|
HC MANIPULAT PALMAR FAC CORD POST INJ
|
Facility
|
IP
|
$504.07
|
|
|
Service Code
|
CPT 26341
|
| Hospital Charge Code |
76100318
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$350.83 |
| Max. Negotiated Rate |
$453.66 |
| Rate for Payer: Aetna Commercial |
$428.46
|
| Rate for Payer: BCBS Trust/PPO |
$416.31
|
| Rate for Payer: BCN Commercial |
$416.31
|
| Rate for Payer: Cash Price |
$403.26
|
| Rate for Payer: Cofinity Commercial |
$433.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$403.26
|
| Rate for Payer: Healthscope Commercial |
$453.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$428.46
|
| Rate for Payer: Nomi Health Commercial |
$413.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.05
|
| Rate for Payer: PHP Commercial |
$428.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$438.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$350.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$443.58
|
| Rate for Payer: UHC Core |
$420.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.05
|
|
|
HC MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH
|
Facility
|
IP
|
$1,522.83
|
|
|
Service Code
|
CPT 50396
|
| Hospital Charge Code |
36100614
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,059.89 |
| Max. Negotiated Rate |
$1,370.55 |
| Rate for Payer: Aetna Commercial |
$1,294.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,257.71
|
| Rate for Payer: BCN Commercial |
$1,257.71
|
| Rate for Payer: Cash Price |
$1,218.26
|
| Rate for Payer: Cofinity Commercial |
$1,309.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,218.26
|
| Rate for Payer: Healthscope Commercial |
$1,370.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,142.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,294.41
|
| Rate for Payer: Nomi Health Commercial |
$1,248.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,142.12
|
| Rate for Payer: PHP Commercial |
$1,294.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,324.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,059.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,340.09
|
| Rate for Payer: UHC Core |
$1,271.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,142.12
|
|
|
HC MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH
|
Facility
|
OP
|
$1,522.83
|
|
|
Service Code
|
CPT 50396
|
| Hospital Charge Code |
36100614
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$268.47 |
| Max. Negotiated Rate |
$1,370.55 |
| Rate for Payer: Aetna Commercial |
$1,294.41
|
| Rate for Payer: Aetna Medicare |
$395.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$475.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$475.88
|
| Rate for Payer: BCBS Complete |
$281.88
|
| Rate for Payer: BCBS MAPPO |
$380.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,251.92
|
| Rate for Payer: BCN Commercial |
$1,251.92
|
| Rate for Payer: BCN Medicare Advantage |
$380.71
|
| Rate for Payer: Cash Price |
$1,218.26
|
| Rate for Payer: Cofinity Commercial |
$1,309.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,218.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.71
|
| Rate for Payer: Healthscope Commercial |
$1,370.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,142.12
|
| Rate for Payer: Mclaren Medicaid |
$268.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.74
|
| Rate for Payer: Meridian Medicaid |
$281.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$437.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$418.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,294.41
|
| Rate for Payer: Nomi Health Commercial |
$1,248.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,142.12
|
| Rate for Payer: PACE Senior Care Partners |
$361.67
|
| Rate for Payer: PACE SWMI |
$380.71
|
| Rate for Payer: PHP Commercial |
$1,294.41
|
| Rate for Payer: PHP Medicare Advantage |
$380.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,324.86
|
| Rate for Payer: Priority Health Medicare |
$384.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,059.89
|
| Rate for Payer: Railroad Medicare Medicare |
$380.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,340.09
|
| Rate for Payer: UHC Core |
$1,271.56
|
| Rate for Payer: UHC Exchange |
$380.71
|
| Rate for Payer: UHC Medicaid |
$268.47
|
| Rate for Payer: UHC Medicare Advantage |
$380.71
|
| Rate for Payer: UHCCP Medicaid |
$268.47
|
| Rate for Payer: VA VA |
$380.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,142.12
|
|
|
HC MANTIS CLIP
|
Facility
|
OP
|
$1,179.81
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27200356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$208.00 |
| Max. Negotiated Rate |
$1,061.83 |
| Rate for Payer: Aetna Commercial |
$1,002.84
|
| Rate for Payer: Aetna Medicare |
$306.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$368.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$368.69
|
| Rate for Payer: BCBS Complete |
$218.38
|
| Rate for Payer: BCBS MAPPO |
$294.95
|
| Rate for Payer: BCBS Trust/PPO |
$969.92
|
| Rate for Payer: BCN Commercial |
$969.92
|
| Rate for Payer: BCN Medicare Advantage |
$294.95
|
| Rate for Payer: Cash Price |
$943.85
|
| Rate for Payer: Cofinity Commercial |
$1,014.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$943.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.95
|
| Rate for Payer: Healthscope Commercial |
$1,061.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$884.86
|
| Rate for Payer: Mclaren Medicaid |
$208.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$309.70
|
| Rate for Payer: Meridian Medicaid |
$218.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$339.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$324.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,002.84
|
| Rate for Payer: Nomi Health Commercial |
$967.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$884.86
|
| Rate for Payer: PACE Senior Care Partners |
$280.20
|
| Rate for Payer: PACE SWMI |
$294.95
|
| Rate for Payer: PHP Commercial |
$1,002.84
|
| Rate for Payer: PHP Medicare Advantage |
$294.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,026.43
|
| Rate for Payer: Priority Health Medicare |
$297.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$821.15
|
| Rate for Payer: Railroad Medicare Medicare |
$294.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,038.23
|
| Rate for Payer: UHC Core |
$985.14
|
| Rate for Payer: UHC Exchange |
$294.95
|
| Rate for Payer: UHC Medicaid |
$208.00
|
| Rate for Payer: UHC Medicare Advantage |
$294.95
|
| Rate for Payer: UHCCP Medicaid |
$208.00
|
| Rate for Payer: VA VA |
$294.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$884.86
|
|
|
HC MANTIS CLIP
|
Facility
|
IP
|
$1,179.81
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27200356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$821.15 |
| Max. Negotiated Rate |
$1,061.83 |
| Rate for Payer: Aetna Commercial |
$1,002.84
|
| Rate for Payer: BCBS Trust/PPO |
$974.41
|
| Rate for Payer: BCN Commercial |
$974.41
|
| Rate for Payer: Cash Price |
$943.85
|
| Rate for Payer: Cofinity Commercial |
$1,014.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$943.85
|
| Rate for Payer: Healthscope Commercial |
$1,061.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$884.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,002.84
|
| Rate for Payer: Nomi Health Commercial |
$967.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$884.86
|
| Rate for Payer: PHP Commercial |
$1,002.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,026.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$821.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,038.23
|
| Rate for Payer: UHC Core |
$985.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$884.86
|
|
|
HC MANUAL DIFFERENTIAL
|
Facility
|
OP
|
$47.24
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
30500002
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.33 |
| Max. Negotiated Rate |
$42.52 |
| Rate for Payer: Aetna Commercial |
$40.15
|
| Rate for Payer: Aetna Medicare |
$12.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.76
|
| Rate for Payer: BCBS Complete |
$8.74
|
| Rate for Payer: BCBS MAPPO |
$11.81
|
| Rate for Payer: BCBS Trust/PPO |
$38.84
|
| Rate for Payer: BCN Commercial |
$38.84
|
| Rate for Payer: BCN Medicare Advantage |
$11.81
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.81
|
| Rate for Payer: Healthscope Commercial |
$42.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.43
|
| Rate for Payer: Mclaren Medicaid |
$8.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.40
|
| Rate for Payer: Meridian Medicaid |
$8.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Nomi Health Commercial |
$38.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.43
|
| Rate for Payer: PACE Senior Care Partners |
$11.22
|
| Rate for Payer: PACE SWMI |
$11.81
|
| Rate for Payer: PHP Commercial |
$40.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.10
|
| Rate for Payer: Priority Health Medicare |
$11.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.88
|
| Rate for Payer: Railroad Medicare Medicare |
$11.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.57
|
| Rate for Payer: UHC Core |
$39.45
|
| Rate for Payer: UHC Exchange |
$11.81
|
| Rate for Payer: UHC Medicaid |
$8.33
|
| Rate for Payer: UHC Medicare Advantage |
$11.81
|
| Rate for Payer: UHCCP Medicaid |
$8.33
|
| Rate for Payer: VA VA |
$11.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.43
|
|
|
HC MANUAL DIFFERENTIAL
|
Facility
|
IP
|
$47.24
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
30500002
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$32.88 |
| Max. Negotiated Rate |
$42.52 |
| Rate for Payer: Aetna Commercial |
$40.15
|
| Rate for Payer: BCBS Trust/PPO |
$39.02
|
| Rate for Payer: BCN Commercial |
$39.02
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Healthscope Commercial |
$42.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Nomi Health Commercial |
$38.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.43
|
| Rate for Payer: PHP Commercial |
$40.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.57
|
| Rate for Payer: UHC Core |
$39.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.43
|
|
|
HC MAPLE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200046
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC MAPLE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200046
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC MAPPING W/INTRACARDIAC 3D
|
Facility
|
IP
|
$6,292.96
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
48100035
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,379.90 |
| Max. Negotiated Rate |
$5,663.66 |
| Rate for Payer: Aetna Commercial |
$5,349.02
|
| Rate for Payer: BCBS Trust/PPO |
$5,197.36
|
| Rate for Payer: BCN Commercial |
$5,197.36
|
| Rate for Payer: Cash Price |
$5,034.37
|
| Rate for Payer: Cofinity Commercial |
$5,411.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,034.37
|
| Rate for Payer: Healthscope Commercial |
$5,663.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,719.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,349.02
|
| Rate for Payer: Nomi Health Commercial |
$5,160.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,719.72
|
| Rate for Payer: PHP Commercial |
$5,349.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,474.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,379.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,537.80
|
| Rate for Payer: UHC Core |
$5,254.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,719.72
|
|
|
HC MAPPING W/INTRACARDIAC 3D
|
Facility
|
OP
|
$6,292.96
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
48100035
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,109.45 |
| Max. Negotiated Rate |
$5,663.66 |
| Rate for Payer: Aetna Commercial |
$5,349.02
|
| Rate for Payer: Aetna Medicare |
$1,636.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,966.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,966.55
|
| Rate for Payer: BCBS Complete |
$1,164.83
|
| Rate for Payer: BCBS MAPPO |
$1,573.24
|
| Rate for Payer: BCBS Trust/PPO |
$5,173.44
|
| Rate for Payer: BCN Commercial |
$5,173.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,573.24
|
| Rate for Payer: Cash Price |
$5,034.37
|
| Rate for Payer: Cofinity Commercial |
$5,411.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,034.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,573.24
|
| Rate for Payer: Healthscope Commercial |
$5,663.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,719.72
|
| Rate for Payer: Mclaren Medicaid |
$1,109.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,651.90
|
| Rate for Payer: Meridian Medicaid |
$1,164.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,809.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,730.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,349.02
|
| Rate for Payer: Nomi Health Commercial |
$5,160.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,719.72
|
| Rate for Payer: PACE Senior Care Partners |
$1,494.58
|
| Rate for Payer: PACE SWMI |
$1,573.24
|
| Rate for Payer: PHP Commercial |
$5,349.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,573.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,109.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,474.88
|
| Rate for Payer: Priority Health Medicare |
$1,588.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,379.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,573.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,537.80
|
| Rate for Payer: UHC Core |
$5,254.62
|
| Rate for Payer: UHC Exchange |
$1,573.24
|
| Rate for Payer: UHC Medicaid |
$1,109.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,573.24
|
| Rate for Payer: UHCCP Medicaid |
$1,109.45
|
| Rate for Payer: VA VA |
$1,573.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,719.72
|
|
|
HC MAPPING W/OUT INTRACARDIAC 3D
|
Facility
|
IP
|
$4,486.04
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
48100032
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,122.28 |
| Max. Negotiated Rate |
$4,037.44 |
| Rate for Payer: Aetna Commercial |
$3,813.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,705.02
|
| Rate for Payer: BCN Commercial |
$3,705.02
|
| Rate for Payer: Cash Price |
$3,588.83
|
| Rate for Payer: Cofinity Commercial |
$3,857.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,588.83
|
| Rate for Payer: Healthscope Commercial |
$4,037.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,364.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,813.13
|
| Rate for Payer: Nomi Health Commercial |
$3,678.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,364.53
|
| Rate for Payer: PHP Commercial |
$3,813.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,902.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,122.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,947.72
|
| Rate for Payer: UHC Core |
$3,745.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,364.53
|
|
|
HC MAPPING W/OUT INTRACARDIAC 3D
|
Facility
|
OP
|
$4,486.04
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
48100032
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$790.89 |
| Max. Negotiated Rate |
$4,037.44 |
| Rate for Payer: Aetna Commercial |
$3,813.13
|
| Rate for Payer: Aetna Medicare |
$1,166.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,401.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,401.89
|
| Rate for Payer: BCBS Complete |
$830.37
|
| Rate for Payer: BCBS MAPPO |
$1,121.51
|
| Rate for Payer: BCBS Trust/PPO |
$3,687.97
|
| Rate for Payer: BCN Commercial |
$3,687.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,121.51
|
| Rate for Payer: Cash Price |
$3,588.83
|
| Rate for Payer: Cofinity Commercial |
$3,857.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,588.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,121.51
|
| Rate for Payer: Healthscope Commercial |
$4,037.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,364.53
|
| Rate for Payer: Mclaren Medicaid |
$790.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,177.59
|
| Rate for Payer: Meridian Medicaid |
$830.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,289.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,233.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,813.13
|
| Rate for Payer: Nomi Health Commercial |
$3,678.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,364.53
|
| Rate for Payer: PACE Senior Care Partners |
$1,065.43
|
| Rate for Payer: PACE SWMI |
$1,121.51
|
| Rate for Payer: PHP Commercial |
$3,813.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,121.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$790.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,902.85
|
| Rate for Payer: Priority Health Medicare |
$1,132.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,122.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1,121.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,947.72
|
| Rate for Payer: UHC Core |
$3,745.84
|
| Rate for Payer: UHC Exchange |
$1,121.51
|
| Rate for Payer: UHC Medicaid |
$790.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,121.51
|
| Rate for Payer: UHCCP Medicaid |
$790.89
|
| Rate for Payer: VA VA |
$1,121.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,364.53
|
|
|
HC MARS BARTHOLINS GLAND CYST
|
Facility
|
OP
|
$8,104.44
|
|
|
Service Code
|
CPT 56440
|
| Hospital Charge Code |
76100331
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,428.81 |
| Max. Negotiated Rate |
$7,294.00 |
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: Aetna Medicare |
$2,107.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,532.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,532.64
|
| Rate for Payer: BCBS Complete |
$1,500.13
|
| Rate for Payer: BCBS MAPPO |
$2,026.11
|
| Rate for Payer: BCBS Trust/PPO |
$6,662.66
|
| Rate for Payer: BCN Commercial |
$6,662.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,026.11
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,026.11
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Mclaren Medicaid |
$1,428.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,127.42
|
| Rate for Payer: Meridian Medicaid |
$1,500.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,330.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,228.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,924.80
|
| Rate for Payer: PACE SWMI |
$2,026.11
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: PHP Medicare Advantage |
$2,026.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,428.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,050.86
|
| Rate for Payer: Priority Health Medicare |
$2,046.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,640.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2,026.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,131.91
|
| Rate for Payer: UHC Core |
$6,767.21
|
| Rate for Payer: UHC Exchange |
$2,026.11
|
| Rate for Payer: UHC Medicaid |
$1,428.81
|
| Rate for Payer: UHC Medicare Advantage |
$2,026.11
|
| Rate for Payer: UHCCP Medicaid |
$1,428.81
|
| Rate for Payer: VA VA |
$2,026.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
|
HC MARS BARTHOLINS GLAND CYST
|
Facility
|
IP
|
$8,104.44
|
|
|
Service Code
|
CPT 56440
|
| Hospital Charge Code |
76100331
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,640.69 |
| Max. Negotiated Rate |
$7,294.00 |
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: BCBS Trust/PPO |
$6,693.46
|
| Rate for Payer: BCN Commercial |
$6,693.46
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,050.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,640.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,131.91
|
| Rate for Payer: UHC Core |
$6,767.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
|
HC MARSUPIALIZ SUBLNGL SALIVARY CYST RANULA
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 42409
|
| Hospital Charge Code |
76100472
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,720.54 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: BCBS Trust/PPO |
$6,788.20
|
| Rate for Payer: BCN Commercial |
$6,788.20
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$6,739.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,150.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,720.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,232.86
|
| Rate for Payer: UHC Core |
$6,863.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC MARSUPIALIZ SUBLNGL SALIVARY CYST RANULA
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 42409
|
| Hospital Charge Code |
76100472
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,449.04 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna Medicare |
$2,136.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,568.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,568.49
|
| Rate for Payer: BCBS Complete |
$1,521.37
|
| Rate for Payer: BCBS MAPPO |
$2,054.79
|
| Rate for Payer: BCBS Trust/PPO |
$6,756.97
|
| Rate for Payer: BCN Commercial |
$6,756.97
|
| Rate for Payer: BCN Medicare Advantage |
$2,054.79
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,054.79
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Mclaren Medicaid |
$1,449.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,157.53
|
| Rate for Payer: Meridian Medicaid |
$1,521.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,363.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,260.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$6,739.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PACE Senior Care Partners |
$1,952.05
|
| Rate for Payer: PACE SWMI |
$2,054.79
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: PHP Medicare Advantage |
$2,054.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,449.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,150.67
|
| Rate for Payer: Priority Health Medicare |
$2,075.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,720.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,054.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,232.86
|
| Rate for Payer: UHC Core |
$6,863.00
|
| Rate for Payer: UHC Exchange |
$2,054.79
|
| Rate for Payer: UHC Medicaid |
$1,449.04
|
| Rate for Payer: UHC Medicare Advantage |
$2,054.79
|
| Rate for Payer: UHCCP Medicaid |
$1,449.04
|
| Rate for Payer: VA VA |
$2,054.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC MASSAGE THERAPY
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 97124
|
| Hospital Charge Code |
42000024
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$5.50 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$8.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.75
|
| Rate for Payer: BCBS Complete |
$5.78
|
| Rate for Payer: BCBS MAPPO |
$7.80
|
| Rate for Payer: BCBS Trust/PPO |
$25.66
|
| Rate for Payer: BCN Commercial |
$25.66
|
| Rate for Payer: BCN Medicare Advantage |
$7.80
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.80
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$5.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.19
|
| Rate for Payer: Meridian Medicaid |
$5.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PACE Senior Care Partners |
$7.41
|
| Rate for Payer: PACE SWMI |
$7.80
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$7.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Medicare |
$7.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.72
|
| Rate for Payer: Railroad Medicare Medicare |
$7.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: UHC Exchange |
$7.80
|
| Rate for Payer: UHC Medicaid |
$5.50
|
| Rate for Payer: UHC Medicare Advantage |
$7.80
|
| Rate for Payer: UHCCP Medicaid |
$5.50
|
| Rate for Payer: VA VA |
$7.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC MASSAGE THERAPY
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 97124
|
| Hospital Charge Code |
42000024
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.72 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$25.78
|
| Rate for Payer: BCN Commercial |
$25.78
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC MASTECTOMY SLEEVE EA $100
|
Facility
|
IP
|
$104.04
|
|
| Hospital Charge Code |
96000004
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$72.41 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: BCBS Trust/PPO |
$85.93
|
| Rate for Payer: BCN Commercial |
$85.93
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.03
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC MASTECTOMY SLEEVE EA $100
|
Facility
|
OP
|
$104.04
|
|
| Hospital Charge Code |
96000004
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.34 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna Medicare |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.51
|
| Rate for Payer: BCBS Complete |
$19.26
|
| Rate for Payer: BCBS MAPPO |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$85.53
|
| Rate for Payer: BCN Commercial |
$85.53
|
| Rate for Payer: BCN Medicare Advantage |
$26.01
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.01
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Mclaren Medicaid |
$18.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.31
|
| Rate for Payer: Meridian Medicaid |
$19.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.03
|
| Rate for Payer: PACE Senior Care Partners |
$24.71
|
| Rate for Payer: PACE SWMI |
$26.01
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: PHP Medicare Advantage |
$26.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Medicare |
$26.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.41
|
| Rate for Payer: Railroad Medicare Medicare |
$26.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: UHC Exchange |
$26.01
|
| Rate for Payer: UHC Medicaid |
$18.34
|
| Rate for Payer: UHC Medicare Advantage |
$26.01
|
| Rate for Payer: UHCCP Medicaid |
$18.34
|
| Rate for Payer: VA VA |
$26.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC MASTECTOMY SLEEVE EA $125
|
Facility
|
OP
|
$130.05
|
|
| Hospital Charge Code |
96000005
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.93 |
| Max. Negotiated Rate |
$117.05 |
| Rate for Payer: Aetna Commercial |
$110.54
|
| Rate for Payer: Aetna Medicare |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.64
|
| Rate for Payer: BCBS Complete |
$24.07
|
| Rate for Payer: BCBS MAPPO |
$32.51
|
| Rate for Payer: BCBS Trust/PPO |
$106.91
|
| Rate for Payer: BCN Commercial |
$106.91
|
| Rate for Payer: BCN Medicare Advantage |
$32.51
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Commercial |
$111.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.51
|
| Rate for Payer: Healthscope Commercial |
$117.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.54
|
| Rate for Payer: Mclaren Medicaid |
$22.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.14
|
| Rate for Payer: Meridian Medicaid |
$24.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: Nomi Health Commercial |
$106.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.54
|
| Rate for Payer: PACE Senior Care Partners |
$30.89
|
| Rate for Payer: PACE SWMI |
$32.51
|
| Rate for Payer: PHP Commercial |
$110.54
|
| Rate for Payer: PHP Medicare Advantage |
$32.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.14
|
| Rate for Payer: Priority Health Medicare |
$32.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.51
|
| Rate for Payer: Railroad Medicare Medicare |
$32.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.44
|
| Rate for Payer: UHC Core |
$108.59
|
| Rate for Payer: UHC Exchange |
$32.51
|
| Rate for Payer: UHC Medicaid |
$22.93
|
| Rate for Payer: UHC Medicare Advantage |
$32.51
|
| Rate for Payer: UHCCP Medicaid |
$22.93
|
| Rate for Payer: VA VA |
$32.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.54
|
|
|
HC MASTECTOMY SLEEVE EA $125
|
Facility
|
IP
|
$130.05
|
|
| Hospital Charge Code |
96000005
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$90.51 |
| Max. Negotiated Rate |
$117.05 |
| Rate for Payer: Aetna Commercial |
$110.54
|
| Rate for Payer: BCBS Trust/PPO |
$107.41
|
| Rate for Payer: BCN Commercial |
$107.41
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Commercial |
$111.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Healthscope Commercial |
$117.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: Nomi Health Commercial |
$106.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.54
|
| Rate for Payer: PHP Commercial |
$110.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.44
|
| Rate for Payer: UHC Core |
$108.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.54
|
|
|
HC MASTECTOMY SLEEVE EA $150
|
Facility
|
OP
|
$156.06
|
|
| Hospital Charge Code |
96000006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.51 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$40.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.77
|
| Rate for Payer: BCBS Complete |
$28.89
|
| Rate for Payer: BCBS MAPPO |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$128.30
|
| Rate for Payer: BCN Commercial |
$128.30
|
| Rate for Payer: BCN Medicare Advantage |
$39.02
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.02
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Mclaren Medicaid |
$27.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.97
|
| Rate for Payer: Meridian Medicaid |
$28.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PACE Senior Care Partners |
$37.06
|
| Rate for Payer: PACE SWMI |
$39.02
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: PHP Medicare Advantage |
$39.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Medicare |
$39.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.62
|
| Rate for Payer: Railroad Medicare Medicare |
$39.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: UHC Exchange |
$39.02
|
| Rate for Payer: UHC Medicaid |
$27.51
|
| Rate for Payer: UHC Medicare Advantage |
$39.02
|
| Rate for Payer: UHCCP Medicaid |
$27.51
|
| Rate for Payer: VA VA |
$39.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC MASTECTOMY SLEEVE EA $150
|
Facility
|
IP
|
$156.06
|
|
| Hospital Charge Code |
96000006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$108.62 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: BCBS Trust/PPO |
$128.89
|
| Rate for Payer: BCN Commercial |
$128.89
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
