|
HC MR LOWER EXTREM NO JOINT WO W CON
|
Facility
|
OP
|
$3,029.70
|
|
|
Service Code
|
CPT 73720
|
| Hospital Charge Code |
61000033
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,726.73 |
| Rate for Payer: Aetna Commercial |
$2,575.24
|
| Rate for Payer: Aetna Commercial |
$3,862.87
|
| Rate for Payer: Aetna Medicare |
$787.72
|
| Rate for Payer: Aetna Medicare |
$1,181.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$946.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,420.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$946.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,420.17
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$1,136.14
|
| Rate for Payer: BCBS MAPPO |
$757.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,490.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,736.07
|
| Rate for Payer: BCN Commercial |
$2,355.59
|
| Rate for Payer: BCN Commercial |
$3,533.39
|
| Rate for Payer: BCN Medicare Advantage |
$757.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,136.14
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cash Price |
$2,423.76
|
| Rate for Payer: Cash Price |
$3,635.64
|
| Rate for Payer: Cofinity Commercial |
$2,605.54
|
| Rate for Payer: Cofinity Commercial |
$3,908.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,635.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,423.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$757.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,136.14
|
| Rate for Payer: Healthscope Commercial |
$4,090.10
|
| Rate for Payer: Healthscope Commercial |
$2,726.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,272.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,408.41
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,192.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$795.30
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$871.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,575.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,862.87
|
| Rate for Payer: Nomi Health Commercial |
$2,484.35
|
| Rate for Payer: Nomi Health Commercial |
$3,726.53
|
| Rate for Payer: PACE Senior Care Partners |
$719.55
|
| Rate for Payer: PACE Senior Care Partners |
$1,079.33
|
| Rate for Payer: PACE SWMI |
$757.42
|
| Rate for Payer: PACE SWMI |
$1,136.14
|
| Rate for Payer: PHP Commercial |
$3,862.87
|
| Rate for Payer: PHP Commercial |
$2,575.24
|
| Rate for Payer: PHP Medicare Advantage |
$757.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,136.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,969.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,953.96
|
| Rate for Payer: Priority Health HMO/PPO |
$3,953.76
|
| Rate for Payer: Priority Health HMO/PPO |
$2,635.84
|
| Rate for Payer: Priority Health Medicare |
$765.00
|
| Rate for Payer: Priority Health Medicare |
$1,147.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,029.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,044.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,136.14
|
| Rate for Payer: Railroad Medicare Medicare |
$757.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,999.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,666.14
|
| Rate for Payer: UHC Core |
$3,794.70
|
| Rate for Payer: UHC Core |
$2,529.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$757.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,136.14
|
| Rate for Payer: UHC Exchange |
$1,136.14
|
| Rate for Payer: UHC Exchange |
$757.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,136.14
|
| Rate for Payer: UHC Medicare Advantage |
$757.42
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$757.42
|
| Rate for Payer: VA VA |
$1,136.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,272.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,408.41
|
|
|
HC MR MRA ABDOMEN W CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8900
|
| Hospital Charge Code |
61000060
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,463.84 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,838.36
|
| Rate for Payer: BCN Commercial |
$1,740.39
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: Nomi Health Commercial |
$1,846.69
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health HMO/PPO |
$1,959.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,508.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.81
|
| Rate for Payer: UHC Core |
$1,880.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
|
|
HC MR MRA ABDOMEN W CON
|
Facility
|
OP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8900
|
| Hospital Charge Code |
61000060
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna Medicare |
$585.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$703.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$703.77
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$563.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,851.42
|
| Rate for Payer: BCN Commercial |
$1,750.98
|
| Rate for Payer: BCN Medicare Advantage |
$563.02
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.02
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.17
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$647.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: Nomi Health Commercial |
$1,846.69
|
| Rate for Payer: PACE Senior Care Partners |
$534.86
|
| Rate for Payer: PACE SWMI |
$563.02
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: PHP Medicare Advantage |
$563.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health HMO/PPO |
$1,959.29
|
| Rate for Payer: Priority Health Medicare |
$568.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,508.88
|
| Rate for Payer: Railroad Medicare Medicare |
$563.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.81
|
| Rate for Payer: UHC Core |
$1,880.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.02
|
| Rate for Payer: UHC Exchange |
$563.02
|
| Rate for Payer: UHC Medicare Advantage |
$563.02
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$563.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
|
|
HC MR MRA ABDOMEN WO CON
|
Facility
|
OP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
61000061
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna Medicare |
$548.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$659.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$659.81
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$527.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,735.78
|
| Rate for Payer: BCN Commercial |
$1,641.61
|
| Rate for Payer: BCN Medicare Advantage |
$527.85
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.85
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,583.55
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.24
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$607.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,794.69
|
| Rate for Payer: Nomi Health Commercial |
$1,731.35
|
| Rate for Payer: PACE Senior Care Partners |
$501.46
|
| Rate for Payer: PACE SWMI |
$527.85
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: PHP Medicare Advantage |
$527.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,372.41
|
| Rate for Payer: Priority Health HMO/PPO |
$1,836.92
|
| Rate for Payer: Priority Health Medicare |
$533.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,414.64
|
| Rate for Payer: Railroad Medicare Medicare |
$527.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,858.03
|
| Rate for Payer: UHC Core |
$1,763.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.85
|
| Rate for Payer: UHC Exchange |
$527.85
|
| Rate for Payer: UHC Medicare Advantage |
$527.85
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$527.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,583.55
|
|
|
HC MR MRA ABDOMEN WO CON
|
Facility
|
IP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8901
|
| Hospital Charge Code |
61000061
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,372.41 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,723.54
|
| Rate for Payer: BCN Commercial |
$1,631.69
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,583.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,794.69
|
| Rate for Payer: Nomi Health Commercial |
$1,731.35
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,372.41
|
| Rate for Payer: Priority Health HMO/PPO |
$1,836.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,414.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,858.03
|
| Rate for Payer: UHC Core |
$1,763.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,583.55
|
|
|
HC MR MRA ABDOMEN WO W CON
|
Facility
|
OP
|
$2,727.83
|
|
|
Service Code
|
HCPCS C8902
|
| Hospital Charge Code |
61000062
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,455.05 |
| Rate for Payer: Aetna Commercial |
$2,318.66
|
| Rate for Payer: Aetna Medicare |
$709.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$852.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$852.45
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$681.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,242.55
|
| Rate for Payer: BCN Commercial |
$2,120.89
|
| Rate for Payer: BCN Medicare Advantage |
$681.96
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cofinity Commercial |
$2,345.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,182.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$681.96
|
| Rate for Payer: Healthscope Commercial |
$2,455.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,045.87
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$716.06
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$784.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,318.66
|
| Rate for Payer: Nomi Health Commercial |
$2,236.82
|
| Rate for Payer: PACE Senior Care Partners |
$647.86
|
| Rate for Payer: PACE SWMI |
$681.96
|
| Rate for Payer: PHP Commercial |
$2,318.66
|
| Rate for Payer: PHP Medicare Advantage |
$681.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.09
|
| Rate for Payer: Priority Health HMO/PPO |
$2,373.21
|
| Rate for Payer: Priority Health Medicare |
$688.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,827.65
|
| Rate for Payer: Railroad Medicare Medicare |
$681.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,400.49
|
| Rate for Payer: UHC Core |
$2,277.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$681.96
|
| Rate for Payer: UHC Exchange |
$681.96
|
| Rate for Payer: UHC Medicare Advantage |
$681.96
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$681.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,045.87
|
|
|
HC MR MRA ABDOMEN WO W CON
|
Facility
|
IP
|
$2,727.83
|
|
|
Service Code
|
HCPCS C8902
|
| Hospital Charge Code |
61000062
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,773.09 |
| Max. Negotiated Rate |
$2,455.05 |
| Rate for Payer: Aetna Commercial |
$2,318.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,226.73
|
| Rate for Payer: BCN Commercial |
$2,108.07
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cofinity Commercial |
$2,345.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,182.26
|
| Rate for Payer: Healthscope Commercial |
$2,455.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,045.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,318.66
|
| Rate for Payer: Nomi Health Commercial |
$2,236.82
|
| Rate for Payer: PHP Commercial |
$2,318.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.09
|
| Rate for Payer: Priority Health HMO/PPO |
$2,373.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,827.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,400.49
|
| Rate for Payer: UHC Core |
$2,277.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,045.87
|
|
|
HC MR MRA CHEST W CON
|
Facility
|
IP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8909
|
| Hospital Charge Code |
61000063
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,463.84 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,838.36
|
| Rate for Payer: BCN Commercial |
$1,740.39
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: Nomi Health Commercial |
$1,846.69
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health HMO/PPO |
$1,959.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,508.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.81
|
| Rate for Payer: UHC Core |
$1,880.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
|
|
HC MR MRA CHEST W CON
|
Facility
|
OP
|
$2,252.06
|
|
|
Service Code
|
HCPCS C8909
|
| Hospital Charge Code |
61000063
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,026.85 |
| Rate for Payer: Aetna Commercial |
$1,914.25
|
| Rate for Payer: Aetna Medicare |
$585.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$703.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$703.77
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$563.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,851.42
|
| Rate for Payer: BCN Commercial |
$1,750.98
|
| Rate for Payer: BCN Medicare Advantage |
$563.02
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cash Price |
$1,801.65
|
| Rate for Payer: Cofinity Commercial |
$1,936.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.02
|
| Rate for Payer: Healthscope Commercial |
$2,026.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.17
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$647.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.25
|
| Rate for Payer: Nomi Health Commercial |
$1,846.69
|
| Rate for Payer: PACE Senior Care Partners |
$534.86
|
| Rate for Payer: PACE SWMI |
$563.02
|
| Rate for Payer: PHP Commercial |
$1,914.25
|
| Rate for Payer: PHP Medicare Advantage |
$563.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.84
|
| Rate for Payer: Priority Health HMO/PPO |
$1,959.29
|
| Rate for Payer: Priority Health Medicare |
$568.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,508.88
|
| Rate for Payer: Railroad Medicare Medicare |
$563.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.81
|
| Rate for Payer: UHC Core |
$1,880.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.02
|
| Rate for Payer: UHC Exchange |
$563.02
|
| Rate for Payer: UHC Medicare Advantage |
$563.02
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$563.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
|
|
HC MR MRA CHEST WO CON
|
Facility
|
IP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8910
|
| Hospital Charge Code |
61000064
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,372.41 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,723.54
|
| Rate for Payer: BCN Commercial |
$1,631.69
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,583.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,794.69
|
| Rate for Payer: Nomi Health Commercial |
$1,731.35
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,372.41
|
| Rate for Payer: Priority Health HMO/PPO |
$1,836.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,414.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,858.03
|
| Rate for Payer: UHC Core |
$1,763.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,583.55
|
|
|
HC MR MRA CHEST WO CON
|
Facility
|
OP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8910
|
| Hospital Charge Code |
61000064
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna Medicare |
$548.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$659.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$659.81
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$527.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,735.78
|
| Rate for Payer: BCN Commercial |
$1,641.61
|
| Rate for Payer: BCN Medicare Advantage |
$527.85
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.85
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,583.55
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.24
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$607.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,794.69
|
| Rate for Payer: Nomi Health Commercial |
$1,731.35
|
| Rate for Payer: PACE Senior Care Partners |
$501.46
|
| Rate for Payer: PACE SWMI |
$527.85
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: PHP Medicare Advantage |
$527.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,372.41
|
| Rate for Payer: Priority Health HMO/PPO |
$1,836.92
|
| Rate for Payer: Priority Health Medicare |
$533.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,414.64
|
| Rate for Payer: Railroad Medicare Medicare |
$527.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,858.03
|
| Rate for Payer: UHC Core |
$1,763.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.85
|
| Rate for Payer: UHC Exchange |
$527.85
|
| Rate for Payer: UHC Medicare Advantage |
$527.85
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$527.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,583.55
|
|
|
HC MR MRA CHEST WO W CON
|
Facility
|
IP
|
$2,727.83
|
|
|
Service Code
|
HCPCS C8911
|
| Hospital Charge Code |
61000065
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,773.09 |
| Max. Negotiated Rate |
$2,455.05 |
| Rate for Payer: Aetna Commercial |
$2,318.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,226.73
|
| Rate for Payer: BCN Commercial |
$2,108.07
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cofinity Commercial |
$2,345.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,182.26
|
| Rate for Payer: Healthscope Commercial |
$2,455.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,045.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,318.66
|
| Rate for Payer: Nomi Health Commercial |
$2,236.82
|
| Rate for Payer: PHP Commercial |
$2,318.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.09
|
| Rate for Payer: Priority Health HMO/PPO |
$2,373.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,827.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,400.49
|
| Rate for Payer: UHC Core |
$2,277.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,045.87
|
|
|
HC MR MRA CHEST WO W CON
|
Facility
|
OP
|
$2,727.83
|
|
|
Service Code
|
HCPCS C8911
|
| Hospital Charge Code |
61000065
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,455.05 |
| Rate for Payer: Aetna Commercial |
$2,318.66
|
| Rate for Payer: Aetna Medicare |
$709.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$852.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$852.45
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$681.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,242.55
|
| Rate for Payer: BCN Commercial |
$2,120.89
|
| Rate for Payer: BCN Medicare Advantage |
$681.96
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cash Price |
$2,182.26
|
| Rate for Payer: Cofinity Commercial |
$2,345.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,182.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$681.96
|
| Rate for Payer: Healthscope Commercial |
$2,455.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,045.87
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$716.06
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$784.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,318.66
|
| Rate for Payer: Nomi Health Commercial |
$2,236.82
|
| Rate for Payer: PACE Senior Care Partners |
$647.86
|
| Rate for Payer: PACE SWMI |
$681.96
|
| Rate for Payer: PHP Commercial |
$2,318.66
|
| Rate for Payer: PHP Medicare Advantage |
$681.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,773.09
|
| Rate for Payer: Priority Health HMO/PPO |
$2,373.21
|
| Rate for Payer: Priority Health Medicare |
$688.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,827.65
|
| Rate for Payer: Railroad Medicare Medicare |
$681.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,400.49
|
| Rate for Payer: UHC Core |
$2,277.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$681.96
|
| Rate for Payer: UHC Exchange |
$681.96
|
| Rate for Payer: UHC Medicare Advantage |
$681.96
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$681.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,045.87
|
|
|
HC MR MRA LOWR EXTREM BIL W CON
|
Facility
|
IP
|
$2,392.92
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000066
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,555.40 |
| Max. Negotiated Rate |
$2,153.63 |
| Rate for Payer: Aetna Commercial |
$2,033.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.34
|
| Rate for Payer: BCN Commercial |
$1,849.25
|
| Rate for Payer: Cash Price |
$1,914.34
|
| Rate for Payer: Cofinity Commercial |
$2,057.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,914.34
|
| Rate for Payer: Healthscope Commercial |
$2,153.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,794.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,033.98
|
| Rate for Payer: Nomi Health Commercial |
$1,962.19
|
| Rate for Payer: PHP Commercial |
$2,033.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,555.40
|
| Rate for Payer: Priority Health HMO/PPO |
$2,081.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,603.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,105.77
|
| Rate for Payer: UHC Core |
$1,998.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,794.69
|
|
|
HC MR MRA LOWR EXTREM BIL W CON
|
Facility
|
OP
|
$2,392.92
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000066
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,153.63 |
| Rate for Payer: Aetna Commercial |
$2,033.98
|
| Rate for Payer: Aetna Medicare |
$622.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$747.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$747.79
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$598.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,967.22
|
| Rate for Payer: BCN Commercial |
$1,860.50
|
| Rate for Payer: BCN Medicare Advantage |
$598.23
|
| Rate for Payer: Cash Price |
$1,914.34
|
| Rate for Payer: Cash Price |
$1,914.34
|
| Rate for Payer: Cofinity Commercial |
$2,057.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,914.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$598.23
|
| Rate for Payer: Healthscope Commercial |
$2,153.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,794.69
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$628.14
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$687.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,033.98
|
| Rate for Payer: Nomi Health Commercial |
$1,962.19
|
| Rate for Payer: PACE Senior Care Partners |
$568.32
|
| Rate for Payer: PACE SWMI |
$598.23
|
| Rate for Payer: PHP Commercial |
$2,033.98
|
| Rate for Payer: PHP Medicare Advantage |
$598.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,555.40
|
| Rate for Payer: Priority Health HMO/PPO |
$2,081.84
|
| Rate for Payer: Priority Health Medicare |
$604.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,603.26
|
| Rate for Payer: Railroad Medicare Medicare |
$598.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,105.77
|
| Rate for Payer: UHC Core |
$1,998.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$598.23
|
| Rate for Payer: UHC Exchange |
$598.23
|
| Rate for Payer: UHC Medicare Advantage |
$598.23
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$598.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,794.69
|
|
|
HC MR MRA LOWR EXTREM BIL WO CON
|
Facility
|
OP
|
$2,181.78
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000067
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,963.60 |
| Rate for Payer: Aetna Commercial |
$1,854.51
|
| Rate for Payer: Aetna Medicare |
$567.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$681.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$681.81
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$545.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,793.64
|
| Rate for Payer: BCN Commercial |
$1,696.33
|
| Rate for Payer: BCN Medicare Advantage |
$545.44
|
| Rate for Payer: Cash Price |
$1,745.42
|
| Rate for Payer: Cash Price |
$1,745.42
|
| Rate for Payer: Cofinity Commercial |
$1,876.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,745.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$545.44
|
| Rate for Payer: Healthscope Commercial |
$1,963.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,636.34
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$572.72
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$627.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,854.51
|
| Rate for Payer: Nomi Health Commercial |
$1,789.06
|
| Rate for Payer: PACE Senior Care Partners |
$518.17
|
| Rate for Payer: PACE SWMI |
$545.44
|
| Rate for Payer: PHP Commercial |
$1,854.51
|
| Rate for Payer: PHP Medicare Advantage |
$545.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,418.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1,898.15
|
| Rate for Payer: Priority Health Medicare |
$550.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,461.79
|
| Rate for Payer: Railroad Medicare Medicare |
$545.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,919.97
|
| Rate for Payer: UHC Core |
$1,821.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$545.44
|
| Rate for Payer: UHC Exchange |
$545.44
|
| Rate for Payer: UHC Medicare Advantage |
$545.44
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$545.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,636.34
|
|
|
HC MR MRA LOWR EXTREM BIL WO CON
|
Facility
|
IP
|
$2,181.78
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000067
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,418.16 |
| Max. Negotiated Rate |
$1,963.60 |
| Rate for Payer: Aetna Commercial |
$1,854.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,780.99
|
| Rate for Payer: BCN Commercial |
$1,686.08
|
| Rate for Payer: Cash Price |
$1,745.42
|
| Rate for Payer: Cofinity Commercial |
$1,876.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,745.42
|
| Rate for Payer: Healthscope Commercial |
$1,963.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,636.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,854.51
|
| Rate for Payer: Nomi Health Commercial |
$1,789.06
|
| Rate for Payer: PHP Commercial |
$1,854.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,418.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1,898.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,461.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,919.97
|
| Rate for Payer: UHC Core |
$1,821.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,636.34
|
|
|
HC MR MRA LOWR EXTREM BIL WO W
|
Facility
|
OP
|
$2,674.34
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000068
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,406.91 |
| Rate for Payer: Aetna Commercial |
$2,273.19
|
| Rate for Payer: Aetna Medicare |
$695.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$835.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$835.73
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$668.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,198.57
|
| Rate for Payer: BCN Commercial |
$2,079.30
|
| Rate for Payer: BCN Medicare Advantage |
$668.58
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cofinity Commercial |
$2,299.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,139.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$668.58
|
| Rate for Payer: Healthscope Commercial |
$2,406.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,005.76
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$702.01
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$768.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,273.19
|
| Rate for Payer: Nomi Health Commercial |
$2,192.96
|
| Rate for Payer: PACE Senior Care Partners |
$635.16
|
| Rate for Payer: PACE SWMI |
$668.58
|
| Rate for Payer: PHP Commercial |
$2,273.19
|
| Rate for Payer: PHP Medicare Advantage |
$668.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,738.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,326.68
|
| Rate for Payer: Priority Health Medicare |
$675.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,791.81
|
| Rate for Payer: Railroad Medicare Medicare |
$668.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,353.42
|
| Rate for Payer: UHC Core |
$2,233.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$668.58
|
| Rate for Payer: UHC Exchange |
$668.58
|
| Rate for Payer: UHC Medicare Advantage |
$668.58
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$668.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,005.76
|
|
|
HC MR MRA LOWR EXTREM BIL WO W
|
Facility
|
IP
|
$2,674.34
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000068
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,738.32 |
| Max. Negotiated Rate |
$2,406.91 |
| Rate for Payer: Aetna Commercial |
$2,273.19
|
| Rate for Payer: BCBS Trust/PPO |
$2,183.06
|
| Rate for Payer: BCN Commercial |
$2,066.73
|
| Rate for Payer: Cash Price |
$2,139.47
|
| Rate for Payer: Cofinity Commercial |
$2,299.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,139.47
|
| Rate for Payer: Healthscope Commercial |
$2,406.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,005.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,273.19
|
| Rate for Payer: Nomi Health Commercial |
$2,192.96
|
| Rate for Payer: PHP Commercial |
$2,273.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,738.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,326.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,791.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,353.42
|
| Rate for Payer: UHC Core |
$2,233.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,005.76
|
|
|
HC MR MRA LOWR EXTREM W CON
|
Facility
|
OP
|
$2,252.05
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000069
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,026.84 |
| Rate for Payer: Aetna Commercial |
$1,914.24
|
| Rate for Payer: Aetna Commercial |
$2,871.37
|
| Rate for Payer: Aetna Medicare |
$585.53
|
| Rate for Payer: Aetna Medicare |
$878.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$703.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,055.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$703.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,055.65
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$844.52
|
| Rate for Payer: BCBS MAPPO |
$563.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,851.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,777.12
|
| Rate for Payer: BCN Commercial |
$1,750.97
|
| Rate for Payer: BCN Commercial |
$2,626.46
|
| Rate for Payer: BCN Medicare Advantage |
$563.01
|
| Rate for Payer: BCN Medicare Advantage |
$844.52
|
| Rate for Payer: Cash Price |
$2,702.46
|
| Rate for Payer: Cash Price |
$1,801.64
|
| Rate for Payer: Cash Price |
$1,801.64
|
| Rate for Payer: Cash Price |
$2,702.46
|
| Rate for Payer: Cofinity Commercial |
$1,936.76
|
| Rate for Payer: Cofinity Commercial |
$2,905.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$844.52
|
| Rate for Payer: Healthscope Commercial |
$3,040.27
|
| Rate for Payer: Healthscope Commercial |
$2,026.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,533.56
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$886.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.16
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$647.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$971.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,871.37
|
| Rate for Payer: Nomi Health Commercial |
$1,846.68
|
| Rate for Payer: Nomi Health Commercial |
$2,770.03
|
| Rate for Payer: PACE Senior Care Partners |
$534.86
|
| Rate for Payer: PACE Senior Care Partners |
$802.29
|
| Rate for Payer: PACE SWMI |
$563.01
|
| Rate for Payer: PACE SWMI |
$844.52
|
| Rate for Payer: PHP Commercial |
$2,871.37
|
| Rate for Payer: PHP Commercial |
$1,914.24
|
| Rate for Payer: PHP Medicare Advantage |
$563.01
|
| Rate for Payer: PHP Medicare Advantage |
$844.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,195.75
|
| Rate for Payer: Priority Health HMO/PPO |
$2,938.93
|
| Rate for Payer: Priority Health HMO/PPO |
$1,959.28
|
| Rate for Payer: Priority Health Medicare |
$568.64
|
| Rate for Payer: Priority Health Medicare |
$852.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,508.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,263.31
|
| Rate for Payer: Railroad Medicare Medicare |
$844.52
|
| Rate for Payer: Railroad Medicare Medicare |
$563.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,972.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.80
|
| Rate for Payer: UHC Core |
$2,820.70
|
| Rate for Payer: UHC Core |
$1,880.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$844.52
|
| Rate for Payer: UHC Exchange |
$844.52
|
| Rate for Payer: UHC Exchange |
$563.01
|
| Rate for Payer: UHC Medicare Advantage |
$844.52
|
| Rate for Payer: UHC Medicare Advantage |
$563.01
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$563.01
|
| Rate for Payer: VA VA |
$844.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,533.56
|
|
|
HC MR MRA LOWR EXTREM W CON
|
Facility
|
IP
|
$2,252.05
|
|
|
Service Code
|
HCPCS C8912
|
| Hospital Charge Code |
61000069
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,463.83 |
| Max. Negotiated Rate |
$2,026.84 |
| Rate for Payer: Aetna Commercial |
$1,914.24
|
| Rate for Payer: Aetna Commercial |
$2,871.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,838.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,757.53
|
| Rate for Payer: BCN Commercial |
$1,740.38
|
| Rate for Payer: BCN Commercial |
$2,610.58
|
| Rate for Payer: Cash Price |
$1,801.64
|
| Rate for Payer: Cash Price |
$2,702.46
|
| Rate for Payer: Cofinity Commercial |
$2,905.15
|
| Rate for Payer: Cofinity Commercial |
$1,936.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,702.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,801.64
|
| Rate for Payer: Healthscope Commercial |
$2,026.84
|
| Rate for Payer: Healthscope Commercial |
$3,040.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,689.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,533.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,914.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,871.37
|
| Rate for Payer: Nomi Health Commercial |
$1,846.68
|
| Rate for Payer: Nomi Health Commercial |
$2,770.03
|
| Rate for Payer: PHP Commercial |
$1,914.24
|
| Rate for Payer: PHP Commercial |
$2,871.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,195.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.83
|
| Rate for Payer: Priority Health HMO/PPO |
$2,938.93
|
| Rate for Payer: Priority Health HMO/PPO |
$1,959.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,508.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,263.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,981.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,972.71
|
| Rate for Payer: UHC Core |
$1,880.46
|
| Rate for Payer: UHC Core |
$2,820.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,689.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,533.56
|
|
|
HC MR MRA LOWR EXTREM WO CON
|
Facility
|
IP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000070
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,372.41 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna Commercial |
$2,692.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,723.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,585.30
|
| Rate for Payer: BCN Commercial |
$1,631.69
|
| Rate for Payer: BCN Commercial |
$2,447.53
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$2,533.68
|
| Rate for Payer: Cofinity Commercial |
$2,723.71
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,533.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Healthscope Commercial |
$2,850.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,583.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,375.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,794.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,692.04
|
| Rate for Payer: Nomi Health Commercial |
$1,731.35
|
| Rate for Payer: Nomi Health Commercial |
$2,597.02
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: PHP Commercial |
$2,692.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,058.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,372.41
|
| Rate for Payer: Priority Health HMO/PPO |
$2,755.38
|
| Rate for Payer: Priority Health HMO/PPO |
$1,836.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,414.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,121.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,858.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,787.05
|
| Rate for Payer: UHC Core |
$1,763.02
|
| Rate for Payer: UHC Core |
$2,644.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,583.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,375.32
|
|
|
HC MR MRA LOWR EXTREM WO CON
|
Facility
|
OP
|
$2,111.40
|
|
|
Service Code
|
HCPCS C8913
|
| Hospital Charge Code |
61000070
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,900.26 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna Commercial |
$2,692.04
|
| Rate for Payer: Aetna Medicare |
$548.96
|
| Rate for Payer: Aetna Medicare |
$823.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$659.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$989.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$659.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$989.72
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$791.78
|
| Rate for Payer: BCBS MAPPO |
$527.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,735.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,603.67
|
| Rate for Payer: BCN Commercial |
$1,641.61
|
| Rate for Payer: BCN Commercial |
$2,462.42
|
| Rate for Payer: BCN Medicare Advantage |
$527.85
|
| Rate for Payer: BCN Medicare Advantage |
$791.78
|
| Rate for Payer: Cash Price |
$2,533.68
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$1,689.12
|
| Rate for Payer: Cash Price |
$2,533.68
|
| Rate for Payer: Cofinity Commercial |
$1,815.80
|
| Rate for Payer: Cofinity Commercial |
$2,723.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,533.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,689.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$791.78
|
| Rate for Payer: Healthscope Commercial |
$2,850.39
|
| Rate for Payer: Healthscope Commercial |
$1,900.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,583.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,375.32
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$831.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$554.24
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$607.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$910.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,794.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,692.04
|
| Rate for Payer: Nomi Health Commercial |
$1,731.35
|
| Rate for Payer: Nomi Health Commercial |
$2,597.02
|
| Rate for Payer: PACE Senior Care Partners |
$501.46
|
| Rate for Payer: PACE Senior Care Partners |
$752.19
|
| Rate for Payer: PACE SWMI |
$527.85
|
| Rate for Payer: PACE SWMI |
$791.78
|
| Rate for Payer: PHP Commercial |
$2,692.04
|
| Rate for Payer: PHP Commercial |
$1,794.69
|
| Rate for Payer: PHP Medicare Advantage |
$527.85
|
| Rate for Payer: PHP Medicare Advantage |
$791.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,372.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,058.62
|
| Rate for Payer: Priority Health HMO/PPO |
$2,755.38
|
| Rate for Payer: Priority Health HMO/PPO |
$1,836.92
|
| Rate for Payer: Priority Health Medicare |
$533.13
|
| Rate for Payer: Priority Health Medicare |
$799.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,414.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,121.96
|
| Rate for Payer: Railroad Medicare Medicare |
$791.78
|
| Rate for Payer: Railroad Medicare Medicare |
$527.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,787.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,858.03
|
| Rate for Payer: UHC Core |
$2,644.53
|
| Rate for Payer: UHC Core |
$1,763.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$791.78
|
| Rate for Payer: UHC Exchange |
$791.78
|
| Rate for Payer: UHC Exchange |
$527.85
|
| Rate for Payer: UHC Medicare Advantage |
$791.78
|
| Rate for Payer: UHC Medicare Advantage |
$527.85
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$527.85
|
| Rate for Payer: VA VA |
$791.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,583.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,375.32
|
|
|
HC MR MRA LOWR EXTREM WO W
|
Facility
|
OP
|
$2,533.57
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000071
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,280.21 |
| Rate for Payer: Aetna Commercial |
$2,153.53
|
| Rate for Payer: Aetna Commercial |
$3,230.31
|
| Rate for Payer: Aetna Medicare |
$658.73
|
| Rate for Payer: Aetna Medicare |
$988.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$791.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,187.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$791.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,187.61
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$950.09
|
| Rate for Payer: BCBS MAPPO |
$633.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,082.85
|
| Rate for Payer: BCBS Trust/PPO |
$3,124.28
|
| Rate for Payer: BCN Commercial |
$1,969.85
|
| Rate for Payer: BCN Commercial |
$2,954.78
|
| Rate for Payer: BCN Medicare Advantage |
$633.39
|
| Rate for Payer: BCN Medicare Advantage |
$950.09
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cofinity Commercial |
$2,178.87
|
| Rate for Payer: Cofinity Commercial |
$3,268.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,040.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$633.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$950.09
|
| Rate for Payer: Healthscope Commercial |
$3,420.32
|
| Rate for Payer: Healthscope Commercial |
$2,280.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,900.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,850.27
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$997.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$665.06
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$728.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,092.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,153.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,230.31
|
| Rate for Payer: Nomi Health Commercial |
$2,077.53
|
| Rate for Payer: Nomi Health Commercial |
$3,116.30
|
| Rate for Payer: PACE Senior Care Partners |
$601.72
|
| Rate for Payer: PACE Senior Care Partners |
$902.59
|
| Rate for Payer: PACE SWMI |
$633.39
|
| Rate for Payer: PACE SWMI |
$950.09
|
| Rate for Payer: PHP Commercial |
$3,230.31
|
| Rate for Payer: PHP Commercial |
$2,153.53
|
| Rate for Payer: PHP Medicare Advantage |
$633.39
|
| Rate for Payer: PHP Medicare Advantage |
$950.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,470.23
|
| Rate for Payer: Priority Health HMO/PPO |
$3,306.31
|
| Rate for Payer: Priority Health HMO/PPO |
$2,204.21
|
| Rate for Payer: Priority Health Medicare |
$639.73
|
| Rate for Payer: Priority Health Medicare |
$959.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,697.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,546.24
|
| Rate for Payer: Railroad Medicare Medicare |
$950.09
|
| Rate for Payer: Railroad Medicare Medicare |
$633.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,344.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,229.54
|
| Rate for Payer: UHC Core |
$3,173.30
|
| Rate for Payer: UHC Core |
$2,115.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$633.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$950.09
|
| Rate for Payer: UHC Exchange |
$950.09
|
| Rate for Payer: UHC Exchange |
$633.39
|
| Rate for Payer: UHC Medicare Advantage |
$950.09
|
| Rate for Payer: UHC Medicare Advantage |
$633.39
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$633.39
|
| Rate for Payer: VA VA |
$950.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,900.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,850.27
|
|
|
HC MR MRA LOWR EXTREM WO W
|
Facility
|
IP
|
$2,533.57
|
|
|
Service Code
|
HCPCS C8914
|
| Hospital Charge Code |
61000071
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,646.82 |
| Max. Negotiated Rate |
$2,280.21 |
| Rate for Payer: Aetna Commercial |
$2,153.53
|
| Rate for Payer: Aetna Commercial |
$3,230.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,068.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,102.23
|
| Rate for Payer: BCN Commercial |
$1,957.94
|
| Rate for Payer: BCN Commercial |
$2,936.92
|
| Rate for Payer: Cash Price |
$2,026.86
|
| Rate for Payer: Cash Price |
$3,040.29
|
| Rate for Payer: Cofinity Commercial |
$3,268.31
|
| Rate for Payer: Cofinity Commercial |
$2,178.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,040.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,026.86
|
| Rate for Payer: Healthscope Commercial |
$2,280.21
|
| Rate for Payer: Healthscope Commercial |
$3,420.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,900.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,850.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,153.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,230.31
|
| Rate for Payer: Nomi Health Commercial |
$2,077.53
|
| Rate for Payer: Nomi Health Commercial |
$3,116.30
|
| Rate for Payer: PHP Commercial |
$2,153.53
|
| Rate for Payer: PHP Commercial |
$3,230.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,470.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,646.82
|
| Rate for Payer: Priority Health HMO/PPO |
$3,306.31
|
| Rate for Payer: Priority Health HMO/PPO |
$2,204.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,697.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,546.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,229.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,344.32
|
| Rate for Payer: UHC Core |
$2,115.53
|
| Rate for Payer: UHC Core |
$3,173.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,900.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,850.27
|
|
