|
HC LEVEL 0.5 INIT 30 MIN
|
Facility
|
OP
|
$939.78
|
|
| Hospital Charge Code |
36000060
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$165.68 |
| Max. Negotiated Rate |
$845.80 |
| Rate for Payer: Aetna Commercial |
$798.81
|
| Rate for Payer: Aetna Medicare |
$244.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.68
|
| Rate for Payer: BCBS Complete |
$173.95
|
| Rate for Payer: BCBS MAPPO |
$234.94
|
| Rate for Payer: BCBS Trust/PPO |
$772.59
|
| Rate for Payer: BCN Commercial |
$772.59
|
| Rate for Payer: BCN Medicare Advantage |
$234.94
|
| Rate for Payer: Cash Price |
$751.82
|
| Rate for Payer: Cofinity Commercial |
$808.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$751.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.94
|
| Rate for Payer: Healthscope Commercial |
$845.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$704.84
|
| Rate for Payer: Mclaren Medicaid |
$165.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.69
|
| Rate for Payer: Meridian Medicaid |
$173.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$258.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$798.81
|
| Rate for Payer: Nomi Health Commercial |
$770.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$704.84
|
| Rate for Payer: PACE Senior Care Partners |
$223.20
|
| Rate for Payer: PACE SWMI |
$234.94
|
| Rate for Payer: PHP Commercial |
$798.81
|
| Rate for Payer: PHP Medicare Advantage |
$234.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$817.61
|
| Rate for Payer: Priority Health Medicare |
$237.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$654.09
|
| Rate for Payer: Railroad Medicare Medicare |
$234.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$827.01
|
| Rate for Payer: UHC Core |
$784.72
|
| Rate for Payer: UHC Exchange |
$234.94
|
| Rate for Payer: UHC Medicaid |
$165.68
|
| Rate for Payer: UHC Medicare Advantage |
$234.94
|
| Rate for Payer: UHCCP Medicaid |
$165.68
|
| Rate for Payer: VA VA |
$234.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$704.84
|
|
|
HC LEVEL 0.5 INIT 30 MIN
|
Facility
|
IP
|
$939.78
|
|
| Hospital Charge Code |
36000060
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$654.09 |
| Max. Negotiated Rate |
$845.80 |
| Rate for Payer: Aetna Commercial |
$798.81
|
| Rate for Payer: BCBS Trust/PPO |
$776.16
|
| Rate for Payer: BCN Commercial |
$776.16
|
| Rate for Payer: Cash Price |
$751.82
|
| Rate for Payer: Cofinity Commercial |
$808.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$751.82
|
| Rate for Payer: Healthscope Commercial |
$845.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$704.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$798.81
|
| Rate for Payer: Nomi Health Commercial |
$770.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$704.84
|
| Rate for Payer: PHP Commercial |
$798.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$817.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$654.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$827.01
|
| Rate for Payer: UHC Core |
$784.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$704.84
|
|
|
HC LEVEL 0.5 SUBSQ 15 MIN
|
Facility
|
IP
|
$270.72
|
|
| Hospital Charge Code |
36000061
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$188.42 |
| Max. Negotiated Rate |
$243.65 |
| Rate for Payer: Aetna Commercial |
$230.11
|
| Rate for Payer: BCBS Trust/PPO |
$223.59
|
| Rate for Payer: BCN Commercial |
$223.59
|
| Rate for Payer: Cash Price |
$216.58
|
| Rate for Payer: Cofinity Commercial |
$232.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.58
|
| Rate for Payer: Healthscope Commercial |
$243.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.11
|
| Rate for Payer: Nomi Health Commercial |
$221.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$203.04
|
| Rate for Payer: PHP Commercial |
$230.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$235.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.23
|
| Rate for Payer: UHC Core |
$226.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.04
|
|
|
HC LEVEL 0.5 SUBSQ 15 MIN
|
Facility
|
OP
|
$270.72
|
|
| Hospital Charge Code |
36000061
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$47.73 |
| Max. Negotiated Rate |
$243.65 |
| Rate for Payer: Aetna Commercial |
$230.11
|
| Rate for Payer: Aetna Medicare |
$70.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.60
|
| Rate for Payer: BCBS Complete |
$50.11
|
| Rate for Payer: BCBS MAPPO |
$67.68
|
| Rate for Payer: BCBS Trust/PPO |
$222.56
|
| Rate for Payer: BCN Commercial |
$222.56
|
| Rate for Payer: BCN Medicare Advantage |
$67.68
|
| Rate for Payer: Cash Price |
$216.58
|
| Rate for Payer: Cofinity Commercial |
$232.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.68
|
| Rate for Payer: Healthscope Commercial |
$243.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.04
|
| Rate for Payer: Mclaren Medicaid |
$47.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.06
|
| Rate for Payer: Meridian Medicaid |
$50.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.11
|
| Rate for Payer: Nomi Health Commercial |
$221.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$203.04
|
| Rate for Payer: PACE Senior Care Partners |
$64.30
|
| Rate for Payer: PACE SWMI |
$67.68
|
| Rate for Payer: PHP Commercial |
$230.11
|
| Rate for Payer: PHP Medicare Advantage |
$67.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$235.53
|
| Rate for Payer: Priority Health Medicare |
$68.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$188.42
|
| Rate for Payer: Railroad Medicare Medicare |
$67.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.23
|
| Rate for Payer: UHC Core |
$226.05
|
| Rate for Payer: UHC Exchange |
$67.68
|
| Rate for Payer: UHC Medicaid |
$47.73
|
| Rate for Payer: UHC Medicare Advantage |
$67.68
|
| Rate for Payer: UHCCP Medicaid |
$47.73
|
| Rate for Payer: VA VA |
$67.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.04
|
|
|
HC LEVEL 1 INIT 30 MIN
|
Facility
|
IP
|
$2,074.72
|
|
| Hospital Charge Code |
36000062
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,444.01 |
| Max. Negotiated Rate |
$1,867.25 |
| Rate for Payer: Aetna Commercial |
$1,763.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,713.51
|
| Rate for Payer: BCN Commercial |
$1,713.51
|
| Rate for Payer: Cash Price |
$1,659.78
|
| Rate for Payer: Cofinity Commercial |
$1,784.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.78
|
| Rate for Payer: Healthscope Commercial |
$1,867.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,556.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.51
|
| Rate for Payer: Nomi Health Commercial |
$1,701.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,556.04
|
| Rate for Payer: PHP Commercial |
$1,763.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,805.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,444.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,825.75
|
| Rate for Payer: UHC Core |
$1,732.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,556.04
|
|
|
HC LEVEL 1 INIT 30 MIN
|
Facility
|
OP
|
$2,074.72
|
|
| Hospital Charge Code |
36000062
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$365.77 |
| Max. Negotiated Rate |
$1,867.25 |
| Rate for Payer: Aetna Commercial |
$1,763.51
|
| Rate for Payer: Aetna Medicare |
$539.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$648.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$648.35
|
| Rate for Payer: BCBS Complete |
$384.03
|
| Rate for Payer: BCBS MAPPO |
$518.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,705.63
|
| Rate for Payer: BCN Commercial |
$1,705.63
|
| Rate for Payer: BCN Medicare Advantage |
$518.68
|
| Rate for Payer: Cash Price |
$1,659.78
|
| Rate for Payer: Cofinity Commercial |
$1,784.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$518.68
|
| Rate for Payer: Healthscope Commercial |
$1,867.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,556.04
|
| Rate for Payer: Mclaren Medicaid |
$365.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$544.61
|
| Rate for Payer: Meridian Medicaid |
$384.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$596.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$570.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.51
|
| Rate for Payer: Nomi Health Commercial |
$1,701.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,556.04
|
| Rate for Payer: PACE Senior Care Partners |
$492.75
|
| Rate for Payer: PACE SWMI |
$518.68
|
| Rate for Payer: PHP Commercial |
$1,763.51
|
| Rate for Payer: PHP Medicare Advantage |
$518.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,805.01
|
| Rate for Payer: Priority Health Medicare |
$523.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,444.01
|
| Rate for Payer: Railroad Medicare Medicare |
$518.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,825.75
|
| Rate for Payer: UHC Core |
$1,732.39
|
| Rate for Payer: UHC Exchange |
$518.68
|
| Rate for Payer: UHC Medicaid |
$365.77
|
| Rate for Payer: UHC Medicare Advantage |
$518.68
|
| Rate for Payer: UHCCP Medicaid |
$365.77
|
| Rate for Payer: VA VA |
$518.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,556.04
|
|
|
HC LEVEL 1 SUBSQ 15 MIN
|
Facility
|
OP
|
$412.97
|
|
| Hospital Charge Code |
36000063
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$72.81 |
| Max. Negotiated Rate |
$371.67 |
| Rate for Payer: Aetna Commercial |
$351.02
|
| Rate for Payer: Aetna Medicare |
$107.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.05
|
| Rate for Payer: BCBS Complete |
$76.44
|
| Rate for Payer: BCBS MAPPO |
$103.24
|
| Rate for Payer: BCBS Trust/PPO |
$339.50
|
| Rate for Payer: BCN Commercial |
$339.50
|
| Rate for Payer: BCN Medicare Advantage |
$103.24
|
| Rate for Payer: Cash Price |
$330.38
|
| Rate for Payer: Cofinity Commercial |
$355.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.24
|
| Rate for Payer: Healthscope Commercial |
$371.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.73
|
| Rate for Payer: Mclaren Medicaid |
$72.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.40
|
| Rate for Payer: Meridian Medicaid |
$76.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$113.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.02
|
| Rate for Payer: Nomi Health Commercial |
$338.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$309.73
|
| Rate for Payer: PACE Senior Care Partners |
$98.08
|
| Rate for Payer: PACE SWMI |
$103.24
|
| Rate for Payer: PHP Commercial |
$351.02
|
| Rate for Payer: PHP Medicare Advantage |
$103.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$359.28
|
| Rate for Payer: Priority Health Medicare |
$104.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$287.43
|
| Rate for Payer: Railroad Medicare Medicare |
$103.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.41
|
| Rate for Payer: UHC Core |
$344.83
|
| Rate for Payer: UHC Exchange |
$103.24
|
| Rate for Payer: UHC Medicaid |
$72.81
|
| Rate for Payer: UHC Medicare Advantage |
$103.24
|
| Rate for Payer: UHCCP Medicaid |
$72.81
|
| Rate for Payer: VA VA |
$103.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.73
|
|
|
HC LEVEL 1 SUBSQ 15 MIN
|
Facility
|
IP
|
$412.97
|
|
| Hospital Charge Code |
36000063
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$287.43 |
| Max. Negotiated Rate |
$371.67 |
| Rate for Payer: Aetna Commercial |
$351.02
|
| Rate for Payer: BCBS Trust/PPO |
$341.07
|
| Rate for Payer: BCN Commercial |
$341.07
|
| Rate for Payer: Cash Price |
$330.38
|
| Rate for Payer: Cofinity Commercial |
$355.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.38
|
| Rate for Payer: Healthscope Commercial |
$371.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.02
|
| Rate for Payer: Nomi Health Commercial |
$338.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$309.73
|
| Rate for Payer: PHP Commercial |
$351.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$359.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$287.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.41
|
| Rate for Payer: UHC Core |
$344.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.73
|
|
|
HC LEVEL 2 INIT 30 MIN
|
Facility
|
IP
|
$3,226.85
|
|
| Hospital Charge Code |
36000064
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,245.89 |
| Max. Negotiated Rate |
$2,904.16 |
| Rate for Payer: Aetna Commercial |
$2,742.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,665.06
|
| Rate for Payer: BCN Commercial |
$2,665.06
|
| Rate for Payer: Cash Price |
$2,581.48
|
| Rate for Payer: Cofinity Commercial |
$2,775.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,581.48
|
| Rate for Payer: Healthscope Commercial |
$2,904.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,420.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,742.82
|
| Rate for Payer: Nomi Health Commercial |
$2,646.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,420.14
|
| Rate for Payer: PHP Commercial |
$2,742.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,807.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,245.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,839.63
|
| Rate for Payer: UHC Core |
$2,694.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,420.14
|
|
|
HC LEVEL 2 INIT 30 MIN
|
Facility
|
OP
|
$3,226.85
|
|
| Hospital Charge Code |
36000064
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$568.89 |
| Max. Negotiated Rate |
$2,904.16 |
| Rate for Payer: Aetna Commercial |
$2,742.82
|
| Rate for Payer: Aetna Medicare |
$838.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,008.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,008.39
|
| Rate for Payer: BCBS Complete |
$597.29
|
| Rate for Payer: BCBS MAPPO |
$806.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,652.79
|
| Rate for Payer: BCN Commercial |
$2,652.79
|
| Rate for Payer: BCN Medicare Advantage |
$806.71
|
| Rate for Payer: Cash Price |
$2,581.48
|
| Rate for Payer: Cofinity Commercial |
$2,775.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,581.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$806.71
|
| Rate for Payer: Healthscope Commercial |
$2,904.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,420.14
|
| Rate for Payer: Mclaren Medicaid |
$568.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$847.05
|
| Rate for Payer: Meridian Medicaid |
$597.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$927.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$887.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,742.82
|
| Rate for Payer: Nomi Health Commercial |
$2,646.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,420.14
|
| Rate for Payer: PACE Senior Care Partners |
$766.38
|
| Rate for Payer: PACE SWMI |
$806.71
|
| Rate for Payer: PHP Commercial |
$2,742.82
|
| Rate for Payer: PHP Medicare Advantage |
$806.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$568.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,807.36
|
| Rate for Payer: Priority Health Medicare |
$814.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,245.89
|
| Rate for Payer: Railroad Medicare Medicare |
$806.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,839.63
|
| Rate for Payer: UHC Core |
$2,694.42
|
| Rate for Payer: UHC Exchange |
$806.71
|
| Rate for Payer: UHC Medicaid |
$568.89
|
| Rate for Payer: UHC Medicare Advantage |
$806.71
|
| Rate for Payer: UHCCP Medicaid |
$568.89
|
| Rate for Payer: VA VA |
$806.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,420.14
|
|
|
HC LEVEL 2 SUBSQ 15 MIN
|
Facility
|
OP
|
$1,237.94
|
|
| Hospital Charge Code |
36000065
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$218.25 |
| Max. Negotiated Rate |
$1,114.15 |
| Rate for Payer: Aetna Commercial |
$1,052.25
|
| Rate for Payer: Aetna Medicare |
$321.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$386.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$386.86
|
| Rate for Payer: BCBS Complete |
$229.14
|
| Rate for Payer: BCBS MAPPO |
$309.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,017.71
|
| Rate for Payer: BCN Commercial |
$1,017.71
|
| Rate for Payer: BCN Medicare Advantage |
$309.49
|
| Rate for Payer: Cash Price |
$990.35
|
| Rate for Payer: Cofinity Commercial |
$1,064.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$990.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.49
|
| Rate for Payer: Healthscope Commercial |
$1,114.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$928.46
|
| Rate for Payer: Mclaren Medicaid |
$218.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.96
|
| Rate for Payer: Meridian Medicaid |
$229.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$355.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$340.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,052.25
|
| Rate for Payer: Nomi Health Commercial |
$1,015.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$928.46
|
| Rate for Payer: PACE Senior Care Partners |
$294.01
|
| Rate for Payer: PACE SWMI |
$309.49
|
| Rate for Payer: PHP Commercial |
$1,052.25
|
| Rate for Payer: PHP Medicare Advantage |
$309.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,077.01
|
| Rate for Payer: Priority Health Medicare |
$312.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$861.61
|
| Rate for Payer: Railroad Medicare Medicare |
$309.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,089.39
|
| Rate for Payer: UHC Core |
$1,033.68
|
| Rate for Payer: UHC Exchange |
$309.49
|
| Rate for Payer: UHC Medicaid |
$218.25
|
| Rate for Payer: UHC Medicare Advantage |
$309.49
|
| Rate for Payer: UHCCP Medicaid |
$218.25
|
| Rate for Payer: VA VA |
$309.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$928.46
|
|
|
HC LEVEL 2 SUBSQ 15 MIN
|
Facility
|
IP
|
$1,237.94
|
|
| Hospital Charge Code |
36000065
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$861.61 |
| Max. Negotiated Rate |
$1,114.15 |
| Rate for Payer: Aetna Commercial |
$1,052.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,022.41
|
| Rate for Payer: BCN Commercial |
$1,022.41
|
| Rate for Payer: Cash Price |
$990.35
|
| Rate for Payer: Cofinity Commercial |
$1,064.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$990.35
|
| Rate for Payer: Healthscope Commercial |
$1,114.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$928.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,052.25
|
| Rate for Payer: Nomi Health Commercial |
$1,015.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$928.46
|
| Rate for Payer: PHP Commercial |
$1,052.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,077.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$861.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,089.39
|
| Rate for Payer: UHC Core |
$1,033.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$928.46
|
|
|
HC LEVEL 3 INIT 30 MIN
|
Facility
|
IP
|
$3,827.33
|
|
| Hospital Charge Code |
36000066
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,663.82 |
| Max. Negotiated Rate |
$3,444.60 |
| Rate for Payer: Aetna Commercial |
$3,253.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,160.99
|
| Rate for Payer: BCN Commercial |
$3,160.99
|
| Rate for Payer: Cash Price |
$3,061.86
|
| Rate for Payer: Cofinity Commercial |
$3,291.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,061.86
|
| Rate for Payer: Healthscope Commercial |
$3,444.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,870.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,253.23
|
| Rate for Payer: Nomi Health Commercial |
$3,138.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,870.50
|
| Rate for Payer: PHP Commercial |
$3,253.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,329.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,663.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,368.05
|
| Rate for Payer: UHC Core |
$3,195.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,870.50
|
|
|
HC LEVEL 3 INIT 30 MIN
|
Facility
|
OP
|
$3,827.33
|
|
| Hospital Charge Code |
36000066
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$674.76 |
| Max. Negotiated Rate |
$3,444.60 |
| Rate for Payer: Aetna Commercial |
$3,253.23
|
| Rate for Payer: Aetna Medicare |
$995.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,196.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,196.04
|
| Rate for Payer: BCBS Complete |
$708.44
|
| Rate for Payer: BCBS MAPPO |
$956.83
|
| Rate for Payer: BCBS Trust/PPO |
$3,146.45
|
| Rate for Payer: BCN Commercial |
$3,146.45
|
| Rate for Payer: BCN Medicare Advantage |
$956.83
|
| Rate for Payer: Cash Price |
$3,061.86
|
| Rate for Payer: Cofinity Commercial |
$3,291.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,061.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$956.83
|
| Rate for Payer: Healthscope Commercial |
$3,444.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,870.50
|
| Rate for Payer: Mclaren Medicaid |
$674.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,004.67
|
| Rate for Payer: Meridian Medicaid |
$708.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,100.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,052.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,253.23
|
| Rate for Payer: Nomi Health Commercial |
$3,138.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,870.50
|
| Rate for Payer: PACE Senior Care Partners |
$908.99
|
| Rate for Payer: PACE SWMI |
$956.83
|
| Rate for Payer: PHP Commercial |
$3,253.23
|
| Rate for Payer: PHP Medicare Advantage |
$956.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$674.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,329.78
|
| Rate for Payer: Priority Health Medicare |
$966.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,663.82
|
| Rate for Payer: Railroad Medicare Medicare |
$956.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,368.05
|
| Rate for Payer: UHC Core |
$3,195.82
|
| Rate for Payer: UHC Exchange |
$956.83
|
| Rate for Payer: UHC Medicaid |
$674.76
|
| Rate for Payer: UHC Medicare Advantage |
$956.83
|
| Rate for Payer: UHCCP Medicaid |
$674.76
|
| Rate for Payer: VA VA |
$956.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,870.50
|
|
|
HC LEVEL 3 SUBSQ 15 MIN
|
Facility
|
OP
|
$1,487.89
|
|
| Hospital Charge Code |
36000067
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$262.32 |
| Max. Negotiated Rate |
$1,339.10 |
| Rate for Payer: Aetna Commercial |
$1,264.71
|
| Rate for Payer: Aetna Medicare |
$386.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.97
|
| Rate for Payer: BCBS Complete |
$275.41
|
| Rate for Payer: BCBS MAPPO |
$371.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,223.19
|
| Rate for Payer: BCN Commercial |
$1,223.19
|
| Rate for Payer: BCN Medicare Advantage |
$371.97
|
| Rate for Payer: Cash Price |
$1,190.31
|
| Rate for Payer: Cofinity Commercial |
$1,279.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,190.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.97
|
| Rate for Payer: Healthscope Commercial |
$1,339.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,115.92
|
| Rate for Payer: Mclaren Medicaid |
$262.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.57
|
| Rate for Payer: Meridian Medicaid |
$275.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,264.71
|
| Rate for Payer: Nomi Health Commercial |
$1,220.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,115.92
|
| Rate for Payer: PACE Senior Care Partners |
$353.37
|
| Rate for Payer: PACE SWMI |
$371.97
|
| Rate for Payer: PHP Commercial |
$1,264.71
|
| Rate for Payer: PHP Medicare Advantage |
$371.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$262.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,294.46
|
| Rate for Payer: Priority Health Medicare |
$375.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,035.57
|
| Rate for Payer: Railroad Medicare Medicare |
$371.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,309.34
|
| Rate for Payer: UHC Core |
$1,242.39
|
| Rate for Payer: UHC Exchange |
$371.97
|
| Rate for Payer: UHC Medicaid |
$262.32
|
| Rate for Payer: UHC Medicare Advantage |
$371.97
|
| Rate for Payer: UHCCP Medicaid |
$262.32
|
| Rate for Payer: VA VA |
$371.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,115.92
|
|
|
HC LEVEL 3 SUBSQ 15 MIN
|
Facility
|
IP
|
$1,487.89
|
|
| Hospital Charge Code |
36000067
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,035.57 |
| Max. Negotiated Rate |
$1,339.10 |
| Rate for Payer: Aetna Commercial |
$1,264.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,228.85
|
| Rate for Payer: BCN Commercial |
$1,228.85
|
| Rate for Payer: Cash Price |
$1,190.31
|
| Rate for Payer: Cofinity Commercial |
$1,279.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,190.31
|
| Rate for Payer: Healthscope Commercial |
$1,339.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,115.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,264.71
|
| Rate for Payer: Nomi Health Commercial |
$1,220.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,115.92
|
| Rate for Payer: PHP Commercial |
$1,264.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,294.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,035.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,309.34
|
| Rate for Payer: UHC Core |
$1,242.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,115.92
|
|
|
HC LEVEL 4 INIT 30 MIN
|
Facility
|
OP
|
$4,556.50
|
|
| Hospital Charge Code |
36000068
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$803.31 |
| Max. Negotiated Rate |
$4,100.85 |
| Rate for Payer: Aetna Commercial |
$3,873.03
|
| Rate for Payer: Aetna Medicare |
$1,184.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,423.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,423.91
|
| Rate for Payer: BCBS Complete |
$843.41
|
| Rate for Payer: BCBS MAPPO |
$1,139.12
|
| Rate for Payer: BCBS Trust/PPO |
$3,745.90
|
| Rate for Payer: BCN Commercial |
$3,745.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,139.12
|
| Rate for Payer: Cash Price |
$3,645.20
|
| Rate for Payer: Cofinity Commercial |
$3,918.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,645.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,139.12
|
| Rate for Payer: Healthscope Commercial |
$4,100.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,417.38
|
| Rate for Payer: Mclaren Medicaid |
$803.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,196.08
|
| Rate for Payer: Meridian Medicaid |
$843.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,309.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,253.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,873.03
|
| Rate for Payer: Nomi Health Commercial |
$3,736.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,417.38
|
| Rate for Payer: PACE Senior Care Partners |
$1,082.17
|
| Rate for Payer: PACE SWMI |
$1,139.12
|
| Rate for Payer: PHP Commercial |
$3,873.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,139.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$803.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,964.16
|
| Rate for Payer: Priority Health Medicare |
$1,150.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,171.32
|
| Rate for Payer: Railroad Medicare Medicare |
$1,139.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,009.72
|
| Rate for Payer: UHC Core |
$3,804.68
|
| Rate for Payer: UHC Exchange |
$1,139.12
|
| Rate for Payer: UHC Medicaid |
$803.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,139.12
|
| Rate for Payer: UHCCP Medicaid |
$803.31
|
| Rate for Payer: VA VA |
$1,139.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,417.38
|
|
|
HC LEVEL 4 INIT 30 MIN
|
Facility
|
IP
|
$4,556.50
|
|
| Hospital Charge Code |
36000068
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,171.32 |
| Max. Negotiated Rate |
$4,100.85 |
| Rate for Payer: Aetna Commercial |
$3,873.03
|
| Rate for Payer: BCBS Trust/PPO |
$3,763.21
|
| Rate for Payer: BCN Commercial |
$3,763.21
|
| Rate for Payer: Cash Price |
$3,645.20
|
| Rate for Payer: Cofinity Commercial |
$3,918.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,645.20
|
| Rate for Payer: Healthscope Commercial |
$4,100.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,417.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,873.03
|
| Rate for Payer: Nomi Health Commercial |
$3,736.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,417.38
|
| Rate for Payer: PHP Commercial |
$3,873.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,964.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,171.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,009.72
|
| Rate for Payer: UHC Core |
$3,804.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,417.38
|
|
|
HC LEVEL 4 SUBSQ 15 MIN
|
Facility
|
OP
|
$1,658.07
|
|
| Hospital Charge Code |
36000069
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$292.32 |
| Max. Negotiated Rate |
$1,492.26 |
| Rate for Payer: Aetna Commercial |
$1,409.36
|
| Rate for Payer: Aetna Medicare |
$431.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$518.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$518.15
|
| Rate for Payer: BCBS Complete |
$306.91
|
| Rate for Payer: BCBS MAPPO |
$414.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,363.10
|
| Rate for Payer: BCN Commercial |
$1,363.10
|
| Rate for Payer: BCN Medicare Advantage |
$414.52
|
| Rate for Payer: Cash Price |
$1,326.46
|
| Rate for Payer: Cofinity Commercial |
$1,425.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,326.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$414.52
|
| Rate for Payer: Healthscope Commercial |
$1,492.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,243.55
|
| Rate for Payer: Mclaren Medicaid |
$292.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$435.24
|
| Rate for Payer: Meridian Medicaid |
$306.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$476.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$455.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,409.36
|
| Rate for Payer: Nomi Health Commercial |
$1,359.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,243.55
|
| Rate for Payer: PACE Senior Care Partners |
$393.79
|
| Rate for Payer: PACE SWMI |
$414.52
|
| Rate for Payer: PHP Commercial |
$1,409.36
|
| Rate for Payer: PHP Medicare Advantage |
$414.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$292.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,442.52
|
| Rate for Payer: Priority Health Medicare |
$418.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,154.02
|
| Rate for Payer: Railroad Medicare Medicare |
$414.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,459.10
|
| Rate for Payer: UHC Core |
$1,384.49
|
| Rate for Payer: UHC Exchange |
$414.52
|
| Rate for Payer: UHC Medicaid |
$292.32
|
| Rate for Payer: UHC Medicare Advantage |
$414.52
|
| Rate for Payer: UHCCP Medicaid |
$292.32
|
| Rate for Payer: VA VA |
$414.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,243.55
|
|
|
HC LEVEL 4 SUBSQ 15 MIN
|
Facility
|
IP
|
$1,658.07
|
|
| Hospital Charge Code |
36000069
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,154.02 |
| Max. Negotiated Rate |
$1,492.26 |
| Rate for Payer: Aetna Commercial |
$1,409.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,369.40
|
| Rate for Payer: BCN Commercial |
$1,369.40
|
| Rate for Payer: Cash Price |
$1,326.46
|
| Rate for Payer: Cofinity Commercial |
$1,425.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,326.46
|
| Rate for Payer: Healthscope Commercial |
$1,492.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,243.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,409.36
|
| Rate for Payer: Nomi Health Commercial |
$1,359.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,243.55
|
| Rate for Payer: PHP Commercial |
$1,409.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,442.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,154.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,459.10
|
| Rate for Payer: UHC Core |
$1,384.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,243.55
|
|
|
HC LEVEL 5 INIT 30 MIN
|
Facility
|
IP
|
$5,084.43
|
|
| Hospital Charge Code |
36000070
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,538.76 |
| Max. Negotiated Rate |
$4,575.99 |
| Rate for Payer: Aetna Commercial |
$4,321.77
|
| Rate for Payer: BCBS Trust/PPO |
$4,199.23
|
| Rate for Payer: BCN Commercial |
$4,199.23
|
| Rate for Payer: Cash Price |
$4,067.54
|
| Rate for Payer: Cofinity Commercial |
$4,372.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,067.54
|
| Rate for Payer: Healthscope Commercial |
$4,575.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,813.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,321.77
|
| Rate for Payer: Nomi Health Commercial |
$4,169.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,813.32
|
| Rate for Payer: PHP Commercial |
$4,321.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,423.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,538.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,474.30
|
| Rate for Payer: UHC Core |
$4,245.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,813.32
|
|
|
HC LEVEL 5 INIT 30 MIN
|
Facility
|
OP
|
$5,084.43
|
|
| Hospital Charge Code |
36000070
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$896.39 |
| Max. Negotiated Rate |
$4,575.99 |
| Rate for Payer: Aetna Commercial |
$4,321.77
|
| Rate for Payer: Aetna Medicare |
$1,321.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,588.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,588.88
|
| Rate for Payer: BCBS Complete |
$941.13
|
| Rate for Payer: BCBS MAPPO |
$1,271.11
|
| Rate for Payer: BCBS Trust/PPO |
$4,179.91
|
| Rate for Payer: BCN Commercial |
$4,179.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,271.11
|
| Rate for Payer: Cash Price |
$4,067.54
|
| Rate for Payer: Cofinity Commercial |
$4,372.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,067.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,271.11
|
| Rate for Payer: Healthscope Commercial |
$4,575.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,813.32
|
| Rate for Payer: Mclaren Medicaid |
$896.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,334.66
|
| Rate for Payer: Meridian Medicaid |
$941.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,461.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,398.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,321.77
|
| Rate for Payer: Nomi Health Commercial |
$4,169.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,813.32
|
| Rate for Payer: PACE Senior Care Partners |
$1,207.55
|
| Rate for Payer: PACE SWMI |
$1,271.11
|
| Rate for Payer: PHP Commercial |
$4,321.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,271.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$896.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,423.45
|
| Rate for Payer: Priority Health Medicare |
$1,283.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,538.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,271.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,474.30
|
| Rate for Payer: UHC Core |
$4,245.50
|
| Rate for Payer: UHC Exchange |
$1,271.11
|
| Rate for Payer: UHC Medicaid |
$896.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,271.11
|
| Rate for Payer: UHCCP Medicaid |
$896.39
|
| Rate for Payer: VA VA |
$1,271.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,813.32
|
|
|
HC LEVEL 5 SUBSQ 15 MIN
|
Facility
|
IP
|
$2,078.52
|
|
| Hospital Charge Code |
36000071
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,446.65 |
| Max. Negotiated Rate |
$1,870.67 |
| Rate for Payer: Aetna Commercial |
$1,766.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.65
|
| Rate for Payer: BCN Commercial |
$1,716.65
|
| Rate for Payer: Cash Price |
$1,662.82
|
| Rate for Payer: Cofinity Commercial |
$1,787.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,662.82
|
| Rate for Payer: Healthscope Commercial |
$1,870.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,558.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,766.74
|
| Rate for Payer: Nomi Health Commercial |
$1,704.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,558.89
|
| Rate for Payer: PHP Commercial |
$1,766.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,808.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,446.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,829.10
|
| Rate for Payer: UHC Core |
$1,735.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,558.89
|
|
|
HC LEVEL 5 SUBSQ 15 MIN
|
Facility
|
OP
|
$2,078.52
|
|
| Hospital Charge Code |
36000071
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$366.44 |
| Max. Negotiated Rate |
$1,870.67 |
| Rate for Payer: Aetna Commercial |
$1,766.74
|
| Rate for Payer: Aetna Medicare |
$540.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$649.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$649.54
|
| Rate for Payer: BCBS Complete |
$384.73
|
| Rate for Payer: BCBS MAPPO |
$519.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,708.75
|
| Rate for Payer: BCN Commercial |
$1,708.75
|
| Rate for Payer: BCN Medicare Advantage |
$519.63
|
| Rate for Payer: Cash Price |
$1,662.82
|
| Rate for Payer: Cofinity Commercial |
$1,787.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,662.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.63
|
| Rate for Payer: Healthscope Commercial |
$1,870.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,558.89
|
| Rate for Payer: Mclaren Medicaid |
$366.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.61
|
| Rate for Payer: Meridian Medicaid |
$384.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$597.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$571.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,766.74
|
| Rate for Payer: Nomi Health Commercial |
$1,704.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,558.89
|
| Rate for Payer: PACE Senior Care Partners |
$493.65
|
| Rate for Payer: PACE SWMI |
$519.63
|
| Rate for Payer: PHP Commercial |
$1,766.74
|
| Rate for Payer: PHP Medicare Advantage |
$519.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,808.31
|
| Rate for Payer: Priority Health Medicare |
$524.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,446.65
|
| Rate for Payer: Railroad Medicare Medicare |
$519.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,829.10
|
| Rate for Payer: UHC Core |
$1,735.56
|
| Rate for Payer: UHC Exchange |
$519.63
|
| Rate for Payer: UHC Medicaid |
$366.44
|
| Rate for Payer: UHC Medicare Advantage |
$519.63
|
| Rate for Payer: UHCCP Medicaid |
$366.44
|
| Rate for Payer: VA VA |
$519.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,558.89
|
|
|
HC LEVETIRACETAM LEVEL
|
Facility
|
IP
|
$78.33
|
|
|
Service Code
|
CPT 80177
|
| Hospital Charge Code |
30100057
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.52 |
| Max. Negotiated Rate |
$70.50 |
| Rate for Payer: Aetna Commercial |
$66.58
|
| Rate for Payer: BCBS Trust/PPO |
$64.69
|
| Rate for Payer: BCN Commercial |
$64.69
|
| Rate for Payer: Cash Price |
$62.66
|
| Rate for Payer: Cofinity Commercial |
$67.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.66
|
| Rate for Payer: Healthscope Commercial |
$70.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.58
|
| Rate for Payer: Nomi Health Commercial |
$64.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.75
|
| Rate for Payer: PHP Commercial |
$66.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$68.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.93
|
| Rate for Payer: UHC Core |
$65.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.75
|
|
