|
HC SICKLE CELL CMS F/U
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51500011
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$29.69 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: Aetna Medicare |
$32.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.06
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS MAPPO |
$31.25
|
| Rate for Payer: BCBS Trust/PPO |
$97.19
|
| Rate for Payer: BCCCP Commercial |
$72.85
|
| Rate for Payer: BCN Commercial |
$97.19
|
| Rate for Payer: BCN Medicare Advantage |
$31.25
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.25
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.25
|
| Rate for Payer: PACE Senior Care Partners |
$29.69
|
| Rate for Payer: PACE SWMI |
$31.25
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: PHP Medicare Advantage |
$31.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.75
|
| Rate for Payer: Priority Health Medicare |
$31.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.24
|
| Rate for Payer: Railroad Medicare Medicare |
$31.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.00
|
| Rate for Payer: UHC Core |
$104.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.25
|
| Rate for Payer: UHC Medicare Advantage |
$32.19
|
| Rate for Payer: VA VA |
$31.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.75
|
|
|
HC SICKLE CELL CMS INITIAL COMP
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500009
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$106.88 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna Commercial |
$382.50
|
| Rate for Payer: Aetna Medicare |
$117.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$140.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$140.62
|
| Rate for Payer: BCBS Complete |
$180.00
|
| Rate for Payer: BCBS MAPPO |
$112.50
|
| Rate for Payer: BCBS Trust/PPO |
$349.88
|
| Rate for Payer: BCN Commercial |
$349.88
|
| Rate for Payer: BCN Medicare Advantage |
$112.50
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$387.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.50
|
| Rate for Payer: Healthscope Commercial |
$405.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$118.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$382.50
|
| Rate for Payer: PACE Senior Care Partners |
$106.88
|
| Rate for Payer: PACE SWMI |
$112.50
|
| Rate for Payer: PHP Commercial |
$382.50
|
| Rate for Payer: PHP Medicare Advantage |
$112.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$391.50
|
| Rate for Payer: Priority Health Medicare |
$112.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.46
|
| Rate for Payer: Railroad Medicare Medicare |
$112.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.00
|
| Rate for Payer: UHC Core |
$375.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.50
|
| Rate for Payer: UHC Medicare Advantage |
$115.88
|
| Rate for Payer: VA VA |
$112.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.50
|
|
|
HC SICKLE CELL CMS INITIAL COMP
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500009
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$274.46 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna Commercial |
$382.50
|
| Rate for Payer: BCBS Trust/PPO |
$347.76
|
| Rate for Payer: BCN Commercial |
$347.76
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$387.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Healthscope Commercial |
$405.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$382.50
|
| Rate for Payer: PHP Commercial |
$382.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$391.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$274.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.00
|
| Rate for Payer: UHC Core |
$375.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.50
|
|
|
HC SICKLE CELL CMS SUPP/SERV
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51500012
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$45.74 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$57.96
|
| Rate for Payer: BCN Commercial |
$57.96
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC SICKLE CELL CMS SUPP/SERV
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51500012
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$17.81 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.44
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCBS MAPPO |
$18.75
|
| Rate for Payer: BCBS Trust/PPO |
$58.31
|
| Rate for Payer: BCCCP Commercial |
$22.00
|
| Rate for Payer: BCN Commercial |
$58.31
|
| Rate for Payer: BCN Medicare Advantage |
$18.75
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.75
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.75
|
| Rate for Payer: PACE Senior Care Partners |
$17.81
|
| Rate for Payer: PACE SWMI |
$18.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: PHP Medicare Advantage |
$18.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.25
|
| Rate for Payer: Priority Health Medicare |
$18.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.74
|
| Rate for Payer: Railroad Medicare Medicare |
$18.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.75
|
| Rate for Payer: UHC Medicare Advantage |
$19.31
|
| Rate for Payer: VA VA |
$18.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC SICKLE CELLS CMS COMP
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500010
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$182.97 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: BCBS Trust/PPO |
$231.84
|
| Rate for Payer: BCN Commercial |
$231.84
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$255.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.00
|
| Rate for Payer: UHC Core |
$250.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.00
|
|
|
HC SICKLE CELLS CMS COMP
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500010
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$71.25 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: Aetna Medicare |
$78.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.75
|
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: BCBS MAPPO |
$75.00
|
| Rate for Payer: BCBS Trust/PPO |
$233.25
|
| Rate for Payer: BCN Commercial |
$233.25
|
| Rate for Payer: BCN Medicare Advantage |
$75.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$255.00
|
| Rate for Payer: PACE Senior Care Partners |
$71.25
|
| Rate for Payer: PACE SWMI |
$75.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: PHP Medicare Advantage |
$75.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.00
|
| Rate for Payer: Priority Health Medicare |
$75.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.97
|
| Rate for Payer: Railroad Medicare Medicare |
$75.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.00
|
| Rate for Payer: UHC Core |
$250.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.00
|
| Rate for Payer: UHC Medicare Advantage |
$77.25
|
| Rate for Payer: VA VA |
$75.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.00
|
|
|
HC SICKLE CELL TEST
|
Facility
|
OP
|
$30.70
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
30500061
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.07 |
| Max. Negotiated Rate |
$27.63 |
| Rate for Payer: Aetna Commercial |
$26.10
|
| Rate for Payer: Aetna Medicare |
$7.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.59
|
| Rate for Payer: BCBS Complete |
$4.27
|
| Rate for Payer: BCBS MAPPO |
$7.68
|
| Rate for Payer: BCBS Trust/PPO |
$23.87
|
| Rate for Payer: BCN Commercial |
$23.87
|
| Rate for Payer: BCN Medicare Advantage |
$7.68
|
| Rate for Payer: Cash Price |
$24.56
|
| Rate for Payer: Cash Price |
$24.56
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.68
|
| Rate for Payer: Healthscope Commercial |
$27.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.02
|
| Rate for Payer: Mclaren Medicaid |
$4.07
|
| Rate for Payer: Meridian Medicaid |
$4.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.10
|
| Rate for Payer: PACE Senior Care Partners |
$7.29
|
| Rate for Payer: PACE SWMI |
$7.68
|
| Rate for Payer: PHP Commercial |
$26.10
|
| Rate for Payer: PHP Medicare Advantage |
$7.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.71
|
| Rate for Payer: Priority Health Medicare |
$7.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.72
|
| Rate for Payer: Railroad Medicare Medicare |
$7.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.02
|
| Rate for Payer: UHC Core |
$25.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.68
|
| Rate for Payer: UHC Medicare Advantage |
$7.91
|
| Rate for Payer: VA VA |
$7.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.02
|
|
|
HC SICKLE CELL TEST
|
Facility
|
IP
|
$30.70
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
30500061
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.72 |
| Max. Negotiated Rate |
$27.63 |
| Rate for Payer: Aetna Commercial |
$26.10
|
| Rate for Payer: BCBS Trust/PPO |
$23.72
|
| Rate for Payer: BCN Commercial |
$23.72
|
| Rate for Payer: Cash Price |
$24.56
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.56
|
| Rate for Payer: Healthscope Commercial |
$27.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.10
|
| Rate for Payer: PHP Commercial |
$26.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.02
|
| Rate for Payer: UHC Core |
$25.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.02
|
|
|
HC SIGMOIDOSCOPY FLX DX W/COLL SPEC BR/WA
|
Facility
|
OP
|
$1,139.69
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
76100186
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$270.68 |
| Max. Negotiated Rate |
$1,025.72 |
| Rate for Payer: Aetna Commercial |
$968.74
|
| Rate for Payer: Aetna Medicare |
$296.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.15
|
| Rate for Payer: BCBS Complete |
$629.53
|
| Rate for Payer: BCBS MAPPO |
$284.92
|
| Rate for Payer: BCBS Trust/PPO |
$886.11
|
| Rate for Payer: BCN Commercial |
$886.11
|
| Rate for Payer: BCN Medicare Advantage |
$284.92
|
| Rate for Payer: Cash Price |
$911.75
|
| Rate for Payer: Cash Price |
$911.75
|
| Rate for Payer: Cofinity Commercial |
$980.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$911.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$284.92
|
| Rate for Payer: Healthscope Commercial |
$1,025.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$854.77
|
| Rate for Payer: Mclaren Medicaid |
$599.55
|
| Rate for Payer: Meridian Medicaid |
$629.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$327.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$968.74
|
| Rate for Payer: PACE Senior Care Partners |
$270.68
|
| Rate for Payer: PACE SWMI |
$284.92
|
| Rate for Payer: PHP Commercial |
$968.74
|
| Rate for Payer: PHP Medicare Advantage |
$284.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$599.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$797.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$991.53
|
| Rate for Payer: Priority Health Medicare |
$284.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$695.10
|
| Rate for Payer: Railroad Medicare Medicare |
$284.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,002.93
|
| Rate for Payer: UHC Core |
$951.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$284.92
|
| Rate for Payer: UHC Medicare Advantage |
$293.47
|
| Rate for Payer: VA VA |
$284.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$854.77
|
|
|
HC SIGMOIDOSCOPY FLX DX W/COLL SPEC BR/WA
|
Facility
|
IP
|
$1,139.69
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
76100186
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$695.10 |
| Max. Negotiated Rate |
$1,025.72 |
| Rate for Payer: Aetna Commercial |
$968.74
|
| Rate for Payer: BCBS Trust/PPO |
$880.75
|
| Rate for Payer: BCN Commercial |
$880.75
|
| Rate for Payer: Cash Price |
$911.75
|
| Rate for Payer: Cofinity Commercial |
$980.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$911.75
|
| Rate for Payer: Healthscope Commercial |
$1,025.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$854.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$968.74
|
| Rate for Payer: PHP Commercial |
$968.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$797.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$991.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$695.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,002.93
|
| Rate for Payer: UHC Core |
$951.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$854.77
|
|
|
HC SIGMOIDOSCOPY W EUS EXAM
|
Facility
|
IP
|
$2,569.73
|
|
| Hospital Charge Code |
36000082
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,567.28 |
| Max. Negotiated Rate |
$2,312.76 |
| Rate for Payer: Aetna Commercial |
$2,184.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,985.89
|
| Rate for Payer: BCN Commercial |
$1,985.89
|
| Rate for Payer: Cash Price |
$2,055.78
|
| Rate for Payer: Cofinity Commercial |
$2,209.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,055.78
|
| Rate for Payer: Healthscope Commercial |
$2,312.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,927.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,184.27
|
| Rate for Payer: PHP Commercial |
$2,184.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,798.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,235.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,567.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,261.36
|
| Rate for Payer: UHC Core |
$2,145.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,927.30
|
|
|
HC SIGMOIDOSCOPY W EUS EXAM
|
Facility
|
OP
|
$2,569.73
|
|
| Hospital Charge Code |
36000082
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$610.31 |
| Max. Negotiated Rate |
$2,312.76 |
| Rate for Payer: Aetna Commercial |
$2,184.27
|
| Rate for Payer: Aetna Medicare |
$668.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$803.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$803.04
|
| Rate for Payer: BCBS Complete |
$1,027.89
|
| Rate for Payer: BCBS MAPPO |
$642.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,997.97
|
| Rate for Payer: BCN Commercial |
$1,997.97
|
| Rate for Payer: BCN Medicare Advantage |
$642.43
|
| Rate for Payer: Cash Price |
$2,055.78
|
| Rate for Payer: Cofinity Commercial |
$2,209.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,055.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$642.43
|
| Rate for Payer: Healthscope Commercial |
$2,312.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,927.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$674.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$738.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,184.27
|
| Rate for Payer: PACE Senior Care Partners |
$610.31
|
| Rate for Payer: PACE SWMI |
$642.43
|
| Rate for Payer: PHP Commercial |
$2,184.27
|
| Rate for Payer: PHP Medicare Advantage |
$642.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,798.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,235.67
|
| Rate for Payer: Priority Health Medicare |
$642.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,567.28
|
| Rate for Payer: Railroad Medicare Medicare |
$642.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,261.36
|
| Rate for Payer: UHC Core |
$2,145.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$642.43
|
| Rate for Payer: UHC Medicare Advantage |
$661.71
|
| Rate for Payer: VA VA |
$642.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,927.30
|
|
|
HC SIGMOIDOSCOPY WITH BIOPSY
|
Facility
|
OP
|
$1,240.03
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
36000111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$294.51 |
| Max. Negotiated Rate |
$1,116.03 |
| Rate for Payer: Aetna Commercial |
$1,054.03
|
| Rate for Payer: Aetna Medicare |
$322.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$387.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$387.51
|
| Rate for Payer: BCBS Complete |
$629.53
|
| Rate for Payer: BCBS MAPPO |
$310.01
|
| Rate for Payer: BCBS Trust/PPO |
$964.12
|
| Rate for Payer: BCN Commercial |
$964.12
|
| Rate for Payer: BCN Medicare Advantage |
$310.01
|
| Rate for Payer: Cash Price |
$992.02
|
| Rate for Payer: Cash Price |
$992.02
|
| Rate for Payer: Cofinity Commercial |
$1,066.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$992.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.01
|
| Rate for Payer: Healthscope Commercial |
$1,116.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$930.02
|
| Rate for Payer: Mclaren Medicaid |
$599.55
|
| Rate for Payer: Meridian Medicaid |
$629.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$325.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$356.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,054.03
|
| Rate for Payer: PACE Senior Care Partners |
$294.51
|
| Rate for Payer: PACE SWMI |
$310.01
|
| Rate for Payer: PHP Commercial |
$1,054.03
|
| Rate for Payer: PHP Medicare Advantage |
$310.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$599.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$868.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,078.83
|
| Rate for Payer: Priority Health Medicare |
$310.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$756.29
|
| Rate for Payer: Railroad Medicare Medicare |
$310.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,091.23
|
| Rate for Payer: UHC Core |
$1,035.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.01
|
| Rate for Payer: UHC Medicare Advantage |
$319.31
|
| Rate for Payer: VA VA |
$310.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$930.02
|
|
|
HC SIGMOIDOSCOPY WITH BIOPSY
|
Facility
|
IP
|
$1,240.03
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
36000111
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$756.29 |
| Max. Negotiated Rate |
$1,116.03 |
| Rate for Payer: Aetna Commercial |
$1,054.03
|
| Rate for Payer: BCBS Trust/PPO |
$958.30
|
| Rate for Payer: BCN Commercial |
$958.30
|
| Rate for Payer: Cash Price |
$992.02
|
| Rate for Payer: Cofinity Commercial |
$1,066.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$992.02
|
| Rate for Payer: Healthscope Commercial |
$1,116.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$930.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,054.03
|
| Rate for Payer: PHP Commercial |
$1,054.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$868.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,078.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$756.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,091.23
|
| Rate for Payer: UHC Core |
$1,035.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$930.02
|
|
|
HC SIGNAL AVERAGE EKG
|
Facility
|
IP
|
$247.91
|
|
|
Service Code
|
CPT 93278
|
| Hospital Charge Code |
73100004
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$151.20 |
| Max. Negotiated Rate |
$223.12 |
| Rate for Payer: Aetna Commercial |
$210.72
|
| Rate for Payer: BCBS Trust/PPO |
$191.58
|
| Rate for Payer: BCN Commercial |
$191.58
|
| Rate for Payer: Cash Price |
$198.33
|
| Rate for Payer: Cofinity Commercial |
$213.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.33
|
| Rate for Payer: Healthscope Commercial |
$223.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$210.72
|
| Rate for Payer: PHP Commercial |
$210.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.16
|
| Rate for Payer: UHC Core |
$207.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.93
|
|
|
HC SIGNAL AVERAGE EKG
|
Facility
|
OP
|
$247.91
|
|
|
Service Code
|
CPT 93278
|
| Hospital Charge Code |
73100004
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$40.13 |
| Max. Negotiated Rate |
$223.12 |
| Rate for Payer: Aetna Commercial |
$210.72
|
| Rate for Payer: Aetna Medicare |
$64.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.47
|
| Rate for Payer: BCBS Complete |
$42.13
|
| Rate for Payer: BCBS MAPPO |
$61.98
|
| Rate for Payer: BCBS Trust/PPO |
$192.75
|
| Rate for Payer: BCN Commercial |
$192.75
|
| Rate for Payer: BCN Medicare Advantage |
$61.98
|
| Rate for Payer: Cash Price |
$198.33
|
| Rate for Payer: Cash Price |
$198.33
|
| Rate for Payer: Cofinity Commercial |
$213.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.98
|
| Rate for Payer: Healthscope Commercial |
$223.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.93
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Meridian Medicaid |
$42.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$210.72
|
| Rate for Payer: PACE Senior Care Partners |
$58.88
|
| Rate for Payer: PACE SWMI |
$61.98
|
| Rate for Payer: PHP Commercial |
$210.72
|
| Rate for Payer: PHP Medicare Advantage |
$61.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.68
|
| Rate for Payer: Priority Health Medicare |
$61.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.20
|
| Rate for Payer: Railroad Medicare Medicare |
$61.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.16
|
| Rate for Payer: UHC Core |
$207.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.98
|
| Rate for Payer: UHC Medicare Advantage |
$63.84
|
| Rate for Payer: VA VA |
$61.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.93
|
|
|
HC SILICA CLOTTING TIME ASSAY
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500099
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: BCBS Trust/PPO |
$19.71
|
| Rate for Payer: BCN Commercial |
$19.71
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC SILICA CLOTTING TIME ASSAY
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500099
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.97
|
| Rate for Payer: BCBS Complete |
$4.66
|
| Rate for Payer: BCBS MAPPO |
$6.38
|
| Rate for Payer: BCBS Trust/PPO |
$19.83
|
| Rate for Payer: BCN Commercial |
$19.83
|
| Rate for Payer: BCN Medicare Advantage |
$6.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.38
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$4.44
|
| Rate for Payer: Meridian Medicaid |
$4.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Senior Care Partners |
$6.06
|
| Rate for Payer: PACE SWMI |
$6.38
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.18
|
| Rate for Payer: Priority Health Medicare |
$6.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.44
|
| Rate for Payer: UHC Core |
$21.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.38
|
| Rate for Payer: UHC Medicare Advantage |
$6.57
|
| Rate for Payer: VA VA |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC SILVADENE 400 GM
|
Facility
|
IP
|
$248.55
|
|
| Hospital Charge Code |
27100016
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$151.59 |
| Max. Negotiated Rate |
$223.70 |
| Rate for Payer: Aetna Commercial |
$211.27
|
| Rate for Payer: BCBS Trust/PPO |
$192.08
|
| Rate for Payer: BCN Commercial |
$192.08
|
| Rate for Payer: Cash Price |
$198.84
|
| Rate for Payer: Cofinity Commercial |
$213.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.84
|
| Rate for Payer: Healthscope Commercial |
$223.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$211.27
|
| Rate for Payer: PHP Commercial |
$211.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$216.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.72
|
| Rate for Payer: UHC Core |
$207.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.41
|
|
|
HC SILVADENE 400 GM
|
Facility
|
OP
|
$248.55
|
|
| Hospital Charge Code |
27100016
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$59.03 |
| Max. Negotiated Rate |
$223.70 |
| Rate for Payer: Aetna Commercial |
$211.27
|
| Rate for Payer: Aetna Medicare |
$64.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: BCBS Complete |
$99.42
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$193.25
|
| Rate for Payer: BCN Commercial |
$193.25
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$198.84
|
| Rate for Payer: Cofinity Commercial |
$213.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$223.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$211.27
|
| Rate for Payer: PACE Senior Care Partners |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$211.27
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$216.24
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.59
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.72
|
| Rate for Payer: UHC Core |
$207.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Medicare Advantage |
$64.00
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.41
|
|
|
HC SILVADENE 85 GM
|
Facility
|
OP
|
$102.57
|
|
| Hospital Charge Code |
27100017
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$24.36 |
| Max. Negotiated Rate |
$92.31 |
| Rate for Payer: Aetna Commercial |
$87.18
|
| Rate for Payer: Aetna Medicare |
$26.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.05
|
| Rate for Payer: BCBS Complete |
$41.03
|
| Rate for Payer: BCBS MAPPO |
$25.64
|
| Rate for Payer: BCBS Trust/PPO |
$79.75
|
| Rate for Payer: BCN Commercial |
$79.75
|
| Rate for Payer: BCN Medicare Advantage |
$25.64
|
| Rate for Payer: Cash Price |
$82.06
|
| Rate for Payer: Cofinity Commercial |
$88.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.64
|
| Rate for Payer: Healthscope Commercial |
$92.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.18
|
| Rate for Payer: PACE Senior Care Partners |
$24.36
|
| Rate for Payer: PACE SWMI |
$25.64
|
| Rate for Payer: PHP Commercial |
$87.18
|
| Rate for Payer: PHP Medicare Advantage |
$25.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.24
|
| Rate for Payer: Priority Health Medicare |
$25.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.56
|
| Rate for Payer: Railroad Medicare Medicare |
$25.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.26
|
| Rate for Payer: UHC Core |
$85.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.64
|
| Rate for Payer: UHC Medicare Advantage |
$26.41
|
| Rate for Payer: VA VA |
$25.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.93
|
|
|
HC SILVADENE 85 GM
|
Facility
|
IP
|
$102.57
|
|
| Hospital Charge Code |
27100017
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$62.56 |
| Max. Negotiated Rate |
$92.31 |
| Rate for Payer: Aetna Commercial |
$87.18
|
| Rate for Payer: BCBS Trust/PPO |
$79.27
|
| Rate for Payer: BCN Commercial |
$79.27
|
| Rate for Payer: Cash Price |
$82.06
|
| Rate for Payer: Cofinity Commercial |
$88.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.06
|
| Rate for Payer: Healthscope Commercial |
$92.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.18
|
| Rate for Payer: PHP Commercial |
$87.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.26
|
| Rate for Payer: UHC Core |
$85.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.93
|
|
|
HC SILVER 4X4
|
Facility
|
OP
|
$64.13
|
|
| Hospital Charge Code |
27000146
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.23 |
| Max. Negotiated Rate |
$57.72 |
| Rate for Payer: Aetna Commercial |
$54.51
|
| Rate for Payer: Aetna Medicare |
$16.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.04
|
| Rate for Payer: BCBS Complete |
$25.65
|
| Rate for Payer: BCBS MAPPO |
$16.03
|
| Rate for Payer: BCBS Trust/PPO |
$49.86
|
| Rate for Payer: BCN Commercial |
$49.86
|
| Rate for Payer: BCN Medicare Advantage |
$16.03
|
| Rate for Payer: Cash Price |
$51.30
|
| Rate for Payer: Cofinity Commercial |
$55.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.03
|
| Rate for Payer: Healthscope Commercial |
$57.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.51
|
| Rate for Payer: PACE Senior Care Partners |
$15.23
|
| Rate for Payer: PACE SWMI |
$16.03
|
| Rate for Payer: PHP Commercial |
$54.51
|
| Rate for Payer: PHP Medicare Advantage |
$16.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.79
|
| Rate for Payer: Priority Health Medicare |
$16.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.11
|
| Rate for Payer: Railroad Medicare Medicare |
$16.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.43
|
| Rate for Payer: UHC Core |
$53.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.03
|
| Rate for Payer: UHC Medicare Advantage |
$16.51
|
| Rate for Payer: VA VA |
$16.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.10
|
|
|
HC SILVER 4X4
|
Facility
|
IP
|
$64.13
|
|
| Hospital Charge Code |
27000146
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.11 |
| Max. Negotiated Rate |
$57.72 |
| Rate for Payer: Aetna Commercial |
$54.51
|
| Rate for Payer: BCBS Trust/PPO |
$49.56
|
| Rate for Payer: BCN Commercial |
$49.56
|
| Rate for Payer: Cash Price |
$51.30
|
| Rate for Payer: Cofinity Commercial |
$55.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.30
|
| Rate for Payer: Healthscope Commercial |
$57.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.51
|
| Rate for Payer: PHP Commercial |
$54.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.43
|
| Rate for Payer: UHC Core |
$53.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.10
|
|
