|
HC MEDTRONIC DUAL PACEMAKER
|
Facility
|
IP
|
$9,020.27
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500007
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,278.11 |
| Max. Negotiated Rate |
$8,118.24 |
| Rate for Payer: Aetna Commercial |
$7,667.23
|
| Rate for Payer: BCBS Trust/PPO |
$7,449.84
|
| Rate for Payer: BCN Commercial |
$7,449.84
|
| Rate for Payer: Cash Price |
$7,216.22
|
| Rate for Payer: Cofinity Commercial |
$7,757.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,216.22
|
| Rate for Payer: Healthscope Commercial |
$8,118.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,765.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,667.23
|
| Rate for Payer: Nomi Health Commercial |
$7,396.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,765.20
|
| Rate for Payer: PHP Commercial |
$7,667.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,847.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,278.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,937.84
|
| Rate for Payer: UHC Core |
$7,531.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,765.20
|
|
|
HC MEDTRONIC ICD DUAL
|
Facility
|
OP
|
$26,848.56
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,733.40 |
| Max. Negotiated Rate |
$24,163.70 |
| Rate for Payer: Aetna Commercial |
$22,821.28
|
| Rate for Payer: Aetna Medicare |
$6,980.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,390.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,390.17
|
| Rate for Payer: BCBS Complete |
$4,969.67
|
| Rate for Payer: BCBS MAPPO |
$6,712.14
|
| Rate for Payer: BCBS Trust/PPO |
$22,072.20
|
| Rate for Payer: BCN Commercial |
$22,072.20
|
| Rate for Payer: BCN Medicare Advantage |
$6,712.14
|
| Rate for Payer: Cash Price |
$21,478.85
|
| Rate for Payer: Cofinity Commercial |
$23,089.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,478.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,712.14
|
| Rate for Payer: Healthscope Commercial |
$24,163.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,136.42
|
| Rate for Payer: Mclaren Medicaid |
$4,733.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,047.75
|
| Rate for Payer: Meridian Medicaid |
$4,969.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,718.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,383.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,821.28
|
| Rate for Payer: Nomi Health Commercial |
$22,015.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,136.42
|
| Rate for Payer: PACE Senior Care Partners |
$6,376.53
|
| Rate for Payer: PACE SWMI |
$6,712.14
|
| Rate for Payer: PHP Commercial |
$22,821.28
|
| Rate for Payer: PHP Medicare Advantage |
$6,712.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,733.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23,358.25
|
| Rate for Payer: Priority Health Medicare |
$6,779.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,686.60
|
| Rate for Payer: Railroad Medicare Medicare |
$6,712.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,626.73
|
| Rate for Payer: UHC Core |
$22,418.55
|
| Rate for Payer: UHC Exchange |
$6,712.14
|
| Rate for Payer: UHC Medicaid |
$4,733.40
|
| Rate for Payer: UHC Medicare Advantage |
$6,712.14
|
| Rate for Payer: UHCCP Medicaid |
$4,733.40
|
| Rate for Payer: VA VA |
$6,712.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,136.42
|
|
|
HC MEDTRONIC ICD DUAL
|
Facility
|
IP
|
$26,848.56
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18,686.60 |
| Max. Negotiated Rate |
$24,163.70 |
| Rate for Payer: Aetna Commercial |
$22,821.28
|
| Rate for Payer: BCBS Trust/PPO |
$22,174.23
|
| Rate for Payer: BCN Commercial |
$22,174.23
|
| Rate for Payer: Cash Price |
$21,478.85
|
| Rate for Payer: Cofinity Commercial |
$23,089.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,478.85
|
| Rate for Payer: Healthscope Commercial |
$24,163.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,136.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,821.28
|
| Rate for Payer: Nomi Health Commercial |
$22,015.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,136.42
|
| Rate for Payer: PHP Commercial |
$22,821.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23,358.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,686.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,626.73
|
| Rate for Payer: UHC Core |
$22,418.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,136.42
|
|
|
HC MEDTRONIC ICD SINGLE
|
Facility
|
IP
|
$24,301.66
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800020
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16,913.96 |
| Max. Negotiated Rate |
$21,871.49 |
| Rate for Payer: Aetna Commercial |
$20,656.41
|
| Rate for Payer: BCBS Trust/PPO |
$20,070.74
|
| Rate for Payer: BCN Commercial |
$20,070.74
|
| Rate for Payer: Cash Price |
$19,441.33
|
| Rate for Payer: Cofinity Commercial |
$20,899.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,441.33
|
| Rate for Payer: Healthscope Commercial |
$21,871.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,226.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,656.41
|
| Rate for Payer: Nomi Health Commercial |
$19,927.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,226.24
|
| Rate for Payer: PHP Commercial |
$20,656.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21,142.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16,913.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21,385.46
|
| Rate for Payer: UHC Core |
$20,291.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,226.24
|
|
|
HC MEDTRONIC ICD SINGLE
|
Facility
|
OP
|
$24,301.66
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800020
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,284.38 |
| Max. Negotiated Rate |
$21,871.49 |
| Rate for Payer: Aetna Commercial |
$20,656.41
|
| Rate for Payer: Aetna Medicare |
$6,318.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,594.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,594.27
|
| Rate for Payer: BCBS Complete |
$4,498.24
|
| Rate for Payer: BCBS MAPPO |
$6,075.41
|
| Rate for Payer: BCBS Trust/PPO |
$19,978.39
|
| Rate for Payer: BCN Commercial |
$19,978.39
|
| Rate for Payer: BCN Medicare Advantage |
$6,075.41
|
| Rate for Payer: Cash Price |
$19,441.33
|
| Rate for Payer: Cofinity Commercial |
$20,899.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,441.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,075.41
|
| Rate for Payer: Healthscope Commercial |
$21,871.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,226.24
|
| Rate for Payer: Mclaren Medicaid |
$4,284.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,379.19
|
| Rate for Payer: Meridian Medicaid |
$4,498.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,986.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,682.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,656.41
|
| Rate for Payer: Nomi Health Commercial |
$19,927.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,226.24
|
| Rate for Payer: PACE Senior Care Partners |
$5,771.64
|
| Rate for Payer: PACE SWMI |
$6,075.41
|
| Rate for Payer: PHP Commercial |
$20,656.41
|
| Rate for Payer: PHP Medicare Advantage |
$6,075.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,284.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$21,142.44
|
| Rate for Payer: Priority Health Medicare |
$6,136.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16,913.96
|
| Rate for Payer: Railroad Medicare Medicare |
$6,075.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21,385.46
|
| Rate for Payer: UHC Core |
$20,291.89
|
| Rate for Payer: UHC Exchange |
$6,075.41
|
| Rate for Payer: UHC Medicaid |
$4,284.38
|
| Rate for Payer: UHC Medicare Advantage |
$6,075.41
|
| Rate for Payer: UHCCP Medicaid |
$4,284.38
|
| Rate for Payer: VA VA |
$6,075.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,226.24
|
|
|
HC MEDTRONIC SINGLE PACEMAKER
|
Facility
|
OP
|
$13,480.45
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500008
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,376.60 |
| Max. Negotiated Rate |
$12,132.41 |
| Rate for Payer: Aetna Commercial |
$11,458.38
|
| Rate for Payer: Aetna Medicare |
$3,504.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,212.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,212.64
|
| Rate for Payer: BCBS Complete |
$2,495.23
|
| Rate for Payer: BCBS MAPPO |
$3,370.11
|
| Rate for Payer: BCBS Trust/PPO |
$11,082.28
|
| Rate for Payer: BCN Commercial |
$11,082.28
|
| Rate for Payer: BCN Medicare Advantage |
$3,370.11
|
| Rate for Payer: Cash Price |
$10,784.36
|
| Rate for Payer: Cofinity Commercial |
$11,593.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,784.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,370.11
|
| Rate for Payer: Healthscope Commercial |
$12,132.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,110.34
|
| Rate for Payer: Mclaren Medicaid |
$2,376.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,538.62
|
| Rate for Payer: Meridian Medicaid |
$2,495.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,875.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,707.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,458.38
|
| Rate for Payer: Nomi Health Commercial |
$11,053.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,110.34
|
| Rate for Payer: PACE Senior Care Partners |
$3,201.61
|
| Rate for Payer: PACE SWMI |
$3,370.11
|
| Rate for Payer: PHP Commercial |
$11,458.38
|
| Rate for Payer: PHP Medicare Advantage |
$3,370.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,376.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,727.99
|
| Rate for Payer: Priority Health Medicare |
$3,403.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,382.39
|
| Rate for Payer: Railroad Medicare Medicare |
$3,370.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,862.80
|
| Rate for Payer: UHC Core |
$11,256.18
|
| Rate for Payer: UHC Exchange |
$3,370.11
|
| Rate for Payer: UHC Medicaid |
$2,376.60
|
| Rate for Payer: UHC Medicare Advantage |
$3,370.11
|
| Rate for Payer: UHCCP Medicaid |
$2,376.60
|
| Rate for Payer: VA VA |
$3,370.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,110.34
|
|
|
HC MEDTRONIC SINGLE PACEMAKER
|
Facility
|
IP
|
$13,480.45
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500008
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$9,382.39 |
| Max. Negotiated Rate |
$12,132.41 |
| Rate for Payer: Aetna Commercial |
$11,458.38
|
| Rate for Payer: BCBS Trust/PPO |
$11,133.50
|
| Rate for Payer: BCN Commercial |
$11,133.50
|
| Rate for Payer: Cash Price |
$10,784.36
|
| Rate for Payer: Cofinity Commercial |
$11,593.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,784.36
|
| Rate for Payer: Healthscope Commercial |
$12,132.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,110.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,458.38
|
| Rate for Payer: Nomi Health Commercial |
$11,053.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,110.34
|
| Rate for Payer: PHP Commercial |
$11,458.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,727.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,382.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,862.80
|
| Rate for Payer: UHC Core |
$11,256.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,110.34
|
|
|
HC MEDTRONIC TACHY (ICD) LEAD
|
Facility
|
OP
|
$15,909.43
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800021
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,804.83 |
| Max. Negotiated Rate |
$14,318.49 |
| Rate for Payer: Aetna Commercial |
$13,523.02
|
| Rate for Payer: Aetna Medicare |
$4,136.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,971.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,971.70
|
| Rate for Payer: BCBS Complete |
$2,944.84
|
| Rate for Payer: BCBS MAPPO |
$3,977.36
|
| Rate for Payer: BCBS Trust/PPO |
$13,079.14
|
| Rate for Payer: BCN Commercial |
$13,079.14
|
| Rate for Payer: BCN Medicare Advantage |
$3,977.36
|
| Rate for Payer: Cash Price |
$12,727.54
|
| Rate for Payer: Cofinity Commercial |
$13,682.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,727.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,977.36
|
| Rate for Payer: Healthscope Commercial |
$14,318.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,932.07
|
| Rate for Payer: Mclaren Medicaid |
$2,804.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,176.23
|
| Rate for Payer: Meridian Medicaid |
$2,944.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,573.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,375.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,523.02
|
| Rate for Payer: Nomi Health Commercial |
$13,045.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,932.07
|
| Rate for Payer: PACE Senior Care Partners |
$3,778.49
|
| Rate for Payer: PACE SWMI |
$3,977.36
|
| Rate for Payer: PHP Commercial |
$13,523.02
|
| Rate for Payer: PHP Medicare Advantage |
$3,977.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,804.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13,841.20
|
| Rate for Payer: Priority Health Medicare |
$4,017.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,072.96
|
| Rate for Payer: Railroad Medicare Medicare |
$3,977.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,000.30
|
| Rate for Payer: UHC Core |
$13,284.37
|
| Rate for Payer: UHC Exchange |
$3,977.36
|
| Rate for Payer: UHC Medicaid |
$2,804.83
|
| Rate for Payer: UHC Medicare Advantage |
$3,977.36
|
| Rate for Payer: UHCCP Medicaid |
$2,804.83
|
| Rate for Payer: VA VA |
$3,977.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,932.07
|
|
|
HC MEDTRONIC TACHY (ICD) LEAD
|
Facility
|
IP
|
$15,909.43
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800021
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,072.96 |
| Max. Negotiated Rate |
$14,318.49 |
| Rate for Payer: Aetna Commercial |
$13,523.02
|
| Rate for Payer: BCBS Trust/PPO |
$13,139.60
|
| Rate for Payer: BCN Commercial |
$13,139.60
|
| Rate for Payer: Cash Price |
$12,727.54
|
| Rate for Payer: Cofinity Commercial |
$13,682.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,727.54
|
| Rate for Payer: Healthscope Commercial |
$14,318.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,932.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,523.02
|
| Rate for Payer: Nomi Health Commercial |
$13,045.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,932.07
|
| Rate for Payer: PHP Commercial |
$13,523.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13,841.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,072.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,000.30
|
| Rate for Payer: UHC Core |
$13,284.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,932.07
|
|
|
HC MENACWY-TT VACCINE IM
|
Facility
|
IP
|
$191.02
|
|
|
Service Code
|
CPT 90619
|
| Hospital Charge Code |
63600210
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$132.95 |
| Max. Negotiated Rate |
$171.92 |
| Rate for Payer: Aetna Commercial |
$162.37
|
| Rate for Payer: BCBS Trust/PPO |
$157.76
|
| Rate for Payer: BCN Commercial |
$157.76
|
| Rate for Payer: Cash Price |
$152.82
|
| Rate for Payer: Cofinity Commercial |
$164.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.82
|
| Rate for Payer: Healthscope Commercial |
$171.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.37
|
| Rate for Payer: Nomi Health Commercial |
$156.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.26
|
| Rate for Payer: PHP Commercial |
$162.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$166.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.10
|
| Rate for Payer: UHC Core |
$159.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.26
|
|
|
HC MENACWY-TT VACCINE IM
|
Facility
|
OP
|
$191.02
|
|
|
Service Code
|
CPT 90619
|
| Hospital Charge Code |
63600210
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$33.68 |
| Max. Negotiated Rate |
$171.92 |
| Rate for Payer: Aetna Commercial |
$162.37
|
| Rate for Payer: Aetna Medicare |
$49.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.69
|
| Rate for Payer: BCBS Complete |
$35.36
|
| Rate for Payer: BCBS MAPPO |
$47.76
|
| Rate for Payer: BCBS Trust/PPO |
$157.04
|
| Rate for Payer: BCN Commercial |
$157.04
|
| Rate for Payer: BCN Medicare Advantage |
$47.76
|
| Rate for Payer: Cash Price |
$152.82
|
| Rate for Payer: Cofinity Commercial |
$164.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.76
|
| Rate for Payer: Healthscope Commercial |
$171.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.26
|
| Rate for Payer: Mclaren Medicaid |
$33.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.14
|
| Rate for Payer: Meridian Medicaid |
$35.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.37
|
| Rate for Payer: Nomi Health Commercial |
$156.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.26
|
| Rate for Payer: PACE Senior Care Partners |
$45.37
|
| Rate for Payer: PACE SWMI |
$47.76
|
| Rate for Payer: PHP Commercial |
$162.37
|
| Rate for Payer: PHP Medicare Advantage |
$47.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$166.19
|
| Rate for Payer: Priority Health Medicare |
$48.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.95
|
| Rate for Payer: Railroad Medicare Medicare |
$47.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.10
|
| Rate for Payer: UHC Core |
$159.50
|
| Rate for Payer: UHC Exchange |
$47.76
|
| Rate for Payer: UHC Medicaid |
$33.68
|
| Rate for Payer: UHC Medicare Advantage |
$47.76
|
| Rate for Payer: UHCCP Medicaid |
$33.68
|
| Rate for Payer: VA VA |
$47.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.26
|
|
|
HC MENB-FHBP VACC 2/3 DOSE IM
|
Facility
|
OP
|
$537.45
|
|
|
Service Code
|
CPT 90621
|
| Hospital Charge Code |
63600187
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$94.75 |
| Max. Negotiated Rate |
$483.70 |
| Rate for Payer: Aetna Commercial |
$456.83
|
| Rate for Payer: Aetna Medicare |
$139.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$167.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$167.95
|
| Rate for Payer: BCBS Complete |
$99.48
|
| Rate for Payer: BCBS MAPPO |
$134.36
|
| Rate for Payer: BCBS Trust/PPO |
$441.84
|
| Rate for Payer: BCN Commercial |
$441.84
|
| Rate for Payer: BCN Medicare Advantage |
$134.36
|
| Rate for Payer: Cash Price |
$429.96
|
| Rate for Payer: Cofinity Commercial |
$462.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.36
|
| Rate for Payer: Healthscope Commercial |
$483.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$403.09
|
| Rate for Payer: Mclaren Medicaid |
$94.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.08
|
| Rate for Payer: Meridian Medicaid |
$99.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$154.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.83
|
| Rate for Payer: Nomi Health Commercial |
$440.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.09
|
| Rate for Payer: PACE Senior Care Partners |
$127.64
|
| Rate for Payer: PACE SWMI |
$134.36
|
| Rate for Payer: PHP Commercial |
$456.83
|
| Rate for Payer: PHP Medicare Advantage |
$134.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$467.58
|
| Rate for Payer: Priority Health Medicare |
$135.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$374.07
|
| Rate for Payer: Railroad Medicare Medicare |
$134.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$472.96
|
| Rate for Payer: UHC Core |
$448.77
|
| Rate for Payer: UHC Exchange |
$134.36
|
| Rate for Payer: UHC Medicaid |
$94.75
|
| Rate for Payer: UHC Medicare Advantage |
$134.36
|
| Rate for Payer: UHCCP Medicaid |
$94.75
|
| Rate for Payer: VA VA |
$134.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$403.09
|
|
|
HC MENB-FHBP VACC 2/3 DOSE IM
|
Facility
|
IP
|
$537.45
|
|
|
Service Code
|
CPT 90621
|
| Hospital Charge Code |
63600187
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$374.07 |
| Max. Negotiated Rate |
$483.70 |
| Rate for Payer: Aetna Commercial |
$456.83
|
| Rate for Payer: BCBS Trust/PPO |
$443.88
|
| Rate for Payer: BCN Commercial |
$443.88
|
| Rate for Payer: Cash Price |
$429.96
|
| Rate for Payer: Cofinity Commercial |
$462.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$429.96
|
| Rate for Payer: Healthscope Commercial |
$483.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$403.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$456.83
|
| Rate for Payer: Nomi Health Commercial |
$440.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.09
|
| Rate for Payer: PHP Commercial |
$456.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$467.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$374.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$472.96
|
| Rate for Payer: UHC Core |
$448.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$403.09
|
|
|
HC MENB RECOMB PROT W/OUT MEMBR VESIC VACC IM
|
Facility
|
IP
|
$268.42
|
|
|
Service Code
|
CPT 90620
|
| Hospital Charge Code |
63600122
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$186.82 |
| Max. Negotiated Rate |
$241.58 |
| Rate for Payer: Aetna Commercial |
$228.16
|
| Rate for Payer: BCBS Trust/PPO |
$221.69
|
| Rate for Payer: BCN Commercial |
$221.69
|
| Rate for Payer: Cash Price |
$214.74
|
| Rate for Payer: Cofinity Commercial |
$230.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.74
|
| Rate for Payer: Healthscope Commercial |
$241.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.16
|
| Rate for Payer: Nomi Health Commercial |
$220.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.31
|
| Rate for Payer: PHP Commercial |
$228.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$233.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.21
|
| Rate for Payer: UHC Core |
$224.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.31
|
|
|
HC MENB RECOMB PROT W/OUT MEMBR VESIC VACC IM
|
Facility
|
OP
|
$268.42
|
|
|
Service Code
|
CPT 90620
|
| Hospital Charge Code |
63600122
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$47.32 |
| Max. Negotiated Rate |
$241.58 |
| Rate for Payer: Aetna Commercial |
$228.16
|
| Rate for Payer: Aetna Medicare |
$69.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.88
|
| Rate for Payer: BCBS Complete |
$49.68
|
| Rate for Payer: BCBS MAPPO |
$67.11
|
| Rate for Payer: BCBS Trust/PPO |
$220.67
|
| Rate for Payer: BCN Commercial |
$220.67
|
| Rate for Payer: BCN Medicare Advantage |
$67.11
|
| Rate for Payer: Cash Price |
$214.74
|
| Rate for Payer: Cofinity Commercial |
$230.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.11
|
| Rate for Payer: Healthscope Commercial |
$241.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.31
|
| Rate for Payer: Mclaren Medicaid |
$47.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.46
|
| Rate for Payer: Meridian Medicaid |
$49.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.16
|
| Rate for Payer: Nomi Health Commercial |
$220.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.31
|
| Rate for Payer: PACE Senior Care Partners |
$63.75
|
| Rate for Payer: PACE SWMI |
$67.11
|
| Rate for Payer: PHP Commercial |
$228.16
|
| Rate for Payer: PHP Medicare Advantage |
$67.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$233.53
|
| Rate for Payer: Priority Health Medicare |
$67.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.82
|
| Rate for Payer: Railroad Medicare Medicare |
$67.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.21
|
| Rate for Payer: UHC Core |
$224.13
|
| Rate for Payer: UHC Exchange |
$67.11
|
| Rate for Payer: UHC Medicaid |
$47.32
|
| Rate for Payer: UHC Medicare Advantage |
$67.11
|
| Rate for Payer: UHCCP Medicaid |
$47.32
|
| Rate for Payer: VA VA |
$67.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.31
|
|
|
HC MENENCEPH CMPT 10
|
Facility
|
OP
|
$14.43
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200307
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Medicare |
$3.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.51
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$3.61
|
| Rate for Payer: BCBS Trust/PPO |
$11.86
|
| Rate for Payer: BCN Commercial |
$11.86
|
| Rate for Payer: BCN Medicare Advantage |
$3.61
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.61
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Mclaren Medicaid |
$2.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.79
|
| Rate for Payer: Meridian Medicaid |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PACE Senior Care Partners |
$3.43
|
| Rate for Payer: PACE SWMI |
$3.61
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: PHP Medicare Advantage |
$3.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.55
|
| Rate for Payer: Priority Health Medicare |
$3.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.04
|
| Rate for Payer: Railroad Medicare Medicare |
$3.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.70
|
| Rate for Payer: UHC Core |
$12.05
|
| Rate for Payer: UHC Exchange |
$3.61
|
| Rate for Payer: UHC Medicaid |
$2.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.61
|
| Rate for Payer: UHCCP Medicaid |
$2.54
|
| Rate for Payer: VA VA |
$3.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 10
|
Facility
|
IP
|
$14.43
|
|
|
Service Code
|
CPT 86735
|
| Hospital Charge Code |
30200307
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.04 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: BCBS Trust/PPO |
$11.92
|
| Rate for Payer: BCN Commercial |
$11.92
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.70
|
| Rate for Payer: UHC Core |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 11
|
Facility
|
OP
|
$14.43
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200258
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Medicare |
$3.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.51
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$3.61
|
| Rate for Payer: BCBS Trust/PPO |
$11.86
|
| Rate for Payer: BCN Commercial |
$11.86
|
| Rate for Payer: BCN Medicare Advantage |
$3.61
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.61
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Mclaren Medicaid |
$2.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.79
|
| Rate for Payer: Meridian Medicaid |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PACE Senior Care Partners |
$3.43
|
| Rate for Payer: PACE SWMI |
$3.61
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: PHP Medicare Advantage |
$3.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.55
|
| Rate for Payer: Priority Health Medicare |
$3.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.04
|
| Rate for Payer: Railroad Medicare Medicare |
$3.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.70
|
| Rate for Payer: UHC Core |
$12.05
|
| Rate for Payer: UHC Exchange |
$3.61
|
| Rate for Payer: UHC Medicaid |
$2.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.61
|
| Rate for Payer: UHCCP Medicaid |
$2.54
|
| Rate for Payer: VA VA |
$3.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 11
|
Facility
|
IP
|
$14.43
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200258
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.04 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: BCBS Trust/PPO |
$11.92
|
| Rate for Payer: BCN Commercial |
$11.92
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.70
|
| Rate for Payer: UHC Core |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 12
|
Facility
|
OP
|
$14.43
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
30200328
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Medicare |
$3.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.51
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$3.61
|
| Rate for Payer: BCBS Trust/PPO |
$11.86
|
| Rate for Payer: BCN Commercial |
$11.86
|
| Rate for Payer: BCN Medicare Advantage |
$3.61
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.61
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Mclaren Medicaid |
$2.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.79
|
| Rate for Payer: Meridian Medicaid |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PACE Senior Care Partners |
$3.43
|
| Rate for Payer: PACE SWMI |
$3.61
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: PHP Medicare Advantage |
$3.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.55
|
| Rate for Payer: Priority Health Medicare |
$3.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.04
|
| Rate for Payer: Railroad Medicare Medicare |
$3.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.70
|
| Rate for Payer: UHC Core |
$12.05
|
| Rate for Payer: UHC Exchange |
$3.61
|
| Rate for Payer: UHC Medicaid |
$2.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.61
|
| Rate for Payer: UHCCP Medicaid |
$2.54
|
| Rate for Payer: VA VA |
$3.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 12
|
Facility
|
IP
|
$14.43
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
30200328
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.04 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: BCBS Trust/PPO |
$11.92
|
| Rate for Payer: BCN Commercial |
$11.92
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.70
|
| Rate for Payer: UHC Core |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 13
|
Facility
|
IP
|
$14.43
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200259
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.04 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: BCBS Trust/PPO |
$11.92
|
| Rate for Payer: BCN Commercial |
$11.92
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.70
|
| Rate for Payer: UHC Core |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 13
|
Facility
|
OP
|
$14.43
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200259
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Medicare |
$3.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.51
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$3.61
|
| Rate for Payer: BCBS Trust/PPO |
$11.86
|
| Rate for Payer: BCN Commercial |
$11.86
|
| Rate for Payer: BCN Medicare Advantage |
$3.61
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.61
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Mclaren Medicaid |
$2.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.79
|
| Rate for Payer: Meridian Medicaid |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PACE Senior Care Partners |
$3.43
|
| Rate for Payer: PACE SWMI |
$3.61
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: PHP Medicare Advantage |
$3.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.55
|
| Rate for Payer: Priority Health Medicare |
$3.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.04
|
| Rate for Payer: Railroad Medicare Medicare |
$3.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.70
|
| Rate for Payer: UHC Core |
$12.05
|
| Rate for Payer: UHC Exchange |
$3.61
|
| Rate for Payer: UHC Medicaid |
$2.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.61
|
| Rate for Payer: UHCCP Medicaid |
$2.54
|
| Rate for Payer: VA VA |
$3.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 14
|
Facility
|
OP
|
$14.43
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
30200300
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Medicare |
$3.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.51
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$3.61
|
| Rate for Payer: BCBS Trust/PPO |
$11.86
|
| Rate for Payer: BCN Commercial |
$11.86
|
| Rate for Payer: BCN Medicare Advantage |
$3.61
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.61
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Mclaren Medicaid |
$2.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.79
|
| Rate for Payer: Meridian Medicaid |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PACE Senior Care Partners |
$3.43
|
| Rate for Payer: PACE SWMI |
$3.61
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: PHP Medicare Advantage |
$3.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.55
|
| Rate for Payer: Priority Health Medicare |
$3.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.04
|
| Rate for Payer: Railroad Medicare Medicare |
$3.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.70
|
| Rate for Payer: UHC Core |
$12.05
|
| Rate for Payer: UHC Exchange |
$3.61
|
| Rate for Payer: UHC Medicaid |
$2.54
|
| Rate for Payer: UHC Medicare Advantage |
$3.61
|
| Rate for Payer: UHCCP Medicaid |
$2.54
|
| Rate for Payer: VA VA |
$3.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 14
|
Facility
|
IP
|
$14.43
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
30200300
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.04 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: BCBS Trust/PPO |
$11.92
|
| Rate for Payer: BCN Commercial |
$11.92
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$11.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.70
|
| Rate for Payer: UHC Core |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
