|
HC KIT ATS
|
Facility
|
IP
|
$153.00
|
|
| Hospital Charge Code |
27000666
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$99.45 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Aetna Commercial |
$130.05
|
| Rate for Payer: BCBS Trust/PPO |
$124.89
|
| Rate for Payer: BCN Commercial |
$118.24
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$131.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Healthscope Commercial |
$137.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.05
|
| Rate for Payer: Nomi Health Commercial |
$125.46
|
| Rate for Payer: PHP Commercial |
$130.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO |
$133.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.64
|
| Rate for Payer: UHC Core |
$127.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.75
|
|
|
HC KIT DILATOR VASC
|
Facility
|
IP
|
$535.50
|
|
| Hospital Charge Code |
27000101
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$348.07 |
| Max. Negotiated Rate |
$481.95 |
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: BCBS Trust/PPO |
$437.13
|
| Rate for Payer: BCN Commercial |
$413.83
|
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Cofinity Commercial |
$460.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.40
|
| Rate for Payer: Healthscope Commercial |
$481.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.18
|
| Rate for Payer: Nomi Health Commercial |
$439.11
|
| Rate for Payer: PHP Commercial |
$455.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.07
|
| Rate for Payer: Priority Health HMO/PPO |
$465.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$471.24
|
| Rate for Payer: UHC Core |
$447.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.62
|
|
|
HC KIT DILATOR VASC
|
Facility
|
OP
|
$535.50
|
|
| Hospital Charge Code |
27000101
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$127.18 |
| Max. Negotiated Rate |
$481.95 |
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna Medicare |
$139.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$167.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$167.34
|
| Rate for Payer: BCBS Complete |
$214.20
|
| Rate for Payer: BCBS MAPPO |
$133.88
|
| Rate for Payer: BCBS Trust/PPO |
$440.23
|
| Rate for Payer: BCN Commercial |
$416.35
|
| Rate for Payer: BCN Medicare Advantage |
$133.88
|
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Cofinity Commercial |
$460.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.88
|
| Rate for Payer: Healthscope Commercial |
$481.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$153.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.18
|
| Rate for Payer: Nomi Health Commercial |
$439.11
|
| Rate for Payer: PACE Senior Care Partners |
$127.18
|
| Rate for Payer: PACE SWMI |
$133.88
|
| Rate for Payer: PHP Commercial |
$455.18
|
| Rate for Payer: PHP Medicare Advantage |
$133.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.07
|
| Rate for Payer: Priority Health HMO/PPO |
$465.88
|
| Rate for Payer: Priority Health Medicare |
$135.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$358.79
|
| Rate for Payer: Railroad Medicare Medicare |
$133.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$471.24
|
| Rate for Payer: UHC Core |
$447.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.88
|
| Rate for Payer: UHC Exchange |
$133.88
|
| Rate for Payer: UHC Medicare Advantage |
$133.88
|
| Rate for Payer: VA VA |
$133.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.62
|
|
|
HC KLEIHAUER-BETKE STAIN
|
Facility
|
OP
|
$123.22
|
|
|
Service Code
|
CPT 85460
|
| Hospital Charge Code |
30500046
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.59 |
| Max. Negotiated Rate |
$110.90 |
| Rate for Payer: Aetna Commercial |
$104.74
|
| Rate for Payer: Aetna Medicare |
$32.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.51
|
| Rate for Payer: BCBS Complete |
$5.87
|
| Rate for Payer: BCBS MAPPO |
$30.80
|
| Rate for Payer: BCBS Trust/PPO |
$101.30
|
| Rate for Payer: BCN Commercial |
$95.80
|
| Rate for Payer: BCN Medicare Advantage |
$30.80
|
| Rate for Payer: Cash Price |
$98.58
|
| Rate for Payer: Cash Price |
$98.58
|
| Rate for Payer: Cofinity Commercial |
$105.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.80
|
| Rate for Payer: Healthscope Commercial |
$110.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.42
|
| Rate for Payer: Mclaren Medicaid |
$5.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.35
|
| Rate for Payer: Meridian Medicaid |
$5.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.74
|
| Rate for Payer: Nomi Health Commercial |
$101.04
|
| Rate for Payer: PACE Senior Care Partners |
$29.26
|
| Rate for Payer: PACE SWMI |
$30.80
|
| Rate for Payer: PHP Commercial |
$104.74
|
| Rate for Payer: PHP Medicare Advantage |
$30.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.09
|
| Rate for Payer: Priority Health HMO/PPO |
$107.20
|
| Rate for Payer: Priority Health Medicare |
$31.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.56
|
| Rate for Payer: Railroad Medicare Medicare |
$30.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.43
|
| Rate for Payer: UHC Core |
$102.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.80
|
| Rate for Payer: UHC Exchange |
$30.80
|
| Rate for Payer: UHC Medicare Advantage |
$30.80
|
| Rate for Payer: UHCCP Medicaid |
$5.59
|
| Rate for Payer: VA VA |
$30.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.42
|
|
|
HC KLEIHAUER-BETKE STAIN
|
Facility
|
IP
|
$123.22
|
|
|
Service Code
|
CPT 85460
|
| Hospital Charge Code |
30500046
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$80.09 |
| Max. Negotiated Rate |
$110.90 |
| Rate for Payer: Aetna Commercial |
$104.74
|
| Rate for Payer: BCBS Trust/PPO |
$100.58
|
| Rate for Payer: BCN Commercial |
$95.22
|
| Rate for Payer: Cash Price |
$98.58
|
| Rate for Payer: Cofinity Commercial |
$105.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.58
|
| Rate for Payer: Healthscope Commercial |
$110.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.74
|
| Rate for Payer: Nomi Health Commercial |
$101.04
|
| Rate for Payer: PHP Commercial |
$104.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.09
|
| Rate for Payer: Priority Health HMO/PPO |
$107.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.43
|
| Rate for Payer: UHC Core |
$102.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.42
|
|
|
HC KOH PREPARATION
|
Facility
|
IP
|
$23.93
|
|
|
Service Code
|
CPT 87220
|
| Hospital Charge Code |
30600111
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$21.54 |
| Rate for Payer: Aetna Commercial |
$20.34
|
| Rate for Payer: BCBS Trust/PPO |
$19.53
|
| Rate for Payer: BCN Commercial |
$18.49
|
| Rate for Payer: Cash Price |
$19.14
|
| Rate for Payer: Cofinity Commercial |
$20.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.14
|
| Rate for Payer: Healthscope Commercial |
$21.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.34
|
| Rate for Payer: Nomi Health Commercial |
$19.62
|
| Rate for Payer: PHP Commercial |
$20.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.55
|
| Rate for Payer: Priority Health HMO/PPO |
$20.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.06
|
| Rate for Payer: UHC Core |
$19.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.95
|
|
|
HC KOH PREPARATION
|
Facility
|
OP
|
$23.93
|
|
|
Service Code
|
CPT 87220
|
| Hospital Charge Code |
30600111
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$21.54 |
| Rate for Payer: Aetna Commercial |
$20.34
|
| Rate for Payer: Aetna Medicare |
$6.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.48
|
| Rate for Payer: BCBS Complete |
$3.24
|
| Rate for Payer: BCBS MAPPO |
$5.98
|
| Rate for Payer: BCBS Trust/PPO |
$19.67
|
| Rate for Payer: BCN Commercial |
$18.61
|
| Rate for Payer: BCN Medicare Advantage |
$5.98
|
| Rate for Payer: Cash Price |
$19.14
|
| Rate for Payer: Cash Price |
$19.14
|
| Rate for Payer: Cofinity Commercial |
$20.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.98
|
| Rate for Payer: Healthscope Commercial |
$21.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.95
|
| Rate for Payer: Mclaren Medicaid |
$3.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.28
|
| Rate for Payer: Meridian Medicaid |
$3.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.34
|
| Rate for Payer: Nomi Health Commercial |
$19.62
|
| Rate for Payer: PACE Senior Care Partners |
$5.68
|
| Rate for Payer: PACE SWMI |
$5.98
|
| Rate for Payer: PHP Commercial |
$20.34
|
| Rate for Payer: PHP Medicare Advantage |
$5.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.55
|
| Rate for Payer: Priority Health HMO/PPO |
$20.82
|
| Rate for Payer: Priority Health Medicare |
$6.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.03
|
| Rate for Payer: Railroad Medicare Medicare |
$5.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.06
|
| Rate for Payer: UHC Core |
$19.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.98
|
| Rate for Payer: UHC Exchange |
$5.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.98
|
| Rate for Payer: UHCCP Medicaid |
$3.09
|
| Rate for Payer: VA VA |
$5.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.95
|
|
|
HC KYLEENA 19.5MG
|
Facility
|
OP
|
$2,936.43
|
|
|
Service Code
|
CPT J7296
|
| Hospital Charge Code |
63600165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$697.40 |
| Max. Negotiated Rate |
$2,642.79 |
| Rate for Payer: Aetna Commercial |
$2,495.97
|
| Rate for Payer: Aetna Medicare |
$763.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$917.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$917.63
|
| Rate for Payer: BCBS Complete |
$1,174.57
|
| Rate for Payer: BCBS MAPPO |
$734.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,414.04
|
| Rate for Payer: BCN Commercial |
$2,283.07
|
| Rate for Payer: BCN Medicare Advantage |
$734.11
|
| Rate for Payer: Cash Price |
$2,349.14
|
| Rate for Payer: Cofinity Commercial |
$2,525.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,349.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$734.11
|
| Rate for Payer: Healthscope Commercial |
$2,642.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,202.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$770.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$844.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,495.97
|
| Rate for Payer: Nomi Health Commercial |
$2,407.87
|
| Rate for Payer: PACE Senior Care Partners |
$697.40
|
| Rate for Payer: PACE SWMI |
$734.11
|
| Rate for Payer: PHP Commercial |
$2,495.97
|
| Rate for Payer: PHP Medicare Advantage |
$734.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,908.68
|
| Rate for Payer: Priority Health HMO/PPO |
$2,554.69
|
| Rate for Payer: Priority Health Medicare |
$741.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,967.41
|
| Rate for Payer: Railroad Medicare Medicare |
$734.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,584.06
|
| Rate for Payer: UHC Core |
$2,451.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$734.11
|
| Rate for Payer: UHC Exchange |
$734.11
|
| Rate for Payer: UHC Medicare Advantage |
$734.11
|
| Rate for Payer: VA VA |
$734.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,202.32
|
|
|
HC KYLEENA 19.5MG
|
Facility
|
IP
|
$2,936.43
|
|
|
Service Code
|
CPT J7296
|
| Hospital Charge Code |
63600165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,908.68 |
| Max. Negotiated Rate |
$2,642.79 |
| Rate for Payer: Aetna Commercial |
$2,495.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,397.01
|
| Rate for Payer: BCN Commercial |
$2,269.27
|
| Rate for Payer: Cash Price |
$2,349.14
|
| Rate for Payer: Cofinity Commercial |
$2,525.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,349.14
|
| Rate for Payer: Healthscope Commercial |
$2,642.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,202.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,495.97
|
| Rate for Payer: Nomi Health Commercial |
$2,407.87
|
| Rate for Payer: PHP Commercial |
$2,495.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,908.68
|
| Rate for Payer: Priority Health HMO/PPO |
$2,554.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,967.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,584.06
|
| Rate for Payer: UHC Core |
$2,451.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,202.32
|
|
|
HC LAAC IMPLANT
|
Facility
|
OP
|
$18,571.14
|
|
| Hospital Charge Code |
27800117
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,410.65 |
| Max. Negotiated Rate |
$16,714.03 |
| Rate for Payer: Aetna Commercial |
$15,785.47
|
| Rate for Payer: Aetna Medicare |
$4,828.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,803.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,803.48
|
| Rate for Payer: BCBS Complete |
$7,428.46
|
| Rate for Payer: BCBS MAPPO |
$4,642.78
|
| Rate for Payer: BCBS Trust/PPO |
$15,267.33
|
| Rate for Payer: BCN Commercial |
$14,439.06
|
| Rate for Payer: BCN Medicare Advantage |
$4,642.78
|
| Rate for Payer: Cash Price |
$14,856.91
|
| Rate for Payer: Cofinity Commercial |
$15,971.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,856.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,642.78
|
| Rate for Payer: Healthscope Commercial |
$16,714.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,928.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,874.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,339.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,785.47
|
| Rate for Payer: Nomi Health Commercial |
$15,228.33
|
| Rate for Payer: PACE Senior Care Partners |
$4,410.65
|
| Rate for Payer: PACE SWMI |
$4,642.78
|
| Rate for Payer: PHP Commercial |
$15,785.47
|
| Rate for Payer: PHP Medicare Advantage |
$4,642.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,071.24
|
| Rate for Payer: Priority Health HMO/PPO |
$16,156.89
|
| Rate for Payer: Priority Health Medicare |
$4,689.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,442.66
|
| Rate for Payer: Railroad Medicare Medicare |
$4,642.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,342.60
|
| Rate for Payer: UHC Core |
$15,506.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,642.78
|
| Rate for Payer: UHC Exchange |
$4,642.78
|
| Rate for Payer: UHC Medicare Advantage |
$4,642.78
|
| Rate for Payer: VA VA |
$4,642.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,928.35
|
|
|
HC LAAC IMPLANT
|
Facility
|
IP
|
$18,571.14
|
|
| Hospital Charge Code |
27800117
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,071.24 |
| Max. Negotiated Rate |
$16,714.03 |
| Rate for Payer: Aetna Commercial |
$15,785.47
|
| Rate for Payer: BCBS Trust/PPO |
$15,159.62
|
| Rate for Payer: BCN Commercial |
$14,351.78
|
| Rate for Payer: Cash Price |
$14,856.91
|
| Rate for Payer: Cofinity Commercial |
$15,971.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,856.91
|
| Rate for Payer: Healthscope Commercial |
$16,714.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,928.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,785.47
|
| Rate for Payer: Nomi Health Commercial |
$15,228.33
|
| Rate for Payer: PHP Commercial |
$15,785.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,071.24
|
| Rate for Payer: Priority Health HMO/PPO |
$16,156.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,442.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,342.60
|
| Rate for Payer: UHC Core |
$15,506.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,928.35
|
|
|
HC LABOR CAT (1) 0-2HRS
|
Facility
|
IP
|
$1,531.01
|
|
| Hospital Charge Code |
72000001
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$995.16 |
| Max. Negotiated Rate |
$1,377.91 |
| Rate for Payer: Aetna Commercial |
$1,301.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,249.76
|
| Rate for Payer: BCN Commercial |
$1,183.16
|
| Rate for Payer: Cash Price |
$1,224.81
|
| Rate for Payer: Cofinity Commercial |
$1,316.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.81
|
| Rate for Payer: Healthscope Commercial |
$1,377.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,148.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,301.36
|
| Rate for Payer: Nomi Health Commercial |
$1,255.43
|
| Rate for Payer: PHP Commercial |
$1,301.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1,331.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,025.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,347.29
|
| Rate for Payer: UHC Core |
$1,278.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,148.26
|
|
|
HC LABOR CAT (1) 0-2HRS
|
Facility
|
OP
|
$1,531.01
|
|
| Hospital Charge Code |
72000001
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$363.61 |
| Max. Negotiated Rate |
$1,377.91 |
| Rate for Payer: Aetna Commercial |
$1,301.36
|
| Rate for Payer: Aetna Medicare |
$398.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$478.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$478.44
|
| Rate for Payer: BCBS Complete |
$612.40
|
| Rate for Payer: BCBS MAPPO |
$382.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,258.64
|
| Rate for Payer: BCN Commercial |
$1,190.36
|
| Rate for Payer: BCN Medicare Advantage |
$382.75
|
| Rate for Payer: Cash Price |
$1,224.81
|
| Rate for Payer: Cofinity Commercial |
$1,316.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.75
|
| Rate for Payer: Healthscope Commercial |
$1,377.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,148.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$401.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$440.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,301.36
|
| Rate for Payer: Nomi Health Commercial |
$1,255.43
|
| Rate for Payer: PACE Senior Care Partners |
$363.61
|
| Rate for Payer: PACE SWMI |
$382.75
|
| Rate for Payer: PHP Commercial |
$1,301.36
|
| Rate for Payer: PHP Medicare Advantage |
$382.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1,331.98
|
| Rate for Payer: Priority Health Medicare |
$386.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,025.78
|
| Rate for Payer: Railroad Medicare Medicare |
$382.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,347.29
|
| Rate for Payer: UHC Core |
$1,278.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.75
|
| Rate for Payer: UHC Exchange |
$382.75
|
| Rate for Payer: UHC Medicare Advantage |
$382.75
|
| Rate for Payer: VA VA |
$382.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,148.26
|
|
|
HC LABOR CAT (2) 2-5HRS
|
Facility
|
OP
|
$2,041.41
|
|
| Hospital Charge Code |
72000002
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$484.83 |
| Max. Negotiated Rate |
$1,837.27 |
| Rate for Payer: Aetna Commercial |
$1,735.20
|
| Rate for Payer: Aetna Medicare |
$530.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$637.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$637.94
|
| Rate for Payer: BCBS Complete |
$816.56
|
| Rate for Payer: BCBS MAPPO |
$510.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,678.24
|
| Rate for Payer: BCN Commercial |
$1,587.20
|
| Rate for Payer: BCN Medicare Advantage |
$510.35
|
| Rate for Payer: Cash Price |
$1,633.13
|
| Rate for Payer: Cofinity Commercial |
$1,755.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,633.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.35
|
| Rate for Payer: Healthscope Commercial |
$1,837.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,531.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$586.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,735.20
|
| Rate for Payer: Nomi Health Commercial |
$1,673.96
|
| Rate for Payer: PACE Senior Care Partners |
$484.83
|
| Rate for Payer: PACE SWMI |
$510.35
|
| Rate for Payer: PHP Commercial |
$1,735.20
|
| Rate for Payer: PHP Medicare Advantage |
$510.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.92
|
| Rate for Payer: Priority Health HMO/PPO |
$1,776.03
|
| Rate for Payer: Priority Health Medicare |
$515.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,367.74
|
| Rate for Payer: Railroad Medicare Medicare |
$510.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,796.44
|
| Rate for Payer: UHC Core |
$1,704.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.35
|
| Rate for Payer: UHC Exchange |
$510.35
|
| Rate for Payer: UHC Medicare Advantage |
$510.35
|
| Rate for Payer: VA VA |
$510.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,531.06
|
|
|
HC LABOR CAT (2) 2-5HRS
|
Facility
|
IP
|
$2,041.41
|
|
| Hospital Charge Code |
72000002
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,326.92 |
| Max. Negotiated Rate |
$1,837.27 |
| Rate for Payer: Aetna Commercial |
$1,735.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,666.40
|
| Rate for Payer: BCN Commercial |
$1,577.60
|
| Rate for Payer: Cash Price |
$1,633.13
|
| Rate for Payer: Cofinity Commercial |
$1,755.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,633.13
|
| Rate for Payer: Healthscope Commercial |
$1,837.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,531.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,735.20
|
| Rate for Payer: Nomi Health Commercial |
$1,673.96
|
| Rate for Payer: PHP Commercial |
$1,735.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.92
|
| Rate for Payer: Priority Health HMO/PPO |
$1,776.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,367.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,796.44
|
| Rate for Payer: UHC Core |
$1,704.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,531.06
|
|
|
HC LABOR CAT (3) 5-8HRS
|
Facility
|
IP
|
$2,551.65
|
|
| Hospital Charge Code |
72000003
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,658.57 |
| Max. Negotiated Rate |
$2,296.49 |
| Rate for Payer: Aetna Commercial |
$2,168.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,082.91
|
| Rate for Payer: BCN Commercial |
$1,971.92
|
| Rate for Payer: Cash Price |
$2,041.32
|
| Rate for Payer: Cofinity Commercial |
$2,194.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,041.32
|
| Rate for Payer: Healthscope Commercial |
$2,296.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,913.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,168.90
|
| Rate for Payer: Nomi Health Commercial |
$2,092.35
|
| Rate for Payer: PHP Commercial |
$2,168.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,658.57
|
| Rate for Payer: Priority Health HMO/PPO |
$2,219.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,709.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,245.45
|
| Rate for Payer: UHC Core |
$2,130.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,913.74
|
|
|
HC LABOR CAT (3) 5-8HRS
|
Facility
|
OP
|
$2,551.65
|
|
| Hospital Charge Code |
72000003
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$606.02 |
| Max. Negotiated Rate |
$2,296.49 |
| Rate for Payer: Aetna Commercial |
$2,168.90
|
| Rate for Payer: Aetna Medicare |
$663.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$797.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$797.39
|
| Rate for Payer: BCBS Complete |
$1,020.66
|
| Rate for Payer: BCBS MAPPO |
$637.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,097.71
|
| Rate for Payer: BCN Commercial |
$1,983.91
|
| Rate for Payer: BCN Medicare Advantage |
$637.91
|
| Rate for Payer: Cash Price |
$2,041.32
|
| Rate for Payer: Cofinity Commercial |
$2,194.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,041.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.91
|
| Rate for Payer: Healthscope Commercial |
$2,296.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,913.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$669.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$733.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,168.90
|
| Rate for Payer: Nomi Health Commercial |
$2,092.35
|
| Rate for Payer: PACE Senior Care Partners |
$606.02
|
| Rate for Payer: PACE SWMI |
$637.91
|
| Rate for Payer: PHP Commercial |
$2,168.90
|
| Rate for Payer: PHP Medicare Advantage |
$637.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,658.57
|
| Rate for Payer: Priority Health HMO/PPO |
$2,219.94
|
| Rate for Payer: Priority Health Medicare |
$644.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,709.61
|
| Rate for Payer: Railroad Medicare Medicare |
$637.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,245.45
|
| Rate for Payer: UHC Core |
$2,130.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$637.91
|
| Rate for Payer: UHC Exchange |
$637.91
|
| Rate for Payer: UHC Medicare Advantage |
$637.91
|
| Rate for Payer: VA VA |
$637.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,913.74
|
|
|
HC LABOR CAT (4) 8-12HRS
|
Facility
|
IP
|
$3,062.03
|
|
| Hospital Charge Code |
72000004
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,990.32 |
| Max. Negotiated Rate |
$2,755.83 |
| Rate for Payer: Aetna Commercial |
$2,602.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,499.54
|
| Rate for Payer: BCN Commercial |
$2,366.34
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cofinity Commercial |
$2,633.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,449.62
|
| Rate for Payer: Healthscope Commercial |
$2,755.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,296.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,602.73
|
| Rate for Payer: Nomi Health Commercial |
$2,510.86
|
| Rate for Payer: PHP Commercial |
$2,602.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,990.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,663.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,051.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,694.59
|
| Rate for Payer: UHC Core |
$2,556.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,296.52
|
|
|
HC LABOR CAT (4) 8-12HRS
|
Facility
|
OP
|
$3,062.03
|
|
| Hospital Charge Code |
72000004
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$727.23 |
| Max. Negotiated Rate |
$2,755.83 |
| Rate for Payer: Aetna Commercial |
$2,602.73
|
| Rate for Payer: Aetna Medicare |
$796.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$956.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$956.88
|
| Rate for Payer: BCBS Complete |
$1,224.81
|
| Rate for Payer: BCBS MAPPO |
$765.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,517.29
|
| Rate for Payer: BCN Commercial |
$2,380.73
|
| Rate for Payer: BCN Medicare Advantage |
$765.51
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cofinity Commercial |
$2,633.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,449.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$765.51
|
| Rate for Payer: Healthscope Commercial |
$2,755.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,296.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$803.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$880.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,602.73
|
| Rate for Payer: Nomi Health Commercial |
$2,510.86
|
| Rate for Payer: PACE Senior Care Partners |
$727.23
|
| Rate for Payer: PACE SWMI |
$765.51
|
| Rate for Payer: PHP Commercial |
$2,602.73
|
| Rate for Payer: PHP Medicare Advantage |
$765.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,990.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,663.97
|
| Rate for Payer: Priority Health Medicare |
$773.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,051.56
|
| Rate for Payer: Railroad Medicare Medicare |
$765.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,694.59
|
| Rate for Payer: UHC Core |
$2,556.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$765.51
|
| Rate for Payer: UHC Exchange |
$765.51
|
| Rate for Payer: UHC Medicare Advantage |
$765.51
|
| Rate for Payer: VA VA |
$765.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,296.52
|
|
|
HC LABOR CAT (5) 12-17HRS
|
Facility
|
IP
|
$4,589.55
|
|
| Hospital Charge Code |
72000007
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$2,983.21 |
| Max. Negotiated Rate |
$4,130.60 |
| Rate for Payer: Aetna Commercial |
$3,901.12
|
| Rate for Payer: BCBS Trust/PPO |
$3,746.45
|
| Rate for Payer: BCN Commercial |
$3,546.80
|
| Rate for Payer: Cash Price |
$3,671.64
|
| Rate for Payer: Cofinity Commercial |
$3,947.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,671.64
|
| Rate for Payer: Healthscope Commercial |
$4,130.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,442.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,901.12
|
| Rate for Payer: Nomi Health Commercial |
$3,763.43
|
| Rate for Payer: PHP Commercial |
$3,901.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.21
|
| Rate for Payer: Priority Health HMO/PPO |
$3,992.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,075.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,038.80
|
| Rate for Payer: UHC Core |
$3,832.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,442.16
|
|
|
HC LABOR CAT (5) 12-17HRS
|
Facility
|
OP
|
$4,589.55
|
|
| Hospital Charge Code |
72000007
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,090.02 |
| Max. Negotiated Rate |
$4,130.60 |
| Rate for Payer: Aetna Commercial |
$3,901.12
|
| Rate for Payer: Aetna Medicare |
$1,193.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,434.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,434.23
|
| Rate for Payer: BCBS Complete |
$1,835.82
|
| Rate for Payer: BCBS MAPPO |
$1,147.39
|
| Rate for Payer: BCBS Trust/PPO |
$3,773.07
|
| Rate for Payer: BCN Commercial |
$3,568.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,147.39
|
| Rate for Payer: Cash Price |
$3,671.64
|
| Rate for Payer: Cofinity Commercial |
$3,947.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,671.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,147.39
|
| Rate for Payer: Healthscope Commercial |
$4,130.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,442.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,204.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,319.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,901.12
|
| Rate for Payer: Nomi Health Commercial |
$3,763.43
|
| Rate for Payer: PACE Senior Care Partners |
$1,090.02
|
| Rate for Payer: PACE SWMI |
$1,147.39
|
| Rate for Payer: PHP Commercial |
$3,901.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,147.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.21
|
| Rate for Payer: Priority Health HMO/PPO |
$3,992.91
|
| Rate for Payer: Priority Health Medicare |
$1,158.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,075.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,147.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,038.80
|
| Rate for Payer: UHC Core |
$3,832.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,147.39
|
| Rate for Payer: UHC Exchange |
$1,147.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,147.39
|
| Rate for Payer: VA VA |
$1,147.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,442.16
|
|
|
HC LABOR CAT (6) 17 OR MORE HRS
|
Facility
|
IP
|
$6,790.05
|
|
| Hospital Charge Code |
72000008
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$4,413.53 |
| Max. Negotiated Rate |
$6,111.05 |
| Rate for Payer: Aetna Commercial |
$5,771.54
|
| Rate for Payer: BCBS Trust/PPO |
$5,542.72
|
| Rate for Payer: BCN Commercial |
$5,247.35
|
| Rate for Payer: Cash Price |
$5,432.04
|
| Rate for Payer: Cofinity Commercial |
$5,839.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,432.04
|
| Rate for Payer: Healthscope Commercial |
$6,111.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,092.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,771.54
|
| Rate for Payer: Nomi Health Commercial |
$5,567.84
|
| Rate for Payer: PHP Commercial |
$5,771.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,413.53
|
| Rate for Payer: Priority Health HMO/PPO |
$5,907.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,549.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,975.24
|
| Rate for Payer: UHC Core |
$5,669.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,092.54
|
|
|
HC LABOR CAT (6) 17 OR MORE HRS
|
Facility
|
OP
|
$6,790.05
|
|
| Hospital Charge Code |
72000008
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,612.64 |
| Max. Negotiated Rate |
$6,111.05 |
| Rate for Payer: Aetna Commercial |
$5,771.54
|
| Rate for Payer: Aetna Medicare |
$1,765.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,121.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,121.89
|
| Rate for Payer: BCBS Complete |
$2,716.02
|
| Rate for Payer: BCBS MAPPO |
$1,697.51
|
| Rate for Payer: BCBS Trust/PPO |
$5,582.10
|
| Rate for Payer: BCN Commercial |
$5,279.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,697.51
|
| Rate for Payer: Cash Price |
$5,432.04
|
| Rate for Payer: Cofinity Commercial |
$5,839.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,432.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,697.51
|
| Rate for Payer: Healthscope Commercial |
$6,111.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,092.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,782.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,952.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,771.54
|
| Rate for Payer: Nomi Health Commercial |
$5,567.84
|
| Rate for Payer: PACE Senior Care Partners |
$1,612.64
|
| Rate for Payer: PACE SWMI |
$1,697.51
|
| Rate for Payer: PHP Commercial |
$5,771.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,697.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,413.53
|
| Rate for Payer: Priority Health HMO/PPO |
$5,907.34
|
| Rate for Payer: Priority Health Medicare |
$1,714.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,549.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,697.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,975.24
|
| Rate for Payer: UHC Core |
$5,669.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,697.51
|
| Rate for Payer: UHC Exchange |
$1,697.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,697.51
|
| Rate for Payer: VA VA |
$1,697.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,092.54
|
|
|
HC LABYRINTHOTOMY TRANSCANAL
|
Facility
|
IP
|
$4,015.74
|
|
|
Service Code
|
CPT 69801
|
| Hospital Charge Code |
76100487
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,610.23 |
| Max. Negotiated Rate |
$3,614.17 |
| Rate for Payer: Aetna Commercial |
$3,413.38
|
| Rate for Payer: BCBS Trust/PPO |
$3,278.05
|
| Rate for Payer: BCN Commercial |
$3,103.36
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cofinity Commercial |
$3,453.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,212.59
|
| Rate for Payer: Healthscope Commercial |
$3,614.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,011.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,413.38
|
| Rate for Payer: Nomi Health Commercial |
$3,292.91
|
| Rate for Payer: PHP Commercial |
$3,413.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,610.23
|
| Rate for Payer: Priority Health HMO/PPO |
$3,493.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,690.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,533.85
|
| Rate for Payer: UHC Core |
$3,353.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,011.80
|
|
|
HC LABYRINTHOTOMY TRANSCANAL
|
Facility
|
OP
|
$4,015.74
|
|
|
Service Code
|
CPT 69801
|
| Hospital Charge Code |
76100487
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$953.74 |
| Max. Negotiated Rate |
$3,614.17 |
| Rate for Payer: Aetna Commercial |
$3,413.38
|
| Rate for Payer: Aetna Medicare |
$1,044.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,254.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,254.92
|
| Rate for Payer: BCBS Complete |
$1,124.59
|
| Rate for Payer: BCBS MAPPO |
$1,003.93
|
| Rate for Payer: BCBS Trust/PPO |
$3,301.34
|
| Rate for Payer: BCN Commercial |
$3,122.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,003.93
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cofinity Commercial |
$3,453.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,212.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,003.93
|
| Rate for Payer: Healthscope Commercial |
$3,614.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,011.80
|
| Rate for Payer: Mclaren Medicaid |
$1,070.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,054.13
|
| Rate for Payer: Meridian Medicaid |
$1,124.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,154.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,413.38
|
| Rate for Payer: Nomi Health Commercial |
$3,292.91
|
| Rate for Payer: PACE Senior Care Partners |
$953.74
|
| Rate for Payer: PACE SWMI |
$1,003.93
|
| Rate for Payer: PHP Commercial |
$3,413.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,003.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,610.23
|
| Rate for Payer: Priority Health HMO/PPO |
$3,493.69
|
| Rate for Payer: Priority Health Medicare |
$1,013.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,690.55
|
| Rate for Payer: Railroad Medicare Medicare |
$1,003.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,533.85
|
| Rate for Payer: UHC Core |
$3,353.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,003.93
|
| Rate for Payer: UHC Exchange |
$1,003.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,003.93
|
| Rate for Payer: UHCCP Medicaid |
$1,070.97
|
| Rate for Payer: VA VA |
$1,003.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,011.80
|
|
