|
HC I-131 CAP (DX) PER MCI
|
Facility
|
OP
|
$74.94
|
|
|
Service Code
|
HCPCS A9528
|
| Hospital Charge Code |
34300011
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$17.80 |
| Max. Negotiated Rate |
$67.45 |
| Rate for Payer: Aetna Commercial |
$63.70
|
| Rate for Payer: Aetna Medicare |
$19.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.42
|
| Rate for Payer: BCBS Complete |
$29.98
|
| Rate for Payer: BCBS MAPPO |
$18.73
|
| Rate for Payer: BCBS Trust/PPO |
$61.61
|
| Rate for Payer: BCN Commercial |
$58.27
|
| Rate for Payer: BCN Medicare Advantage |
$18.73
|
| Rate for Payer: Cash Price |
$59.95
|
| Rate for Payer: Cofinity Commercial |
$64.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.73
|
| Rate for Payer: Healthscope Commercial |
$67.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.70
|
| Rate for Payer: Nomi Health Commercial |
$61.45
|
| Rate for Payer: PACE Senior Care Partners |
$17.80
|
| Rate for Payer: PACE SWMI |
$18.73
|
| Rate for Payer: PHP Commercial |
$63.70
|
| Rate for Payer: PHP Medicare Advantage |
$18.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.71
|
| Rate for Payer: Priority Health HMO/PPO |
$65.20
|
| Rate for Payer: Priority Health Medicare |
$18.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.21
|
| Rate for Payer: Railroad Medicare Medicare |
$18.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.95
|
| Rate for Payer: UHC Core |
$62.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.73
|
| Rate for Payer: UHC Exchange |
$18.73
|
| Rate for Payer: UHC Medicare Advantage |
$18.73
|
| Rate for Payer: VA VA |
$18.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.20
|
|
|
HC I-131 CAP (DX) PER MCI
|
Facility
|
IP
|
$74.94
|
|
|
Service Code
|
HCPCS A9528
|
| Hospital Charge Code |
34300011
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$48.71 |
| Max. Negotiated Rate |
$67.45 |
| Rate for Payer: Aetna Commercial |
$63.70
|
| Rate for Payer: BCBS Trust/PPO |
$61.17
|
| Rate for Payer: BCN Commercial |
$57.91
|
| Rate for Payer: Cash Price |
$59.95
|
| Rate for Payer: Cofinity Commercial |
$64.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.95
|
| Rate for Payer: Healthscope Commercial |
$67.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.70
|
| Rate for Payer: Nomi Health Commercial |
$61.45
|
| Rate for Payer: PHP Commercial |
$63.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.71
|
| Rate for Payer: Priority Health HMO/PPO |
$65.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.95
|
| Rate for Payer: UHC Core |
$62.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.20
|
|
|
HC I-131 CAP (TX) PER MCI
|
Facility
|
IP
|
$68.13
|
|
|
Service Code
|
HCPCS A9517
|
| Hospital Charge Code |
34400001
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$44.28 |
| Max. Negotiated Rate |
$61.32 |
| Rate for Payer: Aetna Commercial |
$57.91
|
| Rate for Payer: BCBS Trust/PPO |
$55.61
|
| Rate for Payer: BCN Commercial |
$52.65
|
| Rate for Payer: Cash Price |
$54.50
|
| Rate for Payer: Cofinity Commercial |
$58.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.50
|
| Rate for Payer: Healthscope Commercial |
$61.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.91
|
| Rate for Payer: Nomi Health Commercial |
$55.87
|
| Rate for Payer: PHP Commercial |
$57.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.28
|
| Rate for Payer: Priority Health HMO/PPO |
$59.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.95
|
| Rate for Payer: UHC Core |
$56.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.10
|
|
|
HC I-131 CAP (TX) PER MCI
|
Facility
|
OP
|
$68.13
|
|
|
Service Code
|
HCPCS A9517
|
| Hospital Charge Code |
34400001
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$16.18 |
| Max. Negotiated Rate |
$61.32 |
| Rate for Payer: Aetna Commercial |
$57.91
|
| Rate for Payer: Aetna Medicare |
$17.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.29
|
| Rate for Payer: BCBS Complete |
$17.56
|
| Rate for Payer: BCBS MAPPO |
$17.03
|
| Rate for Payer: BCBS Trust/PPO |
$56.01
|
| Rate for Payer: BCN Commercial |
$52.97
|
| Rate for Payer: BCN Medicare Advantage |
$17.03
|
| Rate for Payer: Cash Price |
$54.50
|
| Rate for Payer: Cash Price |
$54.50
|
| Rate for Payer: Cofinity Commercial |
$58.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.03
|
| Rate for Payer: Healthscope Commercial |
$61.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.10
|
| Rate for Payer: Mclaren Medicaid |
$16.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.88
|
| Rate for Payer: Meridian Medicaid |
$17.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.91
|
| Rate for Payer: Nomi Health Commercial |
$55.87
|
| Rate for Payer: PACE Senior Care Partners |
$16.18
|
| Rate for Payer: PACE SWMI |
$17.03
|
| Rate for Payer: PHP Commercial |
$57.91
|
| Rate for Payer: PHP Medicare Advantage |
$17.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.28
|
| Rate for Payer: Priority Health HMO/PPO |
$59.27
|
| Rate for Payer: Priority Health Medicare |
$17.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.65
|
| Rate for Payer: Railroad Medicare Medicare |
$17.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.95
|
| Rate for Payer: UHC Core |
$56.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.03
|
| Rate for Payer: UHC Exchange |
$17.03
|
| Rate for Payer: UHC Medicare Advantage |
$17.03
|
| Rate for Payer: UHCCP Medicaid |
$16.72
|
| Rate for Payer: VA VA |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.10
|
|
|
HC I-131 SOD IODIDE DIAG PER UCI
|
Facility
|
IP
|
$47.86
|
|
|
Service Code
|
HCPCS A9531
|
| Hospital Charge Code |
34300031
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$31.11 |
| Max. Negotiated Rate |
$43.07 |
| Rate for Payer: Aetna Commercial |
$40.68
|
| Rate for Payer: BCBS Trust/PPO |
$39.07
|
| Rate for Payer: BCN Commercial |
$36.99
|
| Rate for Payer: Cash Price |
$38.29
|
| Rate for Payer: Cofinity Commercial |
$41.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.29
|
| Rate for Payer: Healthscope Commercial |
$43.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.68
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PHP Commercial |
$40.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.11
|
| Rate for Payer: Priority Health HMO/PPO |
$41.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.12
|
| Rate for Payer: UHC Core |
$39.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC I-131 SOD IODIDE DIAG PER UCI
|
Facility
|
OP
|
$47.86
|
|
|
Service Code
|
HCPCS A9531
|
| Hospital Charge Code |
34300031
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$11.37 |
| Max. Negotiated Rate |
$43.07 |
| Rate for Payer: Aetna Commercial |
$40.68
|
| Rate for Payer: Aetna Medicare |
$12.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.96
|
| Rate for Payer: BCBS Complete |
$19.14
|
| Rate for Payer: BCBS MAPPO |
$11.96
|
| Rate for Payer: BCBS Trust/PPO |
$39.35
|
| Rate for Payer: BCN Commercial |
$37.21
|
| Rate for Payer: BCN Medicare Advantage |
$11.96
|
| Rate for Payer: Cash Price |
$38.29
|
| Rate for Payer: Cofinity Commercial |
$41.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.96
|
| Rate for Payer: Healthscope Commercial |
$43.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.68
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PACE Senior Care Partners |
$11.37
|
| Rate for Payer: PACE SWMI |
$11.96
|
| Rate for Payer: PHP Commercial |
$40.68
|
| Rate for Payer: PHP Medicare Advantage |
$11.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.11
|
| Rate for Payer: Priority Health HMO/PPO |
$41.64
|
| Rate for Payer: Priority Health Medicare |
$12.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.07
|
| Rate for Payer: Railroad Medicare Medicare |
$11.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.12
|
| Rate for Payer: UHC Core |
$39.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.96
|
| Rate for Payer: UHC Exchange |
$11.96
|
| Rate for Payer: UHC Medicare Advantage |
$11.96
|
| Rate for Payer: VA VA |
$11.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC I-131 SOL (DX) PER MCI
|
Facility
|
OP
|
$47.87
|
|
|
Service Code
|
HCPCS A9529
|
| Hospital Charge Code |
34300012
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$11.37 |
| Max. Negotiated Rate |
$43.08 |
| Rate for Payer: Aetna Commercial |
$40.69
|
| Rate for Payer: Aetna Medicare |
$12.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.96
|
| Rate for Payer: BCBS Complete |
$19.15
|
| Rate for Payer: BCBS MAPPO |
$11.97
|
| Rate for Payer: BCBS Trust/PPO |
$39.35
|
| Rate for Payer: BCN Commercial |
$37.22
|
| Rate for Payer: BCN Medicare Advantage |
$11.97
|
| Rate for Payer: Cash Price |
$38.30
|
| Rate for Payer: Cofinity Commercial |
$41.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.97
|
| Rate for Payer: Healthscope Commercial |
$43.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.69
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PACE Senior Care Partners |
$11.37
|
| Rate for Payer: PACE SWMI |
$11.97
|
| Rate for Payer: PHP Commercial |
$40.69
|
| Rate for Payer: PHP Medicare Advantage |
$11.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.12
|
| Rate for Payer: Priority Health HMO/PPO |
$41.65
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.07
|
| Rate for Payer: Railroad Medicare Medicare |
$11.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.13
|
| Rate for Payer: UHC Core |
$39.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.97
|
| Rate for Payer: UHC Exchange |
$11.97
|
| Rate for Payer: UHC Medicare Advantage |
$11.97
|
| Rate for Payer: VA VA |
$11.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC I-131 SOL (DX) PER MCI
|
Facility
|
IP
|
$47.87
|
|
|
Service Code
|
HCPCS A9529
|
| Hospital Charge Code |
34300012
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$31.12 |
| Max. Negotiated Rate |
$43.08 |
| Rate for Payer: Aetna Commercial |
$40.69
|
| Rate for Payer: BCBS Trust/PPO |
$39.08
|
| Rate for Payer: BCN Commercial |
$36.99
|
| Rate for Payer: Cash Price |
$38.30
|
| Rate for Payer: Cofinity Commercial |
$41.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.30
|
| Rate for Payer: Healthscope Commercial |
$43.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.69
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PHP Commercial |
$40.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.12
|
| Rate for Payer: Priority Health HMO/PPO |
$41.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.13
|
| Rate for Payer: UHC Core |
$39.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC I-131 SOL (TX) PER MCI
|
Facility
|
IP
|
$47.87
|
|
|
Service Code
|
HCPCS A9530
|
| Hospital Charge Code |
34400002
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$31.12 |
| Max. Negotiated Rate |
$43.08 |
| Rate for Payer: Aetna Commercial |
$40.69
|
| Rate for Payer: BCBS Trust/PPO |
$39.08
|
| Rate for Payer: BCN Commercial |
$36.99
|
| Rate for Payer: Cash Price |
$38.30
|
| Rate for Payer: Cofinity Commercial |
$41.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.30
|
| Rate for Payer: Healthscope Commercial |
$43.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.69
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PHP Commercial |
$40.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.12
|
| Rate for Payer: Priority Health HMO/PPO |
$41.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.13
|
| Rate for Payer: UHC Core |
$39.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC I-131 SOL (TX) PER MCI
|
Facility
|
OP
|
$47.87
|
|
|
Service Code
|
HCPCS A9530
|
| Hospital Charge Code |
34400002
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$11.37 |
| Max. Negotiated Rate |
$43.08 |
| Rate for Payer: Aetna Commercial |
$40.69
|
| Rate for Payer: Aetna Medicare |
$12.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.96
|
| Rate for Payer: BCBS Complete |
$15.85
|
| Rate for Payer: BCBS MAPPO |
$11.97
|
| Rate for Payer: BCBS Trust/PPO |
$39.35
|
| Rate for Payer: BCN Commercial |
$37.22
|
| Rate for Payer: BCN Medicare Advantage |
$11.97
|
| Rate for Payer: Cash Price |
$38.30
|
| Rate for Payer: Cash Price |
$38.30
|
| Rate for Payer: Cofinity Commercial |
$41.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.97
|
| Rate for Payer: Healthscope Commercial |
$43.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.90
|
| Rate for Payer: Mclaren Medicaid |
$15.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.57
|
| Rate for Payer: Meridian Medicaid |
$15.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.69
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: PACE Senior Care Partners |
$11.37
|
| Rate for Payer: PACE SWMI |
$11.97
|
| Rate for Payer: PHP Commercial |
$40.69
|
| Rate for Payer: PHP Medicare Advantage |
$11.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.12
|
| Rate for Payer: Priority Health HMO/PPO |
$41.65
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.07
|
| Rate for Payer: Railroad Medicare Medicare |
$11.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.13
|
| Rate for Payer: UHC Core |
$39.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.97
|
| Rate for Payer: UHC Exchange |
$11.97
|
| Rate for Payer: UHC Medicare Advantage |
$11.97
|
| Rate for Payer: UHCCP Medicaid |
$15.10
|
| Rate for Payer: VA VA |
$11.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.90
|
|
|
HC IAAD NOS EACH ORGANISM AG IA
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600341
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$68.25 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$89.25
|
| Rate for Payer: BCBS Trust/PPO |
$85.71
|
| Rate for Payer: BCN Commercial |
$81.14
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$90.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.00
|
| Rate for Payer: Healthscope Commercial |
$94.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.25
|
| Rate for Payer: Nomi Health Commercial |
$86.10
|
| Rate for Payer: PHP Commercial |
$89.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.25
|
| Rate for Payer: Priority Health HMO/PPO |
$91.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.40
|
| Rate for Payer: UHC Core |
$87.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.75
|
|
|
HC IAAD NOS EACH ORGANISM AG IA
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600341
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.66 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$89.25
|
| Rate for Payer: Aetna Medicare |
$27.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.81
|
| Rate for Payer: BCBS Complete |
$9.10
|
| Rate for Payer: BCBS MAPPO |
$26.25
|
| Rate for Payer: BCBS Trust/PPO |
$86.32
|
| Rate for Payer: BCN Commercial |
$81.64
|
| Rate for Payer: BCN Medicare Advantage |
$26.25
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$90.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.25
|
| Rate for Payer: Healthscope Commercial |
$94.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.75
|
| Rate for Payer: Mclaren Medicaid |
$8.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.56
|
| Rate for Payer: Meridian Medicaid |
$9.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.25
|
| Rate for Payer: Nomi Health Commercial |
$86.10
|
| Rate for Payer: PACE Senior Care Partners |
$24.94
|
| Rate for Payer: PACE SWMI |
$26.25
|
| Rate for Payer: PHP Commercial |
$89.25
|
| Rate for Payer: PHP Medicare Advantage |
$26.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.25
|
| Rate for Payer: Priority Health HMO/PPO |
$91.35
|
| Rate for Payer: Priority Health Medicare |
$26.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.35
|
| Rate for Payer: Railroad Medicare Medicare |
$26.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.40
|
| Rate for Payer: UHC Core |
$87.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.25
|
| Rate for Payer: UHC Exchange |
$26.25
|
| Rate for Payer: UHC Medicare Advantage |
$26.25
|
| Rate for Payer: UHCCP Medicaid |
$8.66
|
| Rate for Payer: VA VA |
$26.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.75
|
|
|
HC IAPB MONITORING SERVICES HOURL
|
Facility
|
OP
|
$408.67
|
|
| Hospital Charge Code |
27000118
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$97.06 |
| Max. Negotiated Rate |
$367.80 |
| Rate for Payer: Aetna Commercial |
$347.37
|
| Rate for Payer: Aetna Medicare |
$106.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$127.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$127.71
|
| Rate for Payer: BCBS Complete |
$163.47
|
| Rate for Payer: BCBS MAPPO |
$102.17
|
| Rate for Payer: BCBS Trust/PPO |
$335.97
|
| Rate for Payer: BCN Commercial |
$317.74
|
| Rate for Payer: BCN Medicare Advantage |
$102.17
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$351.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.17
|
| Rate for Payer: Healthscope Commercial |
$367.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.37
|
| Rate for Payer: Nomi Health Commercial |
$335.11
|
| Rate for Payer: PACE Senior Care Partners |
$97.06
|
| Rate for Payer: PACE SWMI |
$102.17
|
| Rate for Payer: PHP Commercial |
$347.37
|
| Rate for Payer: PHP Medicare Advantage |
$102.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.64
|
| Rate for Payer: Priority Health HMO/PPO |
$355.54
|
| Rate for Payer: Priority Health Medicare |
$103.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.81
|
| Rate for Payer: Railroad Medicare Medicare |
$102.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.63
|
| Rate for Payer: UHC Core |
$341.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.17
|
| Rate for Payer: UHC Exchange |
$102.17
|
| Rate for Payer: UHC Medicare Advantage |
$102.17
|
| Rate for Payer: VA VA |
$102.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.50
|
|
|
HC IAPB MONITORING SERVICES HOURL
|
Facility
|
IP
|
$408.67
|
|
| Hospital Charge Code |
27000118
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$265.64 |
| Max. Negotiated Rate |
$367.80 |
| Rate for Payer: Aetna Commercial |
$347.37
|
| Rate for Payer: BCBS Trust/PPO |
$333.60
|
| Rate for Payer: BCN Commercial |
$315.82
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$351.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Healthscope Commercial |
$367.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.37
|
| Rate for Payer: Nomi Health Commercial |
$335.11
|
| Rate for Payer: PHP Commercial |
$347.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.64
|
| Rate for Payer: Priority Health HMO/PPO |
$355.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.63
|
| Rate for Payer: UHC Core |
$341.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.50
|
|
|
HC IAP CHEMO ADMINISTRATON
|
Facility
|
IP
|
$398.44
|
|
|
Service Code
|
CPT 96420
|
| Hospital Charge Code |
33500010
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$258.99 |
| Max. Negotiated Rate |
$358.60 |
| Rate for Payer: Aetna Commercial |
$338.67
|
| Rate for Payer: BCBS Trust/PPO |
$325.25
|
| Rate for Payer: BCN Commercial |
$307.91
|
| Rate for Payer: Cash Price |
$318.75
|
| Rate for Payer: Cofinity Commercial |
$342.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.75
|
| Rate for Payer: Healthscope Commercial |
$358.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.67
|
| Rate for Payer: Nomi Health Commercial |
$326.72
|
| Rate for Payer: PHP Commercial |
$338.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.99
|
| Rate for Payer: Priority Health HMO/PPO |
$346.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.63
|
| Rate for Payer: UHC Core |
$332.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.83
|
|
|
HC IAP CHEMO ADMINISTRATON
|
Facility
|
OP
|
$398.44
|
|
|
Service Code
|
CPT 96420
|
| Hospital Charge Code |
33500010
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$94.63 |
| Max. Negotiated Rate |
$358.60 |
| Rate for Payer: Aetna Commercial |
$338.67
|
| Rate for Payer: Aetna Medicare |
$103.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$124.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$124.51
|
| Rate for Payer: BCBS Complete |
$251.82
|
| Rate for Payer: BCBS MAPPO |
$99.61
|
| Rate for Payer: BCBS Trust/PPO |
$327.56
|
| Rate for Payer: BCN Commercial |
$309.79
|
| Rate for Payer: BCN Medicare Advantage |
$99.61
|
| Rate for Payer: Cash Price |
$318.75
|
| Rate for Payer: Cash Price |
$318.75
|
| Rate for Payer: Cofinity Commercial |
$342.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.61
|
| Rate for Payer: Healthscope Commercial |
$358.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.83
|
| Rate for Payer: Mclaren Medicaid |
$239.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.59
|
| Rate for Payer: Meridian Medicaid |
$251.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.67
|
| Rate for Payer: Nomi Health Commercial |
$326.72
|
| Rate for Payer: PACE Senior Care Partners |
$94.63
|
| Rate for Payer: PACE SWMI |
$99.61
|
| Rate for Payer: PHP Commercial |
$338.67
|
| Rate for Payer: PHP Medicare Advantage |
$99.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$239.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.99
|
| Rate for Payer: Priority Health HMO/PPO |
$346.64
|
| Rate for Payer: Priority Health Medicare |
$100.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$266.95
|
| Rate for Payer: Railroad Medicare Medicare |
$99.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.63
|
| Rate for Payer: UHC Core |
$332.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.61
|
| Rate for Payer: UHC Exchange |
$99.61
|
| Rate for Payer: UHC Medicare Advantage |
$99.61
|
| Rate for Payer: UHCCP Medicaid |
$239.81
|
| Rate for Payer: VA VA |
$99.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.83
|
|
|
HC IBD DIFF
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200488
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.44 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: BCBS Trust/PPO |
$50.79
|
| Rate for Payer: BCN Commercial |
$48.08
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO |
$54.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC IBD DIFF
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200488
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.44
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$15.55
|
| Rate for Payer: BCBS Trust/PPO |
$51.15
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$15.55
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.55
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.33
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.78
|
| Rate for Payer: PACE SWMI |
$15.55
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: PHP Medicare Advantage |
$15.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO |
$54.13
|
| Rate for Payer: Priority Health Medicare |
$15.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.69
|
| Rate for Payer: Railroad Medicare Medicare |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.55
|
| Rate for Payer: UHC Exchange |
$15.55
|
| Rate for Payer: UHC Medicare Advantage |
$15.55
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$15.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC IBD DIFFERENTIATION
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200174
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.44 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: BCBS Trust/PPO |
$50.79
|
| Rate for Payer: BCN Commercial |
$48.08
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO |
$54.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC IBD DIFFERENTIATION
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200174
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna Medicare |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.44
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$15.55
|
| Rate for Payer: BCBS Trust/PPO |
$51.15
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$15.55
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.55
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.33
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$51.02
|
| Rate for Payer: PACE Senior Care Partners |
$14.78
|
| Rate for Payer: PACE SWMI |
$15.55
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: PHP Medicare Advantage |
$15.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO |
$54.13
|
| Rate for Payer: Priority Health Medicare |
$15.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.69
|
| Rate for Payer: Railroad Medicare Medicare |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$51.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.55
|
| Rate for Payer: UHC Exchange |
$15.55
|
| Rate for Payer: UHC Medicare Advantage |
$15.55
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$15.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC IBD DIFFERENTIATION CMPT
|
Facility
|
IP
|
$58.14
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: BCBS Trust/PPO |
$47.46
|
| Rate for Payer: BCN Commercial |
$44.93
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO |
$50.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.16
|
| Rate for Payer: UHC Core |
$48.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
|
HC IBD DIFFERENTIATION CMPT
|
Facility
|
OP
|
$58.14
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: Aetna Medicare |
$15.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.17
|
| Rate for Payer: BCBS Complete |
$9.30
|
| Rate for Payer: BCBS MAPPO |
$14.54
|
| Rate for Payer: BCBS Trust/PPO |
$47.80
|
| Rate for Payer: BCN Commercial |
$45.20
|
| Rate for Payer: BCN Medicare Advantage |
$14.54
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.54
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
| Rate for Payer: Mclaren Medicaid |
$8.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.26
|
| Rate for Payer: Meridian Medicaid |
$9.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: PACE Senior Care Partners |
$13.81
|
| Rate for Payer: PACE SWMI |
$14.54
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: PHP Medicare Advantage |
$14.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO |
$50.58
|
| Rate for Payer: Priority Health Medicare |
$14.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.95
|
| Rate for Payer: Railroad Medicare Medicare |
$14.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.16
|
| Rate for Payer: UHC Core |
$48.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.54
|
| Rate for Payer: UHC Exchange |
$14.54
|
| Rate for Payer: UHC Medicare Advantage |
$14.54
|
| Rate for Payer: UHCCP Medicaid |
$8.86
|
| Rate for Payer: VA VA |
$14.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
|
HC ICD CRT/DUAL IMPLANT/REPLACE
|
Facility
|
IP
|
$26,928.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$17,503.20 |
| Max. Negotiated Rate |
$24,235.20 |
| Rate for Payer: Aetna Commercial |
$22,888.80
|
| Rate for Payer: BCBS Trust/PPO |
$21,981.33
|
| Rate for Payer: BCN Commercial |
$20,809.96
|
| Rate for Payer: Cash Price |
$21,542.40
|
| Rate for Payer: Cofinity Commercial |
$23,158.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,542.40
|
| Rate for Payer: Healthscope Commercial |
$24,235.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,196.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,888.80
|
| Rate for Payer: Nomi Health Commercial |
$22,080.96
|
| Rate for Payer: PHP Commercial |
$22,888.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,503.20
|
| Rate for Payer: Priority Health HMO/PPO |
$23,427.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,041.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,696.64
|
| Rate for Payer: UHC Core |
$22,484.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,196.00
|
|
|
HC ICD CRT/DUAL IMPLANT/REPLACE
|
Facility
|
OP
|
$26,928.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,395.40 |
| Max. Negotiated Rate |
$24,341.15 |
| Rate for Payer: Aetna Commercial |
$22,888.80
|
| Rate for Payer: Aetna Medicare |
$7,001.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,415.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,415.00
|
| Rate for Payer: BCBS Complete |
$24,341.15
|
| Rate for Payer: BCBS MAPPO |
$6,732.00
|
| Rate for Payer: BCBS Trust/PPO |
$22,137.51
|
| Rate for Payer: BCN Commercial |
$20,936.52
|
| Rate for Payer: BCN Medicare Advantage |
$6,732.00
|
| Rate for Payer: Cash Price |
$21,542.40
|
| Rate for Payer: Cash Price |
$21,542.40
|
| Rate for Payer: Cofinity Commercial |
$23,158.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,542.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,732.00
|
| Rate for Payer: Healthscope Commercial |
$24,235.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,196.00
|
| Rate for Payer: Mclaren Medicaid |
$23,180.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,068.60
|
| Rate for Payer: Meridian Medicaid |
$24,341.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,741.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,888.80
|
| Rate for Payer: Nomi Health Commercial |
$22,080.96
|
| Rate for Payer: PACE Senior Care Partners |
$6,395.40
|
| Rate for Payer: PACE SWMI |
$6,732.00
|
| Rate for Payer: PHP Commercial |
$22,888.80
|
| Rate for Payer: PHP Medicare Advantage |
$6,732.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$23,180.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,503.20
|
| Rate for Payer: Priority Health HMO/PPO |
$23,427.36
|
| Rate for Payer: Priority Health Medicare |
$6,799.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,041.76
|
| Rate for Payer: Railroad Medicare Medicare |
$6,732.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,696.64
|
| Rate for Payer: UHC Core |
$22,484.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,732.00
|
| Rate for Payer: UHC Exchange |
$6,732.00
|
| Rate for Payer: UHC Medicare Advantage |
$6,732.00
|
| Rate for Payer: UHCCP Medicaid |
$23,180.52
|
| Rate for Payer: VA VA |
$6,732.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,196.00
|
|
|
HC ICD CRT/DUAL REPLACEMENT
|
Facility
|
OP
|
$11,444.40
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
36100075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,718.05 |
| Max. Negotiated Rate |
$17,041.15 |
| Rate for Payer: Aetna Commercial |
$9,727.74
|
| Rate for Payer: Aetna Medicare |
$2,975.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,576.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,576.38
|
| Rate for Payer: BCBS Complete |
$17,041.15
|
| Rate for Payer: BCBS MAPPO |
$2,861.10
|
| Rate for Payer: BCBS Trust/PPO |
$9,408.44
|
| Rate for Payer: BCN Commercial |
$8,898.02
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.10
|
| Rate for Payer: Cash Price |
$9,155.52
|
| Rate for Payer: Cash Price |
$9,155.52
|
| Rate for Payer: Cofinity Commercial |
$9,842.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,155.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.10
|
| Rate for Payer: Healthscope Commercial |
$10,299.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,583.30
|
| Rate for Payer: Mclaren Medicaid |
$16,228.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,004.16
|
| Rate for Payer: Meridian Medicaid |
$17,041.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,290.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,727.74
|
| Rate for Payer: Nomi Health Commercial |
$9,384.41
|
| Rate for Payer: PACE Senior Care Partners |
$2,718.05
|
| Rate for Payer: PACE SWMI |
$2,861.10
|
| Rate for Payer: PHP Commercial |
$9,727.74
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,228.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,438.86
|
| Rate for Payer: Priority Health HMO/PPO |
$9,956.63
|
| Rate for Payer: Priority Health Medicare |
$2,889.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,667.75
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,071.07
|
| Rate for Payer: UHC Core |
$9,556.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,861.10
|
| Rate for Payer: UHC Exchange |
$2,861.10
|
| Rate for Payer: UHC Medicare Advantage |
$2,861.10
|
| Rate for Payer: UHCCP Medicaid |
$16,228.60
|
| Rate for Payer: VA VA |
$2,861.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,583.30
|
|
