|
HC PACEMAKER SINGLE CHAMBER LVL 13
|
Facility
|
OP
|
$13,770.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500351
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,270.38 |
| Max. Negotiated Rate |
$12,393.00 |
| Rate for Payer: Aetna Commercial |
$11,704.50
|
| Rate for Payer: Aetna Medicare |
$3,580.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,303.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,303.12
|
| Rate for Payer: BCBS Complete |
$5,508.00
|
| Rate for Payer: BCBS MAPPO |
$3,442.50
|
| Rate for Payer: BCBS Trust/PPO |
$11,320.32
|
| Rate for Payer: BCN Commercial |
$10,706.17
|
| Rate for Payer: BCN Medicare Advantage |
$3,442.50
|
| Rate for Payer: Cash Price |
$11,016.00
|
| Rate for Payer: Cofinity Commercial |
$11,842.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,016.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,442.50
|
| Rate for Payer: Healthscope Commercial |
$12,393.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,327.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,614.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,704.50
|
| Rate for Payer: Nomi Health Commercial |
$11,291.40
|
| Rate for Payer: PACE Senior Care Partners |
$3,270.38
|
| Rate for Payer: PACE SWMI |
$3,442.50
|
| Rate for Payer: PHP Commercial |
$11,704.50
|
| Rate for Payer: PHP Medicare Advantage |
$3,442.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,950.50
|
| Rate for Payer: Priority Health HMO/PPO |
$11,979.90
|
| Rate for Payer: Priority Health Medicare |
$3,476.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,225.90
|
| Rate for Payer: Railroad Medicare Medicare |
$3,442.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,117.60
|
| Rate for Payer: UHC Core |
$11,497.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,442.50
|
| Rate for Payer: UHC Exchange |
$3,442.50
|
| Rate for Payer: UHC Medicare Advantage |
$3,442.50
|
| Rate for Payer: VA VA |
$3,442.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,327.50
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 13
|
Facility
|
IP
|
$13,770.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500351
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$8,950.50 |
| Max. Negotiated Rate |
$12,393.00 |
| Rate for Payer: Aetna Commercial |
$11,704.50
|
| Rate for Payer: BCBS Trust/PPO |
$11,240.45
|
| Rate for Payer: BCN Commercial |
$10,641.46
|
| Rate for Payer: Cash Price |
$11,016.00
|
| Rate for Payer: Cofinity Commercial |
$11,842.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,016.00
|
| Rate for Payer: Healthscope Commercial |
$12,393.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,327.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,704.50
|
| Rate for Payer: Nomi Health Commercial |
$11,291.40
|
| Rate for Payer: PHP Commercial |
$11,704.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,950.50
|
| Rate for Payer: Priority Health HMO/PPO |
$11,979.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,225.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,117.60
|
| Rate for Payer: UHC Core |
$11,497.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,327.50
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 16
|
Facility
|
IP
|
$16,863.15
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500350
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$10,961.05 |
| Max. Negotiated Rate |
$15,176.83 |
| Rate for Payer: Aetna Commercial |
$14,333.68
|
| Rate for Payer: BCBS Trust/PPO |
$13,765.39
|
| Rate for Payer: BCN Commercial |
$13,031.84
|
| Rate for Payer: Cash Price |
$13,490.52
|
| Rate for Payer: Cofinity Commercial |
$14,502.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,490.52
|
| Rate for Payer: Healthscope Commercial |
$15,176.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,647.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,333.68
|
| Rate for Payer: Nomi Health Commercial |
$13,827.78
|
| Rate for Payer: PHP Commercial |
$14,333.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,961.05
|
| Rate for Payer: Priority Health HMO/PPO |
$14,670.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,298.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,839.57
|
| Rate for Payer: UHC Core |
$14,080.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,647.36
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 16
|
Facility
|
OP
|
$16,863.15
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500350
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,005.00 |
| Max. Negotiated Rate |
$15,176.83 |
| Rate for Payer: Aetna Commercial |
$14,333.68
|
| Rate for Payer: Aetna Medicare |
$4,384.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,269.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,269.73
|
| Rate for Payer: BCBS Complete |
$6,745.26
|
| Rate for Payer: BCBS MAPPO |
$4,215.79
|
| Rate for Payer: BCBS Trust/PPO |
$13,863.20
|
| Rate for Payer: BCN Commercial |
$13,111.10
|
| Rate for Payer: BCN Medicare Advantage |
$4,215.79
|
| Rate for Payer: Cash Price |
$13,490.52
|
| Rate for Payer: Cofinity Commercial |
$14,502.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,490.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,215.79
|
| Rate for Payer: Healthscope Commercial |
$15,176.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,647.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,426.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,848.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,333.68
|
| Rate for Payer: Nomi Health Commercial |
$13,827.78
|
| Rate for Payer: PACE Senior Care Partners |
$4,005.00
|
| Rate for Payer: PACE SWMI |
$4,215.79
|
| Rate for Payer: PHP Commercial |
$14,333.68
|
| Rate for Payer: PHP Medicare Advantage |
$4,215.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,961.05
|
| Rate for Payer: Priority Health HMO/PPO |
$14,670.94
|
| Rate for Payer: Priority Health Medicare |
$4,257.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11,298.31
|
| Rate for Payer: Railroad Medicare Medicare |
$4,215.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,839.57
|
| Rate for Payer: UHC Core |
$14,080.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,215.79
|
| Rate for Payer: UHC Exchange |
$4,215.79
|
| Rate for Payer: UHC Medicare Advantage |
$4,215.79
|
| Rate for Payer: VA VA |
$4,215.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,647.36
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 6
|
Facility
|
IP
|
$6,319.92
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500352
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,107.95 |
| Max. Negotiated Rate |
$5,687.93 |
| Rate for Payer: Aetna Commercial |
$5,371.93
|
| Rate for Payer: BCBS Trust/PPO |
$5,158.95
|
| Rate for Payer: BCN Commercial |
$4,884.03
|
| Rate for Payer: Cash Price |
$5,055.94
|
| Rate for Payer: Cofinity Commercial |
$5,435.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,055.94
|
| Rate for Payer: Healthscope Commercial |
$5,687.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,739.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,371.93
|
| Rate for Payer: Nomi Health Commercial |
$5,182.33
|
| Rate for Payer: PHP Commercial |
$5,371.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,107.95
|
| Rate for Payer: Priority Health HMO/PPO |
$5,498.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,234.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,561.53
|
| Rate for Payer: UHC Core |
$5,277.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,739.94
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 6
|
Facility
|
OP
|
$6,319.92
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500352
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,500.98 |
| Max. Negotiated Rate |
$5,687.93 |
| Rate for Payer: Aetna Commercial |
$5,371.93
|
| Rate for Payer: Aetna Medicare |
$1,643.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,974.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,974.97
|
| Rate for Payer: BCBS Complete |
$2,527.97
|
| Rate for Payer: BCBS MAPPO |
$1,579.98
|
| Rate for Payer: BCBS Trust/PPO |
$5,195.61
|
| Rate for Payer: BCN Commercial |
$4,913.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,579.98
|
| Rate for Payer: Cash Price |
$5,055.94
|
| Rate for Payer: Cofinity Commercial |
$5,435.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,055.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,579.98
|
| Rate for Payer: Healthscope Commercial |
$5,687.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,739.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,658.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,816.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,371.93
|
| Rate for Payer: Nomi Health Commercial |
$5,182.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,500.98
|
| Rate for Payer: PACE SWMI |
$1,579.98
|
| Rate for Payer: PHP Commercial |
$5,371.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,579.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,107.95
|
| Rate for Payer: Priority Health HMO/PPO |
$5,498.33
|
| Rate for Payer: Priority Health Medicare |
$1,595.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,234.35
|
| Rate for Payer: Railroad Medicare Medicare |
$1,579.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,561.53
|
| Rate for Payer: UHC Core |
$5,277.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,579.98
|
| Rate for Payer: UHC Exchange |
$1,579.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,579.98
|
| Rate for Payer: VA VA |
$1,579.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,739.94
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 8
|
Facility
|
OP
|
$8,315.04
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500353
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,974.82 |
| Max. Negotiated Rate |
$7,483.54 |
| Rate for Payer: Aetna Commercial |
$7,067.78
|
| Rate for Payer: Aetna Medicare |
$2,161.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,598.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,598.45
|
| Rate for Payer: BCBS Complete |
$3,326.02
|
| Rate for Payer: BCBS MAPPO |
$2,078.76
|
| Rate for Payer: BCBS Trust/PPO |
$6,835.79
|
| Rate for Payer: BCN Commercial |
$6,464.94
|
| Rate for Payer: BCN Medicare Advantage |
$2,078.76
|
| Rate for Payer: Cash Price |
$6,652.03
|
| Rate for Payer: Cofinity Commercial |
$7,150.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,652.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,078.76
|
| Rate for Payer: Healthscope Commercial |
$7,483.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,236.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,182.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,390.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,067.78
|
| Rate for Payer: Nomi Health Commercial |
$6,818.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,974.82
|
| Rate for Payer: PACE SWMI |
$2,078.76
|
| Rate for Payer: PHP Commercial |
$7,067.78
|
| Rate for Payer: PHP Medicare Advantage |
$2,078.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,404.78
|
| Rate for Payer: Priority Health HMO/PPO |
$7,234.08
|
| Rate for Payer: Priority Health Medicare |
$2,099.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,571.08
|
| Rate for Payer: Railroad Medicare Medicare |
$2,078.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,317.24
|
| Rate for Payer: UHC Core |
$6,943.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,078.76
|
| Rate for Payer: UHC Exchange |
$2,078.76
|
| Rate for Payer: UHC Medicare Advantage |
$2,078.76
|
| Rate for Payer: VA VA |
$2,078.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,236.28
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 8
|
Facility
|
IP
|
$8,315.04
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500353
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,404.78 |
| Max. Negotiated Rate |
$7,483.54 |
| Rate for Payer: Aetna Commercial |
$7,067.78
|
| Rate for Payer: BCBS Trust/PPO |
$6,787.57
|
| Rate for Payer: BCN Commercial |
$6,425.86
|
| Rate for Payer: Cash Price |
$6,652.03
|
| Rate for Payer: Cofinity Commercial |
$7,150.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,652.03
|
| Rate for Payer: Healthscope Commercial |
$7,483.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,236.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,067.78
|
| Rate for Payer: Nomi Health Commercial |
$6,818.33
|
| Rate for Payer: PHP Commercial |
$7,067.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,404.78
|
| Rate for Payer: Priority Health HMO/PPO |
$7,234.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,571.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,317.24
|
| Rate for Payer: UHC Core |
$6,943.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,236.28
|
|
|
HC PACEMAKER TESTING CABLE
|
Facility
|
OP
|
$114.69
|
|
| Hospital Charge Code |
27200143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.24 |
| Max. Negotiated Rate |
$103.22 |
| Rate for Payer: Aetna Commercial |
$97.49
|
| Rate for Payer: Aetna Medicare |
$29.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.84
|
| Rate for Payer: BCBS Complete |
$45.88
|
| Rate for Payer: BCBS MAPPO |
$28.67
|
| Rate for Payer: BCBS Trust/PPO |
$94.29
|
| Rate for Payer: BCN Commercial |
$89.17
|
| Rate for Payer: BCN Medicare Advantage |
$28.67
|
| Rate for Payer: Cash Price |
$91.75
|
| Rate for Payer: Cofinity Commercial |
$98.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.67
|
| Rate for Payer: Healthscope Commercial |
$103.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.49
|
| Rate for Payer: Nomi Health Commercial |
$94.05
|
| Rate for Payer: PACE Senior Care Partners |
$27.24
|
| Rate for Payer: PACE SWMI |
$28.67
|
| Rate for Payer: PHP Commercial |
$97.49
|
| Rate for Payer: PHP Medicare Advantage |
$28.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.55
|
| Rate for Payer: Priority Health HMO/PPO |
$99.78
|
| Rate for Payer: Priority Health Medicare |
$28.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.84
|
| Rate for Payer: Railroad Medicare Medicare |
$28.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.93
|
| Rate for Payer: UHC Core |
$95.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.67
|
| Rate for Payer: UHC Exchange |
$28.67
|
| Rate for Payer: UHC Medicare Advantage |
$28.67
|
| Rate for Payer: VA VA |
$28.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.02
|
|
|
HC PACEMAKER TESTING CABLE
|
Facility
|
IP
|
$114.69
|
|
| Hospital Charge Code |
27200143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$103.22 |
| Rate for Payer: Aetna Commercial |
$97.49
|
| Rate for Payer: BCBS Trust/PPO |
$93.62
|
| Rate for Payer: BCN Commercial |
$88.63
|
| Rate for Payer: Cash Price |
$91.75
|
| Rate for Payer: Cofinity Commercial |
$98.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.75
|
| Rate for Payer: Healthscope Commercial |
$103.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.49
|
| Rate for Payer: Nomi Health Commercial |
$94.05
|
| Rate for Payer: PHP Commercial |
$97.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.55
|
| Rate for Payer: Priority Health HMO/PPO |
$99.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.93
|
| Rate for Payer: UHC Core |
$95.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.02
|
|
|
HC PACER POCKET REVISION
|
Facility
|
OP
|
$2,755.73
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
36100067
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$654.49 |
| Max. Negotiated Rate |
$2,480.16 |
| Rate for Payer: Aetna Commercial |
$2,342.37
|
| Rate for Payer: Aetna Medicare |
$716.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.17
|
| Rate for Payer: BCBS Complete |
$1,388.75
|
| Rate for Payer: BCBS MAPPO |
$688.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,265.49
|
| Rate for Payer: BCN Commercial |
$2,142.58
|
| Rate for Payer: BCN Medicare Advantage |
$688.93
|
| Rate for Payer: Cash Price |
$2,204.58
|
| Rate for Payer: Cash Price |
$2,204.58
|
| Rate for Payer: Cofinity Commercial |
$2,369.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,204.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.93
|
| Rate for Payer: Healthscope Commercial |
$2,480.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,066.80
|
| Rate for Payer: Mclaren Medicaid |
$1,322.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.38
|
| Rate for Payer: Meridian Medicaid |
$1,388.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,342.37
|
| Rate for Payer: Nomi Health Commercial |
$2,259.70
|
| Rate for Payer: PACE Senior Care Partners |
$654.49
|
| Rate for Payer: PACE SWMI |
$688.93
|
| Rate for Payer: PHP Commercial |
$2,342.37
|
| Rate for Payer: PHP Medicare Advantage |
$688.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,322.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.22
|
| Rate for Payer: Priority Health HMO/PPO |
$2,397.49
|
| Rate for Payer: Priority Health Medicare |
$695.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,846.34
|
| Rate for Payer: Railroad Medicare Medicare |
$688.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,425.04
|
| Rate for Payer: UHC Core |
$2,301.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$688.93
|
| Rate for Payer: UHC Exchange |
$688.93
|
| Rate for Payer: UHC Medicare Advantage |
$688.93
|
| Rate for Payer: UHCCP Medicaid |
$1,322.53
|
| Rate for Payer: VA VA |
$688.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,066.80
|
|
|
HC PACER POCKET REVISION
|
Facility
|
IP
|
$2,755.73
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
36100067
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,791.22 |
| Max. Negotiated Rate |
$2,480.16 |
| Rate for Payer: Aetna Commercial |
$2,342.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,249.50
|
| Rate for Payer: BCN Commercial |
$2,129.63
|
| Rate for Payer: Cash Price |
$2,204.58
|
| Rate for Payer: Cofinity Commercial |
$2,369.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,204.58
|
| Rate for Payer: Healthscope Commercial |
$2,480.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,066.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,342.37
|
| Rate for Payer: Nomi Health Commercial |
$2,259.70
|
| Rate for Payer: PHP Commercial |
$2,342.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.22
|
| Rate for Payer: Priority Health HMO/PPO |
$2,397.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,846.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,425.04
|
| Rate for Payer: UHC Core |
$2,301.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,066.80
|
|
|
HC PACK CCS BRONSON FX XC BASE
|
Facility
|
IP
|
$765.00
|
|
| Hospital Charge Code |
27000682
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$497.25 |
| Max. Negotiated Rate |
$688.50 |
| Rate for Payer: Aetna Commercial |
$650.25
|
| Rate for Payer: BCBS Trust/PPO |
$624.47
|
| Rate for Payer: BCN Commercial |
$591.19
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$657.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$612.00
|
| Rate for Payer: Healthscope Commercial |
$688.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$573.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$650.25
|
| Rate for Payer: Nomi Health Commercial |
$627.30
|
| Rate for Payer: PHP Commercial |
$650.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health HMO/PPO |
$665.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$512.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$673.20
|
| Rate for Payer: UHC Core |
$638.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$573.75
|
|
|
HC PACK CCS BRONSON FX XC BASE
|
Facility
|
OP
|
$765.00
|
|
| Hospital Charge Code |
27000682
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$181.69 |
| Max. Negotiated Rate |
$688.50 |
| Rate for Payer: Aetna Commercial |
$650.25
|
| Rate for Payer: Aetna Medicare |
$198.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$239.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$239.06
|
| Rate for Payer: BCBS Complete |
$306.00
|
| Rate for Payer: BCBS MAPPO |
$191.25
|
| Rate for Payer: BCBS Trust/PPO |
$628.91
|
| Rate for Payer: BCN Commercial |
$594.79
|
| Rate for Payer: BCN Medicare Advantage |
$191.25
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$657.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$612.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.25
|
| Rate for Payer: Healthscope Commercial |
$688.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$573.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$200.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$219.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$650.25
|
| Rate for Payer: Nomi Health Commercial |
$627.30
|
| Rate for Payer: PACE Senior Care Partners |
$181.69
|
| Rate for Payer: PACE SWMI |
$191.25
|
| Rate for Payer: PHP Commercial |
$650.25
|
| Rate for Payer: PHP Medicare Advantage |
$191.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health HMO/PPO |
$665.55
|
| Rate for Payer: Priority Health Medicare |
$193.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$512.55
|
| Rate for Payer: Railroad Medicare Medicare |
$191.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$673.20
|
| Rate for Payer: UHC Core |
$638.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.25
|
| Rate for Payer: UHC Exchange |
$191.25
|
| Rate for Payer: UHC Medicare Advantage |
$191.25
|
| Rate for Payer: VA VA |
$191.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$573.75
|
|
|
HC PACKED CELLS DIRECT
|
Facility
|
IP
|
$825.28
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000058
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$536.43 |
| Max. Negotiated Rate |
$742.75 |
| Rate for Payer: Aetna Commercial |
$701.49
|
| Rate for Payer: BCBS Trust/PPO |
$673.68
|
| Rate for Payer: BCN Commercial |
$637.78
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cofinity Commercial |
$709.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.22
|
| Rate for Payer: Healthscope Commercial |
$742.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$618.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.49
|
| Rate for Payer: Nomi Health Commercial |
$676.73
|
| Rate for Payer: PHP Commercial |
$701.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.43
|
| Rate for Payer: Priority Health HMO/PPO |
$717.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$552.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$726.25
|
| Rate for Payer: UHC Core |
$689.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$618.96
|
|
|
HC PACKED CELLS DIRECT
|
Facility
|
OP
|
$825.28
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000058
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$131.59 |
| Max. Negotiated Rate |
$742.75 |
| Rate for Payer: Aetna Commercial |
$701.49
|
| Rate for Payer: Aetna Medicare |
$214.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$257.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$257.90
|
| Rate for Payer: BCBS Complete |
$138.17
|
| Rate for Payer: BCBS MAPPO |
$206.32
|
| Rate for Payer: BCBS Trust/PPO |
$678.46
|
| Rate for Payer: BCN Commercial |
$641.66
|
| Rate for Payer: BCN Medicare Advantage |
$206.32
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cash Price |
$660.22
|
| Rate for Payer: Cofinity Commercial |
$709.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.32
|
| Rate for Payer: Healthscope Commercial |
$742.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$618.96
|
| Rate for Payer: Mclaren Medicaid |
$131.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.64
|
| Rate for Payer: Meridian Medicaid |
$138.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$237.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.49
|
| Rate for Payer: Nomi Health Commercial |
$676.73
|
| Rate for Payer: PACE Senior Care Partners |
$196.00
|
| Rate for Payer: PACE SWMI |
$206.32
|
| Rate for Payer: PHP Commercial |
$701.49
|
| Rate for Payer: PHP Medicare Advantage |
$206.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.43
|
| Rate for Payer: Priority Health HMO/PPO |
$717.99
|
| Rate for Payer: Priority Health Medicare |
$208.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$552.94
|
| Rate for Payer: Railroad Medicare Medicare |
$206.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$726.25
|
| Rate for Payer: UHC Core |
$689.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.32
|
| Rate for Payer: UHC Exchange |
$206.32
|
| Rate for Payer: UHC Medicare Advantage |
$206.32
|
| Rate for Payer: UHCCP Medicaid |
$131.59
|
| Rate for Payer: VA VA |
$206.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$618.96
|
|
|
HC PACKED CELLS DIRECT LRIR
|
Facility
|
IP
|
$1,257.09
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000080
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$817.11 |
| Max. Negotiated Rate |
$1,131.38 |
| Rate for Payer: Aetna Commercial |
$1,068.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,026.16
|
| Rate for Payer: BCN Commercial |
$971.48
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cofinity Commercial |
$1,081.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,005.67
|
| Rate for Payer: Healthscope Commercial |
$1,131.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$942.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,068.53
|
| Rate for Payer: Nomi Health Commercial |
$1,030.81
|
| Rate for Payer: PHP Commercial |
$1,068.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$817.11
|
| Rate for Payer: Priority Health HMO/PPO |
$1,093.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$842.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,106.24
|
| Rate for Payer: UHC Core |
$1,049.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$942.82
|
|
|
HC PACKED CELLS DIRECT LRIR
|
Facility
|
OP
|
$1,257.09
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000080
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$184.94 |
| Max. Negotiated Rate |
$1,131.38 |
| Rate for Payer: Aetna Commercial |
$1,068.53
|
| Rate for Payer: Aetna Medicare |
$326.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$392.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$392.84
|
| Rate for Payer: BCBS Complete |
$194.20
|
| Rate for Payer: BCBS MAPPO |
$314.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,033.45
|
| Rate for Payer: BCN Commercial |
$977.39
|
| Rate for Payer: BCN Medicare Advantage |
$314.27
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cofinity Commercial |
$1,081.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,005.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.27
|
| Rate for Payer: Healthscope Commercial |
$1,131.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$942.82
|
| Rate for Payer: Mclaren Medicaid |
$184.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$329.99
|
| Rate for Payer: Meridian Medicaid |
$194.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$361.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,068.53
|
| Rate for Payer: Nomi Health Commercial |
$1,030.81
|
| Rate for Payer: PACE Senior Care Partners |
$298.56
|
| Rate for Payer: PACE SWMI |
$314.27
|
| Rate for Payer: PHP Commercial |
$1,068.53
|
| Rate for Payer: PHP Medicare Advantage |
$314.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$184.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$817.11
|
| Rate for Payer: Priority Health HMO/PPO |
$1,093.67
|
| Rate for Payer: Priority Health Medicare |
$317.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$842.25
|
| Rate for Payer: Railroad Medicare Medicare |
$314.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,106.24
|
| Rate for Payer: UHC Core |
$1,049.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$314.27
|
| Rate for Payer: UHC Exchange |
$314.27
|
| Rate for Payer: UHC Medicare Advantage |
$314.27
|
| Rate for Payer: UHCCP Medicaid |
$184.94
|
| Rate for Payer: VA VA |
$314.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$942.82
|
|
|
HC PACK LEFT HEART BYPASS
|
Facility
|
IP
|
$97.92
|
|
| Hospital Charge Code |
27000654
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$63.65 |
| Max. Negotiated Rate |
$88.13 |
| Rate for Payer: Aetna Commercial |
$83.23
|
| Rate for Payer: BCBS Trust/PPO |
$79.93
|
| Rate for Payer: BCN Commercial |
$75.67
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$84.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.34
|
| Rate for Payer: Healthscope Commercial |
$88.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.23
|
| Rate for Payer: Nomi Health Commercial |
$80.29
|
| Rate for Payer: PHP Commercial |
$83.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.65
|
| Rate for Payer: Priority Health HMO/PPO |
$85.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.17
|
| Rate for Payer: UHC Core |
$81.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.44
|
|
|
HC PACK LEFT HEART BYPASS
|
Facility
|
OP
|
$97.92
|
|
| Hospital Charge Code |
27000654
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.26 |
| Max. Negotiated Rate |
$88.13 |
| Rate for Payer: Aetna Commercial |
$83.23
|
| Rate for Payer: Aetna Medicare |
$25.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.60
|
| Rate for Payer: BCBS Complete |
$39.17
|
| Rate for Payer: BCBS MAPPO |
$24.48
|
| Rate for Payer: BCBS Trust/PPO |
$80.50
|
| Rate for Payer: BCN Commercial |
$76.13
|
| Rate for Payer: BCN Medicare Advantage |
$24.48
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$84.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$88.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.23
|
| Rate for Payer: Nomi Health Commercial |
$80.29
|
| Rate for Payer: PACE Senior Care Partners |
$23.26
|
| Rate for Payer: PACE SWMI |
$24.48
|
| Rate for Payer: PHP Commercial |
$83.23
|
| Rate for Payer: PHP Medicare Advantage |
$24.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.65
|
| Rate for Payer: Priority Health HMO/PPO |
$85.19
|
| Rate for Payer: Priority Health Medicare |
$24.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.61
|
| Rate for Payer: Railroad Medicare Medicare |
$24.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.17
|
| Rate for Payer: UHC Core |
$81.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.48
|
| Rate for Payer: UHC Exchange |
$24.48
|
| Rate for Payer: UHC Medicare Advantage |
$24.48
|
| Rate for Payer: VA VA |
$24.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.44
|
|
|
HC PACK QUEST CARDIOPLEGIA
|
Facility
|
IP
|
$688.50
|
|
| Hospital Charge Code |
27000457
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$447.52 |
| Max. Negotiated Rate |
$619.65 |
| Rate for Payer: Aetna Commercial |
$585.23
|
| Rate for Payer: BCBS Trust/PPO |
$562.02
|
| Rate for Payer: BCN Commercial |
$532.07
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Commercial |
$592.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Healthscope Commercial |
$619.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$516.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.23
|
| Rate for Payer: Nomi Health Commercial |
$564.57
|
| Rate for Payer: PHP Commercial |
$585.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.52
|
| Rate for Payer: Priority Health HMO/PPO |
$599.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$461.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$605.88
|
| Rate for Payer: UHC Core |
$574.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$516.38
|
|
|
HC PACK QUEST CARDIOPLEGIA
|
Facility
|
OP
|
$688.50
|
|
| Hospital Charge Code |
27000457
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$163.52 |
| Max. Negotiated Rate |
$619.65 |
| Rate for Payer: Aetna Commercial |
$585.23
|
| Rate for Payer: Aetna Medicare |
$179.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$215.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$215.16
|
| Rate for Payer: BCBS Complete |
$275.40
|
| Rate for Payer: BCBS MAPPO |
$172.12
|
| Rate for Payer: BCBS Trust/PPO |
$566.02
|
| Rate for Payer: BCN Commercial |
$535.31
|
| Rate for Payer: BCN Medicare Advantage |
$172.12
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Commercial |
$592.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.12
|
| Rate for Payer: Healthscope Commercial |
$619.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$516.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$197.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.23
|
| Rate for Payer: Nomi Health Commercial |
$564.57
|
| Rate for Payer: PACE Senior Care Partners |
$163.52
|
| Rate for Payer: PACE SWMI |
$172.12
|
| Rate for Payer: PHP Commercial |
$585.23
|
| Rate for Payer: PHP Medicare Advantage |
$172.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.52
|
| Rate for Payer: Priority Health HMO/PPO |
$599.00
|
| Rate for Payer: Priority Health Medicare |
$173.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$461.30
|
| Rate for Payer: Railroad Medicare Medicare |
$172.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$605.88
|
| Rate for Payer: UHC Core |
$574.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.12
|
| Rate for Payer: UHC Exchange |
$172.12
|
| Rate for Payer: UHC Medicare Advantage |
$172.12
|
| Rate for Payer: VA VA |
$172.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$516.38
|
|
|
HC PACK TABLE LINE
|
Facility
|
OP
|
$205.02
|
|
| Hospital Charge Code |
27000676
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$48.69 |
| Max. Negotiated Rate |
$184.52 |
| Rate for Payer: Aetna Commercial |
$174.27
|
| Rate for Payer: Aetna Medicare |
$53.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.07
|
| Rate for Payer: BCBS Complete |
$82.01
|
| Rate for Payer: BCBS MAPPO |
$51.26
|
| Rate for Payer: BCBS Trust/PPO |
$168.55
|
| Rate for Payer: BCN Commercial |
$159.40
|
| Rate for Payer: BCN Medicare Advantage |
$51.26
|
| Rate for Payer: Cash Price |
$164.02
|
| Rate for Payer: Cofinity Commercial |
$176.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.26
|
| Rate for Payer: Healthscope Commercial |
$184.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.27
|
| Rate for Payer: Nomi Health Commercial |
$168.12
|
| Rate for Payer: PACE Senior Care Partners |
$48.69
|
| Rate for Payer: PACE SWMI |
$51.26
|
| Rate for Payer: PHP Commercial |
$174.27
|
| Rate for Payer: PHP Medicare Advantage |
$51.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.26
|
| Rate for Payer: Priority Health HMO/PPO |
$178.37
|
| Rate for Payer: Priority Health Medicare |
$51.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.36
|
| Rate for Payer: Railroad Medicare Medicare |
$51.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.42
|
| Rate for Payer: UHC Core |
$171.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.26
|
| Rate for Payer: UHC Exchange |
$51.26
|
| Rate for Payer: UHC Medicare Advantage |
$51.26
|
| Rate for Payer: VA VA |
$51.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.76
|
|
|
HC PACK TABLE LINE
|
Facility
|
IP
|
$205.02
|
|
| Hospital Charge Code |
27000676
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$133.26 |
| Max. Negotiated Rate |
$184.52 |
| Rate for Payer: Aetna Commercial |
$174.27
|
| Rate for Payer: BCBS Trust/PPO |
$167.36
|
| Rate for Payer: BCN Commercial |
$158.44
|
| Rate for Payer: Cash Price |
$164.02
|
| Rate for Payer: Cofinity Commercial |
$176.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.02
|
| Rate for Payer: Healthscope Commercial |
$184.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.27
|
| Rate for Payer: Nomi Health Commercial |
$168.12
|
| Rate for Payer: PHP Commercial |
$174.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.26
|
| Rate for Payer: Priority Health HMO/PPO |
$178.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.42
|
| Rate for Payer: UHC Core |
$171.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.76
|
|
|
HC PACK W/O RESERV TERUMO
|
Facility
|
OP
|
$841.50
|
|
| Hospital Charge Code |
27000648
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$199.86 |
| Max. Negotiated Rate |
$757.35 |
| Rate for Payer: Aetna Commercial |
$715.27
|
| Rate for Payer: Aetna Medicare |
$218.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.97
|
| Rate for Payer: BCBS Complete |
$336.60
|
| Rate for Payer: BCBS MAPPO |
$210.38
|
| Rate for Payer: BCBS Trust/PPO |
$691.80
|
| Rate for Payer: BCN Commercial |
$654.27
|
| Rate for Payer: BCN Medicare Advantage |
$210.38
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cofinity Commercial |
$723.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.38
|
| Rate for Payer: Healthscope Commercial |
$757.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$220.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.27
|
| Rate for Payer: Nomi Health Commercial |
$690.03
|
| Rate for Payer: PACE Senior Care Partners |
$199.86
|
| Rate for Payer: PACE SWMI |
$210.38
|
| Rate for Payer: PHP Commercial |
$715.27
|
| Rate for Payer: PHP Medicare Advantage |
$210.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.98
|
| Rate for Payer: Priority Health HMO/PPO |
$732.11
|
| Rate for Payer: Priority Health Medicare |
$212.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$563.80
|
| Rate for Payer: Railroad Medicare Medicare |
$210.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.52
|
| Rate for Payer: UHC Core |
$702.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.38
|
| Rate for Payer: UHC Exchange |
$210.38
|
| Rate for Payer: UHC Medicare Advantage |
$210.38
|
| Rate for Payer: VA VA |
$210.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.12
|
|
