|
HC MR UPPER EXTREM BIL NO JOINT WO W CON
|
Facility
|
IP
|
$2,635.94
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000021
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,834.61 |
| Max. Negotiated Rate |
$2,372.35 |
| Rate for Payer: Aetna Commercial |
$2,240.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,177.02
|
| Rate for Payer: BCN Commercial |
$2,177.02
|
| Rate for Payer: Cash Price |
$2,108.75
|
| Rate for Payer: Cofinity Commercial |
$2,266.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,108.75
|
| Rate for Payer: Healthscope Commercial |
$2,372.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,976.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,240.55
|
| Rate for Payer: Nomi Health Commercial |
$2,161.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,976.95
|
| Rate for Payer: PHP Commercial |
$2,240.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,293.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,834.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,319.63
|
| Rate for Payer: UHC Core |
$2,201.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,976.95
|
|
|
HC MR UPPER EXTREM NO JOINT W CON
|
Facility
|
IP
|
$2,375.75
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000018
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,653.52 |
| Max. Negotiated Rate |
$2,138.18 |
| Rate for Payer: Aetna Commercial |
$2,019.39
|
| Rate for Payer: Aetna Commercial |
$3,029.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,962.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,943.20
|
| Rate for Payer: BCN Commercial |
$1,962.13
|
| Rate for Payer: BCN Commercial |
$2,943.20
|
| Rate for Payer: Cash Price |
$1,900.60
|
| Rate for Payer: Cash Price |
$2,850.90
|
| Rate for Payer: Cofinity Commercial |
$3,064.72
|
| Rate for Payer: Cofinity Commercial |
$2,043.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,850.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,900.60
|
| Rate for Payer: Healthscope Commercial |
$2,138.18
|
| Rate for Payer: Healthscope Commercial |
$3,207.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,781.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,672.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,019.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,029.09
|
| Rate for Payer: Nomi Health Commercial |
$1,948.12
|
| Rate for Payer: Nomi Health Commercial |
$2,922.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,781.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,672.72
|
| Rate for Payer: PHP Commercial |
$3,029.09
|
| Rate for Payer: PHP Commercial |
$2,019.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,100.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,066.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,653.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,480.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,090.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,135.99
|
| Rate for Payer: UHC Core |
$1,983.75
|
| Rate for Payer: UHC Core |
$2,975.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,781.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,672.72
|
|
|
HC MR UPPER EXTREM NO JOINT W CON
|
Facility
|
OP
|
$2,375.75
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000018
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$418.84 |
| Max. Negotiated Rate |
$2,138.18 |
| Rate for Payer: Aetna Commercial |
$2,019.39
|
| Rate for Payer: Aetna Commercial |
$3,029.09
|
| Rate for Payer: Aetna Medicare |
$926.54
|
| Rate for Payer: Aetna Medicare |
$617.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,113.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$742.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$742.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,113.63
|
| Rate for Payer: BCBS Complete |
$439.75
|
| Rate for Payer: BCBS Complete |
$659.63
|
| Rate for Payer: BCBS MAPPO |
$593.94
|
| Rate for Payer: BCBS MAPPO |
$890.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,929.66
|
| Rate for Payer: BCN Commercial |
$2,929.66
|
| Rate for Payer: BCN Commercial |
$1,953.10
|
| Rate for Payer: BCN Medicare Advantage |
$890.91
|
| Rate for Payer: BCN Medicare Advantage |
$593.94
|
| Rate for Payer: Cash Price |
$1,900.60
|
| Rate for Payer: Cash Price |
$2,850.90
|
| Rate for Payer: Cofinity Commercial |
$2,043.14
|
| Rate for Payer: Cofinity Commercial |
$3,064.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,850.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,900.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$890.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$593.94
|
| Rate for Payer: Healthscope Commercial |
$2,138.18
|
| Rate for Payer: Healthscope Commercial |
$3,207.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,781.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,672.72
|
| Rate for Payer: Mclaren Medicaid |
$628.27
|
| Rate for Payer: Mclaren Medicaid |
$418.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$935.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$623.63
|
| Rate for Payer: Meridian Medicaid |
$439.75
|
| Rate for Payer: Meridian Medicaid |
$659.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,024.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$683.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$980.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$653.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,029.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,019.39
|
| Rate for Payer: Nomi Health Commercial |
$2,922.18
|
| Rate for Payer: Nomi Health Commercial |
$1,948.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,781.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,672.72
|
| Rate for Payer: PACE Senior Care Partners |
$846.36
|
| Rate for Payer: PACE Senior Care Partners |
$564.24
|
| Rate for Payer: PACE SWMI |
$890.91
|
| Rate for Payer: PACE SWMI |
$593.94
|
| Rate for Payer: PHP Commercial |
$2,019.39
|
| Rate for Payer: PHP Commercial |
$3,029.09
|
| Rate for Payer: PHP Medicare Advantage |
$593.94
|
| Rate for Payer: PHP Medicare Advantage |
$890.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$628.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,100.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,066.90
|
| Rate for Payer: Priority Health Medicare |
$899.82
|
| Rate for Payer: Priority Health Medicare |
$599.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,653.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,480.29
|
| Rate for Payer: Railroad Medicare Medicare |
$593.94
|
| Rate for Payer: Railroad Medicare Medicare |
$890.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,090.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,135.99
|
| Rate for Payer: UHC Core |
$2,975.63
|
| Rate for Payer: UHC Core |
$1,983.75
|
| Rate for Payer: UHC Exchange |
$890.91
|
| Rate for Payer: UHC Exchange |
$593.94
|
| Rate for Payer: UHC Medicaid |
$628.27
|
| Rate for Payer: UHC Medicaid |
$418.84
|
| Rate for Payer: UHC Medicare Advantage |
$593.94
|
| Rate for Payer: UHC Medicare Advantage |
$890.91
|
| Rate for Payer: UHCCP Medicaid |
$418.84
|
| Rate for Payer: UHCCP Medicaid |
$628.27
|
| Rate for Payer: VA VA |
$593.94
|
| Rate for Payer: VA VA |
$890.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,672.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,781.81
|
|
|
HC MR UPPER EXTREM NO JOINT WO CON
|
Facility
|
OP
|
$2,035.12
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000016
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$358.79 |
| Max. Negotiated Rate |
$1,831.61 |
| Rate for Payer: Aetna Commercial |
$1,729.85
|
| Rate for Payer: Aetna Commercial |
$2,594.79
|
| Rate for Payer: Aetna Medicare |
$793.70
|
| Rate for Payer: Aetna Medicare |
$529.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$953.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$635.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$635.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$953.97
|
| Rate for Payer: BCBS Complete |
$376.70
|
| Rate for Payer: BCBS Complete |
$565.05
|
| Rate for Payer: BCBS MAPPO |
$508.78
|
| Rate for Payer: BCBS MAPPO |
$763.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,673.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,509.62
|
| Rate for Payer: BCN Commercial |
$2,509.62
|
| Rate for Payer: BCN Commercial |
$1,673.07
|
| Rate for Payer: BCN Medicare Advantage |
$763.17
|
| Rate for Payer: BCN Medicare Advantage |
$508.78
|
| Rate for Payer: Cash Price |
$1,628.10
|
| Rate for Payer: Cash Price |
$2,442.15
|
| Rate for Payer: Cofinity Commercial |
$1,750.20
|
| Rate for Payer: Cofinity Commercial |
$2,625.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$763.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$508.78
|
| Rate for Payer: Healthscope Commercial |
$1,831.61
|
| Rate for Payer: Healthscope Commercial |
$2,747.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,526.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,289.52
|
| Rate for Payer: Mclaren Medicaid |
$538.19
|
| Rate for Payer: Mclaren Medicaid |
$358.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$801.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$534.22
|
| Rate for Payer: Meridian Medicaid |
$376.70
|
| Rate for Payer: Meridian Medicaid |
$565.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$877.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$585.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$839.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$559.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,729.85
|
| Rate for Payer: Nomi Health Commercial |
$2,503.21
|
| Rate for Payer: Nomi Health Commercial |
$1,668.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,526.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,289.52
|
| Rate for Payer: PACE Senior Care Partners |
$725.01
|
| Rate for Payer: PACE Senior Care Partners |
$483.34
|
| Rate for Payer: PACE SWMI |
$763.17
|
| Rate for Payer: PACE SWMI |
$508.78
|
| Rate for Payer: PHP Commercial |
$1,729.85
|
| Rate for Payer: PHP Commercial |
$2,594.79
|
| Rate for Payer: PHP Medicare Advantage |
$508.78
|
| Rate for Payer: PHP Medicare Advantage |
$763.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$358.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,655.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,770.55
|
| Rate for Payer: Priority Health Medicare |
$770.80
|
| Rate for Payer: Priority Health Medicare |
$513.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,416.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,124.67
|
| Rate for Payer: Railroad Medicare Medicare |
$508.78
|
| Rate for Payer: Railroad Medicare Medicare |
$763.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,790.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,686.37
|
| Rate for Payer: UHC Core |
$2,549.00
|
| Rate for Payer: UHC Core |
$1,699.33
|
| Rate for Payer: UHC Exchange |
$763.17
|
| Rate for Payer: UHC Exchange |
$508.78
|
| Rate for Payer: UHC Medicaid |
$538.19
|
| Rate for Payer: UHC Medicaid |
$358.79
|
| Rate for Payer: UHC Medicare Advantage |
$508.78
|
| Rate for Payer: UHC Medicare Advantage |
$763.17
|
| Rate for Payer: UHCCP Medicaid |
$358.79
|
| Rate for Payer: UHCCP Medicaid |
$538.19
|
| Rate for Payer: VA VA |
$508.78
|
| Rate for Payer: VA VA |
$763.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,289.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,526.34
|
|
|
HC MR UPPER EXTREM NO JOINT WO CON
|
Facility
|
IP
|
$2,035.12
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000016
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,416.44 |
| Max. Negotiated Rate |
$1,831.61 |
| Rate for Payer: Aetna Commercial |
$1,729.85
|
| Rate for Payer: Aetna Commercial |
$2,594.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,680.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,521.22
|
| Rate for Payer: BCN Commercial |
$1,680.81
|
| Rate for Payer: BCN Commercial |
$2,521.22
|
| Rate for Payer: Cash Price |
$1,628.10
|
| Rate for Payer: Cash Price |
$2,442.15
|
| Rate for Payer: Cofinity Commercial |
$2,625.31
|
| Rate for Payer: Cofinity Commercial |
$1,750.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.10
|
| Rate for Payer: Healthscope Commercial |
$1,831.61
|
| Rate for Payer: Healthscope Commercial |
$2,747.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,526.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,289.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,729.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.79
|
| Rate for Payer: Nomi Health Commercial |
$1,668.80
|
| Rate for Payer: Nomi Health Commercial |
$2,503.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,526.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,289.52
|
| Rate for Payer: PHP Commercial |
$2,594.79
|
| Rate for Payer: PHP Commercial |
$1,729.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,655.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,770.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,416.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,124.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,790.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,686.37
|
| Rate for Payer: UHC Core |
$1,699.33
|
| Rate for Payer: UHC Core |
$2,549.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,526.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,289.52
|
|
|
HC MR UPPER EXTREM NO JOINT WO W CON
|
Facility
|
OP
|
$2,336.68
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000020
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$411.96 |
| Max. Negotiated Rate |
$2,103.01 |
| Rate for Payer: Aetna Commercial |
$1,986.18
|
| Rate for Payer: Aetna Commercial |
$2,979.28
|
| Rate for Payer: Aetna Medicare |
$911.31
|
| Rate for Payer: Aetna Medicare |
$607.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,095.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$730.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$730.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,095.32
|
| Rate for Payer: BCBS Complete |
$432.52
|
| Rate for Payer: BCBS Complete |
$648.78
|
| Rate for Payer: BCBS MAPPO |
$584.17
|
| Rate for Payer: BCBS MAPPO |
$876.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,920.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,881.49
|
| Rate for Payer: BCN Commercial |
$2,881.49
|
| Rate for Payer: BCN Commercial |
$1,920.98
|
| Rate for Payer: BCN Medicare Advantage |
$876.26
|
| Rate for Payer: BCN Medicare Advantage |
$584.17
|
| Rate for Payer: Cash Price |
$1,869.34
|
| Rate for Payer: Cash Price |
$2,804.02
|
| Rate for Payer: Cofinity Commercial |
$2,009.54
|
| Rate for Payer: Cofinity Commercial |
$3,014.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,804.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,869.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$876.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$584.17
|
| Rate for Payer: Healthscope Commercial |
$2,103.01
|
| Rate for Payer: Healthscope Commercial |
$3,154.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,752.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,628.77
|
| Rate for Payer: Mclaren Medicaid |
$617.94
|
| Rate for Payer: Mclaren Medicaid |
$411.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$920.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$613.38
|
| Rate for Payer: Meridian Medicaid |
$432.52
|
| Rate for Payer: Meridian Medicaid |
$648.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,007.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$671.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$963.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$642.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,979.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,986.18
|
| Rate for Payer: Nomi Health Commercial |
$2,874.12
|
| Rate for Payer: Nomi Health Commercial |
$1,916.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,752.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,628.77
|
| Rate for Payer: PACE Senior Care Partners |
$832.44
|
| Rate for Payer: PACE Senior Care Partners |
$554.96
|
| Rate for Payer: PACE SWMI |
$876.26
|
| Rate for Payer: PACE SWMI |
$584.17
|
| Rate for Payer: PHP Commercial |
$1,986.18
|
| Rate for Payer: PHP Commercial |
$2,979.28
|
| Rate for Payer: PHP Medicare Advantage |
$584.17
|
| Rate for Payer: PHP Medicare Advantage |
$876.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$617.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,049.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,032.91
|
| Rate for Payer: Priority Health Medicare |
$885.02
|
| Rate for Payer: Priority Health Medicare |
$590.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,626.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,439.50
|
| Rate for Payer: Railroad Medicare Medicare |
$584.17
|
| Rate for Payer: Railroad Medicare Medicare |
$876.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,056.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,084.43
|
| Rate for Payer: UHC Core |
$2,926.70
|
| Rate for Payer: UHC Core |
$1,951.13
|
| Rate for Payer: UHC Exchange |
$876.26
|
| Rate for Payer: UHC Exchange |
$584.17
|
| Rate for Payer: UHC Medicaid |
$617.94
|
| Rate for Payer: UHC Medicaid |
$411.96
|
| Rate for Payer: UHC Medicare Advantage |
$584.17
|
| Rate for Payer: UHC Medicare Advantage |
$876.26
|
| Rate for Payer: UHCCP Medicaid |
$411.96
|
| Rate for Payer: UHCCP Medicaid |
$617.94
|
| Rate for Payer: VA VA |
$584.17
|
| Rate for Payer: VA VA |
$876.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,628.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,752.51
|
|
|
HC MR UPPER EXTREM NO JOINT WO W CON
|
Facility
|
IP
|
$2,336.68
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000020
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,626.33 |
| Max. Negotiated Rate |
$2,103.01 |
| Rate for Payer: Aetna Commercial |
$1,986.18
|
| Rate for Payer: Aetna Commercial |
$2,979.28
|
| Rate for Payer: BCBS Trust/PPO |
$1,929.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,894.80
|
| Rate for Payer: BCN Commercial |
$1,929.86
|
| Rate for Payer: BCN Commercial |
$2,894.80
|
| Rate for Payer: Cash Price |
$1,869.34
|
| Rate for Payer: Cash Price |
$2,804.02
|
| Rate for Payer: Cofinity Commercial |
$3,014.33
|
| Rate for Payer: Cofinity Commercial |
$2,009.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,804.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,869.34
|
| Rate for Payer: Healthscope Commercial |
$2,103.01
|
| Rate for Payer: Healthscope Commercial |
$3,154.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,752.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,628.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,986.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,979.28
|
| Rate for Payer: Nomi Health Commercial |
$1,916.08
|
| Rate for Payer: Nomi Health Commercial |
$2,874.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,752.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,628.77
|
| Rate for Payer: PHP Commercial |
$2,979.28
|
| Rate for Payer: PHP Commercial |
$1,986.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,049.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,032.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,626.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,439.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,056.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,084.43
|
| Rate for Payer: UHC Core |
$1,951.13
|
| Rate for Payer: UHC Core |
$2,926.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,752.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,628.77
|
|
|
HC MSMART BM CMPT1
|
Facility
|
OP
|
$293.76
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100045
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$51.79 |
| Max. Negotiated Rate |
$264.38 |
| Rate for Payer: Aetna Commercial |
$249.70
|
| Rate for Payer: Aetna Medicare |
$76.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.80
|
| Rate for Payer: BCBS Complete |
$54.37
|
| Rate for Payer: BCBS MAPPO |
$73.44
|
| Rate for Payer: BCBS Trust/PPO |
$241.50
|
| Rate for Payer: BCN Commercial |
$241.50
|
| Rate for Payer: BCN Medicare Advantage |
$73.44
|
| Rate for Payer: Cash Price |
$235.01
|
| Rate for Payer: Cofinity Commercial |
$252.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$264.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.32
|
| Rate for Payer: Mclaren Medicaid |
$51.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.11
|
| Rate for Payer: Meridian Medicaid |
$54.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.70
|
| Rate for Payer: Nomi Health Commercial |
$240.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.32
|
| Rate for Payer: PACE Senior Care Partners |
$69.77
|
| Rate for Payer: PACE SWMI |
$73.44
|
| Rate for Payer: PHP Commercial |
$249.70
|
| Rate for Payer: PHP Medicare Advantage |
$73.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$255.57
|
| Rate for Payer: Priority Health Medicare |
$74.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.46
|
| Rate for Payer: Railroad Medicare Medicare |
$73.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.51
|
| Rate for Payer: UHC Core |
$245.29
|
| Rate for Payer: UHC Exchange |
$73.44
|
| Rate for Payer: UHC Medicaid |
$51.79
|
| Rate for Payer: UHC Medicare Advantage |
$73.44
|
| Rate for Payer: UHCCP Medicaid |
$51.79
|
| Rate for Payer: VA VA |
$73.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.32
|
|
|
HC MSMART BM CMPT1
|
Facility
|
IP
|
$293.76
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100045
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$204.46 |
| Max. Negotiated Rate |
$264.38 |
| Rate for Payer: Aetna Commercial |
$249.70
|
| Rate for Payer: BCBS Trust/PPO |
$242.62
|
| Rate for Payer: BCN Commercial |
$242.62
|
| Rate for Payer: Cash Price |
$235.01
|
| Rate for Payer: Cofinity Commercial |
$252.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.01
|
| Rate for Payer: Healthscope Commercial |
$264.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.70
|
| Rate for Payer: Nomi Health Commercial |
$240.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.32
|
| Rate for Payer: PHP Commercial |
$249.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$255.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.51
|
| Rate for Payer: UHC Core |
$245.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.32
|
|
|
HC MSMART BM CMPT2
|
Facility
|
IP
|
$204.94
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100046
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$142.64 |
| Max. Negotiated Rate |
$184.45 |
| Rate for Payer: Aetna Commercial |
$174.20
|
| Rate for Payer: BCBS Trust/PPO |
$169.26
|
| Rate for Payer: BCN Commercial |
$169.26
|
| Rate for Payer: Cash Price |
$163.95
|
| Rate for Payer: Cofinity Commercial |
$176.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.95
|
| Rate for Payer: Healthscope Commercial |
$184.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.20
|
| Rate for Payer: Nomi Health Commercial |
$168.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.71
|
| Rate for Payer: PHP Commercial |
$174.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$178.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.35
|
| Rate for Payer: UHC Core |
$171.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.71
|
|
|
HC MSMART BM CMPT2
|
Facility
|
OP
|
$204.94
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100046
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$36.13 |
| Max. Negotiated Rate |
$184.45 |
| Rate for Payer: Aetna Commercial |
$174.20
|
| Rate for Payer: Aetna Medicare |
$53.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.04
|
| Rate for Payer: BCBS Complete |
$37.93
|
| Rate for Payer: BCBS MAPPO |
$51.23
|
| Rate for Payer: BCBS Trust/PPO |
$168.48
|
| Rate for Payer: BCN Commercial |
$168.48
|
| Rate for Payer: BCN Medicare Advantage |
$51.23
|
| Rate for Payer: Cash Price |
$163.95
|
| Rate for Payer: Cofinity Commercial |
$176.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.23
|
| Rate for Payer: Healthscope Commercial |
$184.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.71
|
| Rate for Payer: Mclaren Medicaid |
$36.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.80
|
| Rate for Payer: Meridian Medicaid |
$37.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.20
|
| Rate for Payer: Nomi Health Commercial |
$168.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.71
|
| Rate for Payer: PACE Senior Care Partners |
$48.67
|
| Rate for Payer: PACE SWMI |
$51.23
|
| Rate for Payer: PHP Commercial |
$174.20
|
| Rate for Payer: PHP Medicare Advantage |
$51.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$178.30
|
| Rate for Payer: Priority Health Medicare |
$51.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.64
|
| Rate for Payer: Railroad Medicare Medicare |
$51.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.35
|
| Rate for Payer: UHC Core |
$171.12
|
| Rate for Payer: UHC Exchange |
$51.23
|
| Rate for Payer: UHC Medicaid |
$36.13
|
| Rate for Payer: UHC Medicare Advantage |
$51.23
|
| Rate for Payer: UHCCP Medicaid |
$36.13
|
| Rate for Payer: VA VA |
$51.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.71
|
|
|
HC MSMART BM CMPT3
|
Facility
|
OP
|
$179.99
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100047
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$31.73 |
| Max. Negotiated Rate |
$161.99 |
| Rate for Payer: Aetna Commercial |
$152.99
|
| Rate for Payer: Aetna Medicare |
$46.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.25
|
| Rate for Payer: BCBS Complete |
$33.32
|
| Rate for Payer: BCBS MAPPO |
$45.00
|
| Rate for Payer: BCBS Trust/PPO |
$147.97
|
| Rate for Payer: BCN Commercial |
$147.97
|
| Rate for Payer: BCN Medicare Advantage |
$45.00
|
| Rate for Payer: Cash Price |
$143.99
|
| Rate for Payer: Cofinity Commercial |
$154.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.00
|
| Rate for Payer: Healthscope Commercial |
$161.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.99
|
| Rate for Payer: Mclaren Medicaid |
$31.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.25
|
| Rate for Payer: Meridian Medicaid |
$33.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.99
|
| Rate for Payer: Nomi Health Commercial |
$147.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$134.99
|
| Rate for Payer: PACE Senior Care Partners |
$42.75
|
| Rate for Payer: PACE SWMI |
$45.00
|
| Rate for Payer: PHP Commercial |
$152.99
|
| Rate for Payer: PHP Medicare Advantage |
$45.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$156.59
|
| Rate for Payer: Priority Health Medicare |
$45.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.27
|
| Rate for Payer: Railroad Medicare Medicare |
$45.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.39
|
| Rate for Payer: UHC Core |
$150.29
|
| Rate for Payer: UHC Exchange |
$45.00
|
| Rate for Payer: UHC Medicaid |
$31.73
|
| Rate for Payer: UHC Medicare Advantage |
$45.00
|
| Rate for Payer: UHCCP Medicaid |
$31.73
|
| Rate for Payer: VA VA |
$45.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.99
|
|
|
HC MSMART BM CMPT3
|
Facility
|
IP
|
$179.99
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100047
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$125.27 |
| Max. Negotiated Rate |
$161.99 |
| Rate for Payer: Aetna Commercial |
$152.99
|
| Rate for Payer: BCBS Trust/PPO |
$148.65
|
| Rate for Payer: BCN Commercial |
$148.65
|
| Rate for Payer: Cash Price |
$143.99
|
| Rate for Payer: Cofinity Commercial |
$154.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.99
|
| Rate for Payer: Healthscope Commercial |
$161.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.99
|
| Rate for Payer: Nomi Health Commercial |
$147.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$134.99
|
| Rate for Payer: PHP Commercial |
$152.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$156.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.39
|
| Rate for Payer: UHC Core |
$150.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.99
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR
|
Facility
|
IP
|
$74.61
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600293
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$51.93 |
| Max. Negotiated Rate |
$67.15 |
| Rate for Payer: Aetna Commercial |
$63.42
|
| Rate for Payer: BCBS Trust/PPO |
$61.62
|
| Rate for Payer: BCN Commercial |
$61.62
|
| Rate for Payer: Cash Price |
$59.69
|
| Rate for Payer: Cofinity Commercial |
$64.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.69
|
| Rate for Payer: Healthscope Commercial |
$67.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.42
|
| Rate for Payer: Nomi Health Commercial |
$61.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.96
|
| Rate for Payer: PHP Commercial |
$63.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.66
|
| Rate for Payer: UHC Core |
$62.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.96
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR
|
Facility
|
OP
|
$74.61
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600293
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.15 |
| Max. Negotiated Rate |
$67.15 |
| Rate for Payer: Aetna Commercial |
$63.42
|
| Rate for Payer: Aetna Medicare |
$19.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.32
|
| Rate for Payer: BCBS Complete |
$13.81
|
| Rate for Payer: BCBS MAPPO |
$18.65
|
| Rate for Payer: BCBS Trust/PPO |
$61.34
|
| Rate for Payer: BCN Commercial |
$61.34
|
| Rate for Payer: BCN Medicare Advantage |
$18.65
|
| Rate for Payer: Cash Price |
$59.69
|
| Rate for Payer: Cofinity Commercial |
$64.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.65
|
| Rate for Payer: Healthscope Commercial |
$67.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.96
|
| Rate for Payer: Mclaren Medicaid |
$13.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.59
|
| Rate for Payer: Meridian Medicaid |
$13.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.42
|
| Rate for Payer: Nomi Health Commercial |
$61.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.96
|
| Rate for Payer: PACE Senior Care Partners |
$17.72
|
| Rate for Payer: PACE SWMI |
$18.65
|
| Rate for Payer: PHP Commercial |
$63.42
|
| Rate for Payer: PHP Medicare Advantage |
$18.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$64.91
|
| Rate for Payer: Priority Health Medicare |
$18.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.93
|
| Rate for Payer: Railroad Medicare Medicare |
$18.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.66
|
| Rate for Payer: UHC Core |
$62.30
|
| Rate for Payer: UHC Exchange |
$18.65
|
| Rate for Payer: UHC Medicaid |
$13.15
|
| Rate for Payer: UHC Medicare Advantage |
$18.65
|
| Rate for Payer: UHCCP Medicaid |
$13.15
|
| Rate for Payer: VA VA |
$18.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.96
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
IP
|
$62.82
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.72 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: BCBS Trust/PPO |
$51.88
|
| Rate for Payer: BCN Commercial |
$51.88
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.28
|
| Rate for Payer: UHC Core |
$52.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
OP
|
$62.82
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: Aetna Medicare |
$16.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.63
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$15.71
|
| Rate for Payer: BCBS Trust/PPO |
$51.64
|
| Rate for Payer: BCN Commercial |
$51.64
|
| Rate for Payer: BCN Medicare Advantage |
$15.71
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.49
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PACE Senior Care Partners |
$14.92
|
| Rate for Payer: PACE SWMI |
$15.71
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: PHP Medicare Advantage |
$15.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.65
|
| Rate for Payer: Priority Health Medicare |
$15.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.72
|
| Rate for Payer: Railroad Medicare Medicare |
$15.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.28
|
| Rate for Payer: UHC Core |
$52.45
|
| Rate for Payer: UHC Exchange |
$15.71
|
| Rate for Payer: UHC Medicaid |
$11.08
|
| Rate for Payer: UHC Medicare Advantage |
$15.71
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: VA VA |
$15.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC MTHFR 2 MUTATIONS
|
Facility
|
IP
|
$517.08
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000126
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$359.89 |
| Max. Negotiated Rate |
$465.37 |
| Rate for Payer: Aetna Commercial |
$439.52
|
| Rate for Payer: BCBS Trust/PPO |
$427.06
|
| Rate for Payer: BCN Commercial |
$427.06
|
| Rate for Payer: Cash Price |
$413.66
|
| Rate for Payer: Cofinity Commercial |
$444.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.66
|
| Rate for Payer: Healthscope Commercial |
$465.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$387.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$439.52
|
| Rate for Payer: Nomi Health Commercial |
$424.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$387.81
|
| Rate for Payer: PHP Commercial |
$439.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$449.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$359.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.03
|
| Rate for Payer: UHC Core |
$431.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$387.81
|
|
|
HC MTHFR 2 MUTATIONS
|
Facility
|
OP
|
$517.08
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000126
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$91.16 |
| Max. Negotiated Rate |
$465.37 |
| Rate for Payer: Aetna Commercial |
$439.52
|
| Rate for Payer: Aetna Medicare |
$134.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$161.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$161.59
|
| Rate for Payer: BCBS Complete |
$95.71
|
| Rate for Payer: BCBS MAPPO |
$129.27
|
| Rate for Payer: BCBS Trust/PPO |
$425.09
|
| Rate for Payer: BCN Commercial |
$425.09
|
| Rate for Payer: BCN Medicare Advantage |
$129.27
|
| Rate for Payer: Cash Price |
$413.66
|
| Rate for Payer: Cofinity Commercial |
$444.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.27
|
| Rate for Payer: Healthscope Commercial |
$465.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$387.81
|
| Rate for Payer: Mclaren Medicaid |
$91.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.73
|
| Rate for Payer: Meridian Medicaid |
$95.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$142.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$439.52
|
| Rate for Payer: Nomi Health Commercial |
$424.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$387.81
|
| Rate for Payer: PACE Senior Care Partners |
$122.81
|
| Rate for Payer: PACE SWMI |
$129.27
|
| Rate for Payer: PHP Commercial |
$439.52
|
| Rate for Payer: PHP Medicare Advantage |
$129.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$449.86
|
| Rate for Payer: Priority Health Medicare |
$130.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$359.89
|
| Rate for Payer: Railroad Medicare Medicare |
$129.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.03
|
| Rate for Payer: UHC Core |
$431.76
|
| Rate for Payer: UHC Exchange |
$129.27
|
| Rate for Payer: UHC Medicaid |
$91.16
|
| Rate for Payer: UHC Medicare Advantage |
$129.27
|
| Rate for Payer: UHCCP Medicaid |
$91.16
|
| Rate for Payer: VA VA |
$129.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$387.81
|
|
|
HC MTHFR MUTATION
|
Facility
|
IP
|
$390.15
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000102
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$271.54 |
| Max. Negotiated Rate |
$351.13 |
| Rate for Payer: Aetna Commercial |
$331.63
|
| Rate for Payer: BCBS Trust/PPO |
$322.22
|
| Rate for Payer: BCN Commercial |
$322.22
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cofinity Commercial |
$335.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.12
|
| Rate for Payer: Healthscope Commercial |
$351.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.63
|
| Rate for Payer: Nomi Health Commercial |
$319.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.61
|
| Rate for Payer: PHP Commercial |
$331.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$339.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.33
|
| Rate for Payer: UHC Core |
$325.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.61
|
|
|
HC MTHFR MUTATION
|
Facility
|
OP
|
$390.15
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000102
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.78 |
| Max. Negotiated Rate |
$351.13 |
| Rate for Payer: Aetna Commercial |
$331.63
|
| Rate for Payer: Aetna Medicare |
$101.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.92
|
| Rate for Payer: BCBS Complete |
$72.22
|
| Rate for Payer: BCBS MAPPO |
$97.54
|
| Rate for Payer: BCBS Trust/PPO |
$320.74
|
| Rate for Payer: BCN Commercial |
$320.74
|
| Rate for Payer: BCN Medicare Advantage |
$97.54
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cofinity Commercial |
$335.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.54
|
| Rate for Payer: Healthscope Commercial |
$351.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.61
|
| Rate for Payer: Mclaren Medicaid |
$68.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.41
|
| Rate for Payer: Meridian Medicaid |
$72.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.63
|
| Rate for Payer: Nomi Health Commercial |
$319.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.61
|
| Rate for Payer: PACE Senior Care Partners |
$92.66
|
| Rate for Payer: PACE SWMI |
$97.54
|
| Rate for Payer: PHP Commercial |
$331.63
|
| Rate for Payer: PHP Medicare Advantage |
$97.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$339.43
|
| Rate for Payer: Priority Health Medicare |
$98.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.54
|
| Rate for Payer: Railroad Medicare Medicare |
$97.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.33
|
| Rate for Payer: UHC Core |
$325.78
|
| Rate for Payer: UHC Exchange |
$97.54
|
| Rate for Payer: UHC Medicaid |
$68.78
|
| Rate for Payer: UHC Medicare Advantage |
$97.54
|
| Rate for Payer: UHCCP Medicaid |
$68.78
|
| Rate for Payer: VA VA |
$97.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.61
|
|
|
HC M TUBERCULOSIS COMPLEX, PCR
|
Facility
|
IP
|
$201.84
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600291
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$140.48 |
| Max. Negotiated Rate |
$181.66 |
| Rate for Payer: Aetna Commercial |
$171.56
|
| Rate for Payer: BCBS Trust/PPO |
$166.70
|
| Rate for Payer: BCN Commercial |
$166.70
|
| Rate for Payer: Cash Price |
$161.47
|
| Rate for Payer: Cofinity Commercial |
$173.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.47
|
| Rate for Payer: Healthscope Commercial |
$181.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.56
|
| Rate for Payer: Nomi Health Commercial |
$165.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.38
|
| Rate for Payer: PHP Commercial |
$171.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$175.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.62
|
| Rate for Payer: UHC Core |
$168.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.38
|
|
|
HC M TUBERCULOSIS COMPLEX, PCR
|
Facility
|
OP
|
$201.84
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600291
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.58 |
| Max. Negotiated Rate |
$181.66 |
| Rate for Payer: Aetna Commercial |
$171.56
|
| Rate for Payer: Aetna Medicare |
$52.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.08
|
| Rate for Payer: BCBS Complete |
$37.36
|
| Rate for Payer: BCBS MAPPO |
$50.46
|
| Rate for Payer: BCBS Trust/PPO |
$165.93
|
| Rate for Payer: BCN Commercial |
$165.93
|
| Rate for Payer: BCN Medicare Advantage |
$50.46
|
| Rate for Payer: Cash Price |
$161.47
|
| Rate for Payer: Cofinity Commercial |
$173.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$161.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.46
|
| Rate for Payer: Healthscope Commercial |
$181.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.38
|
| Rate for Payer: Mclaren Medicaid |
$35.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.98
|
| Rate for Payer: Meridian Medicaid |
$37.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$171.56
|
| Rate for Payer: Nomi Health Commercial |
$165.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$151.38
|
| Rate for Payer: PACE Senior Care Partners |
$47.94
|
| Rate for Payer: PACE SWMI |
$50.46
|
| Rate for Payer: PHP Commercial |
$171.56
|
| Rate for Payer: PHP Medicare Advantage |
$50.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$175.60
|
| Rate for Payer: Priority Health Medicare |
$50.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$140.48
|
| Rate for Payer: Railroad Medicare Medicare |
$50.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$177.62
|
| Rate for Payer: UHC Core |
$168.54
|
| Rate for Payer: UHC Exchange |
$50.46
|
| Rate for Payer: UHC Medicaid |
$35.58
|
| Rate for Payer: UHC Medicare Advantage |
$50.46
|
| Rate for Payer: UHCCP Medicaid |
$35.58
|
| Rate for Payer: VA VA |
$50.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.38
|
|
|
HC MUCORE RACEMOSUS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200093
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC MUCORE RACEMOSUS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200093
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
