|
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
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
OP
|
$2,717.88
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$645.50 |
| Max. Negotiated Rate |
$2,762.96 |
| Rate for Payer: Aetna Commercial |
$2,310.20
|
| Rate for Payer: Aetna Medicare |
$706.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$849.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$849.34
|
| Rate for Payer: BCBS Complete |
$2,762.96
|
| Rate for Payer: BCBS MAPPO |
$679.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,234.37
|
| Rate for Payer: BCN Commercial |
$2,113.15
|
| Rate for Payer: BCN Medicare Advantage |
$679.47
|
| Rate for Payer: Cash Price |
$2,174.30
|
| Rate for Payer: Cash Price |
$2,174.30
|
| Rate for Payer: Cofinity Commercial |
$2,337.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,174.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$679.47
|
| Rate for Payer: Healthscope Commercial |
$2,446.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,038.41
|
| Rate for Payer: Mclaren Medicaid |
$2,631.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$713.44
|
| Rate for Payer: Meridian Medicaid |
$2,762.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$781.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,310.20
|
| Rate for Payer: Nomi Health Commercial |
$2,228.66
|
| Rate for Payer: PACE Senior Care Partners |
$645.50
|
| Rate for Payer: PACE SWMI |
$679.47
|
| Rate for Payer: PHP Commercial |
$2,310.20
|
| Rate for Payer: PHP Medicare Advantage |
$679.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,631.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,766.62
|
| Rate for Payer: Priority Health HMO/PPO |
$2,364.56
|
| Rate for Payer: Priority Health Medicare |
$686.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,820.98
|
| Rate for Payer: Railroad Medicare Medicare |
$679.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,391.73
|
| Rate for Payer: UHC Core |
$2,269.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$679.47
|
| Rate for Payer: UHC Exchange |
$679.47
|
| Rate for Payer: UHC Medicare Advantage |
$679.47
|
| Rate for Payer: UHCCP Medicaid |
$2,631.21
|
| Rate for Payer: VA VA |
$679.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,038.41
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
IP
|
$2,717.88
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,766.62 |
| Max. Negotiated Rate |
$2,446.09 |
| Rate for Payer: Aetna Commercial |
$2,310.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,218.61
|
| Rate for Payer: BCN Commercial |
$2,100.38
|
| Rate for Payer: Cash Price |
$2,174.30
|
| Rate for Payer: Cofinity Commercial |
$2,337.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,174.30
|
| Rate for Payer: Healthscope Commercial |
$2,446.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,038.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,310.20
|
| Rate for Payer: Nomi Health Commercial |
$2,228.66
|
| Rate for Payer: PHP Commercial |
$2,310.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,766.62
|
| Rate for Payer: Priority Health HMO/PPO |
$2,364.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,820.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,391.73
|
| Rate for Payer: UHC Core |
$2,269.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,038.41
|
|
|
HC ICD POCKET REVISION
|
Facility
|
IP
|
$3,164.22
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,056.74 |
| Max. Negotiated Rate |
$2,847.80 |
| Rate for Payer: Aetna Commercial |
$2,689.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,582.95
|
| Rate for Payer: BCN Commercial |
$2,445.31
|
| Rate for Payer: Cash Price |
$2,531.38
|
| Rate for Payer: Cofinity Commercial |
$2,721.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,531.38
|
| Rate for Payer: Healthscope Commercial |
$2,847.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,373.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,689.59
|
| Rate for Payer: Nomi Health Commercial |
$2,594.66
|
| Rate for Payer: PHP Commercial |
$2,689.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.74
|
| Rate for Payer: Priority Health HMO/PPO |
$2,752.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,120.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,784.51
|
| Rate for Payer: UHC Core |
$2,642.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,373.16
|
|
|
HC ICD POCKET REVISION
|
Facility
|
OP
|
$3,164.22
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$751.50 |
| Max. Negotiated Rate |
$2,847.80 |
| Rate for Payer: Aetna Commercial |
$2,689.59
|
| Rate for Payer: Aetna Medicare |
$822.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$988.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$988.82
|
| Rate for Payer: BCBS Complete |
$1,388.75
|
| Rate for Payer: BCBS MAPPO |
$791.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,601.31
|
| Rate for Payer: BCN Commercial |
$2,460.18
|
| Rate for Payer: BCN Medicare Advantage |
$791.05
|
| Rate for Payer: Cash Price |
$2,531.38
|
| Rate for Payer: Cash Price |
$2,531.38
|
| Rate for Payer: Cofinity Commercial |
$2,721.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,531.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$791.05
|
| Rate for Payer: Healthscope Commercial |
$2,847.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,373.16
|
| Rate for Payer: Mclaren Medicaid |
$1,322.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$830.61
|
| Rate for Payer: Meridian Medicaid |
$1,388.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$909.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,689.59
|
| Rate for Payer: Nomi Health Commercial |
$2,594.66
|
| Rate for Payer: PACE Senior Care Partners |
$751.50
|
| Rate for Payer: PACE SWMI |
$791.05
|
| Rate for Payer: PHP Commercial |
$2,689.59
|
| Rate for Payer: PHP Medicare Advantage |
$791.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,322.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.74
|
| Rate for Payer: Priority Health HMO/PPO |
$2,752.87
|
| Rate for Payer: Priority Health Medicare |
$798.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,120.03
|
| Rate for Payer: Railroad Medicare Medicare |
$791.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,784.51
|
| Rate for Payer: UHC Core |
$2,642.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$791.05
|
| Rate for Payer: UHC Exchange |
$791.05
|
| Rate for Payer: UHC Medicare Advantage |
$791.05
|
| Rate for Payer: UHCCP Medicaid |
$1,322.53
|
| Rate for Payer: VA VA |
$791.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,373.16
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
OP
|
$19,074.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,530.07 |
| Max. Negotiated Rate |
$24,341.15 |
| Rate for Payer: Aetna Commercial |
$16,212.90
|
| Rate for Payer: Aetna Medicare |
$4,959.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,960.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,960.62
|
| Rate for Payer: BCBS Complete |
$24,341.15
|
| Rate for Payer: BCBS MAPPO |
$4,768.50
|
| Rate for Payer: BCBS Trust/PPO |
$15,680.74
|
| Rate for Payer: BCN Commercial |
$14,830.03
|
| Rate for Payer: BCN Medicare Advantage |
$4,768.50
|
| Rate for Payer: Cash Price |
$15,259.20
|
| Rate for Payer: Cash Price |
$15,259.20
|
| Rate for Payer: Cofinity Commercial |
$16,403.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,259.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,768.50
|
| Rate for Payer: Healthscope Commercial |
$17,166.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,305.50
|
| Rate for Payer: Mclaren Medicaid |
$23,180.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,006.93
|
| Rate for Payer: Meridian Medicaid |
$24,341.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,483.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,212.90
|
| Rate for Payer: Nomi Health Commercial |
$15,640.68
|
| Rate for Payer: PACE Senior Care Partners |
$4,530.07
|
| Rate for Payer: PACE SWMI |
$4,768.50
|
| Rate for Payer: PHP Commercial |
$16,212.90
|
| Rate for Payer: PHP Medicare Advantage |
$4,768.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$23,180.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,398.10
|
| Rate for Payer: Priority Health HMO/PPO |
$16,594.38
|
| Rate for Payer: Priority Health Medicare |
$4,816.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,779.58
|
| Rate for Payer: Railroad Medicare Medicare |
$4,768.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,785.12
|
| Rate for Payer: UHC Core |
$15,926.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,768.50
|
| Rate for Payer: UHC Exchange |
$4,768.50
|
| Rate for Payer: UHC Medicare Advantage |
$4,768.50
|
| Rate for Payer: UHCCP Medicaid |
$23,180.52
|
| Rate for Payer: VA VA |
$4,768.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,305.50
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
IP
|
$19,074.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,398.10 |
| Max. Negotiated Rate |
$17,166.60 |
| Rate for Payer: Aetna Commercial |
$16,212.90
|
| Rate for Payer: BCBS Trust/PPO |
$15,570.11
|
| Rate for Payer: BCN Commercial |
$14,740.39
|
| Rate for Payer: Cash Price |
$15,259.20
|
| Rate for Payer: Cofinity Commercial |
$16,403.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,259.20
|
| Rate for Payer: Healthscope Commercial |
$17,166.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,305.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,212.90
|
| Rate for Payer: Nomi Health Commercial |
$15,640.68
|
| Rate for Payer: PHP Commercial |
$16,212.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,398.10
|
| Rate for Payer: Priority Health HMO/PPO |
$16,594.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,779.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,785.12
|
| Rate for Payer: UHC Core |
$15,926.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,305.50
|
|
|
HC ICP MONITOR
|
Facility
|
OP
|
$1,996.65
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$474.20 |
| Max. Negotiated Rate |
$1,796.98 |
| Rate for Payer: Aetna Commercial |
$1,697.15
|
| Rate for Payer: Aetna Medicare |
$519.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.95
|
| Rate for Payer: BCBS Complete |
$798.66
|
| Rate for Payer: BCBS MAPPO |
$499.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,641.45
|
| Rate for Payer: BCN Commercial |
$1,552.40
|
| Rate for Payer: BCN Medicare Advantage |
$499.16
|
| Rate for Payer: Cash Price |
$1,597.32
|
| Rate for Payer: Cofinity Commercial |
$1,717.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,597.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$499.16
|
| Rate for Payer: Healthscope Commercial |
$1,796.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,497.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$524.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$574.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,697.15
|
| Rate for Payer: Nomi Health Commercial |
$1,637.25
|
| Rate for Payer: PACE Senior Care Partners |
$474.20
|
| Rate for Payer: PACE SWMI |
$499.16
|
| Rate for Payer: PHP Commercial |
$1,697.15
|
| Rate for Payer: PHP Medicare Advantage |
$499.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.82
|
| Rate for Payer: Priority Health HMO/PPO |
$1,737.09
|
| Rate for Payer: Priority Health Medicare |
$504.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,337.76
|
| Rate for Payer: Railroad Medicare Medicare |
$499.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,757.05
|
| Rate for Payer: UHC Core |
$1,667.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$499.16
|
| Rate for Payer: UHC Exchange |
$499.16
|
| Rate for Payer: UHC Medicare Advantage |
$499.16
|
| Rate for Payer: VA VA |
$499.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,497.49
|
|
|
HC ICP MONITOR
|
Facility
|
IP
|
$1,996.65
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,297.82 |
| Max. Negotiated Rate |
$1,796.98 |
| Rate for Payer: Aetna Commercial |
$1,697.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,629.87
|
| Rate for Payer: BCN Commercial |
$1,543.01
|
| Rate for Payer: Cash Price |
$1,597.32
|
| Rate for Payer: Cofinity Commercial |
$1,717.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,597.32
|
| Rate for Payer: Healthscope Commercial |
$1,796.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,497.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,697.15
|
| Rate for Payer: Nomi Health Commercial |
$1,637.25
|
| Rate for Payer: PHP Commercial |
$1,697.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.82
|
| Rate for Payer: Priority Health HMO/PPO |
$1,737.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,337.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,757.05
|
| Rate for Payer: UHC Core |
$1,667.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,497.49
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
OP
|
$259.06
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$61.53 |
| Max. Negotiated Rate |
$233.15 |
| Rate for Payer: Aetna Commercial |
$220.20
|
| Rate for Payer: Aetna Medicare |
$67.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.96
|
| Rate for Payer: BCBS Complete |
$152.73
|
| Rate for Payer: BCBS MAPPO |
$64.77
|
| Rate for Payer: BCBS Trust/PPO |
$212.97
|
| Rate for Payer: BCN Commercial |
$201.42
|
| Rate for Payer: BCN Medicare Advantage |
$64.77
|
| Rate for Payer: Cash Price |
$207.25
|
| Rate for Payer: Cash Price |
$207.25
|
| Rate for Payer: Cofinity Commercial |
$222.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.77
|
| Rate for Payer: Healthscope Commercial |
$233.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.29
|
| Rate for Payer: Mclaren Medicaid |
$145.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.00
|
| Rate for Payer: Meridian Medicaid |
$152.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.20
|
| Rate for Payer: Nomi Health Commercial |
$212.43
|
| Rate for Payer: PACE Senior Care Partners |
$61.53
|
| Rate for Payer: PACE SWMI |
$64.77
|
| Rate for Payer: PHP Commercial |
$220.20
|
| Rate for Payer: PHP Medicare Advantage |
$64.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.39
|
| Rate for Payer: Priority Health HMO/PPO |
$225.38
|
| Rate for Payer: Priority Health Medicare |
$65.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.57
|
| Rate for Payer: Railroad Medicare Medicare |
$64.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.97
|
| Rate for Payer: UHC Core |
$216.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.77
|
| Rate for Payer: UHC Exchange |
$64.77
|
| Rate for Payer: UHC Medicare Advantage |
$64.77
|
| Rate for Payer: UHCCP Medicaid |
$145.45
|
| Rate for Payer: VA VA |
$64.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.29
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
IP
|
$259.06
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.39 |
| Max. Negotiated Rate |
$233.15 |
| Rate for Payer: Aetna Commercial |
$220.20
|
| Rate for Payer: BCBS Trust/PPO |
$211.47
|
| Rate for Payer: BCN Commercial |
$200.20
|
| Rate for Payer: Cash Price |
$207.25
|
| Rate for Payer: Cofinity Commercial |
$222.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.25
|
| Rate for Payer: Healthscope Commercial |
$233.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.20
|
| Rate for Payer: Nomi Health Commercial |
$212.43
|
| Rate for Payer: PHP Commercial |
$220.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.39
|
| Rate for Payer: Priority Health HMO/PPO |
$225.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.97
|
| Rate for Payer: UHC Core |
$216.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.29
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
OP
|
$29.86
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$26.87 |
| Rate for Payer: Aetna Commercial |
$25.38
|
| Rate for Payer: Aetna Medicare |
$7.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.33
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$7.46
|
| Rate for Payer: BCBS Trust/PPO |
$24.55
|
| Rate for Payer: BCN Commercial |
$23.22
|
| Rate for Payer: BCN Medicare Advantage |
$7.46
|
| Rate for Payer: Cash Price |
$23.89
|
| Rate for Payer: Cash Price |
$23.89
|
| Rate for Payer: Cofinity Commercial |
$25.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.46
|
| Rate for Payer: Healthscope Commercial |
$26.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.39
|
| Rate for Payer: Mclaren Medicaid |
$3.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.84
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.38
|
| Rate for Payer: Nomi Health Commercial |
$24.49
|
| Rate for Payer: PACE Senior Care Partners |
$7.09
|
| Rate for Payer: PACE SWMI |
$7.46
|
| Rate for Payer: PHP Commercial |
$25.38
|
| Rate for Payer: PHP Medicare Advantage |
$7.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.41
|
| Rate for Payer: Priority Health HMO/PPO |
$25.98
|
| Rate for Payer: Priority Health Medicare |
$7.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.01
|
| Rate for Payer: Railroad Medicare Medicare |
$7.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.28
|
| Rate for Payer: UHC Core |
$24.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.46
|
| Rate for Payer: UHC Exchange |
$7.46
|
| Rate for Payer: UHC Medicare Advantage |
$7.46
|
| Rate for Payer: UHCCP Medicaid |
$3.75
|
| Rate for Payer: VA VA |
$7.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.39
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
IP
|
$29.86
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.41 |
| Max. Negotiated Rate |
$26.87 |
| Rate for Payer: Aetna Commercial |
$25.38
|
| Rate for Payer: BCBS Trust/PPO |
$24.37
|
| Rate for Payer: BCN Commercial |
$23.08
|
| Rate for Payer: Cash Price |
$23.89
|
| Rate for Payer: Cofinity Commercial |
$25.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.89
|
| Rate for Payer: Healthscope Commercial |
$26.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.38
|
| Rate for Payer: Nomi Health Commercial |
$24.49
|
| Rate for Payer: PHP Commercial |
$25.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.41
|
| Rate for Payer: Priority Health HMO/PPO |
$25.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.28
|
| Rate for Payer: UHC Core |
$24.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.39
|
|
|
HC I&D (OB SURGERY)
|
Facility
|
IP
|
$535.51
|
|
| Hospital Charge Code |
36000054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$348.08 |
| Max. Negotiated Rate |
$481.96 |
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: BCBS Trust/PPO |
$437.14
|
| Rate for Payer: BCN Commercial |
$413.84
|
| Rate for Payer: Cash Price |
$428.41
|
| Rate for Payer: Cofinity Commercial |
$460.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.41
|
| Rate for Payer: Healthscope Commercial |
$481.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.18
|
| Rate for Payer: Nomi Health Commercial |
$439.12
|
| Rate for Payer: PHP Commercial |
$455.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.08
|
| Rate for Payer: Priority Health HMO/PPO |
$465.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$471.25
|
| Rate for Payer: UHC Core |
$447.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.63
|
|
|
HC I&D (OB SURGERY)
|
Facility
|
OP
|
$535.51
|
|
| Hospital Charge Code |
36000054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$127.18 |
| Max. Negotiated Rate |
$481.96 |
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna Medicare |
$139.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$167.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$167.35
|
| Rate for Payer: BCBS Complete |
$214.20
|
| Rate for Payer: BCBS MAPPO |
$133.88
|
| Rate for Payer: BCBS Trust/PPO |
$440.24
|
| Rate for Payer: BCN Commercial |
$416.36
|
| Rate for Payer: BCN Medicare Advantage |
$133.88
|
| Rate for Payer: Cash Price |
$428.41
|
| Rate for Payer: Cofinity Commercial |
$460.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.88
|
| Rate for Payer: Healthscope Commercial |
$481.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$153.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.18
|
| Rate for Payer: Nomi Health Commercial |
$439.12
|
| Rate for Payer: PACE Senior Care Partners |
$127.18
|
| Rate for Payer: PACE SWMI |
$133.88
|
| Rate for Payer: PHP Commercial |
$455.18
|
| Rate for Payer: PHP Medicare Advantage |
$133.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.08
|
| Rate for Payer: Priority Health HMO/PPO |
$465.89
|
| Rate for Payer: Priority Health Medicare |
$135.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.79
|
| Rate for Payer: Railroad Medicare Medicare |
$133.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$471.25
|
| Rate for Payer: UHC Core |
$447.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.88
|
| Rate for Payer: UHC Exchange |
$133.88
|
| Rate for Payer: UHC Medicare Advantage |
$133.88
|
| Rate for Payer: VA VA |
$133.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.63
|
|
|
HC I&D PILONIDAL CYST
|
Facility
|
OP
|
$931.90
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
45000097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$221.33 |
| Max. Negotiated Rate |
$838.71 |
| Rate for Payer: Aetna Commercial |
$792.12
|
| Rate for Payer: Aetna Medicare |
$242.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$291.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$291.22
|
| Rate for Payer: BCBS Complete |
$534.17
|
| Rate for Payer: BCBS MAPPO |
$232.97
|
| Rate for Payer: BCBS Trust/PPO |
$766.11
|
| Rate for Payer: BCN Commercial |
$724.55
|
| Rate for Payer: BCN Medicare Advantage |
$232.97
|
| Rate for Payer: Cash Price |
$745.52
|
| Rate for Payer: Cash Price |
$745.52
|
| Rate for Payer: Cofinity Commercial |
$801.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$745.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.97
|
| Rate for Payer: Healthscope Commercial |
$838.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$698.92
|
| Rate for Payer: Mclaren Medicaid |
$508.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.62
|
| Rate for Payer: Meridian Medicaid |
$534.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$267.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$792.12
|
| Rate for Payer: Nomi Health Commercial |
$764.16
|
| Rate for Payer: PACE Senior Care Partners |
$221.33
|
| Rate for Payer: PACE SWMI |
$232.97
|
| Rate for Payer: PHP Commercial |
$792.12
|
| Rate for Payer: PHP Medicare Advantage |
$232.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$605.74
|
| Rate for Payer: Priority Health HMO/PPO |
$810.75
|
| Rate for Payer: Priority Health Medicare |
$235.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$624.37
|
| Rate for Payer: Railroad Medicare Medicare |
$232.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$820.07
|
| Rate for Payer: UHC Core |
$778.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$232.97
|
| Rate for Payer: UHC Exchange |
$232.97
|
| Rate for Payer: UHC Medicare Advantage |
$232.97
|
| Rate for Payer: UHCCP Medicaid |
$508.70
|
| Rate for Payer: VA VA |
$232.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$698.92
|
|
|
HC I&D PILONIDAL CYST
|
Facility
|
IP
|
$931.90
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
45000097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$605.74 |
| Max. Negotiated Rate |
$838.71 |
| Rate for Payer: Aetna Commercial |
$792.12
|
| Rate for Payer: BCBS Trust/PPO |
$760.71
|
| Rate for Payer: BCN Commercial |
$720.17
|
| Rate for Payer: Cash Price |
$745.52
|
| Rate for Payer: Cofinity Commercial |
$801.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$745.52
|
| Rate for Payer: Healthscope Commercial |
$838.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$698.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$792.12
|
| Rate for Payer: Nomi Health Commercial |
$764.16
|
| Rate for Payer: PHP Commercial |
$792.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$605.74
|
| Rate for Payer: Priority Health HMO/PPO |
$810.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$624.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$820.07
|
| Rate for Payer: UHC Core |
$778.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$698.92
|
|
|
HC I&D PROCEDURE
|
Facility
|
OP
|
$490.15
|
|
| Hospital Charge Code |
45000045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$116.41 |
| Max. Negotiated Rate |
$441.13 |
| Rate for Payer: Aetna Commercial |
$416.63
|
| Rate for Payer: Aetna Medicare |
$127.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.17
|
| Rate for Payer: BCBS Complete |
$196.06
|
| Rate for Payer: BCBS MAPPO |
$122.54
|
| Rate for Payer: BCBS Trust/PPO |
$402.95
|
| Rate for Payer: BCN Commercial |
$381.09
|
| Rate for Payer: BCN Medicare Advantage |
$122.54
|
| Rate for Payer: Cash Price |
$392.12
|
| Rate for Payer: Cofinity Commercial |
$421.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.54
|
| Rate for Payer: Healthscope Commercial |
$441.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.63
|
| Rate for Payer: Nomi Health Commercial |
$401.92
|
| Rate for Payer: PACE Senior Care Partners |
$116.41
|
| Rate for Payer: PACE SWMI |
$122.54
|
| Rate for Payer: PHP Commercial |
$416.63
|
| Rate for Payer: PHP Medicare Advantage |
$122.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.60
|
| Rate for Payer: Priority Health HMO/PPO |
$426.43
|
| Rate for Payer: Priority Health Medicare |
$123.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.40
|
| Rate for Payer: Railroad Medicare Medicare |
$122.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.33
|
| Rate for Payer: UHC Core |
$409.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.54
|
| Rate for Payer: UHC Exchange |
$122.54
|
| Rate for Payer: UHC Medicare Advantage |
$122.54
|
| Rate for Payer: VA VA |
$122.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.61
|
|
|
HC I&D PROCEDURE
|
Facility
|
IP
|
$490.15
|
|
| Hospital Charge Code |
45000045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$318.60 |
| Max. Negotiated Rate |
$441.13 |
| Rate for Payer: Aetna Commercial |
$416.63
|
| Rate for Payer: BCBS Trust/PPO |
$400.11
|
| Rate for Payer: BCN Commercial |
$378.79
|
| Rate for Payer: Cash Price |
$392.12
|
| Rate for Payer: Cofinity Commercial |
$421.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.12
|
| Rate for Payer: Healthscope Commercial |
$441.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.63
|
| Rate for Payer: Nomi Health Commercial |
$401.92
|
| Rate for Payer: PHP Commercial |
$416.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.60
|
| Rate for Payer: Priority Health HMO/PPO |
$426.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.33
|
| Rate for Payer: UHC Core |
$409.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.61
|
|
|
HC I&D VULVA/PERINEAL ABSCESS
|
Facility
|
IP
|
$849.27
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
76100319
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$552.03 |
| Max. Negotiated Rate |
$764.34 |
| Rate for Payer: Aetna Commercial |
$721.88
|
| Rate for Payer: BCBS Trust/PPO |
$693.26
|
| Rate for Payer: BCN Commercial |
$656.32
|
| Rate for Payer: Cash Price |
$679.42
|
| Rate for Payer: Cofinity Commercial |
$730.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$679.42
|
| Rate for Payer: Healthscope Commercial |
$764.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$636.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$721.88
|
| Rate for Payer: Nomi Health Commercial |
$696.40
|
| Rate for Payer: PHP Commercial |
$721.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$552.03
|
| Rate for Payer: Priority Health HMO/PPO |
$738.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$569.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$747.36
|
| Rate for Payer: UHC Core |
$709.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$636.95
|
|
|
HC I&D VULVA/PERINEAL ABSCESS
|
Facility
|
OP
|
$849.27
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
76100319
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.70 |
| Max. Negotiated Rate |
$764.34 |
| Rate for Payer: Aetna Commercial |
$721.88
|
| Rate for Payer: Aetna Medicare |
$220.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$265.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$265.40
|
| Rate for Payer: BCBS Complete |
$230.94
|
| Rate for Payer: BCBS MAPPO |
$212.32
|
| Rate for Payer: BCBS Trust/PPO |
$698.18
|
| Rate for Payer: BCN Commercial |
$660.31
|
| Rate for Payer: BCN Medicare Advantage |
$212.32
|
| Rate for Payer: Cash Price |
$679.42
|
| Rate for Payer: Cash Price |
$679.42
|
| Rate for Payer: Cofinity Commercial |
$730.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$679.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.32
|
| Rate for Payer: Healthscope Commercial |
$764.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$636.95
|
| Rate for Payer: Mclaren Medicaid |
$219.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$222.93
|
| Rate for Payer: Meridian Medicaid |
$230.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$244.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$721.88
|
| Rate for Payer: Nomi Health Commercial |
$696.40
|
| Rate for Payer: PACE Senior Care Partners |
$201.70
|
| Rate for Payer: PACE SWMI |
$212.32
|
| Rate for Payer: PHP Commercial |
$721.88
|
| Rate for Payer: PHP Medicare Advantage |
$212.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$552.03
|
| Rate for Payer: Priority Health HMO/PPO |
$738.86
|
| Rate for Payer: Priority Health Medicare |
$214.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$569.01
|
| Rate for Payer: Railroad Medicare Medicare |
$212.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$747.36
|
| Rate for Payer: UHC Core |
$709.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$212.32
|
| Rate for Payer: UHC Exchange |
$212.32
|
| Rate for Payer: UHC Medicare Advantage |
$212.32
|
| Rate for Payer: UHCCP Medicaid |
$219.93
|
| Rate for Payer: VA VA |
$212.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$636.95
|
|
|
HC IFR MEASUREMENT
|
Facility
|
IP
|
$3,878.57
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100132
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,521.07 |
| Max. Negotiated Rate |
$3,490.71 |
| Rate for Payer: Aetna Commercial |
$3,296.78
|
| Rate for Payer: BCBS Trust/PPO |
$3,166.08
|
| Rate for Payer: BCN Commercial |
$2,997.36
|
| Rate for Payer: Cash Price |
$3,102.86
|
| Rate for Payer: Cofinity Commercial |
$3,335.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,102.86
|
| Rate for Payer: Healthscope Commercial |
$3,490.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,908.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,296.78
|
| Rate for Payer: Nomi Health Commercial |
$3,180.43
|
| Rate for Payer: PHP Commercial |
$3,296.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,521.07
|
| Rate for Payer: Priority Health HMO/PPO |
$3,374.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,598.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,413.14
|
| Rate for Payer: UHC Core |
$3,238.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,908.93
|
|
|
HC IFR MEASUREMENT
|
Facility
|
OP
|
$3,878.57
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100132
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$113.12 |
| Max. Negotiated Rate |
$3,490.71 |
| Rate for Payer: Aetna Commercial |
$3,296.78
|
| Rate for Payer: Aetna Medicare |
$1,008.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,212.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,212.05
|
| Rate for Payer: BCBS Complete |
$118.78
|
| Rate for Payer: BCBS MAPPO |
$969.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,188.57
|
| Rate for Payer: BCN Commercial |
$3,015.59
|
| Rate for Payer: BCN Medicare Advantage |
$969.64
|
| Rate for Payer: Cash Price |
$3,102.86
|
| Rate for Payer: Cash Price |
$3,102.86
|
| Rate for Payer: Cofinity Commercial |
$3,335.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,102.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$969.64
|
| Rate for Payer: Healthscope Commercial |
$3,490.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,908.93
|
| Rate for Payer: Mclaren Medicaid |
$113.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,018.12
|
| Rate for Payer: Meridian Medicaid |
$118.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,115.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,296.78
|
| Rate for Payer: Nomi Health Commercial |
$3,180.43
|
| Rate for Payer: PACE Senior Care Partners |
$921.16
|
| Rate for Payer: PACE SWMI |
$969.64
|
| Rate for Payer: PHP Commercial |
$3,296.78
|
| Rate for Payer: PHP Medicare Advantage |
$969.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,521.07
|
| Rate for Payer: Priority Health HMO/PPO |
$3,374.36
|
| Rate for Payer: Priority Health Medicare |
$979.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,598.64
|
| Rate for Payer: Railroad Medicare Medicare |
$969.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,413.14
|
| Rate for Payer: UHC Core |
$3,238.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$969.64
|
| Rate for Payer: UHC Exchange |
$969.64
|
| Rate for Payer: UHC Medicare Advantage |
$969.64
|
| Rate for Payer: UHCCP Medicaid |
$113.12
|
| Rate for Payer: VA VA |
$969.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,908.93
|
|
|
HC IGG SUBCLASS 1-4
|
Facility
|
IP
|
$13.46
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100214
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.75 |
| Max. Negotiated Rate |
$12.11 |
| Rate for Payer: Aetna Commercial |
$11.44
|
| Rate for Payer: BCBS Trust/PPO |
$10.99
|
| Rate for Payer: BCN Commercial |
$10.40
|
| Rate for Payer: Cash Price |
$10.77
|
| Rate for Payer: Cofinity Commercial |
$11.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.77
|
| Rate for Payer: Healthscope Commercial |
$12.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.44
|
| Rate for Payer: Nomi Health Commercial |
$11.04
|
| Rate for Payer: PHP Commercial |
$11.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.75
|
| Rate for Payer: Priority Health HMO/PPO |
$11.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.84
|
| Rate for Payer: UHC Core |
$11.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.10
|
|
|
HC IGG SUBCLASS 1-4
|
Facility
|
OP
|
$13.46
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100214
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$12.11 |
| Rate for Payer: Aetna Commercial |
$11.44
|
| Rate for Payer: Aetna Medicare |
$3.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.21
|
| Rate for Payer: BCBS Complete |
$6.09
|
| Rate for Payer: BCBS MAPPO |
$3.37
|
| Rate for Payer: BCBS Trust/PPO |
$11.07
|
| Rate for Payer: BCN Commercial |
$10.47
|
| Rate for Payer: BCN Medicare Advantage |
$3.37
|
| Rate for Payer: Cash Price |
$10.77
|
| Rate for Payer: Cash Price |
$10.77
|
| Rate for Payer: Cofinity Commercial |
$11.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.37
|
| Rate for Payer: Healthscope Commercial |
$12.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.10
|
| Rate for Payer: Mclaren Medicaid |
$5.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.53
|
| Rate for Payer: Meridian Medicaid |
$6.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.44
|
| Rate for Payer: Nomi Health Commercial |
$11.04
|
| Rate for Payer: PACE Senior Care Partners |
$3.20
|
| Rate for Payer: PACE SWMI |
$3.37
|
| Rate for Payer: PHP Commercial |
$11.44
|
| Rate for Payer: PHP Medicare Advantage |
$3.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.75
|
| Rate for Payer: Priority Health HMO/PPO |
$11.71
|
| Rate for Payer: Priority Health Medicare |
$3.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.84
|
| Rate for Payer: UHC Core |
$11.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.37
|
| Rate for Payer: UHC Exchange |
$3.37
|
| Rate for Payer: UHC Medicare Advantage |
$3.37
|
| Rate for Payer: UHCCP Medicaid |
$5.80
|
| Rate for Payer: VA VA |
$3.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.10
|
|
