for Payer: Cofinity Commercial |
$823.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$766.43
|
| Rate for Payer: Healthscope Commercial |
$862.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$718.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$814.33
|
| Rate for Payer: Nomi Health Commercial |
$785.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$718.53
|
| Rate for Payer: PHP Commercial |
$814.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$833.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$666.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$843.08
|
| Rate for Payer: UHC Core |
$799.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$718.53
|
|
|
HC ER CRITICAL CARE EA ADDL 30 MIN
|
Facility
|
OP
|
$958.04
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
45000081
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$862.24 |
| Rate for Payer: Aetna Commercial |
$814.33
|
| Rate for Payer: Aetna Medicare |
$249.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$299.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$299.39
|
| Rate for Payer: BCBS Complete |
$177.33
|
| Rate for Payer: BCBS MAPPO |
$239.51
|
| Rate for Payer: BCBS Trust/PPO |
$787.60
|
| Rate for Payer: BCN Commercial |
$787.60
|
| Rate for Payer: BCN Medicare Advantage |
$239.51
|
| Rate for Payer: Cash Price |
$766.43
|
| Rate for Payer: Cash Price |
$766.43
|
| Rate for Payer: Cofinity Commercial |
$823.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$766.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.51
|
| Rate for Payer: Healthscope Commercial |
$862.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$718.53
|
| Rate for Payer: Mclaren Medicaid |
$168.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.49
|
| Rate for Payer: Meridian Medicaid |
$177.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$275.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$263.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$814.33
|
| Rate for Payer: Nomi Health Commercial |
$785.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$718.53
|
| Rate for Payer: PACE Senior Care Partners |
$227.53
|
| Rate for Payer: PACE SWMI |
$239.51
|
| Rate for Payer: PHP Commercial |
$814.33
|
| Rate for Payer: PHP Medicare Advantage |
$239.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$833.49
|
| Rate for Payer: Priority Health Medicare |
$241.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$666.80
|
| Rate for Payer: Railroad Medicare Medicare |
$239.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$843.08
|
| Rate for Payer: UHC Core |
$799.96
|
| Rate for Payer: UHC Exchange |
$239.51
|
| Rate for Payer: UHC Medicaid |
$168.90
|
| Rate for Payer: UHC Medicare Advantage |
$239.51
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$239.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$718.53
|
|
|
HC ER CRITICAL CARE INITIAL 30-74 MIN
|
Facility
|
OP
|
$3,673.91
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
45000026
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$3,306.52 |
| Rate for Payer: Aetna Commercial |
$3,122.82
|
| Rate for Payer: Aetna Medicare |
$955.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.10
|
| Rate for Payer: BCBS Complete |
$680.04
|
| Rate for Payer: BCBS MAPPO |
$918.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,020.32
|
| Rate for Payer: BCN Commercial |
$3,020.32
|
| Rate for Payer: BCN Medicare Advantage |
$918.48
|
| Rate for Payer: Cash Price |
$2,939.13
|
| Rate for Payer: Cash Price |
$2,939.13
|
| Rate for Payer: Cofinity Commercial |
$3,159.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,939.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.48
|
| Rate for Payer: Healthscope Commercial |
$3,306.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,755.43
|
| Rate for Payer: Mclaren Medicaid |
$647.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.40
|
| Rate for Payer: Meridian Medicaid |
$680.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,010.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,122.82
|
| Rate for Payer: Nomi Health Commercial |
$3,012.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,755.43
|
| Rate for Payer: PACE Senior Care Partners |
$872.55
|
| Rate for Payer: PACE SWMI |
$918.48
|
| Rate for Payer: PHP Commercial |
$3,122.82
|
| Rate for Payer: PHP Medicare Advantage |
$918.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$647.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,196.30
|
| Rate for Payer: Priority Health Medicare |
$927.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,557.04
|
| Rate for Payer: Railroad Medicare Medicare |
$918.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,233.04
|
| Rate for Payer: UHC Core |
$3,067.71
|
| Rate for Payer: UHC Exchange |
$918.48
|
| Rate for Payer: UHC Medicaid |
$647.71
|
| Rate for Payer: UHC Medicare Advantage |
$918.48
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$918.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,755.43
|
|
|
HC ER CRITICAL CARE INITIAL 30-74 MIN
|
Facility
|
IP
|
$3,673.91
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
45000026
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,557.04 |
| Max. Negotiated Rate |
$3,306.52 |
| Rate for Payer: Aetna Commercial |
$3,122.82
|
| Rate for Payer: BCBS Trust/PPO |
$3,034.28
|
| Rate for Payer: BCN Commercial |
$3,034.28
|
| Rate for Payer: Cash Price |
$2,939.13
|
| Rate for Payer: Cofinity Commercial |
$3,159.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,939.13
|
| Rate for Payer: Healthscope Commercial |
$3,306.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,755.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,122.82
|
| Rate for Payer: Nomi Health Commercial |
$3,012.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,755.43
|
| Rate for Payer: PHP Commercial |
$3,122.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,196.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,557.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,233.04
|
| Rate for Payer: UHC Core |
$3,067.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,755.43
|
|
|
HC ER LEVEL FIVE 99285
|
Facility
|
OP
|
$2,191.00
|
|
|
Service Code
|
CPT 99285
|
| Hospital Charge Code |
45000025
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$1,971.90 |
| Rate for Payer: Aetna Commercial |
$1,862.35
|
| Rate for Payer: Aetna Medicare |
$569.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$684.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$684.69
|
| Rate for Payer: BCBS Complete |
$405.55
|
| Rate for Payer: BCBS MAPPO |
$547.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,801.22
|
| Rate for Payer: BCN Commercial |
$1,801.22
|
| Rate for Payer: BCN Medicare Advantage |
$547.75
|
| Rate for Payer: Cash Price |
$1,752.80
|
| Rate for Payer: Cash Price |
$1,752.80
|
| Rate for Payer: Cofinity Commercial |
$1,884.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,752.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$547.75
|
| Rate for Payer: Healthscope Commercial |
$1,971.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,643.25
|
| Rate for Payer: Mclaren Medicaid |
$386.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$575.14
|
| Rate for Payer: Meridian Medicaid |
$405.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$629.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$602.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,862.35
|
| Rate for Payer: Nomi Health Commercial |
$1,796.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,643.25
|
| Rate for Payer: PACE Senior Care Partners |
$520.36
|
| Rate for Payer: PACE SWMI |
$547.75
|
| Rate for Payer: PHP Commercial |
$1,862.35
|
| Rate for Payer: PHP Medicare Advantage |
$547.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$386.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,906.17
|
| Rate for Payer: Priority Health Medicare |
$553.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,524.94
|
| Rate for Payer: Railroad Medicare Medicare |
$547.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,928.08
|
| Rate for Payer: UHC Core |
$1,829.48
|
| Rate for Payer: UHC Exchange |
$547.75
|
| Rate for Payer: UHC Medicaid |
$386.27
|
| Rate for Payer: UHC Medicare Advantage |
$547.75
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$547.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,643.25
|
|
|
HC ER LEVEL FIVE 99285
|
Facility
|
IP
|
$2,191.00
|
|
|
Service Code
|
CPT 99285
|
| Hospital Charge Code |
45000025
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,524.94 |
| Max. Negotiated Rate |
$1,971.90 |
| Rate for Payer: Aetna Commercial |
$1,862.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,809.55
|
| Rate for Payer: BCN Commercial |
$1,809.55
|
| Rate for Payer: Cash Price |
$1,752.80
|
| Rate for Payer: Cofinity Commercial |
$1,884.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,752.80
|
| Rate for Payer: Healthscope Commercial |
$1,971.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,643.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,862.35
|
| Rate for Payer: Nomi Health Commercial |
$1,796.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,643.25
|
| Rate for Payer: PHP Commercial |
$1,862.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,906.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,524.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,928.08
|
| Rate for Payer: UHC Core |
$1,829.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,643.25
|
|
|
HC ER LEVEL FOUR 99284
|
Facility
|
IP
|
$1,518.34
|
|
|
Service Code
|
CPT 99284
|
| Hospital Charge Code |
45000024
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,056.76 |
| Max. Negotiated Rate |
$1,366.51 |
| Rate for Payer: Aetna Commercial |
$1,290.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.00
|
| Rate for Payer: BCN Commercial |
$1,254.00
|
| Rate for Payer: Cash Price |
$1,214.67
|
| Rate for Payer: Cofinity Commercial |
$1,305.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,214.67
|
| Rate for Payer: Healthscope Commercial |
$1,366.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,138.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,290.59
|
| Rate for Payer: Nomi Health Commercial |
$1,245.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,138.76
|
| Rate for Payer: PHP Commercial |
$1,290.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,320.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,056.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,336.14
|
| Rate for Payer: UHC Core |
$1,267.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,138.76
|
|
|
HC ER LEVEL FOUR 99284
|
Facility
|
OP
|
$1,518.34
|
|
|
Service Code
|
CPT 99284
|
| Hospital Charge Code |
45000024
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$1,366.51 |
| Rate for Payer: Aetna Commercial |
$1,290.59
|
| Rate for Payer: Aetna Medicare |
$394.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$474.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$474.48
|
| Rate for Payer: BCBS Complete |
$281.04
|
| Rate for Payer: BCBS MAPPO |
$379.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.23
|
| Rate for Payer: BCN Commercial |
$1,248.23
|
| Rate for Payer: BCN Medicare Advantage |
$379.58
|
| Rate for Payer: Cash Price |
$1,214.67
|
| Rate for Payer: Cash Price |
$1,214.67
|
| Rate for Payer: Cofinity Commercial |
$1,305.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,214.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$379.58
|
| Rate for Payer: Healthscope Commercial |
$1,366.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,138.76
|
| Rate for Payer: Mclaren Medicaid |
$267.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$398.56
|
| Rate for Payer: Meridian Medicaid |
$281.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$436.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$417.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,290.59
|
| Rate for Payer: Nomi Health Commercial |
$1,245.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,138.76
|
| Rate for Payer: PACE Senior Care Partners |
$360.61
|
| Rate for Payer: PACE SWMI |
$379.58
|
| Rate for Payer: PHP Commercial |
$1,290.59
|
| Rate for Payer: PHP Medicare Advantage |
$379.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,320.96
|
| Rate for Payer: Priority Health Medicare |
$383.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,056.76
|
| Rate for Payer: Railroad Medicare Medicare |
$379.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,336.14
|
| Rate for Payer: UHC Core |
$1,267.81
|
| Rate for Payer: UHC Exchange |
$379.58
|
| Rate for Payer: UHC Medicaid |
$267.68
|
| Rate for Payer: UHC Medicare Advantage |
$379.58
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$379.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,138.76
|
|
|
HC ER LEVEL ONE 99281
|
Facility
|
IP
|
$275.38
|
|
|
Service Code
|
CPT 99281
|
| Hospital Charge Code |
45000020
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$191.66 |
| Max. Negotiated Rate |
$247.84 |
| Rate for Payer: Aetna Commercial |
$234.07
|
| Rate for Payer: BCBS Trust/PPO |
$227.44
|
| Rate for Payer: BCN Commercial |
$227.44
|
| Rate for Payer: Cash Price |
$220.30
|
| Rate for Payer: Cofinity Commercial |
$236.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.30
|
| Rate for Payer: Healthscope Commercial |
$247.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.07
|
| Rate for Payer: Nomi Health Commercial |
$225.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.53
|
| Rate for Payer: PHP Commercial |
$234.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$239.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.33
|
| Rate for Payer: UHC Core |
$229.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.53
|
|
|
HC ER LEVEL ONE 99281
|
Facility
|
OP
|
$275.38
|
|
|
Service Code
|
CPT 99281
|
| Hospital Charge Code |
45000020
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$48.55 |
| Max. Negotiated Rate |
$247.84 |
| Rate for Payer: Aetna Commercial |
$234.07
|
| Rate for Payer: Aetna Medicare |
$71.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$86.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$86.06
|
| Rate for Payer: BCBS Complete |
$50.97
|
| Rate for Payer: BCBS MAPPO |
$68.84
|
| Rate for Payer: BCBS Trust/PPO |
$226.39
|
| Rate for Payer: BCN Commercial |
$226.39
|
| Rate for Payer: BCN Medicare Advantage |
$68.84
|
| Rate for Payer: Cash Price |
$220.30
|
| Rate for Payer: Cash Price |
$220.30
|
| Rate for Payer: Cofinity Commercial |
$236.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.84
|
| Rate for Payer: Healthscope Commercial |
$247.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.53
|
| Rate for Payer: Mclaren Medicaid |
$48.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.29
|
| Rate for Payer: Meridian Medicaid |
$50.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$75.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.07
|
| Rate for Payer: Nomi Health Commercial |
$225.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.53
|
| Rate for Payer: PACE Senior Care Partners |
$65.40
|
| Rate for Payer: PACE SWMI |
$68.84
|
| Rate for Payer: PHP Commercial |
$234.07
|
| Rate for Payer: PHP Medicare Advantage |
$68.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$239.58
|
| Rate for Payer: Priority Health Medicare |
$69.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.66
|
| Rate for Payer: Railroad Medicare Medicare |
$68.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.33
|
| Rate for Payer: UHC Core |
$229.94
|
| Rate for Payer: UHC Exchange |
$68.84
|
| Rate for Payer: UHC Medicaid |
$48.55
|
| Rate for Payer: UHC Medicare Advantage |
$68.84
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$68.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.53
|
|
|
HC ER LEVEL THREE 99283
|
Facility
|
IP
|
$966.87
|
|
|
Service Code
|
CPT 99283
|
| Hospital Charge Code |
45000022
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$672.94 |
| Max. Negotiated Rate |
$870.18 |
| Rate for Payer: Aetna Commercial |
$821.84
|
| Rate for Payer: BCBS Trust/PPO |
$798.54
|
| Rate for Payer: BCN Commercial |
$798.54
|
| Rate for Payer: Cash Price |
$773.50
|
| Rate for Payer: Cofinity Commercial |
$831.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.50
|
| Rate for Payer: Healthscope Commercial |
$870.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$821.84
|
| Rate for Payer: Nomi Health Commercial |
$792.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$725.15
|
| Rate for Payer: PHP Commercial |
$821.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$841.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$672.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$850.85
|
| Rate for Payer: UHC Core |
$807.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.15
|
|
|
HC ER LEVEL THREE 99283
|
Facility
|
OP
|
$966.87
|
|
|
Service Code
|
CPT 99283
|
| Hospital Charge Code |
45000022
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$870.18 |
| Rate for Payer: Aetna Commercial |
$821.84
|
| Rate for Payer: Aetna Medicare |
$251.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$302.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$302.15
|
| Rate for Payer: BCBS Complete |
$178.97
|
| Rate for Payer: BCBS MAPPO |
$241.72
|
| Rate for Payer: BCBS Trust/PPO |
$794.86
|
| Rate for Payer: BCN Commercial |
$794.86
|
| Rate for Payer: BCN Medicare Advantage |
$241.72
|
| Rate for Payer: Cash Price |
$773.50
|
| Rate for Payer: Cash Price |
$773.50
|
| Rate for Payer: Cofinity Commercial |
$831.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$773.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.72
|
| Rate for Payer: Healthscope Commercial |
$870.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$725.15
|
| Rate for Payer: Mclaren Medicaid |
$170.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$253.80
|
| Rate for Payer: Meridian Medicaid |
$178.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$277.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$265.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$821.84
|
| Rate for Payer: Nomi Health Commercial |
$792.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$725.15
|
| Rate for Payer: PACE Senior Care Partners |
$229.63
|
| Rate for Payer: PACE SWMI |
$241.72
|
| Rate for Payer: PHP Commercial |
$821.84
|
| Rate for Payer: PHP Medicare Advantage |
$241.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$170.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$841.18
|
| Rate for Payer: Priority Health Medicare |
$244.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$672.94
|
| Rate for Payer: Railroad Medicare Medicare |
$241.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$850.85
|
| Rate for Payer: UHC Core |
$807.34
|
| Rate for Payer: UHC Exchange |
$241.72
|
| Rate for Payer: UHC Medicaid |
$170.46
|
| Rate for Payer: UHC Medicare Advantage |
$241.72
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$241.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$725.15
|
|
|
HC ER LEVEL TWO 99282
|
Facility
|
IP
|
$547.90
|
|
|
Service Code
|
CPT 99282
|
| Hospital Charge Code |
45000021
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$381.34 |
| Max. Negotiated Rate |
$493.11 |
| Rate for Payer: Aetna Commercial |
$465.71
|
| Rate for Payer: BCBS Trust/PPO |
$452.51
|
| Rate for Payer: BCN Commercial |
$452.51
|
| Rate for Payer: Cash Price |
$438.32
|
| Rate for Payer: Cofinity Commercial |
$471.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$438.32
|
| Rate for Payer: Healthscope Commercial |
$493.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$410.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$465.71
|
| Rate for Payer: Nomi Health Commercial |
$449.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$410.93
|
| Rate for Payer: PHP Commercial |
$465.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$476.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$381.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$482.15
|
| Rate for Payer: UHC Core |
$457.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$410.93
|
|
|
HC ER LEVEL TWO 99282
|
Facility
|
OP
|
$547.90
|
|
|
Service Code
|
CPT 99282
|
| Hospital Charge Code |
45000021
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$96.59 |
| Max. Negotiated Rate |
$493.11 |
| Rate for Payer: Aetna Commercial |
$465.71
|
| Rate for Payer: Aetna Medicare |
$142.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$171.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$171.22
|
| Rate for Payer: BCBS Complete |
$101.42
|
| Rate for Payer: BCBS MAPPO |
$136.97
|
| Rate for Payer: BCBS Trust/PPO |
$450.43
|
| Rate for Payer: BCN Commercial |
$450.43
|
| Rate for Payer: BCN Medicare Advantage |
$136.97
|
| Rate for Payer: Cash Price |
$438.32
|
| Rate for Payer: Cash Price |
$438.32
|
| Rate for Payer: Cofinity Commercial |
$471.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$438.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.97
|
| Rate for Payer: Healthscope Commercial |
$493.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$410.93
|
| Rate for Payer: Mclaren Medicaid |
$96.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.82
|
| Rate for Payer: Meridian Medicaid |
$101.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$157.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$465.71
|
| Rate for Payer: Nomi Health Commercial |
$449.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$410.93
|
| Rate for Payer: PACE Senior Care Partners |
$130.13
|
| Rate for Payer: PACE SWMI |
$136.97
|
| Rate for Payer: PHP Commercial |
$465.71
|
| Rate for Payer: PHP Medicare Advantage |
$136.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$476.67
|
| Rate for Payer: Priority Health Medicare |
$138.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$381.34
|
| Rate for Payer: Railroad Medicare Medicare |
$136.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$482.15
|
| Rate for Payer: UHC Core |
$457.50
|
| Rate for Payer: UHC Exchange |
$136.97
|
| Rate for Payer: UHC Medicaid |
$96.59
|
| Rate for Payer: UHC Medicare Advantage |
$136.97
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$136.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$410.93
|
|
|
HC ER OBSERVATION PER HOUR
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200002
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna Medicare |
$41.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.00
|
| Rate for Payer: BCBS Complete |
$29.62
|
| Rate for Payer: BCBS MAPPO |
$40.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.54
|
| Rate for Payer: BCN Commercial |
$131.54
|
| Rate for Payer: BCN Medicare Advantage |
$40.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Mclaren Medicaid |
$28.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.00
|
| Rate for Payer: Meridian Medicaid |
$29.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PACE Senior Care Partners |
$38.00
|
| Rate for Payer: PACE SWMI |
$40.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: PHP Medicare Advantage |
$40.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: Railroad Medicare Medicare |
$40.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: UHC Exchange |
$40.00
|
| Rate for Payer: UHC Medicaid |
$28.21
|
| Rate for Payer: UHC Medicare Advantage |
$40.00
|
| Rate for Payer: UHCCP Medicaid |
$850.00
|
| Rate for Payer: VA VA |
$40.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC ER OBSERVATION PER HOUR
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200002
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$111.36 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: BCBS Trust/PPO |
$132.14
|
| Rate for Payer: BCN Commercial |
$132.14
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC ERO OR PACU R&B
|
Facility
|
IP
|
$3,423.98
|
|
| Hospital Charge Code |
12000001
|
|
Hospital Revenue Code
|
120
|
| Min. Negotiated Rate |
$1,819.25 |
| Max. Negotiated Rate |
$3,081.58 |
| Rate for Payer: Aetna Commercial |
$2,910.38
|
| Rate for Payer: Aetna Medicare |
$1,991.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,393.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,393.75
|
| Rate for Payer: BCBS MAPPO |
$1,915.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,827.87
|
| Rate for Payer: BCN Commercial |
$2,827.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,915.00
|
| Rate for Payer: Cash Price |
$2,739.18
|
| Rate for Payer: Cash Price |
$2,739.18
|
| Rate for Payer: Cofinity Commercial |
$2,944.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,739.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,915.00
|
| Rate for Payer: Healthscope Commercial |
$3,081.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,567.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,010.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,202.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,106.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,910.38
|
| Rate for Payer: Nomi Health Commercial |
$2,807.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,567.99
|
| Rate for Payer: PACE Senior Care Partners |
$1,819.25
|
| Rate for Payer: PACE SWMI |
$1,915.00
|
| Rate for Payer: PHP Commercial |
$2,910.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,915.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,978.86
|
| Rate for Payer: Priority Health Medicare |
$1,934.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,383.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,915.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,013.10
|
| Rate for Payer: UHC Core |
$2,859.02
|
| Rate for Payer: UHC Exchange |
$1,915.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,915.00
|
| Rate for Payer: VA VA |
$1,915.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,567.99
|
|
|
HC ER REDUCTION/DISLOCATION LEVEL 1
|
Facility
|
IP
|
$704.42
|
|
| Hospital Charge Code |
45000039
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$490.28 |
| Max. Negotiated Rate |
$633.98 |
| Rate for Payer: Aetna Commercial |
$598.76
|
| Rate for Payer: BCBS Trust/PPO |
$581.78
|
| Rate for Payer: BCN Commercial |
$581.78
|
| Rate for Payer: Cash Price |
$563.54
|
| Rate for Payer: Cofinity Commercial |
$605.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.54
|
| Rate for Payer: Healthscope Commercial |
$633.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.76
|
| Rate for Payer: Nomi Health Commercial |
$577.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$528.32
|
| Rate for Payer: PHP Commercial |
$598.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$612.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$490.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.89
|
| Rate for Payer: UHC Core |
$588.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.32
|
|
|
HC ER REDUCTION/DISLOCATION LEVEL 1
|
Facility
|
OP
|
$704.42
|
|
| Hospital Charge Code |
45000039
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$124.19 |
| Max. Negotiated Rate |
$633.98 |
| Rate for Payer: Aetna Commercial |
$598.76
|
| Rate for Payer: Aetna Medicare |
$183.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.13
|
| Rate for Payer: BCBS Complete |
$130.39
|
| Rate for Payer: BCBS MAPPO |
$176.10
|
| Rate for Payer: BCBS Trust/PPO |
$579.10
|
| Rate for Payer: BCN Commercial |
$579.10
|
| Rate for Payer: BCN Medicare Advantage |
$176.10
|
| Rate for Payer: Cash Price |
$563.54
|
| Rate for Payer: Cash Price |
$563.54
|
| Rate for Payer: Cofinity Commercial |
$605.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.10
|
| Rate for Payer: Healthscope Commercial |
$633.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.32
|
| Rate for Payer: Mclaren Medicaid |
$124.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.91
|
| Rate for Payer: Meridian Medicaid |
$130.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$193.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.76
|
| Rate for Payer: Nomi Health Commercial |
$577.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$528.32
|
| Rate for Payer: PACE Senior Care Partners |
$167.30
|
| Rate for Payer: PACE SWMI |
$176.10
|
| Rate for Payer: PHP Commercial |
$598.76
|
| Rate for Payer: PHP Medicare Advantage |
$176.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$612.85
|
| Rate for Payer: Priority Health Medicare |
$177.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$490.28
|
| Rate for Payer: Railroad Medicare Medicare |
$176.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.89
|
| Rate for Payer: UHC Core |
$588.19
|
| Rate for Payer: UHC Exchange |
$176.10
|
| Rate for Payer: UHC Medicaid |
$124.19
|
| Rate for Payer: UHC Medicare Advantage |
$176.10
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$176.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.32
|
|
|
HC ER SURGICAL HAND/FOOT CARE
|
Facility
|
OP
|
$704.42
|
|
| Hospital Charge Code |
45000040
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$124.19 |
| Max. Negotiated Rate |
$633.98 |
| Rate for Payer: Aetna Commercial |
$598.76
|
| Rate for Payer: Aetna Medicare |
$183.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.13
|
| Rate for Payer: BCBS Complete |
$130.39
|
| Rate for Payer: BCBS MAPPO |
$176.10
|
| Rate for Payer: BCBS Trust/PPO |
$579.10
|
| Rate for Payer: BCN Commercial |
$579.10
|
| Rate for Payer: BCN Medicare Advantage |
$176.10
|
| Rate for Payer: Cash Price |
$563.54
|
| Rate for Payer: Cash Price |
$563.54
|
| Rate for Payer: Cofinity Commercial |
$605.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.10
|
| Rate for Payer: Healthscope Commercial |
$633.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.32
|
| Rate for Payer: Mclaren Medicaid |
$124.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.91
|
| Rate for Payer: Meridian Medicaid |
$130.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$193.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.76
|
| Rate for Payer: Nomi Health Commercial |
$577.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$528.32
|
| Rate for Payer: PACE Senior Care Partners |
$167.30
|
| Rate for Payer: PACE SWMI |
$176.10
|
| Rate for Payer: PHP Commercial |
$598.76
|
| Rate for Payer: PHP Medicare Advantage |
$176.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$612.85
|
| Rate for Payer: Priority Health Medicare |
$177.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$490.28
|
| Rate for Payer: Railroad Medicare Medicare |
$176.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.89
|
| Rate for Payer: UHC Core |
$588.19
|
| Rate for Payer: UHC Exchange |
$176.10
|
| Rate for Payer: UHC Medicaid |
$124.19
|
| Rate for Payer: UHC Medicare Advantage |
$176.10
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$176.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.32
|
|
|
HC ER SURGICAL HAND/FOOT CARE
|
Facility
|
IP
|
$704.42
|
|
| Hospital Charge Code |
45000040
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$490.28 |
| Max. Negotiated Rate |
$633.98 |
| Rate for Payer: Aetna Commercial |
$598.76
|
| Rate for Payer: BCBS Trust/PPO |
$581.78
|
| Rate for Payer: BCN Commercial |
$581.78
|
| Rate for Payer: Cash Price |
$563.54
|
| Rate for Payer: Cofinity Commercial |
$605.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.54
|
| Rate for Payer: Healthscope Commercial |
$633.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.76
|
| Rate for Payer: Nomi Health Commercial |
$577.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$528.32
|
| Rate for Payer: PHP Commercial |
$598.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$612.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$490.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.89
|
| Rate for Payer: UHC Core |
$588.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.32
|
|
|
HC ERYTHROPOIETIN
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 82668
|
| Hospital Charge Code |
30100191
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.48 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$11.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.27
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$34.90
|
| Rate for Payer: BCN Commercial |
$34.90
|
| Rate for Payer: BCN Medicare Advantage |
$10.61
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.61
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.14
|
| Rate for Payer: Meridian Medicaid |
$7.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Senior Care Partners |
$10.08
|
| Rate for Payer: PACE SWMI |
$10.61
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$10.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Medicare |
$10.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: Railroad Medicare Medicare |
$10.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: UHC Exchange |
$10.61
|
| Rate for Payer: UHC Medicaid |
$7.48
|
| Rate for Payer: UHC Medicare Advantage |
$10.61
|
| Rate for Payer: UHCCP Medicaid |
$7.48
|
| Rate for Payer: VA VA |
$10.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC ERYTHROPOIETIN
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 82668
|
| Hospital Charge Code |
30100191
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.55 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: BCBS Trust/PPO |
$35.06
|
| Rate for Payer: BCN Commercial |
$35.06
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.36
|
| Rate for Payer: UHC Core |
$35.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC ESCHERICHIA COLI K1
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600268
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC ESCHERICHIA COLI K1
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600268
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
