|
HC RAPID HIV ANTIBODY
|
Facility
|
IP
|
$150.70
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200290
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$91.91 |
| Max. Negotiated Rate |
$135.63 |
| Rate for Payer: Aetna Commercial |
$128.10
|
| Rate for Payer: BCBS Trust/PPO |
$116.46
|
| Rate for Payer: BCN Commercial |
$116.46
|
| Rate for Payer: Cash Price |
$120.56
|
| Rate for Payer: Cofinity Commercial |
$129.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.56
|
| Rate for Payer: Healthscope Commercial |
$135.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.10
|
| Rate for Payer: PHP Commercial |
$128.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.62
|
| Rate for Payer: UHC Core |
$125.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.02
|
|
|
HC RAPID HIV ANTIBODY
|
Facility
|
OP
|
$150.70
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200290
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.56 |
| Max. Negotiated Rate |
$135.63 |
| Rate for Payer: Aetna Commercial |
$128.10
|
| Rate for Payer: Aetna Medicare |
$39.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.09
|
| Rate for Payer: BCBS Complete |
$6.89
|
| Rate for Payer: BCBS MAPPO |
$37.68
|
| Rate for Payer: BCBS Trust/PPO |
$117.17
|
| Rate for Payer: BCN Commercial |
$117.17
|
| Rate for Payer: BCN Medicare Advantage |
$37.68
|
| Rate for Payer: Cash Price |
$120.56
|
| Rate for Payer: Cash Price |
$120.56
|
| Rate for Payer: Cofinity Commercial |
$129.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.68
|
| Rate for Payer: Healthscope Commercial |
$135.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.02
|
| Rate for Payer: Mclaren Medicaid |
$6.56
|
| Rate for Payer: Meridian Medicaid |
$6.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.10
|
| Rate for Payer: PACE Senior Care Partners |
$35.79
|
| Rate for Payer: PACE SWMI |
$37.68
|
| Rate for Payer: PHP Commercial |
$128.10
|
| Rate for Payer: PHP Medicare Advantage |
$37.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$131.11
|
| Rate for Payer: Priority Health Medicare |
$37.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.91
|
| Rate for Payer: Railroad Medicare Medicare |
$37.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.62
|
| Rate for Payer: UHC Core |
$125.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.68
|
| Rate for Payer: UHC Medicare Advantage |
$38.81
|
| Rate for Payer: VA VA |
$37.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.02
|
|
|
HC RAPID INFLUENZA A & B SCREEN
|
Facility
|
OP
|
$76.40
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
30600174
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.21 |
| Max. Negotiated Rate |
$68.76 |
| Rate for Payer: Aetna Commercial |
$64.94
|
| Rate for Payer: Aetna Medicare |
$19.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.88
|
| Rate for Payer: BCBS Complete |
$12.82
|
| Rate for Payer: BCBS MAPPO |
$19.10
|
| Rate for Payer: BCBS Trust/PPO |
$59.40
|
| Rate for Payer: BCN Commercial |
$59.40
|
| Rate for Payer: BCN Medicare Advantage |
$19.10
|
| Rate for Payer: Cash Price |
$61.12
|
| Rate for Payer: Cash Price |
$61.12
|
| Rate for Payer: Cofinity Commercial |
$65.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.10
|
| Rate for Payer: Healthscope Commercial |
$68.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$12.21
|
| Rate for Payer: Meridian Medicaid |
$12.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.94
|
| Rate for Payer: PACE Senior Care Partners |
$18.14
|
| Rate for Payer: PACE SWMI |
$19.10
|
| Rate for Payer: PHP Commercial |
$64.94
|
| Rate for Payer: PHP Medicare Advantage |
$19.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.47
|
| Rate for Payer: Priority Health Medicare |
$19.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.60
|
| Rate for Payer: Railroad Medicare Medicare |
$19.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.23
|
| Rate for Payer: UHC Core |
$63.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.10
|
| Rate for Payer: UHC Medicare Advantage |
$19.67
|
| Rate for Payer: VA VA |
$19.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.30
|
|
|
HC RAPID INFLUENZA A & B SCREEN
|
Facility
|
IP
|
$76.40
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
30600174
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$46.60 |
| Max. Negotiated Rate |
$68.76 |
| Rate for Payer: Aetna Commercial |
$64.94
|
| Rate for Payer: BCBS Trust/PPO |
$59.04
|
| Rate for Payer: BCN Commercial |
$59.04
|
| Rate for Payer: Cash Price |
$61.12
|
| Rate for Payer: Cofinity Commercial |
$65.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.12
|
| Rate for Payer: Healthscope Commercial |
$68.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.94
|
| Rate for Payer: PHP Commercial |
$64.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.23
|
| Rate for Payer: UHC Core |
$63.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.30
|
|
|
HC RAPID INFUSER
|
Facility
|
IP
|
$1,404.36
|
|
| Hospital Charge Code |
27000294
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$856.52 |
| Max. Negotiated Rate |
$1,263.92 |
| Rate for Payer: Aetna Commercial |
$1,193.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,085.29
|
| Rate for Payer: BCN Commercial |
$1,085.29
|
| Rate for Payer: Cash Price |
$1,123.49
|
| Rate for Payer: Cofinity Commercial |
$1,207.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.49
|
| Rate for Payer: Healthscope Commercial |
$1,263.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,053.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,193.71
|
| Rate for Payer: PHP Commercial |
$1,193.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,221.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$856.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,235.84
|
| Rate for Payer: UHC Core |
$1,172.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,053.27
|
|
|
HC RAPID INFUSER
|
Facility
|
OP
|
$1,404.36
|
|
| Hospital Charge Code |
27000294
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$333.54 |
| Max. Negotiated Rate |
$1,263.92 |
| Rate for Payer: Aetna Commercial |
$1,193.71
|
| Rate for Payer: Aetna Medicare |
$365.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$438.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$438.86
|
| Rate for Payer: BCBS Complete |
$561.74
|
| Rate for Payer: BCBS MAPPO |
$351.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,091.89
|
| Rate for Payer: BCN Commercial |
$1,091.89
|
| Rate for Payer: BCN Medicare Advantage |
$351.09
|
| Rate for Payer: Cash Price |
$1,123.49
|
| Rate for Payer: Cofinity Commercial |
$1,207.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.09
|
| Rate for Payer: Healthscope Commercial |
$1,263.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,053.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$368.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$403.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,193.71
|
| Rate for Payer: PACE Senior Care Partners |
$333.54
|
| Rate for Payer: PACE SWMI |
$351.09
|
| Rate for Payer: PHP Commercial |
$1,193.71
|
| Rate for Payer: PHP Medicare Advantage |
$351.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,221.79
|
| Rate for Payer: Priority Health Medicare |
$351.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$856.52
|
| Rate for Payer: Railroad Medicare Medicare |
$351.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,235.84
|
| Rate for Payer: UHC Core |
$1,172.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$351.09
|
| Rate for Payer: UHC Medicare Advantage |
$361.62
|
| Rate for Payer: VA VA |
$351.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,053.27
|
|
|
HC RAPID MALARIA ASSAY
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600298
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC RAPID MALARIA ASSAY
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600298
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.86 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$12.45
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$11.86
|
| Rate for Payer: Meridian Medicaid |
$12.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC RAPID STREP SCREEN.
|
Facility
|
OP
|
$60.49
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
30600176
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.20 |
| Max. Negotiated Rate |
$54.44 |
| Rate for Payer: Aetna Commercial |
$51.42
|
| Rate for Payer: Aetna Medicare |
$15.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.90
|
| Rate for Payer: BCBS Complete |
$12.81
|
| Rate for Payer: BCBS MAPPO |
$15.12
|
| Rate for Payer: BCBS Trust/PPO |
$47.03
|
| Rate for Payer: BCN Commercial |
$47.03
|
| Rate for Payer: BCN Medicare Advantage |
$15.12
|
| Rate for Payer: Cash Price |
$48.39
|
| Rate for Payer: Cash Price |
$48.39
|
| Rate for Payer: Cofinity Commercial |
$52.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.12
|
| Rate for Payer: Healthscope Commercial |
$54.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.37
|
| Rate for Payer: Mclaren Medicaid |
$12.20
|
| Rate for Payer: Meridian Medicaid |
$12.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.42
|
| Rate for Payer: PACE Senior Care Partners |
$14.37
|
| Rate for Payer: PACE SWMI |
$15.12
|
| Rate for Payer: PHP Commercial |
$51.42
|
| Rate for Payer: PHP Medicare Advantage |
$15.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.63
|
| Rate for Payer: Priority Health Medicare |
$15.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.89
|
| Rate for Payer: Railroad Medicare Medicare |
$15.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.23
|
| Rate for Payer: UHC Core |
$50.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.12
|
| Rate for Payer: UHC Medicare Advantage |
$15.58
|
| Rate for Payer: VA VA |
$15.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.37
|
|
|
HC RAPID STREP SCREEN.
|
Facility
|
IP
|
$60.49
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
30600176
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.89 |
| Max. Negotiated Rate |
$54.44 |
| Rate for Payer: Aetna Commercial |
$51.42
|
| Rate for Payer: BCBS Trust/PPO |
$46.75
|
| Rate for Payer: BCN Commercial |
$46.75
|
| Rate for Payer: Cash Price |
$48.39
|
| Rate for Payer: Cofinity Commercial |
$52.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.39
|
| Rate for Payer: Healthscope Commercial |
$54.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.42
|
| Rate for Payer: PHP Commercial |
$51.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.23
|
| Rate for Payer: UHC Core |
$50.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.37
|
|
|
HC RAVAS CTO/DES
|
Facility
|
IP
|
$29,091.52
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
48100088
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$17,742.92 |
| Max. Negotiated Rate |
$26,182.37 |
| Rate for Payer: Aetna Commercial |
$24,727.79
|
| Rate for Payer: BCBS Trust/PPO |
$22,481.93
|
| Rate for Payer: BCN Commercial |
$22,481.93
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cofinity Commercial |
$25,018.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,273.22
|
| Rate for Payer: Healthscope Commercial |
$26,182.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,818.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,727.79
|
| Rate for Payer: PHP Commercial |
$24,727.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,364.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,309.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,742.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,600.54
|
| Rate for Payer: UHC Core |
$24,291.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,818.64
|
|
|
HC RAVAS CTO/DES
|
Facility
|
OP
|
$29,091.52
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
48100088
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,909.24 |
| Max. Negotiated Rate |
$26,182.37 |
| Rate for Payer: Aetna Commercial |
$24,727.79
|
| Rate for Payer: Aetna Medicare |
$7,563.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,091.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,091.10
|
| Rate for Payer: BCBS Complete |
$12,078.04
|
| Rate for Payer: BCBS MAPPO |
$7,272.88
|
| Rate for Payer: BCBS Trust/PPO |
$22,618.66
|
| Rate for Payer: BCN Commercial |
$22,618.66
|
| Rate for Payer: BCN Medicare Advantage |
$7,272.88
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cofinity Commercial |
$25,018.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,273.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,272.88
|
| Rate for Payer: Healthscope Commercial |
$26,182.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,818.64
|
| Rate for Payer: Mclaren Medicaid |
$11,502.90
|
| Rate for Payer: Meridian Medicaid |
$12,078.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,636.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,363.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,727.79
|
| Rate for Payer: PACE Senior Care Partners |
$6,909.24
|
| Rate for Payer: PACE SWMI |
$7,272.88
|
| Rate for Payer: PHP Commercial |
$24,727.79
|
| Rate for Payer: PHP Medicare Advantage |
$7,272.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,502.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,364.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,309.62
|
| Rate for Payer: Priority Health Medicare |
$7,272.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,742.92
|
| Rate for Payer: Railroad Medicare Medicare |
$7,272.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,600.54
|
| Rate for Payer: UHC Core |
$24,291.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,272.88
|
| Rate for Payer: UHC Medicare Advantage |
$7,491.07
|
| Rate for Payer: VA VA |
$7,272.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,818.64
|
|
|
HC RAVAS CTO/STENT
|
Facility
|
IP
|
$29,091.52
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
48100087
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$17,742.92 |
| Max. Negotiated Rate |
$26,182.37 |
| Rate for Payer: Aetna Commercial |
$24,727.79
|
| Rate for Payer: BCBS Trust/PPO |
$22,481.93
|
| Rate for Payer: BCN Commercial |
$22,481.93
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cofinity Commercial |
$25,018.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,273.22
|
| Rate for Payer: Healthscope Commercial |
$26,182.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,818.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,727.79
|
| Rate for Payer: PHP Commercial |
$24,727.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,364.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,309.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,742.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,600.54
|
| Rate for Payer: UHC Core |
$24,291.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,818.64
|
|
|
HC RAVAS CTO/STENT
|
Facility
|
OP
|
$29,091.52
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
48100087
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,909.24 |
| Max. Negotiated Rate |
$26,182.37 |
| Rate for Payer: Aetna Commercial |
$24,727.79
|
| Rate for Payer: Aetna Medicare |
$7,563.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,091.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,091.10
|
| Rate for Payer: BCBS Complete |
$7,577.51
|
| Rate for Payer: BCBS MAPPO |
$7,272.88
|
| Rate for Payer: BCBS Trust/PPO |
$22,618.66
|
| Rate for Payer: BCN Commercial |
$22,618.66
|
| Rate for Payer: BCN Medicare Advantage |
$7,272.88
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cofinity Commercial |
$25,018.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,273.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,272.88
|
| Rate for Payer: Healthscope Commercial |
$26,182.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,818.64
|
| Rate for Payer: Mclaren Medicaid |
$7,216.67
|
| Rate for Payer: Meridian Medicaid |
$7,577.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,636.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,363.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,727.79
|
| Rate for Payer: PACE Senior Care Partners |
$6,909.24
|
| Rate for Payer: PACE SWMI |
$7,272.88
|
| Rate for Payer: PHP Commercial |
$24,727.79
|
| Rate for Payer: PHP Medicare Advantage |
$7,272.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,216.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,364.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,309.62
|
| Rate for Payer: Priority Health Medicare |
$7,272.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17,742.92
|
| Rate for Payer: Railroad Medicare Medicare |
$7,272.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,600.54
|
| Rate for Payer: UHC Core |
$24,291.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,272.88
|
| Rate for Payer: UHC Medicare Advantage |
$7,491.07
|
| Rate for Payer: VA VA |
$7,272.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,818.64
|
|
|
HC RBC LEUKO REDUCED
|
Facility
|
IP
|
$711.37
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000059
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$433.86 |
| Max. Negotiated Rate |
$640.23 |
| Rate for Payer: Aetna Commercial |
$604.66
|
| Rate for Payer: BCBS Trust/PPO |
$549.75
|
| Rate for Payer: BCN Commercial |
$549.75
|
| Rate for Payer: Cash Price |
$569.10
|
| Rate for Payer: Cofinity Commercial |
$611.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$569.10
|
| Rate for Payer: Healthscope Commercial |
$640.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$533.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$604.66
|
| Rate for Payer: PHP Commercial |
$604.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$618.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$433.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$626.01
|
| Rate for Payer: UHC Core |
$593.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$533.53
|
|
|
HC RBC LEUKO REDUCED
|
Facility
|
OP
|
$711.37
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000059
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$124.49 |
| Max. Negotiated Rate |
$640.23 |
| Rate for Payer: Aetna Commercial |
$604.66
|
| Rate for Payer: Aetna Medicare |
$184.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.30
|
| Rate for Payer: BCBS Complete |
$130.72
|
| Rate for Payer: BCBS MAPPO |
$177.84
|
| Rate for Payer: BCBS Trust/PPO |
$553.09
|
| Rate for Payer: BCN Commercial |
$553.09
|
| Rate for Payer: BCN Medicare Advantage |
$177.84
|
| Rate for Payer: Cash Price |
$569.10
|
| Rate for Payer: Cash Price |
$569.10
|
| Rate for Payer: Cofinity Commercial |
$611.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$569.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.84
|
| Rate for Payer: Healthscope Commercial |
$640.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$533.53
|
| Rate for Payer: Mclaren Medicaid |
$124.49
|
| Rate for Payer: Meridian Medicaid |
$130.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$604.66
|
| Rate for Payer: PACE Senior Care Partners |
$168.95
|
| Rate for Payer: PACE SWMI |
$177.84
|
| Rate for Payer: PHP Commercial |
$604.66
|
| Rate for Payer: PHP Medicare Advantage |
$177.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$618.89
|
| Rate for Payer: Priority Health Medicare |
$177.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$433.86
|
| Rate for Payer: Railroad Medicare Medicare |
$177.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$626.01
|
| Rate for Payer: UHC Core |
$593.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.84
|
| Rate for Payer: UHC Medicare Advantage |
$183.18
|
| Rate for Payer: VA VA |
$177.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$533.53
|
|
|
HC RBC LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$1,232.44
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000072
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$173.83 |
| Max. Negotiated Rate |
$1,109.20 |
| Rate for Payer: Aetna Commercial |
$1,047.57
|
| Rate for Payer: Aetna Medicare |
$320.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$385.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$385.14
|
| Rate for Payer: BCBS Complete |
$182.52
|
| Rate for Payer: BCBS MAPPO |
$308.11
|
| Rate for Payer: BCBS Trust/PPO |
$958.22
|
| Rate for Payer: BCN Commercial |
$958.22
|
| Rate for Payer: BCN Medicare Advantage |
$308.11
|
| Rate for Payer: Cash Price |
$985.95
|
| Rate for Payer: Cash Price |
$985.95
|
| Rate for Payer: Cofinity Commercial |
$1,059.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$985.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.11
|
| Rate for Payer: Healthscope Commercial |
$1,109.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.33
|
| Rate for Payer: Mclaren Medicaid |
$173.83
|
| Rate for Payer: Meridian Medicaid |
$182.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$323.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$354.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,047.57
|
| Rate for Payer: PACE Senior Care Partners |
$292.70
|
| Rate for Payer: PACE SWMI |
$308.11
|
| Rate for Payer: PHP Commercial |
$1,047.57
|
| Rate for Payer: PHP Medicare Advantage |
$308.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$862.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,072.22
|
| Rate for Payer: Priority Health Medicare |
$308.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$751.67
|
| Rate for Payer: Railroad Medicare Medicare |
$308.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,084.55
|
| Rate for Payer: UHC Core |
$1,029.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.11
|
| Rate for Payer: UHC Medicare Advantage |
$317.35
|
| Rate for Payer: VA VA |
$308.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.33
|
|
|
HC RBC LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$1,232.44
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000072
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$751.67 |
| Max. Negotiated Rate |
$1,109.20 |
| Rate for Payer: Aetna Commercial |
$1,047.57
|
| Rate for Payer: BCBS Trust/PPO |
$952.43
|
| Rate for Payer: BCN Commercial |
$952.43
|
| Rate for Payer: Cash Price |
$985.95
|
| Rate for Payer: Cofinity Commercial |
$1,059.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$985.95
|
| Rate for Payer: Healthscope Commercial |
$1,109.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,047.57
|
| Rate for Payer: PHP Commercial |
$1,047.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$862.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,072.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$751.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,084.55
|
| Rate for Payer: UHC Core |
$1,029.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.33
|
|
|
HC RECEPTOR ASSAY OTHER ENDOCRINE
|
Facility
|
OP
|
$199.97
|
|
|
Service Code
|
CPT 84235
|
| Hospital Charge Code |
30100418
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.49 |
| Max. Negotiated Rate |
$179.97 |
| Rate for Payer: Aetna Commercial |
$169.97
|
| Rate for Payer: Aetna Medicare |
$51.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$62.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$62.49
|
| Rate for Payer: BCBS Complete |
$55.20
|
| Rate for Payer: BCBS MAPPO |
$49.99
|
| Rate for Payer: BCBS Trust/PPO |
$155.48
|
| Rate for Payer: BCN Commercial |
$155.48
|
| Rate for Payer: BCN Medicare Advantage |
$49.99
|
| Rate for Payer: Cash Price |
$159.98
|
| Rate for Payer: Cash Price |
$159.98
|
| Rate for Payer: Cofinity Commercial |
$171.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.99
|
| Rate for Payer: Healthscope Commercial |
$179.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.98
|
| Rate for Payer: Mclaren Medicaid |
$52.57
|
| Rate for Payer: Meridian Medicaid |
$55.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$169.97
|
| Rate for Payer: PACE Senior Care Partners |
$47.49
|
| Rate for Payer: PACE SWMI |
$49.99
|
| Rate for Payer: PHP Commercial |
$169.97
|
| Rate for Payer: PHP Medicare Advantage |
$49.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.97
|
| Rate for Payer: Priority Health Medicare |
$49.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.96
|
| Rate for Payer: Railroad Medicare Medicare |
$49.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.97
|
| Rate for Payer: UHC Core |
$166.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.99
|
| Rate for Payer: UHC Medicare Advantage |
$51.49
|
| Rate for Payer: VA VA |
$49.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.98
|
|
|
HC RECEPTOR ASSAY OTHER ENDOCRINE
|
Facility
|
IP
|
$199.97
|
|
|
Service Code
|
CPT 84235
|
| Hospital Charge Code |
30100418
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$121.96 |
| Max. Negotiated Rate |
$179.97 |
| Rate for Payer: Aetna Commercial |
$169.97
|
| Rate for Payer: BCBS Trust/PPO |
$154.54
|
| Rate for Payer: BCN Commercial |
$154.54
|
| Rate for Payer: Cash Price |
$159.98
|
| Rate for Payer: Cofinity Commercial |
$171.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.98
|
| Rate for Payer: Healthscope Commercial |
$179.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$169.97
|
| Rate for Payer: PHP Commercial |
$169.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.97
|
| Rate for Payer: UHC Core |
$166.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.98
|
|
|
HC RECOVERY 1 ADD'L 15 MIN
|
Facility
|
IP
|
$153.93
|
|
| Hospital Charge Code |
71000020
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$93.88 |
| Max. Negotiated Rate |
$138.54 |
| Rate for Payer: Aetna Commercial |
$130.84
|
| Rate for Payer: BCBS Trust/PPO |
$118.96
|
| Rate for Payer: BCN Commercial |
$118.96
|
| Rate for Payer: Cash Price |
$123.14
|
| Rate for Payer: Cofinity Commercial |
$132.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.14
|
| Rate for Payer: Healthscope Commercial |
$138.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$130.84
|
| Rate for Payer: PHP Commercial |
$130.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.46
|
| Rate for Payer: UHC Core |
$128.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.45
|
|
|
HC RECOVERY 1 ADD'L 15 MIN
|
Facility
|
OP
|
$153.93
|
|
| Hospital Charge Code |
71000020
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$36.56 |
| Max. Negotiated Rate |
$138.54 |
| Rate for Payer: Aetna Commercial |
$130.84
|
| Rate for Payer: Aetna Medicare |
$40.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.10
|
| Rate for Payer: BCBS Complete |
$61.57
|
| Rate for Payer: BCBS MAPPO |
$38.48
|
| Rate for Payer: BCBS Trust/PPO |
$119.68
|
| Rate for Payer: BCN Commercial |
$119.68
|
| Rate for Payer: BCN Medicare Advantage |
$38.48
|
| Rate for Payer: Cash Price |
$123.14
|
| Rate for Payer: Cofinity Commercial |
$132.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.48
|
| Rate for Payer: Healthscope Commercial |
$138.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$130.84
|
| Rate for Payer: PACE Senior Care Partners |
$36.56
|
| Rate for Payer: PACE SWMI |
$38.48
|
| Rate for Payer: PHP Commercial |
$130.84
|
| Rate for Payer: PHP Medicare Advantage |
$38.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.92
|
| Rate for Payer: Priority Health Medicare |
$38.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.88
|
| Rate for Payer: Railroad Medicare Medicare |
$38.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.46
|
| Rate for Payer: UHC Core |
$128.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.48
|
| Rate for Payer: UHC Medicare Advantage |
$39.64
|
| Rate for Payer: VA VA |
$38.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.45
|
|
|
HC RECOVERY 1 INIT 30 MIN
|
Facility
|
OP
|
$363.41
|
|
| Hospital Charge Code |
71000021
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$86.31 |
| Max. Negotiated Rate |
$327.07 |
| Rate for Payer: Aetna Commercial |
$308.90
|
| Rate for Payer: Aetna Medicare |
$94.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.57
|
| Rate for Payer: BCBS Complete |
$145.36
|
| Rate for Payer: BCBS MAPPO |
$90.85
|
| Rate for Payer: BCBS Trust/PPO |
$282.55
|
| Rate for Payer: BCN Commercial |
$282.55
|
| Rate for Payer: BCN Medicare Advantage |
$90.85
|
| Rate for Payer: Cash Price |
$290.73
|
| Rate for Payer: Cofinity Commercial |
$312.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.85
|
| Rate for Payer: Healthscope Commercial |
$327.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$95.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$308.90
|
| Rate for Payer: PACE Senior Care Partners |
$86.31
|
| Rate for Payer: PACE SWMI |
$90.85
|
| Rate for Payer: PHP Commercial |
$308.90
|
| Rate for Payer: PHP Medicare Advantage |
$90.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.17
|
| Rate for Payer: Priority Health Medicare |
$90.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$221.64
|
| Rate for Payer: Railroad Medicare Medicare |
$90.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$319.80
|
| Rate for Payer: UHC Core |
$303.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.85
|
| Rate for Payer: UHC Medicare Advantage |
$93.58
|
| Rate for Payer: VA VA |
$90.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.56
|
|
|
HC RECOVERY 1 INIT 30 MIN
|
Facility
|
IP
|
$363.41
|
|
| Hospital Charge Code |
71000021
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$221.64 |
| Max. Negotiated Rate |
$327.07 |
| Rate for Payer: Aetna Commercial |
$308.90
|
| Rate for Payer: BCBS Trust/PPO |
$280.84
|
| Rate for Payer: BCN Commercial |
$280.84
|
| Rate for Payer: Cash Price |
$290.73
|
| Rate for Payer: Cofinity Commercial |
$312.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$290.73
|
| Rate for Payer: Healthscope Commercial |
$327.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$308.90
|
| Rate for Payer: PHP Commercial |
$308.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$254.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$316.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$221.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$319.80
|
| Rate for Payer: UHC Core |
$303.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.56
|
|
|
HC RECOVERY 2 ADD'L 15 MIN
|
Facility
|
OP
|
$180.23
|
|
| Hospital Charge Code |
71000022
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$162.21 |
| Rate for Payer: Aetna Commercial |
$153.20
|
| Rate for Payer: Aetna Medicare |
$46.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.32
|
| Rate for Payer: BCBS Complete |
$72.09
|
| Rate for Payer: BCBS MAPPO |
$45.06
|
| Rate for Payer: BCBS Trust/PPO |
$140.13
|
| Rate for Payer: BCN Commercial |
$140.13
|
| Rate for Payer: BCN Medicare Advantage |
$45.06
|
| Rate for Payer: Cash Price |
$144.18
|
| Rate for Payer: Cofinity Commercial |
$155.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.06
|
| Rate for Payer: Healthscope Commercial |
$162.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.20
|
| Rate for Payer: PACE Senior Care Partners |
$42.80
|
| Rate for Payer: PACE SWMI |
$45.06
|
| Rate for Payer: PHP Commercial |
$153.20
|
| Rate for Payer: PHP Medicare Advantage |
$45.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$156.80
|
| Rate for Payer: Priority Health Medicare |
$45.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.92
|
| Rate for Payer: Railroad Medicare Medicare |
$45.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.60
|
| Rate for Payer: UHC Core |
$150.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.06
|
| Rate for Payer: UHC Medicare Advantage |
$46.41
|
| Rate for Payer: VA VA |
$45.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.17
|
|
