|
HC OB POSTPARTUM R&B
|
Facility
|
IP
|
$2,611.50
|
|
| Hospital Charge Code |
11200002
|
|
Hospital Revenue Code
|
112
|
| Min. Negotiated Rate |
$1,817.60 |
| Max. Negotiated Rate |
$2,393.75 |
| Rate for Payer: Aetna Commercial |
$2,219.78
|
| Rate for Payer: Aetna Medicare |
$1,991.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,393.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,393.75
|
| Rate for Payer: BCBS MAPPO |
$1,915.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,156.84
|
| Rate for Payer: BCN Commercial |
$2,156.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,915.00
|
| Rate for Payer: Cash Price |
$2,089.20
|
| Rate for Payer: Cash Price |
$2,089.20
|
| Rate for Payer: Cofinity Commercial |
$2,245.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,089.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,915.00
|
| Rate for Payer: Healthscope Commercial |
$2,350.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,958.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,010.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,202.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,106.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,219.78
|
| Rate for Payer: Nomi Health Commercial |
$2,141.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,958.62
|
| Rate for Payer: PACE Senior Care Partners |
$1,819.25
|
| Rate for Payer: PACE SWMI |
$1,915.00
|
| Rate for Payer: PHP Commercial |
$2,219.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,915.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,272.01
|
| Rate for Payer: Priority Health Medicare |
$1,934.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,817.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,915.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,298.12
|
| Rate for Payer: UHC Core |
$2,180.60
|
| Rate for Payer: UHC Exchange |
$1,915.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,915.00
|
| Rate for Payer: VA VA |
$1,915.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,958.62
|
|
|
HC OBSERVATION OVERFLOW PER HOUR
|
Facility
|
OP
|
$160.00
|
|
| Hospital Charge Code |
76900005
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna Medicare |
$41.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.00
|
| Rate for Payer: BCBS Complete |
$29.62
|
| Rate for Payer: BCBS MAPPO |
$40.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.54
|
| Rate for Payer: BCN Commercial |
$131.54
|
| Rate for Payer: BCN Medicare Advantage |
$40.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Mclaren Medicaid |
$28.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.00
|
| Rate for Payer: Meridian Medicaid |
$29.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PACE Senior Care Partners |
$38.00
|
| Rate for Payer: PACE SWMI |
$40.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: PHP Medicare Advantage |
$40.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: Railroad Medicare Medicare |
$40.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: UHC Exchange |
$40.00
|
| Rate for Payer: UHC Medicaid |
$28.21
|
| Rate for Payer: UHC Medicare Advantage |
$40.00
|
| Rate for Payer: UHCCP Medicaid |
$28.21
|
| Rate for Payer: VA VA |
$40.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC OBSERVATION OVERFLOW PER HOUR
|
Facility
|
IP
|
$160.00
|
|
| Hospital Charge Code |
76900005
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$111.36 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: BCBS Trust/PPO |
$132.14
|
| Rate for Payer: BCN Commercial |
$132.14
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC OBSERVATION PER HOUR
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200023
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$111.36 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: BCBS Trust/PPO |
$132.14
|
| Rate for Payer: BCN Commercial |
$132.14
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC OBSERVATION PER HOUR
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200023
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna Medicare |
$41.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.00
|
| Rate for Payer: BCBS Complete |
$29.62
|
| Rate for Payer: BCBS MAPPO |
$40.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.54
|
| Rate for Payer: BCN Commercial |
$131.54
|
| Rate for Payer: BCN Medicare Advantage |
$40.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Mclaren Medicaid |
$28.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.00
|
| Rate for Payer: Meridian Medicaid |
$29.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PACE Senior Care Partners |
$38.00
|
| Rate for Payer: PACE SWMI |
$40.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: PHP Medicare Advantage |
$40.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: Railroad Medicare Medicare |
$40.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: UHC Exchange |
$40.00
|
| Rate for Payer: UHC Medicaid |
$28.21
|
| Rate for Payer: UHC Medicare Advantage |
$40.00
|
| Rate for Payer: UHCCP Medicaid |
$850.00
|
| Rate for Payer: VA VA |
$40.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC OBS OVERFLOW PER HR
|
Facility
|
IP
|
$160.00
|
|
| Hospital Charge Code |
76900002
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$111.36 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: BCBS Trust/PPO |
$132.14
|
| Rate for Payer: BCN Commercial |
$132.14
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC OBS OVERFLOW PER HR
|
Facility
|
OP
|
$160.00
|
|
| Hospital Charge Code |
76900002
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna Medicare |
$41.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.00
|
| Rate for Payer: BCBS Complete |
$29.62
|
| Rate for Payer: BCBS MAPPO |
$40.00
|
| Rate for Payer: BCBS Trust/PPO |
$131.54
|
| Rate for Payer: BCN Commercial |
$131.54
|
| Rate for Payer: BCN Medicare Advantage |
$40.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Mclaren Medicaid |
$28.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.00
|
| Rate for Payer: Meridian Medicaid |
$29.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Nomi Health Commercial |
$131.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PACE Senior Care Partners |
$38.00
|
| Rate for Payer: PACE SWMI |
$40.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: PHP Medicare Advantage |
$40.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.20
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.36
|
| Rate for Payer: Railroad Medicare Medicare |
$40.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.80
|
| Rate for Payer: UHC Core |
$133.60
|
| Rate for Payer: UHC Exchange |
$40.00
|
| Rate for Payer: UHC Medicaid |
$28.21
|
| Rate for Payer: UHC Medicare Advantage |
$40.00
|
| Rate for Payer: UHCCP Medicaid |
$28.21
|
| Rate for Payer: VA VA |
$40.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC OB SURGERY ADDL 15 MIN
|
Facility
|
IP
|
$279.50
|
|
| Hospital Charge Code |
36000104
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$194.53 |
| Max. Negotiated Rate |
$251.55 |
| Rate for Payer: Aetna Commercial |
$237.57
|
| Rate for Payer: BCBS Trust/PPO |
$230.84
|
| Rate for Payer: BCN Commercial |
$230.84
|
| Rate for Payer: Cash Price |
$223.60
|
| Rate for Payer: Cofinity Commercial |
$240.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.60
|
| Rate for Payer: Healthscope Commercial |
$251.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.57
|
| Rate for Payer: Nomi Health Commercial |
$229.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$209.62
|
| Rate for Payer: PHP Commercial |
$237.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$243.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$194.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.96
|
| Rate for Payer: UHC Core |
$233.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.62
|
|
|
HC OB SURGERY ADDL 15 MIN
|
Facility
|
OP
|
$279.50
|
|
| Hospital Charge Code |
36000104
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$49.28 |
| Max. Negotiated Rate |
$251.55 |
| Rate for Payer: Aetna Commercial |
$237.57
|
| Rate for Payer: Aetna Medicare |
$72.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.34
|
| Rate for Payer: BCBS Complete |
$51.74
|
| Rate for Payer: BCBS MAPPO |
$69.88
|
| Rate for Payer: BCBS Trust/PPO |
$229.78
|
| Rate for Payer: BCN Commercial |
$229.78
|
| Rate for Payer: BCN Medicare Advantage |
$69.88
|
| Rate for Payer: Cash Price |
$223.60
|
| Rate for Payer: Cofinity Commercial |
$240.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.88
|
| Rate for Payer: Healthscope Commercial |
$251.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.62
|
| Rate for Payer: Mclaren Medicaid |
$49.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.37
|
| Rate for Payer: Meridian Medicaid |
$51.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.57
|
| Rate for Payer: Nomi Health Commercial |
$229.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$209.62
|
| Rate for Payer: PACE Senior Care Partners |
$66.38
|
| Rate for Payer: PACE SWMI |
$69.88
|
| Rate for Payer: PHP Commercial |
$237.57
|
| Rate for Payer: PHP Medicare Advantage |
$69.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$243.16
|
| Rate for Payer: Priority Health Medicare |
$70.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$194.53
|
| Rate for Payer: Railroad Medicare Medicare |
$69.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.96
|
| Rate for Payer: UHC Core |
$233.38
|
| Rate for Payer: UHC Exchange |
$69.88
|
| Rate for Payer: UHC Medicaid |
$49.28
|
| Rate for Payer: UHC Medicare Advantage |
$69.88
|
| Rate for Payer: UHCCP Medicaid |
$49.28
|
| Rate for Payer: VA VA |
$69.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.62
|
|
|
HC OB SURGERY INITIAL 30 MIN
|
Facility
|
IP
|
$1,482.63
|
|
| Hospital Charge Code |
36000077
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,031.91 |
| Max. Negotiated Rate |
$1,334.37 |
| Rate for Payer: Aetna Commercial |
$1,260.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,224.50
|
| Rate for Payer: BCN Commercial |
$1,224.50
|
| Rate for Payer: Cash Price |
$1,186.10
|
| Rate for Payer: Cofinity Commercial |
$1,275.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,186.10
|
| Rate for Payer: Healthscope Commercial |
$1,334.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,111.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,260.24
|
| Rate for Payer: Nomi Health Commercial |
$1,215.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,111.97
|
| Rate for Payer: PHP Commercial |
$1,260.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,289.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,031.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,304.71
|
| Rate for Payer: UHC Core |
$1,238.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,111.97
|
|
|
HC OB SURGERY INITIAL 30 MIN
|
Facility
|
OP
|
$1,482.63
|
|
| Hospital Charge Code |
36000077
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$261.39 |
| Max. Negotiated Rate |
$1,334.37 |
| Rate for Payer: Aetna Commercial |
$1,260.24
|
| Rate for Payer: Aetna Medicare |
$385.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$463.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$463.32
|
| Rate for Payer: BCBS Complete |
$274.43
|
| Rate for Payer: BCBS MAPPO |
$370.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.87
|
| Rate for Payer: BCN Commercial |
$1,218.87
|
| Rate for Payer: BCN Medicare Advantage |
$370.66
|
| Rate for Payer: Cash Price |
$1,186.10
|
| Rate for Payer: Cofinity Commercial |
$1,275.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,186.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.66
|
| Rate for Payer: Healthscope Commercial |
$1,334.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,111.97
|
| Rate for Payer: Mclaren Medicaid |
$261.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$389.19
|
| Rate for Payer: Meridian Medicaid |
$274.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$426.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$407.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,260.24
|
| Rate for Payer: Nomi Health Commercial |
$1,215.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,111.97
|
| Rate for Payer: PACE Senior Care Partners |
$352.12
|
| Rate for Payer: PACE SWMI |
$370.66
|
| Rate for Payer: PHP Commercial |
$1,260.24
|
| Rate for Payer: PHP Medicare Advantage |
$370.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$261.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,289.89
|
| Rate for Payer: Priority Health Medicare |
$374.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,031.91
|
| Rate for Payer: Railroad Medicare Medicare |
$370.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,304.71
|
| Rate for Payer: UHC Core |
$1,238.00
|
| Rate for Payer: UHC Exchange |
$370.66
|
| Rate for Payer: UHC Medicaid |
$261.39
|
| Rate for Payer: UHC Medicare Advantage |
$370.66
|
| Rate for Payer: UHCCP Medicaid |
$261.39
|
| Rate for Payer: VA VA |
$370.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,111.97
|
|
|
HC OB VAC DEL KIT DISP (OB)
|
Facility
|
OP
|
$262.93
|
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.35 |
| Max. Negotiated Rate |
$236.64 |
| Rate for Payer: Aetna Commercial |
$223.49
|
| Rate for Payer: Aetna Medicare |
$68.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.17
|
| Rate for Payer: BCBS Complete |
$48.67
|
| Rate for Payer: BCBS MAPPO |
$65.73
|
| Rate for Payer: BCBS Trust/PPO |
$216.15
|
| Rate for Payer: BCN Commercial |
$216.15
|
| Rate for Payer: BCN Medicare Advantage |
$65.73
|
| Rate for Payer: Cash Price |
$210.34
|
| Rate for Payer: Cofinity Commercial |
$226.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.73
|
| Rate for Payer: Healthscope Commercial |
$236.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.20
|
| Rate for Payer: Mclaren Medicaid |
$46.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.02
|
| Rate for Payer: Meridian Medicaid |
$48.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.49
|
| Rate for Payer: Nomi Health Commercial |
$215.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.20
|
| Rate for Payer: PACE Senior Care Partners |
$62.45
|
| Rate for Payer: PACE SWMI |
$65.73
|
| Rate for Payer: PHP Commercial |
$223.49
|
| Rate for Payer: PHP Medicare Advantage |
$65.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.75
|
| Rate for Payer: Priority Health Medicare |
$66.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.00
|
| Rate for Payer: Railroad Medicare Medicare |
$65.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.38
|
| Rate for Payer: UHC Core |
$219.55
|
| Rate for Payer: UHC Exchange |
$65.73
|
| Rate for Payer: UHC Medicaid |
$46.35
|
| Rate for Payer: UHC Medicare Advantage |
$65.73
|
| Rate for Payer: UHCCP Medicaid |
$46.35
|
| Rate for Payer: VA VA |
$65.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.20
|
|
|
HC OB VAC DEL KIT DISP (OB)
|
Facility
|
IP
|
$262.93
|
|
| Hospital Charge Code |
27000127
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$183.00 |
| Max. Negotiated Rate |
$236.64 |
| Rate for Payer: Aetna Commercial |
$223.49
|
| Rate for Payer: BCBS Trust/PPO |
$217.15
|
| Rate for Payer: BCN Commercial |
$217.15
|
| Rate for Payer: Cash Price |
$210.34
|
| Rate for Payer: Cofinity Commercial |
$226.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.34
|
| Rate for Payer: Healthscope Commercial |
$236.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.49
|
| Rate for Payer: Nomi Health Commercial |
$215.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.20
|
| Rate for Payer: PHP Commercial |
$223.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.38
|
| Rate for Payer: UHC Core |
$219.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.20
|
|
|
HC OCCLUSION CATH
|
Facility
|
OP
|
$4,849.72
|
|
|
Service Code
|
HCPCS C2628
|
| Hospital Charge Code |
27200344
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$855.01 |
| Max. Negotiated Rate |
$4,364.75 |
| Rate for Payer: Aetna Commercial |
$4,122.26
|
| Rate for Payer: Aetna Medicare |
$1,260.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,515.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,515.54
|
| Rate for Payer: BCBS Complete |
$897.68
|
| Rate for Payer: BCBS MAPPO |
$1,212.43
|
| Rate for Payer: BCBS Trust/PPO |
$3,986.95
|
| Rate for Payer: BCN Commercial |
$3,986.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,212.43
|
| Rate for Payer: Cash Price |
$3,879.78
|
| Rate for Payer: Cofinity Commercial |
$4,170.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,879.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,212.43
|
| Rate for Payer: Healthscope Commercial |
$4,364.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,637.29
|
| Rate for Payer: Mclaren Medicaid |
$855.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,273.05
|
| Rate for Payer: Meridian Medicaid |
$897.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,394.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,333.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,122.26
|
| Rate for Payer: Nomi Health Commercial |
$3,976.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,637.29
|
| Rate for Payer: PACE Senior Care Partners |
$1,151.81
|
| Rate for Payer: PACE SWMI |
$1,212.43
|
| Rate for Payer: PHP Commercial |
$4,122.26
|
| Rate for Payer: PHP Medicare Advantage |
$1,212.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$855.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,219.26
|
| Rate for Payer: Priority Health Medicare |
$1,224.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,375.41
|
| Rate for Payer: Railroad Medicare Medicare |
$1,212.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,267.75
|
| Rate for Payer: UHC Core |
$4,049.52
|
| Rate for Payer: UHC Exchange |
$1,212.43
|
| Rate for Payer: UHC Medicaid |
$855.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,212.43
|
| Rate for Payer: UHCCP Medicaid |
$855.01
|
| Rate for Payer: VA VA |
$1,212.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,637.29
|
|
|
HC OCCLUSION CATH
|
Facility
|
IP
|
$4,849.72
|
|
|
Service Code
|
HCPCS C2628
|
| Hospital Charge Code |
27200344
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,375.41 |
| Max. Negotiated Rate |
$4,364.75 |
| Rate for Payer: Aetna Commercial |
$4,122.26
|
| Rate for Payer: BCBS Trust/PPO |
$4,005.38
|
| Rate for Payer: BCN Commercial |
$4,005.38
|
| Rate for Payer: Cash Price |
$3,879.78
|
| Rate for Payer: Cofinity Commercial |
$4,170.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,879.78
|
| Rate for Payer: Healthscope Commercial |
$4,364.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,637.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,122.26
|
| Rate for Payer: Nomi Health Commercial |
$3,976.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,637.29
|
| Rate for Payer: PHP Commercial |
$4,122.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,219.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,375.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,267.75
|
| Rate for Payer: UHC Core |
$4,049.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,637.29
|
|
|
HC OCCULT BLOOD OTHER SOURCES
|
Facility
|
OP
|
$31.31
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
30100122
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$28.18 |
| Rate for Payer: Aetna Commercial |
$26.61
|
| Rate for Payer: Aetna Medicare |
$8.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.78
|
| Rate for Payer: BCBS Complete |
$5.80
|
| Rate for Payer: BCBS MAPPO |
$7.83
|
| Rate for Payer: BCBS Trust/PPO |
$25.74
|
| Rate for Payer: BCN Commercial |
$25.74
|
| Rate for Payer: BCN Medicare Advantage |
$7.83
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$26.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.83
|
| Rate for Payer: Healthscope Commercial |
$28.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.48
|
| Rate for Payer: Mclaren Medicaid |
$5.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.22
|
| Rate for Payer: Meridian Medicaid |
$5.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.61
|
| Rate for Payer: Nomi Health Commercial |
$25.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.48
|
| Rate for Payer: PACE Senior Care Partners |
$7.44
|
| Rate for Payer: PACE SWMI |
$7.83
|
| Rate for Payer: PHP Commercial |
$26.61
|
| Rate for Payer: PHP Medicare Advantage |
$7.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.24
|
| Rate for Payer: Priority Health Medicare |
$7.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.79
|
| Rate for Payer: Railroad Medicare Medicare |
$7.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.55
|
| Rate for Payer: UHC Core |
$26.14
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$5.52
|
| Rate for Payer: UHC Medicare Advantage |
$7.83
|
| Rate for Payer: UHCCP Medicaid |
$5.52
|
| Rate for Payer: VA VA |
$7.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.48
|
|
|
HC OCCULT BLOOD OTHER SOURCES
|
Facility
|
IP
|
$31.31
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
30100122
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.79 |
| Max. Negotiated Rate |
$28.18 |
| Rate for Payer: Aetna Commercial |
$26.61
|
| Rate for Payer: BCBS Trust/PPO |
$25.86
|
| Rate for Payer: BCN Commercial |
$25.86
|
| Rate for Payer: Cash Price |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$26.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.05
|
| Rate for Payer: Healthscope Commercial |
$28.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.61
|
| Rate for Payer: Nomi Health Commercial |
$25.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.48
|
| Rate for Payer: PHP Commercial |
$26.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.55
|
| Rate for Payer: UHC Core |
$26.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.48
|
|
|
HC OCT CATHETER
|
Facility
|
OP
|
$2,631.90
|
|
|
Service Code
|
HCPCS C1753
|
| Hospital Charge Code |
27200243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$464.00 |
| Max. Negotiated Rate |
$2,368.71 |
| Rate for Payer: Aetna Commercial |
$2,237.11
|
| Rate for Payer: Aetna Medicare |
$684.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$822.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$822.47
|
| Rate for Payer: BCBS Complete |
$487.16
|
| Rate for Payer: BCBS MAPPO |
$657.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,163.68
|
| Rate for Payer: BCN Commercial |
$2,163.68
|
| Rate for Payer: BCN Medicare Advantage |
$657.98
|
| Rate for Payer: Cash Price |
$2,105.52
|
| Rate for Payer: Cofinity Commercial |
$2,263.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,105.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$657.98
|
| Rate for Payer: Healthscope Commercial |
$2,368.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,973.92
|
| Rate for Payer: Mclaren Medicaid |
$464.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$690.87
|
| Rate for Payer: Meridian Medicaid |
$487.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$756.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$723.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,237.11
|
| Rate for Payer: Nomi Health Commercial |
$2,158.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,973.92
|
| Rate for Payer: PACE Senior Care Partners |
$625.08
|
| Rate for Payer: PACE SWMI |
$657.98
|
| Rate for Payer: PHP Commercial |
$2,237.11
|
| Rate for Payer: PHP Medicare Advantage |
$657.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,289.75
|
| Rate for Payer: Priority Health Medicare |
$664.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,831.80
|
| Rate for Payer: Railroad Medicare Medicare |
$657.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,316.07
|
| Rate for Payer: UHC Core |
$2,197.64
|
| Rate for Payer: UHC Exchange |
$657.98
|
| Rate for Payer: UHC Medicaid |
$464.00
|
| Rate for Payer: UHC Medicare Advantage |
$657.98
|
| Rate for Payer: UHCCP Medicaid |
$464.00
|
| Rate for Payer: VA VA |
$657.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,973.92
|
|
|
HC OCT CATHETER
|
Facility
|
IP
|
$2,631.90
|
|
|
Service Code
|
HCPCS C1753
|
| Hospital Charge Code |
27200243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,831.80 |
| Max. Negotiated Rate |
$2,368.71 |
| Rate for Payer: Aetna Commercial |
$2,237.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,173.69
|
| Rate for Payer: BCN Commercial |
$2,173.69
|
| Rate for Payer: Cash Price |
$2,105.52
|
| Rate for Payer: Cofinity Commercial |
$2,263.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,105.52
|
| Rate for Payer: Healthscope Commercial |
$2,368.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,973.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,237.11
|
| Rate for Payer: Nomi Health Commercial |
$2,158.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,973.92
|
| Rate for Payer: PHP Commercial |
$2,237.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,289.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,831.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,316.07
|
| Rate for Payer: UHC Core |
$2,197.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,973.92
|
|
|
HC OCTOPUS SET CARDIOPLEGIA
|
Facility
|
OP
|
$46.82
|
|
| Hospital Charge Code |
27000106
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.63
|
| Rate for Payer: BCBS Complete |
$8.67
|
| Rate for Payer: BCBS MAPPO |
$11.71
|
| Rate for Payer: BCBS Trust/PPO |
$38.49
|
| Rate for Payer: BCN Commercial |
$38.49
|
| Rate for Payer: BCN Medicare Advantage |
$11.71
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.71
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$8.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.29
|
| Rate for Payer: Meridian Medicaid |
$8.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PACE Senior Care Partners |
$11.12
|
| Rate for Payer: PACE SWMI |
$11.71
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: Railroad Medicare Medicare |
$11.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: UHC Exchange |
$11.71
|
| Rate for Payer: UHC Medicaid |
$8.25
|
| Rate for Payer: UHC Medicare Advantage |
$11.71
|
| Rate for Payer: UHCCP Medicaid |
$8.25
|
| Rate for Payer: VA VA |
$11.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC OCTOPUS SET CARDIOPLEGIA
|
Facility
|
IP
|
$46.82
|
|
| Hospital Charge Code |
27000106
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$32.59 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: BCBS Trust/PPO |
$38.67
|
| Rate for Payer: BCN Commercial |
$38.67
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC OCULAR INSTRMNT SCREEN BILAT
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 99174
|
| Hospital Charge Code |
51000105
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC OCULAR INSTRMNT SCREEN BILAT
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 99174
|
| Hospital Charge Code |
51000105
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC OLIGOCLONAL BANDS
|
Facility
|
IP
|
$49.02
|
|
|
Service Code
|
CPT 83916
|
| Hospital Charge Code |
30100371
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.12 |
| Max. Negotiated Rate |
$44.12 |
| Rate for Payer: Aetna Commercial |
$41.67
|
| Rate for Payer: BCBS Trust/PPO |
$40.49
|
| Rate for Payer: BCN Commercial |
$40.49
|
| Rate for Payer: Cash Price |
$39.22
|
| Rate for Payer: Cofinity Commercial |
$42.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.22
|
| Rate for Payer: Healthscope Commercial |
$44.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.67
|
| Rate for Payer: Nomi Health Commercial |
$40.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.77
|
| Rate for Payer: PHP Commercial |
$41.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.14
|
| Rate for Payer: UHC Core |
$40.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.77
|
|
|
HC OLIGOCLONAL BANDS
|
Facility
|
OP
|
$49.02
|
|
|
Service Code
|
CPT 83916
|
| Hospital Charge Code |
30100371
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.64 |
| Max. Negotiated Rate |
$44.12 |
| Rate for Payer: Aetna Commercial |
$41.67
|
| Rate for Payer: Aetna Medicare |
$12.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.32
|
| Rate for Payer: BCBS Complete |
$9.07
|
| Rate for Payer: BCBS MAPPO |
$12.26
|
| Rate for Payer: BCBS Trust/PPO |
$40.30
|
| Rate for Payer: BCN Commercial |
$40.30
|
| Rate for Payer: BCN Medicare Advantage |
$12.26
|
| Rate for Payer: Cash Price |
$39.22
|
| Rate for Payer: Cofinity Commercial |
$42.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.26
|
| Rate for Payer: Healthscope Commercial |
$44.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.77
|
| Rate for Payer: Mclaren Medicaid |
$8.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.87
|
| Rate for Payer: Meridian Medicaid |
$9.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.67
|
| Rate for Payer: Nomi Health Commercial |
$40.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.77
|
| Rate for Payer: PACE Senior Care Partners |
$11.64
|
| Rate for Payer: PACE SWMI |
$12.26
|
| Rate for Payer: PHP Commercial |
$41.67
|
| Rate for Payer: PHP Medicare Advantage |
$12.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$42.65
|
| Rate for Payer: Priority Health Medicare |
$12.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.12
|
| Rate for Payer: Railroad Medicare Medicare |
$12.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.14
|
| Rate for Payer: UHC Core |
$40.93
|
| Rate for Payer: UHC Exchange |
$12.26
|
| Rate for Payer: UHC Medicaid |
$8.64
|
| Rate for Payer: UHC Medicare Advantage |
$12.26
|
| Rate for Payer: UHCCP Medicaid |
$8.64
|
| Rate for Payer: VA VA |
$12.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.77
|
|
