|
HC MASTECTOMY SLEEVE EA $450
|
Facility
|
IP
|
$468.18
|
|
| Hospital Charge Code |
96000019
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$325.85 |
| Max. Negotiated Rate |
$421.36 |
| Rate for Payer: Aetna Commercial |
$397.95
|
| Rate for Payer: BCBS Trust/PPO |
$386.67
|
| Rate for Payer: BCN Commercial |
$386.67
|
| Rate for Payer: Cash Price |
$374.54
|
| Rate for Payer: Cofinity Commercial |
$402.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.54
|
| Rate for Payer: Healthscope Commercial |
$421.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$397.95
|
| Rate for Payer: Nomi Health Commercial |
$383.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.13
|
| Rate for Payer: PHP Commercial |
$397.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$407.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.00
|
| Rate for Payer: UHC Core |
$390.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.13
|
|
|
HC MASTECTOMY SLEEVE EA $50
|
Facility
|
IP
|
$52.02
|
|
| Hospital Charge Code |
96000020
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.21 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.96
|
| Rate for Payer: BCN Commercial |
$42.96
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC MASTECTOMY SLEEVE EA $50
|
Facility
|
OP
|
$52.02
|
|
| Hospital Charge Code |
96000020
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$9.63
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$42.77
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$9.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$9.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicaid |
$9.17
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$9.17
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC MASTECTOMY SLEEVE EA $60
|
Facility
|
IP
|
$62.42
|
|
| Hospital Charge Code |
96000021
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$43.44 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$51.55
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC MASTECTOMY SLEEVE EA $60
|
Facility
|
OP
|
$62.42
|
|
| Hospital Charge Code |
96000021
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.51
|
| Rate for Payer: BCBS Complete |
$11.55
|
| Rate for Payer: BCBS MAPPO |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$51.32
|
| Rate for Payer: BCN Medicare Advantage |
$15.61
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.61
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Mclaren Medicaid |
$11.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$11.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PACE Senior Care Partners |
$14.82
|
| Rate for Payer: PACE SWMI |
$15.61
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.44
|
| Rate for Payer: Railroad Medicare Medicare |
$15.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Exchange |
$15.61
|
| Rate for Payer: UHC Medicaid |
$11.00
|
| Rate for Payer: UHC Medicare Advantage |
$15.61
|
| Rate for Payer: UHCCP Medicaid |
$11.00
|
| Rate for Payer: VA VA |
$15.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC MASTECTOMY SLEEVE EA $70
|
Facility
|
IP
|
$72.83
|
|
| Hospital Charge Code |
96000022
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$50.69 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: BCBS Trust/PPO |
$60.15
|
| Rate for Payer: BCN Commercial |
$60.15
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.09
|
| Rate for Payer: UHC Core |
$60.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC MASTECTOMY SLEEVE EA $70
|
Facility
|
OP
|
$72.83
|
|
| Hospital Charge Code |
96000022
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.84 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: Aetna Medicare |
$18.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.76
|
| Rate for Payer: BCBS Complete |
$13.48
|
| Rate for Payer: BCBS MAPPO |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$59.87
|
| Rate for Payer: BCN Commercial |
$59.87
|
| Rate for Payer: BCN Medicare Advantage |
$18.21
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.21
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: Mclaren Medicaid |
$12.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.12
|
| Rate for Payer: Meridian Medicaid |
$13.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PACE Senior Care Partners |
$17.30
|
| Rate for Payer: PACE SWMI |
$18.21
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: PHP Medicare Advantage |
$18.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.36
|
| Rate for Payer: Priority Health Medicare |
$18.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.69
|
| Rate for Payer: Railroad Medicare Medicare |
$18.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.09
|
| Rate for Payer: UHC Core |
$60.81
|
| Rate for Payer: UHC Exchange |
$18.21
|
| Rate for Payer: UHC Medicaid |
$12.84
|
| Rate for Payer: UHC Medicare Advantage |
$18.21
|
| Rate for Payer: UHCCP Medicaid |
$12.84
|
| Rate for Payer: VA VA |
$18.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC MASTECTOMY SLEEVE EA $80
|
Facility
|
IP
|
$83.23
|
|
| Hospital Charge Code |
96000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$57.93 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$70.75
|
| Rate for Payer: BCBS Trust/PPO |
$68.74
|
| Rate for Payer: BCN Commercial |
$68.74
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.58
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.75
|
| Rate for Payer: Nomi Health Commercial |
$68.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.42
|
| Rate for Payer: PHP Commercial |
$70.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$72.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.24
|
| Rate for Payer: UHC Core |
$69.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.42
|
|
|
HC MASTECTOMY SLEEVE EA $80
|
Facility
|
OP
|
$83.23
|
|
| Hospital Charge Code |
96000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.67 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$70.75
|
| Rate for Payer: Aetna Medicare |
$21.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: BCBS Complete |
$15.41
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$68.42
|
| Rate for Payer: BCN Commercial |
$68.42
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.42
|
| Rate for Payer: Mclaren Medicaid |
$14.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: Meridian Medicaid |
$15.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.75
|
| Rate for Payer: Nomi Health Commercial |
$68.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.42
|
| Rate for Payer: PACE Senior Care Partners |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$70.75
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$72.41
|
| Rate for Payer: Priority Health Medicare |
$21.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.93
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.24
|
| Rate for Payer: UHC Core |
$69.50
|
| Rate for Payer: UHC Exchange |
$20.81
|
| Rate for Payer: UHC Medicaid |
$14.67
|
| Rate for Payer: UHC Medicare Advantage |
$20.81
|
| Rate for Payer: UHCCP Medicaid |
$14.67
|
| Rate for Payer: VA VA |
$20.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.42
|
|
|
HC MASTECTOMY SLEEVE EA $90
|
Facility
|
IP
|
$93.64
|
|
| Hospital Charge Code |
96000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$65.17 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: BCBS Trust/PPO |
$77.34
|
| Rate for Payer: BCN Commercial |
$77.34
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.40
|
| Rate for Payer: UHC Core |
$78.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC MASTECTOMY SLEEVE EA $90
|
Facility
|
OP
|
$93.64
|
|
| Hospital Charge Code |
96000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.51 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna Medicare |
$24.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.26
|
| Rate for Payer: BCBS Complete |
$17.33
|
| Rate for Payer: BCBS MAPPO |
$23.41
|
| Rate for Payer: BCBS Trust/PPO |
$76.98
|
| Rate for Payer: BCN Commercial |
$76.98
|
| Rate for Payer: BCN Medicare Advantage |
$23.41
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.41
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$16.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.58
|
| Rate for Payer: Meridian Medicaid |
$17.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PACE Senior Care Partners |
$22.24
|
| Rate for Payer: PACE SWMI |
$23.41
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: PHP Medicare Advantage |
$23.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.47
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.17
|
| Rate for Payer: Railroad Medicare Medicare |
$23.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.40
|
| Rate for Payer: UHC Core |
$78.19
|
| Rate for Payer: UHC Exchange |
$23.41
|
| Rate for Payer: UHC Medicaid |
$16.51
|
| Rate for Payer: UHC Medicare Advantage |
$23.41
|
| Rate for Payer: UHCCP Medicaid |
$16.51
|
| Rate for Payer: VA VA |
$23.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC MASTOTOMY W/EXPLORATION OR DRAINAGE OF ABSCESS, DEEP
|
Facility
|
OP
|
$2,184.92
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
76100281
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.20 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: Aetna Medicare |
$568.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$682.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$682.79
|
| Rate for Payer: BCBS Complete |
$404.43
|
| Rate for Payer: BCBS MAPPO |
$546.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,796.22
|
| Rate for Payer: BCN Commercial |
$1,796.22
|
| Rate for Payer: BCN Medicare Advantage |
$546.23
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$546.23
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.69
|
| Rate for Payer: Mclaren Medicaid |
$385.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$573.54
|
| Rate for Payer: Meridian Medicaid |
$404.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$628.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$600.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$1,791.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PACE Senior Care Partners |
$518.92
|
| Rate for Payer: PACE SWMI |
$546.23
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: PHP Medicare Advantage |
$546.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,900.88
|
| Rate for Payer: Priority Health Medicare |
$551.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,520.70
|
| Rate for Payer: Railroad Medicare Medicare |
$546.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.73
|
| Rate for Payer: UHC Core |
$1,824.41
|
| Rate for Payer: UHC Exchange |
$546.23
|
| Rate for Payer: UHC Medicaid |
$385.20
|
| Rate for Payer: UHC Medicare Advantage |
$546.23
|
| Rate for Payer: UHCCP Medicaid |
$385.20
|
| Rate for Payer: VA VA |
$546.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.69
|
|
|
HC MASTOTOMY W/EXPLORATION OR DRAINAGE OF ABSCESS, DEEP
|
Facility
|
IP
|
$2,184.92
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
76100281
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,520.70 |
| Max. Negotiated Rate |
$1,966.43 |
| Rate for Payer: Aetna Commercial |
$1,857.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,804.53
|
| Rate for Payer: BCN Commercial |
$1,804.53
|
| Rate for Payer: Cash Price |
$1,747.94
|
| Rate for Payer: Cofinity Commercial |
$1,879.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,747.94
|
| Rate for Payer: Healthscope Commercial |
$1,966.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,638.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,857.18
|
| Rate for Payer: Nomi Health Commercial |
$1,791.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.69
|
| Rate for Payer: PHP Commercial |
$1,857.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,900.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,520.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,922.73
|
| Rate for Payer: UHC Core |
$1,824.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,638.69
|
|
|
HC MATERNAL SCRN INTEGRATED SERUM 1
|
Facility
|
IP
|
$114.44
|
|
|
Service Code
|
CPT 84163
|
| Hospital Charge Code |
30100641
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$79.65 |
| Max. Negotiated Rate |
$103.00 |
| Rate for Payer: Aetna Commercial |
$97.27
|
| Rate for Payer: BCBS Trust/PPO |
$94.52
|
| Rate for Payer: BCN Commercial |
$94.52
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Commercial |
$98.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Nomi Health Commercial |
$93.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.83
|
| Rate for Payer: PHP Commercial |
$97.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.71
|
| Rate for Payer: UHC Core |
$95.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.83
|
|
|
HC MATERNAL SCRN INTEGRATED SERUM 1
|
Facility
|
OP
|
$114.44
|
|
|
Service Code
|
CPT 84163
|
| Hospital Charge Code |
30100641
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.18 |
| Max. Negotiated Rate |
$103.00 |
| Rate for Payer: Aetna Commercial |
$97.27
|
| Rate for Payer: Aetna Medicare |
$29.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.76
|
| Rate for Payer: BCBS Complete |
$21.18
|
| Rate for Payer: BCBS MAPPO |
$28.61
|
| Rate for Payer: BCBS Trust/PPO |
$94.08
|
| Rate for Payer: BCN Commercial |
$94.08
|
| Rate for Payer: BCN Medicare Advantage |
$28.61
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Commercial |
$98.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.61
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.83
|
| Rate for Payer: Mclaren Medicaid |
$20.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.04
|
| Rate for Payer: Meridian Medicaid |
$21.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Nomi Health Commercial |
$93.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.83
|
| Rate for Payer: PACE Senior Care Partners |
$27.18
|
| Rate for Payer: PACE SWMI |
$28.61
|
| Rate for Payer: PHP Commercial |
$97.27
|
| Rate for Payer: PHP Medicare Advantage |
$28.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.56
|
| Rate for Payer: Priority Health Medicare |
$28.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.65
|
| Rate for Payer: Railroad Medicare Medicare |
$28.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.71
|
| Rate for Payer: UHC Core |
$95.56
|
| Rate for Payer: UHC Exchange |
$28.61
|
| Rate for Payer: UHC Medicaid |
$20.18
|
| Rate for Payer: UHC Medicare Advantage |
$28.61
|
| Rate for Payer: UHCCP Medicaid |
$20.18
|
| Rate for Payer: VA VA |
$28.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.83
|
|
|
HC MATERNAL SCRN INTEGRATED SERUM 2
|
Facility
|
IP
|
$247.20
|
|
|
Service Code
|
CPT 81511
|
| Hospital Charge Code |
30100654
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$172.05 |
| Max. Negotiated Rate |
$222.48 |
| Rate for Payer: Aetna Commercial |
$210.12
|
| Rate for Payer: BCBS Trust/PPO |
$204.16
|
| Rate for Payer: BCN Commercial |
$204.16
|
| Rate for Payer: Cash Price |
$197.76
|
| Rate for Payer: Cofinity Commercial |
$212.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.76
|
| Rate for Payer: Healthscope Commercial |
$222.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.12
|
| Rate for Payer: Nomi Health Commercial |
$202.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.40
|
| Rate for Payer: PHP Commercial |
$210.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.54
|
| Rate for Payer: UHC Core |
$206.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.40
|
|
|
HC MATERNAL SCRN INTEGRATED SERUM 2
|
Facility
|
OP
|
$247.20
|
|
|
Service Code
|
CPT 81511
|
| Hospital Charge Code |
30100654
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.58 |
| Max. Negotiated Rate |
$222.48 |
| Rate for Payer: Aetna Commercial |
$210.12
|
| Rate for Payer: Aetna Medicare |
$64.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.25
|
| Rate for Payer: BCBS Complete |
$45.76
|
| Rate for Payer: BCBS MAPPO |
$61.80
|
| Rate for Payer: BCBS Trust/PPO |
$203.22
|
| Rate for Payer: BCN Commercial |
$203.22
|
| Rate for Payer: BCN Medicare Advantage |
$61.80
|
| Rate for Payer: Cash Price |
$197.76
|
| Rate for Payer: Cofinity Commercial |
$212.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.80
|
| Rate for Payer: Healthscope Commercial |
$222.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.40
|
| Rate for Payer: Mclaren Medicaid |
$43.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.89
|
| Rate for Payer: Meridian Medicaid |
$45.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.12
|
| Rate for Payer: Nomi Health Commercial |
$202.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.40
|
| Rate for Payer: PACE Senior Care Partners |
$58.71
|
| Rate for Payer: PACE SWMI |
$61.80
|
| Rate for Payer: PHP Commercial |
$210.12
|
| Rate for Payer: PHP Medicare Advantage |
$61.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.06
|
| Rate for Payer: Priority Health Medicare |
$62.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.05
|
| Rate for Payer: Railroad Medicare Medicare |
$61.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.54
|
| Rate for Payer: UHC Core |
$206.41
|
| Rate for Payer: UHC Exchange |
$61.80
|
| Rate for Payer: UHC Medicaid |
$43.58
|
| Rate for Payer: UHC Medicare Advantage |
$61.80
|
| Rate for Payer: UHCCP Medicaid |
$43.58
|
| Rate for Payer: VA VA |
$61.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.40
|
|
|
HC MAXIMUM VOLUNTARY VENTILATION
|
Facility
|
IP
|
$125.08
|
|
|
Service Code
|
CPT 94200
|
| Hospital Charge Code |
46000022
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$87.06 |
| Max. Negotiated Rate |
$112.57 |
| Rate for Payer: Aetna Commercial |
$106.32
|
| Rate for Payer: BCBS Trust/PPO |
$103.30
|
| Rate for Payer: BCN Commercial |
$103.30
|
| Rate for Payer: Cash Price |
$100.06
|
| Rate for Payer: Cofinity Commercial |
$107.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.06
|
| Rate for Payer: Healthscope Commercial |
$112.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.32
|
| Rate for Payer: Nomi Health Commercial |
$102.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.81
|
| Rate for Payer: PHP Commercial |
$106.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$108.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.07
|
| Rate for Payer: UHC Core |
$104.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.81
|
|
|
HC MAXIMUM VOLUNTARY VENTILATION
|
Facility
|
OP
|
$125.08
|
|
|
Service Code
|
CPT 94200
|
| Hospital Charge Code |
46000022
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$22.05 |
| Max. Negotiated Rate |
$112.57 |
| Rate for Payer: Aetna Commercial |
$106.32
|
| Rate for Payer: Aetna Medicare |
$32.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.09
|
| Rate for Payer: BCBS Complete |
$23.15
|
| Rate for Payer: BCBS MAPPO |
$31.27
|
| Rate for Payer: BCBS Trust/PPO |
$102.83
|
| Rate for Payer: BCN Commercial |
$102.83
|
| Rate for Payer: BCN Medicare Advantage |
$31.27
|
| Rate for Payer: Cash Price |
$100.06
|
| Rate for Payer: Cofinity Commercial |
$107.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.27
|
| Rate for Payer: Healthscope Commercial |
$112.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.81
|
| Rate for Payer: Mclaren Medicaid |
$22.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.83
|
| Rate for Payer: Meridian Medicaid |
$23.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.32
|
| Rate for Payer: Nomi Health Commercial |
$102.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.81
|
| Rate for Payer: PACE Senior Care Partners |
$29.71
|
| Rate for Payer: PACE SWMI |
$31.27
|
| Rate for Payer: PHP Commercial |
$106.32
|
| Rate for Payer: PHP Medicare Advantage |
$31.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$108.82
|
| Rate for Payer: Priority Health Medicare |
$31.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.06
|
| Rate for Payer: Railroad Medicare Medicare |
$31.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.07
|
| Rate for Payer: UHC Core |
$104.44
|
| Rate for Payer: UHC Exchange |
$31.27
|
| Rate for Payer: UHC Medicaid |
$22.05
|
| Rate for Payer: UHC Medicare Advantage |
$31.27
|
| Rate for Payer: UHCCP Medicaid |
$22.05
|
| Rate for Payer: VA VA |
$31.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.81
|
|
|
HC MAYO CHROMOGENIC FACTOR 8
|
Facility
|
IP
|
$344.99
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500105
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$240.11 |
| Max. Negotiated Rate |
$310.49 |
| Rate for Payer: Aetna Commercial |
$293.24
|
| Rate for Payer: BCBS Trust/PPO |
$284.93
|
| Rate for Payer: BCN Commercial |
$284.93
|
| Rate for Payer: Cash Price |
$275.99
|
| Rate for Payer: Cofinity Commercial |
$296.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.99
|
| Rate for Payer: Healthscope Commercial |
$310.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.24
|
| Rate for Payer: Nomi Health Commercial |
$282.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.74
|
| Rate for Payer: PHP Commercial |
$293.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$300.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.59
|
| Rate for Payer: UHC Core |
$288.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.74
|
|
|
HC MAYO CHROMOGENIC FACTOR 8
|
Facility
|
OP
|
$344.99
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500105
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$60.82 |
| Max. Negotiated Rate |
$310.49 |
| Rate for Payer: Aetna Commercial |
$293.24
|
| Rate for Payer: Aetna Medicare |
$89.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.81
|
| Rate for Payer: BCBS Complete |
$63.86
|
| Rate for Payer: BCBS MAPPO |
$86.25
|
| Rate for Payer: BCBS Trust/PPO |
$283.62
|
| Rate for Payer: BCN Commercial |
$283.62
|
| Rate for Payer: BCN Medicare Advantage |
$86.25
|
| Rate for Payer: Cash Price |
$275.99
|
| Rate for Payer: Cofinity Commercial |
$296.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.25
|
| Rate for Payer: Healthscope Commercial |
$310.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.74
|
| Rate for Payer: Mclaren Medicaid |
$60.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.56
|
| Rate for Payer: Meridian Medicaid |
$63.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.24
|
| Rate for Payer: Nomi Health Commercial |
$282.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.74
|
| Rate for Payer: PACE Senior Care Partners |
$81.94
|
| Rate for Payer: PACE SWMI |
$86.25
|
| Rate for Payer: PHP Commercial |
$293.24
|
| Rate for Payer: PHP Medicare Advantage |
$86.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$300.14
|
| Rate for Payer: Priority Health Medicare |
$87.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.11
|
| Rate for Payer: Railroad Medicare Medicare |
$86.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.59
|
| Rate for Payer: UHC Core |
$288.07
|
| Rate for Payer: UHC Exchange |
$86.25
|
| Rate for Payer: UHC Medicaid |
$60.82
|
| Rate for Payer: UHC Medicare Advantage |
$86.25
|
| Rate for Payer: UHCCP Medicaid |
$60.82
|
| Rate for Payer: VA VA |
$86.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.74
|
|
|
HC MAYO CHROMOGENIC FACTOR 9
|
Facility
|
OP
|
$365.73
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500104
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$64.48 |
| Max. Negotiated Rate |
$329.16 |
| Rate for Payer: Aetna Commercial |
$310.87
|
| Rate for Payer: Aetna Medicare |
$95.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.29
|
| Rate for Payer: BCBS Complete |
$67.70
|
| Rate for Payer: BCBS MAPPO |
$91.43
|
| Rate for Payer: BCBS Trust/PPO |
$300.67
|
| Rate for Payer: BCN Commercial |
$300.67
|
| Rate for Payer: BCN Medicare Advantage |
$91.43
|
| Rate for Payer: Cash Price |
$292.58
|
| Rate for Payer: Cofinity Commercial |
$314.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.43
|
| Rate for Payer: Healthscope Commercial |
$329.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.30
|
| Rate for Payer: Mclaren Medicaid |
$64.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.00
|
| Rate for Payer: Meridian Medicaid |
$67.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.87
|
| Rate for Payer: Nomi Health Commercial |
$299.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.30
|
| Rate for Payer: PACE Senior Care Partners |
$86.86
|
| Rate for Payer: PACE SWMI |
$91.43
|
| Rate for Payer: PHP Commercial |
$310.87
|
| Rate for Payer: PHP Medicare Advantage |
$91.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$318.19
|
| Rate for Payer: Priority Health Medicare |
$92.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.55
|
| Rate for Payer: Railroad Medicare Medicare |
$91.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.84
|
| Rate for Payer: UHC Core |
$305.38
|
| Rate for Payer: UHC Exchange |
$91.43
|
| Rate for Payer: UHC Medicaid |
$64.48
|
| Rate for Payer: UHC Medicare Advantage |
$91.43
|
| Rate for Payer: UHCCP Medicaid |
$64.48
|
| Rate for Payer: VA VA |
$91.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.30
|
|
|
HC MAYO CHROMOGENIC FACTOR 9
|
Facility
|
IP
|
$365.73
|
|
|
Service Code
|
CPT 85130
|
| Hospital Charge Code |
30500104
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$254.55 |
| Max. Negotiated Rate |
$329.16 |
| Rate for Payer: Aetna Commercial |
$310.87
|
| Rate for Payer: BCBS Trust/PPO |
$302.06
|
| Rate for Payer: BCN Commercial |
$302.06
|
| Rate for Payer: Cash Price |
$292.58
|
| Rate for Payer: Cofinity Commercial |
$314.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.58
|
| Rate for Payer: Healthscope Commercial |
$329.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.87
|
| Rate for Payer: Nomi Health Commercial |
$299.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.30
|
| Rate for Payer: PHP Commercial |
$310.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$318.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.84
|
| Rate for Payer: UHC Core |
$305.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.30
|
|
|
HC MAYOCOMPLETE MYELOID NEOPLASMS, NGS
|
Facility
|
OP
|
$2,002.77
|
|
|
Service Code
|
CPT 81450
|
| Hospital Charge Code |
31000084
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$353.09 |
| Max. Negotiated Rate |
$1,802.49 |
| Rate for Payer: Aetna Commercial |
$1,702.35
|
| Rate for Payer: Aetna Medicare |
$520.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$625.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$625.87
|
| Rate for Payer: BCBS Complete |
$370.71
|
| Rate for Payer: BCBS MAPPO |
$500.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,646.48
|
| Rate for Payer: BCN Commercial |
$1,646.48
|
| Rate for Payer: BCN Medicare Advantage |
$500.69
|
| Rate for Payer: Cash Price |
$1,602.22
|
| Rate for Payer: Cofinity Commercial |
$1,722.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,602.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.69
|
| Rate for Payer: Healthscope Commercial |
$1,802.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,502.08
|
| Rate for Payer: Mclaren Medicaid |
$353.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$525.73
|
| Rate for Payer: Meridian Medicaid |
$370.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$575.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$550.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,702.35
|
| Rate for Payer: Nomi Health Commercial |
$1,642.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,502.08
|
| Rate for Payer: PACE Senior Care Partners |
$475.66
|
| Rate for Payer: PACE SWMI |
$500.69
|
| Rate for Payer: PHP Commercial |
$1,702.35
|
| Rate for Payer: PHP Medicare Advantage |
$500.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,742.41
|
| Rate for Payer: Priority Health Medicare |
$505.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,393.93
|
| Rate for Payer: Railroad Medicare Medicare |
$500.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,762.44
|
| Rate for Payer: UHC Core |
$1,672.31
|
| Rate for Payer: UHC Exchange |
$500.69
|
| Rate for Payer: UHC Medicaid |
$353.09
|
| Rate for Payer: UHC Medicare Advantage |
$500.69
|
| Rate for Payer: UHCCP Medicaid |
$353.09
|
| Rate for Payer: VA VA |
$500.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,502.08
|
|
|
HC MAYOCOMPLETE MYELOID NEOPLASMS, NGS
|
Facility
|
IP
|
$2,002.77
|
|
|
Service Code
|
CPT 81450
|
| Hospital Charge Code |
31000084
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,393.93 |
| Max. Negotiated Rate |
$1,802.49 |
| Rate for Payer: Aetna Commercial |
$1,702.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,654.09
|
| Rate for Payer: BCN Commercial |
$1,654.09
|
| Rate for Payer: Cash Price |
$1,602.22
|
| Rate for Payer: Cofinity Commercial |
$1,722.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,602.22
|
| Rate for Payer: Healthscope Commercial |
$1,802.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,502.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,702.35
|
| Rate for Payer: Nomi Health Commercial |
$1,642.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,502.08
|
| Rate for Payer: PHP Commercial |
$1,702.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,742.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,393.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,762.44
|
| Rate for Payer: UHC Core |
$1,672.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,502.08
|
|
