|
HC LEUK/LYMPH IMMUNOPHENO CMPT D
|
Facility
|
IP
|
$54.83
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000010
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.64 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Aetna Commercial |
$46.61
|
| Rate for Payer: BCBS Trust/PPO |
$44.76
|
| Rate for Payer: BCN Commercial |
$42.37
|
| Rate for Payer: Cash Price |
$43.86
|
| Rate for Payer: Cofinity Commercial |
$47.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.86
|
| Rate for Payer: Healthscope Commercial |
$49.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.61
|
| Rate for Payer: Nomi Health Commercial |
$44.96
|
| Rate for Payer: PHP Commercial |
$46.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.64
|
| Rate for Payer: Priority Health HMO/PPO |
$47.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.25
|
| Rate for Payer: UHC Core |
$45.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.12
|
|
|
HC LEUK/LYMPH IMMUNOPHENO CMPT D
|
Facility
|
OP
|
$54.83
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000010
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$13.02 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Aetna Commercial |
$46.61
|
| Rate for Payer: Aetna Medicare |
$14.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.13
|
| Rate for Payer: BCBS Complete |
$21.93
|
| Rate for Payer: BCBS MAPPO |
$13.71
|
| Rate for Payer: BCBS Trust/PPO |
$45.08
|
| Rate for Payer: BCN Commercial |
$42.63
|
| Rate for Payer: BCN Medicare Advantage |
$13.71
|
| Rate for Payer: Cash Price |
$43.86
|
| Rate for Payer: Cofinity Commercial |
$47.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.71
|
| Rate for Payer: Healthscope Commercial |
$49.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.61
|
| Rate for Payer: Nomi Health Commercial |
$44.96
|
| Rate for Payer: PACE Senior Care Partners |
$13.02
|
| Rate for Payer: PACE SWMI |
$13.71
|
| Rate for Payer: PHP Commercial |
$46.61
|
| Rate for Payer: PHP Medicare Advantage |
$13.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.64
|
| Rate for Payer: Priority Health HMO/PPO |
$47.70
|
| Rate for Payer: Priority Health Medicare |
$13.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.74
|
| Rate for Payer: Railroad Medicare Medicare |
$13.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.25
|
| Rate for Payer: UHC Core |
$45.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.71
|
| Rate for Payer: UHC Exchange |
$13.71
|
| Rate for Payer: UHC Medicare Advantage |
$13.71
|
| Rate for Payer: VA VA |
$13.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.12
|
|
|
HC LEUK LYMPHOMA IMMUNOPHEN TISSUE
|
Facility
|
OP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100015
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$12.41 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna Medicare |
$13.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.32
|
| Rate for Payer: BCBS Complete |
$20.90
|
| Rate for Payer: BCBS MAPPO |
$13.06
|
| Rate for Payer: BCBS Trust/PPO |
$42.95
|
| Rate for Payer: BCN Commercial |
$40.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.06
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.06
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: Nomi Health Commercial |
$42.84
|
| Rate for Payer: PACE Senior Care Partners |
$12.41
|
| Rate for Payer: PACE SWMI |
$13.06
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: PHP Medicare Advantage |
$13.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health HMO/PPO |
$45.45
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.00
|
| Rate for Payer: Railroad Medicare Medicare |
$13.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.97
|
| Rate for Payer: UHC Core |
$43.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.06
|
| Rate for Payer: UHC Exchange |
$13.06
|
| Rate for Payer: UHC Medicare Advantage |
$13.06
|
| Rate for Payer: VA VA |
$13.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC LEUK LYMPHOMA IMMUNOPHEN TISSUE
|
Facility
|
IP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100015
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: BCBS Trust/PPO |
$42.64
|
| Rate for Payer: BCN Commercial |
$40.37
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: Nomi Health Commercial |
$42.84
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health HMO/PPO |
$45.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.97
|
| Rate for Payer: UHC Core |
$43.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC LEUKOTRIENE E4, U
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100715
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.42 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna Medicare |
$67.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.28
|
| Rate for Payer: BCBS Complete |
$18.29
|
| Rate for Payer: BCBS MAPPO |
$65.03
|
| Rate for Payer: BCBS Trust/PPO |
$213.83
|
| Rate for Payer: BCN Commercial |
$202.23
|
| Rate for Payer: BCN Medicare Advantage |
$65.03
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.03
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Mclaren Medicaid |
$17.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.28
|
| Rate for Payer: Meridian Medicaid |
$18.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: PACE Senior Care Partners |
$61.77
|
| Rate for Payer: PACE SWMI |
$65.03
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: PHP Medicare Advantage |
$65.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health HMO/PPO |
$226.29
|
| Rate for Payer: Priority Health Medicare |
$65.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.27
|
| Rate for Payer: Railroad Medicare Medicare |
$65.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.03
|
| Rate for Payer: UHC Exchange |
$65.03
|
| Rate for Payer: UHC Medicare Advantage |
$65.03
|
| Rate for Payer: UHCCP Medicaid |
$17.42
|
| Rate for Payer: VA VA |
$65.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC LEUKOTRIENE E4, U
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100715
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$169.06 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: BCBS Trust/PPO |
$212.32
|
| Rate for Payer: BCN Commercial |
$201.01
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health HMO/PPO |
$226.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$174.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC LEUPROLIDE ACETATE 3.75MG
|
Facility
|
OP
|
$1,031.14
|
|
|
Service Code
|
HCPCS J1950
|
| Hospital Charge Code |
63600142
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$244.90 |
| Max. Negotiated Rate |
$1,313.66 |
| Rate for Payer: Aetna Commercial |
$876.47
|
| Rate for Payer: Aetna Medicare |
$268.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$322.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$322.23
|
| Rate for Payer: BCBS Complete |
$1,313.66
|
| Rate for Payer: BCBS MAPPO |
$257.79
|
| Rate for Payer: BCBS Trust/PPO |
$847.70
|
| Rate for Payer: BCN Commercial |
$801.71
|
| Rate for Payer: BCN Medicare Advantage |
$257.79
|
| Rate for Payer: Cash Price |
$824.91
|
| Rate for Payer: Cash Price |
$824.91
|
| Rate for Payer: Cofinity Commercial |
$886.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$824.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.79
|
| Rate for Payer: Healthscope Commercial |
$928.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.36
|
| Rate for Payer: Mclaren Medicaid |
$1,251.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.67
|
| Rate for Payer: Meridian Medicaid |
$1,313.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.47
|
| Rate for Payer: Nomi Health Commercial |
$845.53
|
| Rate for Payer: PACE Senior Care Partners |
$244.90
|
| Rate for Payer: PACE SWMI |
$257.79
|
| Rate for Payer: PHP Commercial |
$876.47
|
| Rate for Payer: PHP Medicare Advantage |
$257.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,251.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.24
|
| Rate for Payer: Priority Health HMO/PPO |
$897.09
|
| Rate for Payer: Priority Health Medicare |
$260.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$690.86
|
| Rate for Payer: Railroad Medicare Medicare |
$257.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$907.40
|
| Rate for Payer: UHC Core |
$861.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.79
|
| Rate for Payer: UHC Exchange |
$257.79
|
| Rate for Payer: UHC Medicare Advantage |
$257.79
|
| Rate for Payer: UHCCP Medicaid |
$1,251.02
|
| Rate for Payer: VA VA |
$257.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.36
|
|
|
HC LEUPROLIDE ACETATE 3.75MG
|
Facility
|
IP
|
$1,031.14
|
|
|
Service Code
|
HCPCS J1950
|
| Hospital Charge Code |
63600142
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$670.24 |
| Max. Negotiated Rate |
$928.03 |
| Rate for Payer: Aetna Commercial |
$876.47
|
| Rate for Payer: BCBS Trust/PPO |
$841.72
|
| Rate for Payer: BCN Commercial |
$796.86
|
| Rate for Payer: Cash Price |
$824.91
|
| Rate for Payer: Cofinity Commercial |
$886.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$824.91
|
| Rate for Payer: Healthscope Commercial |
$928.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.47
|
| Rate for Payer: Nomi Health Commercial |
$845.53
|
| Rate for Payer: PHP Commercial |
$876.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$670.24
|
| Rate for Payer: Priority Health HMO/PPO |
$897.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$690.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$907.40
|
| Rate for Payer: UHC Core |
$861.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.36
|
|
|
HC LEUPROLIDE ACETATE SUSPNSION/ 7.5MG
|
Facility
|
OP
|
$461.04
|
|
|
Service Code
|
HCPCS J9217
|
| Hospital Charge Code |
63600147
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$109.50 |
| Max. Negotiated Rate |
$414.94 |
| Rate for Payer: Aetna Commercial |
$391.88
|
| Rate for Payer: Aetna Medicare |
$119.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$144.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$144.07
|
| Rate for Payer: BCBS Complete |
$133.96
|
| Rate for Payer: BCBS MAPPO |
$115.26
|
| Rate for Payer: BCBS Trust/PPO |
$379.02
|
| Rate for Payer: BCN Commercial |
$358.46
|
| Rate for Payer: BCN Medicare Advantage |
$115.26
|
| Rate for Payer: Cash Price |
$368.83
|
| Rate for Payer: Cash Price |
$368.83
|
| Rate for Payer: Cofinity Commercial |
$396.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.26
|
| Rate for Payer: Healthscope Commercial |
$414.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.78
|
| Rate for Payer: Mclaren Medicaid |
$127.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.02
|
| Rate for Payer: Meridian Medicaid |
$133.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.88
|
| Rate for Payer: Nomi Health Commercial |
$378.05
|
| Rate for Payer: PACE Senior Care Partners |
$109.50
|
| Rate for Payer: PACE SWMI |
$115.26
|
| Rate for Payer: PHP Commercial |
$391.88
|
| Rate for Payer: PHP Medicare Advantage |
$115.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.68
|
| Rate for Payer: Priority Health HMO/PPO |
$401.10
|
| Rate for Payer: Priority Health Medicare |
$116.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$308.90
|
| Rate for Payer: Railroad Medicare Medicare |
$115.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.72
|
| Rate for Payer: UHC Core |
$384.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.26
|
| Rate for Payer: UHC Exchange |
$115.26
|
| Rate for Payer: UHC Medicare Advantage |
$115.26
|
| Rate for Payer: UHCCP Medicaid |
$127.57
|
| Rate for Payer: VA VA |
$115.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.78
|
|
|
HC LEUPROLIDE ACETATE SUSPNSION/ 7.5MG
|
Facility
|
IP
|
$461.04
|
|
|
Service Code
|
HCPCS J9217
|
| Hospital Charge Code |
63600147
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$299.68 |
| Max. Negotiated Rate |
$414.94 |
| Rate for Payer: Aetna Commercial |
$391.88
|
| Rate for Payer: BCBS Trust/PPO |
$376.35
|
| Rate for Payer: BCN Commercial |
$356.29
|
| Rate for Payer: Cash Price |
$368.83
|
| Rate for Payer: Cofinity Commercial |
$396.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.83
|
| Rate for Payer: Healthscope Commercial |
$414.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.88
|
| Rate for Payer: Nomi Health Commercial |
$378.05
|
| Rate for Payer: PHP Commercial |
$391.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$299.68
|
| Rate for Payer: Priority Health HMO/PPO |
$401.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$308.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.72
|
| Rate for Payer: UHC Core |
$384.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.78
|
|
|
HC LEVEL 0.5 INIT 30 MIN
|
Facility
|
IP
|
$939.78
|
|
| Hospital Charge Code |
36000060
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$610.86 |
| Max. Negotiated Rate |
$845.80 |
| Rate for Payer: Aetna Commercial |
$798.81
|
| Rate for Payer: BCBS Trust/PPO |
$767.14
|
| Rate for Payer: BCN Commercial |
$726.26
|
| Rate for Payer: Cash Price |
$751.82
|
| Rate for Payer: Cofinity Commercial |
$808.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$751.82
|
| Rate for Payer: Healthscope Commercial |
$845.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$704.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$798.81
|
| Rate for Payer: Nomi Health Commercial |
$770.62
|
| Rate for Payer: PHP Commercial |
$798.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$610.86
|
| Rate for Payer: Priority Health HMO/PPO |
$817.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$629.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$827.01
|
| Rate for Payer: UHC Core |
$784.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$704.84
|
|
|
HC LEVEL 0.5 INIT 30 MIN
|
Facility
|
OP
|
$939.78
|
|
| Hospital Charge Code |
36000060
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$223.20 |
| Max. Negotiated Rate |
$845.80 |
| Rate for Payer: Aetna Commercial |
$798.81
|
| Rate for Payer: Aetna Medicare |
$244.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.68
|
| Rate for Payer: BCBS Complete |
$375.91
|
| Rate for Payer: BCBS MAPPO |
$234.94
|
| Rate for Payer: BCBS Trust/PPO |
$772.59
|
| Rate for Payer: BCN Commercial |
$730.68
|
| Rate for Payer: BCN Medicare Advantage |
$234.94
|
| Rate for Payer: Cash Price |
$751.82
|
| Rate for Payer: Cofinity Commercial |
$808.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$751.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$234.94
|
| Rate for Payer: Healthscope Commercial |
$845.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$704.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$798.81
|
| Rate for Payer: Nomi Health Commercial |
$770.62
|
| Rate for Payer: PACE Senior Care Partners |
$223.20
|
| Rate for Payer: PACE SWMI |
$234.94
|
| Rate for Payer: PHP Commercial |
$798.81
|
| Rate for Payer: PHP Medicare Advantage |
$234.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$610.86
|
| Rate for Payer: Priority Health HMO/PPO |
$817.61
|
| Rate for Payer: Priority Health Medicare |
$237.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$629.65
|
| Rate for Payer: Railroad Medicare Medicare |
$234.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$827.01
|
| Rate for Payer: UHC Core |
$784.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$234.94
|
| Rate for Payer: UHC Exchange |
$234.94
|
| Rate for Payer: UHC Medicare Advantage |
$234.94
|
| Rate for Payer: VA VA |
$234.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$704.84
|
|
|
HC LEVEL 0.5 SUBSQ 15 MIN
|
Facility
|
OP
|
$270.72
|
|
| Hospital Charge Code |
36000061
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$64.30 |
| Max. Negotiated Rate |
$243.65 |
| Rate for Payer: Aetna Commercial |
$230.11
|
| Rate for Payer: Aetna Medicare |
$70.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.60
|
| Rate for Payer: BCBS Complete |
$108.29
|
| Rate for Payer: BCBS MAPPO |
$67.68
|
| Rate for Payer: BCBS Trust/PPO |
$222.56
|
| Rate for Payer: BCN Commercial |
$210.48
|
| Rate for Payer: BCN Medicare Advantage |
$67.68
|
| Rate for Payer: Cash Price |
$216.58
|
| Rate for Payer: Cofinity Commercial |
$232.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.68
|
| Rate for Payer: Healthscope Commercial |
$243.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.11
|
| Rate for Payer: Nomi Health Commercial |
$221.99
|
| Rate for Payer: PACE Senior Care Partners |
$64.30
|
| Rate for Payer: PACE SWMI |
$67.68
|
| Rate for Payer: PHP Commercial |
$230.11
|
| Rate for Payer: PHP Medicare Advantage |
$67.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.97
|
| Rate for Payer: Priority Health HMO/PPO |
$235.53
|
| Rate for Payer: Priority Health Medicare |
$68.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.38
|
| Rate for Payer: Railroad Medicare Medicare |
$67.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.23
|
| Rate for Payer: UHC Core |
$226.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.68
|
| Rate for Payer: UHC Exchange |
$67.68
|
| Rate for Payer: UHC Medicare Advantage |
$67.68
|
| Rate for Payer: VA VA |
$67.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.04
|
|
|
HC LEVEL 0.5 SUBSQ 15 MIN
|
Facility
|
IP
|
$270.72
|
|
| Hospital Charge Code |
36000061
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$175.97 |
| Max. Negotiated Rate |
$243.65 |
| Rate for Payer: Aetna Commercial |
$230.11
|
| Rate for Payer: BCBS Trust/PPO |
$220.99
|
| Rate for Payer: BCN Commercial |
$209.21
|
| Rate for Payer: Cash Price |
$216.58
|
| Rate for Payer: Cofinity Commercial |
$232.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.58
|
| Rate for Payer: Healthscope Commercial |
$243.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.11
|
| Rate for Payer: Nomi Health Commercial |
$221.99
|
| Rate for Payer: PHP Commercial |
$230.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.97
|
| Rate for Payer: Priority Health HMO/PPO |
$235.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.23
|
| Rate for Payer: UHC Core |
$226.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.04
|
|
|
HC LEVEL 1 INIT 30 MIN
|
Facility
|
OP
|
$2,074.72
|
|
| Hospital Charge Code |
36000062
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$492.75 |
| Max. Negotiated Rate |
$1,867.25 |
| Rate for Payer: Aetna Commercial |
$1,763.51
|
| Rate for Payer: Aetna Medicare |
$539.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$648.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$648.35
|
| Rate for Payer: BCBS Complete |
$829.89
|
| Rate for Payer: BCBS MAPPO |
$518.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,705.63
|
| Rate for Payer: BCN Commercial |
$1,613.09
|
| Rate for Payer: BCN Medicare Advantage |
$518.68
|
| Rate for Payer: Cash Price |
$1,659.78
|
| Rate for Payer: Cofinity Commercial |
$1,784.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$518.68
|
| Rate for Payer: Healthscope Commercial |
$1,867.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,556.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$544.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$596.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.51
|
| Rate for Payer: Nomi Health Commercial |
$1,701.27
|
| Rate for Payer: PACE Senior Care Partners |
$492.75
|
| Rate for Payer: PACE SWMI |
$518.68
|
| Rate for Payer: PHP Commercial |
$1,763.51
|
| Rate for Payer: PHP Medicare Advantage |
$518.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.57
|
| Rate for Payer: Priority Health HMO/PPO |
$1,805.01
|
| Rate for Payer: Priority Health Medicare |
$523.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,390.06
|
| Rate for Payer: Railroad Medicare Medicare |
$518.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,825.75
|
| Rate for Payer: UHC Core |
$1,732.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$518.68
|
| Rate for Payer: UHC Exchange |
$518.68
|
| Rate for Payer: UHC Medicare Advantage |
$518.68
|
| Rate for Payer: VA VA |
$518.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,556.04
|
|
|
HC LEVEL 1 INIT 30 MIN
|
Facility
|
IP
|
$2,074.72
|
|
| Hospital Charge Code |
36000062
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,348.57 |
| Max. Negotiated Rate |
$1,867.25 |
| Rate for Payer: Aetna Commercial |
$1,763.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,693.59
|
| Rate for Payer: BCN Commercial |
$1,603.34
|
| Rate for Payer: Cash Price |
$1,659.78
|
| Rate for Payer: Cofinity Commercial |
$1,784.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.78
|
| Rate for Payer: Healthscope Commercial |
$1,867.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,556.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.51
|
| Rate for Payer: Nomi Health Commercial |
$1,701.27
|
| Rate for Payer: PHP Commercial |
$1,763.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.57
|
| Rate for Payer: Priority Health HMO/PPO |
$1,805.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,390.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,825.75
|
| Rate for Payer: UHC Core |
$1,732.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,556.04
|
|
|
HC LEVEL 1 SUBSQ 15 MIN
|
Facility
|
IP
|
$412.97
|
|
| Hospital Charge Code |
36000063
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$268.43 |
| Max. Negotiated Rate |
$371.67 |
| Rate for Payer: Aetna Commercial |
$351.02
|
| Rate for Payer: BCBS Trust/PPO |
$337.11
|
| Rate for Payer: BCN Commercial |
$319.14
|
| Rate for Payer: Cash Price |
$330.38
|
| Rate for Payer: Cofinity Commercial |
$355.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.38
|
| Rate for Payer: Healthscope Commercial |
$371.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.02
|
| Rate for Payer: Nomi Health Commercial |
$338.64
|
| Rate for Payer: PHP Commercial |
$351.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.43
|
| Rate for Payer: Priority Health HMO/PPO |
$359.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$276.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.41
|
| Rate for Payer: UHC Core |
$344.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.73
|
|
|
HC LEVEL 1 SUBSQ 15 MIN
|
Facility
|
OP
|
$412.97
|
|
| Hospital Charge Code |
36000063
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$98.08 |
| Max. Negotiated Rate |
$371.67 |
| Rate for Payer: Aetna Commercial |
$351.02
|
| Rate for Payer: Aetna Medicare |
$107.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.05
|
| Rate for Payer: BCBS Complete |
$165.19
|
| Rate for Payer: BCBS MAPPO |
$103.24
|
| Rate for Payer: BCBS Trust/PPO |
$339.50
|
| Rate for Payer: BCN Commercial |
$321.08
|
| Rate for Payer: BCN Medicare Advantage |
$103.24
|
| Rate for Payer: Cash Price |
$330.38
|
| Rate for Payer: Cofinity Commercial |
$355.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.24
|
| Rate for Payer: Healthscope Commercial |
$371.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$351.02
|
| Rate for Payer: Nomi Health Commercial |
$338.64
|
| Rate for Payer: PACE Senior Care Partners |
$98.08
|
| Rate for Payer: PACE SWMI |
$103.24
|
| Rate for Payer: PHP Commercial |
$351.02
|
| Rate for Payer: PHP Medicare Advantage |
$103.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.43
|
| Rate for Payer: Priority Health HMO/PPO |
$359.28
|
| Rate for Payer: Priority Health Medicare |
$104.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$276.69
|
| Rate for Payer: Railroad Medicare Medicare |
$103.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.41
|
| Rate for Payer: UHC Core |
$344.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.24
|
| Rate for Payer: UHC Exchange |
$103.24
|
| Rate for Payer: UHC Medicare Advantage |
$103.24
|
| Rate for Payer: VA VA |
$103.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.73
|
|
|
HC LEVEL 2 INIT 30 MIN
|
Facility
|
IP
|
$3,226.85
|
|
| Hospital Charge Code |
36000064
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,097.45 |
| Max. Negotiated Rate |
$2,904.16 |
| Rate for Payer: Aetna Commercial |
$2,742.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,634.08
|
| Rate for Payer: BCN Commercial |
$2,493.71
|
| Rate for Payer: Cash Price |
$2,581.48
|
| Rate for Payer: Cofinity Commercial |
$2,775.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,581.48
|
| Rate for Payer: Healthscope Commercial |
$2,904.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,420.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,742.82
|
| Rate for Payer: Nomi Health Commercial |
$2,646.02
|
| Rate for Payer: PHP Commercial |
$2,742.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,097.45
|
| Rate for Payer: Priority Health HMO/PPO |
$2,807.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,161.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,839.63
|
| Rate for Payer: UHC Core |
$2,694.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,420.14
|
|
|
HC LEVEL 2 INIT 30 MIN
|
Facility
|
OP
|
$3,226.85
|
|
| Hospital Charge Code |
36000064
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$766.38 |
| Max. Negotiated Rate |
$2,904.16 |
| Rate for Payer: Aetna Commercial |
$2,742.82
|
| Rate for Payer: Aetna Medicare |
$838.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,008.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,008.39
|
| Rate for Payer: BCBS Complete |
$1,290.74
|
| Rate for Payer: BCBS MAPPO |
$806.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,652.79
|
| Rate for Payer: BCN Commercial |
$2,508.88
|
| Rate for Payer: BCN Medicare Advantage |
$806.71
|
| Rate for Payer: Cash Price |
$2,581.48
|
| Rate for Payer: Cofinity Commercial |
$2,775.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,581.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$806.71
|
| Rate for Payer: Healthscope Commercial |
$2,904.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,420.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$847.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$927.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,742.82
|
| Rate for Payer: Nomi Health Commercial |
$2,646.02
|
| Rate for Payer: PACE Senior Care Partners |
$766.38
|
| Rate for Payer: PACE SWMI |
$806.71
|
| Rate for Payer: PHP Commercial |
$2,742.82
|
| Rate for Payer: PHP Medicare Advantage |
$806.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,097.45
|
| Rate for Payer: Priority Health HMO/PPO |
$2,807.36
|
| Rate for Payer: Priority Health Medicare |
$814.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,161.99
|
| Rate for Payer: Railroad Medicare Medicare |
$806.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,839.63
|
| Rate for Payer: UHC Core |
$2,694.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$806.71
|
| Rate for Payer: UHC Exchange |
$806.71
|
| Rate for Payer: UHC Medicare Advantage |
$806.71
|
| Rate for Payer: VA VA |
$806.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,420.14
|
|
|
HC LEVEL 2 SUBSQ 15 MIN
|
Facility
|
OP
|
$1,237.94
|
|
| Hospital Charge Code |
36000065
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$294.01 |
| Max. Negotiated Rate |
$1,114.15 |
| Rate for Payer: Aetna Commercial |
$1,052.25
|
| Rate for Payer: Aetna Medicare |
$321.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$386.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$386.86
|
| Rate for Payer: BCBS Complete |
$495.18
|
| Rate for Payer: BCBS MAPPO |
$309.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,017.71
|
| Rate for Payer: BCN Commercial |
$962.50
|
| Rate for Payer: BCN Medicare Advantage |
$309.49
|
| Rate for Payer: Cash Price |
$990.35
|
| Rate for Payer: Cofinity Commercial |
$1,064.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$990.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.49
|
| Rate for Payer: Healthscope Commercial |
$1,114.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$928.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$355.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,052.25
|
| Rate for Payer: Nomi Health Commercial |
$1,015.11
|
| Rate for Payer: PACE Senior Care Partners |
$294.01
|
| Rate for Payer: PACE SWMI |
$309.49
|
| Rate for Payer: PHP Commercial |
$1,052.25
|
| Rate for Payer: PHP Medicare Advantage |
$309.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$804.66
|
| Rate for Payer: Priority Health HMO/PPO |
$1,077.01
|
| Rate for Payer: Priority Health Medicare |
$312.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$829.42
|
| Rate for Payer: Railroad Medicare Medicare |
$309.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,089.39
|
| Rate for Payer: UHC Core |
$1,033.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$309.49
|
| Rate for Payer: UHC Exchange |
$309.49
|
| Rate for Payer: UHC Medicare Advantage |
$309.49
|
| Rate for Payer: VA VA |
$309.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$928.46
|
|
|
HC LEVEL 2 SUBSQ 15 MIN
|
Facility
|
IP
|
$1,237.94
|
|
| Hospital Charge Code |
36000065
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$804.66 |
| Max. Negotiated Rate |
$1,114.15 |
| Rate for Payer: Aetna Commercial |
$1,052.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,010.53
|
| Rate for Payer: BCN Commercial |
$956.68
|
| Rate for Payer: Cash Price |
$990.35
|
| Rate for Payer: Cofinity Commercial |
$1,064.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$990.35
|
| Rate for Payer: Healthscope Commercial |
$1,114.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$928.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,052.25
|
| Rate for Payer: Nomi Health Commercial |
$1,015.11
|
| Rate for Payer: PHP Commercial |
$1,052.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$804.66
|
| Rate for Payer: Priority Health HMO/PPO |
$1,077.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$829.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,089.39
|
| Rate for Payer: UHC Core |
$1,033.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$928.46
|
|
|
HC LEVEL 3 INIT 30 MIN
|
Facility
|
OP
|
$3,827.33
|
|
| Hospital Charge Code |
36000066
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$908.99 |
| Max. Negotiated Rate |
$3,444.60 |
| Rate for Payer: Aetna Commercial |
$3,253.23
|
| Rate for Payer: Aetna Medicare |
$995.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,196.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,196.04
|
| Rate for Payer: BCBS Complete |
$1,530.93
|
| Rate for Payer: BCBS MAPPO |
$956.83
|
| Rate for Payer: BCBS Trust/PPO |
$3,146.45
|
| Rate for Payer: BCN Commercial |
$2,975.75
|
| Rate for Payer: BCN Medicare Advantage |
$956.83
|
| Rate for Payer: Cash Price |
$3,061.86
|
| Rate for Payer: Cofinity Commercial |
$3,291.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,061.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$956.83
|
| Rate for Payer: Healthscope Commercial |
$3,444.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,870.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,004.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,100.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,253.23
|
| Rate for Payer: Nomi Health Commercial |
$3,138.41
|
| Rate for Payer: PACE Senior Care Partners |
$908.99
|
| Rate for Payer: PACE SWMI |
$956.83
|
| Rate for Payer: PHP Commercial |
$3,253.23
|
| Rate for Payer: PHP Medicare Advantage |
$956.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,487.76
|
| Rate for Payer: Priority Health HMO/PPO |
$3,329.78
|
| Rate for Payer: Priority Health Medicare |
$966.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,564.31
|
| Rate for Payer: Railroad Medicare Medicare |
$956.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,368.05
|
| Rate for Payer: UHC Core |
$3,195.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$956.83
|
| Rate for Payer: UHC Exchange |
$956.83
|
| Rate for Payer: UHC Medicare Advantage |
$956.83
|
| Rate for Payer: VA VA |
$956.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,870.50
|
|
|
HC LEVEL 3 INIT 30 MIN
|
Facility
|
IP
|
$3,827.33
|
|
| Hospital Charge Code |
36000066
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,487.76 |
| Max. Negotiated Rate |
$3,444.60 |
| Rate for Payer: Aetna Commercial |
$3,253.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,124.25
|
| Rate for Payer: BCN Commercial |
$2,957.76
|
| Rate for Payer: Cash Price |
$3,061.86
|
| Rate for Payer: Cofinity Commercial |
$3,291.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,061.86
|
| Rate for Payer: Healthscope Commercial |
$3,444.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,870.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,253.23
|
| Rate for Payer: Nomi Health Commercial |
$3,138.41
|
| Rate for Payer: PHP Commercial |
$3,253.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,487.76
|
| Rate for Payer: Priority Health HMO/PPO |
$3,329.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,564.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,368.05
|
| Rate for Payer: UHC Core |
$3,195.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,870.50
|
|
|
HC LEVEL 3 SUBSQ 15 MIN
|
Facility
|
OP
|
$1,487.89
|
|
| Hospital Charge Code |
36000067
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$353.37 |
| Max. Negotiated Rate |
$1,339.10 |
| Rate for Payer: Aetna Commercial |
$1,264.71
|
| Rate for Payer: Aetna Medicare |
$386.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.97
|
| Rate for Payer: BCBS Complete |
$595.16
|
| Rate for Payer: BCBS MAPPO |
$371.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,223.19
|
| Rate for Payer: BCN Commercial |
$1,156.83
|
| Rate for Payer: BCN Medicare Advantage |
$371.97
|
| Rate for Payer: Cash Price |
$1,190.31
|
| Rate for Payer: Cofinity Commercial |
$1,279.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,190.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.97
|
| Rate for Payer: Healthscope Commercial |
$1,339.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,115.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,264.71
|
| Rate for Payer: Nomi Health Commercial |
$1,220.07
|
| Rate for Payer: PACE Senior Care Partners |
$353.37
|
| Rate for Payer: PACE SWMI |
$371.97
|
| Rate for Payer: PHP Commercial |
$1,264.71
|
| Rate for Payer: PHP Medicare Advantage |
$371.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$967.13
|
| Rate for Payer: Priority Health HMO/PPO |
$1,294.46
|
| Rate for Payer: Priority Health Medicare |
$375.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$996.89
|
| Rate for Payer: Railroad Medicare Medicare |
$371.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,309.34
|
| Rate for Payer: UHC Core |
$1,242.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$371.97
|
| Rate for Payer: UHC Exchange |
$371.97
|
| Rate for Payer: UHC Medicare Advantage |
$371.97
|
| Rate for Payer: VA VA |
$371.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,115.92
|
|
