|
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
|
|
|
HC RECOVERY 2 INIT 30 MIN
|
Facility
|
IP
|
$325.07
|
|
| Hospital Charge Code |
71000023
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$198.26 |
| Max. Negotiated Rate |
$292.56 |
| Rate for Payer: Aetna Commercial |
$276.31
|
| Rate for Payer: BCBS Trust/PPO |
$251.21
|
| Rate for Payer: BCN Commercial |
$251.21
|
| Rate for Payer: Cash Price |
$260.06
|
| Rate for Payer: Cofinity Commercial |
$279.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.06
|
| Rate for Payer: Healthscope Commercial |
$292.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$276.31
|
| Rate for Payer: PHP Commercial |
$276.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.06
|
| Rate for Payer: UHC Core |
$271.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.80
|
|
|
HC RECOVERY 2 INIT 30 MIN
|
Facility
|
OP
|
$325.07
|
|
| Hospital Charge Code |
71000023
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$77.20 |
| Max. Negotiated Rate |
$292.56 |
| Rate for Payer: Aetna Commercial |
$276.31
|
| Rate for Payer: Aetna Medicare |
$84.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$101.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$101.58
|
| Rate for Payer: BCBS Complete |
$130.03
|
| Rate for Payer: BCBS MAPPO |
$81.27
|
| Rate for Payer: BCBS Trust/PPO |
$252.74
|
| Rate for Payer: BCN Commercial |
$252.74
|
| Rate for Payer: BCN Medicare Advantage |
$81.27
|
| Rate for Payer: Cash Price |
$260.06
|
| Rate for Payer: Cofinity Commercial |
$279.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.27
|
| Rate for Payer: Healthscope Commercial |
$292.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$85.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$276.31
|
| Rate for Payer: PACE Senior Care Partners |
$77.20
|
| Rate for Payer: PACE SWMI |
$81.27
|
| Rate for Payer: PHP Commercial |
$276.31
|
| Rate for Payer: PHP Medicare Advantage |
$81.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.81
|
| Rate for Payer: Priority Health Medicare |
$81.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.26
|
| Rate for Payer: Railroad Medicare Medicare |
$81.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.06
|
| Rate for Payer: UHC Core |
$271.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.27
|
| Rate for Payer: UHC Medicare Advantage |
$83.71
|
| Rate for Payer: VA VA |
$81.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.80
|
|
|
HC RECOVERY 3 ADD'L 15 MIN
|
Facility
|
IP
|
$100.17
|
|
| Hospital Charge Code |
71000024
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$61.09 |
| Max. Negotiated Rate |
$90.15 |
| Rate for Payer: Aetna Commercial |
$85.14
|
| Rate for Payer: BCBS Trust/PPO |
$77.41
|
| Rate for Payer: BCN Commercial |
$77.41
|
| Rate for Payer: Cash Price |
$80.14
|
| Rate for Payer: Cofinity Commercial |
$86.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.14
|
| Rate for Payer: Healthscope Commercial |
$90.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.14
|
| Rate for Payer: PHP Commercial |
$85.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.15
|
| Rate for Payer: UHC Core |
$83.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.13
|
|
|
HC RECOVERY 3 ADD'L 15 MIN
|
Facility
|
OP
|
$100.17
|
|
| Hospital Charge Code |
71000024
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$23.79 |
| Max. Negotiated Rate |
$90.15 |
| Rate for Payer: Aetna Commercial |
$85.14
|
| Rate for Payer: Aetna Medicare |
$26.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.30
|
| Rate for Payer: BCBS Complete |
$40.07
|
| Rate for Payer: BCBS MAPPO |
$25.04
|
| Rate for Payer: BCBS Trust/PPO |
$77.88
|
| Rate for Payer: BCN Commercial |
$77.88
|
| Rate for Payer: BCN Medicare Advantage |
$25.04
|
| Rate for Payer: Cash Price |
$80.14
|
| Rate for Payer: Cofinity Commercial |
$86.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.04
|
| Rate for Payer: Healthscope Commercial |
$90.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.14
|
| Rate for Payer: PACE Senior Care Partners |
$23.79
|
| Rate for Payer: PACE SWMI |
$25.04
|
| Rate for Payer: PHP Commercial |
$85.14
|
| Rate for Payer: PHP Medicare Advantage |
$25.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.15
|
| Rate for Payer: Priority Health Medicare |
$25.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.09
|
| Rate for Payer: Railroad Medicare Medicare |
$25.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.15
|
| Rate for Payer: UHC Core |
$83.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.04
|
| Rate for Payer: UHC Medicare Advantage |
$25.79
|
| Rate for Payer: VA VA |
$25.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.13
|
|
|
HC RECOVERY 3 INIT 30 MIN
|
Facility
|
OP
|
$202.38
|
|
| Hospital Charge Code |
71000025
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$48.07 |
| Max. Negotiated Rate |
$182.14 |
| Rate for Payer: Aetna Commercial |
$172.02
|
| Rate for Payer: Aetna Medicare |
$52.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.24
|
| Rate for Payer: BCBS Complete |
$80.95
|
| Rate for Payer: BCBS MAPPO |
$50.60
|
| Rate for Payer: BCBS Trust/PPO |
$157.35
|
| Rate for Payer: BCN Commercial |
$157.35
|
| Rate for Payer: BCN Medicare Advantage |
$50.60
|
| Rate for Payer: Cash Price |
$161.90
|
| Rate for Payer: Cofinity Commercial |
$174.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.60
|
| Rate for Payer: Healthscope Commercial |
$182.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$172.02
|
| Rate for Payer: PACE Senior Care Partners |
$48.07
|
| Rate for Payer: PACE SWMI |
$50.60
|
| Rate for Payer: PHP Commercial |
$172.02
|
| Rate for Payer: PHP Medicare Advantage |
$50.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.07
|
| Rate for Payer: Priority Health Medicare |
$50.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.43
|
| Rate for Payer: Railroad Medicare Medicare |
$50.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.09
|
| Rate for Payer: UHC Core |
$168.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.60
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: VA VA |
$50.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.78
|
|
|
HC RECOVERY 3 INIT 30 MIN
|
Facility
|
IP
|
$202.38
|
|
| Hospital Charge Code |
71000025
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$123.43 |
| Max. Negotiated Rate |
$182.14 |
| Rate for Payer: Aetna Commercial |
$172.02
|
| Rate for Payer: BCBS Trust/PPO |
$156.40
|
| Rate for Payer: BCN Commercial |
$156.40
|
| Rate for Payer: Cash Price |
$161.90
|
| Rate for Payer: Cofinity Commercial |
$174.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.90
|
| Rate for Payer: Healthscope Commercial |
$182.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$172.02
|
| Rate for Payer: PHP Commercial |
$172.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.09
|
| Rate for Payer: UHC Core |
$168.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.78
|
|
|
HC RED CEDAR IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200099
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC RED CEDAR IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200099
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC RED CELL GENO MI BLD
|
Facility
|
IP
|
$286.73
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
31000135
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$174.88 |
| Max. Negotiated Rate |
$258.06 |
| Rate for Payer: Aetna Commercial |
$243.72
|
| Rate for Payer: BCBS Trust/PPO |
$221.58
|
| Rate for Payer: BCN Commercial |
$221.58
|
| Rate for Payer: Cash Price |
$229.38
|
| Rate for Payer: Cofinity Commercial |
$246.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.38
|
| Rate for Payer: Healthscope Commercial |
$258.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.72
|
| Rate for Payer: PHP Commercial |
$243.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.32
|
| Rate for Payer: UHC Core |
$239.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.05
|
|
|
HC RED CELL GENO MI BLD
|
Facility
|
OP
|
$286.73
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
31000135
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.10 |
| Max. Negotiated Rate |
$258.06 |
| Rate for Payer: Aetna Commercial |
$243.72
|
| Rate for Payer: Aetna Medicare |
$74.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.60
|
| Rate for Payer: BCBS Complete |
$143.51
|
| Rate for Payer: BCBS MAPPO |
$71.68
|
| Rate for Payer: BCBS Trust/PPO |
$222.93
|
| Rate for Payer: BCN Commercial |
$222.93
|
| Rate for Payer: BCN Medicare Advantage |
$71.68
|
| Rate for Payer: Cash Price |
$229.38
|
| Rate for Payer: Cash Price |
$229.38
|
| Rate for Payer: Cofinity Commercial |
$246.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.68
|
| Rate for Payer: Healthscope Commercial |
$258.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.05
|
| Rate for Payer: Mclaren Medicaid |
$136.68
|
| Rate for Payer: Meridian Medicaid |
$143.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.72
|
| Rate for Payer: PACE Senior Care Partners |
$68.10
|
| Rate for Payer: PACE SWMI |
$71.68
|
| Rate for Payer: PHP Commercial |
$243.72
|
| Rate for Payer: PHP Medicare Advantage |
$71.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.46
|
| Rate for Payer: Priority Health Medicare |
$71.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.88
|
| Rate for Payer: Railroad Medicare Medicare |
$71.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.32
|
| Rate for Payer: UHC Core |
$239.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.68
|
| Rate for Payer: UHC Medicare Advantage |
$73.83
|
| Rate for Payer: VA VA |
$71.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.05
|
|
|
HC RED CELL GENO MI BLD CMPT
|
Facility
|
OP
|
$204.69
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
31000136
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$48.61 |
| Max. Negotiated Rate |
$184.22 |
| Rate for Payer: Aetna Commercial |
$173.99
|
| Rate for Payer: Aetna Medicare |
$53.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.97
|
| Rate for Payer: BCBS Complete |
$81.88
|
| Rate for Payer: BCBS MAPPO |
$51.17
|
| Rate for Payer: BCBS Trust/PPO |
$159.15
|
| Rate for Payer: BCN Commercial |
$159.15
|
| Rate for Payer: BCN Medicare Advantage |
$51.17
|
| Rate for Payer: Cash Price |
$163.75
|
| Rate for Payer: Cofinity Commercial |
$176.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.17
|
| Rate for Payer: Healthscope Commercial |
$184.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.99
|
| Rate for Payer: PACE Senior Care Partners |
$48.61
|
| Rate for Payer: PACE SWMI |
$51.17
|
| Rate for Payer: PHP Commercial |
$173.99
|
| Rate for Payer: PHP Medicare Advantage |
$51.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.08
|
| Rate for Payer: Priority Health Medicare |
$51.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.84
|
| Rate for Payer: Railroad Medicare Medicare |
$51.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.13
|
| Rate for Payer: UHC Core |
$170.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.17
|
| Rate for Payer: UHC Medicare Advantage |
$52.71
|
| Rate for Payer: VA VA |
$51.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.52
|
|
|
HC RED CELL GENO MI BLD CMPT
|
Facility
|
IP
|
$204.69
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
31000136
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$124.84 |
| Max. Negotiated Rate |
$184.22 |
| Rate for Payer: Aetna Commercial |
$173.99
|
| Rate for Payer: BCBS Trust/PPO |
$158.18
|
| Rate for Payer: BCN Commercial |
$158.18
|
| Rate for Payer: Cash Price |
$163.75
|
| Rate for Payer: Cofinity Commercial |
$176.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.75
|
| Rate for Payer: Healthscope Commercial |
$184.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.99
|
| Rate for Payer: PHP Commercial |
$173.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.13
|
| Rate for Payer: UHC Core |
$170.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.52
|
|
|
HC RED CELLS, DIRECTED, LEUKO RED
|
Facility
|
IP
|
$1,084.60
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000061
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$661.50 |
| Max. Negotiated Rate |
$976.14 |
| Rate for Payer: Aetna Commercial |
$921.91
|
| Rate for Payer: BCBS Trust/PPO |
$838.18
|
| Rate for Payer: BCN Commercial |
$838.18
|
| Rate for Payer: Cash Price |
$867.68
|
| Rate for Payer: Cofinity Commercial |
$932.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.68
|
| Rate for Payer: Healthscope Commercial |
$976.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$813.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$921.91
|
| Rate for Payer: PHP Commercial |
$921.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$759.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$943.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$661.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$954.45
|
| Rate for Payer: UHC Core |
$905.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$813.45
|
|
|
HC RED CELLS, DIRECTED, LEUKO RED
|
Facility
|
OP
|
$1,084.60
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000061
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$124.49 |
| Max. Negotiated Rate |
$976.14 |
| Rate for Payer: Aetna Commercial |
$921.91
|
| Rate for Payer: Aetna Medicare |
$282.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$338.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$338.94
|
| Rate for Payer: BCBS Complete |
$130.72
|
| Rate for Payer: BCBS MAPPO |
$271.15
|
| Rate for Payer: BCBS Trust/PPO |
$843.28
|
| Rate for Payer: BCN Commercial |
$843.28
|
| Rate for Payer: BCN Medicare Advantage |
$271.15
|
| Rate for Payer: Cash Price |
$867.68
|
| Rate for Payer: Cash Price |
$867.68
|
| Rate for Payer: Cofinity Commercial |
$932.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$867.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.15
|
| Rate for Payer: Healthscope Commercial |
$976.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$813.45
|
| Rate for Payer: Mclaren Medicaid |
$124.49
|
| Rate for Payer: Meridian Medicaid |
$130.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$284.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$311.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$921.91
|
| Rate for Payer: PACE Senior Care Partners |
$257.59
|
| Rate for Payer: PACE SWMI |
$271.15
|
| Rate for Payer: PHP Commercial |
$921.91
|
| Rate for Payer: PHP Medicare Advantage |
$271.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$759.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$943.60
|
| Rate for Payer: Priority Health Medicare |
$271.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$661.50
|
| Rate for Payer: Railroad Medicare Medicare |
$271.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$954.45
|
| Rate for Payer: UHC Core |
$905.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$271.15
|
| Rate for Payer: UHC Medicare Advantage |
$279.28
|
| Rate for Payer: VA VA |
$271.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$813.45
|
|
|
HC REDTOP BENT GRASS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200057
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC REDTOP BENT GRASS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200057
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC REDUCER W/LL ASY 1/4 X 3/8
|
Facility
|
OP
|
$9.00
|
|
| Hospital Charge Code |
27000679
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.14 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna Commercial |
$7.65
|
| Rate for Payer: Aetna Medicare |
$2.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.81
|
| Rate for Payer: BCBS Complete |
$3.60
|
| Rate for Payer: BCBS MAPPO |
$2.25
|
| Rate for Payer: BCBS Trust/PPO |
$7.00
|
| Rate for Payer: BCN Commercial |
$7.00
|
| Rate for Payer: BCN Medicare Advantage |
$2.25
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$7.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.25
|
| Rate for Payer: Healthscope Commercial |
$8.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7.65
|
| Rate for Payer: PACE Senior Care Partners |
$2.14
|
| Rate for Payer: PACE SWMI |
$2.25
|
| Rate for Payer: PHP Commercial |
$7.65
|
| Rate for Payer: PHP Medicare Advantage |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.83
|
| Rate for Payer: Priority Health Medicare |
$2.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.92
|
| Rate for Payer: UHC Core |
$7.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.25
|
| Rate for Payer: UHC Medicare Advantage |
$2.32
|
| Rate for Payer: VA VA |
$2.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.75
|
|
|
HC REDUCER W/LL ASY 1/4 X 3/8
|
Facility
|
IP
|
$9.00
|
|
| Hospital Charge Code |
27000679
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.49 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna Commercial |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$6.96
|
| Rate for Payer: BCN Commercial |
$6.96
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$7.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.20
|
| Rate for Payer: Healthscope Commercial |
$8.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7.65
|
| Rate for Payer: PHP Commercial |
$7.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.92
|
| Rate for Payer: UHC Core |
$7.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.75
|
|
|
HC REFILL AND MAINTENANCE OF IMPLANTED PUMP
|
Facility
|
IP
|
$350.20
|
|
|
Service Code
|
HCPCS 96522
|
| Hospital Charge Code |
33500009
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$213.59 |
| Max. Negotiated Rate |
$315.18 |
| Rate for Payer: Aetna Commercial |
$297.67
|
| Rate for Payer: Aetna Commercial |
$365.54
|
| Rate for Payer: BCBS Trust/PPO |
$332.34
|
| Rate for Payer: BCBS Trust/PPO |
$270.63
|
| Rate for Payer: BCN Commercial |
$332.34
|
| Rate for Payer: BCN Commercial |
$270.63
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Cofinity Commercial |
$369.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Healthscope Commercial |
$315.18
|
| Rate for Payer: Healthscope Commercial |
$387.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: PHP Commercial |
$365.54
|
| Rate for Payer: PHP Commercial |
$297.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$374.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.44
|
| Rate for Payer: UHC Core |
$292.42
|
| Rate for Payer: UHC Core |
$359.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.54
|
|
|
HC REFILL AND MAINTENANCE OF IMPLANTED PUMP
|
Facility
|
OP
|
$430.05
|
|
|
Service Code
|
HCPCS 96522
|
| Hospital Charge Code |
33500009
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$102.14 |
| Max. Negotiated Rate |
$387.04 |
| Rate for Payer: Aetna Commercial |
$365.54
|
| Rate for Payer: Aetna Commercial |
$297.67
|
| Rate for Payer: Aetna Medicare |
$91.05
|
| Rate for Payer: Aetna Medicare |
$111.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.44
|
| Rate for Payer: BCBS Complete |
$147.63
|
| Rate for Payer: BCBS Complete |
$147.63
|
| Rate for Payer: BCBS MAPPO |
$87.55
|
| Rate for Payer: BCBS MAPPO |
$107.51
|
| Rate for Payer: BCBS Trust/PPO |
$272.28
|
| Rate for Payer: BCBS Trust/PPO |
$334.36
|
| Rate for Payer: BCN Commercial |
$272.28
|
| Rate for Payer: BCN Commercial |
$334.36
|
| Rate for Payer: BCN Medicare Advantage |
$107.51
|
| Rate for Payer: BCN Medicare Advantage |
$87.55
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cash Price |
$344.04
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Cofinity Commercial |
$369.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.51
|
| Rate for Payer: Healthscope Commercial |
$387.04
|
| Rate for Payer: Healthscope Commercial |
$315.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.65
|
| Rate for Payer: Mclaren Medicaid |
$140.60
|
| Rate for Payer: Mclaren Medicaid |
$140.60
|
| Rate for Payer: Meridian Medicaid |
$147.63
|
| Rate for Payer: Meridian Medicaid |
$147.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.54
|
| Rate for Payer: PACE Senior Care Partners |
$83.17
|
| Rate for Payer: PACE Senior Care Partners |
$102.14
|
| Rate for Payer: PACE SWMI |
$107.51
|
| Rate for Payer: PACE SWMI |
$87.55
|
| Rate for Payer: PHP Commercial |
$365.54
|
| Rate for Payer: PHP Commercial |
$297.67
|
| Rate for Payer: PHP Medicare Advantage |
$107.51
|
| Rate for Payer: PHP Medicare Advantage |
$87.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$374.14
|
| Rate for Payer: Priority Health Medicare |
$107.51
|
| Rate for Payer: Priority Health Medicare |
$87.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$262.29
|
| Rate for Payer: Railroad Medicare Medicare |
$107.51
|
| Rate for Payer: Railroad Medicare Medicare |
$87.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.44
|
| Rate for Payer: UHC Core |
$292.42
|
| Rate for Payer: UHC Core |
$359.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.51
|
| Rate for Payer: UHC Medicare Advantage |
$90.18
|
| Rate for Payer: UHC Medicare Advantage |
$110.74
|
| Rate for Payer: VA VA |
$107.51
|
| Rate for Payer: VA VA |
$87.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.65
|
|
|
HC REFILL AND MAINTENANCE OF PORT PUMP
|
Facility
|
OP
|
$350.20
|
|
|
Service Code
|
CPT 96521
|
| Hospital Charge Code |
33500008
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$83.17 |
| Max. Negotiated Rate |
$315.18 |
| Rate for Payer: Aetna Commercial |
$297.67
|
| Rate for Payer: Aetna Commercial |
$735.00
|
| Rate for Payer: Aetna Medicare |
$224.82
|
| Rate for Payer: Aetna Medicare |
$91.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$270.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$270.22
|
| Rate for Payer: BCBS Complete |
$147.63
|
| Rate for Payer: BCBS Complete |
$147.63
|
| Rate for Payer: BCBS MAPPO |
$216.18
|
| Rate for Payer: BCBS MAPPO |
$87.55
|
| Rate for Payer: BCBS Trust/PPO |
$272.28
|
| Rate for Payer: BCBS Trust/PPO |
$672.30
|
| Rate for Payer: BCN Commercial |
$672.30
|
| Rate for Payer: BCN Commercial |
$272.28
|
| Rate for Payer: BCN Medicare Advantage |
$87.55
|
| Rate for Payer: BCN Medicare Advantage |
$216.18
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$691.76
|
| Rate for Payer: Cash Price |
$691.76
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Cofinity Commercial |
$743.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.55
|
| Rate for Payer: Healthscope Commercial |
$778.23
|
| Rate for Payer: Healthscope Commercial |
$315.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$648.52
|
| Rate for Payer: Mclaren Medicaid |
$140.60
|
| Rate for Payer: Mclaren Medicaid |
$140.60
|
| Rate for Payer: Meridian Medicaid |
$147.63
|
| Rate for Payer: Meridian Medicaid |
$147.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$226.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$248.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$735.00
|
| Rate for Payer: PACE Senior Care Partners |
$205.37
|
| Rate for Payer: PACE Senior Care Partners |
$83.17
|
| Rate for Payer: PACE SWMI |
$87.55
|
| Rate for Payer: PACE SWMI |
$216.18
|
| Rate for Payer: PHP Commercial |
$297.67
|
| Rate for Payer: PHP Commercial |
$735.00
|
| Rate for Payer: PHP Medicare Advantage |
$216.18
|
| Rate for Payer: PHP Medicare Advantage |
$87.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$605.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$752.29
|
| Rate for Payer: Priority Health Medicare |
$87.55
|
| Rate for Payer: Priority Health Medicare |
$216.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$527.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.59
|
| Rate for Payer: Railroad Medicare Medicare |
$87.55
|
| Rate for Payer: Railroad Medicare Medicare |
$216.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$760.94
|
| Rate for Payer: UHC Core |
$292.42
|
| Rate for Payer: UHC Core |
$722.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.55
|
| Rate for Payer: UHC Medicare Advantage |
$90.18
|
| Rate for Payer: UHC Medicare Advantage |
$222.66
|
| Rate for Payer: VA VA |
$87.55
|
| Rate for Payer: VA VA |
$216.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$648.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.65
|
|
|
HC REFILL AND MAINTENANCE OF PORT PUMP
|
Facility
|
IP
|
$864.70
|
|
|
Service Code
|
CPT 96521
|
| Hospital Charge Code |
33500008
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$527.38 |
| Max. Negotiated Rate |
$778.23 |
| Rate for Payer: Aetna Commercial |
$735.00
|
| Rate for Payer: Aetna Commercial |
$297.67
|
| Rate for Payer: BCBS Trust/PPO |
$270.63
|
| Rate for Payer: BCBS Trust/PPO |
$668.24
|
| Rate for Payer: BCN Commercial |
$270.63
|
| Rate for Payer: BCN Commercial |
$668.24
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cash Price |
$691.76
|
| Rate for Payer: Cofinity Commercial |
$743.64
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Healthscope Commercial |
$315.18
|
| Rate for Payer: Healthscope Commercial |
$778.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$648.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$735.00
|
| Rate for Payer: PHP Commercial |
$297.67
|
| Rate for Payer: PHP Commercial |
$735.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$605.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$752.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$527.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$760.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.18
|
| Rate for Payer: UHC Core |
$292.42
|
| Rate for Payer: UHC Core |
$722.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$648.52
|
|
|
HC REFILL AND REPROGRAM INTRATHECAL INF PUMP
|
Facility
|
IP
|
$413.30
|
|
|
Service Code
|
CPT 62370
|
| Hospital Charge Code |
36100587
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$252.07 |
| Max. Negotiated Rate |
$371.97 |
| Rate for Payer: Aetna Commercial |
$351.30
|
| Rate for Payer: BCBS Trust/PPO |
$319.40
|
| Rate for Payer: BCN Commercial |
$319.40
|
| Rate for Payer: Cash Price |
$330.64
|
| Rate for Payer: Cofinity Commercial |
$355.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.64
|
| Rate for Payer: Healthscope Commercial |
$371.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.30
|
| Rate for Payer: PHP Commercial |
$351.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.70
|
| Rate for Payer: UHC Core |
$345.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.98
|
|
|
HC REFILL AND REPROGRAM INTRATHECAL INF PUMP
|
Facility
|
OP
|
$413.30
|
|
|
Service Code
|
CPT 62370
|
| Hospital Charge Code |
36100587
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$98.16 |
| Max. Negotiated Rate |
$371.97 |
| Rate for Payer: Aetna Commercial |
$351.30
|
| Rate for Payer: Aetna Medicare |
$107.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.16
|
| Rate for Payer: BCBS Complete |
$205.74
|
| Rate for Payer: BCBS MAPPO |
$103.32
|
| Rate for Payer: BCBS Trust/PPO |
$321.34
|
| Rate for Payer: BCN Commercial |
$321.34
|
| Rate for Payer: BCN Medicare Advantage |
$103.32
|
| Rate for Payer: Cash Price |
$330.64
|
| Rate for Payer: Cash Price |
$330.64
|
| Rate for Payer: Cofinity Commercial |
$355.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.32
|
| Rate for Payer: Healthscope Commercial |
$371.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.98
|
| Rate for Payer: Mclaren Medicaid |
$195.94
|
| Rate for Payer: Meridian Medicaid |
$205.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.30
|
| Rate for Payer: PACE Senior Care Partners |
$98.16
|
| Rate for Payer: PACE SWMI |
$103.32
|
| Rate for Payer: PHP Commercial |
$351.30
|
| Rate for Payer: PHP Medicare Advantage |
$103.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.57
|
| Rate for Payer: Priority Health Medicare |
$103.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$252.07
|
| Rate for Payer: Railroad Medicare Medicare |
$103.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.70
|
| Rate for Payer: UHC Core |
$345.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.32
|
| Rate for Payer: UHC Medicare Advantage |
$106.42
|
| Rate for Payer: VA VA |
$103.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.98
|
|
