|
HC OT Z STOCKINGS NON CUSTOM $350
|
Facility
|
OP
|
$364.14
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300125
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$64.20 |
| Max. Negotiated Rate |
$327.73 |
| Rate for Payer: Aetna Commercial |
$309.52
|
| Rate for Payer: Aetna Medicare |
$94.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.79
|
| Rate for Payer: BCBS Complete |
$67.40
|
| Rate for Payer: BCBS MAPPO |
$91.03
|
| Rate for Payer: BCBS Trust/PPO |
$299.36
|
| Rate for Payer: BCN Commercial |
$299.36
|
| Rate for Payer: BCN Medicare Advantage |
$91.03
|
| 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: Health Alliance Plan Medicare Advantage |
$91.03
|
| Rate for Payer: Healthscope Commercial |
$327.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.11
|
| Rate for Payer: Mclaren Medicaid |
$64.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.59
|
| Rate for Payer: Meridian Medicaid |
$67.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.14
|
| 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: PACE Senior Care Partners |
$86.48
|
| Rate for Payer: PACE SWMI |
$91.03
|
| Rate for Payer: PHP Commercial |
$309.52
|
| Rate for Payer: PHP Medicare Advantage |
$91.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$316.80
|
| Rate for Payer: Priority Health Medicare |
$91.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$253.44
|
| Rate for Payer: Railroad Medicare Medicare |
$91.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.44
|
| Rate for Payer: UHC Core |
$304.06
|
| Rate for Payer: UHC Exchange |
$91.03
|
| Rate for Payer: UHC Medicaid |
$64.20
|
| Rate for Payer: UHC Medicare Advantage |
$91.03
|
| Rate for Payer: UHCCP Medicaid |
$64.20
|
| Rate for Payer: VA VA |
$91.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.11
|
|
|
HC OT Z STOCKINGS NON CUSTOM $375
|
Facility
|
OP
|
$390.15
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300126
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$68.78 |
| Max. Negotiated Rate |
$351.13 |
| Rate for Payer: Aetna Commercial |
$331.63
|
| Rate for Payer: Aetna Medicare |
$101.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.92
|
| Rate for Payer: BCBS Complete |
$72.22
|
| Rate for Payer: BCBS MAPPO |
$97.54
|
| Rate for Payer: BCBS Trust/PPO |
$320.74
|
| Rate for Payer: BCN Commercial |
$320.74
|
| Rate for Payer: BCN Medicare Advantage |
$97.54
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cofinity Commercial |
$335.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.54
|
| Rate for Payer: Healthscope Commercial |
$351.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.61
|
| Rate for Payer: Mclaren Medicaid |
$68.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.41
|
| Rate for Payer: Meridian Medicaid |
$72.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.63
|
| Rate for Payer: Nomi Health Commercial |
$319.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.61
|
| Rate for Payer: PACE Senior Care Partners |
$92.66
|
| Rate for Payer: PACE SWMI |
$97.54
|
| Rate for Payer: PHP Commercial |
$331.63
|
| Rate for Payer: PHP Medicare Advantage |
$97.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$339.43
|
| Rate for Payer: Priority Health Medicare |
$98.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.54
|
| Rate for Payer: Railroad Medicare Medicare |
$97.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.33
|
| Rate for Payer: UHC Core |
$325.78
|
| Rate for Payer: UHC Exchange |
$97.54
|
| Rate for Payer: UHC Medicaid |
$68.78
|
| Rate for Payer: UHC Medicare Advantage |
$97.54
|
| Rate for Payer: UHCCP Medicaid |
$68.78
|
| Rate for Payer: VA VA |
$97.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.61
|
|
|
HC OT Z STOCKINGS NON CUSTOM $375
|
Facility
|
IP
|
$390.15
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300126
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$271.54 |
| Max. Negotiated Rate |
$351.13 |
| Rate for Payer: Aetna Commercial |
$331.63
|
| Rate for Payer: BCBS Trust/PPO |
$322.22
|
| Rate for Payer: BCN Commercial |
$322.22
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cofinity Commercial |
$335.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.12
|
| Rate for Payer: Healthscope Commercial |
$351.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.63
|
| Rate for Payer: Nomi Health Commercial |
$319.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.61
|
| Rate for Payer: PHP Commercial |
$331.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$339.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$271.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.33
|
| Rate for Payer: UHC Core |
$325.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.61
|
|
|
HC OT Z STOCKINGS NON CUSTOM $40
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300127
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$34.37
|
| Rate for Payer: BCN Commercial |
$34.37
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC OT Z STOCKINGS NON CUSTOM $40
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300127
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.34 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$7.70
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$34.22
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$7.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$7.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.97
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicaid |
$7.34
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$7.34
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC OT Z STOCKINGS NON CUSTOM $400
|
Facility
|
OP
|
$416.16
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300128
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$73.37 |
| Max. Negotiated Rate |
$374.54 |
| Rate for Payer: Aetna Commercial |
$353.74
|
| Rate for Payer: Aetna Medicare |
$108.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.05
|
| Rate for Payer: BCBS Complete |
$77.03
|
| Rate for Payer: BCBS MAPPO |
$104.04
|
| Rate for Payer: BCBS Trust/PPO |
$342.13
|
| Rate for Payer: BCN Commercial |
$342.13
|
| Rate for Payer: BCN Medicare Advantage |
$104.04
|
| Rate for Payer: Cash Price |
$332.93
|
| Rate for Payer: Cofinity Commercial |
$357.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.04
|
| Rate for Payer: Healthscope Commercial |
$374.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.12
|
| Rate for Payer: Mclaren Medicaid |
$73.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.24
|
| Rate for Payer: Meridian Medicaid |
$77.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.74
|
| Rate for Payer: Nomi Health Commercial |
$341.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.12
|
| Rate for Payer: PACE Senior Care Partners |
$98.84
|
| Rate for Payer: PACE SWMI |
$104.04
|
| Rate for Payer: PHP Commercial |
$353.74
|
| Rate for Payer: PHP Medicare Advantage |
$104.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.06
|
| Rate for Payer: Priority Health Medicare |
$105.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.65
|
| Rate for Payer: Railroad Medicare Medicare |
$104.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.22
|
| Rate for Payer: UHC Core |
$347.49
|
| Rate for Payer: UHC Exchange |
$104.04
|
| Rate for Payer: UHC Medicaid |
$73.37
|
| Rate for Payer: UHC Medicare Advantage |
$104.04
|
| Rate for Payer: UHCCP Medicaid |
$73.37
|
| Rate for Payer: VA VA |
$104.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.12
|
|
|
HC OT Z STOCKINGS NON CUSTOM $400
|
Facility
|
IP
|
$416.16
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300128
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$289.65 |
| Max. Negotiated Rate |
$374.54 |
| Rate for Payer: Aetna Commercial |
$353.74
|
| Rate for Payer: BCBS Trust/PPO |
$343.71
|
| Rate for Payer: BCN Commercial |
$343.71
|
| Rate for Payer: Cash Price |
$332.93
|
| Rate for Payer: Cofinity Commercial |
$357.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.93
|
| Rate for Payer: Healthscope Commercial |
$374.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.74
|
| Rate for Payer: Nomi Health Commercial |
$341.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.12
|
| Rate for Payer: PHP Commercial |
$353.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.22
|
| Rate for Payer: UHC Core |
$347.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.12
|
|
|
HC OT Z STOCKINGS NON CUSTOM $425
|
Facility
|
IP
|
$442.17
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$307.75 |
| Max. Negotiated Rate |
$397.95 |
| Rate for Payer: Aetna Commercial |
$375.84
|
| Rate for Payer: BCBS Trust/PPO |
$365.19
|
| Rate for Payer: BCN Commercial |
$365.19
|
| Rate for Payer: Cash Price |
$353.74
|
| Rate for Payer: Cofinity Commercial |
$380.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.74
|
| Rate for Payer: Healthscope Commercial |
$397.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$331.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$375.84
|
| Rate for Payer: Nomi Health Commercial |
$362.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.63
|
| Rate for Payer: PHP Commercial |
$375.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$384.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$389.11
|
| Rate for Payer: UHC Core |
$369.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$331.63
|
|
|
HC OT Z STOCKINGS NON CUSTOM $425
|
Facility
|
OP
|
$442.17
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300129
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$77.95 |
| Max. Negotiated Rate |
$397.95 |
| Rate for Payer: Aetna Commercial |
$375.84
|
| Rate for Payer: Aetna Medicare |
$114.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$138.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$138.18
|
| Rate for Payer: BCBS Complete |
$81.85
|
| Rate for Payer: BCBS MAPPO |
$110.54
|
| Rate for Payer: BCBS Trust/PPO |
$363.51
|
| Rate for Payer: BCN Commercial |
$363.51
|
| Rate for Payer: BCN Medicare Advantage |
$110.54
|
| Rate for Payer: Cash Price |
$353.74
|
| Rate for Payer: Cofinity Commercial |
$380.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$353.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.54
|
| Rate for Payer: Healthscope Commercial |
$397.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$331.63
|
| Rate for Payer: Mclaren Medicaid |
$77.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.07
|
| Rate for Payer: Meridian Medicaid |
$81.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$127.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$121.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$375.84
|
| Rate for Payer: Nomi Health Commercial |
$362.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.63
|
| Rate for Payer: PACE Senior Care Partners |
$105.02
|
| Rate for Payer: PACE SWMI |
$110.54
|
| Rate for Payer: PHP Commercial |
$375.84
|
| Rate for Payer: PHP Medicare Advantage |
$110.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$384.69
|
| Rate for Payer: Priority Health Medicare |
$111.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$307.75
|
| Rate for Payer: Railroad Medicare Medicare |
$110.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$389.11
|
| Rate for Payer: UHC Core |
$369.21
|
| Rate for Payer: UHC Exchange |
$110.54
|
| Rate for Payer: UHC Medicaid |
$77.95
|
| Rate for Payer: UHC Medicare Advantage |
$110.54
|
| Rate for Payer: UHCCP Medicaid |
$77.95
|
| Rate for Payer: VA VA |
$110.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$331.63
|
|
|
HC OT Z STOCKINGS NON CUSTOM $450
|
Facility
|
OP
|
$468.18
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300130
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$82.54 |
| Max. Negotiated Rate |
$421.36 |
| Rate for Payer: Aetna Commercial |
$397.95
|
| Rate for Payer: Aetna Medicare |
$121.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.31
|
| Rate for Payer: BCBS Complete |
$86.66
|
| Rate for Payer: BCBS MAPPO |
$117.05
|
| Rate for Payer: BCBS Trust/PPO |
$384.89
|
| Rate for Payer: BCN Commercial |
$384.89
|
| Rate for Payer: BCN Medicare Advantage |
$117.05
|
| Rate for Payer: Cash Price |
$374.54
|
| Rate for Payer: Cofinity Commercial |
$402.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.05
|
| Rate for Payer: Healthscope Commercial |
$421.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.13
|
| Rate for Payer: Mclaren Medicaid |
$82.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.90
|
| Rate for Payer: Meridian Medicaid |
$86.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$134.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$128.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$397.95
|
| Rate for Payer: Nomi Health Commercial |
$383.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.13
|
| Rate for Payer: PACE Senior Care Partners |
$111.19
|
| Rate for Payer: PACE SWMI |
$117.05
|
| Rate for Payer: PHP Commercial |
$397.95
|
| Rate for Payer: PHP Medicare Advantage |
$117.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$407.32
|
| Rate for Payer: Priority Health Medicare |
$118.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.85
|
| Rate for Payer: Railroad Medicare Medicare |
$117.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.00
|
| Rate for Payer: UHC Core |
$390.93
|
| Rate for Payer: UHC Exchange |
$117.05
|
| Rate for Payer: UHC Medicaid |
$82.54
|
| Rate for Payer: UHC Medicare Advantage |
$117.05
|
| Rate for Payer: UHCCP Medicaid |
$82.54
|
| Rate for Payer: VA VA |
$117.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.13
|
|
|
HC OT Z STOCKINGS NON CUSTOM $450
|
Facility
|
IP
|
$468.18
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300130
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$325.85 |
| Max. Negotiated Rate |
$421.36 |
| Rate for Payer: Aetna Commercial |
$397.95
|
| Rate for Payer: BCBS Trust/PPO |
$386.67
|
| Rate for Payer: BCN Commercial |
$386.67
|
| Rate for Payer: Cash Price |
$374.54
|
| Rate for Payer: Cofinity Commercial |
$402.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.54
|
| Rate for Payer: Healthscope Commercial |
$421.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$397.95
|
| Rate for Payer: Nomi Health Commercial |
$383.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$351.13
|
| Rate for Payer: PHP Commercial |
$397.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$407.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$325.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$412.00
|
| Rate for Payer: UHC Core |
$390.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.13
|
|
|
HC OT Z STOCKINGS NON CUSTOM $50
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300131
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$9.63
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$42.77
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$9.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$9.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicaid |
$9.17
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$9.17
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC OT Z STOCKINGS NON CUSTOM $50
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300131
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.21 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.96
|
| Rate for Payer: BCN Commercial |
$42.96
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC OT Z STOCKINGS NON CUSTOM $60
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300132
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$43.44 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$51.55
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC OT Z STOCKINGS NON CUSTOM $60
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300132
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.51
|
| Rate for Payer: BCBS Complete |
$11.55
|
| Rate for Payer: BCBS MAPPO |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$51.32
|
| Rate for Payer: BCN Medicare Advantage |
$15.61
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.61
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Mclaren Medicaid |
$11.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$11.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PACE Senior Care Partners |
$14.82
|
| Rate for Payer: PACE SWMI |
$15.61
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.44
|
| Rate for Payer: Railroad Medicare Medicare |
$15.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Exchange |
$15.61
|
| Rate for Payer: UHC Medicaid |
$11.00
|
| Rate for Payer: UHC Medicare Advantage |
$15.61
|
| Rate for Payer: UHCCP Medicaid |
$11.00
|
| Rate for Payer: VA VA |
$15.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC OT Z STOCKINGS NON CUSTOM $70
|
Facility
|
OP
|
$72.83
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300133
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.84 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: Aetna Medicare |
$18.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.76
|
| Rate for Payer: BCBS Complete |
$13.48
|
| Rate for Payer: BCBS MAPPO |
$18.21
|
| Rate for Payer: BCBS Trust/PPO |
$59.87
|
| Rate for Payer: BCN Commercial |
$59.87
|
| Rate for Payer: BCN Medicare Advantage |
$18.21
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.21
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: Mclaren Medicaid |
$12.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.12
|
| Rate for Payer: Meridian Medicaid |
$13.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PACE Senior Care Partners |
$17.30
|
| Rate for Payer: PACE SWMI |
$18.21
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: PHP Medicare Advantage |
$18.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.36
|
| Rate for Payer: Priority Health Medicare |
$18.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.69
|
| Rate for Payer: Railroad Medicare Medicare |
$18.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.09
|
| Rate for Payer: UHC Core |
$60.81
|
| Rate for Payer: UHC Exchange |
$18.21
|
| Rate for Payer: UHC Medicaid |
$12.84
|
| Rate for Payer: UHC Medicare Advantage |
$18.21
|
| Rate for Payer: UHCCP Medicaid |
$12.84
|
| Rate for Payer: VA VA |
$18.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC OT Z STOCKINGS NON CUSTOM $70
|
Facility
|
IP
|
$72.83
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300133
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$50.69 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: BCBS Trust/PPO |
$60.15
|
| Rate for Payer: BCN Commercial |
$60.15
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Nomi Health Commercial |
$59.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.09
|
| Rate for Payer: UHC Core |
$60.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC OT Z STOCKINGS NON CUSTOM $80
|
Facility
|
IP
|
$83.23
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300134
|
|
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 NON CUSTOM $80
|
Facility
|
OP
|
$83.23
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300134
|
|
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 NON CUSTOM $90
|
Facility
|
OP
|
$93.64
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300135
|
|
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 NON CUSTOM $90
|
Facility
|
IP
|
$93.64
|
|
|
Service Code
|
HCPCS A6549
|
| Hospital Charge Code |
98300135
|
|
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 OVA & PARASITES
|
Facility
|
IP
|
$89.58
|
|
|
Service Code
|
CPT 87177
|
| Hospital Charge Code |
30600096
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$62.35 |
| Max. Negotiated Rate |
$80.62 |
| Rate for Payer: Aetna Commercial |
$76.14
|
| Rate for Payer: BCBS Trust/PPO |
$73.98
|
| Rate for Payer: BCN Commercial |
$73.98
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cofinity Commercial |
$77.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.66
|
| Rate for Payer: Healthscope Commercial |
$80.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.14
|
| Rate for Payer: Nomi Health Commercial |
$73.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.19
|
| Rate for Payer: PHP Commercial |
$76.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.83
|
| Rate for Payer: UHC Core |
$74.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.19
|
|
|
HC OVA & PARASITES
|
Facility
|
OP
|
$89.58
|
|
|
Service Code
|
CPT 87177
|
| Hospital Charge Code |
30600096
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.79 |
| Max. Negotiated Rate |
$80.62 |
| Rate for Payer: Aetna Commercial |
$76.14
|
| Rate for Payer: Aetna Medicare |
$23.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.99
|
| Rate for Payer: BCBS Complete |
$16.58
|
| Rate for Payer: BCBS MAPPO |
$22.39
|
| Rate for Payer: BCBS Trust/PPO |
$73.64
|
| Rate for Payer: BCN Commercial |
$73.64
|
| Rate for Payer: BCN Medicare Advantage |
$22.39
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cofinity Commercial |
$77.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.39
|
| Rate for Payer: Healthscope Commercial |
$80.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.19
|
| Rate for Payer: Mclaren Medicaid |
$15.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.51
|
| Rate for Payer: Meridian Medicaid |
$16.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.14
|
| Rate for Payer: Nomi Health Commercial |
$73.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.19
|
| Rate for Payer: PACE Senior Care Partners |
$21.28
|
| Rate for Payer: PACE SWMI |
$22.39
|
| Rate for Payer: PHP Commercial |
$76.14
|
| Rate for Payer: PHP Medicare Advantage |
$22.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$77.93
|
| Rate for Payer: Priority Health Medicare |
$22.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.35
|
| Rate for Payer: Railroad Medicare Medicare |
$22.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.83
|
| Rate for Payer: UHC Core |
$74.80
|
| Rate for Payer: UHC Exchange |
$22.39
|
| Rate for Payer: UHC Medicaid |
$15.79
|
| Rate for Payer: UHC Medicare Advantage |
$22.39
|
| Rate for Payer: UHCCP Medicaid |
$15.79
|
| Rate for Payer: VA VA |
$22.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.19
|
|
|
HC OVA & PARASITES SPECIAL STAIN
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 87209
|
| Hospital Charge Code |
30600190
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.07 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: BCBS Trust/PPO |
$55.86
|
| Rate for Payer: BCN Commercial |
$55.86
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC OVA & PARASITES SPECIAL STAIN
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 87209
|
| Hospital Charge Code |
30600190
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$17.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.13
|
| Rate for Payer: BCBS Complete |
$12.52
|
| Rate for Payer: BCBS MAPPO |
$16.91
|
| Rate for Payer: BCBS Trust/PPO |
$55.60
|
| Rate for Payer: BCN Commercial |
$55.60
|
| Rate for Payer: BCN Medicare Advantage |
$16.91
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.91
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$11.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.75
|
| Rate for Payer: Meridian Medicaid |
$12.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$55.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: PACE Senior Care Partners |
$16.06
|
| Rate for Payer: PACE SWMI |
$16.91
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$16.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$58.84
|
| Rate for Payer: Priority Health Medicare |
$17.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.07
|
| Rate for Payer: Railroad Medicare Medicare |
$16.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.51
|
| Rate for Payer: UHC Core |
$56.47
|
| Rate for Payer: UHC Exchange |
$16.91
|
| Rate for Payer: UHC Medicaid |
$11.92
|
| Rate for Payer: UHC Medicare Advantage |
$16.91
|
| Rate for Payer: UHCCP Medicaid |
$11.92
|
| Rate for Payer: VA VA |
$16.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
