|
HC MR LOWER EXTREM NO JOINT WO W CON
|
Facility
|
OP
|
$4,544.55
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000033
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$4,090.10 |
| Rate for Payer: Aetna Commercial |
$3,862.87
|
| Rate for Payer: Aetna Commercial |
$2,575.24
|
| Rate for Payer: Aetna Medicare |
$787.72
|
| Rate for Payer: Aetna Medicare |
$1,181.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$946.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,420.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$946.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,420.17
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$1,136.14
|
| Rate for Payer: BCBS MAPPO |
$757.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,355.59
|
| Rate for Payer: BCBS Trust/PPO |
$3,533.39
|
| Rate for Payer: BCN Commercial |
$3,533.39
|
| Rate for Payer: BCN Commercial |
$2,355.59
|
| Rate for Payer: BCN Medicare Advantage |
$757.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,136.14
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cofinity Commercial |
$3,908.31
|
| Rate for Payer: Cofinity Commercial |
$2,605.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,423.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,635.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$757.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,136.14
|
| Rate for Payer: Healthscope Commercial |
$2,726.73
|
| Rate for Payer: Healthscope Commercial |
$4,090.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,272.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,408.41
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,192.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$795.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,306.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$871.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,575.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,862.87
|
| Rate for Payer: PACE Senior Care Partners |
$1,079.33
|
| Rate for Payer: PACE Senior Care Partners |
$719.55
|
| Rate for Payer: PACE SWMI |
$1,136.14
|
| Rate for Payer: PACE SWMI |
$757.42
|
| Rate for Payer: PHP Commercial |
$3,862.87
|
| Rate for Payer: PHP Commercial |
$2,575.24
|
| Rate for Payer: PHP Medicare Advantage |
$1,136.14
|
| Rate for Payer: PHP Medicare Advantage |
$757.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,181.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,120.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,953.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,635.84
|
| Rate for Payer: Priority Health Medicare |
$1,136.14
|
| Rate for Payer: Priority Health Medicare |
$757.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,771.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,847.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,136.14
|
| Rate for Payer: Railroad Medicare Medicare |
$757.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,666.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,999.20
|
| Rate for Payer: UHC Core |
$2,529.80
|
| Rate for Payer: UHC Core |
$3,794.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$757.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,136.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,170.22
|
| Rate for Payer: UHC Medicare Advantage |
$780.15
|
| Rate for Payer: VA VA |
$757.42
|
| Rate for Payer: VA VA |
$1,136.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,272.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,408.41
|
|
|
HC MR LOWER EXTREM NO JOINT WO W CON
|
Facility
|
IP
|
$3,029.70
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000033
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,847.81 |
| Max. Negotiated Rate |
$2,726.73 |
| Rate for Payer: Aetna Commercial |
$2,575.24
|
| Rate for Payer: Aetna Commercial |
$3,862.87
|
| Rate for Payer: BCBS Trust/PPO |
$3,512.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,341.35
|
| Rate for Payer: BCN Commercial |
$3,512.03
|
| Rate for Payer: BCN Commercial |
$2,341.35
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cofinity Commercial |
$3,908.31
|
| Rate for Payer: Cofinity Commercial |
$2,605.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,635.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,423.76
|
| Rate for Payer: Healthscope Commercial |
$2,726.73
|
| Rate for Payer: Healthscope Commercial |
$4,090.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,408.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,272.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,862.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,575.24
|
| Rate for Payer: PHP Commercial |
$3,862.87
|
| Rate for Payer: PHP Commercial |
$2,575.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,120.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,181.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,635.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,953.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,847.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,771.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,666.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,999.20
|
| Rate for Payer: UHC Core |
$3,794.70
|
| Rate for Payer: UHC Core |
$2,529.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,408.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,272.28
|
|
|
HC MR MRA ABDOMEN W CON
|
Facility
|
OP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8900
|
| Hospital Charge Code |
61000060
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$1,987.11 |
| Rate for Payer: Aetna Commercial |
$1,876.72
|
| Rate for Payer: Aetna Medicare |
$574.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$689.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$689.97
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$551.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.64
|
| Rate for Payer: BCN Commercial |
$1,716.64
|
| Rate for Payer: BCN Medicare Advantage |
$551.98
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$1,898.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.98
|
| Rate for Payer: Healthscope Commercial |
$1,987.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,655.92
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$579.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$634.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,876.72
|
| Rate for Payer: PACE Senior Care Partners |
$524.38
|
| Rate for Payer: PACE SWMI |
$551.98
|
| Rate for Payer: PHP Commercial |
$1,876.72
|
| Rate for Payer: PHP Medicare Advantage |
$551.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,545.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,920.87
|
| Rate for Payer: Priority Health Medicare |
$551.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,346.60
|
| Rate for Payer: Railroad Medicare Medicare |
$551.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,942.95
|
| Rate for Payer: UHC Core |
$1,843.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$551.98
|
| Rate for Payer: UHC Medicare Advantage |
$568.53
|
| Rate for Payer: VA VA |
$551.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,655.92
|
|
|
HC MR MRA ABDOMEN W CON
|
Facility
|
IP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8900
|
| Hospital Charge Code |
61000060
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,346.60 |
| Max. Negotiated Rate |
$1,987.11 |
| Rate for Payer: Aetna Commercial |
$1,876.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,706.27
|
| Rate for Payer: BCN Commercial |
$1,706.27
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$1,898.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Healthscope Commercial |
$1,987.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,655.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,876.72
|
| Rate for Payer: PHP Commercial |
$1,876.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,545.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,920.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,346.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,942.95
|
| Rate for Payer: UHC Core |
$1,843.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,655.92
|
|
|
HC MR MRA ABDOMEN WO CON
|
Facility
|
IP
|
$2,070.00
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
61000061
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,262.49 |
| Max. Negotiated Rate |
$1,863.00 |
| Rate for Payer: Aetna Commercial |
$1,759.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,599.70
|
| Rate for Payer: BCN Commercial |
$1,599.70
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cofinity Commercial |
$1,780.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.00
|
| Rate for Payer: Healthscope Commercial |
$1,863.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,552.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,759.50
|
| Rate for Payer: PHP Commercial |
$1,759.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,449.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,800.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,262.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,821.60
|
| Rate for Payer: UHC Core |
$1,728.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,552.50
|
|
|
HC MR MRA ABDOMEN WO CON
|
Facility
|
OP
|
$2,070.00
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
61000061
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,863.00 |
| Rate for Payer: Aetna Commercial |
$1,759.50
|
| Rate for Payer: Aetna Medicare |
$538.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$646.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$646.88
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$517.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,609.42
|
| Rate for Payer: BCN Commercial |
$1,609.42
|
| Rate for Payer: BCN Medicare Advantage |
$517.50
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cofinity Commercial |
$1,780.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.50
|
| Rate for Payer: Healthscope Commercial |
$1,863.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,552.50
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$543.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,759.50
|
| Rate for Payer: PACE Senior Care Partners |
$491.62
|
| Rate for Payer: PACE SWMI |
$517.50
|
| Rate for Payer: PHP Commercial |
$1,759.50
|
| Rate for Payer: PHP Medicare Advantage |
$517.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,449.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,800.90
|
| Rate for Payer: Priority Health Medicare |
$517.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,262.49
|
| Rate for Payer: Railroad Medicare Medicare |
$517.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,821.60
|
| Rate for Payer: UHC Core |
$1,728.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.50
|
| Rate for Payer: UHC Medicare Advantage |
$533.02
|
| Rate for Payer: VA VA |
$517.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,552.50
|
|
|
HC MR MRA ABDOMEN WO W CON
|
Facility
|
OP
|
$2,674.34
|
|
|
Service Code
|
HCPCS C8902
|
| Hospital Charge Code |
61000062
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,406.91 |
| Rate for Payer: Aetna Commercial |
$2,273.19
|
| Rate for Payer: Aetna Medicare |
$695.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$835.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$835.73
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$668.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,079.30
|
| Rate for Payer: BCN Commercial |
$2,079.30
|
| Rate for Payer: BCN Medicare Advantage |
$668.58
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cofinity Commercial |
$2,299.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,139.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$668.58
|
| Rate for Payer: Healthscope Commercial |
$2,406.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,005.76
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$702.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$768.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,273.19
|
| Rate for Payer: PACE Senior Care Partners |
$635.16
|
| Rate for Payer: PACE SWMI |
$668.58
|
| Rate for Payer: PHP Commercial |
$2,273.19
|
| Rate for Payer: PHP Medicare Advantage |
$668.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,872.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,326.68
|
| Rate for Payer: Priority Health Medicare |
$668.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,631.08
|
| Rate for Payer: Railroad Medicare Medicare |
$668.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,353.42
|
| Rate for Payer: UHC Core |
$2,233.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$668.58
|
| Rate for Payer: UHC Medicare Advantage |
$688.64
|
| Rate for Payer: VA VA |
$668.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,005.76
|
|
|
HC MR MRA ABDOMEN WO W CON
|
Facility
|
IP
|
$2,674.34
|
|
|
Service Code
|
HCPCS C8902
|
| Hospital Charge Code |
61000062
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,631.08 |
| Max. Negotiated Rate |
$2,406.91 |
| Rate for Payer: Aetna Commercial |
$2,273.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,066.73
|
| Rate for Payer: BCN Commercial |
$2,066.73
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cofinity Commercial |
$2,299.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,139.47
|
| Rate for Payer: Healthscope Commercial |
$2,406.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,005.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,273.19
|
| Rate for Payer: PHP Commercial |
$2,273.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,872.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,326.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,631.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,353.42
|
| Rate for Payer: UHC Core |
$2,233.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,005.76
|
|
|
HC MR MRA CHEST W CON
|
Facility
|
IP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8909
|
| Hospital Charge Code |
61000063
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,346.60 |
| Max. Negotiated Rate |
$1,987.11 |
| Rate for Payer: Aetna Commercial |
$1,876.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,706.27
|
| Rate for Payer: BCN Commercial |
$1,706.27
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$1,898.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Healthscope Commercial |
$1,987.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,655.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,876.72
|
| Rate for Payer: PHP Commercial |
$1,876.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,545.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,920.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,346.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,942.95
|
| Rate for Payer: UHC Core |
$1,843.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,655.92
|
|
|
HC MR MRA CHEST W CON
|
Facility
|
OP
|
$2,207.90
|
|
|
Service Code
|
HCPCS C8909
|
| Hospital Charge Code |
61000063
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$1,987.11 |
| Rate for Payer: Aetna Commercial |
$1,876.72
|
| Rate for Payer: Aetna Medicare |
$574.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$689.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$689.97
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$551.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.64
|
| Rate for Payer: BCN Commercial |
$1,716.64
|
| Rate for Payer: BCN Medicare Advantage |
$551.98
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cash Price |
$1,766.32
|
| Rate for Payer: Cofinity Commercial |
$1,898.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,766.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.98
|
| Rate for Payer: Healthscope Commercial |
$1,987.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,655.92
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$579.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$634.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,876.72
|
| Rate for Payer: PACE Senior Care Partners |
$524.38
|
| Rate for Payer: PACE SWMI |
$551.98
|
| Rate for Payer: PHP Commercial |
$1,876.72
|
| Rate for Payer: PHP Medicare Advantage |
$551.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,545.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,920.87
|
| Rate for Payer: Priority Health Medicare |
$551.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,346.60
|
| Rate for Payer: Railroad Medicare Medicare |
$551.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,942.95
|
| Rate for Payer: UHC Core |
$1,843.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$551.98
|
| Rate for Payer: UHC Medicare Advantage |
$568.53
|
| Rate for Payer: VA VA |
$551.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,655.92
|
|
|
HC MR MRA CHEST WO CON
|
Facility
|
OP
|
$2,070.00
|
|
|
Service Code
|
HCPCS C8910
|
| Hospital Charge Code |
61000064
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,863.00 |
| Rate for Payer: Aetna Commercial |
$1,759.50
|
| Rate for Payer: Aetna Medicare |
$538.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$646.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$646.88
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$517.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,609.42
|
| Rate for Payer: BCN Commercial |
$1,609.42
|
| Rate for Payer: BCN Medicare Advantage |
$517.50
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cofinity Commercial |
$1,780.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.50
|
| Rate for Payer: Healthscope Commercial |
$1,863.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,552.50
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$543.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,759.50
|
| Rate for Payer: PACE Senior Care Partners |
$491.62
|
| Rate for Payer: PACE SWMI |
$517.50
|
| Rate for Payer: PHP Commercial |
$1,759.50
|
| Rate for Payer: PHP Medicare Advantage |
$517.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,449.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,800.90
|
| Rate for Payer: Priority Health Medicare |
$517.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,262.49
|
| Rate for Payer: Railroad Medicare Medicare |
$517.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,821.60
|
| Rate for Payer: UHC Core |
$1,728.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.50
|
| Rate for Payer: UHC Medicare Advantage |
$533.02
|
| Rate for Payer: VA VA |
$517.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,552.50
|
|
|
HC MR MRA CHEST WO CON
|
Facility
|
IP
|
$2,070.00
|
|
|
Service Code
|
HCPCS C8910
|
| Hospital Charge Code |
61000064
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,262.49 |
| Max. Negotiated Rate |
$1,863.00 |
| Rate for Payer: Aetna Commercial |
$1,759.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,599.70
|
| Rate for Payer: BCN Commercial |
$1,599.70
|
| Rate for Payer: Cash Price |
$1,656.00
|
| Rate for Payer: Cofinity Commercial |
$1,780.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,656.00
|
| Rate for Payer: Healthscope Commercial |
$1,863.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,552.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,759.50
|
| Rate for Payer: PHP Commercial |
$1,759.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,449.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,800.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,262.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,821.60
|
| Rate for Payer: UHC Core |
$1,728.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,552.50
|
|
|
HC MR MRA CHEST WO W CON
|
Facility
|
OP
|
$2,674.34
|
|
|
Service Code
|
HCPCS C8911
|
| Hospital Charge Code |
61000065
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,406.91 |
| Rate for Payer: Aetna Commercial |
$2,273.19
|
| Rate for Payer: Aetna Medicare |
$695.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$835.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$835.73
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$668.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,079.30
|
| Rate for Payer: BCN Commercial |
$2,079.30
|
| Rate for Payer: BCN Medicare Advantage |
$668.58
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cofinity Commercial |
$2,299.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,139.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$668.58
|
| Rate for Payer: Healthscope Commercial |
$2,406.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,005.76
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$702.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$768.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,273.19
|
| Rate for Payer: PACE Senior Care Partners |
$635.16
|
| Rate for Payer: PACE SWMI |
$668.58
|
| Rate for Payer: PHP Commercial |
$2,273.19
|
| Rate for Payer: PHP Medicare Advantage |
$668.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,872.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,326.68
|
| Rate for Payer: Priority Health Medicare |
$668.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,631.08
|
| Rate for Payer: Railroad Medicare Medicare |
$668.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,353.42
|
| Rate for Payer: UHC Core |
$2,233.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$668.58
|
| Rate for Payer: UHC Medicare Advantage |
$688.64
|
| Rate for Payer: VA VA |
$668.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,005.76
|
|
|
HC MR MRA CHEST WO W CON
|
Facility
|
IP
|
$2,674.34
|
|
|
Service Code
|
HCPCS C8911
|
| Hospital Charge Code |
61000065
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,631.08 |
| Max. Negotiated Rate |
$2,406.91 |
| Rate for Payer: Aetna Commercial |
$2,273.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,066.73
|
| Rate for Payer: BCN Commercial |
$2,066.73
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cofinity Commercial |
$2,299.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,139.47
|
| Rate for Payer: Healthscope Commercial |
$2,406.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,005.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,273.19
|
| Rate for Payer: PHP Commercial |
$2,273.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,872.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,326.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,631.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,353.42
|
| Rate for Payer: UHC Core |
$2,233.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,005.76
|
|
|
HC MR MRA LOWR EXTREM BIL W CON
|
Facility
|
OP
|
$2,346.00
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000066
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,111.40 |
| Rate for Payer: Aetna Commercial |
$1,994.10
|
| Rate for Payer: Aetna Medicare |
$609.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$733.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$733.12
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$586.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,824.02
|
| Rate for Payer: BCN Commercial |
$1,824.02
|
| Rate for Payer: BCN Medicare Advantage |
$586.50
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cofinity Commercial |
$2,017.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,876.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$586.50
|
| Rate for Payer: Healthscope Commercial |
$2,111.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,759.50
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$615.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$674.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,994.10
|
| Rate for Payer: PACE Senior Care Partners |
$557.18
|
| Rate for Payer: PACE SWMI |
$586.50
|
| Rate for Payer: PHP Commercial |
$1,994.10
|
| Rate for Payer: PHP Medicare Advantage |
$586.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,642.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,041.02
|
| Rate for Payer: Priority Health Medicare |
$586.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,430.83
|
| Rate for Payer: Railroad Medicare Medicare |
$586.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,064.48
|
| Rate for Payer: UHC Core |
$1,958.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$586.50
|
| Rate for Payer: UHC Medicare Advantage |
$604.10
|
| Rate for Payer: VA VA |
$586.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,759.50
|
|
|
HC MR MRA LOWR EXTREM BIL W CON
|
Facility
|
IP
|
$2,346.00
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000066
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,430.83 |
| Max. Negotiated Rate |
$2,111.40 |
| Rate for Payer: Aetna Commercial |
$1,994.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,812.99
|
| Rate for Payer: BCN Commercial |
$1,812.99
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cofinity Commercial |
$2,017.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,876.80
|
| Rate for Payer: Healthscope Commercial |
$2,111.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,759.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,994.10
|
| Rate for Payer: PHP Commercial |
$1,994.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,642.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,041.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,430.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,064.48
|
| Rate for Payer: UHC Core |
$1,958.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,759.50
|
|
|
HC MR MRA LOWR EXTREM BIL WO CON
|
Facility
|
IP
|
$2,139.00
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000067
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,304.58 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,818.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,653.02
|
| Rate for Payer: BCN Commercial |
$1,653.02
|
| Rate for Payer: Cash Price |
$1,711.20
|
| Rate for Payer: Cofinity Commercial |
$1,839.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,711.20
|
| Rate for Payer: Healthscope Commercial |
$1,925.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,604.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,818.15
|
| Rate for Payer: PHP Commercial |
$1,818.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,497.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,860.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,304.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,882.32
|
| Rate for Payer: UHC Core |
$1,786.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,604.25
|
|
|
HC MR MRA LOWR EXTREM BIL WO CON
|
Facility
|
OP
|
$2,139.00
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000067
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,925.10 |
| Rate for Payer: Aetna Commercial |
$1,818.15
|
| Rate for Payer: Aetna Medicare |
$556.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$668.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$668.44
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,663.07
|
| Rate for Payer: BCN Commercial |
$1,663.07
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$1,711.20
|
| Rate for Payer: Cash Price |
$1,711.20
|
| Rate for Payer: Cofinity Commercial |
$1,839.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,711.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Healthscope Commercial |
$1,925.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,604.25
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,818.15
|
| Rate for Payer: PACE Senior Care Partners |
$508.01
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Commercial |
$1,818.15
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,497.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,860.93
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,304.58
|
| Rate for Payer: Railroad Medicare Medicare |
$534.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,882.32
|
| Rate for Payer: UHC Core |
$1,786.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Medicare Advantage |
$550.79
|
| Rate for Payer: VA VA |
$534.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,604.25
|
|
|
HC MR MRA LOWR EXTREM BIL WO W
|
Facility
|
OP
|
$2,621.90
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000068
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,359.71 |
| Rate for Payer: Aetna Commercial |
$2,228.62
|
| Rate for Payer: Aetna Medicare |
$681.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$819.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$819.34
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$655.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,038.53
|
| Rate for Payer: BCN Commercial |
$2,038.53
|
| Rate for Payer: BCN Medicare Advantage |
$655.48
|
| Rate for Payer: Cash Price |
$2,097.52
|
| Rate for Payer: Cash Price |
$2,097.52
|
| Rate for Payer: Cofinity Commercial |
$2,254.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,097.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$655.48
|
| Rate for Payer: Healthscope Commercial |
$2,359.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,966.42
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$688.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$753.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,228.62
|
| Rate for Payer: PACE Senior Care Partners |
$622.70
|
| Rate for Payer: PACE SWMI |
$655.48
|
| Rate for Payer: PHP Commercial |
$2,228.62
|
| Rate for Payer: PHP Medicare Advantage |
$655.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,835.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,281.05
|
| Rate for Payer: Priority Health Medicare |
$655.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,599.10
|
| Rate for Payer: Railroad Medicare Medicare |
$655.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,307.27
|
| Rate for Payer: UHC Core |
$2,189.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$655.48
|
| Rate for Payer: UHC Medicare Advantage |
$675.14
|
| Rate for Payer: VA VA |
$655.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,966.42
|
|
|
HC MR MRA LOWR EXTREM BIL WO W
|
Facility
|
IP
|
$2,621.90
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000068
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,599.10 |
| Max. Negotiated Rate |
$2,359.71 |
| Rate for Payer: Aetna Commercial |
$2,228.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,026.20
|
| Rate for Payer: BCN Commercial |
$2,026.20
|
| Rate for Payer: Cash Price |
$2,097.52
|
| Rate for Payer: Cofinity Commercial |
$2,254.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,097.52
|
| Rate for Payer: Healthscope Commercial |
$2,359.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,966.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,228.62
|
| Rate for Payer: PHP Commercial |
$2,228.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,835.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,281.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,599.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,307.27
|
| Rate for Payer: UHC Core |
$2,189.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,966.42
|
|
|
HC MR MRA LOWR EXTREM W CON
|
Facility
|
IP
|
$3,378.08
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000069
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,060.29 |
| Max. Negotiated Rate |
$3,040.27 |
| Rate for Payer: Aetna Commercial |
$2,871.37
|
| Rate for Payer: Aetna Commercial |
$1,914.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,610.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,740.38
|
| Rate for Payer: BCN Commercial |
$1,740.38
|
| Rate for Payer: BCN Commercial |
$2,610.58
|
| Rate for Payer: Cash Price |
$2,702.46
|
| Rate for Payer: Cash Price |
$1,801.64
|
| Rate for Payer: Cofinity Commercial |
$1,936.76
|
| Rate for Payer: Cofinity Commercial |
$2,905.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.64
|
| Rate for Payer: Healthscope Commercial |
$2,026.84
|
| Rate for Payer: Healthscope Commercial |
$3,040.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,533.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,871.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,914.24
|
| Rate for Payer: PHP Commercial |
$2,871.37
|
| Rate for Payer: PHP Commercial |
$1,914.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,364.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,938.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,959.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,060.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,373.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,972.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.80
|
| Rate for Payer: UHC Core |
$1,880.46
|
| Rate for Payer: UHC Core |
$2,820.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,533.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
|
|
HC MR MRA LOWR EXTREM W CON
|
Facility
|
OP
|
$3,378.08
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000069
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$3,040.27 |
| Rate for Payer: Aetna Commercial |
$2,871.37
|
| Rate for Payer: Aetna Commercial |
$1,914.24
|
| Rate for Payer: Aetna Medicare |
$878.30
|
| Rate for Payer: Aetna Medicare |
$585.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,055.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$703.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$703.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,055.65
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$844.52
|
| Rate for Payer: BCBS MAPPO |
$563.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,750.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,626.46
|
| Rate for Payer: BCN Commercial |
$2,626.46
|
| Rate for Payer: BCN Commercial |
$1,750.97
|
| Rate for Payer: BCN Medicare Advantage |
$563.01
|
| Rate for Payer: BCN Medicare Advantage |
$844.52
|
| Rate for Payer: Cash Price |
$1,801.64
|
| Rate for Payer: Cash Price |
$1,801.64
|
| Rate for Payer: Cash Price |
$2,702.46
|
| Rate for Payer: Cash Price |
$2,702.46
|
| Rate for Payer: Cofinity Commercial |
$2,905.15
|
| Rate for Payer: Cofinity Commercial |
$1,936.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$844.52
|
| Rate for Payer: Healthscope Commercial |
$3,040.27
|
| Rate for Payer: Healthscope Commercial |
$2,026.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,533.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$591.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$886.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$647.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$971.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,914.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,871.37
|
| Rate for Payer: PACE Senior Care Partners |
$802.29
|
| Rate for Payer: PACE Senior Care Partners |
$534.86
|
| Rate for Payer: PACE SWMI |
$563.01
|
| Rate for Payer: PACE SWMI |
$844.52
|
| Rate for Payer: PHP Commercial |
$2,871.37
|
| Rate for Payer: PHP Commercial |
$1,914.24
|
| Rate for Payer: PHP Medicare Advantage |
$844.52
|
| Rate for Payer: PHP Medicare Advantage |
$563.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,364.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,959.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,938.93
|
| Rate for Payer: Priority Health Medicare |
$563.01
|
| Rate for Payer: Priority Health Medicare |
$844.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,373.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,060.29
|
| Rate for Payer: Railroad Medicare Medicare |
$563.01
|
| Rate for Payer: Railroad Medicare Medicare |
$844.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,972.71
|
| Rate for Payer: UHC Core |
$1,880.46
|
| Rate for Payer: UHC Core |
$2,820.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$844.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.01
|
| Rate for Payer: UHC Medicare Advantage |
$869.86
|
| Rate for Payer: UHC Medicare Advantage |
$579.90
|
| Rate for Payer: VA VA |
$563.01
|
| Rate for Payer: VA VA |
$844.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,533.56
|
|
|
HC MR MRA LOWR EXTREM WO CON
|
Facility
|
IP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000070
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,287.74 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna Commercial |
$2,692.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,447.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,631.69
|
| Rate for Payer: BCN Commercial |
$2,447.53
|
| Rate for Payer: BCN Commercial |
$1,631.69
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$2,533.68
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Cofinity Commercial |
$2,723.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,533.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Healthscope Commercial |
$2,850.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,583.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,375.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,692.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,794.69
|
| Rate for Payer: PHP Commercial |
$2,692.04
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,216.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,477.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,755.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,836.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,931.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,287.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,787.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,858.03
|
| Rate for Payer: UHC Core |
$1,763.02
|
| Rate for Payer: UHC Core |
$2,644.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,583.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,375.32
|
|
|
HC MR MRA LOWR EXTREM WO CON
|
Facility
|
OP
|
$3,167.10
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000070
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$2,850.39 |
| Rate for Payer: Aetna Commercial |
$2,692.04
|
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna Medicare |
$548.96
|
| Rate for Payer: Aetna Medicare |
$823.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$989.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$659.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$989.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$659.81
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$527.85
|
| Rate for Payer: BCBS MAPPO |
$791.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,462.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,641.61
|
| Rate for Payer: BCN Commercial |
$2,462.42
|
| Rate for Payer: BCN Commercial |
$1,641.61
|
| Rate for Payer: BCN Medicare Advantage |
$791.78
|
| Rate for Payer: BCN Medicare Advantage |
$527.85
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$2,533.68
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$2,533.68
|
| Rate for Payer: Cofinity Commercial |
$2,723.71
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,533.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$791.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.85
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Healthscope Commercial |
$2,850.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,583.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,375.32
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$831.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$554.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$910.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$607.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,794.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,692.04
|
| Rate for Payer: PACE Senior Care Partners |
$752.19
|
| Rate for Payer: PACE Senior Care Partners |
$501.46
|
| Rate for Payer: PACE SWMI |
$527.85
|
| Rate for Payer: PACE SWMI |
$791.78
|
| Rate for Payer: PHP Commercial |
$2,692.04
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: PHP Medicare Advantage |
$527.85
|
| Rate for Payer: PHP Medicare Advantage |
$791.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,216.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,477.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,836.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,755.38
|
| Rate for Payer: Priority Health Medicare |
$791.78
|
| Rate for Payer: Priority Health Medicare |
$527.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,287.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,931.61
|
| Rate for Payer: Railroad Medicare Medicare |
$791.78
|
| Rate for Payer: Railroad Medicare Medicare |
$527.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,858.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,787.05
|
| Rate for Payer: UHC Core |
$1,763.02
|
| Rate for Payer: UHC Core |
$2,644.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$791.78
|
| Rate for Payer: UHC Medicare Advantage |
$815.53
|
| Rate for Payer: UHC Medicare Advantage |
$543.69
|
| Rate for Payer: VA VA |
$527.85
|
| Rate for Payer: VA VA |
$791.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,375.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,583.55
|
|
|
HC MR MRA LOWR EXTREM WO W
|
Facility
|
OP
|
$2,533.57
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000071
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,280.21 |
| Rate for Payer: Aetna Commercial |
$2,153.53
|
| Rate for Payer: Aetna Commercial |
$3,230.31
|
| Rate for Payer: Aetna Medicare |
$988.09
|
| Rate for Payer: Aetna Medicare |
$658.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,187.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$791.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,187.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$791.74
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$633.39
|
| Rate for Payer: BCBS MAPPO |
$950.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,954.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,969.85
|
| Rate for Payer: BCN Commercial |
$2,954.78
|
| Rate for Payer: BCN Commercial |
$1,969.85
|
| Rate for Payer: BCN Medicare Advantage |
$950.09
|
| Rate for Payer: BCN Medicare Advantage |
$633.39
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cofinity Commercial |
$2,178.87
|
| Rate for Payer: Cofinity Commercial |
$3,268.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,040.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$950.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$633.39
|
| Rate for Payer: Healthscope Commercial |
$3,420.32
|
| Rate for Payer: Healthscope Commercial |
$2,280.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,850.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,900.18
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$997.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$665.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,092.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$728.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,153.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,230.31
|
| Rate for Payer: PACE Senior Care Partners |
$601.72
|
| Rate for Payer: PACE Senior Care Partners |
$902.59
|
| Rate for Payer: PACE SWMI |
$950.09
|
| Rate for Payer: PACE SWMI |
$633.39
|
| Rate for Payer: PHP Commercial |
$2,153.53
|
| Rate for Payer: PHP Commercial |
$3,230.31
|
| Rate for Payer: PHP Medicare Advantage |
$950.09
|
| Rate for Payer: PHP Medicare Advantage |
$633.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,660.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,306.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,204.21
|
| Rate for Payer: Priority Health Medicare |
$950.09
|
| Rate for Payer: Priority Health Medicare |
$633.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,317.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,545.22
|
| Rate for Payer: Railroad Medicare Medicare |
$633.39
|
| Rate for Payer: Railroad Medicare Medicare |
$950.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,229.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,344.32
|
| Rate for Payer: UHC Core |
$2,115.53
|
| Rate for Payer: UHC Core |
$3,173.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$950.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$633.39
|
| Rate for Payer: UHC Medicare Advantage |
$652.39
|
| Rate for Payer: UHC Medicare Advantage |
$978.59
|
| Rate for Payer: VA VA |
$950.09
|
| Rate for Payer: VA VA |
$633.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,900.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,850.27
|
|
