|
HC MR UPPER EXTREM BIL NO JOINT WO CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000017
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,373.53 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,740.39
|
| Rate for Payer: BCN Commercial |
$1,740.39
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,914.25
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,576.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,959.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,373.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.81
|
| Rate for Payer: UHC Core |
$1,880.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
|
|
HC MR UPPER EXTREM BIL NO JOINT WO W CON
|
Facility
|
IP
|
$2,533.58
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000021
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,545.23 |
| Max. Negotiated Rate |
$2,280.22 |
| Rate for Payer: Aetna Commercial |
$2,153.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,957.95
|
| Rate for Payer: BCN Commercial |
$1,957.95
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cofinity Commercial |
$2,178.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Healthscope Commercial |
$2,280.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,900.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,153.54
|
| Rate for Payer: PHP Commercial |
$2,153.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,204.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,545.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,229.55
|
| Rate for Payer: UHC Core |
$2,115.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,900.18
|
|
|
HC MR UPPER EXTREM BIL NO JOINT WO W CON
|
Facility
|
OP
|
$2,533.58
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000021
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$2,280.22 |
| Rate for Payer: Aetna Commercial |
$2,153.54
|
| Rate for Payer: Aetna Medicare |
$658.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$791.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$791.74
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$633.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,969.86
|
| Rate for Payer: BCN Commercial |
$1,969.86
|
| Rate for Payer: BCN Medicare Advantage |
$633.40
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cofinity Commercial |
$2,178.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$633.40
|
| Rate for Payer: Healthscope Commercial |
$2,280.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,900.18
|
| Rate for Payer: Mclaren Medicaid |
$252.28
|
| Rate for Payer: Meridian Medicaid |
$264.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$665.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$728.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,153.54
|
| Rate for Payer: PACE Senior Care Partners |
$601.73
|
| Rate for Payer: PACE SWMI |
$633.40
|
| Rate for Payer: PHP Commercial |
$2,153.54
|
| Rate for Payer: PHP Medicare Advantage |
$633.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,204.21
|
| Rate for Payer: Priority Health Medicare |
$633.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,545.23
|
| Rate for Payer: Railroad Medicare Medicare |
$633.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,229.55
|
| Rate for Payer: UHC Core |
$2,115.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$633.40
|
| Rate for Payer: UHC Medicare Advantage |
$652.40
|
| Rate for Payer: VA VA |
$633.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,900.18
|
|
|
HC MR UPPER EXTREM NO JOINT W CON
|
Facility
|
IP
|
$2,329.17
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000018
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,420.56 |
| Max. Negotiated Rate |
$2,096.25 |
| Rate for Payer: Aetna Commercial |
$1,979.79
|
| Rate for Payer: Aetna Commercial |
$2,969.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,799.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,699.97
|
| Rate for Payer: BCN Commercial |
$2,699.97
|
| Rate for Payer: BCN Commercial |
$1,799.98
|
| Rate for Payer: Cash Price |
$2,795.00
|
| Rate for Payer: Cash Price |
$1,863.34
|
| Rate for Payer: Cofinity Commercial |
$3,004.62
|
| Rate for Payer: Cofinity Commercial |
$2,003.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,795.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,863.34
|
| Rate for Payer: Healthscope Commercial |
$2,096.25
|
| Rate for Payer: Healthscope Commercial |
$3,144.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,620.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,746.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,979.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,969.69
|
| Rate for Payer: PHP Commercial |
$1,979.79
|
| Rate for Payer: PHP Commercial |
$2,969.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,445.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,026.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,039.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,130.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,420.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,049.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,074.50
|
| Rate for Payer: UHC Core |
$1,944.86
|
| Rate for Payer: UHC Core |
$2,917.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,746.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,620.31
|
|
|
HC MR UPPER EXTREM NO JOINT W CON
|
Facility
|
OP
|
$3,493.75
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000018
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$3,144.38 |
| Rate for Payer: Aetna Commercial |
$2,969.69
|
| Rate for Payer: Aetna Commercial |
$1,979.79
|
| Rate for Payer: Aetna Medicare |
$605.58
|
| Rate for Payer: Aetna Medicare |
$908.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,091.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$727.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,091.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$727.87
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$582.29
|
| Rate for Payer: BCBS MAPPO |
$873.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,810.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,716.39
|
| Rate for Payer: BCN Commercial |
$1,810.93
|
| Rate for Payer: BCN Commercial |
$2,716.39
|
| Rate for Payer: BCN Medicare Advantage |
$582.29
|
| Rate for Payer: BCN Medicare Advantage |
$873.44
|
| Rate for Payer: Cash Price |
$1,863.34
|
| Rate for Payer: Cash Price |
$2,795.00
|
| Rate for Payer: Cash Price |
$1,863.34
|
| Rate for Payer: Cash Price |
$2,795.00
|
| Rate for Payer: Cofinity Commercial |
$3,004.62
|
| Rate for Payer: Cofinity Commercial |
$2,003.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,795.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,863.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$873.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$582.29
|
| Rate for Payer: Healthscope Commercial |
$2,096.25
|
| Rate for Payer: Healthscope Commercial |
$3,144.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,746.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,620.31
|
| 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 |
$917.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$611.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,004.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$669.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,979.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,969.69
|
| Rate for Payer: PACE Senior Care Partners |
$829.77
|
| Rate for Payer: PACE Senior Care Partners |
$553.18
|
| Rate for Payer: PACE SWMI |
$582.29
|
| Rate for Payer: PACE SWMI |
$873.44
|
| Rate for Payer: PHP Commercial |
$2,969.69
|
| Rate for Payer: PHP Commercial |
$1,979.79
|
| Rate for Payer: PHP Medicare Advantage |
$582.29
|
| Rate for Payer: PHP Medicare Advantage |
$873.44
|
| 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 |
$2,445.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,026.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,039.56
|
| Rate for Payer: Priority Health Medicare |
$873.44
|
| Rate for Payer: Priority Health Medicare |
$582.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,420.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,130.84
|
| Rate for Payer: Railroad Medicare Medicare |
$873.44
|
| Rate for Payer: Railroad Medicare Medicare |
$582.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,074.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,049.67
|
| Rate for Payer: UHC Core |
$2,917.28
|
| Rate for Payer: UHC Core |
$1,944.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$582.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$873.44
|
| Rate for Payer: UHC Medicare Advantage |
$899.64
|
| Rate for Payer: UHC Medicare Advantage |
$599.76
|
| Rate for Payer: VA VA |
$873.44
|
| Rate for Payer: VA VA |
$582.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,746.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,620.31
|
|
|
HC MR UPPER EXTREM NO JOINT WO CON
|
Facility
|
OP
|
$1,995.22
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000016
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,795.70 |
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna Commercial |
$2,543.91
|
| Rate for Payer: Aetna Medicare |
$778.14
|
| Rate for Payer: Aetna Medicare |
$518.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$935.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$935.26
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$498.80
|
| Rate for Payer: BCBS MAPPO |
$748.21
|
| Rate for Payer: BCBS Trust/PPO |
$2,326.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,551.28
|
| Rate for Payer: BCN Commercial |
$2,326.93
|
| Rate for Payer: BCN Commercial |
$1,551.28
|
| Rate for Payer: BCN Medicare Advantage |
$498.80
|
| Rate for Payer: BCN Medicare Advantage |
$748.21
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Cofinity Commercial |
$2,573.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$748.21
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Healthscope Commercial |
$2,693.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,244.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.42
|
| 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 |
$785.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$523.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$860.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,695.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,543.91
|
| Rate for Payer: PACE Senior Care Partners |
$710.80
|
| Rate for Payer: PACE Senior Care Partners |
$473.86
|
| Rate for Payer: PACE SWMI |
$498.80
|
| Rate for Payer: PACE SWMI |
$748.21
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| Rate for Payer: PHP Commercial |
$2,543.91
|
| Rate for Payer: PHP Medicare Advantage |
$498.80
|
| Rate for Payer: PHP Medicare Advantage |
$748.21
|
| 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 |
$2,094.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,603.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,735.84
|
| Rate for Payer: Priority Health Medicare |
$748.21
|
| Rate for Payer: Priority Health Medicare |
$498.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,825.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,216.88
|
| Rate for Payer: Railroad Medicare Medicare |
$748.21
|
| Rate for Payer: Railroad Medicare Medicare |
$498.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,755.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,633.69
|
| Rate for Payer: UHC Core |
$1,666.01
|
| Rate for Payer: UHC Core |
$2,499.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$748.21
|
| Rate for Payer: UHC Medicare Advantage |
$770.65
|
| Rate for Payer: UHC Medicare Advantage |
$513.77
|
| Rate for Payer: VA VA |
$498.80
|
| Rate for Payer: VA VA |
$748.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,244.62
|
|
|
HC MR UPPER EXTREM NO JOINT WO CON
|
Facility
|
IP
|
$1,995.22
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000016
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,216.88 |
| Max. Negotiated Rate |
$1,795.70 |
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna Commercial |
$2,543.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,541.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,312.86
|
| Rate for Payer: BCN Commercial |
$2,312.86
|
| Rate for Payer: BCN Commercial |
$1,541.91
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Cofinity Commercial |
$2,573.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Healthscope Commercial |
$2,693.55
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,244.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,543.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,695.94
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| Rate for Payer: PHP Commercial |
$2,543.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,094.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,603.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,735.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,825.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,216.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,633.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,755.79
|
| Rate for Payer: UHC Core |
$1,666.01
|
| Rate for Payer: UHC Core |
$2,499.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,244.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.42
|
|
|
HC MR UPPER EXTREM NO JOINT WO W CON
|
Facility
|
OP
|
$3,436.30
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000020
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.28 |
| Max. Negotiated Rate |
$3,092.67 |
| Rate for Payer: Aetna Commercial |
$2,920.86
|
| Rate for Payer: Aetna Commercial |
$1,947.23
|
| Rate for Payer: Aetna Medicare |
$893.44
|
| Rate for Payer: Aetna Medicare |
$595.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,073.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$715.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$715.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,073.84
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS Complete |
$264.89
|
| Rate for Payer: BCBS MAPPO |
$859.08
|
| Rate for Payer: BCBS MAPPO |
$572.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,781.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,671.72
|
| Rate for Payer: BCN Commercial |
$2,671.72
|
| Rate for Payer: BCN Commercial |
$1,781.14
|
| Rate for Payer: BCN Medicare Advantage |
$572.72
|
| Rate for Payer: BCN Medicare Advantage |
$859.08
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cofinity Commercial |
$1,970.14
|
| Rate for Payer: Cofinity Commercial |
$2,955.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$859.08
|
| Rate for Payer: Healthscope Commercial |
$3,092.67
|
| Rate for Payer: Healthscope Commercial |
$2,061.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,577.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,718.14
|
| 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 |
$902.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$601.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$987.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$658.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,920.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,947.23
|
| Rate for Payer: PACE Senior Care Partners |
$816.12
|
| Rate for Payer: PACE Senior Care Partners |
$544.08
|
| Rate for Payer: PACE SWMI |
$859.08
|
| Rate for Payer: PACE SWMI |
$572.72
|
| Rate for Payer: PHP Commercial |
$1,947.23
|
| Rate for Payer: PHP Commercial |
$2,920.86
|
| Rate for Payer: PHP Medicare Advantage |
$859.08
|
| Rate for Payer: PHP Medicare Advantage |
$572.72
|
| 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 |
$1,603.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,405.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,993.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,989.58
|
| Rate for Payer: Priority Health Medicare |
$859.08
|
| Rate for Payer: Priority Health Medicare |
$572.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,095.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,397.20
|
| Rate for Payer: Railroad Medicare Medicare |
$572.72
|
| Rate for Payer: Railroad Medicare Medicare |
$859.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,023.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,015.96
|
| Rate for Payer: UHC Core |
$1,912.87
|
| Rate for Payer: UHC Core |
$2,869.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$859.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$572.72
|
| Rate for Payer: UHC Medicare Advantage |
$884.85
|
| Rate for Payer: UHC Medicare Advantage |
$589.90
|
| Rate for Payer: VA VA |
$572.72
|
| Rate for Payer: VA VA |
$859.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,577.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,718.14
|
|
|
HC MR UPPER EXTREM NO JOINT WO W CON
|
Facility
|
IP
|
$2,290.86
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000020
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,397.20 |
| Max. Negotiated Rate |
$2,061.77 |
| Rate for Payer: Aetna Commercial |
$1,947.23
|
| Rate for Payer: Aetna Commercial |
$2,920.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,655.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,770.38
|
| Rate for Payer: BCN Commercial |
$1,770.38
|
| Rate for Payer: BCN Commercial |
$2,655.57
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cofinity Commercial |
$2,955.22
|
| Rate for Payer: Cofinity Commercial |
$1,970.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Healthscope Commercial |
$3,092.67
|
| Rate for Payer: Healthscope Commercial |
$2,061.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,577.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,718.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,920.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,947.23
|
| Rate for Payer: PHP Commercial |
$2,920.86
|
| Rate for Payer: PHP Commercial |
$1,947.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,603.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,405.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,993.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,989.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,397.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,095.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,015.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,023.94
|
| Rate for Payer: UHC Core |
$2,869.31
|
| Rate for Payer: UHC Core |
$1,912.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,718.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,577.22
|
|
|
HC MSMART BM CMPT1
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100045
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$146.38 |
| Max. Negotiated Rate |
$216.00 |
| Rate for Payer: Aetna Commercial |
$204.00
|
| Rate for Payer: BCBS Trust/PPO |
$185.47
|
| Rate for Payer: BCN Commercial |
$185.47
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$206.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.00
|
| Rate for Payer: Healthscope Commercial |
$216.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$204.00
|
| Rate for Payer: PHP Commercial |
$204.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.20
|
| Rate for Payer: UHC Core |
$200.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.00
|
|
|
HC MSMART BM CMPT1
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100045
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$35.55 |
| Max. Negotiated Rate |
$216.00 |
| Rate for Payer: Aetna Commercial |
$204.00
|
| Rate for Payer: Aetna Medicare |
$62.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75.00
|
| Rate for Payer: BCBS Complete |
$37.33
|
| Rate for Payer: BCBS MAPPO |
$60.00
|
| Rate for Payer: BCBS Trust/PPO |
$186.60
|
| Rate for Payer: BCN Commercial |
$186.60
|
| Rate for Payer: BCN Medicare Advantage |
$60.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$206.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$216.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.00
|
| Rate for Payer: Mclaren Medicaid |
$35.55
|
| Rate for Payer: Meridian Medicaid |
$37.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$63.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$204.00
|
| Rate for Payer: PACE Senior Care Partners |
$57.00
|
| Rate for Payer: PACE SWMI |
$60.00
|
| Rate for Payer: PHP Commercial |
$204.00
|
| Rate for Payer: PHP Medicare Advantage |
$60.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.80
|
| Rate for Payer: Priority Health Medicare |
$60.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.38
|
| Rate for Payer: Railroad Medicare Medicare |
$60.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.20
|
| Rate for Payer: UHC Core |
$200.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.00
|
| Rate for Payer: UHC Medicare Advantage |
$61.80
|
| Rate for Payer: VA VA |
$60.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.00
|
|
|
HC MSMART BM CMPT2
|
Facility
|
OP
|
$167.43
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100046
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$39.76 |
| Max. Negotiated Rate |
$247.59 |
| Rate for Payer: Aetna Commercial |
$142.32
|
| Rate for Payer: Aetna Medicare |
$43.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.32
|
| Rate for Payer: BCBS Complete |
$247.59
|
| Rate for Payer: BCBS MAPPO |
$41.86
|
| Rate for Payer: BCBS Trust/PPO |
$130.18
|
| Rate for Payer: BCN Commercial |
$130.18
|
| Rate for Payer: BCN Medicare Advantage |
$41.86
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Cofinity Commercial |
$143.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.86
|
| Rate for Payer: Healthscope Commercial |
$150.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.57
|
| Rate for Payer: Mclaren Medicaid |
$235.80
|
| Rate for Payer: Meridian Medicaid |
$247.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.32
|
| Rate for Payer: PACE Senior Care Partners |
$39.76
|
| Rate for Payer: PACE SWMI |
$41.86
|
| Rate for Payer: PHP Commercial |
$142.32
|
| Rate for Payer: PHP Medicare Advantage |
$41.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.66
|
| Rate for Payer: Priority Health Medicare |
$41.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.12
|
| Rate for Payer: Railroad Medicare Medicare |
$41.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.34
|
| Rate for Payer: UHC Core |
$139.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.86
|
| Rate for Payer: UHC Medicare Advantage |
$43.11
|
| Rate for Payer: VA VA |
$41.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.57
|
|
|
HC MSMART BM CMPT2
|
Facility
|
IP
|
$167.43
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100046
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$102.12 |
| Max. Negotiated Rate |
$150.69 |
| Rate for Payer: Aetna Commercial |
$142.32
|
| Rate for Payer: BCBS Trust/PPO |
$129.39
|
| Rate for Payer: BCN Commercial |
$129.39
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Cofinity Commercial |
$143.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.94
|
| Rate for Payer: Healthscope Commercial |
$150.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.32
|
| Rate for Payer: PHP Commercial |
$142.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.34
|
| Rate for Payer: UHC Core |
$139.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.57
|
|
|
HC MSMART BM CMPT3
|
Facility
|
OP
|
$173.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100047
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$41.09 |
| Max. Negotiated Rate |
$155.70 |
| Rate for Payer: Aetna Commercial |
$147.05
|
| Rate for Payer: Aetna Medicare |
$44.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.06
|
| Rate for Payer: BCBS Complete |
$69.20
|
| Rate for Payer: BCBS MAPPO |
$43.25
|
| Rate for Payer: BCBS Trust/PPO |
$134.51
|
| Rate for Payer: BCN Commercial |
$134.51
|
| Rate for Payer: BCN Medicare Advantage |
$43.25
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$148.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.25
|
| Rate for Payer: Healthscope Commercial |
$155.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.05
|
| Rate for Payer: PACE Senior Care Partners |
$41.09
|
| Rate for Payer: PACE SWMI |
$43.25
|
| Rate for Payer: PHP Commercial |
$147.05
|
| Rate for Payer: PHP Medicare Advantage |
$43.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.51
|
| Rate for Payer: Priority Health Medicare |
$43.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.51
|
| Rate for Payer: Railroad Medicare Medicare |
$43.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.24
|
| Rate for Payer: UHC Core |
$144.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.25
|
| Rate for Payer: UHC Medicare Advantage |
$44.55
|
| Rate for Payer: VA VA |
$43.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.75
|
|
|
HC MSMART BM CMPT3
|
Facility
|
IP
|
$173.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100047
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$105.51 |
| Max. Negotiated Rate |
$155.70 |
| Rate for Payer: Aetna Commercial |
$147.05
|
| Rate for Payer: BCBS Trust/PPO |
$133.69
|
| Rate for Payer: BCN Commercial |
$133.69
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$148.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.40
|
| Rate for Payer: Healthscope Commercial |
$155.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.05
|
| Rate for Payer: PHP Commercial |
$147.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.24
|
| Rate for Payer: UHC Core |
$144.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.75
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR
|
Facility
|
IP
|
$63.99
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600293
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.03 |
| Max. Negotiated Rate |
$57.59 |
| Rate for Payer: Aetna Commercial |
$54.39
|
| Rate for Payer: BCBS Trust/PPO |
$49.45
|
| Rate for Payer: BCN Commercial |
$49.45
|
| Rate for Payer: Cash Price |
$51.19
|
| Rate for Payer: Cofinity Commercial |
$55.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$57.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.39
|
| Rate for Payer: PHP Commercial |
$54.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.31
|
| Rate for Payer: UHC Core |
$53.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.99
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR
|
Facility
|
OP
|
$63.99
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600293
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$57.59 |
| Rate for Payer: Aetna Commercial |
$54.39
|
| Rate for Payer: Aetna Medicare |
$16.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.00
|
| Rate for Payer: BCBS Complete |
$32.30
|
| Rate for Payer: BCBS MAPPO |
$16.00
|
| Rate for Payer: BCBS Trust/PPO |
$49.75
|
| Rate for Payer: BCN Commercial |
$49.75
|
| Rate for Payer: BCN Medicare Advantage |
$16.00
|
| Rate for Payer: Cash Price |
$51.19
|
| Rate for Payer: Cash Price |
$51.19
|
| Rate for Payer: Cofinity Commercial |
$55.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.00
|
| Rate for Payer: Healthscope Commercial |
$57.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.99
|
| Rate for Payer: Mclaren Medicaid |
$30.76
|
| Rate for Payer: Meridian Medicaid |
$32.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.39
|
| Rate for Payer: PACE Senior Care Partners |
$15.20
|
| Rate for Payer: PACE SWMI |
$16.00
|
| Rate for Payer: PHP Commercial |
$54.39
|
| Rate for Payer: PHP Medicare Advantage |
$16.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.67
|
| Rate for Payer: Priority Health Medicare |
$16.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.03
|
| Rate for Payer: Railroad Medicare Medicare |
$16.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.31
|
| Rate for Payer: UHC Core |
$53.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.00
|
| Rate for Payer: UHC Medicare Advantage |
$16.48
|
| Rate for Payer: VA VA |
$16.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.99
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
IP
|
$53.50
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.63 |
| Max. Negotiated Rate |
$48.15 |
| Rate for Payer: Aetna Commercial |
$45.48
|
| Rate for Payer: BCBS Trust/PPO |
$41.34
|
| Rate for Payer: BCN Commercial |
$41.34
|
| Rate for Payer: Cash Price |
$42.80
|
| Rate for Payer: Cofinity Commercial |
$46.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.80
|
| Rate for Payer: Healthscope Commercial |
$48.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.48
|
| Rate for Payer: PHP Commercial |
$45.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.08
|
| Rate for Payer: UHC Core |
$44.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.12
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
OP
|
$53.50
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.71 |
| Max. Negotiated Rate |
$48.15 |
| Rate for Payer: Aetna Commercial |
$45.48
|
| Rate for Payer: Aetna Medicare |
$13.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.72
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$13.38
|
| Rate for Payer: BCBS Trust/PPO |
$41.60
|
| Rate for Payer: BCN Commercial |
$41.60
|
| Rate for Payer: BCN Medicare Advantage |
$13.38
|
| Rate for Payer: Cash Price |
$42.80
|
| Rate for Payer: Cash Price |
$42.80
|
| Rate for Payer: Cofinity Commercial |
$46.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.38
|
| Rate for Payer: Healthscope Commercial |
$48.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.12
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.48
|
| Rate for Payer: PACE Senior Care Partners |
$12.71
|
| Rate for Payer: PACE SWMI |
$13.38
|
| Rate for Payer: PHP Commercial |
$45.48
|
| Rate for Payer: PHP Medicare Advantage |
$13.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.54
|
| Rate for Payer: Priority Health Medicare |
$13.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.63
|
| Rate for Payer: Railroad Medicare Medicare |
$13.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.08
|
| Rate for Payer: UHC Core |
$44.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.38
|
| Rate for Payer: UHC Medicare Advantage |
$13.78
|
| Rate for Payer: VA VA |
$13.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.12
|
|
|
HC MTHFR 2 MUTATIONS
|
Facility
|
IP
|
$497.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000126
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$303.12 |
| Max. Negotiated Rate |
$447.30 |
| Rate for Payer: Aetna Commercial |
$422.45
|
| Rate for Payer: BCBS Trust/PPO |
$384.08
|
| Rate for Payer: BCN Commercial |
$384.08
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cofinity Commercial |
$427.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$397.60
|
| Rate for Payer: Healthscope Commercial |
$447.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$372.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$422.45
|
| Rate for Payer: PHP Commercial |
$422.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$432.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$303.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$437.36
|
| Rate for Payer: UHC Core |
$415.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$372.75
|
|
|
HC MTHFR 2 MUTATIONS
|
Facility
|
OP
|
$497.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000126
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$48.22 |
| Max. Negotiated Rate |
$447.30 |
| Rate for Payer: Aetna Commercial |
$422.45
|
| Rate for Payer: Aetna Medicare |
$129.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.31
|
| Rate for Payer: BCBS Complete |
$50.63
|
| Rate for Payer: BCBS MAPPO |
$124.25
|
| Rate for Payer: BCBS Trust/PPO |
$386.42
|
| Rate for Payer: BCN Commercial |
$386.42
|
| Rate for Payer: BCN Medicare Advantage |
$124.25
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cofinity Commercial |
$427.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$397.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.25
|
| Rate for Payer: Healthscope Commercial |
$447.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$372.75
|
| Rate for Payer: Mclaren Medicaid |
$48.22
|
| Rate for Payer: Meridian Medicaid |
$50.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$130.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$142.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$422.45
|
| Rate for Payer: PACE Senior Care Partners |
$118.04
|
| Rate for Payer: PACE SWMI |
$124.25
|
| Rate for Payer: PHP Commercial |
$422.45
|
| Rate for Payer: PHP Medicare Advantage |
$124.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$432.39
|
| Rate for Payer: Priority Health Medicare |
$124.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$303.12
|
| Rate for Payer: Railroad Medicare Medicare |
$124.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$437.36
|
| Rate for Payer: UHC Core |
$415.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.25
|
| Rate for Payer: UHC Medicare Advantage |
$127.98
|
| Rate for Payer: VA VA |
$124.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$372.75
|
|
|
HC MTHFR MUTATION
|
Facility
|
OP
|
$375.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000102
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$48.22 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna Commercial |
$318.75
|
| Rate for Payer: Aetna Medicare |
$97.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$117.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$117.19
|
| Rate for Payer: BCBS Complete |
$50.63
|
| Rate for Payer: BCBS MAPPO |
$93.75
|
| Rate for Payer: BCBS Trust/PPO |
$291.56
|
| Rate for Payer: BCN Commercial |
$291.56
|
| Rate for Payer: BCN Medicare Advantage |
$93.75
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$322.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.75
|
| Rate for Payer: Healthscope Commercial |
$337.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.25
|
| Rate for Payer: Mclaren Medicaid |
$48.22
|
| Rate for Payer: Meridian Medicaid |
$50.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.75
|
| Rate for Payer: PACE Senior Care Partners |
$89.06
|
| Rate for Payer: PACE SWMI |
$93.75
|
| Rate for Payer: PHP Commercial |
$318.75
|
| Rate for Payer: PHP Medicare Advantage |
$93.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$326.25
|
| Rate for Payer: Priority Health Medicare |
$93.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.71
|
| Rate for Payer: Railroad Medicare Medicare |
$93.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.00
|
| Rate for Payer: UHC Core |
$313.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.75
|
| Rate for Payer: UHC Medicare Advantage |
$96.56
|
| Rate for Payer: VA VA |
$93.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.25
|
|
|
HC MTHFR MUTATION
|
Facility
|
IP
|
$375.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000102
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$228.71 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna Commercial |
$318.75
|
| Rate for Payer: BCBS Trust/PPO |
$289.80
|
| Rate for Payer: BCN Commercial |
$289.80
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$322.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.00
|
| Rate for Payer: Healthscope Commercial |
$337.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.75
|
| Rate for Payer: PHP Commercial |
$318.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$326.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.00
|
| Rate for Payer: UHC Core |
$313.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.25
|
|
|
HC M TUBERCULOSIS COMPLEX, PCR
|
Facility
|
IP
|
$194.00
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600291
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$118.32 |
| Max. Negotiated Rate |
$174.60 |
| Rate for Payer: Aetna Commercial |
$164.90
|
| Rate for Payer: BCBS Trust/PPO |
$149.92
|
| Rate for Payer: BCN Commercial |
$149.92
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$166.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.20
|
| Rate for Payer: Healthscope Commercial |
$174.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.90
|
| Rate for Payer: PHP Commercial |
$164.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.72
|
| Rate for Payer: UHC Core |
$161.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.50
|
|
|
HC M TUBERCULOSIS COMPLEX, PCR
|
Facility
|
OP
|
$194.00
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600291
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.76 |
| Max. Negotiated Rate |
$174.60 |
| Rate for Payer: Aetna Commercial |
$164.90
|
| Rate for Payer: Aetna Medicare |
$50.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.62
|
| Rate for Payer: BCBS Complete |
$32.30
|
| Rate for Payer: BCBS MAPPO |
$48.50
|
| Rate for Payer: BCBS Trust/PPO |
$150.84
|
| Rate for Payer: BCN Commercial |
$150.84
|
| Rate for Payer: BCN Medicare Advantage |
$48.50
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$166.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.50
|
| Rate for Payer: Healthscope Commercial |
$174.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.50
|
| Rate for Payer: Mclaren Medicaid |
$30.76
|
| Rate for Payer: Meridian Medicaid |
$32.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.90
|
| Rate for Payer: PACE Senior Care Partners |
$46.08
|
| Rate for Payer: PACE SWMI |
$48.50
|
| Rate for Payer: PHP Commercial |
$164.90
|
| Rate for Payer: PHP Medicare Advantage |
$48.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.78
|
| Rate for Payer: Priority Health Medicare |
$48.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.32
|
| Rate for Payer: Railroad Medicare Medicare |
$48.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.72
|
| Rate for Payer: UHC Core |
$161.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.50
|
| Rate for Payer: UHC Medicare Advantage |
$49.96
|
| Rate for Payer: VA VA |
$48.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.50
|
|
