|
HC I-131 SOL (DX) PER MCI
|
Facility
|
OP
|
$48.83
|
|
|
Service Code
|
HCPCS A9529
|
| Hospital Charge Code |
34300012
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$43.95 |
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna Medicare |
$12.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.26
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$12.21
|
| Rate for Payer: BCBS Trust/PPO |
$40.14
|
| Rate for Payer: BCN Commercial |
$40.14
|
| Rate for Payer: BCN Medicare Advantage |
$12.21
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.21
|
| Rate for Payer: Healthscope Commercial |
$43.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.82
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Nomi Health Commercial |
$40.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PACE Senior Care Partners |
$11.60
|
| Rate for Payer: PACE SWMI |
$12.21
|
| Rate for Payer: PHP Commercial |
$41.51
|
| Rate for Payer: PHP Medicare Advantage |
$12.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.48
|
| Rate for Payer: Priority Health Medicare |
$12.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.99
|
| Rate for Payer: Railroad Medicare Medicare |
$12.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.97
|
| Rate for Payer: UHC Core |
$40.77
|
| Rate for Payer: UHC Exchange |
$12.21
|
| Rate for Payer: UHC Medicaid |
$8.61
|
| Rate for Payer: UHC Medicare Advantage |
$12.21
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$12.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
HC I-131 SOL (TX) PER MCI
|
Facility
|
IP
|
$48.83
|
|
|
Service Code
|
HCPCS A9530
|
| Hospital Charge Code |
34400002
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$33.99 |
| Max. Negotiated Rate |
$43.95 |
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: BCBS Trust/PPO |
$40.33
|
| Rate for Payer: BCN Commercial |
$40.33
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$43.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Nomi Health Commercial |
$40.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PHP Commercial |
$41.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.97
|
| Rate for Payer: UHC Core |
$40.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
HC I-131 SOL (TX) PER MCI
|
Facility
|
OP
|
$48.83
|
|
|
Service Code
|
HCPCS A9530
|
| Hospital Charge Code |
34400002
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$43.95 |
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna Medicare |
$12.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.26
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$12.21
|
| Rate for Payer: BCBS Trust/PPO |
$40.14
|
| Rate for Payer: BCN Commercial |
$40.14
|
| Rate for Payer: BCN Medicare Advantage |
$12.21
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.21
|
| Rate for Payer: Healthscope Commercial |
$43.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.82
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Nomi Health Commercial |
$40.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PACE Senior Care Partners |
$11.60
|
| Rate for Payer: PACE SWMI |
$12.21
|
| Rate for Payer: PHP Commercial |
$41.51
|
| Rate for Payer: PHP Medicare Advantage |
$12.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.48
|
| Rate for Payer: Priority Health Medicare |
$12.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.99
|
| Rate for Payer: Railroad Medicare Medicare |
$12.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.97
|
| Rate for Payer: UHC Core |
$40.77
|
| Rate for Payer: UHC Exchange |
$12.21
|
| Rate for Payer: UHC Medicaid |
$8.61
|
| Rate for Payer: UHC Medicare Advantage |
$12.21
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: VA VA |
$12.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
HC IAAD NOS EACH ORGANISM AG IA
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600341
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.88 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$27.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.47
|
| Rate for Payer: BCBS Complete |
$19.82
|
| Rate for Payer: BCBS MAPPO |
$26.77
|
| Rate for Payer: BCBS Trust/PPO |
$88.05
|
| Rate for Payer: BCN Commercial |
$88.05
|
| Rate for Payer: BCN Medicare Advantage |
$26.77
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.77
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.33
|
| Rate for Payer: Mclaren Medicaid |
$18.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.11
|
| Rate for Payer: Meridian Medicaid |
$19.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.33
|
| Rate for Payer: PACE Senior Care Partners |
$25.44
|
| Rate for Payer: PACE SWMI |
$26.77
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: PHP Medicare Advantage |
$26.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.18
|
| Rate for Payer: Priority Health Medicare |
$27.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.54
|
| Rate for Payer: Railroad Medicare Medicare |
$26.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.25
|
| Rate for Payer: UHC Core |
$89.43
|
| Rate for Payer: UHC Exchange |
$26.77
|
| Rate for Payer: UHC Medicaid |
$18.88
|
| Rate for Payer: UHC Medicare Advantage |
$26.77
|
| Rate for Payer: UHCCP Medicaid |
$18.88
|
| Rate for Payer: VA VA |
$26.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.33
|
|
|
HC IAAD NOS EACH ORGANISM AG IA
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600341
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$74.54 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: BCBS Trust/PPO |
$88.45
|
| Rate for Payer: BCN Commercial |
$88.45
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: Nomi Health Commercial |
$87.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.33
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.25
|
| Rate for Payer: UHC Core |
$89.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.33
|
|
|
HC IAPB MONITORING SERVICES HOURL
|
Facility
|
IP
|
$416.84
|
|
| Hospital Charge Code |
27000118
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$290.12 |
| Max. Negotiated Rate |
$375.16 |
| Rate for Payer: Aetna Commercial |
$354.31
|
| Rate for Payer: BCBS Trust/PPO |
$344.27
|
| Rate for Payer: BCN Commercial |
$344.27
|
| Rate for Payer: Cash Price |
$333.47
|
| Rate for Payer: Cofinity Commercial |
$358.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.47
|
| Rate for Payer: Healthscope Commercial |
$375.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.31
|
| Rate for Payer: Nomi Health Commercial |
$341.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.63
|
| Rate for Payer: PHP Commercial |
$354.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$290.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.82
|
| Rate for Payer: UHC Core |
$348.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.63
|
|
|
HC IAPB MONITORING SERVICES HOURL
|
Facility
|
OP
|
$416.84
|
|
| Hospital Charge Code |
27000118
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$73.49 |
| Max. Negotiated Rate |
$375.16 |
| Rate for Payer: Aetna Commercial |
$354.31
|
| Rate for Payer: Aetna Medicare |
$108.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.26
|
| Rate for Payer: BCBS Complete |
$77.16
|
| Rate for Payer: BCBS MAPPO |
$104.21
|
| Rate for Payer: BCBS Trust/PPO |
$342.68
|
| Rate for Payer: BCN Commercial |
$342.68
|
| Rate for Payer: BCN Medicare Advantage |
$104.21
|
| Rate for Payer: Cash Price |
$333.47
|
| Rate for Payer: Cofinity Commercial |
$358.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.21
|
| Rate for Payer: Healthscope Commercial |
$375.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.63
|
| Rate for Payer: Mclaren Medicaid |
$73.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.42
|
| Rate for Payer: Meridian Medicaid |
$77.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.31
|
| Rate for Payer: Nomi Health Commercial |
$341.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.63
|
| Rate for Payer: PACE Senior Care Partners |
$99.00
|
| Rate for Payer: PACE SWMI |
$104.21
|
| Rate for Payer: PHP Commercial |
$354.31
|
| Rate for Payer: PHP Medicare Advantage |
$104.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.65
|
| Rate for Payer: Priority Health Medicare |
$105.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$290.12
|
| Rate for Payer: Railroad Medicare Medicare |
$104.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.82
|
| Rate for Payer: UHC Core |
$348.06
|
| Rate for Payer: UHC Exchange |
$104.21
|
| Rate for Payer: UHC Medicaid |
$73.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.21
|
| Rate for Payer: UHCCP Medicaid |
$73.49
|
| Rate for Payer: VA VA |
$104.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.63
|
|
|
HC IAP CHEMO ADMINISTRATON
|
Facility
|
OP
|
$406.41
|
|
|
Service Code
|
CPT 96420
|
| Hospital Charge Code |
33500010
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$71.65 |
| Max. Negotiated Rate |
$365.77 |
| Rate for Payer: Aetna Commercial |
$345.45
|
| Rate for Payer: Aetna Medicare |
$105.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$127.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$127.00
|
| Rate for Payer: BCBS Complete |
$75.23
|
| Rate for Payer: BCBS MAPPO |
$101.60
|
| Rate for Payer: BCBS Trust/PPO |
$334.11
|
| Rate for Payer: BCN Commercial |
$334.11
|
| Rate for Payer: BCN Medicare Advantage |
$101.60
|
| Rate for Payer: Cash Price |
$325.13
|
| Rate for Payer: Cofinity Commercial |
$349.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.60
|
| Rate for Payer: Healthscope Commercial |
$365.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.81
|
| Rate for Payer: Mclaren Medicaid |
$71.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.68
|
| Rate for Payer: Meridian Medicaid |
$75.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.45
|
| Rate for Payer: Nomi Health Commercial |
$333.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.81
|
| Rate for Payer: PACE Senior Care Partners |
$96.52
|
| Rate for Payer: PACE SWMI |
$101.60
|
| Rate for Payer: PHP Commercial |
$345.45
|
| Rate for Payer: PHP Medicare Advantage |
$101.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$353.58
|
| Rate for Payer: Priority Health Medicare |
$102.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$282.86
|
| Rate for Payer: Railroad Medicare Medicare |
$101.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$357.64
|
| Rate for Payer: UHC Core |
$339.35
|
| Rate for Payer: UHC Exchange |
$101.60
|
| Rate for Payer: UHC Medicaid |
$71.65
|
| Rate for Payer: UHC Medicare Advantage |
$101.60
|
| Rate for Payer: UHCCP Medicaid |
$71.65
|
| Rate for Payer: VA VA |
$101.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.81
|
|
|
HC IAP CHEMO ADMINISTRATON
|
Facility
|
IP
|
$406.41
|
|
|
Service Code
|
CPT 96420
|
| Hospital Charge Code |
33500010
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$282.86 |
| Max. Negotiated Rate |
$365.77 |
| Rate for Payer: Aetna Commercial |
$345.45
|
| Rate for Payer: BCBS Trust/PPO |
$335.65
|
| Rate for Payer: BCN Commercial |
$335.65
|
| Rate for Payer: Cash Price |
$325.13
|
| Rate for Payer: Cofinity Commercial |
$349.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.13
|
| Rate for Payer: Healthscope Commercial |
$365.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.45
|
| Rate for Payer: Nomi Health Commercial |
$333.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.81
|
| Rate for Payer: PHP Commercial |
$345.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$353.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$282.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$357.64
|
| Rate for Payer: UHC Core |
$339.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.81
|
|
|
HC IBD DIFF
|
Facility
|
IP
|
$63.46
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200488
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.17 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: BCBS Trust/PPO |
$52.41
|
| Rate for Payer: BCN Commercial |
$52.41
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.84
|
| Rate for Payer: UHC Core |
$52.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC IBD DIFF
|
Facility
|
OP
|
$63.46
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200488
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.19 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.83
|
| Rate for Payer: BCBS Complete |
$11.75
|
| Rate for Payer: BCBS MAPPO |
$15.87
|
| Rate for Payer: BCBS Trust/PPO |
$52.17
|
| Rate for Payer: BCN Commercial |
$52.17
|
| Rate for Payer: BCN Medicare Advantage |
$15.87
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.87
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| Rate for Payer: Mclaren Medicaid |
$11.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.66
|
| Rate for Payer: Meridian Medicaid |
$11.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PACE Senior Care Partners |
$15.07
|
| Rate for Payer: PACE SWMI |
$15.87
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: PHP Medicare Advantage |
$15.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.21
|
| Rate for Payer: Priority Health Medicare |
$16.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.17
|
| Rate for Payer: Railroad Medicare Medicare |
$15.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.84
|
| Rate for Payer: UHC Core |
$52.99
|
| Rate for Payer: UHC Exchange |
$15.87
|
| Rate for Payer: UHC Medicaid |
$11.19
|
| Rate for Payer: UHC Medicare Advantage |
$15.87
|
| Rate for Payer: UHCCP Medicaid |
$11.19
|
| Rate for Payer: VA VA |
$15.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC IBD DIFFERENTIATION
|
Facility
|
IP
|
$63.46
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200174
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.17 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: BCBS Trust/PPO |
$52.41
|
| Rate for Payer: BCN Commercial |
$52.41
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.84
|
| Rate for Payer: UHC Core |
$52.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC IBD DIFFERENTIATION
|
Facility
|
OP
|
$63.46
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200174
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.19 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.83
|
| Rate for Payer: BCBS Complete |
$11.75
|
| Rate for Payer: BCBS MAPPO |
$15.87
|
| Rate for Payer: BCBS Trust/PPO |
$52.17
|
| Rate for Payer: BCN Commercial |
$52.17
|
| Rate for Payer: BCN Medicare Advantage |
$15.87
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.87
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| Rate for Payer: Mclaren Medicaid |
$11.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.66
|
| Rate for Payer: Meridian Medicaid |
$11.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PACE Senior Care Partners |
$15.07
|
| Rate for Payer: PACE SWMI |
$15.87
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: PHP Medicare Advantage |
$15.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.21
|
| Rate for Payer: Priority Health Medicare |
$16.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.17
|
| Rate for Payer: Railroad Medicare Medicare |
$15.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.84
|
| Rate for Payer: UHC Core |
$52.99
|
| Rate for Payer: UHC Exchange |
$15.87
|
| Rate for Payer: UHC Medicaid |
$11.19
|
| Rate for Payer: UHC Medicare Advantage |
$15.87
|
| Rate for Payer: UHCCP Medicaid |
$11.19
|
| Rate for Payer: VA VA |
$15.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC IBD DIFFERENTIATION CMPT
|
Facility
|
OP
|
$59.30
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: Aetna Medicare |
$15.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.53
|
| Rate for Payer: BCBS Complete |
$10.98
|
| Rate for Payer: BCBS MAPPO |
$14.82
|
| Rate for Payer: BCBS Trust/PPO |
$48.75
|
| Rate for Payer: BCN Commercial |
$48.75
|
| Rate for Payer: BCN Medicare Advantage |
$14.82
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.82
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Mclaren Medicaid |
$10.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.57
|
| Rate for Payer: Meridian Medicaid |
$10.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Nomi Health Commercial |
$48.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.48
|
| Rate for Payer: PACE Senior Care Partners |
$14.08
|
| Rate for Payer: PACE SWMI |
$14.82
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: PHP Medicare Advantage |
$14.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.59
|
| Rate for Payer: Priority Health Medicare |
$14.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.27
|
| Rate for Payer: Railroad Medicare Medicare |
$14.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.18
|
| Rate for Payer: UHC Core |
$49.52
|
| Rate for Payer: UHC Exchange |
$14.82
|
| Rate for Payer: UHC Medicaid |
$10.45
|
| Rate for Payer: UHC Medicare Advantage |
$14.82
|
| Rate for Payer: UHCCP Medicaid |
$10.45
|
| Rate for Payer: VA VA |
$14.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC IBD DIFFERENTIATION CMPT
|
Facility
|
IP
|
$59.30
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$41.27 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: BCBS Trust/PPO |
$48.98
|
| Rate for Payer: BCN Commercial |
$48.98
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Nomi Health Commercial |
$48.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.48
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.18
|
| Rate for Payer: UHC Core |
$49.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC ICD CRT/DUAL IMPLANT/REPLACE
|
Facility
|
IP
|
$28,274.40
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$19,678.98 |
| Max. Negotiated Rate |
$25,446.96 |
| Rate for Payer: Aetna Commercial |
$24,033.24
|
| Rate for Payer: BCBS Trust/PPO |
$23,351.83
|
| Rate for Payer: BCN Commercial |
$23,351.83
|
| Rate for Payer: Cash Price |
$22,619.52
|
| Rate for Payer: Cofinity Commercial |
$24,315.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,619.52
|
| Rate for Payer: Healthscope Commercial |
$25,446.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,205.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,033.24
|
| Rate for Payer: Nomi Health Commercial |
$23,185.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,205.80
|
| Rate for Payer: PHP Commercial |
$24,033.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24,598.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,678.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,881.47
|
| Rate for Payer: UHC Core |
$23,609.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,205.80
|
|
|
HC ICD CRT/DUAL IMPLANT/REPLACE
|
Facility
|
OP
|
$28,274.40
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,984.78 |
| Max. Negotiated Rate |
$25,446.96 |
| Rate for Payer: Aetna Commercial |
$24,033.24
|
| Rate for Payer: Aetna Medicare |
$7,351.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,835.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,835.75
|
| Rate for Payer: BCBS Complete |
$5,233.59
|
| Rate for Payer: BCBS MAPPO |
$7,068.60
|
| Rate for Payer: BCBS Trust/PPO |
$23,244.38
|
| Rate for Payer: BCN Commercial |
$23,244.38
|
| Rate for Payer: BCN Medicare Advantage |
$7,068.60
|
| Rate for Payer: Cash Price |
$22,619.52
|
| Rate for Payer: Cofinity Commercial |
$24,315.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,619.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,068.60
|
| Rate for Payer: Healthscope Commercial |
$25,446.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,205.80
|
| Rate for Payer: Mclaren Medicaid |
$4,984.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,422.03
|
| Rate for Payer: Meridian Medicaid |
$5,233.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,128.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,775.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,033.24
|
| Rate for Payer: Nomi Health Commercial |
$23,185.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,205.80
|
| Rate for Payer: PACE Senior Care Partners |
$6,715.17
|
| Rate for Payer: PACE SWMI |
$7,068.60
|
| Rate for Payer: PHP Commercial |
$24,033.24
|
| Rate for Payer: PHP Medicare Advantage |
$7,068.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,984.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24,598.73
|
| Rate for Payer: Priority Health Medicare |
$7,139.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19,678.98
|
| Rate for Payer: Railroad Medicare Medicare |
$7,068.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,881.47
|
| Rate for Payer: UHC Core |
$23,609.12
|
| Rate for Payer: UHC Exchange |
$7,068.60
|
| Rate for Payer: UHC Medicaid |
$4,984.78
|
| Rate for Payer: UHC Medicare Advantage |
$7,068.60
|
| Rate for Payer: UHCCP Medicaid |
$4,984.78
|
| Rate for Payer: VA VA |
$7,068.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,205.80
|
|
|
HC ICD CRT/DUAL REPLACEMENT
|
Facility
|
IP
|
$11,673.29
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
36100075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,124.61 |
| Max. Negotiated Rate |
$10,505.96 |
| Rate for Payer: Aetna Commercial |
$9,922.30
|
| Rate for Payer: BCBS Trust/PPO |
$9,640.97
|
| Rate for Payer: BCN Commercial |
$9,640.97
|
| Rate for Payer: Cash Price |
$9,338.63
|
| Rate for Payer: Cofinity Commercial |
$10,039.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,338.63
|
| Rate for Payer: Healthscope Commercial |
$10,505.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,754.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,922.30
|
| Rate for Payer: Nomi Health Commercial |
$9,572.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,754.97
|
| Rate for Payer: PHP Commercial |
$9,922.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,155.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,124.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,272.50
|
| Rate for Payer: UHC Core |
$9,747.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,754.97
|
|
|
HC ICD CRT/DUAL REPLACEMENT
|
Facility
|
OP
|
$11,673.29
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
36100075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,058.00 |
| Max. Negotiated Rate |
$10,505.96 |
| Rate for Payer: Aetna Commercial |
$9,922.30
|
| Rate for Payer: Aetna Medicare |
$3,035.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,647.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,647.90
|
| Rate for Payer: BCBS Complete |
$2,160.73
|
| Rate for Payer: BCBS MAPPO |
$2,918.32
|
| Rate for Payer: BCBS Trust/PPO |
$9,596.61
|
| Rate for Payer: BCN Commercial |
$9,596.61
|
| Rate for Payer: BCN Medicare Advantage |
$2,918.32
|
| Rate for Payer: Cash Price |
$9,338.63
|
| Rate for Payer: Cofinity Commercial |
$10,039.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,338.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,918.32
|
| Rate for Payer: Healthscope Commercial |
$10,505.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,754.97
|
| Rate for Payer: Mclaren Medicaid |
$2,058.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,064.24
|
| Rate for Payer: Meridian Medicaid |
$2,160.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,356.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,210.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,922.30
|
| Rate for Payer: Nomi Health Commercial |
$9,572.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,754.97
|
| Rate for Payer: PACE Senior Care Partners |
$2,772.41
|
| Rate for Payer: PACE SWMI |
$2,918.32
|
| Rate for Payer: PHP Commercial |
$9,922.30
|
| Rate for Payer: PHP Medicare Advantage |
$2,918.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,058.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,155.76
|
| Rate for Payer: Priority Health Medicare |
$2,947.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,124.61
|
| Rate for Payer: Railroad Medicare Medicare |
$2,918.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,272.50
|
| Rate for Payer: UHC Core |
$9,747.20
|
| Rate for Payer: UHC Exchange |
$2,918.32
|
| Rate for Payer: UHC Medicaid |
$2,058.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.32
|
| Rate for Payer: UHCCP Medicaid |
$2,058.00
|
| Rate for Payer: VA VA |
$2,918.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,754.97
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
IP
|
$2,772.24
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,929.48 |
| Max. Negotiated Rate |
$2,495.02 |
| Rate for Payer: Aetna Commercial |
$2,356.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,289.59
|
| Rate for Payer: BCN Commercial |
$2,289.59
|
| Rate for Payer: Cash Price |
$2,217.79
|
| Rate for Payer: Cofinity Commercial |
$2,384.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,217.79
|
| Rate for Payer: Healthscope Commercial |
$2,495.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,079.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,356.40
|
| Rate for Payer: Nomi Health Commercial |
$2,273.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,079.18
|
| Rate for Payer: PHP Commercial |
$2,356.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,411.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,929.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,439.57
|
| Rate for Payer: UHC Core |
$2,314.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,079.18
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
OP
|
$2,772.24
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$488.75 |
| Max. Negotiated Rate |
$2,495.02 |
| Rate for Payer: Aetna Commercial |
$2,356.40
|
| Rate for Payer: Aetna Medicare |
$720.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$866.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$866.33
|
| Rate for Payer: BCBS Complete |
$513.14
|
| Rate for Payer: BCBS MAPPO |
$693.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,279.06
|
| Rate for Payer: BCN Commercial |
$2,279.06
|
| Rate for Payer: BCN Medicare Advantage |
$693.06
|
| Rate for Payer: Cash Price |
$2,217.79
|
| Rate for Payer: Cofinity Commercial |
$2,384.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,217.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$693.06
|
| Rate for Payer: Healthscope Commercial |
$2,495.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,079.18
|
| Rate for Payer: Mclaren Medicaid |
$488.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$727.71
|
| Rate for Payer: Meridian Medicaid |
$513.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$797.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$762.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,356.40
|
| Rate for Payer: Nomi Health Commercial |
$2,273.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,079.18
|
| Rate for Payer: PACE Senior Care Partners |
$658.41
|
| Rate for Payer: PACE SWMI |
$693.06
|
| Rate for Payer: PHP Commercial |
$2,356.40
|
| Rate for Payer: PHP Medicare Advantage |
$693.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$488.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,411.85
|
| Rate for Payer: Priority Health Medicare |
$699.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,929.48
|
| Rate for Payer: Railroad Medicare Medicare |
$693.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,439.57
|
| Rate for Payer: UHC Core |
$2,314.82
|
| Rate for Payer: UHC Exchange |
$693.06
|
| Rate for Payer: UHC Medicaid |
$488.75
|
| Rate for Payer: UHC Medicare Advantage |
$693.06
|
| Rate for Payer: UHCCP Medicaid |
$488.75
|
| Rate for Payer: VA VA |
$693.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,079.18
|
|
|
HC ICD POCKET REVISION
|
Facility
|
OP
|
$3,227.50
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$569.01 |
| Max. Negotiated Rate |
$2,904.75 |
| Rate for Payer: Aetna Commercial |
$2,743.38
|
| Rate for Payer: Aetna Medicare |
$839.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,008.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,008.59
|
| Rate for Payer: BCBS Complete |
$597.41
|
| Rate for Payer: BCBS MAPPO |
$806.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,653.33
|
| Rate for Payer: BCN Commercial |
$2,653.33
|
| Rate for Payer: BCN Medicare Advantage |
$806.88
|
| Rate for Payer: Cash Price |
$2,582.00
|
| Rate for Payer: Cofinity Commercial |
$2,775.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,582.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$806.88
|
| Rate for Payer: Healthscope Commercial |
$2,904.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,420.62
|
| Rate for Payer: Mclaren Medicaid |
$569.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$847.22
|
| Rate for Payer: Meridian Medicaid |
$597.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$927.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$887.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,743.38
|
| Rate for Payer: Nomi Health Commercial |
$2,646.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,420.62
|
| Rate for Payer: PACE Senior Care Partners |
$766.53
|
| Rate for Payer: PACE SWMI |
$806.88
|
| Rate for Payer: PHP Commercial |
$2,743.38
|
| Rate for Payer: PHP Medicare Advantage |
$806.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$569.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,807.93
|
| Rate for Payer: Priority Health Medicare |
$814.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,246.34
|
| Rate for Payer: Railroad Medicare Medicare |
$806.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,840.20
|
| Rate for Payer: UHC Core |
$2,694.96
|
| Rate for Payer: UHC Exchange |
$806.88
|
| Rate for Payer: UHC Medicaid |
$569.01
|
| Rate for Payer: UHC Medicare Advantage |
$806.88
|
| Rate for Payer: UHCCP Medicaid |
$569.01
|
| Rate for Payer: VA VA |
$806.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,420.62
|
|
|
HC ICD POCKET REVISION
|
Facility
|
IP
|
$3,227.50
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,246.34 |
| Max. Negotiated Rate |
$2,904.75 |
| Rate for Payer: Aetna Commercial |
$2,743.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,665.59
|
| Rate for Payer: BCN Commercial |
$2,665.59
|
| Rate for Payer: Cash Price |
$2,582.00
|
| Rate for Payer: Cofinity Commercial |
$2,775.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,582.00
|
| Rate for Payer: Healthscope Commercial |
$2,904.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,420.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,743.38
|
| Rate for Payer: Nomi Health Commercial |
$2,646.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,420.62
|
| Rate for Payer: PHP Commercial |
$2,743.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,807.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,246.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,840.20
|
| Rate for Payer: UHC Core |
$2,694.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,420.62
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
OP
|
$20,027.70
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,530.88 |
| Max. Negotiated Rate |
$18,024.93 |
| Rate for Payer: Aetna Commercial |
$17,023.54
|
| Rate for Payer: Aetna Medicare |
$5,207.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,258.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,258.66
|
| Rate for Payer: BCBS Complete |
$3,707.13
|
| Rate for Payer: BCBS MAPPO |
$5,006.93
|
| Rate for Payer: BCBS Trust/PPO |
$16,464.77
|
| Rate for Payer: BCN Commercial |
$16,464.77
|
| Rate for Payer: BCN Medicare Advantage |
$5,006.93
|
| Rate for Payer: Cash Price |
$16,022.16
|
| Rate for Payer: Cofinity Commercial |
$17,223.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,022.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,006.93
|
| Rate for Payer: Healthscope Commercial |
$18,024.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,020.77
|
| Rate for Payer: Mclaren Medicaid |
$3,530.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,257.27
|
| Rate for Payer: Meridian Medicaid |
$3,707.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,757.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,507.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,023.54
|
| Rate for Payer: Nomi Health Commercial |
$16,422.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,020.77
|
| Rate for Payer: PACE Senior Care Partners |
$4,756.58
|
| Rate for Payer: PACE SWMI |
$5,006.93
|
| Rate for Payer: PHP Commercial |
$17,023.54
|
| Rate for Payer: PHP Medicare Advantage |
$5,006.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,530.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17,424.10
|
| Rate for Payer: Priority Health Medicare |
$5,056.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,939.28
|
| Rate for Payer: Railroad Medicare Medicare |
$5,006.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,624.38
|
| Rate for Payer: UHC Core |
$16,723.13
|
| Rate for Payer: UHC Exchange |
$5,006.93
|
| Rate for Payer: UHC Medicaid |
$3,530.88
|
| Rate for Payer: UHC Medicare Advantage |
$5,006.93
|
| Rate for Payer: UHCCP Medicaid |
$3,530.88
|
| Rate for Payer: VA VA |
$5,006.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,020.77
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
IP
|
$20,027.70
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,939.28 |
| Max. Negotiated Rate |
$18,024.93 |
| Rate for Payer: Aetna Commercial |
$17,023.54
|
| Rate for Payer: BCBS Trust/PPO |
$16,540.88
|
| Rate for Payer: BCN Commercial |
$16,540.88
|
| Rate for Payer: Cash Price |
$16,022.16
|
| Rate for Payer: Cofinity Commercial |
$17,223.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,022.16
|
| Rate for Payer: Healthscope Commercial |
$18,024.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,020.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,023.54
|
| Rate for Payer: Nomi Health Commercial |
$16,422.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,020.77
|
| Rate for Payer: PHP Commercial |
$17,023.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17,424.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13,939.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,624.38
|
| Rate for Payer: UHC Core |
$16,723.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,020.77
|
|
