|
HC OR LEVEL 5 PER MINUTE
|
Facility
|
IP
|
$121.00
|
|
| Hospital Charge Code |
36000135
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$78.65 |
| Max. Negotiated Rate |
$108.90 |
| Rate for Payer: Aetna Commercial |
$102.85
|
| Rate for Payer: BCBS Trust/PPO |
$98.77
|
| Rate for Payer: BCN Commercial |
$93.51
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cofinity Commercial |
$104.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.80
|
| Rate for Payer: Healthscope Commercial |
$108.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.85
|
| Rate for Payer: Nomi Health Commercial |
$99.22
|
| Rate for Payer: PHP Commercial |
$102.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.65
|
| Rate for Payer: Priority Health HMO/PPO |
$105.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.48
|
| Rate for Payer: UHC Core |
$101.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.75
|
|
|
HC ORPHENADRINE INJECTION, PER 60MG
|
Facility
|
OP
|
$30.17
|
|
|
Service Code
|
HCPCS J2360
|
| Hospital Charge Code |
63600143
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.17 |
| Max. Negotiated Rate |
$27.15 |
| Rate for Payer: Aetna Commercial |
$25.64
|
| Rate for Payer: Aetna Medicare |
$7.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.43
|
| Rate for Payer: BCBS Complete |
$12.07
|
| Rate for Payer: BCBS MAPPO |
$7.54
|
| Rate for Payer: BCBS Trust/PPO |
$24.80
|
| Rate for Payer: BCN Commercial |
$23.46
|
| Rate for Payer: BCN Medicare Advantage |
$7.54
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$25.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.54
|
| Rate for Payer: Healthscope Commercial |
$27.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.64
|
| Rate for Payer: Nomi Health Commercial |
$24.74
|
| Rate for Payer: PACE Senior Care Partners |
$7.17
|
| Rate for Payer: PACE SWMI |
$7.54
|
| Rate for Payer: PHP Commercial |
$25.64
|
| Rate for Payer: PHP Medicare Advantage |
$7.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.61
|
| Rate for Payer: Priority Health HMO/PPO |
$26.25
|
| Rate for Payer: Priority Health Medicare |
$7.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.21
|
| Rate for Payer: Railroad Medicare Medicare |
$7.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.55
|
| Rate for Payer: UHC Core |
$25.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.54
|
| Rate for Payer: UHC Exchange |
$7.54
|
| Rate for Payer: UHC Medicare Advantage |
$7.54
|
| Rate for Payer: VA VA |
$7.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.63
|
|
|
HC ORPHENADRINE INJECTION, PER 60MG
|
Facility
|
IP
|
$30.17
|
|
|
Service Code
|
HCPCS J2360
|
| Hospital Charge Code |
63600143
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.61 |
| Max. Negotiated Rate |
$27.15 |
| Rate for Payer: Aetna Commercial |
$25.64
|
| Rate for Payer: BCBS Trust/PPO |
$24.63
|
| Rate for Payer: BCN Commercial |
$23.32
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$25.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.14
|
| Rate for Payer: Healthscope Commercial |
$27.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.64
|
| Rate for Payer: Nomi Health Commercial |
$24.74
|
| Rate for Payer: PHP Commercial |
$25.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.61
|
| Rate for Payer: Priority Health HMO/PPO |
$26.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.55
|
| Rate for Payer: UHC Core |
$25.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.63
|
|
|
HC ORTHOPOX (AKA MONKEY)
|
Facility
|
IP
|
$123.27
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600334
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$80.13 |
| Max. Negotiated Rate |
$110.94 |
| Rate for Payer: Aetna Commercial |
$104.78
|
| Rate for Payer: BCBS Trust/PPO |
$100.63
|
| Rate for Payer: BCN Commercial |
$95.26
|
| Rate for Payer: Cash Price |
$98.62
|
| Rate for Payer: Cofinity Commercial |
$106.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.62
|
| Rate for Payer: Healthscope Commercial |
$110.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.78
|
| Rate for Payer: Nomi Health Commercial |
$101.08
|
| Rate for Payer: PHP Commercial |
$104.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.13
|
| Rate for Payer: Priority Health HMO/PPO |
$107.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.48
|
| Rate for Payer: UHC Core |
$102.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.45
|
|
|
HC ORTHOPOX (AKA MONKEY)
|
Facility
|
OP
|
$123.27
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600334
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.28 |
| Max. Negotiated Rate |
$110.94 |
| Rate for Payer: Aetna Commercial |
$104.78
|
| Rate for Payer: Aetna Medicare |
$32.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.52
|
| Rate for Payer: BCBS Complete |
$38.95
|
| Rate for Payer: BCBS MAPPO |
$30.82
|
| Rate for Payer: BCBS Trust/PPO |
$101.34
|
| Rate for Payer: BCN Commercial |
$95.84
|
| Rate for Payer: BCN Medicare Advantage |
$30.82
|
| Rate for Payer: Cash Price |
$98.62
|
| Rate for Payer: Cash Price |
$98.62
|
| Rate for Payer: Cofinity Commercial |
$106.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.82
|
| Rate for Payer: Healthscope Commercial |
$110.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.45
|
| Rate for Payer: Mclaren Medicaid |
$37.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.36
|
| Rate for Payer: Meridian Medicaid |
$38.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.78
|
| Rate for Payer: Nomi Health Commercial |
$101.08
|
| Rate for Payer: PACE Senior Care Partners |
$29.28
|
| Rate for Payer: PACE SWMI |
$30.82
|
| Rate for Payer: PHP Commercial |
$104.78
|
| Rate for Payer: PHP Medicare Advantage |
$30.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.13
|
| Rate for Payer: Priority Health HMO/PPO |
$107.24
|
| Rate for Payer: Priority Health Medicare |
$31.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.59
|
| Rate for Payer: Railroad Medicare Medicare |
$30.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.48
|
| Rate for Payer: UHC Core |
$102.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.82
|
| Rate for Payer: UHC Exchange |
$30.82
|
| Rate for Payer: UHC Medicare Advantage |
$30.82
|
| Rate for Payer: UHCCP Medicaid |
$37.10
|
| Rate for Payer: VA VA |
$30.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.45
|
|
|
HC ORTHOPOX DNA, PCR
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600332
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.17 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$38.95
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$62.89
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$37.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: Meridian Medicaid |
$38.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Exchange |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.12
|
| Rate for Payer: UHCCP Medicaid |
$37.10
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC ORTHOPOX DNA, PCR
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600332
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$49.72 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: BCBS Trust/PPO |
$62.45
|
| Rate for Payer: BCN Commercial |
$59.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC ORTHO/PROSTH MGMT SUBSEQ EA 15 MIN
|
Facility
|
IP
|
$129.45
|
|
|
Service Code
|
CPT 97763
|
| Hospital Charge Code |
42000056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$84.14 |
| Max. Negotiated Rate |
$116.50 |
| Rate for Payer: Aetna Commercial |
$110.03
|
| Rate for Payer: BCBS Trust/PPO |
$105.67
|
| Rate for Payer: BCN Commercial |
$100.04
|
| Rate for Payer: Cash Price |
$103.56
|
| Rate for Payer: Cofinity Commercial |
$111.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.56
|
| Rate for Payer: Healthscope Commercial |
$116.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.03
|
| Rate for Payer: Nomi Health Commercial |
$106.15
|
| Rate for Payer: PHP Commercial |
$110.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.14
|
| Rate for Payer: Priority Health HMO/PPO |
$112.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.92
|
| Rate for Payer: UHC Core |
$108.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.09
|
|
|
HC ORTHO/PROSTH MGMT SUBSEQ EA 15 MIN
|
Facility
|
OP
|
$129.45
|
|
|
Service Code
|
CPT 97763
|
| Hospital Charge Code |
42000056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$116.50 |
| Rate for Payer: Aetna Commercial |
$110.03
|
| Rate for Payer: Aetna Medicare |
$33.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.45
|
| Rate for Payer: BCBS Complete |
$51.78
|
| Rate for Payer: BCBS MAPPO |
$32.36
|
| Rate for Payer: BCBS Trust/PPO |
$106.42
|
| Rate for Payer: BCN Commercial |
$100.65
|
| Rate for Payer: BCN Medicare Advantage |
$32.36
|
| Rate for Payer: Cash Price |
$103.56
|
| Rate for Payer: Cofinity Commercial |
$111.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.36
|
| Rate for Payer: Healthscope Commercial |
$116.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.03
|
| Rate for Payer: Nomi Health Commercial |
$106.15
|
| Rate for Payer: PACE Senior Care Partners |
$30.74
|
| Rate for Payer: PACE SWMI |
$32.36
|
| Rate for Payer: PHP Commercial |
$110.03
|
| Rate for Payer: PHP Medicare Advantage |
$32.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.14
|
| Rate for Payer: Priority Health HMO/PPO |
$112.62
|
| Rate for Payer: Priority Health Medicare |
$32.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$86.73
|
| Rate for Payer: Railroad Medicare Medicare |
$32.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.92
|
| Rate for Payer: UHC Core |
$108.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.36
|
| Rate for Payer: UHC Exchange |
$32.36
|
| Rate for Payer: UHC Medicare Advantage |
$32.36
|
| Rate for Payer: VA VA |
$32.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.09
|
|
|
HC ORTHOTIC FIT/TRAIN INITIAL EA 15 MIN
|
Facility
|
OP
|
$125.37
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
42000039
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$29.78 |
| Max. Negotiated Rate |
$112.83 |
| Rate for Payer: Aetna Commercial |
$106.56
|
| Rate for Payer: Aetna Medicare |
$32.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.18
|
| Rate for Payer: BCBS Complete |
$50.15
|
| Rate for Payer: BCBS MAPPO |
$31.34
|
| Rate for Payer: BCBS Trust/PPO |
$103.07
|
| Rate for Payer: BCN Commercial |
$97.48
|
| Rate for Payer: BCN Medicare Advantage |
$31.34
|
| Rate for Payer: Cash Price |
$100.30
|
| Rate for Payer: Cofinity Commercial |
$107.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.34
|
| Rate for Payer: Healthscope Commercial |
$112.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.56
|
| Rate for Payer: Nomi Health Commercial |
$102.80
|
| Rate for Payer: PACE Senior Care Partners |
$29.78
|
| Rate for Payer: PACE SWMI |
$31.34
|
| Rate for Payer: PHP Commercial |
$106.56
|
| Rate for Payer: PHP Medicare Advantage |
$31.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.49
|
| Rate for Payer: Priority Health HMO/PPO |
$109.07
|
| Rate for Payer: Priority Health Medicare |
$31.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.00
|
| Rate for Payer: Railroad Medicare Medicare |
$31.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.33
|
| Rate for Payer: UHC Core |
$104.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.34
|
| Rate for Payer: UHC Exchange |
$31.34
|
| Rate for Payer: UHC Medicare Advantage |
$31.34
|
| Rate for Payer: VA VA |
$31.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.03
|
|
|
HC ORTHOTIC FIT/TRAIN INITIAL EA 15 MIN
|
Facility
|
IP
|
$125.37
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
42000039
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$81.49 |
| Max. Negotiated Rate |
$112.83 |
| Rate for Payer: Aetna Commercial |
$106.56
|
| Rate for Payer: BCBS Trust/PPO |
$102.34
|
| Rate for Payer: BCN Commercial |
$96.89
|
| Rate for Payer: Cash Price |
$100.30
|
| Rate for Payer: Cofinity Commercial |
$107.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.30
|
| Rate for Payer: Healthscope Commercial |
$112.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.56
|
| Rate for Payer: Nomi Health Commercial |
$102.80
|
| Rate for Payer: PHP Commercial |
$106.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.49
|
| Rate for Payer: Priority Health HMO/PPO |
$109.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.33
|
| Rate for Payer: UHC Core |
$104.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.03
|
|
|
HC OSCILLATOR INIT DAY
|
Facility
|
OP
|
$2,410.38
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000039
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$468.31 |
| Max. Negotiated Rate |
$2,169.34 |
| Rate for Payer: Aetna Commercial |
$2,048.82
|
| Rate for Payer: Aetna Medicare |
$626.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$753.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$753.24
|
| Rate for Payer: BCBS Complete |
$491.76
|
| Rate for Payer: BCBS MAPPO |
$602.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,981.57
|
| Rate for Payer: BCN Commercial |
$1,874.07
|
| Rate for Payer: BCN Medicare Advantage |
$602.60
|
| Rate for Payer: Cash Price |
$1,928.30
|
| Rate for Payer: Cash Price |
$1,928.30
|
| Rate for Payer: Cofinity Commercial |
$2,072.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,928.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.60
|
| Rate for Payer: Healthscope Commercial |
$2,169.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,807.78
|
| Rate for Payer: Mclaren Medicaid |
$468.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$632.72
|
| Rate for Payer: Meridian Medicaid |
$491.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$692.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,048.82
|
| Rate for Payer: Nomi Health Commercial |
$1,976.51
|
| Rate for Payer: PACE Senior Care Partners |
$572.47
|
| Rate for Payer: PACE SWMI |
$602.60
|
| Rate for Payer: PHP Commercial |
$2,048.82
|
| Rate for Payer: PHP Medicare Advantage |
$602.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$468.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,566.75
|
| Rate for Payer: Priority Health HMO/PPO |
$2,097.03
|
| Rate for Payer: Priority Health Medicare |
$608.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,614.95
|
| Rate for Payer: Railroad Medicare Medicare |
$602.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,121.13
|
| Rate for Payer: UHC Core |
$2,012.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.60
|
| Rate for Payer: UHC Exchange |
$602.60
|
| Rate for Payer: UHC Medicare Advantage |
$602.60
|
| Rate for Payer: UHCCP Medicaid |
$468.31
|
| Rate for Payer: VA VA |
$602.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,807.78
|
|
|
HC OSCILLATOR INIT DAY
|
Facility
|
IP
|
$2,410.38
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000039
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,566.75 |
| Max. Negotiated Rate |
$2,169.34 |
| Rate for Payer: Aetna Commercial |
$2,048.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,967.59
|
| Rate for Payer: BCN Commercial |
$1,862.74
|
| Rate for Payer: Cash Price |
$1,928.30
|
| Rate for Payer: Cofinity Commercial |
$2,072.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,928.30
|
| Rate for Payer: Healthscope Commercial |
$2,169.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,807.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,048.82
|
| Rate for Payer: Nomi Health Commercial |
$1,976.51
|
| Rate for Payer: PHP Commercial |
$2,048.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,566.75
|
| Rate for Payer: Priority Health HMO/PPO |
$2,097.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,614.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,121.13
|
| Rate for Payer: UHC Core |
$2,012.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,807.78
|
|
|
HC OSCILLATOR SUB DAY
|
Facility
|
IP
|
$1,348.28
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000040
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$876.38 |
| Max. Negotiated Rate |
$1,213.45 |
| Rate for Payer: Aetna Commercial |
$1,146.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.60
|
| Rate for Payer: BCN Commercial |
$1,041.95
|
| Rate for Payer: Cash Price |
$1,078.62
|
| Rate for Payer: Cofinity Commercial |
$1,159.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,078.62
|
| Rate for Payer: Healthscope Commercial |
$1,213.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,011.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,146.04
|
| Rate for Payer: Nomi Health Commercial |
$1,105.59
|
| Rate for Payer: PHP Commercial |
$1,146.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.38
|
| Rate for Payer: Priority Health HMO/PPO |
$1,173.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$903.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,186.49
|
| Rate for Payer: UHC Core |
$1,125.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,011.21
|
|
|
HC OSCILLATOR SUB DAY
|
Facility
|
OP
|
$1,348.28
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000040
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$320.22 |
| Max. Negotiated Rate |
$1,213.45 |
| Rate for Payer: Aetna Commercial |
$1,146.04
|
| Rate for Payer: Aetna Medicare |
$350.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$421.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$421.34
|
| Rate for Payer: BCBS Complete |
$491.76
|
| Rate for Payer: BCBS MAPPO |
$337.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,108.42
|
| Rate for Payer: BCN Commercial |
$1,048.29
|
| Rate for Payer: BCN Medicare Advantage |
$337.07
|
| Rate for Payer: Cash Price |
$1,078.62
|
| Rate for Payer: Cash Price |
$1,078.62
|
| Rate for Payer: Cofinity Commercial |
$1,159.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,078.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$337.07
|
| Rate for Payer: Healthscope Commercial |
$1,213.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,011.21
|
| Rate for Payer: Mclaren Medicaid |
$468.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$353.92
|
| Rate for Payer: Meridian Medicaid |
$491.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$387.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,146.04
|
| Rate for Payer: Nomi Health Commercial |
$1,105.59
|
| Rate for Payer: PACE Senior Care Partners |
$320.22
|
| Rate for Payer: PACE SWMI |
$337.07
|
| Rate for Payer: PHP Commercial |
$1,146.04
|
| Rate for Payer: PHP Medicare Advantage |
$337.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$468.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.38
|
| Rate for Payer: Priority Health HMO/PPO |
$1,173.00
|
| Rate for Payer: Priority Health Medicare |
$340.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$903.35
|
| Rate for Payer: Railroad Medicare Medicare |
$337.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,186.49
|
| Rate for Payer: UHC Core |
$1,125.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$337.07
|
| Rate for Payer: UHC Exchange |
$337.07
|
| Rate for Payer: UHC Medicare Advantage |
$337.07
|
| Rate for Payer: UHCCP Medicaid |
$468.31
|
| Rate for Payer: VA VA |
$337.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,011.21
|
|
|
HC OSMOLALITY SERUM
|
Facility
|
OP
|
$54.94
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
30100378
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.78 |
| Max. Negotiated Rate |
$49.45 |
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: Aetna Medicare |
$14.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.17
|
| Rate for Payer: BCBS Complete |
$5.02
|
| Rate for Payer: BCBS MAPPO |
$13.74
|
| Rate for Payer: BCBS Trust/PPO |
$45.17
|
| Rate for Payer: BCN Commercial |
$42.72
|
| Rate for Payer: BCN Medicare Advantage |
$13.74
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$47.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.74
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$4.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.42
|
| Rate for Payer: Meridian Medicaid |
$5.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Nomi Health Commercial |
$45.05
|
| Rate for Payer: PACE Senior Care Partners |
$13.05
|
| Rate for Payer: PACE SWMI |
$13.74
|
| Rate for Payer: PHP Commercial |
$46.70
|
| Rate for Payer: PHP Medicare Advantage |
$13.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.71
|
| Rate for Payer: Priority Health HMO/PPO |
$47.80
|
| Rate for Payer: Priority Health Medicare |
$13.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.81
|
| Rate for Payer: Railroad Medicare Medicare |
$13.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.35
|
| Rate for Payer: UHC Core |
$45.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.74
|
| Rate for Payer: UHC Exchange |
$13.74
|
| Rate for Payer: UHC Medicare Advantage |
$13.74
|
| Rate for Payer: UHCCP Medicaid |
$4.78
|
| Rate for Payer: VA VA |
$13.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.20
|
|
|
HC OSMOLALITY SERUM
|
Facility
|
IP
|
$54.94
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
30100378
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.71 |
| Max. Negotiated Rate |
$49.45 |
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: BCBS Trust/PPO |
$44.85
|
| Rate for Payer: BCN Commercial |
$42.46
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$47.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Nomi Health Commercial |
$45.05
|
| Rate for Payer: PHP Commercial |
$46.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.71
|
| Rate for Payer: Priority Health HMO/PPO |
$47.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.35
|
| Rate for Payer: UHC Core |
$45.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.20
|
|
|
HC OSMOLALITY URINE
|
Facility
|
OP
|
$53.86
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
30100379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.93 |
| Max. Negotiated Rate |
$48.47 |
| Rate for Payer: Aetna Commercial |
$45.78
|
| Rate for Payer: Aetna Medicare |
$14.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.83
|
| Rate for Payer: BCBS Complete |
$5.18
|
| Rate for Payer: BCBS MAPPO |
$13.46
|
| Rate for Payer: BCBS Trust/PPO |
$44.28
|
| Rate for Payer: BCN Commercial |
$41.88
|
| Rate for Payer: BCN Medicare Advantage |
$13.46
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$46.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.46
|
| Rate for Payer: Healthscope Commercial |
$48.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.40
|
| Rate for Payer: Mclaren Medicaid |
$4.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.14
|
| Rate for Payer: Meridian Medicaid |
$5.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.78
|
| Rate for Payer: Nomi Health Commercial |
$44.17
|
| Rate for Payer: PACE Senior Care Partners |
$12.79
|
| Rate for Payer: PACE SWMI |
$13.46
|
| Rate for Payer: PHP Commercial |
$45.78
|
| Rate for Payer: PHP Medicare Advantage |
$13.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.01
|
| Rate for Payer: Priority Health HMO/PPO |
$46.86
|
| Rate for Payer: Priority Health Medicare |
$13.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.09
|
| Rate for Payer: Railroad Medicare Medicare |
$13.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.40
|
| Rate for Payer: UHC Core |
$44.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.46
|
| Rate for Payer: UHC Exchange |
$13.46
|
| Rate for Payer: UHC Medicare Advantage |
$13.46
|
| Rate for Payer: UHCCP Medicaid |
$4.93
|
| Rate for Payer: VA VA |
$13.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.40
|
|
|
HC OSMOLALITY URINE
|
Facility
|
IP
|
$53.86
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
30100379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.01 |
| Max. Negotiated Rate |
$48.47 |
| Rate for Payer: Aetna Commercial |
$45.78
|
| Rate for Payer: BCBS Trust/PPO |
$43.97
|
| Rate for Payer: BCN Commercial |
$41.62
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$46.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Healthscope Commercial |
$48.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.78
|
| Rate for Payer: Nomi Health Commercial |
$44.17
|
| Rate for Payer: PHP Commercial |
$45.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.01
|
| Rate for Payer: Priority Health HMO/PPO |
$46.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.40
|
| Rate for Payer: UHC Core |
$44.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.40
|
|
|
HC OSMOTIC FRAGILITY RBC
|
Facility
|
OP
|
$131.42
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
30500052
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.66 |
| Max. Negotiated Rate |
$118.28 |
| Rate for Payer: Aetna Commercial |
$111.71
|
| Rate for Payer: Aetna Medicare |
$34.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.07
|
| Rate for Payer: BCBS Complete |
$10.14
|
| Rate for Payer: BCBS MAPPO |
$32.86
|
| Rate for Payer: BCBS Trust/PPO |
$108.04
|
| Rate for Payer: BCN Commercial |
$102.18
|
| Rate for Payer: BCN Medicare Advantage |
$32.86
|
| Rate for Payer: Cash Price |
$105.14
|
| Rate for Payer: Cash Price |
$105.14
|
| Rate for Payer: Cofinity Commercial |
$113.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.86
|
| Rate for Payer: Healthscope Commercial |
$118.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.56
|
| Rate for Payer: Mclaren Medicaid |
$9.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.50
|
| Rate for Payer: Meridian Medicaid |
$10.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.71
|
| Rate for Payer: Nomi Health Commercial |
$107.76
|
| Rate for Payer: PACE Senior Care Partners |
$31.21
|
| Rate for Payer: PACE SWMI |
$32.86
|
| Rate for Payer: PHP Commercial |
$111.71
|
| Rate for Payer: PHP Medicare Advantage |
$32.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.42
|
| Rate for Payer: Priority Health HMO/PPO |
$114.34
|
| Rate for Payer: Priority Health Medicare |
$33.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.05
|
| Rate for Payer: Railroad Medicare Medicare |
$32.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.65
|
| Rate for Payer: UHC Core |
$109.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.86
|
| Rate for Payer: UHC Exchange |
$32.86
|
| Rate for Payer: UHC Medicare Advantage |
$32.86
|
| Rate for Payer: UHCCP Medicaid |
$9.66
|
| Rate for Payer: VA VA |
$32.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.56
|
|
|
HC OSMOTIC FRAGILITY RBC
|
Facility
|
IP
|
$131.42
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
30500052
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$85.42 |
| Max. Negotiated Rate |
$118.28 |
| Rate for Payer: Aetna Commercial |
$111.71
|
| Rate for Payer: BCBS Trust/PPO |
$107.28
|
| Rate for Payer: BCN Commercial |
$101.56
|
| Rate for Payer: Cash Price |
$105.14
|
| Rate for Payer: Cofinity Commercial |
$113.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.14
|
| Rate for Payer: Healthscope Commercial |
$118.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.71
|
| Rate for Payer: Nomi Health Commercial |
$107.76
|
| Rate for Payer: PHP Commercial |
$111.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.42
|
| Rate for Payer: Priority Health HMO/PPO |
$114.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.65
|
| Rate for Payer: UHC Core |
$109.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.56
|
|
|
HC OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Facility
|
OP
|
$8,364.00
|
|
|
Service Code
|
CPT 28111
|
| Hospital Charge Code |
76100365
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,986.45 |
| Max. Negotiated Rate |
$7,527.60 |
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna Medicare |
$2,174.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,613.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,613.75
|
| Rate for Payer: BCBS Complete |
$2,413.50
|
| Rate for Payer: BCBS MAPPO |
$2,091.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,876.04
|
| Rate for Payer: BCN Commercial |
$6,503.01
|
| Rate for Payer: BCN Medicare Advantage |
$2,091.00
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,091.00
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,273.00
|
| Rate for Payer: Mclaren Medicaid |
$2,298.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,195.55
|
| Rate for Payer: Meridian Medicaid |
$2,413.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,404.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: Nomi Health Commercial |
$6,858.48
|
| Rate for Payer: PACE Senior Care Partners |
$1,986.45
|
| Rate for Payer: PACE SWMI |
$2,091.00
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,091.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,298.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health HMO/PPO |
$7,276.68
|
| Rate for Payer: Priority Health Medicare |
$2,111.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,603.88
|
| Rate for Payer: Railroad Medicare Medicare |
$2,091.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,360.32
|
| Rate for Payer: UHC Core |
$6,983.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,091.00
|
| Rate for Payer: UHC Exchange |
$2,091.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,091.00
|
| Rate for Payer: UHCCP Medicaid |
$2,298.42
|
| Rate for Payer: VA VA |
$2,091.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,273.00
|
|
|
HC OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Facility
|
IP
|
$8,364.00
|
|
|
Service Code
|
CPT 28111
|
| Hospital Charge Code |
76100365
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,436.60 |
| Max. Negotiated Rate |
$7,527.60 |
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: BCBS Trust/PPO |
$6,827.53
|
| Rate for Payer: BCN Commercial |
$6,463.70
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,273.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: Nomi Health Commercial |
$6,858.48
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health HMO/PPO |
$7,276.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,603.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,360.32
|
| Rate for Payer: UHC Core |
$6,983.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,273.00
|
|
|
HC OSTECTOMY COMPLETE 2,3 OR 4TH METATARSAL HEAD
|
Facility
|
OP
|
$8,364.00
|
|
|
Service Code
|
CPT 28112
|
| Hospital Charge Code |
76100366
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,986.45 |
| Max. Negotiated Rate |
$7,527.60 |
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna Medicare |
$2,174.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,613.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,613.75
|
| Rate for Payer: BCBS Complete |
$2,413.50
|
| Rate for Payer: BCBS MAPPO |
$2,091.00
|
| Rate for Payer: BCBS Trust/PPO |
$6,876.04
|
| Rate for Payer: BCN Commercial |
$6,503.01
|
| Rate for Payer: BCN Medicare Advantage |
$2,091.00
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,091.00
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,273.00
|
| Rate for Payer: Mclaren Medicaid |
$2,298.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,195.55
|
| Rate for Payer: Meridian Medicaid |
$2,413.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,404.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: Nomi Health Commercial |
$6,858.48
|
| Rate for Payer: PACE Senior Care Partners |
$1,986.45
|
| Rate for Payer: PACE SWMI |
$2,091.00
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: PHP Medicare Advantage |
$2,091.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,298.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health HMO/PPO |
$7,276.68
|
| Rate for Payer: Priority Health Medicare |
$2,111.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,603.88
|
| Rate for Payer: Railroad Medicare Medicare |
$2,091.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,360.32
|
| Rate for Payer: UHC Core |
$6,983.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,091.00
|
| Rate for Payer: UHC Exchange |
$2,091.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,091.00
|
| Rate for Payer: UHCCP Medicaid |
$2,298.42
|
| Rate for Payer: VA VA |
$2,091.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,273.00
|
|
|
HC OSTECTOMY COMPLETE 2,3 OR 4TH METATARSAL HEAD
|
Facility
|
IP
|
$8,364.00
|
|
|
Service Code
|
CPT 28112
|
| Hospital Charge Code |
76100366
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,436.60 |
| Max. Negotiated Rate |
$7,527.60 |
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: BCBS Trust/PPO |
$6,827.53
|
| Rate for Payer: BCN Commercial |
$6,463.70
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,273.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: Nomi Health Commercial |
$6,858.48
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health HMO/PPO |
$7,276.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,603.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,360.32
|
| Rate for Payer: UHC Core |
$6,983.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,273.00
|
|
