|
HC RECOVERY 2 INIT 30 MIN
|
Facility
|
OP
|
$338.20
|
|
| Hospital Charge Code |
71000023
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$59.62 |
| Max. Negotiated Rate |
$304.38 |
| Rate for Payer: Aetna Commercial |
$287.47
|
| Rate for Payer: Aetna Medicare |
$87.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$105.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$105.69
|
| Rate for Payer: BCBS Complete |
$62.60
|
| Rate for Payer: BCBS MAPPO |
$84.55
|
| Rate for Payer: BCBS Trust/PPO |
$278.03
|
| Rate for Payer: BCN Commercial |
$278.03
|
| Rate for Payer: BCN Medicare Advantage |
$84.55
|
| Rate for Payer: Cash Price |
$270.56
|
| Rate for Payer: Cofinity Commercial |
$290.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.55
|
| Rate for Payer: Healthscope Commercial |
$304.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.65
|
| Rate for Payer: Mclaren Medicaid |
$59.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.78
|
| Rate for Payer: Meridian Medicaid |
$62.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.47
|
| Rate for Payer: Nomi Health Commercial |
$277.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.65
|
| Rate for Payer: PACE Senior Care Partners |
$80.32
|
| Rate for Payer: PACE SWMI |
$84.55
|
| Rate for Payer: PHP Commercial |
$287.47
|
| Rate for Payer: PHP Medicare Advantage |
$84.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$294.23
|
| Rate for Payer: Priority Health Medicare |
$85.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.39
|
| Rate for Payer: Railroad Medicare Medicare |
$84.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.62
|
| Rate for Payer: UHC Core |
$282.40
|
| Rate for Payer: UHC Exchange |
$84.55
|
| Rate for Payer: UHC Medicaid |
$59.62
|
| Rate for Payer: UHC Medicare Advantage |
$84.55
|
| Rate for Payer: UHCCP Medicaid |
$59.62
|
| Rate for Payer: VA VA |
$84.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.65
|
|
|
HC RECOVERY 3 ADD'L 15 MIN
|
Facility
|
OP
|
$104.21
|
|
| Hospital Charge Code |
71000024
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$18.37 |
| Max. Negotiated Rate |
$93.79 |
| Rate for Payer: Aetna Commercial |
$88.58
|
| Rate for Payer: Aetna Medicare |
$27.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.57
|
| Rate for Payer: BCBS Complete |
$19.29
|
| Rate for Payer: BCBS MAPPO |
$26.05
|
| Rate for Payer: BCBS Trust/PPO |
$85.67
|
| Rate for Payer: BCN Commercial |
$85.67
|
| Rate for Payer: BCN Medicare Advantage |
$26.05
|
| Rate for Payer: Cash Price |
$83.37
|
| Rate for Payer: Cofinity Commercial |
$89.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.05
|
| Rate for Payer: Healthscope Commercial |
$93.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.16
|
| Rate for Payer: Mclaren Medicaid |
$18.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.36
|
| Rate for Payer: Meridian Medicaid |
$19.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.58
|
| Rate for Payer: Nomi Health Commercial |
$85.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.16
|
| Rate for Payer: PACE Senior Care Partners |
$24.75
|
| Rate for Payer: PACE SWMI |
$26.05
|
| Rate for Payer: PHP Commercial |
$88.58
|
| Rate for Payer: PHP Medicare Advantage |
$26.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.66
|
| Rate for Payer: Priority Health Medicare |
$26.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.53
|
| Rate for Payer: Railroad Medicare Medicare |
$26.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.70
|
| Rate for Payer: UHC Core |
$87.02
|
| Rate for Payer: UHC Exchange |
$26.05
|
| Rate for Payer: UHC Medicaid |
$18.37
|
| Rate for Payer: UHC Medicare Advantage |
$26.05
|
| Rate for Payer: UHCCP Medicaid |
$18.37
|
| Rate for Payer: VA VA |
$26.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.16
|
|
|
HC RECOVERY 3 ADD'L 15 MIN
|
Facility
|
IP
|
$104.21
|
|
| Hospital Charge Code |
71000024
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$72.53 |
| Max. Negotiated Rate |
$93.79 |
| Rate for Payer: Aetna Commercial |
$88.58
|
| Rate for Payer: BCBS Trust/PPO |
$86.07
|
| Rate for Payer: BCN Commercial |
$86.07
|
| Rate for Payer: Cash Price |
$83.37
|
| Rate for Payer: Cofinity Commercial |
$89.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.37
|
| Rate for Payer: Healthscope Commercial |
$93.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.58
|
| Rate for Payer: Nomi Health Commercial |
$85.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.16
|
| Rate for Payer: PHP Commercial |
$88.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.70
|
| Rate for Payer: UHC Core |
$87.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.16
|
|
|
HC RECOVERY 3 BASE CHARGE
|
Facility
|
OP
|
$63.00
|
|
| Hospital Charge Code |
71000040
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$11.11 |
| Max. Negotiated Rate |
$56.70 |
| Rate for Payer: Aetna Commercial |
$53.55
|
| Rate for Payer: Aetna Medicare |
$16.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.69
|
| Rate for Payer: BCBS Complete |
$11.66
|
| Rate for Payer: BCBS MAPPO |
$15.75
|
| Rate for Payer: BCBS Trust/PPO |
$51.79
|
| Rate for Payer: BCN Commercial |
$51.79
|
| Rate for Payer: BCN Medicare Advantage |
$15.75
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$54.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.75
|
| Rate for Payer: Healthscope Commercial |
$56.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.25
|
| Rate for Payer: Mclaren Medicaid |
$11.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.54
|
| Rate for Payer: Meridian Medicaid |
$11.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.55
|
| Rate for Payer: Nomi Health Commercial |
$51.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
| Rate for Payer: PACE Senior Care Partners |
$14.96
|
| Rate for Payer: PACE SWMI |
$15.75
|
| Rate for Payer: PHP Commercial |
$53.55
|
| Rate for Payer: PHP Medicare Advantage |
$15.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.81
|
| Rate for Payer: Priority Health Medicare |
$15.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.85
|
| Rate for Payer: Railroad Medicare Medicare |
$15.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.44
|
| Rate for Payer: UHC Core |
$52.60
|
| Rate for Payer: UHC Exchange |
$15.75
|
| Rate for Payer: UHC Medicaid |
$11.11
|
| Rate for Payer: UHC Medicare Advantage |
$15.75
|
| Rate for Payer: UHCCP Medicaid |
$11.11
|
| Rate for Payer: VA VA |
$15.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.25
|
|
|
HC RECOVERY 3 BASE CHARGE
|
Facility
|
IP
|
$63.00
|
|
| Hospital Charge Code |
71000040
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$43.85 |
| Max. Negotiated Rate |
$56.70 |
| Rate for Payer: Aetna Commercial |
$53.55
|
| Rate for Payer: BCBS Trust/PPO |
$52.03
|
| Rate for Payer: BCN Commercial |
$52.03
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$54.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.40
|
| Rate for Payer: Healthscope Commercial |
$56.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.55
|
| Rate for Payer: Nomi Health Commercial |
$51.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
| Rate for Payer: PHP Commercial |
$53.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.44
|
| Rate for Payer: UHC Core |
$52.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.25
|
|
|
HC RECOVERY 3 EA MIN
|
Facility
|
IP
|
$9.18
|
|
| Hospital Charge Code |
71000037
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$6.39 |
| Max. Negotiated Rate |
$8.26 |
| Rate for Payer: Aetna Commercial |
$7.80
|
| Rate for Payer: BCBS Trust/PPO |
$7.58
|
| Rate for Payer: BCN Commercial |
$7.58
|
| Rate for Payer: Cash Price |
$7.34
|
| Rate for Payer: Cofinity Commercial |
$7.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.34
|
| Rate for Payer: Healthscope Commercial |
$8.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.80
|
| Rate for Payer: Nomi Health Commercial |
$7.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.88
|
| Rate for Payer: PHP Commercial |
$7.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.08
|
| Rate for Payer: UHC Core |
$7.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.88
|
|
|
HC RECOVERY 3 EA MIN
|
Facility
|
OP
|
$9.18
|
|
| Hospital Charge Code |
71000037
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1.62 |
| Max. Negotiated Rate |
$8.26 |
| Rate for Payer: Aetna Commercial |
$7.80
|
| Rate for Payer: Aetna Medicare |
$2.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.87
|
| Rate for Payer: BCBS Complete |
$1.70
|
| Rate for Payer: BCBS MAPPO |
$2.29
|
| Rate for Payer: BCBS Trust/PPO |
$7.55
|
| Rate for Payer: BCN Commercial |
$7.55
|
| Rate for Payer: BCN Medicare Advantage |
$2.29
|
| Rate for Payer: Cash Price |
$7.34
|
| Rate for Payer: Cofinity Commercial |
$7.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.29
|
| Rate for Payer: Healthscope Commercial |
$8.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.88
|
| Rate for Payer: Mclaren Medicaid |
$1.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.41
|
| Rate for Payer: Meridian Medicaid |
$1.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.80
|
| Rate for Payer: Nomi Health Commercial |
$7.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.88
|
| Rate for Payer: PACE Senior Care Partners |
$2.18
|
| Rate for Payer: PACE SWMI |
$2.29
|
| Rate for Payer: PHP Commercial |
$7.80
|
| Rate for Payer: PHP Medicare Advantage |
$2.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.99
|
| Rate for Payer: Priority Health Medicare |
$2.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.39
|
| Rate for Payer: Railroad Medicare Medicare |
$2.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.08
|
| Rate for Payer: UHC Core |
$7.67
|
| Rate for Payer: UHC Exchange |
$2.29
|
| Rate for Payer: UHC Medicaid |
$1.62
|
| Rate for Payer: UHC Medicare Advantage |
$2.29
|
| Rate for Payer: UHCCP Medicaid |
$1.62
|
| Rate for Payer: VA VA |
$2.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.88
|
|
|
HC RECOVERY 3 INIT 30 MIN
|
Facility
|
IP
|
$210.56
|
|
| Hospital Charge Code |
71000025
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$146.55 |
| Max. Negotiated Rate |
$189.50 |
| Rate for Payer: Aetna Commercial |
$178.98
|
| Rate for Payer: BCBS Trust/PPO |
$173.90
|
| Rate for Payer: BCN Commercial |
$173.90
|
| Rate for Payer: Cash Price |
$168.45
|
| Rate for Payer: Cofinity Commercial |
$181.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.45
|
| Rate for Payer: Healthscope Commercial |
$189.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.98
|
| Rate for Payer: Nomi Health Commercial |
$172.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.92
|
| Rate for Payer: PHP Commercial |
$178.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$183.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.29
|
| Rate for Payer: UHC Core |
$175.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.92
|
|
|
HC RECOVERY 3 INIT 30 MIN
|
Facility
|
OP
|
$210.56
|
|
| Hospital Charge Code |
71000025
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$37.12 |
| Max. Negotiated Rate |
$189.50 |
| Rate for Payer: Aetna Commercial |
$178.98
|
| Rate for Payer: Aetna Medicare |
$54.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.80
|
| Rate for Payer: BCBS Complete |
$38.97
|
| Rate for Payer: BCBS MAPPO |
$52.64
|
| Rate for Payer: BCBS Trust/PPO |
$173.10
|
| Rate for Payer: BCN Commercial |
$173.10
|
| Rate for Payer: BCN Medicare Advantage |
$52.64
|
| Rate for Payer: Cash Price |
$168.45
|
| Rate for Payer: Cofinity Commercial |
$181.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.64
|
| Rate for Payer: Healthscope Commercial |
$189.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.92
|
| Rate for Payer: Mclaren Medicaid |
$37.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.27
|
| Rate for Payer: Meridian Medicaid |
$38.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.98
|
| Rate for Payer: Nomi Health Commercial |
$172.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.92
|
| Rate for Payer: PACE Senior Care Partners |
$50.01
|
| Rate for Payer: PACE SWMI |
$52.64
|
| Rate for Payer: PHP Commercial |
$178.98
|
| Rate for Payer: PHP Medicare Advantage |
$52.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$183.19
|
| Rate for Payer: Priority Health Medicare |
$53.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.55
|
| Rate for Payer: Railroad Medicare Medicare |
$52.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.29
|
| Rate for Payer: UHC Core |
$175.82
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$37.12
|
| Rate for Payer: UHC Medicare Advantage |
$52.64
|
| Rate for Payer: UHCCP Medicaid |
$37.12
|
| Rate for Payer: VA VA |
$52.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.92
|
|
|
HC RED CEDAR IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200099
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC RED CEDAR IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200099
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC RED CELL GENO MI BLD
|
Facility
|
OP
|
$331.53
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
31000135
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$58.45 |
| Max. Negotiated Rate |
$298.38 |
| Rate for Payer: Aetna Commercial |
$281.80
|
| Rate for Payer: Aetna Medicare |
$86.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.60
|
| Rate for Payer: BCBS Complete |
$61.37
|
| Rate for Payer: BCBS MAPPO |
$82.88
|
| Rate for Payer: BCBS Trust/PPO |
$272.55
|
| Rate for Payer: BCN Commercial |
$272.55
|
| Rate for Payer: BCN Medicare Advantage |
$82.88
|
| Rate for Payer: Cash Price |
$265.22
|
| Rate for Payer: Cofinity Commercial |
$285.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.88
|
| Rate for Payer: Healthscope Commercial |
$298.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.65
|
| Rate for Payer: Mclaren Medicaid |
$58.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.03
|
| Rate for Payer: Meridian Medicaid |
$61.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$91.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.80
|
| Rate for Payer: Nomi Health Commercial |
$271.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.65
|
| Rate for Payer: PACE Senior Care Partners |
$78.74
|
| Rate for Payer: PACE SWMI |
$82.88
|
| Rate for Payer: PHP Commercial |
$281.80
|
| Rate for Payer: PHP Medicare Advantage |
$82.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$288.43
|
| Rate for Payer: Priority Health Medicare |
$83.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.74
|
| Rate for Payer: Railroad Medicare Medicare |
$82.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.75
|
| Rate for Payer: UHC Core |
$276.83
|
| Rate for Payer: UHC Exchange |
$82.88
|
| Rate for Payer: UHC Medicaid |
$58.45
|
| Rate for Payer: UHC Medicare Advantage |
$82.88
|
| Rate for Payer: UHCCP Medicaid |
$58.45
|
| Rate for Payer: VA VA |
$82.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.65
|
|
|
HC RED CELL GENO MI BLD
|
Facility
|
IP
|
$331.53
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
31000135
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$230.74 |
| Max. Negotiated Rate |
$298.38 |
| Rate for Payer: Aetna Commercial |
$281.80
|
| Rate for Payer: BCBS Trust/PPO |
$273.81
|
| Rate for Payer: BCN Commercial |
$273.81
|
| Rate for Payer: Cash Price |
$265.22
|
| Rate for Payer: Cofinity Commercial |
$285.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.22
|
| Rate for Payer: Healthscope Commercial |
$298.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.80
|
| Rate for Payer: Nomi Health Commercial |
$271.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$248.65
|
| Rate for Payer: PHP Commercial |
$281.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$288.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$230.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.75
|
| Rate for Payer: UHC Core |
$276.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.65
|
|
|
HC RED CELL GENO MI BLD CMPT
|
Facility
|
IP
|
$238.68
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
31000136
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$166.12 |
| Max. Negotiated Rate |
$214.81 |
| Rate for Payer: Aetna Commercial |
$202.88
|
| Rate for Payer: BCBS Trust/PPO |
$197.13
|
| Rate for Payer: BCN Commercial |
$197.13
|
| Rate for Payer: Cash Price |
$190.94
|
| Rate for Payer: Cofinity Commercial |
$205.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.94
|
| Rate for Payer: Healthscope Commercial |
$214.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.88
|
| Rate for Payer: Nomi Health Commercial |
$195.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.01
|
| Rate for Payer: PHP Commercial |
$202.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$207.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.04
|
| Rate for Payer: UHC Core |
$199.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.01
|
|
|
HC RED CELL GENO MI BLD CMPT
|
Facility
|
OP
|
$238.68
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
31000136
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$42.08 |
| Max. Negotiated Rate |
$214.81 |
| Rate for Payer: Aetna Commercial |
$202.88
|
| Rate for Payer: Aetna Medicare |
$62.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.59
|
| Rate for Payer: BCBS Complete |
$44.18
|
| Rate for Payer: BCBS MAPPO |
$59.67
|
| Rate for Payer: BCBS Trust/PPO |
$196.22
|
| Rate for Payer: BCN Commercial |
$196.22
|
| Rate for Payer: BCN Medicare Advantage |
$59.67
|
| Rate for Payer: Cash Price |
$190.94
|
| Rate for Payer: Cofinity Commercial |
$205.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.67
|
| Rate for Payer: Healthscope Commercial |
$214.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.01
|
| Rate for Payer: Mclaren Medicaid |
$42.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.65
|
| Rate for Payer: Meridian Medicaid |
$44.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.88
|
| Rate for Payer: Nomi Health Commercial |
$195.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$179.01
|
| Rate for Payer: PACE Senior Care Partners |
$56.69
|
| Rate for Payer: PACE SWMI |
$59.67
|
| Rate for Payer: PHP Commercial |
$202.88
|
| Rate for Payer: PHP Medicare Advantage |
$59.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$207.65
|
| Rate for Payer: Priority Health Medicare |
$60.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.12
|
| Rate for Payer: Railroad Medicare Medicare |
$59.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.04
|
| Rate for Payer: UHC Core |
$199.30
|
| Rate for Payer: UHC Exchange |
$59.67
|
| Rate for Payer: UHC Medicaid |
$42.08
|
| Rate for Payer: UHC Medicare Advantage |
$59.67
|
| Rate for Payer: UHCCP Medicaid |
$42.08
|
| Rate for Payer: VA VA |
$59.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.01
|
|
|
HC RED CELLS, DIRECTED, LEUKO RED
|
Facility
|
IP
|
$1,128.42
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000061
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$785.38 |
| Max. Negotiated Rate |
$1,015.58 |
| Rate for Payer: Aetna Commercial |
$959.16
|
| Rate for Payer: BCBS Trust/PPO |
$931.96
|
| Rate for Payer: BCN Commercial |
$931.96
|
| Rate for Payer: Cash Price |
$902.74
|
| Rate for Payer: Cofinity Commercial |
$970.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$902.74
|
| Rate for Payer: Healthscope Commercial |
$1,015.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$846.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.16
|
| Rate for Payer: Nomi Health Commercial |
$925.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$846.32
|
| Rate for Payer: PHP Commercial |
$959.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$981.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$785.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$993.01
|
| Rate for Payer: UHC Core |
$942.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$846.32
|
|
|
HC RED CELLS, DIRECTED, LEUKO RED
|
Facility
|
OP
|
$1,128.42
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000061
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$198.94 |
| Max. Negotiated Rate |
$1,015.58 |
| Rate for Payer: Aetna Commercial |
$959.16
|
| Rate for Payer: Aetna Medicare |
$293.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$352.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$352.63
|
| Rate for Payer: BCBS Complete |
$208.87
|
| Rate for Payer: BCBS MAPPO |
$282.11
|
| Rate for Payer: BCBS Trust/PPO |
$927.67
|
| Rate for Payer: BCN Commercial |
$927.67
|
| Rate for Payer: BCN Medicare Advantage |
$282.11
|
| Rate for Payer: Cash Price |
$902.74
|
| Rate for Payer: Cofinity Commercial |
$970.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$902.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.11
|
| Rate for Payer: Healthscope Commercial |
$1,015.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$846.32
|
| Rate for Payer: Mclaren Medicaid |
$198.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.21
|
| Rate for Payer: Meridian Medicaid |
$208.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$324.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$310.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$959.16
|
| Rate for Payer: Nomi Health Commercial |
$925.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$846.32
|
| Rate for Payer: PACE Senior Care Partners |
$268.00
|
| Rate for Payer: PACE SWMI |
$282.11
|
| Rate for Payer: PHP Commercial |
$959.16
|
| Rate for Payer: PHP Medicare Advantage |
$282.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$981.73
|
| Rate for Payer: Priority Health Medicare |
$284.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$785.38
|
| Rate for Payer: Railroad Medicare Medicare |
$282.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$993.01
|
| Rate for Payer: UHC Core |
$942.23
|
| Rate for Payer: UHC Exchange |
$282.11
|
| Rate for Payer: UHC Medicaid |
$198.94
|
| Rate for Payer: UHC Medicare Advantage |
$282.11
|
| Rate for Payer: UHCCP Medicaid |
$198.94
|
| Rate for Payer: VA VA |
$282.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$846.32
|
|
|
HC REDTOP BENT GRASS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200057
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC REDTOP BENT GRASS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200057
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC REDUCER ASY 3/8 X 3/8 STRAIGHT
|
Facility
|
OP
|
$6.00
|
|
| Hospital Charge Code |
27000717
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$5.40 |
| Rate for Payer: Aetna Commercial |
$5.10
|
| Rate for Payer: Aetna Medicare |
$1.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.88
|
| Rate for Payer: BCBS Complete |
$1.11
|
| Rate for Payer: BCBS MAPPO |
$1.50
|
| Rate for Payer: BCBS Trust/PPO |
$4.93
|
| Rate for Payer: BCN Commercial |
$4.93
|
| Rate for Payer: BCN Medicare Advantage |
$1.50
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$5.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.50
|
| Rate for Payer: Healthscope Commercial |
$5.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.50
|
| Rate for Payer: Mclaren Medicaid |
$1.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.57
|
| Rate for Payer: Meridian Medicaid |
$1.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.10
|
| Rate for Payer: Nomi Health Commercial |
$4.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.50
|
| Rate for Payer: PACE Senior Care Partners |
$1.43
|
| Rate for Payer: PACE SWMI |
$1.50
|
| Rate for Payer: PHP Commercial |
$5.10
|
| Rate for Payer: PHP Medicare Advantage |
$1.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$1.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.28
|
| Rate for Payer: UHC Core |
$5.01
|
| Rate for Payer: UHC Exchange |
$1.50
|
| Rate for Payer: UHC Medicaid |
$1.06
|
| Rate for Payer: UHC Medicare Advantage |
$1.50
|
| Rate for Payer: UHCCP Medicaid |
$1.06
|
| Rate for Payer: VA VA |
$1.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.50
|
|
|
HC REDUCER ASY 3/8 X 3/8 STRAIGHT
|
Facility
|
IP
|
$6.00
|
|
| Hospital Charge Code |
27000717
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$5.40 |
| Rate for Payer: Aetna Commercial |
$5.10
|
| Rate for Payer: BCBS Trust/PPO |
$4.96
|
| Rate for Payer: BCN Commercial |
$4.96
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$5.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.80
|
| Rate for Payer: Healthscope Commercial |
$5.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.10
|
| Rate for Payer: Nomi Health Commercial |
$4.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.50
|
| Rate for Payer: PHP Commercial |
$5.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.28
|
| Rate for Payer: UHC Core |
$5.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.50
|
|
|
HC REDUCER W/LL ASY 1/4 X 3/8
|
Facility
|
IP
|
$9.36
|
|
| Hospital Charge Code |
27000679
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$8.42 |
| Rate for Payer: Aetna Commercial |
$7.96
|
| Rate for Payer: BCBS Trust/PPO |
$7.73
|
| Rate for Payer: BCN Commercial |
$7.73
|
| Rate for Payer: Cash Price |
$7.49
|
| Rate for Payer: Cofinity Commercial |
$8.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.49
|
| Rate for Payer: Healthscope Commercial |
$8.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.96
|
| Rate for Payer: Nomi Health Commercial |
$7.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.02
|
| Rate for Payer: PHP Commercial |
$7.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.24
|
| Rate for Payer: UHC Core |
$7.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.02
|
|
|
HC REDUCER W/LL ASY 1/4 X 3/8
|
Facility
|
OP
|
$9.36
|
|
| Hospital Charge Code |
27000679
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.65 |
| Max. Negotiated Rate |
$8.42 |
| Rate for Payer: Aetna Commercial |
$7.96
|
| Rate for Payer: Aetna Medicare |
$2.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.92
|
| Rate for Payer: BCBS Complete |
$1.73
|
| Rate for Payer: BCBS MAPPO |
$2.34
|
| Rate for Payer: BCBS Trust/PPO |
$7.69
|
| Rate for Payer: BCN Commercial |
$7.69
|
| Rate for Payer: BCN Medicare Advantage |
$2.34
|
| Rate for Payer: Cash Price |
$7.49
|
| Rate for Payer: Cofinity Commercial |
$8.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.34
|
| Rate for Payer: Healthscope Commercial |
$8.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.02
|
| Rate for Payer: Mclaren Medicaid |
$1.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.46
|
| Rate for Payer: Meridian Medicaid |
$1.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.96
|
| Rate for Payer: Nomi Health Commercial |
$7.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.02
|
| Rate for Payer: PACE Senior Care Partners |
$2.22
|
| Rate for Payer: PACE SWMI |
$2.34
|
| Rate for Payer: PHP Commercial |
$7.96
|
| Rate for Payer: PHP Medicare Advantage |
$2.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8.14
|
| Rate for Payer: Priority Health Medicare |
$2.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.51
|
| Rate for Payer: Railroad Medicare Medicare |
$2.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.24
|
| Rate for Payer: UHC Core |
$7.82
|
| Rate for Payer: UHC Exchange |
$2.34
|
| Rate for Payer: UHC Medicaid |
$1.65
|
| Rate for Payer: UHC Medicare Advantage |
$2.34
|
| Rate for Payer: UHCCP Medicaid |
$1.65
|
| Rate for Payer: VA VA |
$2.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.02
|
|
|
HC REFILL AND MAINTENANCE OF IMPLANTED PUMP
|
Facility
|
IP
|
$447.42
|
|
|
Service Code
|
HCPCS 96522
|
| Hospital Charge Code |
33500009
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$311.40 |
| Max. Negotiated Rate |
$402.68 |
| Rate for Payer: Aetna Commercial |
$380.31
|
| Rate for Payer: BCBS Trust/PPO |
$369.52
|
| Rate for Payer: BCN Commercial |
$369.52
|
| Rate for Payer: Cash Price |
$357.94
|
| Rate for Payer: Cofinity Commercial |
$384.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.94
|
| Rate for Payer: Healthscope Commercial |
$402.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.31
|
| Rate for Payer: Nomi Health Commercial |
$366.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.56
|
| Rate for Payer: PHP Commercial |
$380.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$389.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.73
|
| Rate for Payer: UHC Core |
$373.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.56
|
|
|
HC REFILL AND MAINTENANCE OF IMPLANTED PUMP
|
Facility
|
OP
|
$447.42
|
|
|
Service Code
|
HCPCS 96522
|
| Hospital Charge Code |
33500009
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$78.88 |
| Max. Negotiated Rate |
$402.68 |
| Rate for Payer: Aetna Commercial |
$380.31
|
| Rate for Payer: Aetna Medicare |
$116.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$139.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$139.82
|
| Rate for Payer: BCBS Complete |
$82.82
|
| Rate for Payer: BCBS MAPPO |
$111.86
|
| Rate for Payer: BCBS Trust/PPO |
$367.82
|
| Rate for Payer: BCN Commercial |
$367.82
|
| Rate for Payer: BCN Medicare Advantage |
$111.86
|
| Rate for Payer: Cash Price |
$357.94
|
| Rate for Payer: Cofinity Commercial |
$384.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.86
|
| Rate for Payer: Healthscope Commercial |
$402.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.56
|
| Rate for Payer: Mclaren Medicaid |
$78.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.45
|
| Rate for Payer: Meridian Medicaid |
$82.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.31
|
| Rate for Payer: Nomi Health Commercial |
$366.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.56
|
| Rate for Payer: PACE Senior Care Partners |
$106.26
|
| Rate for Payer: PACE SWMI |
$111.86
|
| Rate for Payer: PHP Commercial |
$380.31
|
| Rate for Payer: PHP Medicare Advantage |
$111.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$389.26
|
| Rate for Payer: Priority Health Medicare |
$112.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.40
|
| Rate for Payer: Railroad Medicare Medicare |
$111.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.73
|
| Rate for Payer: UHC Core |
$373.60
|
| Rate for Payer: UHC Exchange |
$111.86
|
| Rate for Payer: UHC Medicaid |
$78.88
|
| Rate for Payer: UHC Medicare Advantage |
$111.86
|
| Rate for Payer: UHCCP Medicaid |
$78.88
|
| Rate for Payer: VA VA |
$111.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.56
|
|
