|
HC MPN, CALR GENE MUTATION, EXON 9
|
Facility
|
OP
|
$648.17
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000110
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$87.94 |
| Max. Negotiated Rate |
$583.35 |
| Rate for Payer: Aetna Commercial |
$550.94
|
| Rate for Payer: Aetna Medicare |
$168.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.55
|
| Rate for Payer: BCBS Complete |
$92.34
|
| Rate for Payer: BCBS MAPPO |
$162.04
|
| Rate for Payer: BCBS Trust/PPO |
$532.86
|
| Rate for Payer: BCN Commercial |
$503.95
|
| Rate for Payer: BCN Medicare Advantage |
$162.04
|
| Rate for Payer: Cash Price |
$518.54
|
| Rate for Payer: Cash Price |
$518.54
|
| Rate for Payer: Cofinity Commercial |
$557.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.04
|
| Rate for Payer: Healthscope Commercial |
$583.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$486.13
|
| Rate for Payer: Mclaren Medicaid |
$87.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.14
|
| Rate for Payer: Meridian Medicaid |
$92.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.94
|
| Rate for Payer: Nomi Health Commercial |
$531.50
|
| Rate for Payer: PACE Senior Care Partners |
$153.94
|
| Rate for Payer: PACE SWMI |
$162.04
|
| Rate for Payer: PHP Commercial |
$550.94
|
| Rate for Payer: PHP Medicare Advantage |
$162.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.31
|
| Rate for Payer: Priority Health HMO/PPO |
$563.91
|
| Rate for Payer: Priority Health Medicare |
$163.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.27
|
| Rate for Payer: Railroad Medicare Medicare |
$162.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$570.39
|
| Rate for Payer: UHC Core |
$541.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.04
|
| Rate for Payer: UHC Exchange |
$162.04
|
| Rate for Payer: UHC Medicare Advantage |
$162.04
|
| Rate for Payer: UHCCP Medicaid |
$87.94
|
| Rate for Payer: VA VA |
$162.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$486.13
|
|
|
HC MPN, CALR GENE MUTATION, EXON 9
|
Facility
|
IP
|
$648.17
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000110
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$421.31 |
| Max. Negotiated Rate |
$583.35 |
| Rate for Payer: Aetna Commercial |
$550.94
|
| Rate for Payer: BCBS Trust/PPO |
$529.10
|
| Rate for Payer: BCN Commercial |
$500.91
|
| Rate for Payer: Cash Price |
$518.54
|
| Rate for Payer: Cofinity Commercial |
$557.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.54
|
| Rate for Payer: Healthscope Commercial |
$583.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$486.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.94
|
| Rate for Payer: Nomi Health Commercial |
$531.50
|
| Rate for Payer: PHP Commercial |
$550.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.31
|
| Rate for Payer: Priority Health HMO/PPO |
$563.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$570.39
|
| Rate for Payer: UHC Core |
$541.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$486.13
|
|
|
HC MPN (JAK2, V617F, CALR, MPL) REFLEX
|
Facility
|
IP
|
$412.00
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
30000107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$267.80 |
| Max. Negotiated Rate |
$370.80 |
| Rate for Payer: Aetna Commercial |
$350.20
|
| Rate for Payer: BCBS Trust/PPO |
$336.32
|
| Rate for Payer: BCN Commercial |
$318.39
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cofinity Commercial |
$354.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.60
|
| Rate for Payer: Healthscope Commercial |
$370.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.20
|
| Rate for Payer: Nomi Health Commercial |
$337.84
|
| Rate for Payer: PHP Commercial |
$350.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: Priority Health HMO/PPO |
$358.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$276.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.56
|
| Rate for Payer: UHC Core |
$344.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.00
|
|
|
HC MPN (JAK2, V617F, CALR, MPL) REFLEX
|
Facility
|
OP
|
$412.00
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
30000107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$66.27 |
| Max. Negotiated Rate |
$370.80 |
| Rate for Payer: Aetna Commercial |
$350.20
|
| Rate for Payer: Aetna Medicare |
$107.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$128.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$128.75
|
| Rate for Payer: BCBS Complete |
$69.59
|
| Rate for Payer: BCBS MAPPO |
$103.00
|
| Rate for Payer: BCBS Trust/PPO |
$338.71
|
| Rate for Payer: BCN Commercial |
$320.33
|
| Rate for Payer: BCN Medicare Advantage |
$103.00
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cofinity Commercial |
$354.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.00
|
| Rate for Payer: Healthscope Commercial |
$370.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.00
|
| Rate for Payer: Mclaren Medicaid |
$66.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.15
|
| Rate for Payer: Meridian Medicaid |
$69.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.20
|
| Rate for Payer: Nomi Health Commercial |
$337.84
|
| Rate for Payer: PACE Senior Care Partners |
$97.85
|
| Rate for Payer: PACE SWMI |
$103.00
|
| Rate for Payer: PHP Commercial |
$350.20
|
| Rate for Payer: PHP Medicare Advantage |
$103.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: Priority Health HMO/PPO |
$358.44
|
| Rate for Payer: Priority Health Medicare |
$104.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$276.04
|
| Rate for Payer: Railroad Medicare Medicare |
$103.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.56
|
| Rate for Payer: UHC Core |
$344.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.00
|
| Rate for Payer: UHC Exchange |
$103.00
|
| Rate for Payer: UHC Medicare Advantage |
$103.00
|
| Rate for Payer: UHCCP Medicaid |
$66.27
|
| Rate for Payer: VA VA |
$103.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.00
|
|
|
HC MR ABDOMEN W CON
|
Facility
|
OP
|
$2,364.72
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$258.20 |
| Max. Negotiated Rate |
$2,128.25 |
| Rate for Payer: Aetna Commercial |
$2,010.01
|
| Rate for Payer: Aetna Medicare |
$614.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$738.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$738.98
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$591.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,944.04
|
| Rate for Payer: BCN Commercial |
$1,838.57
|
| Rate for Payer: BCN Medicare Advantage |
$591.18
|
| Rate for Payer: Cash Price |
$1,891.78
|
| Rate for Payer: Cash Price |
$1,891.78
|
| Rate for Payer: Cofinity Commercial |
$2,033.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.18
|
| Rate for Payer: Healthscope Commercial |
$2,128.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,773.54
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$620.74
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$679.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,010.01
|
| Rate for Payer: Nomi Health Commercial |
$1,939.07
|
| Rate for Payer: PACE Senior Care Partners |
$561.62
|
| Rate for Payer: PACE SWMI |
$591.18
|
| Rate for Payer: PHP Commercial |
$2,010.01
|
| Rate for Payer: PHP Medicare Advantage |
$591.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.07
|
| Rate for Payer: Priority Health HMO/PPO |
$2,057.31
|
| Rate for Payer: Priority Health Medicare |
$597.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,584.36
|
| Rate for Payer: Railroad Medicare Medicare |
$591.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,080.95
|
| Rate for Payer: UHC Core |
$1,974.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$591.18
|
| Rate for Payer: UHC Exchange |
$591.18
|
| Rate for Payer: UHC Medicare Advantage |
$591.18
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$591.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,773.54
|
|
|
HC MR ABDOMEN W CON
|
Facility
|
IP
|
$2,364.72
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,537.07 |
| Max. Negotiated Rate |
$2,128.25 |
| Rate for Payer: Aetna Commercial |
$2,010.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,930.32
|
| Rate for Payer: BCN Commercial |
$1,827.46
|
| Rate for Payer: Cash Price |
$1,891.78
|
| Rate for Payer: Cofinity Commercial |
$2,033.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.78
|
| Rate for Payer: Healthscope Commercial |
$2,128.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,773.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,010.01
|
| Rate for Payer: Nomi Health Commercial |
$1,939.07
|
| Rate for Payer: PHP Commercial |
$2,010.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.07
|
| Rate for Payer: Priority Health HMO/PPO |
$2,057.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,584.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,080.95
|
| Rate for Payer: UHC Core |
$1,974.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,773.54
|
|
|
HC MR ABDOMEN WO CON
|
Facility
|
IP
|
$2,110.45
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000082
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,371.79 |
| Max. Negotiated Rate |
$1,899.40 |
| Rate for Payer: Aetna Commercial |
$1,793.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,722.76
|
| Rate for Payer: BCN Commercial |
$1,630.96
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cofinity Commercial |
$1,814.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,688.36
|
| Rate for Payer: Healthscope Commercial |
$1,899.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,582.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,793.88
|
| Rate for Payer: Nomi Health Commercial |
$1,730.57
|
| Rate for Payer: PHP Commercial |
$1,793.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,371.79
|
| Rate for Payer: Priority Health HMO/PPO |
$1,836.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,414.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,857.20
|
| Rate for Payer: UHC Core |
$1,762.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,582.84
|
|
|
HC MR ABDOMEN WO CON
|
Facility
|
OP
|
$2,110.45
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000082
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$174.76 |
| Max. Negotiated Rate |
$1,899.40 |
| Rate for Payer: Aetna Commercial |
$1,793.88
|
| Rate for Payer: Aetna Medicare |
$548.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$659.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$659.52
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$527.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,735.00
|
| Rate for Payer: BCN Commercial |
$1,640.87
|
| Rate for Payer: BCN Medicare Advantage |
$527.61
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cofinity Commercial |
$1,814.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,688.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.61
|
| Rate for Payer: Healthscope Commercial |
$1,899.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,582.84
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.99
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$606.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,793.88
|
| Rate for Payer: Nomi Health Commercial |
$1,730.57
|
| Rate for Payer: PACE Senior Care Partners |
$501.23
|
| Rate for Payer: PACE SWMI |
$527.61
|
| Rate for Payer: PHP Commercial |
$1,793.88
|
| Rate for Payer: PHP Medicare Advantage |
$527.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,371.79
|
| Rate for Payer: Priority Health HMO/PPO |
$1,836.09
|
| Rate for Payer: Priority Health Medicare |
$532.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,414.00
|
| Rate for Payer: Railroad Medicare Medicare |
$527.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,857.20
|
| Rate for Payer: UHC Core |
$1,762.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.61
|
| Rate for Payer: UHC Exchange |
$527.61
|
| Rate for Payer: UHC Medicare Advantage |
$527.61
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$527.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,582.84
|
|
|
HC MR ABDOMEN WO W CON
|
Facility
|
OP
|
$3,090.30
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
61000044
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$258.20 |
| Max. Negotiated Rate |
$2,781.27 |
| Rate for Payer: Aetna Commercial |
$2,626.76
|
| Rate for Payer: Aetna Medicare |
$803.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$965.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$965.72
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$772.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,540.54
|
| Rate for Payer: BCN Commercial |
$2,402.71
|
| Rate for Payer: BCN Medicare Advantage |
$772.58
|
| Rate for Payer: Cash Price |
$2,472.24
|
| Rate for Payer: Cash Price |
$2,472.24
|
| Rate for Payer: Cofinity Commercial |
$2,657.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,472.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.58
|
| Rate for Payer: Healthscope Commercial |
$2,781.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,317.72
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$811.20
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$888.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,626.76
|
| Rate for Payer: Nomi Health Commercial |
$2,534.05
|
| Rate for Payer: PACE Senior Care Partners |
$733.95
|
| Rate for Payer: PACE SWMI |
$772.58
|
| Rate for Payer: PHP Commercial |
$2,626.76
|
| Rate for Payer: PHP Medicare Advantage |
$772.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,008.69
|
| Rate for Payer: Priority Health HMO/PPO |
$2,688.56
|
| Rate for Payer: Priority Health Medicare |
$780.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,070.50
|
| Rate for Payer: Railroad Medicare Medicare |
$772.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,719.46
|
| Rate for Payer: UHC Core |
$2,580.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$772.58
|
| Rate for Payer: UHC Exchange |
$772.58
|
| Rate for Payer: UHC Medicare Advantage |
$772.58
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$772.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,317.72
|
|
|
HC MR ABDOMEN WO W CON
|
Facility
|
IP
|
$3,090.30
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
61000044
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,008.69 |
| Max. Negotiated Rate |
$2,781.27 |
| Rate for Payer: Aetna Commercial |
$2,626.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,522.61
|
| Rate for Payer: BCN Commercial |
$2,388.18
|
| Rate for Payer: Cash Price |
$2,472.24
|
| Rate for Payer: Cofinity Commercial |
$2,657.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,472.24
|
| Rate for Payer: Healthscope Commercial |
$2,781.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,317.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,626.76
|
| Rate for Payer: Nomi Health Commercial |
$2,534.05
|
| Rate for Payer: PHP Commercial |
$2,626.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,008.69
|
| Rate for Payer: Priority Health HMO/PPO |
$2,688.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,070.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,719.46
|
| Rate for Payer: UHC Core |
$2,580.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,317.72
|
|
|
HC MRA HEAD WO CON
|
Facility
|
OP
|
$1,809.20
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
61500001
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$174.76 |
| Max. Negotiated Rate |
$1,628.28 |
| Rate for Payer: Aetna Commercial |
$1,537.82
|
| Rate for Payer: Aetna Medicare |
$470.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$565.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$565.38
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$452.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,487.34
|
| Rate for Payer: BCN Commercial |
$1,406.65
|
| Rate for Payer: BCN Medicare Advantage |
$452.30
|
| Rate for Payer: Cash Price |
$1,447.36
|
| Rate for Payer: Cash Price |
$1,447.36
|
| Rate for Payer: Cofinity Commercial |
$1,555.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,447.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$452.30
|
| Rate for Payer: Healthscope Commercial |
$1,628.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,356.90
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$474.92
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$520.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,537.82
|
| Rate for Payer: Nomi Health Commercial |
$1,483.54
|
| Rate for Payer: PACE Senior Care Partners |
$429.69
|
| Rate for Payer: PACE SWMI |
$452.30
|
| Rate for Payer: PHP Commercial |
$1,537.82
|
| Rate for Payer: PHP Medicare Advantage |
$452.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,175.98
|
| Rate for Payer: Priority Health HMO/PPO |
$1,574.00
|
| Rate for Payer: Priority Health Medicare |
$456.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,212.16
|
| Rate for Payer: Railroad Medicare Medicare |
$452.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,592.10
|
| Rate for Payer: UHC Core |
$1,510.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$452.30
|
| Rate for Payer: UHC Exchange |
$452.30
|
| Rate for Payer: UHC Medicare Advantage |
$452.30
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$452.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,356.90
|
|
|
HC MRA HEAD WO CON
|
Facility
|
IP
|
$1,809.20
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
61500001
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,175.98 |
| Max. Negotiated Rate |
$1,628.28 |
| Rate for Payer: Aetna Commercial |
$1,537.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.85
|
| Rate for Payer: BCN Commercial |
$1,398.15
|
| Rate for Payer: Cash Price |
$1,447.36
|
| Rate for Payer: Cofinity Commercial |
$1,555.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,447.36
|
| Rate for Payer: Healthscope Commercial |
$1,628.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,356.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,537.82
|
| Rate for Payer: Nomi Health Commercial |
$1,483.54
|
| Rate for Payer: PHP Commercial |
$1,537.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,175.98
|
| Rate for Payer: Priority Health HMO/PPO |
$1,574.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,212.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,592.10
|
| Rate for Payer: UHC Core |
$1,510.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,356.90
|
|
|
HC MRA HEAD WO W CON
|
Facility
|
IP
|
$3,052.80
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
61000006
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,984.32 |
| Max. Negotiated Rate |
$2,747.52 |
| Rate for Payer: Aetna Commercial |
$2,594.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,492.00
|
| Rate for Payer: BCN Commercial |
$2,359.20
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cofinity Commercial |
$2,625.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.24
|
| Rate for Payer: Healthscope Commercial |
$2,747.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,289.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.88
|
| Rate for Payer: Nomi Health Commercial |
$2,503.30
|
| Rate for Payer: PHP Commercial |
$2,594.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,655.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,045.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,686.46
|
| Rate for Payer: UHC Core |
$2,549.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,289.60
|
|
|
HC MRA HEAD WO W CON
|
Facility
|
OP
|
$3,052.80
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
61000006
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$258.20 |
| Max. Negotiated Rate |
$2,747.52 |
| Rate for Payer: Aetna Commercial |
$2,594.88
|
| Rate for Payer: Aetna Medicare |
$793.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$954.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$954.00
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$763.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,509.71
|
| Rate for Payer: BCN Commercial |
$2,373.55
|
| Rate for Payer: BCN Medicare Advantage |
$763.20
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cofinity Commercial |
$2,625.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$763.20
|
| Rate for Payer: Healthscope Commercial |
$2,747.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,289.60
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$801.36
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$877.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.88
|
| Rate for Payer: Nomi Health Commercial |
$2,503.30
|
| Rate for Payer: PACE Senior Care Partners |
$725.04
|
| Rate for Payer: PACE SWMI |
$763.20
|
| Rate for Payer: PHP Commercial |
$2,594.88
|
| Rate for Payer: PHP Medicare Advantage |
$763.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,655.94
|
| Rate for Payer: Priority Health Medicare |
$770.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,045.38
|
| Rate for Payer: Railroad Medicare Medicare |
$763.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,686.46
|
| Rate for Payer: UHC Core |
$2,549.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$763.20
|
| Rate for Payer: UHC Exchange |
$763.20
|
| Rate for Payer: UHC Medicare Advantage |
$763.20
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$763.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,289.60
|
|
|
HC MR BONE MARROW BLOOD SUPPLY
|
Facility
|
IP
|
$1,412.55
|
|
|
Service Code
|
CPT 77084
|
| Hospital Charge Code |
61000051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$918.16 |
| Max. Negotiated Rate |
$1,271.30 |
| Rate for Payer: Aetna Commercial |
$1,200.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,153.06
|
| Rate for Payer: BCN Commercial |
$1,091.62
|
| Rate for Payer: Cash Price |
$1,130.04
|
| Rate for Payer: Cofinity Commercial |
$1,214.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.04
|
| Rate for Payer: Healthscope Commercial |
$1,271.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,059.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.67
|
| Rate for Payer: Nomi Health Commercial |
$1,158.29
|
| Rate for Payer: PHP Commercial |
$1,200.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1,228.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$946.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,243.04
|
| Rate for Payer: UHC Core |
$1,179.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,059.41
|
|
|
HC MR BONE MARROW BLOOD SUPPLY
|
Facility
|
OP
|
$1,412.55
|
|
|
Service Code
|
CPT 77084
|
| Hospital Charge Code |
61000051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$174.76 |
| Max. Negotiated Rate |
$1,271.30 |
| Rate for Payer: Aetna Commercial |
$1,200.67
|
| Rate for Payer: Aetna Medicare |
$367.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$441.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$441.42
|
| Rate for Payer: BCBS Complete |
$183.51
|
| Rate for Payer: BCBS MAPPO |
$353.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,161.26
|
| Rate for Payer: BCN Commercial |
$1,098.26
|
| Rate for Payer: BCN Medicare Advantage |
$353.14
|
| Rate for Payer: Cash Price |
$1,130.04
|
| Rate for Payer: Cash Price |
$1,130.04
|
| Rate for Payer: Cofinity Commercial |
$1,214.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$353.14
|
| Rate for Payer: Healthscope Commercial |
$1,271.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,059.41
|
| Rate for Payer: Mclaren Medicaid |
$174.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.79
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$406.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.67
|
| Rate for Payer: Nomi Health Commercial |
$1,158.29
|
| Rate for Payer: PACE Senior Care Partners |
$335.48
|
| Rate for Payer: PACE SWMI |
$353.14
|
| Rate for Payer: PHP Commercial |
$1,200.67
|
| Rate for Payer: PHP Medicare Advantage |
$353.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1,228.92
|
| Rate for Payer: Priority Health Medicare |
$356.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$946.41
|
| Rate for Payer: Railroad Medicare Medicare |
$353.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,243.04
|
| Rate for Payer: UHC Core |
$1,179.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$353.14
|
| Rate for Payer: UHC Exchange |
$353.14
|
| Rate for Payer: UHC Medicare Advantage |
$353.14
|
| Rate for Payer: UHCCP Medicaid |
$174.76
|
| Rate for Payer: VA VA |
$353.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,059.41
|
|
|
HC MR BRAIN STEREO W CON REDUCED
|
Facility
|
IP
|
$1,857.93
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100006
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,207.65 |
| Max. Negotiated Rate |
$1,672.14 |
| Rate for Payer: Aetna Commercial |
$1,579.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,516.63
|
| Rate for Payer: BCN Commercial |
$1,435.81
|
| Rate for Payer: Cash Price |
$1,486.34
|
| Rate for Payer: Cofinity Commercial |
$1,597.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,486.34
|
| Rate for Payer: Healthscope Commercial |
$1,672.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,393.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,579.24
|
| Rate for Payer: Nomi Health Commercial |
$1,523.50
|
| Rate for Payer: PHP Commercial |
$1,579.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,207.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,616.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,244.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,634.98
|
| Rate for Payer: UHC Core |
$1,551.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,393.45
|
|
|
HC MR BRAIN STEREO W CON REDUCED
|
Facility
|
OP
|
$1,857.93
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100006
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$441.26 |
| Max. Negotiated Rate |
$1,672.14 |
| Rate for Payer: Aetna Commercial |
$1,579.24
|
| Rate for Payer: Aetna Medicare |
$483.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$580.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$580.60
|
| Rate for Payer: BCBS Complete |
$743.17
|
| Rate for Payer: BCBS MAPPO |
$464.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,527.40
|
| Rate for Payer: BCN Commercial |
$1,444.54
|
| Rate for Payer: BCN Medicare Advantage |
$464.48
|
| Rate for Payer: Cash Price |
$1,486.34
|
| Rate for Payer: Cofinity Commercial |
$1,597.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,486.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$464.48
|
| Rate for Payer: Healthscope Commercial |
$1,672.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,393.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$487.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$534.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,579.24
|
| Rate for Payer: Nomi Health Commercial |
$1,523.50
|
| Rate for Payer: PACE Senior Care Partners |
$441.26
|
| Rate for Payer: PACE SWMI |
$464.48
|
| Rate for Payer: PHP Commercial |
$1,579.24
|
| Rate for Payer: PHP Medicare Advantage |
$464.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,207.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,616.40
|
| Rate for Payer: Priority Health Medicare |
$469.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,244.81
|
| Rate for Payer: Railroad Medicare Medicare |
$464.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,634.98
|
| Rate for Payer: UHC Core |
$1,551.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$464.48
|
| Rate for Payer: UHC Exchange |
$464.48
|
| Rate for Payer: UHC Medicare Advantage |
$464.48
|
| Rate for Payer: VA VA |
$464.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,393.45
|
|
|
HC MR BRAIN STEREO WO CON REDUCED
|
Facility
|
OP
|
$1,548.26
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100005
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$367.71 |
| Max. Negotiated Rate |
$1,393.43 |
| Rate for Payer: Aetna Commercial |
$1,316.02
|
| Rate for Payer: Aetna Medicare |
$402.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$483.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$483.83
|
| Rate for Payer: BCBS Complete |
$619.30
|
| Rate for Payer: BCBS MAPPO |
$387.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,272.82
|
| Rate for Payer: BCN Commercial |
$1,203.77
|
| Rate for Payer: BCN Medicare Advantage |
$387.06
|
| Rate for Payer: Cash Price |
$1,238.61
|
| Rate for Payer: Cofinity Commercial |
$1,331.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.06
|
| Rate for Payer: Healthscope Commercial |
$1,393.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,161.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$445.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,316.02
|
| Rate for Payer: Nomi Health Commercial |
$1,269.57
|
| Rate for Payer: PACE Senior Care Partners |
$367.71
|
| Rate for Payer: PACE SWMI |
$387.06
|
| Rate for Payer: PHP Commercial |
$1,316.02
|
| Rate for Payer: PHP Medicare Advantage |
$387.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.37
|
| Rate for Payer: Priority Health HMO/PPO |
$1,346.99
|
| Rate for Payer: Priority Health Medicare |
$390.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,037.33
|
| Rate for Payer: Railroad Medicare Medicare |
$387.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,362.47
|
| Rate for Payer: UHC Core |
$1,292.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.06
|
| Rate for Payer: UHC Exchange |
$387.06
|
| Rate for Payer: UHC Medicare Advantage |
$387.06
|
| Rate for Payer: VA VA |
$387.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,161.19
|
|
|
HC MR BRAIN STEREO WO CON REDUCED
|
Facility
|
IP
|
$1,548.26
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100005
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,006.37 |
| Max. Negotiated Rate |
$1,393.43 |
| Rate for Payer: Aetna Commercial |
$1,316.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,263.84
|
| Rate for Payer: BCN Commercial |
$1,196.50
|
| Rate for Payer: Cash Price |
$1,238.61
|
| Rate for Payer: Cofinity Commercial |
$1,331.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,238.61
|
| Rate for Payer: Healthscope Commercial |
$1,393.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,161.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,316.02
|
| Rate for Payer: Nomi Health Commercial |
$1,269.57
|
| Rate for Payer: PHP Commercial |
$1,316.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.37
|
| Rate for Payer: Priority Health HMO/PPO |
$1,346.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,037.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,362.47
|
| Rate for Payer: UHC Core |
$1,292.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,161.19
|
|
|
HC MR BRAIN STEREO WO W CON REDUCED
|
Facility
|
IP
|
$2,365.89
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100007
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,537.83 |
| Max. Negotiated Rate |
$2,129.30 |
| Rate for Payer: Aetna Commercial |
$2,011.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,931.28
|
| Rate for Payer: BCN Commercial |
$1,828.36
|
| Rate for Payer: Cash Price |
$1,892.71
|
| Rate for Payer: Cofinity Commercial |
$2,034.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,892.71
|
| Rate for Payer: Healthscope Commercial |
$2,129.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,774.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.01
|
| Rate for Payer: Nomi Health Commercial |
$1,940.03
|
| Rate for Payer: PHP Commercial |
$2,011.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.83
|
| Rate for Payer: Priority Health HMO/PPO |
$2,058.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,585.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,081.98
|
| Rate for Payer: UHC Core |
$1,975.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,774.42
|
|
|
HC MR BRAIN STEREO WO W CON REDUCED
|
Facility
|
OP
|
$2,365.89
|
|
|
Service Code
|
CPT 77021
|
| Hospital Charge Code |
61100007
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$561.90 |
| Max. Negotiated Rate |
$2,129.30 |
| Rate for Payer: Aetna Commercial |
$2,011.01
|
| Rate for Payer: Aetna Medicare |
$615.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$739.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$739.34
|
| Rate for Payer: BCBS Complete |
$946.36
|
| Rate for Payer: BCBS MAPPO |
$591.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,945.00
|
| Rate for Payer: BCN Commercial |
$1,839.48
|
| Rate for Payer: BCN Medicare Advantage |
$591.47
|
| Rate for Payer: Cash Price |
$1,892.71
|
| Rate for Payer: Cofinity Commercial |
$2,034.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,892.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.47
|
| Rate for Payer: Healthscope Commercial |
$2,129.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,774.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$621.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$680.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.01
|
| Rate for Payer: Nomi Health Commercial |
$1,940.03
|
| Rate for Payer: PACE Senior Care Partners |
$561.90
|
| Rate for Payer: PACE SWMI |
$591.47
|
| Rate for Payer: PHP Commercial |
$2,011.01
|
| Rate for Payer: PHP Medicare Advantage |
$591.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.83
|
| Rate for Payer: Priority Health HMO/PPO |
$2,058.32
|
| Rate for Payer: Priority Health Medicare |
$597.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,585.15
|
| Rate for Payer: Railroad Medicare Medicare |
$591.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,081.98
|
| Rate for Payer: UHC Core |
$1,975.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$591.47
|
| Rate for Payer: UHC Exchange |
$591.47
|
| Rate for Payer: UHC Medicare Advantage |
$591.47
|
| Rate for Payer: VA VA |
$591.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,774.42
|
|
|
HC MR BRAIN W CON
|
Facility
|
OP
|
$2,487.28
|
|
|
Service Code
|
CPT 70552
|
| Hospital Charge Code |
61100002
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$258.20 |
| Max. Negotiated Rate |
$2,238.55 |
| Rate for Payer: Aetna Commercial |
$2,114.19
|
| Rate for Payer: Aetna Medicare |
$646.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$777.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$777.27
|
| Rate for Payer: BCBS Complete |
$271.13
|
| Rate for Payer: BCBS MAPPO |
$621.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,044.79
|
| Rate for Payer: BCN Commercial |
$1,933.86
|
| Rate for Payer: BCN Medicare Advantage |
$621.82
|
| Rate for Payer: Cash Price |
$1,989.82
|
| Rate for Payer: Cash Price |
$1,989.82
|
| Rate for Payer: Cofinity Commercial |
$2,139.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,989.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$621.82
|
| Rate for Payer: Healthscope Commercial |
$2,238.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,865.46
|
| Rate for Payer: Mclaren Medicaid |
$258.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$652.91
|
| Rate for Payer: Meridian Medicaid |
$271.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$715.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,114.19
|
| Rate for Payer: Nomi Health Commercial |
$2,039.57
|
| Rate for Payer: PACE Senior Care Partners |
$590.73
|
| Rate for Payer: PACE SWMI |
$621.82
|
| Rate for Payer: PHP Commercial |
$2,114.19
|
| Rate for Payer: PHP Medicare Advantage |
$621.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$258.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,616.73
|
| Rate for Payer: Priority Health HMO/PPO |
$2,163.93
|
| Rate for Payer: Priority Health Medicare |
$628.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,666.48
|
| Rate for Payer: Railroad Medicare Medicare |
$621.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,188.81
|
| Rate for Payer: UHC Core |
$2,076.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$621.82
|
| Rate for Payer: UHC Exchange |
$621.82
|
| Rate for Payer: UHC Medicare Advantage |
$621.82
|
| Rate for Payer: UHCCP Medicaid |
$258.20
|
| Rate for Payer: VA VA |
$621.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,865.46
|
|
|
HC MR BRAIN W CON
|
Facility
|
IP
|
$2,487.28
|
|
|
Service Code
|
CPT 70552
|
| Hospital Charge Code |
61100002
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,616.73 |
| Max. Negotiated Rate |
$2,238.55 |
| Rate for Payer: Aetna Commercial |
$2,114.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,030.37
|
| Rate for Payer: BCN Commercial |
$1,922.17
|
| Rate for Payer: Cash Price |
$1,989.82
|
| Rate for Payer: Cofinity Commercial |
$2,139.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,989.82
|
| Rate for Payer: Healthscope Commercial |
$2,238.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,865.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,114.19
|
| Rate for Payer: Nomi Health Commercial |
$2,039.57
|
| Rate for Payer: PHP Commercial |
$2,114.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,616.73
|
| Rate for Payer: Priority Health HMO/PPO |
$2,163.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,666.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,188.81
|
| Rate for Payer: UHC Core |
$2,076.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,865.46
|
|
|
HC MR BRAIN WO CON
|
Facility
|
IP
|
$2,072.90
|
|
|
Service Code
|
CPT 70551
|
| Hospital Charge Code |
61100001
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,347.38 |
| Max. Negotiated Rate |
$1,865.61 |
| Rate for Payer: Aetna Commercial |
$1,761.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,692.11
|
| Rate for Payer: BCN Commercial |
$1,601.94
|
| Rate for Payer: Cash Price |
$1,658.32
|
| Rate for Payer: Cofinity Commercial |
$1,782.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,658.32
|
| Rate for Payer: Healthscope Commercial |
$1,865.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,554.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,761.96
|
| Rate for Payer: Nomi Health Commercial |
$1,699.78
|
| Rate for Payer: PHP Commercial |
$1,761.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.38
|
| Rate for Payer: Priority Health HMO/PPO |
$1,803.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,388.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,824.15
|
| Rate for Payer: UHC Core |
$1,730.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,554.67
|
|
