|
HC OT Z STOCKINGS CUSTOM EA $80
|
Facility
|
OP
|
$83.23
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.67 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$70.75
|
| Rate for Payer: Aetna Medicare |
$21.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: BCBS Complete |
$15.41
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$68.42
|
| Rate for Payer: BCN Commercial |
$68.42
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.42
|
| Rate for Payer: Mclaren Medicaid |
$14.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: Meridian Medicaid |
$15.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.75
|
| Rate for Payer: Nomi Health Commercial |
$68.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.42
|
| Rate for Payer: PACE Senior Care Partners |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$70.75
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$72.41
|
| Rate for Payer: Priority Health Medicare |
$21.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.93
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.24
|
| Rate for Payer: UHC Core |
$69.50
|
| Rate for Payer: UHC Exchange |
$20.81
|
| Rate for Payer: UHC Medicaid |
$14.67
|
| Rate for Payer: UHC Medicare Advantage |
$20.81
|
| Rate for Payer: UHCCP Medicaid |
$14.67
|
| Rate for Payer: VA VA |
$20.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.42
|
|
|
HC OT Z STOCKINGS CUSTOM EA $80
|
Facility
|
IP
|
$83.23
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$57.93 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna Commercial |
$70.75
|
| Rate for Payer: BCBS Trust/PPO |
$68.74
|
| Rate for Payer: BCN Commercial |
$68.74
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.58
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.75
|
| Rate for Payer: Nomi Health Commercial |
$68.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.42
|
| Rate for Payer: PHP Commercial |
$70.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$72.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.24
|
| Rate for Payer: UHC Core |
$69.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.42
|
|
|
HC OT Z STOCKINGS CUSTOM EA $90
|
Facility
|
OP
|
$93.64
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300114
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.51 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna Medicare |
$24.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.26
|
| Rate for Payer: BCBS Complete |
$17.33
|
| Rate for Payer: BCBS MAPPO |
$23.41
|
| Rate for Payer: BCBS Trust/PPO |
$76.98
|
| Rate for Payer: BCN Commercial |
$76.98
|
| Rate for Payer: BCN Medicare Advantage |
$23.41
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.41
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$16.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.58
|
| Rate for Payer: Meridian Medicaid |
$17.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PACE Senior Care Partners |
$22.24
|
| Rate for Payer: PACE SWMI |
$23.41
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: PHP Medicare Advantage |
$23.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.47
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.17
|
| Rate for Payer: Railroad Medicare Medicare |
$23.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.40
|
| Rate for Payer: UHC Core |
$78.19
|
| Rate for Payer: UHC Exchange |
$23.41
|
| Rate for Payer: UHC Medicaid |
$16.51
|
| Rate for Payer: UHC Medicare Advantage |
$23.41
|
| Rate for Payer: UHCCP Medicaid |
$16.51
|
| Rate for Payer: VA VA |
$23.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC OT Z STOCKINGS CUSTOM EA $90
|
Facility
|
IP
|
$93.64
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300114
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$65.17 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: BCBS Trust/PPO |
$77.34
|
| Rate for Payer: BCN Commercial |
$77.34
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.40
|
| Rate for Payer: UHC Core |
$78.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC OT Z STOCKINGS NON CUSTOM $100
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300115
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.34 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna Medicare |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.51
|
| Rate for Payer: BCBS Complete |
$19.26
|
| Rate for Payer: BCBS MAPPO |
$26.01
|
| Rate for Payer: BCBS Trust/PPO |
$85.53
|
| Rate for Payer: BCN Commercial |
$85.53
|
| Rate for Payer: BCN Medicare Advantage |
$26.01
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.01
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Mclaren Medicaid |
$18.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.31
|
| Rate for Payer: Meridian Medicaid |
$19.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.03
|
| Rate for Payer: PACE Senior Care Partners |
$24.71
|
| Rate for Payer: PACE SWMI |
$26.01
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: PHP Medicare Advantage |
$26.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Medicare |
$26.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.41
|
| Rate for Payer: Railroad Medicare Medicare |
$26.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: UHC Exchange |
$26.01
|
| Rate for Payer: UHC Medicaid |
$18.34
|
| Rate for Payer: UHC Medicare Advantage |
$26.01
|
| Rate for Payer: UHCCP Medicaid |
$18.34
|
| Rate for Payer: VA VA |
$26.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC OT Z STOCKINGS NON CUSTOM $100
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300115
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$72.41 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: BCBS Trust/PPO |
$85.93
|
| Rate for Payer: BCN Commercial |
$85.93
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$85.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.03
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.56
|
| Rate for Payer: UHC Core |
$86.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC OT Z STOCKINGS NON CUSTOM $125
|
Facility
|
OP
|
$130.05
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300116
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.93 |
| Max. Negotiated Rate |
$117.05 |
| Rate for Payer: Aetna Commercial |
$110.54
|
| Rate for Payer: Aetna Medicare |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.64
|
| Rate for Payer: BCBS Complete |
$24.07
|
| Rate for Payer: BCBS MAPPO |
$32.51
|
| Rate for Payer: BCBS Trust/PPO |
$106.91
|
| Rate for Payer: BCN Commercial |
$106.91
|
| Rate for Payer: BCN Medicare Advantage |
$32.51
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Commercial |
$111.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.51
|
| Rate for Payer: Healthscope Commercial |
$117.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.54
|
| Rate for Payer: Mclaren Medicaid |
$22.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.14
|
| Rate for Payer: Meridian Medicaid |
$24.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: Nomi Health Commercial |
$106.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.54
|
| Rate for Payer: PACE Senior Care Partners |
$30.89
|
| Rate for Payer: PACE SWMI |
$32.51
|
| Rate for Payer: PHP Commercial |
$110.54
|
| Rate for Payer: PHP Medicare Advantage |
$32.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.14
|
| Rate for Payer: Priority Health Medicare |
$32.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.51
|
| Rate for Payer: Railroad Medicare Medicare |
$32.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.44
|
| Rate for Payer: UHC Core |
$108.59
|
| Rate for Payer: UHC Exchange |
$32.51
|
| Rate for Payer: UHC Medicaid |
$22.93
|
| Rate for Payer: UHC Medicare Advantage |
$32.51
|
| Rate for Payer: UHCCP Medicaid |
$22.93
|
| Rate for Payer: VA VA |
$32.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.54
|
|
|
HC OT Z STOCKINGS NON CUSTOM $125
|
Facility
|
IP
|
$130.05
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300116
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$90.51 |
| Max. Negotiated Rate |
$117.05 |
| Rate for Payer: Aetna Commercial |
$110.54
|
| Rate for Payer: BCBS Trust/PPO |
$107.41
|
| Rate for Payer: BCN Commercial |
$107.41
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Commercial |
$111.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Healthscope Commercial |
$117.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: Nomi Health Commercial |
$106.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.54
|
| Rate for Payer: PHP Commercial |
$110.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$113.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.44
|
| Rate for Payer: UHC Core |
$108.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.54
|
|
|
HC OT Z STOCKINGS NON CUSTOM $150
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300117
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$108.62 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: BCBS Trust/PPO |
$128.89
|
| Rate for Payer: BCN Commercial |
$128.89
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC OT Z STOCKINGS NON CUSTOM $150
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300117
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.51 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$40.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.77
|
| Rate for Payer: BCBS Complete |
$28.89
|
| Rate for Payer: BCBS MAPPO |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$128.30
|
| Rate for Payer: BCN Commercial |
$128.30
|
| Rate for Payer: BCN Medicare Advantage |
$39.02
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.02
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Mclaren Medicaid |
$27.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.97
|
| Rate for Payer: Meridian Medicaid |
$28.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PACE Senior Care Partners |
$37.06
|
| Rate for Payer: PACE SWMI |
$39.02
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: PHP Medicare Advantage |
$39.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Medicare |
$39.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.62
|
| Rate for Payer: Railroad Medicare Medicare |
$39.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: UHC Exchange |
$39.02
|
| Rate for Payer: UHC Medicaid |
$27.51
|
| Rate for Payer: UHC Medicare Advantage |
$39.02
|
| Rate for Payer: UHCCP Medicaid |
$27.51
|
| Rate for Payer: VA VA |
$39.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC OT Z STOCKINGS NON CUSTOM $175
|
Facility
|
IP
|
$182.07
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300118
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$126.72 |
| Max. Negotiated Rate |
$163.86 |
| Rate for Payer: Aetna Commercial |
$154.76
|
| Rate for Payer: BCBS Trust/PPO |
$150.37
|
| Rate for Payer: BCN Commercial |
$150.37
|
| Rate for Payer: Cash Price |
$145.66
|
| Rate for Payer: Cofinity Commercial |
$156.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.66
|
| Rate for Payer: Healthscope Commercial |
$163.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.76
|
| Rate for Payer: Nomi Health Commercial |
$149.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.55
|
| Rate for Payer: PHP Commercial |
$154.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$158.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.22
|
| Rate for Payer: UHC Core |
$152.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.55
|
|
|
HC OT Z STOCKINGS NON CUSTOM $175
|
Facility
|
OP
|
$182.07
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300118
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$32.10 |
| Max. Negotiated Rate |
$163.86 |
| Rate for Payer: Aetna Commercial |
$154.76
|
| Rate for Payer: Aetna Medicare |
$47.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.90
|
| Rate for Payer: BCBS Complete |
$33.70
|
| Rate for Payer: BCBS MAPPO |
$45.52
|
| Rate for Payer: BCBS Trust/PPO |
$149.68
|
| Rate for Payer: BCN Commercial |
$149.68
|
| Rate for Payer: BCN Medicare Advantage |
$45.52
|
| Rate for Payer: Cash Price |
$145.66
|
| Rate for Payer: Cofinity Commercial |
$156.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.52
|
| Rate for Payer: Healthscope Commercial |
$163.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.55
|
| Rate for Payer: Mclaren Medicaid |
$32.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.79
|
| Rate for Payer: Meridian Medicaid |
$33.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$50.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.76
|
| Rate for Payer: Nomi Health Commercial |
$149.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.55
|
| Rate for Payer: PACE Senior Care Partners |
$43.24
|
| Rate for Payer: PACE SWMI |
$45.52
|
| Rate for Payer: PHP Commercial |
$154.76
|
| Rate for Payer: PHP Medicare Advantage |
$45.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$158.40
|
| Rate for Payer: Priority Health Medicare |
$45.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.72
|
| Rate for Payer: Railroad Medicare Medicare |
$45.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.22
|
| Rate for Payer: UHC Core |
$152.03
|
| Rate for Payer: UHC Exchange |
$45.52
|
| Rate for Payer: UHC Medicaid |
$32.10
|
| Rate for Payer: UHC Medicare Advantage |
$45.52
|
| Rate for Payer: UHCCP Medicaid |
$32.10
|
| Rate for Payer: VA VA |
$45.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.55
|
|
|
HC OT Z STOCKINGS NON CUSTOM $200
|
Facility
|
OP
|
$208.08
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.68 |
| Max. Negotiated Rate |
$187.27 |
| Rate for Payer: Aetna Commercial |
$176.87
|
| Rate for Payer: Aetna Medicare |
$54.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.03
|
| Rate for Payer: BCBS Complete |
$38.52
|
| Rate for Payer: BCBS MAPPO |
$52.02
|
| Rate for Payer: BCBS Trust/PPO |
$171.06
|
| Rate for Payer: BCN Commercial |
$171.06
|
| Rate for Payer: BCN Medicare Advantage |
$52.02
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$178.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.02
|
| Rate for Payer: Healthscope Commercial |
$187.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.06
|
| Rate for Payer: Mclaren Medicaid |
$36.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.62
|
| Rate for Payer: Meridian Medicaid |
$38.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: Nomi Health Commercial |
$170.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.06
|
| Rate for Payer: PACE Senior Care Partners |
$49.42
|
| Rate for Payer: PACE SWMI |
$52.02
|
| Rate for Payer: PHP Commercial |
$176.87
|
| Rate for Payer: PHP Medicare Advantage |
$52.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$181.03
|
| Rate for Payer: Priority Health Medicare |
$52.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.82
|
| Rate for Payer: Railroad Medicare Medicare |
$52.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.11
|
| Rate for Payer: UHC Core |
$173.75
|
| Rate for Payer: UHC Exchange |
$52.02
|
| Rate for Payer: UHC Medicaid |
$36.68
|
| Rate for Payer: UHC Medicare Advantage |
$52.02
|
| Rate for Payer: UHCCP Medicaid |
$36.68
|
| Rate for Payer: VA VA |
$52.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.06
|
|
|
HC OT Z STOCKINGS NON CUSTOM $200
|
Facility
|
IP
|
$208.08
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$144.82 |
| Max. Negotiated Rate |
$187.27 |
| Rate for Payer: Aetna Commercial |
$176.87
|
| Rate for Payer: BCBS Trust/PPO |
$171.85
|
| Rate for Payer: BCN Commercial |
$171.85
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$178.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Healthscope Commercial |
$187.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: Nomi Health Commercial |
$170.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.06
|
| Rate for Payer: PHP Commercial |
$176.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$181.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.11
|
| Rate for Payer: UHC Core |
$173.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.06
|
|
|
HC OT Z STOCKINGS NON CUSTOM $225
|
Facility
|
IP
|
$234.09
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300120
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$162.93 |
| Max. Negotiated Rate |
$210.68 |
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: BCBS Trust/PPO |
$193.33
|
| Rate for Payer: BCN Commercial |
$193.33
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$191.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$175.57
|
| Rate for Payer: PHP Commercial |
$198.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$203.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.00
|
| Rate for Payer: UHC Core |
$195.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC OT Z STOCKINGS NON CUSTOM $225
|
Facility
|
OP
|
$234.09
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300120
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$41.27 |
| Max. Negotiated Rate |
$210.68 |
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: Aetna Medicare |
$60.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.15
|
| Rate for Payer: BCBS Complete |
$43.33
|
| Rate for Payer: BCBS MAPPO |
$58.52
|
| Rate for Payer: BCBS Trust/PPO |
$192.45
|
| Rate for Payer: BCN Commercial |
$192.45
|
| Rate for Payer: BCN Medicare Advantage |
$58.52
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.52
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| Rate for Payer: Mclaren Medicaid |
$41.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.45
|
| Rate for Payer: Meridian Medicaid |
$43.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Nomi Health Commercial |
$191.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$175.57
|
| Rate for Payer: PACE Senior Care Partners |
$55.60
|
| Rate for Payer: PACE SWMI |
$58.52
|
| Rate for Payer: PHP Commercial |
$198.98
|
| Rate for Payer: PHP Medicare Advantage |
$58.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$203.66
|
| Rate for Payer: Priority Health Medicare |
$59.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.93
|
| Rate for Payer: Railroad Medicare Medicare |
$58.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.00
|
| Rate for Payer: UHC Core |
$195.47
|
| Rate for Payer: UHC Exchange |
$58.52
|
| Rate for Payer: UHC Medicaid |
$41.27
|
| Rate for Payer: UHC Medicare Advantage |
$58.52
|
| Rate for Payer: UHCCP Medicaid |
$41.27
|
| Rate for Payer: VA VA |
$58.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC OT Z STOCKINGS NON CUSTOM $250
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300121
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.86 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna Medicare |
$67.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.28
|
| Rate for Payer: BCBS Complete |
$48.14
|
| Rate for Payer: BCBS MAPPO |
$65.03
|
| Rate for Payer: BCBS Trust/PPO |
$213.83
|
| Rate for Payer: BCN Commercial |
$213.83
|
| Rate for Payer: BCN Medicare Advantage |
$65.03
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.03
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Mclaren Medicaid |
$45.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.28
|
| Rate for Payer: Meridian Medicaid |
$48.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.07
|
| Rate for Payer: PACE Senior Care Partners |
$61.77
|
| Rate for Payer: PACE SWMI |
$65.03
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: PHP Medicare Advantage |
$65.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.29
|
| Rate for Payer: Priority Health Medicare |
$65.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.03
|
| Rate for Payer: Railroad Medicare Medicare |
$65.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: UHC Exchange |
$65.03
|
| Rate for Payer: UHC Medicaid |
$45.86
|
| Rate for Payer: UHC Medicare Advantage |
$65.03
|
| Rate for Payer: UHCCP Medicaid |
$45.86
|
| Rate for Payer: VA VA |
$65.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC OT Z STOCKINGS NON CUSTOM $250
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300121
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$181.03 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: BCBS Trust/PPO |
$214.82
|
| Rate for Payer: BCN Commercial |
$214.82
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$213.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.07
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$181.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.89
|
| Rate for Payer: UHC Core |
$217.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC OT Z STOCKINGS NON CUSTOM $275
|
Facility
|
IP
|
$286.11
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300122
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$199.13 |
| Max. Negotiated Rate |
$257.50 |
| Rate for Payer: Aetna Commercial |
$243.19
|
| Rate for Payer: BCBS Trust/PPO |
$236.30
|
| Rate for Payer: BCN Commercial |
$236.30
|
| Rate for Payer: Cash Price |
$228.89
|
| Rate for Payer: Cofinity Commercial |
$246.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.89
|
| Rate for Payer: Healthscope Commercial |
$257.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.19
|
| Rate for Payer: Nomi Health Commercial |
$234.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.58
|
| Rate for Payer: PHP Commercial |
$243.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$248.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.78
|
| Rate for Payer: UHC Core |
$238.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.58
|
|
|
HC OT Z STOCKINGS NON CUSTOM $275
|
Facility
|
OP
|
$286.11
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300122
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$50.44 |
| Max. Negotiated Rate |
$257.50 |
| Rate for Payer: Aetna Commercial |
$243.19
|
| Rate for Payer: Aetna Medicare |
$74.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.41
|
| Rate for Payer: BCBS Complete |
$52.96
|
| Rate for Payer: BCBS MAPPO |
$71.53
|
| Rate for Payer: BCBS Trust/PPO |
$235.21
|
| Rate for Payer: BCN Commercial |
$235.21
|
| Rate for Payer: BCN Medicare Advantage |
$71.53
|
| Rate for Payer: Cash Price |
$228.89
|
| Rate for Payer: Cofinity Commercial |
$246.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.53
|
| Rate for Payer: Healthscope Commercial |
$257.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.58
|
| Rate for Payer: Mclaren Medicaid |
$50.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.10
|
| Rate for Payer: Meridian Medicaid |
$52.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.19
|
| Rate for Payer: Nomi Health Commercial |
$234.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.58
|
| Rate for Payer: PACE Senior Care Partners |
$67.95
|
| Rate for Payer: PACE SWMI |
$71.53
|
| Rate for Payer: PHP Commercial |
$243.19
|
| Rate for Payer: PHP Medicare Advantage |
$71.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$248.92
|
| Rate for Payer: Priority Health Medicare |
$72.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.13
|
| Rate for Payer: Railroad Medicare Medicare |
$71.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.78
|
| Rate for Payer: UHC Core |
$238.90
|
| Rate for Payer: UHC Exchange |
$71.53
|
| Rate for Payer: UHC Medicaid |
$50.44
|
| Rate for Payer: UHC Medicare Advantage |
$71.53
|
| Rate for Payer: UHCCP Medicaid |
$50.44
|
| Rate for Payer: VA VA |
$71.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.58
|
|
|
HC OT Z STOCKINGS NON CUSTOM $300
|
Facility
|
IP
|
$312.12
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300123
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$217.24 |
| Max. Negotiated Rate |
$280.91 |
| Rate for Payer: Aetna Commercial |
$265.30
|
| Rate for Payer: BCBS Trust/PPO |
$257.78
|
| Rate for Payer: BCN Commercial |
$257.78
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cofinity Commercial |
$268.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.70
|
| Rate for Payer: Healthscope Commercial |
$280.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.30
|
| Rate for Payer: Nomi Health Commercial |
$255.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.09
|
| Rate for Payer: PHP Commercial |
$265.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$271.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.67
|
| Rate for Payer: UHC Core |
$260.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.09
|
|
|
HC OT Z STOCKINGS NON CUSTOM $300
|
Facility
|
OP
|
$312.12
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300123
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.03 |
| Max. Negotiated Rate |
$280.91 |
| Rate for Payer: Aetna Commercial |
$265.30
|
| Rate for Payer: Aetna Medicare |
$81.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$97.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$97.54
|
| Rate for Payer: BCBS Complete |
$57.77
|
| Rate for Payer: BCBS MAPPO |
$78.03
|
| Rate for Payer: BCBS Trust/PPO |
$256.59
|
| Rate for Payer: BCN Commercial |
$256.59
|
| Rate for Payer: BCN Medicare Advantage |
$78.03
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cofinity Commercial |
$268.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.03
|
| Rate for Payer: Healthscope Commercial |
$280.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.09
|
| Rate for Payer: Mclaren Medicaid |
$55.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.93
|
| Rate for Payer: Meridian Medicaid |
$57.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.30
|
| Rate for Payer: Nomi Health Commercial |
$255.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.09
|
| Rate for Payer: PACE Senior Care Partners |
$74.13
|
| Rate for Payer: PACE SWMI |
$78.03
|
| Rate for Payer: PHP Commercial |
$265.30
|
| Rate for Payer: PHP Medicare Advantage |
$78.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$271.54
|
| Rate for Payer: Priority Health Medicare |
$78.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.24
|
| Rate for Payer: Railroad Medicare Medicare |
$78.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.67
|
| Rate for Payer: UHC Core |
$260.62
|
| Rate for Payer: UHC Exchange |
$78.03
|
| Rate for Payer: UHC Medicaid |
$55.03
|
| Rate for Payer: UHC Medicare Advantage |
$78.03
|
| Rate for Payer: UHCCP Medicaid |
$55.03
|
| Rate for Payer: VA VA |
$78.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.09
|
|
|
HC OT Z STOCKINGS NON CUSTOM $325
|
Facility
|
IP
|
$338.13
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300124
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$235.34 |
| Max. Negotiated Rate |
$304.32 |
| Rate for Payer: Aetna Commercial |
$287.41
|
| Rate for Payer: BCBS Trust/PPO |
$279.26
|
| Rate for Payer: BCN Commercial |
$279.26
|
| Rate for Payer: Cash Price |
$270.50
|
| Rate for Payer: Cofinity Commercial |
$290.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.50
|
| Rate for Payer: Healthscope Commercial |
$304.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.41
|
| Rate for Payer: Nomi Health Commercial |
$277.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.60
|
| Rate for Payer: PHP Commercial |
$287.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$294.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.55
|
| Rate for Payer: UHC Core |
$282.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.60
|
|
|
HC OT Z STOCKINGS NON CUSTOM $325
|
Facility
|
OP
|
$338.13
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300124
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$59.61 |
| Max. Negotiated Rate |
$304.32 |
| Rate for Payer: Aetna Commercial |
$287.41
|
| Rate for Payer: Aetna Medicare |
$87.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$105.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$105.67
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$84.53
|
| Rate for Payer: BCBS Trust/PPO |
$277.98
|
| Rate for Payer: BCN Commercial |
$277.98
|
| Rate for Payer: BCN Medicare Advantage |
$84.53
|
| Rate for Payer: Cash Price |
$270.50
|
| Rate for Payer: Cofinity Commercial |
$290.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.53
|
| Rate for Payer: Healthscope Commercial |
$304.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.60
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.76
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.41
|
| Rate for Payer: Nomi Health Commercial |
$277.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.60
|
| Rate for Payer: PACE Senior Care Partners |
$80.31
|
| Rate for Payer: PACE SWMI |
$84.53
|
| Rate for Payer: PHP Commercial |
$287.41
|
| Rate for Payer: PHP Medicare Advantage |
$84.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$294.17
|
| Rate for Payer: Priority Health Medicare |
$85.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.34
|
| Rate for Payer: Railroad Medicare Medicare |
$84.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.55
|
| Rate for Payer: UHC Core |
$282.34
|
| Rate for Payer: UHC Exchange |
$84.53
|
| Rate for Payer: UHC Medicaid |
$59.61
|
| Rate for Payer: UHC Medicare Advantage |
$84.53
|
| Rate for Payer: UHCCP Medicaid |
$59.61
|
| Rate for Payer: VA VA |
$84.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.60
|
|
|
HC OT Z STOCKINGS NON CUSTOM $350
|
Facility
|
IP
|
$364.14
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300125
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$253.44 |
| Max. Negotiated Rate |
$327.73 |
| Rate for Payer: Aetna Commercial |
$309.52
|
| Rate for Payer: BCBS Trust/PPO |
$300.74
|
| Rate for Payer: BCN Commercial |
$300.74
|
| Rate for Payer: Cash Price |
$291.31
|
| Rate for Payer: Cofinity Commercial |
$313.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.31
|
| Rate for Payer: Healthscope Commercial |
$327.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.52
|
| Rate for Payer: Nomi Health Commercial |
$298.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.11
|
| Rate for Payer: PHP Commercial |
$309.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$316.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.44
|
| Rate for Payer: UHC Core |
$304.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.11
|
|
