|
HC MR UPPER EXTREM BIL NO JOINT WO W CON
|
Facility
|
OP
|
$2,584.25
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000021
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,325.82 |
| Rate for Payer: Aetna Commercial |
$2,196.61
|
| Rate for Payer: Aetna Medicare |
$671.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$807.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$807.58
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$646.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,124.51
|
| Rate for Payer: BCN Commercial |
$2,009.25
|
| Rate for Payer: BCN Medicare Advantage |
$646.06
|
| Rate for Payer: Cash Price |
$2,067.40
|
| Rate for Payer: Cash Price |
$2,067.40
|
| Rate for Payer: Cofinity Commercial |
$2,222.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$646.06
|
| Rate for Payer: Healthscope Commercial |
$2,325.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,938.19
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$678.37
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$742.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,196.61
|
| Rate for Payer: Nomi Health Commercial |
$2,119.08
|
| Rate for Payer: PACE Senior Care Partners |
$613.76
|
| Rate for Payer: PACE SWMI |
$646.06
|
| Rate for Payer: PHP Commercial |
$2,196.61
|
| Rate for Payer: PHP Medicare Advantage |
$646.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,679.76
|
| Rate for Payer: Priority Health HMO/PPO |
$2,248.30
|
| Rate for Payer: Priority Health Medicare |
$652.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,731.45
|
| Rate for Payer: Railroad Medicare Medicare |
$646.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,274.14
|
| Rate for Payer: UHC Core |
$2,157.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$646.06
|
| Rate for Payer: UHC Exchange |
$646.06
|
| Rate for Payer: UHC Medicare Advantage |
$646.06
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$646.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,938.19
|
|
|
HC MR UPPER EXTREM BIL NO JOINT WO W CON
|
Facility
|
IP
|
$2,584.25
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000021
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,679.76 |
| Max. Negotiated Rate |
$2,325.82 |
| Rate for Payer: Aetna Commercial |
$2,196.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,109.52
|
| Rate for Payer: BCN Commercial |
$1,997.11
|
| Rate for Payer: Cash Price |
$2,067.40
|
| Rate for Payer: Cofinity Commercial |
$2,222.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.40
|
| Rate for Payer: Healthscope Commercial |
$2,325.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,938.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,196.61
|
| Rate for Payer: Nomi Health Commercial |
$2,119.08
|
| Rate for Payer: PHP Commercial |
$2,196.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,679.76
|
| Rate for Payer: Priority Health HMO/PPO |
$2,248.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,731.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,274.14
|
| Rate for Payer: UHC Core |
$2,157.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,938.19
|
|
|
HC MR UPPER EXTREM NO JOINT W CON
|
Facility
|
IP
|
$2,329.17
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000018
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,513.96 |
| Max. Negotiated Rate |
$2,096.25 |
| Rate for Payer: Aetna Commercial |
$1,979.79
|
| Rate for Payer: Aetna Commercial |
$2,969.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,901.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,851.95
|
| Rate for Payer: BCN Commercial |
$1,799.98
|
| Rate for Payer: BCN Commercial |
$2,699.97
|
| Rate for Payer: Cash Price |
$1,863.34
|
| Rate for Payer: Cash Price |
$2,795.00
|
| Rate for Payer: Cofinity Commercial |
$3,004.62
|
| Rate for Payer: Cofinity Commercial |
$2,003.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,795.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,863.34
|
| Rate for Payer: Healthscope Commercial |
$2,096.25
|
| Rate for Payer: Healthscope Commercial |
$3,144.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,746.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,620.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,979.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,969.69
|
| Rate for Payer: Nomi Health Commercial |
$1,909.92
|
| Rate for Payer: Nomi Health Commercial |
$2,864.88
|
| Rate for Payer: PHP Commercial |
$1,979.79
|
| Rate for Payer: PHP Commercial |
$2,969.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,270.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,513.96
|
| Rate for Payer: Priority Health HMO/PPO |
$3,039.56
|
| Rate for Payer: Priority Health HMO/PPO |
$2,026.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,560.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,340.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,049.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,074.50
|
| Rate for Payer: UHC Core |
$1,944.86
|
| Rate for Payer: UHC Core |
$2,917.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,746.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,620.31
|
|
|
HC MR UPPER EXTREM NO JOINT W CON
|
Facility
|
OP
|
$2,329.17
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000018
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,096.25 |
| Rate for Payer: Aetna Commercial |
$1,979.79
|
| Rate for Payer: Aetna Commercial |
$2,969.69
|
| Rate for Payer: Aetna Medicare |
$605.58
|
| Rate for Payer: Aetna Medicare |
$908.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$727.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,091.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$727.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,091.80
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$873.44
|
| Rate for Payer: BCBS MAPPO |
$582.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,914.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,872.21
|
| Rate for Payer: BCN Commercial |
$1,810.93
|
| Rate for Payer: BCN Commercial |
$2,716.39
|
| Rate for Payer: BCN Medicare Advantage |
$582.29
|
| Rate for Payer: BCN Medicare Advantage |
$873.44
|
| Rate for Payer: Cash Price |
$2,795.00
|
| Rate for Payer: Cash Price |
$1,863.34
|
| Rate for Payer: Cash Price |
$1,863.34
|
| Rate for Payer: Cash Price |
$2,795.00
|
| Rate for Payer: Cofinity Commercial |
$2,003.09
|
| Rate for Payer: Cofinity Commercial |
$3,004.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,795.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,863.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$582.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$873.44
|
| Rate for Payer: Healthscope Commercial |
$3,144.38
|
| Rate for Payer: Healthscope Commercial |
$2,096.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,746.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,620.31
|
| 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 |
$917.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$611.41
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$669.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,004.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,979.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,969.69
|
| Rate for Payer: Nomi Health Commercial |
$1,909.92
|
| Rate for Payer: Nomi Health Commercial |
$2,864.88
|
| Rate for Payer: PACE Senior Care Partners |
$553.18
|
| Rate for Payer: PACE Senior Care Partners |
$829.77
|
| Rate for Payer: PACE SWMI |
$582.29
|
| Rate for Payer: PACE SWMI |
$873.44
|
| Rate for Payer: PHP Commercial |
$2,969.69
|
| Rate for Payer: PHP Commercial |
$1,979.79
|
| Rate for Payer: PHP Medicare Advantage |
$582.29
|
| Rate for Payer: PHP Medicare Advantage |
$873.44
|
| 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 |
$1,513.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,270.94
|
| Rate for Payer: Priority Health HMO/PPO |
$3,039.56
|
| Rate for Payer: Priority Health HMO/PPO |
$2,026.38
|
| Rate for Payer: Priority Health Medicare |
$588.12
|
| Rate for Payer: Priority Health Medicare |
$882.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,560.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,340.81
|
| Rate for Payer: Railroad Medicare Medicare |
$873.44
|
| Rate for Payer: Railroad Medicare Medicare |
$582.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,074.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,049.67
|
| Rate for Payer: UHC Core |
$2,917.28
|
| Rate for Payer: UHC Core |
$1,944.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$582.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$873.44
|
| Rate for Payer: UHC Exchange |
$873.44
|
| Rate for Payer: UHC Exchange |
$582.29
|
| Rate for Payer: UHC Medicare Advantage |
$873.44
|
| Rate for Payer: UHC Medicare Advantage |
$582.29
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$582.29
|
| Rate for Payer: VA VA |
$873.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,746.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,620.31
|
|
|
HC MR UPPER EXTREM NO JOINT WO CON
|
Facility
|
OP
|
$1,995.22
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000016
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,795.70 |
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna Commercial |
$2,543.91
|
| Rate for Payer: Aetna Medicare |
$518.76
|
| Rate for Payer: Aetna Medicare |
$778.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$935.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$935.26
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$748.21
|
| Rate for Payer: BCBS MAPPO |
$498.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,640.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,460.41
|
| Rate for Payer: BCN Commercial |
$1,551.28
|
| Rate for Payer: BCN Commercial |
$2,326.93
|
| Rate for Payer: BCN Medicare Advantage |
$498.80
|
| Rate for Payer: BCN Medicare Advantage |
$748.21
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Cofinity Commercial |
$2,573.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$748.21
|
| Rate for Payer: Healthscope Commercial |
$2,693.55
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,244.62
|
| 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 |
$785.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.75
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$860.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,543.91
|
| Rate for Payer: Nomi Health Commercial |
$1,636.08
|
| Rate for Payer: Nomi Health Commercial |
$2,454.12
|
| Rate for Payer: PACE Senior Care Partners |
$473.86
|
| Rate for Payer: PACE Senior Care Partners |
$710.80
|
| Rate for Payer: PACE SWMI |
$498.80
|
| Rate for Payer: PACE SWMI |
$748.21
|
| Rate for Payer: PHP Commercial |
$2,543.91
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| Rate for Payer: PHP Medicare Advantage |
$498.80
|
| Rate for Payer: PHP Medicare Advantage |
$748.21
|
| 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 |
$1,296.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,945.34
|
| Rate for Payer: Priority Health HMO/PPO |
$2,603.76
|
| Rate for Payer: Priority Health HMO/PPO |
$1,735.84
|
| Rate for Payer: Priority Health Medicare |
$503.79
|
| Rate for Payer: Priority Health Medicare |
$755.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,336.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,005.20
|
| Rate for Payer: Railroad Medicare Medicare |
$748.21
|
| Rate for Payer: Railroad Medicare Medicare |
$498.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,633.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,755.79
|
| Rate for Payer: UHC Core |
$2,499.01
|
| Rate for Payer: UHC Core |
$1,666.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$748.21
|
| Rate for Payer: UHC Exchange |
$748.21
|
| Rate for Payer: UHC Exchange |
$498.80
|
| Rate for Payer: UHC Medicare Advantage |
$748.21
|
| Rate for Payer: UHC Medicare Advantage |
$498.80
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$498.80
|
| Rate for Payer: VA VA |
$748.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,244.62
|
|
|
HC MR UPPER EXTREM NO JOINT WO CON
|
Facility
|
IP
|
$1,995.22
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000016
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,296.89 |
| Max. Negotiated Rate |
$1,795.70 |
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna Commercial |
$2,543.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.70
|
| Rate for Payer: BCBS Trust/PPO |
$2,443.05
|
| Rate for Payer: BCN Commercial |
$1,541.91
|
| Rate for Payer: BCN Commercial |
$2,312.86
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cofinity Commercial |
$2,573.83
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Healthscope Commercial |
$2,693.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,244.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,543.91
|
| Rate for Payer: Nomi Health Commercial |
$1,636.08
|
| Rate for Payer: Nomi Health Commercial |
$2,454.12
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| Rate for Payer: PHP Commercial |
$2,543.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,945.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.89
|
| Rate for Payer: Priority Health HMO/PPO |
$2,603.76
|
| Rate for Payer: Priority Health HMO/PPO |
$1,735.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,336.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,005.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,755.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,633.69
|
| Rate for Payer: UHC Core |
$1,666.01
|
| Rate for Payer: UHC Core |
$2,499.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,244.62
|
|
|
HC MR UPPER EXTREM NO JOINT WO W CON
|
Facility
|
OP
|
$2,290.86
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000020
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,061.77 |
| Rate for Payer: Aetna Commercial |
$1,947.23
|
| Rate for Payer: Aetna Commercial |
$2,920.86
|
| Rate for Payer: Aetna Medicare |
$595.62
|
| Rate for Payer: Aetna Medicare |
$893.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$715.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,073.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$715.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,073.84
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$859.08
|
| Rate for Payer: BCBS MAPPO |
$572.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,883.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,824.98
|
| Rate for Payer: BCN Commercial |
$1,781.14
|
| Rate for Payer: BCN Commercial |
$2,671.72
|
| Rate for Payer: BCN Medicare Advantage |
$572.72
|
| Rate for Payer: BCN Medicare Advantage |
$859.08
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cofinity Commercial |
$1,970.14
|
| Rate for Payer: Cofinity Commercial |
$2,955.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$859.08
|
| Rate for Payer: Healthscope Commercial |
$3,092.67
|
| Rate for Payer: Healthscope Commercial |
$2,061.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,718.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,577.22
|
| 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 |
$902.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.35
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$658.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$987.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,947.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,920.86
|
| Rate for Payer: Nomi Health Commercial |
$1,878.51
|
| Rate for Payer: Nomi Health Commercial |
$2,817.77
|
| Rate for Payer: PACE Senior Care Partners |
$544.08
|
| Rate for Payer: PACE Senior Care Partners |
$816.12
|
| Rate for Payer: PACE SWMI |
$572.72
|
| Rate for Payer: PACE SWMI |
$859.08
|
| Rate for Payer: PHP Commercial |
$2,920.86
|
| Rate for Payer: PHP Commercial |
$1,947.23
|
| Rate for Payer: PHP Medicare Advantage |
$572.72
|
| Rate for Payer: PHP Medicare Advantage |
$859.08
|
| 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 |
$1,489.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,233.60
|
| Rate for Payer: Priority Health HMO/PPO |
$2,989.58
|
| Rate for Payer: Priority Health HMO/PPO |
$1,993.05
|
| Rate for Payer: Priority Health Medicare |
$578.44
|
| Rate for Payer: Priority Health Medicare |
$867.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,534.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,302.32
|
| Rate for Payer: Railroad Medicare Medicare |
$859.08
|
| Rate for Payer: Railroad Medicare Medicare |
$572.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,023.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,015.96
|
| Rate for Payer: UHC Core |
$2,869.31
|
| Rate for Payer: UHC Core |
$1,912.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$572.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$859.08
|
| Rate for Payer: UHC Exchange |
$859.08
|
| Rate for Payer: UHC Exchange |
$572.72
|
| Rate for Payer: UHC Medicare Advantage |
$859.08
|
| Rate for Payer: UHC Medicare Advantage |
$572.72
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$572.72
|
| Rate for Payer: VA VA |
$859.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,718.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,577.22
|
|
|
HC MR UPPER EXTREM NO JOINT WO W CON
|
Facility
|
IP
|
$2,290.86
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000020
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,489.06 |
| Max. Negotiated Rate |
$2,061.77 |
| Rate for Payer: Aetna Commercial |
$1,947.23
|
| Rate for Payer: Aetna Commercial |
$2,920.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,870.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,805.05
|
| Rate for Payer: BCN Commercial |
$1,770.38
|
| Rate for Payer: BCN Commercial |
$2,655.57
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cofinity Commercial |
$2,955.22
|
| Rate for Payer: Cofinity Commercial |
$1,970.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Healthscope Commercial |
$2,061.77
|
| Rate for Payer: Healthscope Commercial |
$3,092.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,718.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,577.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,947.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,920.86
|
| Rate for Payer: Nomi Health Commercial |
$1,878.51
|
| Rate for Payer: Nomi Health Commercial |
$2,817.77
|
| Rate for Payer: PHP Commercial |
$1,947.23
|
| Rate for Payer: PHP Commercial |
$2,920.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,233.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,489.06
|
| Rate for Payer: Priority Health HMO/PPO |
$2,989.58
|
| Rate for Payer: Priority Health HMO/PPO |
$1,993.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,534.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,302.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,015.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,023.94
|
| Rate for Payer: UHC Core |
$1,912.87
|
| Rate for Payer: UHC Core |
$2,869.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,718.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,577.22
|
|
|
HC MSMART BM CMPT1
|
Facility
|
OP
|
$244.80
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100045
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$37.85 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: Aetna Medicare |
$63.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.50
|
| Rate for Payer: BCBS Complete |
$39.74
|
| Rate for Payer: BCBS MAPPO |
$61.20
|
| Rate for Payer: BCBS Trust/PPO |
$201.25
|
| Rate for Payer: BCN Commercial |
$190.33
|
| Rate for Payer: BCN Medicare Advantage |
$61.20
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.60
|
| Rate for Payer: Mclaren Medicaid |
$37.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.26
|
| Rate for Payer: Meridian Medicaid |
$39.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: Nomi Health Commercial |
$200.74
|
| Rate for Payer: PACE Senior Care Partners |
$58.14
|
| Rate for Payer: PACE SWMI |
$61.20
|
| Rate for Payer: PHP Commercial |
$208.08
|
| Rate for Payer: PHP Medicare Advantage |
$61.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health HMO/PPO |
$212.98
|
| Rate for Payer: Priority Health Medicare |
$61.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.02
|
| Rate for Payer: Railroad Medicare Medicare |
$61.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.42
|
| Rate for Payer: UHC Core |
$204.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.20
|
| Rate for Payer: UHC Exchange |
$61.20
|
| Rate for Payer: UHC Medicare Advantage |
$61.20
|
| Rate for Payer: UHCCP Medicaid |
$37.85
|
| Rate for Payer: VA VA |
$61.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.60
|
|
|
HC MSMART BM CMPT1
|
Facility
|
IP
|
$244.80
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100045
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$159.12 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: BCBS Trust/PPO |
$199.83
|
| Rate for Payer: BCN Commercial |
$189.18
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: Nomi Health Commercial |
$200.74
|
| Rate for Payer: PHP Commercial |
$208.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health HMO/PPO |
$212.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.42
|
| Rate for Payer: UHC Core |
$204.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.60
|
|
|
HC MSMART BM CMPT2
|
Facility
|
IP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100046
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$111.01 |
| Max. Negotiated Rate |
$153.70 |
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: BCBS Trust/PPO |
$139.41
|
| Rate for Payer: BCN Commercial |
$131.98
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: Nomi Health Commercial |
$140.04
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health HMO/PPO |
$148.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.29
|
| Rate for Payer: UHC Core |
$142.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.08
|
|
|
HC MSMART BM CMPT2
|
Facility
|
OP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100046
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$40.56 |
| Max. Negotiated Rate |
$267.58 |
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: Aetna Medicare |
$44.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.37
|
| Rate for Payer: BCBS Complete |
$267.58
|
| Rate for Payer: BCBS MAPPO |
$42.70
|
| Rate for Payer: BCBS Trust/PPO |
$140.40
|
| Rate for Payer: BCN Commercial |
$132.78
|
| Rate for Payer: BCN Medicare Advantage |
$42.70
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.70
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.08
|
| Rate for Payer: Mclaren Medicaid |
$254.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.83
|
| Rate for Payer: Meridian Medicaid |
$267.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: Nomi Health Commercial |
$140.04
|
| Rate for Payer: PACE Senior Care Partners |
$40.56
|
| Rate for Payer: PACE SWMI |
$42.70
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: PHP Medicare Advantage |
$42.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health HMO/PPO |
$148.58
|
| Rate for Payer: Priority Health Medicare |
$43.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.42
|
| Rate for Payer: Railroad Medicare Medicare |
$42.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.29
|
| Rate for Payer: UHC Core |
$142.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.70
|
| Rate for Payer: UHC Exchange |
$42.70
|
| Rate for Payer: UHC Medicare Advantage |
$42.70
|
| Rate for Payer: UHCCP Medicaid |
$254.82
|
| Rate for Payer: VA VA |
$42.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.08
|
|
|
HC MSMART BM CMPT3
|
Facility
|
IP
|
$176.46
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100047
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$114.70 |
| Max. Negotiated Rate |
$158.81 |
| Rate for Payer: Aetna Commercial |
$149.99
|
| Rate for Payer: BCBS Trust/PPO |
$144.04
|
| Rate for Payer: BCN Commercial |
$136.37
|
| Rate for Payer: Cash Price |
$141.17
|
| Rate for Payer: Cofinity Commercial |
$151.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.17
|
| Rate for Payer: Healthscope Commercial |
$158.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.99
|
| Rate for Payer: Nomi Health Commercial |
$144.70
|
| Rate for Payer: PHP Commercial |
$149.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.70
|
| Rate for Payer: Priority Health HMO/PPO |
$153.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.28
|
| Rate for Payer: UHC Core |
$147.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.34
|
|
|
HC MSMART BM CMPT3
|
Facility
|
OP
|
$176.46
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100047
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$41.91 |
| Max. Negotiated Rate |
$158.81 |
| Rate for Payer: Aetna Commercial |
$149.99
|
| Rate for Payer: Aetna Medicare |
$45.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.14
|
| Rate for Payer: BCBS Complete |
$70.58
|
| Rate for Payer: BCBS MAPPO |
$44.12
|
| Rate for Payer: BCBS Trust/PPO |
$145.07
|
| Rate for Payer: BCN Commercial |
$137.20
|
| Rate for Payer: BCN Medicare Advantage |
$44.12
|
| Rate for Payer: Cash Price |
$141.17
|
| Rate for Payer: Cofinity Commercial |
$151.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.12
|
| Rate for Payer: Healthscope Commercial |
$158.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.99
|
| Rate for Payer: Nomi Health Commercial |
$144.70
|
| Rate for Payer: PACE Senior Care Partners |
$41.91
|
| Rate for Payer: PACE SWMI |
$44.12
|
| Rate for Payer: PHP Commercial |
$149.99
|
| Rate for Payer: PHP Medicare Advantage |
$44.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.70
|
| Rate for Payer: Priority Health HMO/PPO |
$153.52
|
| Rate for Payer: Priority Health Medicare |
$44.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.23
|
| Rate for Payer: Railroad Medicare Medicare |
$44.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.28
|
| Rate for Payer: UHC Core |
$147.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.12
|
| Rate for Payer: UHC Exchange |
$44.12
|
| Rate for Payer: UHC Medicare Advantage |
$44.12
|
| Rate for Payer: VA VA |
$44.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.34
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR
|
Facility
|
OP
|
$68.18
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600293
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$61.36 |
| Rate for Payer: Aetna Commercial |
$57.95
|
| Rate for Payer: Aetna Medicare |
$17.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.31
|
| Rate for Payer: BCBS Complete |
$31.64
|
| Rate for Payer: BCBS MAPPO |
$17.04
|
| Rate for Payer: BCBS Trust/PPO |
$56.05
|
| Rate for Payer: BCN Commercial |
$53.01
|
| Rate for Payer: BCN Medicare Advantage |
$17.04
|
| Rate for Payer: Cash Price |
$54.54
|
| Rate for Payer: Cash Price |
$54.54
|
| Rate for Payer: Cofinity Commercial |
$58.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.04
|
| Rate for Payer: Healthscope Commercial |
$61.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.14
|
| Rate for Payer: Mclaren Medicaid |
$30.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.90
|
| Rate for Payer: Meridian Medicaid |
$31.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.95
|
| Rate for Payer: Nomi Health Commercial |
$55.91
|
| Rate for Payer: PACE Senior Care Partners |
$16.19
|
| Rate for Payer: PACE SWMI |
$17.04
|
| Rate for Payer: PHP Commercial |
$57.95
|
| Rate for Payer: PHP Medicare Advantage |
$17.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.32
|
| Rate for Payer: Priority Health HMO/PPO |
$59.32
|
| Rate for Payer: Priority Health Medicare |
$17.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.68
|
| Rate for Payer: Railroad Medicare Medicare |
$17.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.00
|
| Rate for Payer: UHC Core |
$56.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.04
|
| Rate for Payer: UHC Exchange |
$17.04
|
| Rate for Payer: UHC Medicare Advantage |
$17.04
|
| Rate for Payer: UHCCP Medicaid |
$30.13
|
| Rate for Payer: VA VA |
$17.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.14
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR
|
Facility
|
IP
|
$68.18
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600293
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$44.32 |
| Max. Negotiated Rate |
$61.36 |
| Rate for Payer: Aetna Commercial |
$57.95
|
| Rate for Payer: BCBS Trust/PPO |
$55.66
|
| Rate for Payer: BCN Commercial |
$52.69
|
| Rate for Payer: Cash Price |
$54.54
|
| Rate for Payer: Cofinity Commercial |
$58.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.54
|
| Rate for Payer: Healthscope Commercial |
$61.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.95
|
| Rate for Payer: Nomi Health Commercial |
$55.91
|
| Rate for Payer: PHP Commercial |
$57.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.32
|
| Rate for Payer: Priority Health HMO/PPO |
$59.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.00
|
| Rate for Payer: UHC Core |
$56.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.14
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
OP
|
$57.40
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$51.66 |
| Rate for Payer: Aetna Commercial |
$48.79
|
| Rate for Payer: Aetna Medicare |
$14.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.94
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$14.35
|
| Rate for Payer: BCBS Trust/PPO |
$47.19
|
| Rate for Payer: BCN Commercial |
$44.63
|
| Rate for Payer: BCN Medicare Advantage |
$14.35
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$49.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.35
|
| Rate for Payer: Healthscope Commercial |
$51.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.05
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.07
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.79
|
| Rate for Payer: Nomi Health Commercial |
$47.07
|
| Rate for Payer: PACE Senior Care Partners |
$13.63
|
| Rate for Payer: PACE SWMI |
$14.35
|
| Rate for Payer: PHP Commercial |
$48.79
|
| Rate for Payer: PHP Medicare Advantage |
$14.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.31
|
| Rate for Payer: Priority Health HMO/PPO |
$49.94
|
| Rate for Payer: Priority Health Medicare |
$14.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.46
|
| Rate for Payer: Railroad Medicare Medicare |
$14.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.51
|
| Rate for Payer: UHC Core |
$47.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.35
|
| Rate for Payer: UHC Exchange |
$14.35
|
| Rate for Payer: UHC Medicare Advantage |
$14.35
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$14.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.05
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
IP
|
$57.40
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.31 |
| Max. Negotiated Rate |
$51.66 |
| Rate for Payer: Aetna Commercial |
$48.79
|
| Rate for Payer: BCBS Trust/PPO |
$46.86
|
| Rate for Payer: BCN Commercial |
$44.36
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$49.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.92
|
| Rate for Payer: Healthscope Commercial |
$51.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.79
|
| Rate for Payer: Nomi Health Commercial |
$47.07
|
| Rate for Payer: PHP Commercial |
$48.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.31
|
| Rate for Payer: Priority Health HMO/PPO |
$49.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.51
|
| Rate for Payer: UHC Core |
$47.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.05
|
|
|
HC MTHFR 2 MUTATIONS
|
Facility
|
OP
|
$506.94
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000126
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$47.24 |
| Max. Negotiated Rate |
$456.25 |
| Rate for Payer: Aetna Commercial |
$430.90
|
| Rate for Payer: Aetna Medicare |
$131.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$158.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$158.42
|
| Rate for Payer: BCBS Complete |
$49.61
|
| Rate for Payer: BCBS MAPPO |
$126.74
|
| Rate for Payer: BCBS Trust/PPO |
$416.76
|
| Rate for Payer: BCN Commercial |
$394.15
|
| Rate for Payer: BCN Medicare Advantage |
$126.74
|
| Rate for Payer: Cash Price |
$405.55
|
| Rate for Payer: Cash Price |
$405.55
|
| Rate for Payer: Cofinity Commercial |
$435.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$405.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.74
|
| Rate for Payer: Healthscope Commercial |
$456.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$380.20
|
| Rate for Payer: Mclaren Medicaid |
$47.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.07
|
| Rate for Payer: Meridian Medicaid |
$49.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$430.90
|
| Rate for Payer: Nomi Health Commercial |
$415.69
|
| Rate for Payer: PACE Senior Care Partners |
$120.40
|
| Rate for Payer: PACE SWMI |
$126.74
|
| Rate for Payer: PHP Commercial |
$430.90
|
| Rate for Payer: PHP Medicare Advantage |
$126.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.51
|
| Rate for Payer: Priority Health HMO/PPO |
$441.04
|
| Rate for Payer: Priority Health Medicare |
$128.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$339.65
|
| Rate for Payer: Railroad Medicare Medicare |
$126.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.11
|
| Rate for Payer: UHC Core |
$423.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.74
|
| Rate for Payer: UHC Exchange |
$126.74
|
| Rate for Payer: UHC Medicare Advantage |
$126.74
|
| Rate for Payer: UHCCP Medicaid |
$47.24
|
| Rate for Payer: VA VA |
$126.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$380.20
|
|
|
HC MTHFR 2 MUTATIONS
|
Facility
|
IP
|
$506.94
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000126
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$329.51 |
| Max. Negotiated Rate |
$456.25 |
| Rate for Payer: Aetna Commercial |
$430.90
|
| Rate for Payer: BCBS Trust/PPO |
$413.82
|
| Rate for Payer: BCN Commercial |
$391.76
|
| Rate for Payer: Cash Price |
$405.55
|
| Rate for Payer: Cofinity Commercial |
$435.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$405.55
|
| Rate for Payer: Healthscope Commercial |
$456.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$380.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$430.90
|
| Rate for Payer: Nomi Health Commercial |
$415.69
|
| Rate for Payer: PHP Commercial |
$430.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.51
|
| Rate for Payer: Priority Health HMO/PPO |
$441.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$339.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.11
|
| Rate for Payer: UHC Core |
$423.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$380.20
|
|
|
HC MTHFR MUTATION
|
Facility
|
IP
|
$382.50
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000102
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$248.62 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Aetna Commercial |
$325.12
|
| Rate for Payer: BCBS Trust/PPO |
$312.23
|
| Rate for Payer: BCN Commercial |
$295.60
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cofinity Commercial |
$328.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.00
|
| Rate for Payer: Healthscope Commercial |
$344.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.12
|
| Rate for Payer: Nomi Health Commercial |
$313.65
|
| Rate for Payer: PHP Commercial |
$325.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.62
|
| Rate for Payer: Priority Health HMO/PPO |
$332.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.60
|
| Rate for Payer: UHC Core |
$319.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.88
|
|
|
HC MTHFR MUTATION
|
Facility
|
OP
|
$382.50
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000102
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$47.24 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Aetna Commercial |
$325.12
|
| Rate for Payer: Aetna Medicare |
$99.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.53
|
| Rate for Payer: BCBS Complete |
$49.61
|
| Rate for Payer: BCBS MAPPO |
$95.62
|
| Rate for Payer: BCBS Trust/PPO |
$314.45
|
| Rate for Payer: BCN Commercial |
$297.39
|
| Rate for Payer: BCN Medicare Advantage |
$95.62
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cofinity Commercial |
$328.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.62
|
| Rate for Payer: Healthscope Commercial |
$344.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.88
|
| Rate for Payer: Mclaren Medicaid |
$47.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.41
|
| Rate for Payer: Meridian Medicaid |
$49.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.12
|
| Rate for Payer: Nomi Health Commercial |
$313.65
|
| Rate for Payer: PACE Senior Care Partners |
$90.84
|
| Rate for Payer: PACE SWMI |
$95.62
|
| Rate for Payer: PHP Commercial |
$325.12
|
| Rate for Payer: PHP Medicare Advantage |
$95.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.62
|
| Rate for Payer: Priority Health HMO/PPO |
$332.78
|
| Rate for Payer: Priority Health Medicare |
$96.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$256.28
|
| Rate for Payer: Railroad Medicare Medicare |
$95.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.60
|
| Rate for Payer: UHC Core |
$319.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.62
|
| Rate for Payer: UHC Exchange |
$95.62
|
| Rate for Payer: UHC Medicare Advantage |
$95.62
|
| Rate for Payer: UHCCP Medicaid |
$47.24
|
| Rate for Payer: VA VA |
$95.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.88
|
|
|
HC M TUBERCULOSIS COMPLEX, PCR
|
Facility
|
IP
|
$197.88
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600291
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$128.62 |
| Max. Negotiated Rate |
$178.09 |
| Rate for Payer: Aetna Commercial |
$168.20
|
| Rate for Payer: BCBS Trust/PPO |
$161.53
|
| Rate for Payer: BCN Commercial |
$152.92
|
| Rate for Payer: Cash Price |
$158.30
|
| Rate for Payer: Cofinity Commercial |
$170.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.30
|
| Rate for Payer: Healthscope Commercial |
$178.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.20
|
| Rate for Payer: Nomi Health Commercial |
$162.26
|
| Rate for Payer: PHP Commercial |
$168.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.62
|
| Rate for Payer: Priority Health HMO/PPO |
$172.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.13
|
| Rate for Payer: UHC Core |
$165.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.41
|
|
|
HC M TUBERCULOSIS COMPLEX, PCR
|
Facility
|
OP
|
$197.88
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600291
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.13 |
| Max. Negotiated Rate |
$178.09 |
| Rate for Payer: Aetna Commercial |
$168.20
|
| Rate for Payer: Aetna Medicare |
$51.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.84
|
| Rate for Payer: BCBS Complete |
$31.64
|
| Rate for Payer: BCBS MAPPO |
$49.47
|
| Rate for Payer: BCBS Trust/PPO |
$162.68
|
| Rate for Payer: BCN Commercial |
$153.85
|
| Rate for Payer: BCN Medicare Advantage |
$49.47
|
| Rate for Payer: Cash Price |
$158.30
|
| Rate for Payer: Cash Price |
$158.30
|
| Rate for Payer: Cofinity Commercial |
$170.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.47
|
| Rate for Payer: Healthscope Commercial |
$178.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.41
|
| Rate for Payer: Mclaren Medicaid |
$30.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.94
|
| Rate for Payer: Meridian Medicaid |
$31.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.20
|
| Rate for Payer: Nomi Health Commercial |
$162.26
|
| Rate for Payer: PACE Senior Care Partners |
$47.00
|
| Rate for Payer: PACE SWMI |
$49.47
|
| Rate for Payer: PHP Commercial |
$168.20
|
| Rate for Payer: PHP Medicare Advantage |
$49.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.62
|
| Rate for Payer: Priority Health HMO/PPO |
$172.16
|
| Rate for Payer: Priority Health Medicare |
$49.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.58
|
| Rate for Payer: Railroad Medicare Medicare |
$49.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.13
|
| Rate for Payer: UHC Core |
$165.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.47
|
| Rate for Payer: UHC Exchange |
$49.47
|
| Rate for Payer: UHC Medicare Advantage |
$49.47
|
| Rate for Payer: UHCCP Medicaid |
$30.13
|
| Rate for Payer: VA VA |
$49.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.41
|
|
|
HC MUCORE RACEMOSUS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200093
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
