|
HC RO INFUS RADIOACTIVE MATERIAL
|
Facility
|
IP
|
$325.38
|
|
|
Service Code
|
CPT 77750
|
| Hospital Charge Code |
33300042
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$198.45 |
| Max. Negotiated Rate |
$292.84 |
| Rate for Payer: Aetna Commercial |
$276.57
|
| Rate for Payer: BCBS Trust/PPO |
$251.45
|
| Rate for Payer: BCN Commercial |
$251.45
|
| Rate for Payer: Cash Price |
$260.30
|
| Rate for Payer: Cofinity Commercial |
$279.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.30
|
| Rate for Payer: Healthscope Commercial |
$292.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$276.57
|
| Rate for Payer: PHP Commercial |
$276.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$283.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.33
|
| Rate for Payer: UHC Core |
$271.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.04
|
|
|
HC RO INS VAG BRACHTHER DEVICE
|
Facility
|
IP
|
$539.61
|
|
|
Service Code
|
CPT 57156
|
| Hospital Charge Code |
36100444
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$329.11 |
| Max. Negotiated Rate |
$485.65 |
| Rate for Payer: Aetna Commercial |
$458.67
|
| Rate for Payer: BCBS Trust/PPO |
$417.01
|
| Rate for Payer: BCN Commercial |
$417.01
|
| Rate for Payer: Cash Price |
$431.69
|
| Rate for Payer: Cofinity Commercial |
$464.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$431.69
|
| Rate for Payer: Healthscope Commercial |
$485.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$404.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$458.67
|
| Rate for Payer: PHP Commercial |
$458.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$469.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$474.86
|
| Rate for Payer: UHC Core |
$450.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$404.71
|
|
|
HC RO INS VAG BRACHTHER DEVICE
|
Facility
|
OP
|
$539.61
|
|
|
Service Code
|
CPT 57156
|
| Hospital Charge Code |
36100444
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$128.16 |
| Max. Negotiated Rate |
$485.65 |
| Rate for Payer: Aetna Commercial |
$458.67
|
| Rate for Payer: Aetna Medicare |
$140.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$168.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$168.63
|
| Rate for Payer: BCBS Complete |
$220.97
|
| Rate for Payer: BCBS MAPPO |
$134.90
|
| Rate for Payer: BCBS Trust/PPO |
$419.55
|
| Rate for Payer: BCN Commercial |
$419.55
|
| Rate for Payer: BCN Medicare Advantage |
$134.90
|
| Rate for Payer: Cash Price |
$431.69
|
| Rate for Payer: Cash Price |
$431.69
|
| Rate for Payer: Cofinity Commercial |
$464.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$431.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.90
|
| Rate for Payer: Healthscope Commercial |
$485.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$404.71
|
| Rate for Payer: Mclaren Medicaid |
$210.45
|
| Rate for Payer: Meridian Medicaid |
$220.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$141.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$155.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$458.67
|
| Rate for Payer: PACE Senior Care Partners |
$128.16
|
| Rate for Payer: PACE SWMI |
$134.90
|
| Rate for Payer: PHP Commercial |
$458.67
|
| Rate for Payer: PHP Medicare Advantage |
$134.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$377.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$469.46
|
| Rate for Payer: Priority Health Medicare |
$134.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.11
|
| Rate for Payer: Railroad Medicare Medicare |
$134.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$474.86
|
| Rate for Payer: UHC Core |
$450.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.90
|
| Rate for Payer: UHC Medicare Advantage |
$138.95
|
| Rate for Payer: VA VA |
$134.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$404.71
|
|
|
HC RO INTRSTI RADELEMENT APPL CMPLX
|
Facility
|
IP
|
$2,781.54
|
|
|
Service Code
|
CPT 77778
|
| Hospital Charge Code |
33300035
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,696.46 |
| Max. Negotiated Rate |
$2,503.39 |
| Rate for Payer: Aetna Commercial |
$2,364.31
|
| Rate for Payer: Aetna Commercial |
$1,075.25
|
| Rate for Payer: BCBS Trust/PPO |
$2,149.57
|
| Rate for Payer: BCBS Trust/PPO |
$977.59
|
| Rate for Payer: BCN Commercial |
$977.59
|
| Rate for Payer: BCN Commercial |
$2,149.57
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$2,225.23
|
| Rate for Payer: Cofinity Commercial |
$2,392.12
|
| Rate for Payer: Cofinity Commercial |
$1,087.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,012.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,225.23
|
| Rate for Payer: Healthscope Commercial |
$2,503.39
|
| Rate for Payer: Healthscope Commercial |
$1,138.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$948.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,086.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,364.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,075.25
|
| Rate for Payer: PHP Commercial |
$1,075.25
|
| Rate for Payer: PHP Commercial |
$2,364.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,947.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,100.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,419.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,696.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$771.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,113.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,447.76
|
| Rate for Payer: UHC Core |
$1,056.28
|
| Rate for Payer: UHC Core |
$2,322.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$948.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,086.16
|
|
|
HC RO INTRSTI RADELEMENT APPL CMPLX
|
Facility
|
OP
|
$2,781.54
|
|
|
Service Code
|
CPT 77778
|
| Hospital Charge Code |
33300035
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$470.33 |
| Max. Negotiated Rate |
$2,503.39 |
| Rate for Payer: Aetna Commercial |
$2,364.31
|
| Rate for Payer: Aetna Commercial |
$1,075.25
|
| Rate for Payer: Aetna Medicare |
$328.90
|
| Rate for Payer: Aetna Medicare |
$723.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$869.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$395.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$395.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$869.23
|
| Rate for Payer: BCBS Complete |
$493.85
|
| Rate for Payer: BCBS Complete |
$493.85
|
| Rate for Payer: BCBS MAPPO |
$316.25
|
| Rate for Payer: BCBS MAPPO |
$695.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,162.65
|
| Rate for Payer: BCBS Trust/PPO |
$983.54
|
| Rate for Payer: BCN Commercial |
$2,162.65
|
| Rate for Payer: BCN Commercial |
$983.54
|
| Rate for Payer: BCN Medicare Advantage |
$316.25
|
| Rate for Payer: BCN Medicare Advantage |
$695.38
|
| Rate for Payer: Cash Price |
$2,225.23
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$2,225.23
|
| Rate for Payer: Cofinity Commercial |
$2,392.12
|
| Rate for Payer: Cofinity Commercial |
$1,087.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,225.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,012.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$695.38
|
| Rate for Payer: Healthscope Commercial |
$1,138.50
|
| Rate for Payer: Healthscope Commercial |
$2,503.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,086.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$948.75
|
| Rate for Payer: Mclaren Medicaid |
$470.33
|
| Rate for Payer: Mclaren Medicaid |
$470.33
|
| Rate for Payer: Meridian Medicaid |
$493.85
|
| Rate for Payer: Meridian Medicaid |
$493.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$332.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$730.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$799.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$363.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,075.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,364.31
|
| Rate for Payer: PACE Senior Care Partners |
$660.62
|
| Rate for Payer: PACE Senior Care Partners |
$300.44
|
| Rate for Payer: PACE SWMI |
$695.38
|
| Rate for Payer: PACE SWMI |
$316.25
|
| Rate for Payer: PHP Commercial |
$1,075.25
|
| Rate for Payer: PHP Commercial |
$2,364.31
|
| Rate for Payer: PHP Medicare Advantage |
$695.38
|
| Rate for Payer: PHP Medicare Advantage |
$316.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$470.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,947.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,100.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,419.94
|
| Rate for Payer: Priority Health Medicare |
$695.38
|
| Rate for Payer: Priority Health Medicare |
$316.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,696.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$771.52
|
| Rate for Payer: Railroad Medicare Medicare |
$316.25
|
| Rate for Payer: Railroad Medicare Medicare |
$695.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,113.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,447.76
|
| Rate for Payer: UHC Core |
$2,322.59
|
| Rate for Payer: UHC Core |
$1,056.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$316.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$695.38
|
| Rate for Payer: UHC Medicare Advantage |
$716.25
|
| Rate for Payer: UHC Medicare Advantage |
$325.74
|
| Rate for Payer: VA VA |
$316.25
|
| Rate for Payer: VA VA |
$695.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,086.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$948.75
|
|
|
HC RO ISODOSE BRACH CALC SIMPLE
|
Facility
|
IP
|
$230.25
|
|
|
Service Code
|
CPT 77316
|
| Hospital Charge Code |
33300045
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$140.43 |
| Max. Negotiated Rate |
$207.22 |
| Rate for Payer: Aetna Commercial |
$195.71
|
| Rate for Payer: Aetna Commercial |
$846.60
|
| Rate for Payer: BCBS Trust/PPO |
$769.71
|
| Rate for Payer: BCBS Trust/PPO |
$177.94
|
| Rate for Payer: BCN Commercial |
$769.71
|
| Rate for Payer: BCN Commercial |
$177.94
|
| Rate for Payer: Cash Price |
$796.80
|
| Rate for Payer: Cash Price |
$184.20
|
| Rate for Payer: Cofinity Commercial |
$198.02
|
| Rate for Payer: Cofinity Commercial |
$856.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.80
|
| Rate for Payer: Healthscope Commercial |
$896.40
|
| Rate for Payer: Healthscope Commercial |
$207.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$747.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$846.60
|
| Rate for Payer: PHP Commercial |
$846.60
|
| Rate for Payer: PHP Commercial |
$195.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$866.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$607.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$876.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.62
|
| Rate for Payer: UHC Core |
$192.26
|
| Rate for Payer: UHC Core |
$831.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$747.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.69
|
|
|
HC RO ISODOSE BRACH CALC SIMPLE
|
Facility
|
OP
|
$996.00
|
|
|
Service Code
|
CPT 77316
|
| Hospital Charge Code |
33300045
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$236.55 |
| Max. Negotiated Rate |
$896.40 |
| Rate for Payer: Aetna Commercial |
$846.60
|
| Rate for Payer: Aetna Commercial |
$195.71
|
| Rate for Payer: Aetna Medicare |
$59.86
|
| Rate for Payer: Aetna Medicare |
$258.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.25
|
| Rate for Payer: BCBS Complete |
$254.50
|
| Rate for Payer: BCBS Complete |
$254.50
|
| Rate for Payer: BCBS MAPPO |
$249.00
|
| Rate for Payer: BCBS MAPPO |
$57.56
|
| Rate for Payer: BCBS Trust/PPO |
$179.02
|
| Rate for Payer: BCBS Trust/PPO |
$774.39
|
| Rate for Payer: BCN Commercial |
$179.02
|
| Rate for Payer: BCN Commercial |
$774.39
|
| Rate for Payer: BCN Medicare Advantage |
$57.56
|
| Rate for Payer: BCN Medicare Advantage |
$249.00
|
| Rate for Payer: Cash Price |
$184.20
|
| Rate for Payer: Cash Price |
$796.80
|
| Rate for Payer: Cash Price |
$796.80
|
| Rate for Payer: Cash Price |
$184.20
|
| Rate for Payer: Cofinity Commercial |
$856.56
|
| Rate for Payer: Cofinity Commercial |
$198.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$249.00
|
| Rate for Payer: Healthscope Commercial |
$207.22
|
| Rate for Payer: Healthscope Commercial |
$896.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$747.00
|
| Rate for Payer: Mclaren Medicaid |
$242.38
|
| Rate for Payer: Mclaren Medicaid |
$242.38
|
| Rate for Payer: Meridian Medicaid |
$254.50
|
| Rate for Payer: Meridian Medicaid |
$254.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$60.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$261.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$846.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.71
|
| Rate for Payer: PACE Senior Care Partners |
$236.55
|
| Rate for Payer: PACE Senior Care Partners |
$54.68
|
| Rate for Payer: PACE SWMI |
$249.00
|
| Rate for Payer: PACE SWMI |
$57.56
|
| Rate for Payer: PHP Commercial |
$846.60
|
| Rate for Payer: PHP Commercial |
$195.71
|
| Rate for Payer: PHP Medicare Advantage |
$249.00
|
| Rate for Payer: PHP Medicare Advantage |
$57.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$866.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.32
|
| Rate for Payer: Priority Health Medicare |
$249.00
|
| Rate for Payer: Priority Health Medicare |
$57.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$607.46
|
| Rate for Payer: Railroad Medicare Medicare |
$57.56
|
| Rate for Payer: Railroad Medicare Medicare |
$249.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$876.48
|
| Rate for Payer: UHC Core |
$831.66
|
| Rate for Payer: UHC Core |
$192.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$249.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.56
|
| Rate for Payer: UHC Medicare Advantage |
$256.47
|
| Rate for Payer: UHC Medicare Advantage |
$59.29
|
| Rate for Payer: VA VA |
$249.00
|
| Rate for Payer: VA VA |
$57.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$747.00
|
|
|
HC RO ISODOSE BRACHY CALC COMPLEX
|
Facility
|
IP
|
$671.51
|
|
|
Service Code
|
CPT 77318
|
| Hospital Charge Code |
33300047
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$409.55 |
| Max. Negotiated Rate |
$604.36 |
| Rate for Payer: Aetna Commercial |
$570.78
|
| Rate for Payer: Aetna Commercial |
$1,495.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,359.36
|
| Rate for Payer: BCBS Trust/PPO |
$518.94
|
| Rate for Payer: BCN Commercial |
$518.94
|
| Rate for Payer: BCN Commercial |
$1,359.36
|
| Rate for Payer: Cash Price |
$1,407.20
|
| Rate for Payer: Cash Price |
$537.21
|
| Rate for Payer: Cofinity Commercial |
$577.50
|
| Rate for Payer: Cofinity Commercial |
$1,512.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,407.20
|
| Rate for Payer: Healthscope Commercial |
$604.36
|
| Rate for Payer: Healthscope Commercial |
$1,583.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,319.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$570.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,495.15
|
| Rate for Payer: PHP Commercial |
$570.78
|
| Rate for Payer: PHP Commercial |
$1,495.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,231.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,530.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$584.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$409.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,072.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$590.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,547.92
|
| Rate for Payer: UHC Core |
$1,468.76
|
| Rate for Payer: UHC Core |
$560.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,319.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.63
|
|
|
HC RO ISODOSE BRACHY CALC COMPLEX
|
Facility
|
OP
|
$1,759.00
|
|
|
Service Code
|
CPT 77318
|
| Hospital Charge Code |
33300047
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$242.38 |
| Max. Negotiated Rate |
$1,583.10 |
| Rate for Payer: Aetna Commercial |
$1,495.15
|
| Rate for Payer: Aetna Commercial |
$570.78
|
| Rate for Payer: Aetna Medicare |
$457.34
|
| Rate for Payer: Aetna Medicare |
$174.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$549.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$549.69
|
| Rate for Payer: BCBS Complete |
$254.50
|
| Rate for Payer: BCBS Complete |
$254.50
|
| Rate for Payer: BCBS MAPPO |
$439.75
|
| Rate for Payer: BCBS MAPPO |
$167.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,367.62
|
| Rate for Payer: BCBS Trust/PPO |
$522.10
|
| Rate for Payer: BCN Commercial |
$522.10
|
| Rate for Payer: BCN Commercial |
$1,367.62
|
| Rate for Payer: BCN Medicare Advantage |
$439.75
|
| Rate for Payer: BCN Medicare Advantage |
$167.88
|
| Rate for Payer: Cash Price |
$1,407.20
|
| Rate for Payer: Cash Price |
$1,407.20
|
| Rate for Payer: Cash Price |
$537.21
|
| Rate for Payer: Cash Price |
$537.21
|
| Rate for Payer: Cofinity Commercial |
$1,512.74
|
| Rate for Payer: Cofinity Commercial |
$577.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,407.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.75
|
| Rate for Payer: Healthscope Commercial |
$1,583.10
|
| Rate for Payer: Healthscope Commercial |
$604.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,319.25
|
| Rate for Payer: Mclaren Medicaid |
$242.38
|
| Rate for Payer: Mclaren Medicaid |
$242.38
|
| Rate for Payer: Meridian Medicaid |
$254.50
|
| Rate for Payer: Meridian Medicaid |
$254.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$176.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$461.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$505.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,495.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$570.78
|
| Rate for Payer: PACE Senior Care Partners |
$417.76
|
| Rate for Payer: PACE Senior Care Partners |
$159.48
|
| Rate for Payer: PACE SWMI |
$167.88
|
| Rate for Payer: PACE SWMI |
$439.75
|
| Rate for Payer: PHP Commercial |
$570.78
|
| Rate for Payer: PHP Commercial |
$1,495.15
|
| Rate for Payer: PHP Medicare Advantage |
$167.88
|
| Rate for Payer: PHP Medicare Advantage |
$439.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$470.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,231.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,530.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$584.21
|
| Rate for Payer: Priority Health Medicare |
$167.88
|
| Rate for Payer: Priority Health Medicare |
$439.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,072.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$409.55
|
| Rate for Payer: Railroad Medicare Medicare |
$439.75
|
| Rate for Payer: Railroad Medicare Medicare |
$167.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,547.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$590.93
|
| Rate for Payer: UHC Core |
$1,468.76
|
| Rate for Payer: UHC Core |
$560.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$439.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.88
|
| Rate for Payer: UHC Medicare Advantage |
$452.94
|
| Rate for Payer: UHC Medicare Advantage |
$172.91
|
| Rate for Payer: VA VA |
$167.88
|
| Rate for Payer: VA VA |
$439.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,319.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.63
|
|
|
HC RO ISODOSE BRACHY CALC INTRM
|
Facility
|
OP
|
$610.46
|
|
|
Service Code
|
CPT 77317
|
| Hospital Charge Code |
33300046
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$144.98 |
| Max. Negotiated Rate |
$549.41 |
| Rate for Payer: Aetna Commercial |
$518.89
|
| Rate for Payer: Aetna Commercial |
$1,090.55
|
| Rate for Payer: Aetna Medicare |
$333.58
|
| Rate for Payer: Aetna Medicare |
$158.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$400.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$400.94
|
| Rate for Payer: BCBS Complete |
$254.50
|
| Rate for Payer: BCBS Complete |
$254.50
|
| Rate for Payer: BCBS MAPPO |
$320.75
|
| Rate for Payer: BCBS MAPPO |
$152.62
|
| Rate for Payer: BCBS Trust/PPO |
$997.53
|
| Rate for Payer: BCBS Trust/PPO |
$474.63
|
| Rate for Payer: BCN Commercial |
$474.63
|
| Rate for Payer: BCN Commercial |
$997.53
|
| Rate for Payer: BCN Medicare Advantage |
$320.75
|
| Rate for Payer: BCN Medicare Advantage |
$152.62
|
| Rate for Payer: Cash Price |
$488.37
|
| Rate for Payer: Cash Price |
$1,026.40
|
| Rate for Payer: Cash Price |
$1,026.40
|
| Rate for Payer: Cash Price |
$488.37
|
| Rate for Payer: Cofinity Commercial |
$1,103.38
|
| Rate for Payer: Cofinity Commercial |
$525.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,026.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.62
|
| Rate for Payer: Healthscope Commercial |
$1,154.70
|
| Rate for Payer: Healthscope Commercial |
$549.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$962.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.84
|
| Rate for Payer: Mclaren Medicaid |
$242.38
|
| Rate for Payer: Mclaren Medicaid |
$242.38
|
| Rate for Payer: Meridian Medicaid |
$254.50
|
| Rate for Payer: Meridian Medicaid |
$254.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$160.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$336.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$368.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,090.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.89
|
| Rate for Payer: PACE Senior Care Partners |
$304.71
|
| Rate for Payer: PACE Senior Care Partners |
$144.98
|
| Rate for Payer: PACE SWMI |
$320.75
|
| Rate for Payer: PACE SWMI |
$152.62
|
| Rate for Payer: PHP Commercial |
$1,090.55
|
| Rate for Payer: PHP Commercial |
$518.89
|
| Rate for Payer: PHP Medicare Advantage |
$152.62
|
| Rate for Payer: PHP Medicare Advantage |
$320.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$531.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,116.21
|
| Rate for Payer: Priority Health Medicare |
$152.62
|
| Rate for Payer: Priority Health Medicare |
$320.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$782.50
|
| Rate for Payer: Railroad Medicare Medicare |
$320.75
|
| Rate for Payer: Railroad Medicare Medicare |
$152.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,129.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$537.20
|
| Rate for Payer: UHC Core |
$1,071.30
|
| Rate for Payer: UHC Core |
$509.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.62
|
| Rate for Payer: UHC Medicare Advantage |
$330.37
|
| Rate for Payer: UHC Medicare Advantage |
$157.19
|
| Rate for Payer: VA VA |
$152.62
|
| Rate for Payer: VA VA |
$320.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$962.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.84
|
|
|
HC RO ISODOSE BRACHY CALC INTRM
|
Facility
|
IP
|
$610.46
|
|
|
Service Code
|
CPT 77317
|
| Hospital Charge Code |
33300046
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$372.32 |
| Max. Negotiated Rate |
$549.41 |
| Rate for Payer: Aetna Commercial |
$518.89
|
| Rate for Payer: Aetna Commercial |
$1,090.55
|
| Rate for Payer: BCBS Trust/PPO |
$471.76
|
| Rate for Payer: BCBS Trust/PPO |
$991.50
|
| Rate for Payer: BCN Commercial |
$991.50
|
| Rate for Payer: BCN Commercial |
$471.76
|
| Rate for Payer: Cash Price |
$1,026.40
|
| Rate for Payer: Cash Price |
$488.37
|
| Rate for Payer: Cofinity Commercial |
$1,103.38
|
| Rate for Payer: Cofinity Commercial |
$525.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,026.40
|
| Rate for Payer: Healthscope Commercial |
$549.41
|
| Rate for Payer: Healthscope Commercial |
$1,154.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$962.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,090.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.89
|
| Rate for Payer: PHP Commercial |
$1,090.55
|
| Rate for Payer: PHP Commercial |
$518.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$531.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,116.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$782.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,129.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$537.20
|
| Rate for Payer: UHC Core |
$1,071.30
|
| Rate for Payer: UHC Core |
$509.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$962.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.84
|
|
|
HC RO ISODOSE TELETHRPY COMPLEX
|
Facility
|
IP
|
$1,174.00
|
|
|
Service Code
|
CPT 77307
|
| Hospital Charge Code |
33300044
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$716.02 |
| Max. Negotiated Rate |
$1,056.60 |
| Rate for Payer: Aetna Commercial |
$997.90
|
| Rate for Payer: Aetna Commercial |
$964.97
|
| Rate for Payer: BCBS Trust/PPO |
$877.33
|
| Rate for Payer: BCBS Trust/PPO |
$907.27
|
| Rate for Payer: BCN Commercial |
$877.33
|
| Rate for Payer: BCN Commercial |
$907.27
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cash Price |
$908.21
|
| Rate for Payer: Cofinity Commercial |
$1,009.64
|
| Rate for Payer: Cofinity Commercial |
$976.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$939.20
|
| Rate for Payer: Healthscope Commercial |
$1,021.73
|
| Rate for Payer: Healthscope Commercial |
$1,056.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$880.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$964.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$997.90
|
| Rate for Payer: PHP Commercial |
$964.97
|
| Rate for Payer: PHP Commercial |
$997.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$794.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$821.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$987.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$692.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$716.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$999.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,033.12
|
| Rate for Payer: UHC Core |
$980.29
|
| Rate for Payer: UHC Core |
$947.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$880.50
|
|
|
HC RO ISODOSE TELETHRPY COMPLEX
|
Facility
|
OP
|
$1,135.26
|
|
|
Service Code
|
CPT 77307
|
| Hospital Charge Code |
33300044
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$242.38 |
| Max. Negotiated Rate |
$1,021.73 |
| Rate for Payer: Aetna Commercial |
$964.97
|
| Rate for Payer: Aetna Commercial |
$997.90
|
| Rate for Payer: Aetna Medicare |
$305.24
|
| Rate for Payer: Aetna Medicare |
$295.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$354.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$366.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$354.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$366.88
|
| Rate for Payer: BCBS Complete |
$254.50
|
| Rate for Payer: BCBS Complete |
$254.50
|
| Rate for Payer: BCBS MAPPO |
$293.50
|
| Rate for Payer: BCBS MAPPO |
$283.82
|
| Rate for Payer: BCBS Trust/PPO |
$882.66
|
| Rate for Payer: BCBS Trust/PPO |
$912.78
|
| Rate for Payer: BCN Commercial |
$912.78
|
| Rate for Payer: BCN Commercial |
$882.66
|
| Rate for Payer: BCN Medicare Advantage |
$283.82
|
| Rate for Payer: BCN Medicare Advantage |
$293.50
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cash Price |
$908.21
|
| Rate for Payer: Cash Price |
$939.20
|
| Rate for Payer: Cash Price |
$908.21
|
| Rate for Payer: Cofinity Commercial |
$1,009.64
|
| Rate for Payer: Cofinity Commercial |
$976.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$939.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$283.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.50
|
| Rate for Payer: Healthscope Commercial |
$1,056.60
|
| Rate for Payer: Healthscope Commercial |
$1,021.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$880.50
|
| Rate for Payer: Mclaren Medicaid |
$242.38
|
| Rate for Payer: Mclaren Medicaid |
$242.38
|
| Rate for Payer: Meridian Medicaid |
$254.50
|
| Rate for Payer: Meridian Medicaid |
$254.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$308.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$298.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$326.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$337.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$997.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$964.97
|
| Rate for Payer: PACE Senior Care Partners |
$278.82
|
| Rate for Payer: PACE Senior Care Partners |
$269.62
|
| Rate for Payer: PACE SWMI |
$283.82
|
| Rate for Payer: PACE SWMI |
$293.50
|
| Rate for Payer: PHP Commercial |
$964.97
|
| Rate for Payer: PHP Commercial |
$997.90
|
| Rate for Payer: PHP Medicare Advantage |
$293.50
|
| Rate for Payer: PHP Medicare Advantage |
$283.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$821.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$794.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$987.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.38
|
| Rate for Payer: Priority Health Medicare |
$293.50
|
| Rate for Payer: Priority Health Medicare |
$283.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$692.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$716.02
|
| Rate for Payer: Railroad Medicare Medicare |
$283.82
|
| Rate for Payer: Railroad Medicare Medicare |
$293.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$999.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,033.12
|
| Rate for Payer: UHC Core |
$980.29
|
| Rate for Payer: UHC Core |
$947.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$283.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$293.50
|
| Rate for Payer: UHC Medicare Advantage |
$292.33
|
| Rate for Payer: UHC Medicare Advantage |
$302.30
|
| Rate for Payer: VA VA |
$283.82
|
| Rate for Payer: VA VA |
$293.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$880.50
|
|
|
HC RO ISODOSE TELETHRPY SIMPLE
|
Facility
|
IP
|
$247.86
|
|
|
Service Code
|
CPT 77306
|
| Hospital Charge Code |
33300043
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$151.17 |
| Max. Negotiated Rate |
$223.07 |
| Rate for Payer: Aetna Commercial |
$210.68
|
| Rate for Payer: Aetna Commercial |
$544.85
|
| Rate for Payer: BCBS Trust/PPO |
$191.55
|
| Rate for Payer: BCBS Trust/PPO |
$495.36
|
| Rate for Payer: BCN Commercial |
$495.36
|
| Rate for Payer: BCN Commercial |
$191.55
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cash Price |
$198.29
|
| Rate for Payer: Cofinity Commercial |
$213.16
|
| Rate for Payer: Cofinity Commercial |
$551.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.29
|
| Rate for Payer: Healthscope Commercial |
$576.90
|
| Rate for Payer: Healthscope Commercial |
$223.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$480.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$544.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$210.68
|
| Rate for Payer: PHP Commercial |
$210.68
|
| Rate for Payer: PHP Commercial |
$544.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$448.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.08
|
| Rate for Payer: UHC Core |
$535.24
|
| Rate for Payer: UHC Core |
$206.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$480.75
|
|
|
HC RO ISODOSE TELETHRPY SIMPLE
|
Facility
|
OP
|
$641.00
|
|
|
Service Code
|
CPT 77306
|
| Hospital Charge Code |
33300043
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$152.24 |
| Max. Negotiated Rate |
$576.90 |
| Rate for Payer: Aetna Commercial |
$544.85
|
| Rate for Payer: Aetna Commercial |
$210.68
|
| Rate for Payer: Aetna Medicare |
$64.44
|
| Rate for Payer: Aetna Medicare |
$166.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$200.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$200.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.46
|
| Rate for Payer: BCBS Complete |
$254.50
|
| Rate for Payer: BCBS Complete |
$254.50
|
| Rate for Payer: BCBS MAPPO |
$61.96
|
| Rate for Payer: BCBS MAPPO |
$160.25
|
| Rate for Payer: BCBS Trust/PPO |
$192.71
|
| Rate for Payer: BCBS Trust/PPO |
$498.38
|
| Rate for Payer: BCN Commercial |
$498.38
|
| Rate for Payer: BCN Commercial |
$192.71
|
| Rate for Payer: BCN Medicare Advantage |
$160.25
|
| Rate for Payer: BCN Medicare Advantage |
$61.96
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cash Price |
$198.29
|
| Rate for Payer: Cash Price |
$198.29
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cofinity Commercial |
$213.16
|
| Rate for Payer: Cofinity Commercial |
$551.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.96
|
| Rate for Payer: Healthscope Commercial |
$223.07
|
| Rate for Payer: Healthscope Commercial |
$576.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$480.75
|
| Rate for Payer: Mclaren Medicaid |
$242.38
|
| Rate for Payer: Mclaren Medicaid |
$242.38
|
| Rate for Payer: Meridian Medicaid |
$254.50
|
| Rate for Payer: Meridian Medicaid |
$254.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$168.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$184.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$210.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$544.85
|
| Rate for Payer: PACE Senior Care Partners |
$58.87
|
| Rate for Payer: PACE Senior Care Partners |
$152.24
|
| Rate for Payer: PACE SWMI |
$160.25
|
| Rate for Payer: PACE SWMI |
$61.96
|
| Rate for Payer: PHP Commercial |
$544.85
|
| Rate for Payer: PHP Commercial |
$210.68
|
| Rate for Payer: PHP Medicare Advantage |
$61.96
|
| Rate for Payer: PHP Medicare Advantage |
$160.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$242.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$448.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.67
|
| Rate for Payer: Priority Health Medicare |
$160.25
|
| Rate for Payer: Priority Health Medicare |
$61.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.95
|
| Rate for Payer: Railroad Medicare Medicare |
$160.25
|
| Rate for Payer: Railroad Medicare Medicare |
$61.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.08
|
| Rate for Payer: UHC Core |
$206.96
|
| Rate for Payer: UHC Core |
$535.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$160.25
|
| Rate for Payer: UHC Medicare Advantage |
$165.06
|
| Rate for Payer: UHC Medicare Advantage |
$63.82
|
| Rate for Payer: VA VA |
$61.96
|
| Rate for Payer: VA VA |
$160.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$480.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.90
|
|
|
HC RO LINAC SBRT PER SESSION
|
Facility
|
OP
|
$3,476.48
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300041
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$825.66 |
| Max. Negotiated Rate |
$3,128.83 |
| Rate for Payer: Aetna Commercial |
$2,955.01
|
| Rate for Payer: Aetna Medicare |
$903.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,086.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,086.40
|
| Rate for Payer: BCBS Complete |
$1,229.05
|
| Rate for Payer: BCBS MAPPO |
$869.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,702.96
|
| Rate for Payer: BCN Commercial |
$2,702.96
|
| Rate for Payer: BCN Medicare Advantage |
$869.12
|
| Rate for Payer: Cash Price |
$2,781.18
|
| Rate for Payer: Cash Price |
$2,781.18
|
| Rate for Payer: Cofinity Commercial |
$2,989.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,781.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$869.12
|
| Rate for Payer: Healthscope Commercial |
$3,128.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,607.36
|
| Rate for Payer: Mclaren Medicaid |
$1,170.53
|
| Rate for Payer: Meridian Medicaid |
$1,229.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$912.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$999.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,955.01
|
| Rate for Payer: PACE Senior Care Partners |
$825.66
|
| Rate for Payer: PACE SWMI |
$869.12
|
| Rate for Payer: PHP Commercial |
$2,955.01
|
| Rate for Payer: PHP Medicare Advantage |
$869.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,170.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,433.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,024.54
|
| Rate for Payer: Priority Health Medicare |
$869.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,120.31
|
| Rate for Payer: Railroad Medicare Medicare |
$869.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,059.30
|
| Rate for Payer: UHC Core |
$2,902.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$869.12
|
| Rate for Payer: UHC Medicare Advantage |
$895.19
|
| Rate for Payer: VA VA |
$869.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,607.36
|
|
|
HC RO LINAC SBRT PER SESSION
|
Facility
|
IP
|
$3,476.48
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300041
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,120.31 |
| Max. Negotiated Rate |
$3,128.83 |
| Rate for Payer: Aetna Commercial |
$2,955.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,686.62
|
| Rate for Payer: BCN Commercial |
$2,686.62
|
| Rate for Payer: Cash Price |
$2,781.18
|
| Rate for Payer: Cofinity Commercial |
$2,989.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,781.18
|
| Rate for Payer: Healthscope Commercial |
$3,128.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,607.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,955.01
|
| Rate for Payer: PHP Commercial |
$2,955.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,433.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,024.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,120.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,059.30
|
| Rate for Payer: UHC Core |
$2,902.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,607.36
|
|
|
HC ROMOSOZUMAB-AQQG INJ 1 MG
|
Facility
|
OP
|
$11.22
|
|
|
Service Code
|
HCPCS J3111
|
| Hospital Charge Code |
63600150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.66 |
| Max. Negotiated Rate |
$10.10 |
| Rate for Payer: Aetna Commercial |
$9.54
|
| Rate for Payer: Aetna Medicare |
$2.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.51
|
| Rate for Payer: BCBS Complete |
$8.31
|
| Rate for Payer: BCBS MAPPO |
$2.80
|
| Rate for Payer: BCBS Trust/PPO |
$8.72
|
| Rate for Payer: BCN Commercial |
$8.72
|
| Rate for Payer: BCN Medicare Advantage |
$2.80
|
| Rate for Payer: Cash Price |
$8.98
|
| Rate for Payer: Cash Price |
$8.98
|
| Rate for Payer: Cofinity Commercial |
$9.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.80
|
| Rate for Payer: Healthscope Commercial |
$10.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.42
|
| Rate for Payer: Mclaren Medicaid |
$7.92
|
| Rate for Payer: Meridian Medicaid |
$8.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.54
|
| Rate for Payer: PACE Senior Care Partners |
$2.66
|
| Rate for Payer: PACE SWMI |
$2.80
|
| Rate for Payer: PHP Commercial |
$9.54
|
| Rate for Payer: PHP Medicare Advantage |
$2.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.76
|
| Rate for Payer: Priority Health Medicare |
$2.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.84
|
| Rate for Payer: Railroad Medicare Medicare |
$2.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.87
|
| Rate for Payer: UHC Core |
$9.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.80
|
| Rate for Payer: UHC Medicare Advantage |
$2.89
|
| Rate for Payer: VA VA |
$2.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.42
|
|
|
HC ROMOSOZUMAB-AQQG INJ 1 MG
|
Facility
|
IP
|
$11.22
|
|
|
Service Code
|
HCPCS J3111
|
| Hospital Charge Code |
63600150
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.84 |
| Max. Negotiated Rate |
$10.10 |
| Rate for Payer: Aetna Commercial |
$9.54
|
| Rate for Payer: BCBS Trust/PPO |
$8.67
|
| Rate for Payer: BCN Commercial |
$8.67
|
| Rate for Payer: Cash Price |
$8.98
|
| Rate for Payer: Cofinity Commercial |
$9.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.98
|
| Rate for Payer: Healthscope Commercial |
$10.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.54
|
| Rate for Payer: PHP Commercial |
$9.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.87
|
| Rate for Payer: UHC Core |
$9.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.42
|
|
|
HC ROOM & BOARD PSYCH
|
Facility
|
IP
|
$1,775.22
|
|
| Hospital Charge Code |
12400001
|
|
Hospital Revenue Code
|
124
|
| Min. Negotiated Rate |
$1,082.71 |
| Max. Negotiated Rate |
$166,100.00 |
| Rate for Payer: Aetna Commercial |
$1,508.94
|
| Rate for Payer: Aetna Medicare |
$1,727.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,076.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,076.25
|
| Rate for Payer: BCBS MAPPO |
$1,661.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,371.89
|
| Rate for Payer: BCN Commercial |
$1,371.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,661.00
|
| Rate for Payer: Cash Price |
$1,420.18
|
| Rate for Payer: Cash Price |
$1,420.18
|
| Rate for Payer: Cash Price |
$1,420.18
|
| Rate for Payer: Cofinity Commercial |
$1,526.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,420.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,661.00
|
| Rate for Payer: Healthscope Commercial |
$1,597.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,331.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,744.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,910.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,508.94
|
| Rate for Payer: PACE Senior Care Partners |
$1,577.95
|
| Rate for Payer: PACE SWMI |
$1,661.00
|
| Rate for Payer: PHP Commercial |
$1,508.94
|
| Rate for Payer: PHP Medicare Advantage |
$1,661.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,242.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,544.44
|
| Rate for Payer: Priority Health Medicare |
$1,661.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,082.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,661.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,562.19
|
| Rate for Payer: UHC Core |
$1,482.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$166,100.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,710.83
|
| Rate for Payer: VA VA |
$1,661.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,331.42
|
|
|
HC ROOM MED SURG
|
Facility
|
IP
|
$3,291.02
|
|
| Hospital Charge Code |
12100001
|
|
Hospital Revenue Code
|
121
|
| Min. Negotiated Rate |
$1,577.95 |
| Max. Negotiated Rate |
$166,100.00 |
| Rate for Payer: Aetna Commercial |
$2,797.37
|
| Rate for Payer: Aetna Medicare |
$1,727.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,076.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,076.25
|
| Rate for Payer: BCBS MAPPO |
$1,661.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,543.30
|
| Rate for Payer: BCN Commercial |
$2,543.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,661.00
|
| Rate for Payer: Cash Price |
$2,632.82
|
| Rate for Payer: Cash Price |
$2,632.82
|
| Rate for Payer: Cash Price |
$2,632.82
|
| Rate for Payer: Cofinity Commercial |
$2,830.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,632.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,661.00
|
| Rate for Payer: Healthscope Commercial |
$2,961.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,468.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,744.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,910.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,797.37
|
| Rate for Payer: PACE Senior Care Partners |
$1,577.95
|
| Rate for Payer: PACE SWMI |
$1,661.00
|
| Rate for Payer: PHP Commercial |
$2,797.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,661.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,303.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,863.19
|
| Rate for Payer: Priority Health Medicare |
$1,661.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,007.19
|
| Rate for Payer: Railroad Medicare Medicare |
$1,661.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,896.10
|
| Rate for Payer: UHC Core |
$2,748.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$166,100.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,710.83
|
| Rate for Payer: VA VA |
$1,661.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,468.26
|
|
|
HC ROOM SCU
|
Facility
|
IP
|
$2,305.94
|
|
| Hospital Charge Code |
20000002
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$1,406.39 |
| Max. Negotiated Rate |
$166,100.00 |
| Rate for Payer: Aetna Commercial |
$1,960.05
|
| Rate for Payer: Aetna Medicare |
$1,727.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,076.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,076.25
|
| Rate for Payer: BCBS MAPPO |
$1,661.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,782.03
|
| Rate for Payer: BCN Commercial |
$1,782.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,661.00
|
| Rate for Payer: Cash Price |
$1,844.75
|
| Rate for Payer: Cash Price |
$1,844.75
|
| Rate for Payer: Cash Price |
$1,844.75
|
| Rate for Payer: Cofinity Commercial |
$1,983.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,844.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,661.00
|
| Rate for Payer: Healthscope Commercial |
$2,075.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,729.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,744.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,910.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,960.05
|
| Rate for Payer: PACE Senior Care Partners |
$1,577.95
|
| Rate for Payer: PACE SWMI |
$1,661.00
|
| Rate for Payer: PHP Commercial |
$1,960.05
|
| Rate for Payer: PHP Medicare Advantage |
$1,661.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,614.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,006.17
|
| Rate for Payer: Priority Health Medicare |
$1,661.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,406.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,661.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,029.23
|
| Rate for Payer: UHC Core |
$1,925.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$166,100.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,710.83
|
| Rate for Payer: VA VA |
$1,661.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,729.46
|
|
|
HC RO OR SSA SJOGRENS AB
|
Facility
|
OP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200162
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$26.81
|
| Rate for Payer: BCN Commercial |
$26.81
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PACE Senior Care Partners |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
| Rate for Payer: UHC Core |
$28.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$8.88
|
| Rate for Payer: VA VA |
$8.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC RO OR SSA SJOGRENS AB
|
Facility
|
IP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200162
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.03 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: BCBS Trust/PPO |
$26.65
|
| Rate for Payer: BCN Commercial |
$26.65
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
| Rate for Payer: UHC Core |
$28.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC ROPIVACAINE HYDROCHLORIDE 1 MG
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
CPT J2795
|
| Hospital Charge Code |
63600236
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$3.60 |
| Rate for Payer: Aetna Commercial |
$3.40
|
| Rate for Payer: BCBS Trust/PPO |
$3.09
|
| Rate for Payer: BCN Commercial |
$3.09
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$3.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.20
|
| Rate for Payer: Healthscope Commercial |
$3.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.40
|
| Rate for Payer: PHP Commercial |
$3.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.52
|
| Rate for Payer: UHC Core |
$3.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.00
|
|
