|
HC LOC INFIL W/CS 15 MIN
|
Facility
|
OP
|
$141.54
|
|
| Hospital Charge Code |
37000007
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$33.62 |
| Max. Negotiated Rate |
$127.39 |
| Rate for Payer: Aetna Commercial |
$120.31
|
| Rate for Payer: Aetna Medicare |
$36.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.23
|
| Rate for Payer: BCBS Complete |
$56.62
|
| Rate for Payer: BCBS MAPPO |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$110.05
|
| Rate for Payer: BCN Commercial |
$110.05
|
| Rate for Payer: BCN Medicare Advantage |
$35.38
|
| Rate for Payer: Cash Price |
$113.23
|
| Rate for Payer: Cofinity Commercial |
$121.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.38
|
| Rate for Payer: Healthscope Commercial |
$127.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$120.31
|
| Rate for Payer: PACE Senior Care Partners |
$33.62
|
| Rate for Payer: PACE SWMI |
$35.38
|
| Rate for Payer: PHP Commercial |
$120.31
|
| Rate for Payer: PHP Medicare Advantage |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$123.14
|
| Rate for Payer: Priority Health Medicare |
$35.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.33
|
| Rate for Payer: Railroad Medicare Medicare |
$35.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.56
|
| Rate for Payer: UHC Core |
$118.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.38
|
| Rate for Payer: UHC Medicare Advantage |
$36.45
|
| Rate for Payer: VA VA |
$35.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.16
|
|
|
HC LOC INFIL W/CS 15 MIN
|
Facility
|
IP
|
$141.54
|
|
| Hospital Charge Code |
37000007
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$86.33 |
| Max. Negotiated Rate |
$127.39 |
| Rate for Payer: Aetna Commercial |
$120.31
|
| Rate for Payer: BCBS Trust/PPO |
$109.38
|
| Rate for Payer: BCN Commercial |
$109.38
|
| Rate for Payer: Cash Price |
$113.23
|
| Rate for Payer: Cofinity Commercial |
$121.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.23
|
| Rate for Payer: Healthscope Commercial |
$127.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$120.31
|
| Rate for Payer: PHP Commercial |
$120.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$123.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.56
|
| Rate for Payer: UHC Core |
$118.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.16
|
|
|
HC LOC INFIL W/CS 30 MIN
|
Facility
|
OP
|
$707.43
|
|
| Hospital Charge Code |
37000008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$168.01 |
| Max. Negotiated Rate |
$636.69 |
| Rate for Payer: Aetna Commercial |
$601.32
|
| Rate for Payer: Aetna Medicare |
$183.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.07
|
| Rate for Payer: BCBS Complete |
$282.97
|
| Rate for Payer: BCBS MAPPO |
$176.86
|
| Rate for Payer: BCBS Trust/PPO |
$550.03
|
| Rate for Payer: BCN Commercial |
$550.03
|
| Rate for Payer: BCN Medicare Advantage |
$176.86
|
| Rate for Payer: Cash Price |
$565.94
|
| Rate for Payer: Cofinity Commercial |
$608.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$565.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.86
|
| Rate for Payer: Healthscope Commercial |
$636.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$530.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$185.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$601.32
|
| Rate for Payer: PACE Senior Care Partners |
$168.01
|
| Rate for Payer: PACE SWMI |
$176.86
|
| Rate for Payer: PHP Commercial |
$601.32
|
| Rate for Payer: PHP Medicare Advantage |
$176.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$495.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$615.46
|
| Rate for Payer: Priority Health Medicare |
$176.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$431.46
|
| Rate for Payer: Railroad Medicare Medicare |
$176.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$622.54
|
| Rate for Payer: UHC Core |
$590.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.86
|
| Rate for Payer: UHC Medicare Advantage |
$182.16
|
| Rate for Payer: VA VA |
$176.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$530.57
|
|
|
HC LOC INFIL W/CS 30 MIN
|
Facility
|
IP
|
$707.43
|
|
| Hospital Charge Code |
37000008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$431.46 |
| Max. Negotiated Rate |
$636.69 |
| Rate for Payer: Aetna Commercial |
$601.32
|
| Rate for Payer: BCBS Trust/PPO |
$546.70
|
| Rate for Payer: BCN Commercial |
$546.70
|
| Rate for Payer: Cash Price |
$565.94
|
| Rate for Payer: Cofinity Commercial |
$608.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$565.94
|
| Rate for Payer: Healthscope Commercial |
$636.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$530.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$601.32
|
| Rate for Payer: PHP Commercial |
$601.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$495.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$615.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$431.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$622.54
|
| Rate for Payer: UHC Core |
$590.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$530.57
|
|
|
HC LOCM 100-199 MG/ML IODINE/ML1
|
Facility
|
OP
|
$3.68
|
|
|
Service Code
|
HCPCS Q9965
|
| Hospital Charge Code |
25500002
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$3.31 |
| Rate for Payer: Aetna Commercial |
$3.13
|
| Rate for Payer: Aetna Medicare |
$0.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.15
|
| Rate for Payer: BCBS Complete |
$1.47
|
| Rate for Payer: BCBS MAPPO |
$0.92
|
| Rate for Payer: BCBS Trust/PPO |
$2.86
|
| Rate for Payer: BCN Commercial |
$2.86
|
| Rate for Payer: BCN Medicare Advantage |
$0.92
|
| Rate for Payer: Cash Price |
$2.94
|
| Rate for Payer: Cofinity Commercial |
$3.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.92
|
| Rate for Payer: Healthscope Commercial |
$3.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.13
|
| Rate for Payer: PACE Senior Care Partners |
$0.87
|
| Rate for Payer: PACE SWMI |
$0.92
|
| Rate for Payer: PHP Commercial |
$3.13
|
| Rate for Payer: PHP Medicare Advantage |
$0.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.20
|
| Rate for Payer: Priority Health Medicare |
$0.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.24
|
| Rate for Payer: Railroad Medicare Medicare |
$0.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.24
|
| Rate for Payer: UHC Core |
$3.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.92
|
| Rate for Payer: UHC Medicare Advantage |
$0.95
|
| Rate for Payer: VA VA |
$0.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.76
|
|
|
HC LOCM 100-199 MG/ML IODINE/ML1
|
Facility
|
IP
|
$3.68
|
|
|
Service Code
|
HCPCS Q9965
|
| Hospital Charge Code |
25500002
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$2.24 |
| Max. Negotiated Rate |
$3.31 |
| Rate for Payer: Aetna Commercial |
$3.13
|
| Rate for Payer: BCBS Trust/PPO |
$2.84
|
| Rate for Payer: BCN Commercial |
$2.84
|
| Rate for Payer: Cash Price |
$2.94
|
| Rate for Payer: Cofinity Commercial |
$3.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.94
|
| Rate for Payer: Healthscope Commercial |
$3.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.13
|
| Rate for Payer: PHP Commercial |
$3.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.24
|
| Rate for Payer: UHC Core |
$3.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.76
|
|
|
HC LOOP AV 3/8 INCH OR 1/2 INCH
|
Facility
|
IP
|
$211.80
|
|
| Hospital Charge Code |
27000444
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$129.18 |
| Max. Negotiated Rate |
$190.62 |
| Rate for Payer: Aetna Commercial |
$180.03
|
| Rate for Payer: BCBS Trust/PPO |
$163.68
|
| Rate for Payer: BCN Commercial |
$163.68
|
| Rate for Payer: Cash Price |
$169.44
|
| Rate for Payer: Cofinity Commercial |
$182.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.44
|
| Rate for Payer: Healthscope Commercial |
$190.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$180.03
|
| Rate for Payer: PHP Commercial |
$180.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.38
|
| Rate for Payer: UHC Core |
$176.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.85
|
|
|
HC LOOP AV 3/8 INCH OR 1/2 INCH
|
Facility
|
OP
|
$211.80
|
|
| Hospital Charge Code |
27000444
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$50.30 |
| Max. Negotiated Rate |
$190.62 |
| Rate for Payer: Aetna Commercial |
$180.03
|
| Rate for Payer: Aetna Medicare |
$55.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.19
|
| Rate for Payer: BCBS Complete |
$84.72
|
| Rate for Payer: BCBS MAPPO |
$52.95
|
| Rate for Payer: BCBS Trust/PPO |
$164.67
|
| Rate for Payer: BCN Commercial |
$164.67
|
| Rate for Payer: BCN Medicare Advantage |
$52.95
|
| Rate for Payer: Cash Price |
$169.44
|
| Rate for Payer: Cofinity Commercial |
$182.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.95
|
| Rate for Payer: Healthscope Commercial |
$190.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$180.03
|
| Rate for Payer: PACE Senior Care Partners |
$50.30
|
| Rate for Payer: PACE SWMI |
$52.95
|
| Rate for Payer: PHP Commercial |
$180.03
|
| Rate for Payer: PHP Medicare Advantage |
$52.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.27
|
| Rate for Payer: Priority Health Medicare |
$52.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.18
|
| Rate for Payer: Railroad Medicare Medicare |
$52.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.38
|
| Rate for Payer: UHC Core |
$176.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.95
|
| Rate for Payer: UHC Medicare Advantage |
$54.54
|
| Rate for Payer: VA VA |
$52.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.85
|
|
|
HC LOW-LEVEL LASER THERAPY
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT 0552T
|
| Hospital Charge Code |
43000024
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.38 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: Aetna Medicare |
$23.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.12
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCBS MAPPO |
$22.50
|
| Rate for Payer: BCBS Trust/PPO |
$69.98
|
| Rate for Payer: BCN Commercial |
$69.98
|
| Rate for Payer: BCN Medicare Advantage |
$22.50
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$77.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.50
|
| Rate for Payer: Healthscope Commercial |
$81.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: PACE Senior Care Partners |
$21.38
|
| Rate for Payer: PACE SWMI |
$22.50
|
| Rate for Payer: PHP Commercial |
$76.50
|
| Rate for Payer: PHP Medicare Advantage |
$22.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.30
|
| Rate for Payer: Priority Health Medicare |
$22.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.89
|
| Rate for Payer: Railroad Medicare Medicare |
$22.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.20
|
| Rate for Payer: UHC Core |
$75.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.50
|
| Rate for Payer: UHC Medicare Advantage |
$23.18
|
| Rate for Payer: VA VA |
$22.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.50
|
|
|
HC LOW-LEVEL LASER THERAPY
|
Facility
|
IP
|
$90.00
|
|
|
Service Code
|
CPT 0552T
|
| Hospital Charge Code |
43000024
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$54.89 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: BCBS Trust/PPO |
$69.55
|
| Rate for Payer: BCN Commercial |
$69.55
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$77.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Healthscope Commercial |
$81.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: PHP Commercial |
$76.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.20
|
| Rate for Payer: UHC Core |
$75.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.50
|
|
|
HC LP (A) CHOLESTEROL LMPP
|
Facility
|
IP
|
$23.46
|
|
|
Service Code
|
CPT 83700
|
| Hospital Charge Code |
30100636
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.31 |
| Max. Negotiated Rate |
$21.11 |
| Rate for Payer: Aetna Commercial |
$19.94
|
| Rate for Payer: BCBS Trust/PPO |
$18.13
|
| Rate for Payer: BCN Commercial |
$18.13
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$20.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Healthscope Commercial |
$21.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.94
|
| Rate for Payer: PHP Commercial |
$19.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.64
|
| Rate for Payer: UHC Core |
$19.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.60
|
|
|
HC LP (A) CHOLESTEROL LMPP
|
Facility
|
OP
|
$23.46
|
|
|
Service Code
|
CPT 83700
|
| Hospital Charge Code |
30100636
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.57 |
| Max. Negotiated Rate |
$21.11 |
| Rate for Payer: Aetna Commercial |
$19.94
|
| Rate for Payer: Aetna Medicare |
$6.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.33
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS MAPPO |
$5.86
|
| Rate for Payer: BCBS Trust/PPO |
$18.24
|
| Rate for Payer: BCN Commercial |
$18.24
|
| Rate for Payer: BCN Medicare Advantage |
$5.86
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$20.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.86
|
| Rate for Payer: Healthscope Commercial |
$21.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.60
|
| Rate for Payer: Mclaren Medicaid |
$8.31
|
| Rate for Payer: Meridian Medicaid |
$8.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.94
|
| Rate for Payer: PACE Senior Care Partners |
$5.57
|
| Rate for Payer: PACE SWMI |
$5.86
|
| Rate for Payer: PHP Commercial |
$19.94
|
| Rate for Payer: PHP Medicare Advantage |
$5.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.41
|
| Rate for Payer: Priority Health Medicare |
$5.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.31
|
| Rate for Payer: Railroad Medicare Medicare |
$5.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.64
|
| Rate for Payer: UHC Core |
$19.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.86
|
| Rate for Payer: UHC Medicare Advantage |
$6.04
|
| Rate for Payer: VA VA |
$5.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.60
|
|
|
HC LTC ROOM AND BOARD
|
Facility
|
IP
|
$377.40
|
|
| Hospital Charge Code |
11000003
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$230.18 |
| Max. Negotiated Rate |
$339.66 |
| Rate for Payer: Aetna Commercial |
$320.79
|
| Rate for Payer: BCBS Trust/PPO |
$291.65
|
| Rate for Payer: BCN Commercial |
$291.65
|
| Rate for Payer: Cash Price |
$301.92
|
| Rate for Payer: Cofinity Commercial |
$324.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.92
|
| Rate for Payer: Healthscope Commercial |
$339.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$320.79
|
| Rate for Payer: PHP Commercial |
$320.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$264.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$328.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$332.11
|
| Rate for Payer: UHC Core |
$315.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.05
|
|
|
HC LT/RT/C'S/CABG'S W INTERVENTION
|
Facility
|
IP
|
$12,115.61
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100051
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,389.31 |
| Max. Negotiated Rate |
$10,904.05 |
| Rate for Payer: Aetna Commercial |
$10,298.27
|
| Rate for Payer: BCBS Trust/PPO |
$9,362.94
|
| Rate for Payer: BCN Commercial |
$9,362.94
|
| Rate for Payer: Cash Price |
$9,692.49
|
| Rate for Payer: Cofinity Commercial |
$10,419.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,692.49
|
| Rate for Payer: Healthscope Commercial |
$10,904.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,086.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,298.27
|
| Rate for Payer: PHP Commercial |
$10,298.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,480.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,540.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,389.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,661.74
|
| Rate for Payer: UHC Core |
$10,116.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,086.71
|
|
|
HC LT/RT/C'S/CABG'S W INTERVENTION
|
Facility
|
OP
|
$12,115.61
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100051
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,137.59 |
| Max. Negotiated Rate |
$10,904.05 |
| Rate for Payer: Aetna Commercial |
$10,298.27
|
| Rate for Payer: Aetna Medicare |
$3,150.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,786.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,786.13
|
| Rate for Payer: BCBS Complete |
$2,244.47
|
| Rate for Payer: BCBS MAPPO |
$3,028.90
|
| Rate for Payer: BCBS Trust/PPO |
$9,419.89
|
| Rate for Payer: BCN Commercial |
$9,419.89
|
| Rate for Payer: BCN Medicare Advantage |
$3,028.90
|
| Rate for Payer: Cash Price |
$9,692.49
|
| Rate for Payer: Cash Price |
$9,692.49
|
| Rate for Payer: Cofinity Commercial |
$10,419.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,692.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,028.90
|
| Rate for Payer: Healthscope Commercial |
$10,904.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,086.71
|
| Rate for Payer: Mclaren Medicaid |
$2,137.59
|
| Rate for Payer: Meridian Medicaid |
$2,244.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,180.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,483.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,298.27
|
| Rate for Payer: PACE Senior Care Partners |
$2,877.46
|
| Rate for Payer: PACE SWMI |
$3,028.90
|
| Rate for Payer: PHP Commercial |
$10,298.27
|
| Rate for Payer: PHP Medicare Advantage |
$3,028.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,137.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,480.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,540.58
|
| Rate for Payer: Priority Health Medicare |
$3,028.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,389.31
|
| Rate for Payer: Railroad Medicare Medicare |
$3,028.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,661.74
|
| Rate for Payer: UHC Core |
$10,116.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,028.90
|
| Rate for Payer: UHC Medicare Advantage |
$3,119.77
|
| Rate for Payer: VA VA |
$3,028.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,086.71
|
|
|
HC LUMASON PER ML
|
Facility
|
IP
|
$77.94
|
|
|
Service Code
|
HCPCS Q9950
|
| Hospital Charge Code |
63600066
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$47.54 |
| Max. Negotiated Rate |
$70.15 |
| Rate for Payer: Aetna Commercial |
$66.25
|
| Rate for Payer: BCBS Trust/PPO |
$60.23
|
| Rate for Payer: BCN Commercial |
$60.23
|
| Rate for Payer: Cash Price |
$62.35
|
| Rate for Payer: Cofinity Commercial |
$67.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.35
|
| Rate for Payer: Healthscope Commercial |
$70.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$66.25
|
| Rate for Payer: PHP Commercial |
$66.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.59
|
| Rate for Payer: UHC Core |
$65.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.46
|
|
|
HC LUMASON PER ML
|
Facility
|
OP
|
$77.94
|
|
|
Service Code
|
HCPCS Q9950
|
| Hospital Charge Code |
63600066
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.51 |
| Max. Negotiated Rate |
$70.15 |
| Rate for Payer: Aetna Commercial |
$66.25
|
| Rate for Payer: Aetna Medicare |
$20.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.36
|
| Rate for Payer: BCBS Complete |
$31.18
|
| Rate for Payer: BCBS MAPPO |
$19.48
|
| Rate for Payer: BCBS Trust/PPO |
$60.60
|
| Rate for Payer: BCN Commercial |
$60.60
|
| Rate for Payer: BCN Medicare Advantage |
$19.48
|
| Rate for Payer: Cash Price |
$62.35
|
| Rate for Payer: Cofinity Commercial |
$67.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.48
|
| Rate for Payer: Healthscope Commercial |
$70.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$66.25
|
| Rate for Payer: PACE Senior Care Partners |
$18.51
|
| Rate for Payer: PACE SWMI |
$19.48
|
| Rate for Payer: PHP Commercial |
$66.25
|
| Rate for Payer: PHP Medicare Advantage |
$19.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.81
|
| Rate for Payer: Priority Health Medicare |
$19.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.54
|
| Rate for Payer: Railroad Medicare Medicare |
$19.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.59
|
| Rate for Payer: UHC Core |
$65.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.48
|
| Rate for Payer: UHC Medicare Advantage |
$20.07
|
| Rate for Payer: VA VA |
$19.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.46
|
|
|
HC LUMBAR PUNCTURE
|
Facility
|
IP
|
$748.54
|
|
| Hospital Charge Code |
45000046
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$456.53 |
| Max. Negotiated Rate |
$673.69 |
| Rate for Payer: Aetna Commercial |
$636.26
|
| Rate for Payer: BCBS Trust/PPO |
$578.47
|
| Rate for Payer: BCN Commercial |
$578.47
|
| Rate for Payer: Cash Price |
$598.83
|
| Rate for Payer: Cofinity Commercial |
$643.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$598.83
|
| Rate for Payer: Healthscope Commercial |
$673.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$561.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$636.26
|
| Rate for Payer: PHP Commercial |
$636.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$651.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$456.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.72
|
| Rate for Payer: UHC Core |
$625.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$561.40
|
|
|
HC LUMBAR PUNCTURE
|
Facility
|
OP
|
$748.54
|
|
| Hospital Charge Code |
45000046
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$177.78 |
| Max. Negotiated Rate |
$673.69 |
| Rate for Payer: Aetna Commercial |
$636.26
|
| Rate for Payer: Aetna Medicare |
$194.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$233.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$233.92
|
| Rate for Payer: BCBS Complete |
$299.42
|
| Rate for Payer: BCBS MAPPO |
$187.14
|
| Rate for Payer: BCBS Trust/PPO |
$581.99
|
| Rate for Payer: BCN Commercial |
$581.99
|
| Rate for Payer: BCN Medicare Advantage |
$187.14
|
| Rate for Payer: Cash Price |
$598.83
|
| Rate for Payer: Cofinity Commercial |
$643.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$598.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.14
|
| Rate for Payer: Healthscope Commercial |
$673.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$561.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$196.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$215.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$636.26
|
| Rate for Payer: PACE Senior Care Partners |
$177.78
|
| Rate for Payer: PACE SWMI |
$187.14
|
| Rate for Payer: PHP Commercial |
$636.26
|
| Rate for Payer: PHP Medicare Advantage |
$187.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$651.23
|
| Rate for Payer: Priority Health Medicare |
$187.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$456.53
|
| Rate for Payer: Railroad Medicare Medicare |
$187.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.72
|
| Rate for Payer: UHC Core |
$625.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.14
|
| Rate for Payer: UHC Medicare Advantage |
$192.75
|
| Rate for Payer: VA VA |
$187.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$561.40
|
|
|
HC LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$853.63
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
36100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$520.63 |
| Max. Negotiated Rate |
$768.27 |
| Rate for Payer: Aetna Commercial |
$725.59
|
| Rate for Payer: Aetna Commercial |
$763.65
|
| Rate for Payer: BCBS Trust/PPO |
$659.69
|
| Rate for Payer: BCBS Trust/PPO |
$694.29
|
| Rate for Payer: BCN Commercial |
$694.29
|
| Rate for Payer: BCN Commercial |
$659.69
|
| Rate for Payer: Cash Price |
$718.73
|
| Rate for Payer: Cash Price |
$682.90
|
| Rate for Payer: Cofinity Commercial |
$772.63
|
| Rate for Payer: Cofinity Commercial |
$734.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$718.73
|
| Rate for Payer: Healthscope Commercial |
$808.57
|
| Rate for Payer: Healthscope Commercial |
$768.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$640.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$673.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$763.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$725.59
|
| Rate for Payer: PHP Commercial |
$725.59
|
| Rate for Payer: PHP Commercial |
$763.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$628.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$742.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$781.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$520.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$751.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$790.60
|
| Rate for Payer: UHC Core |
$712.78
|
| Rate for Payer: UHC Core |
$750.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$640.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$673.81
|
|
|
HC LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$853.63
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
36100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$202.74 |
| Max. Negotiated Rate |
$768.27 |
| Rate for Payer: Aetna Commercial |
$725.59
|
| Rate for Payer: Aetna Commercial |
$763.65
|
| Rate for Payer: Aetna Medicare |
$221.94
|
| Rate for Payer: Aetna Medicare |
$233.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$280.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$266.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$280.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$266.76
|
| Rate for Payer: BCBS Complete |
$476.33
|
| Rate for Payer: BCBS Complete |
$476.33
|
| Rate for Payer: BCBS MAPPO |
$224.60
|
| Rate for Payer: BCBS MAPPO |
$213.41
|
| Rate for Payer: BCBS Trust/PPO |
$663.70
|
| Rate for Payer: BCBS Trust/PPO |
$698.51
|
| Rate for Payer: BCN Commercial |
$698.51
|
| Rate for Payer: BCN Commercial |
$663.70
|
| Rate for Payer: BCN Medicare Advantage |
$224.60
|
| Rate for Payer: BCN Medicare Advantage |
$213.41
|
| Rate for Payer: Cash Price |
$718.73
|
| Rate for Payer: Cash Price |
$682.90
|
| Rate for Payer: Cash Price |
$718.73
|
| Rate for Payer: Cash Price |
$682.90
|
| Rate for Payer: Cofinity Commercial |
$734.12
|
| Rate for Payer: Cofinity Commercial |
$772.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$718.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$224.60
|
| Rate for Payer: Healthscope Commercial |
$808.57
|
| Rate for Payer: Healthscope Commercial |
$768.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$640.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$673.81
|
| Rate for Payer: Mclaren Medicaid |
$453.65
|
| Rate for Payer: Mclaren Medicaid |
$453.65
|
| Rate for Payer: Meridian Medicaid |
$476.33
|
| Rate for Payer: Meridian Medicaid |
$476.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$224.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$235.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$258.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$245.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$725.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$763.65
|
| Rate for Payer: PACE Senior Care Partners |
$213.37
|
| Rate for Payer: PACE Senior Care Partners |
$202.74
|
| Rate for Payer: PACE SWMI |
$213.41
|
| Rate for Payer: PACE SWMI |
$224.60
|
| Rate for Payer: PHP Commercial |
$725.59
|
| Rate for Payer: PHP Commercial |
$763.65
|
| Rate for Payer: PHP Medicare Advantage |
$224.60
|
| Rate for Payer: PHP Medicare Advantage |
$213.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$628.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$742.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$781.62
|
| Rate for Payer: Priority Health Medicare |
$213.41
|
| Rate for Payer: Priority Health Medicare |
$224.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$520.63
|
| Rate for Payer: Railroad Medicare Medicare |
$224.60
|
| Rate for Payer: Railroad Medicare Medicare |
$213.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$751.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$790.60
|
| Rate for Payer: UHC Core |
$712.78
|
| Rate for Payer: UHC Core |
$750.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$213.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$224.60
|
| Rate for Payer: UHC Medicare Advantage |
$231.34
|
| Rate for Payer: UHC Medicare Advantage |
$219.81
|
| Rate for Payer: VA VA |
$213.41
|
| Rate for Payer: VA VA |
$224.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$640.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$673.81
|
|
|
HC LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
IP
|
$755.88
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
36100279
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$461.01 |
| Max. Negotiated Rate |
$680.29 |
| Rate for Payer: Aetna Commercial |
$642.50
|
| Rate for Payer: BCBS Trust/PPO |
$584.14
|
| Rate for Payer: BCN Commercial |
$584.14
|
| Rate for Payer: Cash Price |
$604.70
|
| Rate for Payer: Cofinity Commercial |
$650.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$604.70
|
| Rate for Payer: Healthscope Commercial |
$680.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$566.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$642.50
|
| Rate for Payer: PHP Commercial |
$642.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$657.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$461.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.17
|
| Rate for Payer: UHC Core |
$631.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$566.91
|
|
|
HC LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
OP
|
$755.88
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
36100279
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$179.52 |
| Max. Negotiated Rate |
$680.29 |
| Rate for Payer: Aetna Commercial |
$642.50
|
| Rate for Payer: Aetna Medicare |
$196.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.21
|
| Rate for Payer: BCBS Complete |
$476.33
|
| Rate for Payer: BCBS MAPPO |
$188.97
|
| Rate for Payer: BCBS Trust/PPO |
$587.70
|
| Rate for Payer: BCN Commercial |
$587.70
|
| Rate for Payer: BCN Medicare Advantage |
$188.97
|
| Rate for Payer: Cash Price |
$604.70
|
| Rate for Payer: Cash Price |
$604.70
|
| Rate for Payer: Cofinity Commercial |
$650.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$604.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.97
|
| Rate for Payer: Healthscope Commercial |
$680.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$566.91
|
| Rate for Payer: Mclaren Medicaid |
$453.65
|
| Rate for Payer: Meridian Medicaid |
$476.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$198.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$217.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$642.50
|
| Rate for Payer: PACE Senior Care Partners |
$179.52
|
| Rate for Payer: PACE SWMI |
$188.97
|
| Rate for Payer: PHP Commercial |
$642.50
|
| Rate for Payer: PHP Medicare Advantage |
$188.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$453.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$657.62
|
| Rate for Payer: Priority Health Medicare |
$188.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$461.01
|
| Rate for Payer: Railroad Medicare Medicare |
$188.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$665.17
|
| Rate for Payer: UHC Core |
$631.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.97
|
| Rate for Payer: UHC Medicare Advantage |
$194.64
|
| Rate for Payer: VA VA |
$188.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$566.91
|
|
|
HC LUNG/MED BIOPSY
|
Facility
|
IP
|
$2,066.60
|
|
|
Service Code
|
CPT 32408
|
| Hospital Charge Code |
36100609
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,260.42 |
| Max. Negotiated Rate |
$1,859.94 |
| Rate for Payer: Aetna Commercial |
$1,756.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,597.07
|
| Rate for Payer: BCN Commercial |
$1,597.07
|
| Rate for Payer: Cash Price |
$1,653.28
|
| Rate for Payer: Cofinity Commercial |
$1,777.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,653.28
|
| Rate for Payer: Healthscope Commercial |
$1,859.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,549.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,756.61
|
| Rate for Payer: PHP Commercial |
$1,756.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,797.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,260.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,818.61
|
| Rate for Payer: UHC Core |
$1,725.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,549.95
|
|
|
HC LUNG/MED BIOPSY
|
Facility
|
OP
|
$2,066.60
|
|
|
Service Code
|
CPT 32408
|
| Hospital Charge Code |
36100609
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$490.82 |
| Max. Negotiated Rate |
$1,859.94 |
| Rate for Payer: Aetna Commercial |
$1,756.61
|
| Rate for Payer: Aetna Medicare |
$537.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$645.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$645.81
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$516.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,606.78
|
| Rate for Payer: BCN Commercial |
$1,606.78
|
| Rate for Payer: BCN Medicare Advantage |
$516.65
|
| Rate for Payer: Cash Price |
$1,653.28
|
| Rate for Payer: Cash Price |
$1,653.28
|
| Rate for Payer: Cofinity Commercial |
$1,777.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,653.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$516.65
|
| Rate for Payer: Healthscope Commercial |
$1,859.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,549.95
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$542.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$594.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,756.61
|
| Rate for Payer: PACE Senior Care Partners |
$490.82
|
| Rate for Payer: PACE SWMI |
$516.65
|
| Rate for Payer: PHP Commercial |
$1,756.61
|
| Rate for Payer: PHP Medicare Advantage |
$516.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,797.94
|
| Rate for Payer: Priority Health Medicare |
$516.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,260.42
|
| Rate for Payer: Railroad Medicare Medicare |
$516.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,818.61
|
| Rate for Payer: UHC Core |
$1,725.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$516.65
|
| Rate for Payer: UHC Medicare Advantage |
$532.15
|
| Rate for Payer: VA VA |
$516.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,549.95
|
|
