|
HC WEST NILE VIRUS CSF CMPT
|
Facility
|
IP
|
$43.86
|
|
|
Service Code
|
CPT 86789
|
| Hospital Charge Code |
30200332
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.75 |
| Max. Negotiated Rate |
$39.47 |
| Rate for Payer: Aetna Commercial |
$37.28
|
| Rate for Payer: BCBS Trust/PPO |
$33.90
|
| Rate for Payer: BCN Commercial |
$33.90
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$37.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$39.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.28
|
| Rate for Payer: PHP Commercial |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.60
|
| Rate for Payer: UHC Core |
$36.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.90
|
|
|
HC WEST NILE VIRUS CSF CMPT
|
Facility
|
OP
|
$43.86
|
|
|
Service Code
|
CPT 86789
|
| Hospital Charge Code |
30200332
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.42 |
| Max. Negotiated Rate |
$39.47 |
| Rate for Payer: Aetna Commercial |
$37.28
|
| Rate for Payer: Aetna Medicare |
$11.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.71
|
| Rate for Payer: BCBS Complete |
$11.15
|
| Rate for Payer: BCBS MAPPO |
$10.96
|
| Rate for Payer: BCBS Trust/PPO |
$34.10
|
| Rate for Payer: BCN Commercial |
$34.10
|
| Rate for Payer: BCN Medicare Advantage |
$10.96
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$37.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.96
|
| Rate for Payer: Healthscope Commercial |
$39.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.90
|
| Rate for Payer: Mclaren Medicaid |
$10.62
|
| Rate for Payer: Meridian Medicaid |
$11.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.28
|
| Rate for Payer: PACE Senior Care Partners |
$10.42
|
| Rate for Payer: PACE SWMI |
$10.96
|
| Rate for Payer: PHP Commercial |
$37.28
|
| Rate for Payer: PHP Medicare Advantage |
$10.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.16
|
| Rate for Payer: Priority Health Medicare |
$10.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.75
|
| Rate for Payer: Railroad Medicare Medicare |
$10.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.60
|
| Rate for Payer: UHC Core |
$36.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.96
|
| Rate for Payer: UHC Medicare Advantage |
$11.29
|
| Rate for Payer: VA VA |
$10.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.90
|
|
|
HC WET PREP
|
Facility
|
OP
|
$50.30
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
30600109
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$45.27 |
| Rate for Payer: Aetna Commercial |
$42.76
|
| Rate for Payer: Aetna Medicare |
$13.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.72
|
| Rate for Payer: BCBS Complete |
$4.51
|
| Rate for Payer: BCBS MAPPO |
$12.58
|
| Rate for Payer: BCBS Trust/PPO |
$39.11
|
| Rate for Payer: BCN Commercial |
$39.11
|
| Rate for Payer: BCN Medicare Advantage |
$12.58
|
| Rate for Payer: Cash Price |
$40.24
|
| Rate for Payer: Cash Price |
$40.24
|
| Rate for Payer: Cofinity Commercial |
$43.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.58
|
| Rate for Payer: Healthscope Commercial |
$45.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.72
|
| Rate for Payer: Mclaren Medicaid |
$4.30
|
| Rate for Payer: Meridian Medicaid |
$4.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.76
|
| Rate for Payer: PACE Senior Care Partners |
$11.95
|
| Rate for Payer: PACE SWMI |
$12.58
|
| Rate for Payer: PHP Commercial |
$42.76
|
| Rate for Payer: PHP Medicare Advantage |
$12.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.76
|
| Rate for Payer: Priority Health Medicare |
$12.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.68
|
| Rate for Payer: Railroad Medicare Medicare |
$12.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.26
|
| Rate for Payer: UHC Core |
$42.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.58
|
| Rate for Payer: UHC Medicare Advantage |
$12.95
|
| Rate for Payer: VA VA |
$12.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.72
|
|
|
HC WET PREP
|
Facility
|
IP
|
$50.30
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
30600109
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.68 |
| Max. Negotiated Rate |
$45.27 |
| Rate for Payer: Aetna Commercial |
$42.76
|
| Rate for Payer: BCBS Trust/PPO |
$38.87
|
| Rate for Payer: BCN Commercial |
$38.87
|
| Rate for Payer: Cash Price |
$40.24
|
| Rate for Payer: Cofinity Commercial |
$43.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.24
|
| Rate for Payer: Healthscope Commercial |
$45.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.76
|
| Rate for Payer: PHP Commercial |
$42.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.26
|
| Rate for Payer: UHC Core |
$42.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.72
|
|
|
HC WHEAT IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200066
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC WHEAT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200066
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC WHEELCHAIR MANAGEMENT EA 15 MIN
|
Facility
|
IP
|
$96.90
|
|
|
Service Code
|
CPT 97542
|
| Hospital Charge Code |
42000032
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$59.10 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: BCBS Trust/PPO |
$74.88
|
| Rate for Payer: BCN Commercial |
$74.88
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.36
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.27
|
| Rate for Payer: UHC Core |
$80.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.68
|
|
|
HC WHEELCHAIR MANAGEMENT EA 15 MIN
|
Facility
|
OP
|
$96.90
|
|
|
Service Code
|
CPT 97542
|
| Hospital Charge Code |
42000032
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.01 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: Aetna Medicare |
$25.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.28
|
| Rate for Payer: BCBS Complete |
$38.76
|
| Rate for Payer: BCBS MAPPO |
$24.22
|
| Rate for Payer: BCBS Trust/PPO |
$75.34
|
| Rate for Payer: BCN Commercial |
$75.34
|
| Rate for Payer: BCN Medicare Advantage |
$24.22
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.22
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$82.36
|
| Rate for Payer: PACE Senior Care Partners |
$23.01
|
| Rate for Payer: PACE SWMI |
$24.22
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: PHP Medicare Advantage |
$24.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.30
|
| Rate for Payer: Priority Health Medicare |
$24.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.10
|
| Rate for Payer: Railroad Medicare Medicare |
$24.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.27
|
| Rate for Payer: UHC Core |
$80.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.22
|
| Rate for Payer: UHC Medicare Advantage |
$24.95
|
| Rate for Payer: VA VA |
$24.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.68
|
|
|
HC WHIRLPOOL
|
Facility
|
OP
|
$90.78
|
|
|
Service Code
|
CPT 97022
|
| Hospital Charge Code |
42000012
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.56 |
| Max. Negotiated Rate |
$81.70 |
| Rate for Payer: Aetna Commercial |
$77.16
|
| Rate for Payer: Aetna Medicare |
$23.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.37
|
| Rate for Payer: BCBS Complete |
$36.31
|
| Rate for Payer: BCBS MAPPO |
$22.70
|
| Rate for Payer: BCBS Trust/PPO |
$70.58
|
| Rate for Payer: BCN Commercial |
$70.58
|
| Rate for Payer: BCN Medicare Advantage |
$22.70
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$78.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.70
|
| Rate for Payer: Healthscope Commercial |
$81.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$77.16
|
| Rate for Payer: PACE Senior Care Partners |
$21.56
|
| Rate for Payer: PACE SWMI |
$22.70
|
| Rate for Payer: PHP Commercial |
$77.16
|
| Rate for Payer: PHP Medicare Advantage |
$22.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.98
|
| Rate for Payer: Priority Health Medicare |
$22.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.37
|
| Rate for Payer: Railroad Medicare Medicare |
$22.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.89
|
| Rate for Payer: UHC Core |
$75.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.70
|
| Rate for Payer: UHC Medicare Advantage |
$23.38
|
| Rate for Payer: VA VA |
$22.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.08
|
|
|
HC WHIRLPOOL
|
Facility
|
IP
|
$90.78
|
|
|
Service Code
|
CPT 97022
|
| Hospital Charge Code |
42000012
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$55.37 |
| Max. Negotiated Rate |
$81.70 |
| Rate for Payer: Aetna Commercial |
$77.16
|
| Rate for Payer: BCBS Trust/PPO |
$70.15
|
| Rate for Payer: BCN Commercial |
$70.15
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$78.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Healthscope Commercial |
$81.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$77.16
|
| Rate for Payer: PHP Commercial |
$77.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.89
|
| Rate for Payer: UHC Core |
$75.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.08
|
|
|
HC WHITE ASH IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200106
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC WHITE ASH IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200106
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC WHITE FACED HORNET IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200107
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC WHITE FACED HORNET IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200107
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC WHITE HICKORY IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200108
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC WHITE HICKORY IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200108
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC WHITE PINE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200109
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC WHITE PINE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200109
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC WHOLE BLOOD DIRECT
|
Facility
|
IP
|
$874.70
|
|
|
Service Code
|
CPT P9010
|
| Hospital Charge Code |
39000074
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$533.48 |
| Max. Negotiated Rate |
$787.23 |
| Rate for Payer: Aetna Commercial |
$743.50
|
| Rate for Payer: BCBS Trust/PPO |
$675.97
|
| Rate for Payer: BCN Commercial |
$675.97
|
| Rate for Payer: Cash Price |
$699.76
|
| Rate for Payer: Cofinity Commercial |
$752.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.76
|
| Rate for Payer: Healthscope Commercial |
$787.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$656.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$743.50
|
| Rate for Payer: PHP Commercial |
$743.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$533.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.74
|
| Rate for Payer: UHC Core |
$730.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$656.02
|
|
|
HC WHOLE BLOOD DIRECT
|
Facility
|
OP
|
$874.70
|
|
|
Service Code
|
CPT P9010
|
| Hospital Charge Code |
39000074
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$139.84 |
| Max. Negotiated Rate |
$787.23 |
| Rate for Payer: Aetna Commercial |
$743.50
|
| Rate for Payer: Aetna Medicare |
$227.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$273.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$273.34
|
| Rate for Payer: BCBS Complete |
$146.83
|
| Rate for Payer: BCBS MAPPO |
$218.68
|
| Rate for Payer: BCBS Trust/PPO |
$680.08
|
| Rate for Payer: BCN Commercial |
$680.08
|
| Rate for Payer: BCN Medicare Advantage |
$218.68
|
| Rate for Payer: Cash Price |
$699.76
|
| Rate for Payer: Cash Price |
$699.76
|
| Rate for Payer: Cofinity Commercial |
$752.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.68
|
| Rate for Payer: Healthscope Commercial |
$787.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$656.02
|
| Rate for Payer: Mclaren Medicaid |
$139.84
|
| Rate for Payer: Meridian Medicaid |
$146.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$229.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$251.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$743.50
|
| Rate for Payer: PACE Senior Care Partners |
$207.74
|
| Rate for Payer: PACE SWMI |
$218.68
|
| Rate for Payer: PHP Commercial |
$743.50
|
| Rate for Payer: PHP Medicare Advantage |
$218.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$760.99
|
| Rate for Payer: Priority Health Medicare |
$218.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$533.48
|
| Rate for Payer: Railroad Medicare Medicare |
$218.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$769.74
|
| Rate for Payer: UHC Core |
$730.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.68
|
| Rate for Payer: UHC Medicare Advantage |
$225.24
|
| Rate for Payer: VA VA |
$218.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$656.02
|
|
|
HC WHOLEY EXCHANGE
|
Facility
|
OP
|
$499.36
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200081
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.60 |
| Max. Negotiated Rate |
$449.42 |
| Rate for Payer: Aetna Commercial |
$424.46
|
| Rate for Payer: Aetna Medicare |
$129.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.05
|
| Rate for Payer: BCBS Complete |
$199.74
|
| Rate for Payer: BCBS MAPPO |
$124.84
|
| Rate for Payer: BCBS Trust/PPO |
$388.25
|
| Rate for Payer: BCN Commercial |
$388.25
|
| Rate for Payer: BCN Medicare Advantage |
$124.84
|
| Rate for Payer: Cash Price |
$399.49
|
| Rate for Payer: Cofinity Commercial |
$429.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.84
|
| Rate for Payer: Healthscope Commercial |
$449.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$131.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$424.46
|
| Rate for Payer: PACE Senior Care Partners |
$118.60
|
| Rate for Payer: PACE SWMI |
$124.84
|
| Rate for Payer: PHP Commercial |
$424.46
|
| Rate for Payer: PHP Medicare Advantage |
$124.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$434.44
|
| Rate for Payer: Priority Health Medicare |
$124.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.56
|
| Rate for Payer: Railroad Medicare Medicare |
$124.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.44
|
| Rate for Payer: UHC Core |
$416.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.84
|
| Rate for Payer: UHC Medicare Advantage |
$128.59
|
| Rate for Payer: VA VA |
$124.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.52
|
|
|
HC WHOLEY EXCHANGE
|
Facility
|
IP
|
$499.36
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200081
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$304.56 |
| Max. Negotiated Rate |
$449.42 |
| Rate for Payer: Aetna Commercial |
$424.46
|
| Rate for Payer: BCBS Trust/PPO |
$385.91
|
| Rate for Payer: BCN Commercial |
$385.91
|
| Rate for Payer: Cash Price |
$399.49
|
| Rate for Payer: Cofinity Commercial |
$429.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.49
|
| Rate for Payer: Healthscope Commercial |
$449.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$424.46
|
| Rate for Payer: PHP Commercial |
$424.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$434.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.44
|
| Rate for Payer: UHC Core |
$416.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.52
|
|
|
HC WILLOW IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200110
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC WILLOW IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200110
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC WMC FDG PER DOSE
|
Facility
|
OP
|
$374.82
|
|
|
Service Code
|
HCPCS A9552
|
| Hospital Charge Code |
34300026
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$89.02 |
| Max. Negotiated Rate |
$337.34 |
| Rate for Payer: Aetna Commercial |
$318.60
|
| Rate for Payer: Aetna Commercial |
$260.02
|
| Rate for Payer: Aetna Medicare |
$97.45
|
| Rate for Payer: Aetna Medicare |
$79.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$117.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$117.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.60
|
| Rate for Payer: BCBS Complete |
$122.36
|
| Rate for Payer: BCBS Complete |
$149.93
|
| Rate for Payer: BCBS MAPPO |
$93.70
|
| Rate for Payer: BCBS MAPPO |
$76.48
|
| Rate for Payer: BCBS Trust/PPO |
$291.42
|
| Rate for Payer: BCBS Trust/PPO |
$237.85
|
| Rate for Payer: BCN Commercial |
$291.42
|
| Rate for Payer: BCN Commercial |
$237.85
|
| Rate for Payer: BCN Medicare Advantage |
$76.48
|
| Rate for Payer: BCN Medicare Advantage |
$93.70
|
| Rate for Payer: Cash Price |
$299.86
|
| Rate for Payer: Cash Price |
$244.73
|
| Rate for Payer: Cofinity Commercial |
$322.35
|
| Rate for Payer: Cofinity Commercial |
$263.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.48
|
| Rate for Payer: Healthscope Commercial |
$337.34
|
| Rate for Payer: Healthscope Commercial |
$275.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$80.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$260.02
|
| Rate for Payer: PACE Senior Care Partners |
$89.02
|
| Rate for Payer: PACE Senior Care Partners |
$72.65
|
| Rate for Payer: PACE SWMI |
$76.48
|
| Rate for Payer: PACE SWMI |
$93.70
|
| Rate for Payer: PHP Commercial |
$318.60
|
| Rate for Payer: PHP Commercial |
$260.02
|
| Rate for Payer: PHP Medicare Advantage |
$76.48
|
| Rate for Payer: PHP Medicare Advantage |
$93.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$326.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.14
|
| Rate for Payer: Priority Health Medicare |
$76.48
|
| Rate for Payer: Priority Health Medicare |
$93.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.57
|
| Rate for Payer: Railroad Medicare Medicare |
$76.48
|
| Rate for Payer: Railroad Medicare Medicare |
$93.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.20
|
| Rate for Payer: UHC Core |
$312.97
|
| Rate for Payer: UHC Core |
$255.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.70
|
| Rate for Payer: UHC Medicare Advantage |
$96.52
|
| Rate for Payer: UHC Medicare Advantage |
$78.77
|
| Rate for Payer: VA VA |
$76.48
|
| Rate for Payer: VA VA |
$93.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.12
|
|
