|
HC REFILL AND MAINTENANCE OF PORT PUMP
|
Facility
|
OP
|
$899.63
|
|
|
Service Code
|
CPT 96521
|
| Hospital Charge Code |
33500008
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$158.60 |
| Max. Negotiated Rate |
$809.67 |
| Rate for Payer: Aetna Commercial |
$764.69
|
| Rate for Payer: Aetna Medicare |
$233.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$281.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$281.13
|
| Rate for Payer: BCBS Complete |
$166.52
|
| Rate for Payer: BCBS MAPPO |
$224.91
|
| Rate for Payer: BCBS Trust/PPO |
$739.59
|
| Rate for Payer: BCN Commercial |
$739.59
|
| Rate for Payer: BCN Medicare Advantage |
$224.91
|
| Rate for Payer: Cash Price |
$719.70
|
| Rate for Payer: Cofinity Commercial |
$773.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$719.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$224.91
|
| Rate for Payer: Healthscope Commercial |
$809.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$674.72
|
| Rate for Payer: Mclaren Medicaid |
$158.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.15
|
| Rate for Payer: Meridian Medicaid |
$166.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$258.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$247.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$764.69
|
| Rate for Payer: Nomi Health Commercial |
$737.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$674.72
|
| Rate for Payer: PACE Senior Care Partners |
$213.66
|
| Rate for Payer: PACE SWMI |
$224.91
|
| Rate for Payer: PHP Commercial |
$764.69
|
| Rate for Payer: PHP Medicare Advantage |
$224.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$782.68
|
| Rate for Payer: Priority Health Medicare |
$227.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$626.14
|
| Rate for Payer: Railroad Medicare Medicare |
$224.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$791.67
|
| Rate for Payer: UHC Core |
$751.19
|
| Rate for Payer: UHC Exchange |
$224.91
|
| Rate for Payer: UHC Medicaid |
$158.60
|
| Rate for Payer: UHC Medicare Advantage |
$224.91
|
| Rate for Payer: UHCCP Medicaid |
$158.60
|
| Rate for Payer: VA VA |
$224.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$674.72
|
|
|
HC REFILL AND MAINTENANCE OF PORT PUMP
|
Facility
|
IP
|
$899.63
|
|
|
Service Code
|
CPT 96521
|
| Hospital Charge Code |
33500008
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$626.14 |
| Max. Negotiated Rate |
$809.67 |
| Rate for Payer: Aetna Commercial |
$764.69
|
| Rate for Payer: BCBS Trust/PPO |
$743.00
|
| Rate for Payer: BCN Commercial |
$743.00
|
| Rate for Payer: Cash Price |
$719.70
|
| Rate for Payer: Cofinity Commercial |
$773.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$719.70
|
| Rate for Payer: Healthscope Commercial |
$809.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$674.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$764.69
|
| Rate for Payer: Nomi Health Commercial |
$737.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$674.72
|
| Rate for Payer: PHP Commercial |
$764.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$782.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$626.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$791.67
|
| Rate for Payer: UHC Core |
$751.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$674.72
|
|
|
HC REFILL AND REPROGRAM INTRATHECAL INF PUMP
|
Facility
|
IP
|
$430.00
|
|
|
Service Code
|
CPT 62370
|
| Hospital Charge Code |
36100587
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$299.28 |
| Max. Negotiated Rate |
$387.00 |
| Rate for Payer: Aetna Commercial |
$365.50
|
| Rate for Payer: BCBS Trust/PPO |
$355.14
|
| Rate for Payer: BCN Commercial |
$355.14
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cofinity Commercial |
$369.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.00
|
| Rate for Payer: Healthscope Commercial |
$387.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.50
|
| Rate for Payer: Nomi Health Commercial |
$352.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$322.50
|
| Rate for Payer: PHP Commercial |
$365.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$374.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$299.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.40
|
| Rate for Payer: UHC Core |
$359.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.50
|
|
|
HC REFILL AND REPROGRAM INTRATHECAL INF PUMP
|
Facility
|
OP
|
$430.00
|
|
|
Service Code
|
CPT 62370
|
| Hospital Charge Code |
36100587
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$75.81 |
| Max. Negotiated Rate |
$387.00 |
| Rate for Payer: Aetna Commercial |
$365.50
|
| Rate for Payer: Aetna Medicare |
$111.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.38
|
| Rate for Payer: BCBS Complete |
$79.59
|
| Rate for Payer: BCBS MAPPO |
$107.50
|
| Rate for Payer: BCBS Trust/PPO |
$353.50
|
| Rate for Payer: BCN Commercial |
$353.50
|
| Rate for Payer: BCN Medicare Advantage |
$107.50
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cofinity Commercial |
$369.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.50
|
| Rate for Payer: Healthscope Commercial |
$387.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.50
|
| Rate for Payer: Mclaren Medicaid |
$75.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.88
|
| Rate for Payer: Meridian Medicaid |
$79.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.50
|
| Rate for Payer: Nomi Health Commercial |
$352.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$322.50
|
| Rate for Payer: PACE Senior Care Partners |
$102.12
|
| Rate for Payer: PACE SWMI |
$107.50
|
| Rate for Payer: PHP Commercial |
$365.50
|
| Rate for Payer: PHP Medicare Advantage |
$107.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$374.10
|
| Rate for Payer: Priority Health Medicare |
$108.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$299.28
|
| Rate for Payer: Railroad Medicare Medicare |
$107.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$378.40
|
| Rate for Payer: UHC Core |
$359.05
|
| Rate for Payer: UHC Exchange |
$107.50
|
| Rate for Payer: UHC Medicaid |
$75.81
|
| Rate for Payer: UHC Medicare Advantage |
$107.50
|
| Rate for Payer: UHCCP Medicaid |
$75.81
|
| Rate for Payer: VA VA |
$107.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.50
|
|
|
HC REFLEX BETHESDA UNITS
|
Facility
|
IP
|
$158.12
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30500042
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$110.05 |
| Max. Negotiated Rate |
$142.31 |
| Rate for Payer: Aetna Commercial |
$134.40
|
| Rate for Payer: BCBS Trust/PPO |
$130.59
|
| Rate for Payer: BCN Commercial |
$130.59
|
| Rate for Payer: Cash Price |
$126.50
|
| Rate for Payer: Cofinity Commercial |
$135.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.50
|
| Rate for Payer: Healthscope Commercial |
$142.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.40
|
| Rate for Payer: Nomi Health Commercial |
$129.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.59
|
| Rate for Payer: PHP Commercial |
$134.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$137.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.15
|
| Rate for Payer: UHC Core |
$132.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.59
|
|
|
HC REFLEX BETHESDA UNITS
|
Facility
|
OP
|
$158.12
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30500042
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$27.88 |
| Max. Negotiated Rate |
$142.31 |
| Rate for Payer: Aetna Commercial |
$134.40
|
| Rate for Payer: Aetna Medicare |
$41.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.41
|
| Rate for Payer: BCBS Complete |
$29.27
|
| Rate for Payer: BCBS MAPPO |
$39.53
|
| Rate for Payer: BCBS Trust/PPO |
$129.99
|
| Rate for Payer: BCN Commercial |
$129.99
|
| Rate for Payer: BCN Medicare Advantage |
$39.53
|
| Rate for Payer: Cash Price |
$126.50
|
| Rate for Payer: Cofinity Commercial |
$135.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.53
|
| Rate for Payer: Healthscope Commercial |
$142.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.59
|
| Rate for Payer: Mclaren Medicaid |
$27.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.51
|
| Rate for Payer: Meridian Medicaid |
$29.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.40
|
| Rate for Payer: Nomi Health Commercial |
$129.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.59
|
| Rate for Payer: PACE Senior Care Partners |
$37.55
|
| Rate for Payer: PACE SWMI |
$39.53
|
| Rate for Payer: PHP Commercial |
$134.40
|
| Rate for Payer: PHP Medicare Advantage |
$39.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$137.56
|
| Rate for Payer: Priority Health Medicare |
$39.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$110.05
|
| Rate for Payer: Railroad Medicare Medicare |
$39.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.15
|
| Rate for Payer: UHC Core |
$132.03
|
| Rate for Payer: UHC Exchange |
$39.53
|
| Rate for Payer: UHC Medicaid |
$27.88
|
| Rate for Payer: UHC Medicare Advantage |
$39.53
|
| Rate for Payer: UHCCP Medicaid |
$27.88
|
| Rate for Payer: VA VA |
$39.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.59
|
|
|
HC REFLEX COAG FACTOR VIII INHIBITOR
|
Facility
|
OP
|
$326.85
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30500043
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$57.62 |
| Max. Negotiated Rate |
$294.17 |
| Rate for Payer: Aetna Commercial |
$277.82
|
| Rate for Payer: Aetna Medicare |
$84.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.14
|
| Rate for Payer: BCBS Complete |
$60.50
|
| Rate for Payer: BCBS MAPPO |
$81.71
|
| Rate for Payer: BCBS Trust/PPO |
$268.70
|
| Rate for Payer: BCN Commercial |
$268.70
|
| Rate for Payer: BCN Medicare Advantage |
$81.71
|
| Rate for Payer: Cash Price |
$261.48
|
| Rate for Payer: Cofinity Commercial |
$281.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.71
|
| Rate for Payer: Healthscope Commercial |
$294.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$245.14
|
| Rate for Payer: Mclaren Medicaid |
$57.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.80
|
| Rate for Payer: Meridian Medicaid |
$60.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$89.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.82
|
| Rate for Payer: Nomi Health Commercial |
$268.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.14
|
| Rate for Payer: PACE Senior Care Partners |
$77.63
|
| Rate for Payer: PACE SWMI |
$81.71
|
| Rate for Payer: PHP Commercial |
$277.82
|
| Rate for Payer: PHP Medicare Advantage |
$81.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$284.36
|
| Rate for Payer: Priority Health Medicare |
$82.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.49
|
| Rate for Payer: Railroad Medicare Medicare |
$81.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.63
|
| Rate for Payer: UHC Core |
$272.92
|
| Rate for Payer: UHC Exchange |
$81.71
|
| Rate for Payer: UHC Medicaid |
$57.62
|
| Rate for Payer: UHC Medicare Advantage |
$81.71
|
| Rate for Payer: UHCCP Medicaid |
$57.62
|
| Rate for Payer: VA VA |
$81.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$245.14
|
|
|
HC REFLEX COAG FACTOR VIII INHIBITOR
|
Facility
|
IP
|
$326.85
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30500043
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$227.49 |
| Max. Negotiated Rate |
$294.17 |
| Rate for Payer: Aetna Commercial |
$277.82
|
| Rate for Payer: BCBS Trust/PPO |
$269.95
|
| Rate for Payer: BCN Commercial |
$269.95
|
| Rate for Payer: Cash Price |
$261.48
|
| Rate for Payer: Cofinity Commercial |
$281.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.48
|
| Rate for Payer: Healthscope Commercial |
$294.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$245.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.82
|
| Rate for Payer: Nomi Health Commercial |
$268.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.14
|
| Rate for Payer: PHP Commercial |
$277.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$284.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.63
|
| Rate for Payer: UHC Core |
$272.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$245.14
|
|
|
HC REG/SEDAT ADDL 15 MIN
|
Facility
|
IP
|
$120.14
|
|
| Hospital Charge Code |
37000011
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$83.62 |
| Max. Negotiated Rate |
$108.13 |
| Rate for Payer: Aetna Commercial |
$102.12
|
| Rate for Payer: BCBS Trust/PPO |
$99.22
|
| Rate for Payer: BCN Commercial |
$99.22
|
| Rate for Payer: Cash Price |
$96.11
|
| Rate for Payer: Cofinity Commercial |
$103.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.11
|
| Rate for Payer: Healthscope Commercial |
$108.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.12
|
| Rate for Payer: Nomi Health Commercial |
$98.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.11
|
| Rate for Payer: PHP Commercial |
$102.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.72
|
| Rate for Payer: UHC Core |
$100.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.11
|
|
|
HC REG/SEDAT ADDL 15 MIN
|
Facility
|
OP
|
$120.14
|
|
| Hospital Charge Code |
37000011
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$21.18 |
| Max. Negotiated Rate |
$108.13 |
| Rate for Payer: Aetna Commercial |
$102.12
|
| Rate for Payer: Aetna Medicare |
$31.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.54
|
| Rate for Payer: BCBS Complete |
$22.24
|
| Rate for Payer: BCBS MAPPO |
$30.04
|
| Rate for Payer: BCBS Trust/PPO |
$98.77
|
| Rate for Payer: BCN Commercial |
$98.77
|
| Rate for Payer: BCN Medicare Advantage |
$30.04
|
| Rate for Payer: Cash Price |
$96.11
|
| Rate for Payer: Cofinity Commercial |
$103.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.04
|
| Rate for Payer: Healthscope Commercial |
$108.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.11
|
| Rate for Payer: Mclaren Medicaid |
$21.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.54
|
| Rate for Payer: Meridian Medicaid |
$22.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.12
|
| Rate for Payer: Nomi Health Commercial |
$98.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.11
|
| Rate for Payer: PACE Senior Care Partners |
$28.53
|
| Rate for Payer: PACE SWMI |
$30.04
|
| Rate for Payer: PHP Commercial |
$102.12
|
| Rate for Payer: PHP Medicare Advantage |
$30.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.52
|
| Rate for Payer: Priority Health Medicare |
$30.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.62
|
| Rate for Payer: Railroad Medicare Medicare |
$30.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.72
|
| Rate for Payer: UHC Core |
$100.32
|
| Rate for Payer: UHC Exchange |
$30.04
|
| Rate for Payer: UHC Medicaid |
$21.18
|
| Rate for Payer: UHC Medicare Advantage |
$30.04
|
| Rate for Payer: UHCCP Medicaid |
$21.18
|
| Rate for Payer: VA VA |
$30.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.11
|
|
|
HC REG/SEDAT INIT 30 MIN
|
Facility
|
OP
|
$607.70
|
|
| Hospital Charge Code |
37000012
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$107.14 |
| Max. Negotiated Rate |
$546.93 |
| Rate for Payer: Aetna Commercial |
$516.54
|
| Rate for Payer: Aetna Medicare |
$158.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.91
|
| Rate for Payer: BCBS Complete |
$112.49
|
| Rate for Payer: BCBS MAPPO |
$151.93
|
| Rate for Payer: BCBS Trust/PPO |
$499.59
|
| Rate for Payer: BCN Commercial |
$499.59
|
| Rate for Payer: BCN Medicare Advantage |
$151.93
|
| Rate for Payer: Cash Price |
$486.16
|
| Rate for Payer: Cofinity Commercial |
$522.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$486.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.93
|
| Rate for Payer: Healthscope Commercial |
$546.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$455.77
|
| Rate for Payer: Mclaren Medicaid |
$107.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.52
|
| Rate for Payer: Meridian Medicaid |
$112.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$167.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$516.54
|
| Rate for Payer: Nomi Health Commercial |
$498.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$455.77
|
| Rate for Payer: PACE Senior Care Partners |
$144.33
|
| Rate for Payer: PACE SWMI |
$151.93
|
| Rate for Payer: PHP Commercial |
$516.54
|
| Rate for Payer: PHP Medicare Advantage |
$151.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$528.70
|
| Rate for Payer: Priority Health Medicare |
$153.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$422.96
|
| Rate for Payer: Railroad Medicare Medicare |
$151.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$534.78
|
| Rate for Payer: UHC Core |
$507.43
|
| Rate for Payer: UHC Exchange |
$151.93
|
| Rate for Payer: UHC Medicaid |
$107.14
|
| Rate for Payer: UHC Medicare Advantage |
$151.93
|
| Rate for Payer: UHCCP Medicaid |
$107.14
|
| Rate for Payer: VA VA |
$151.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$455.77
|
|
|
HC REG/SEDAT INIT 30 MIN
|
Facility
|
IP
|
$607.70
|
|
| Hospital Charge Code |
37000012
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$422.96 |
| Max. Negotiated Rate |
$546.93 |
| Rate for Payer: Aetna Commercial |
$516.54
|
| Rate for Payer: BCBS Trust/PPO |
$501.90
|
| Rate for Payer: BCN Commercial |
$501.90
|
| Rate for Payer: Cash Price |
$486.16
|
| Rate for Payer: Cofinity Commercial |
$522.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$486.16
|
| Rate for Payer: Healthscope Commercial |
$546.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$455.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$516.54
|
| Rate for Payer: Nomi Health Commercial |
$498.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$455.77
|
| Rate for Payer: PHP Commercial |
$516.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$528.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$422.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$534.78
|
| Rate for Payer: UHC Core |
$507.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$455.77
|
|
|
HC REM MNTR PHYSIOL PARAM 16-30 DAYS
|
Facility
|
OP
|
$109.24
|
|
|
Service Code
|
CPT 99454
|
| Hospital Charge Code |
51000110
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.26 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna Medicare |
$28.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.14
|
| Rate for Payer: BCBS Complete |
$20.22
|
| Rate for Payer: BCBS MAPPO |
$27.31
|
| Rate for Payer: BCBS Trust/PPO |
$89.81
|
| Rate for Payer: BCN Commercial |
$89.81
|
| Rate for Payer: BCN Medicare Advantage |
$27.31
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.31
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Mclaren Medicaid |
$19.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.68
|
| Rate for Payer: Meridian Medicaid |
$20.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PACE Senior Care Partners |
$25.94
|
| Rate for Payer: PACE SWMI |
$27.31
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: PHP Medicare Advantage |
$27.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.04
|
| Rate for Payer: Priority Health Medicare |
$27.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.03
|
| Rate for Payer: Railroad Medicare Medicare |
$27.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.13
|
| Rate for Payer: UHC Core |
$91.22
|
| Rate for Payer: UHC Exchange |
$27.31
|
| Rate for Payer: UHC Medicaid |
$19.26
|
| Rate for Payer: UHC Medicare Advantage |
$27.31
|
| Rate for Payer: UHCCP Medicaid |
$19.26
|
| Rate for Payer: VA VA |
$27.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC REM MNTR PHYSIOL PARAM 16-30 DAYS
|
Facility
|
IP
|
$109.24
|
|
|
Service Code
|
CPT 99454
|
| Hospital Charge Code |
51000110
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$76.03 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: BCBS Trust/PPO |
$90.22
|
| Rate for Payer: BCN Commercial |
$90.22
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.13
|
| Rate for Payer: UHC Core |
$91.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Facility
|
OP
|
$353.74
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
51000111
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$62.36 |
| Max. Negotiated Rate |
$318.37 |
| Rate for Payer: Aetna Commercial |
$300.68
|
| Rate for Payer: Aetna Medicare |
$91.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110.54
|
| Rate for Payer: BCBS Complete |
$65.48
|
| Rate for Payer: BCBS MAPPO |
$88.44
|
| Rate for Payer: BCBS Trust/PPO |
$290.81
|
| Rate for Payer: BCN Commercial |
$290.81
|
| Rate for Payer: BCN Medicare Advantage |
$88.44
|
| Rate for Payer: Cash Price |
$282.99
|
| Rate for Payer: Cofinity Commercial |
$304.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.44
|
| Rate for Payer: Healthscope Commercial |
$318.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.31
|
| Rate for Payer: Mclaren Medicaid |
$62.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.86
|
| Rate for Payer: Meridian Medicaid |
$65.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$101.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.68
|
| Rate for Payer: Nomi Health Commercial |
$290.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.31
|
| Rate for Payer: PACE Senior Care Partners |
$84.01
|
| Rate for Payer: PACE SWMI |
$88.44
|
| Rate for Payer: PHP Commercial |
$300.68
|
| Rate for Payer: PHP Medicare Advantage |
$88.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$307.75
|
| Rate for Payer: Priority Health Medicare |
$89.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.20
|
| Rate for Payer: Railroad Medicare Medicare |
$88.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.29
|
| Rate for Payer: UHC Core |
$295.37
|
| Rate for Payer: UHC Exchange |
$88.44
|
| Rate for Payer: UHC Medicaid |
$62.36
|
| Rate for Payer: UHC Medicare Advantage |
$88.44
|
| Rate for Payer: UHCCP Medicaid |
$62.36
|
| Rate for Payer: VA VA |
$88.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.31
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Facility
|
IP
|
$353.74
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
51000111
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$246.20 |
| Max. Negotiated Rate |
$318.37 |
| Rate for Payer: Aetna Commercial |
$300.68
|
| Rate for Payer: BCBS Trust/PPO |
$292.15
|
| Rate for Payer: BCN Commercial |
$292.15
|
| Rate for Payer: Cash Price |
$282.99
|
| Rate for Payer: Cofinity Commercial |
$304.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$282.99
|
| Rate for Payer: Healthscope Commercial |
$318.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.68
|
| Rate for Payer: Nomi Health Commercial |
$290.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.31
|
| Rate for Payer: PHP Commercial |
$300.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$307.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.29
|
| Rate for Payer: UHC Core |
$295.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.31
|
|
|
HC REMOTE THER MON DEVICE SUPPLY MS 16-30 DAYS
|
Facility
|
OP
|
$117.05
|
|
|
Service Code
|
CPT 98977
|
| Hospital Charge Code |
42000063
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$105.34 |
| Rate for Payer: Aetna Commercial |
$99.49
|
| Rate for Payer: Aetna Medicare |
$30.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.58
|
| Rate for Payer: BCBS Complete |
$21.67
|
| Rate for Payer: BCBS MAPPO |
$29.26
|
| Rate for Payer: BCBS Trust/PPO |
$96.23
|
| Rate for Payer: BCN Commercial |
$96.23
|
| Rate for Payer: BCN Medicare Advantage |
$29.26
|
| Rate for Payer: Cash Price |
$93.64
|
| Rate for Payer: Cofinity Commercial |
$100.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.26
|
| Rate for Payer: Healthscope Commercial |
$105.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.79
|
| Rate for Payer: Mclaren Medicaid |
$20.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.73
|
| Rate for Payer: Meridian Medicaid |
$21.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.49
|
| Rate for Payer: Nomi Health Commercial |
$95.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.79
|
| Rate for Payer: PACE Senior Care Partners |
$27.80
|
| Rate for Payer: PACE SWMI |
$29.26
|
| Rate for Payer: PHP Commercial |
$99.49
|
| Rate for Payer: PHP Medicare Advantage |
$29.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.83
|
| Rate for Payer: Priority Health Medicare |
$29.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.47
|
| Rate for Payer: Railroad Medicare Medicare |
$29.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.00
|
| Rate for Payer: UHC Core |
$97.74
|
| Rate for Payer: UHC Exchange |
$29.26
|
| Rate for Payer: UHC Medicaid |
$20.64
|
| Rate for Payer: UHC Medicare Advantage |
$29.26
|
| Rate for Payer: UHCCP Medicaid |
$20.64
|
| Rate for Payer: VA VA |
$29.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.79
|
|
|
HC REMOTE THER MON DEVICE SUPPLY MS 16-30 DAYS
|
Facility
|
IP
|
$117.05
|
|
|
Service Code
|
CPT 98977
|
| Hospital Charge Code |
42000063
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$81.47 |
| Max. Negotiated Rate |
$105.34 |
| Rate for Payer: Aetna Commercial |
$99.49
|
| Rate for Payer: BCBS Trust/PPO |
$96.67
|
| Rate for Payer: BCN Commercial |
$96.67
|
| Rate for Payer: Cash Price |
$93.64
|
| Rate for Payer: Cofinity Commercial |
$100.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.64
|
| Rate for Payer: Healthscope Commercial |
$105.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.49
|
| Rate for Payer: Nomi Health Commercial |
$95.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.79
|
| Rate for Payer: PHP Commercial |
$99.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$101.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.00
|
| Rate for Payer: UHC Core |
$97.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.79
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
OP
|
$373.46
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$65.84 |
| Max. Negotiated Rate |
$336.11 |
| Rate for Payer: Aetna Commercial |
$317.44
|
| Rate for Payer: Aetna Medicare |
$97.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$116.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$116.71
|
| Rate for Payer: BCBS Complete |
$69.13
|
| Rate for Payer: BCBS MAPPO |
$93.36
|
| Rate for Payer: BCBS Trust/PPO |
$307.02
|
| Rate for Payer: BCN Commercial |
$307.02
|
| Rate for Payer: BCN Medicare Advantage |
$93.36
|
| Rate for Payer: Cash Price |
$298.77
|
| Rate for Payer: Cofinity Commercial |
$321.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.36
|
| Rate for Payer: Healthscope Commercial |
$336.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.10
|
| Rate for Payer: Mclaren Medicaid |
$65.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.03
|
| Rate for Payer: Meridian Medicaid |
$69.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.44
|
| Rate for Payer: Nomi Health Commercial |
$306.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.10
|
| Rate for Payer: PACE Senior Care Partners |
$88.70
|
| Rate for Payer: PACE SWMI |
$93.36
|
| Rate for Payer: PHP Commercial |
$317.44
|
| Rate for Payer: PHP Medicare Advantage |
$93.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$324.91
|
| Rate for Payer: Priority Health Medicare |
$94.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$259.93
|
| Rate for Payer: Railroad Medicare Medicare |
$93.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.64
|
| Rate for Payer: UHC Core |
$311.84
|
| Rate for Payer: UHC Exchange |
$93.36
|
| Rate for Payer: UHC Medicaid |
$65.84
|
| Rate for Payer: UHC Medicare Advantage |
$93.36
|
| Rate for Payer: UHCCP Medicaid |
$65.84
|
| Rate for Payer: VA VA |
$93.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.10
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
IP
|
$373.46
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$259.93 |
| Max. Negotiated Rate |
$336.11 |
| Rate for Payer: Aetna Commercial |
$317.44
|
| Rate for Payer: BCBS Trust/PPO |
$308.44
|
| Rate for Payer: BCN Commercial |
$308.44
|
| Rate for Payer: Cash Price |
$298.77
|
| Rate for Payer: Cofinity Commercial |
$321.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.77
|
| Rate for Payer: Healthscope Commercial |
$336.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.44
|
| Rate for Payer: Nomi Health Commercial |
$306.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.10
|
| Rate for Payer: PHP Commercial |
$317.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$324.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$259.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.64
|
| Rate for Payer: UHC Core |
$311.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.10
|
|
|
HC REMOVAL BILIARY STONE
|
Facility
|
IP
|
$675.66
|
|
|
Service Code
|
CPT 47544
|
| Hospital Charge Code |
36100516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$470.26 |
| Max. Negotiated Rate |
$608.09 |
| Rate for Payer: Aetna Commercial |
$574.31
|
| Rate for Payer: BCBS Trust/PPO |
$558.03
|
| Rate for Payer: BCN Commercial |
$558.03
|
| Rate for Payer: Cash Price |
$540.53
|
| Rate for Payer: Cofinity Commercial |
$581.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.53
|
| Rate for Payer: Healthscope Commercial |
$608.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$506.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.31
|
| Rate for Payer: Nomi Health Commercial |
$554.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.75
|
| Rate for Payer: PHP Commercial |
$574.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$587.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$470.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$594.58
|
| Rate for Payer: UHC Core |
$564.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$506.75
|
|
|
HC REMOVAL BILIARY STONE
|
Facility
|
OP
|
$675.66
|
|
|
Service Code
|
CPT 47544
|
| Hospital Charge Code |
36100516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$119.12 |
| Max. Negotiated Rate |
$608.09 |
| Rate for Payer: Aetna Commercial |
$574.31
|
| Rate for Payer: Aetna Medicare |
$175.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$211.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$211.14
|
| Rate for Payer: BCBS Complete |
$125.06
|
| Rate for Payer: BCBS MAPPO |
$168.91
|
| Rate for Payer: BCBS Trust/PPO |
$555.46
|
| Rate for Payer: BCN Commercial |
$555.46
|
| Rate for Payer: BCN Medicare Advantage |
$168.91
|
| Rate for Payer: Cash Price |
$540.53
|
| Rate for Payer: Cofinity Commercial |
$581.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.91
|
| Rate for Payer: Healthscope Commercial |
$608.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$506.75
|
| Rate for Payer: Mclaren Medicaid |
$119.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$177.36
|
| Rate for Payer: Meridian Medicaid |
$125.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$194.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$185.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.31
|
| Rate for Payer: Nomi Health Commercial |
$554.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.75
|
| Rate for Payer: PACE Senior Care Partners |
$160.47
|
| Rate for Payer: PACE SWMI |
$168.91
|
| Rate for Payer: PHP Commercial |
$574.31
|
| Rate for Payer: PHP Medicare Advantage |
$168.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$587.82
|
| Rate for Payer: Priority Health Medicare |
$170.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$470.26
|
| Rate for Payer: Railroad Medicare Medicare |
$168.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$594.58
|
| Rate for Payer: UHC Core |
$564.18
|
| Rate for Payer: UHC Exchange |
$168.91
|
| Rate for Payer: UHC Medicaid |
$119.12
|
| Rate for Payer: UHC Medicare Advantage |
$168.91
|
| Rate for Payer: UHCCP Medicaid |
$119.12
|
| Rate for Payer: VA VA |
$168.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$506.75
|
|
|
HC REMOVAL CHEST PORT OR PUMP
|
Facility
|
OP
|
$2,289.60
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36100141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$403.66 |
| Max. Negotiated Rate |
$2,060.64 |
| Rate for Payer: Aetna Commercial |
$1,946.16
|
| Rate for Payer: Aetna Medicare |
$595.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$715.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$715.50
|
| Rate for Payer: BCBS Complete |
$423.80
|
| Rate for Payer: BCBS MAPPO |
$572.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,882.28
|
| Rate for Payer: BCN Commercial |
$1,882.28
|
| Rate for Payer: BCN Medicare Advantage |
$572.40
|
| Rate for Payer: Cash Price |
$1,831.68
|
| Rate for Payer: Cofinity Commercial |
$1,969.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,831.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.40
|
| Rate for Payer: Healthscope Commercial |
$2,060.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,717.20
|
| Rate for Payer: Mclaren Medicaid |
$403.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.02
|
| Rate for Payer: Meridian Medicaid |
$423.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$658.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$629.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,946.16
|
| Rate for Payer: Nomi Health Commercial |
$1,877.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,717.20
|
| Rate for Payer: PACE Senior Care Partners |
$543.78
|
| Rate for Payer: PACE SWMI |
$572.40
|
| Rate for Payer: PHP Commercial |
$1,946.16
|
| Rate for Payer: PHP Medicare Advantage |
$572.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,991.95
|
| Rate for Payer: Priority Health Medicare |
$578.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,593.56
|
| Rate for Payer: Railroad Medicare Medicare |
$572.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,014.85
|
| Rate for Payer: UHC Core |
$1,911.82
|
| Rate for Payer: UHC Exchange |
$572.40
|
| Rate for Payer: UHC Medicaid |
$403.66
|
| Rate for Payer: UHC Medicare Advantage |
$572.40
|
| Rate for Payer: UHCCP Medicaid |
$403.66
|
| Rate for Payer: VA VA |
$572.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,717.20
|
|
|
HC REMOVAL CHEST PORT OR PUMP
|
Facility
|
IP
|
$2,289.60
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36100141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,593.56 |
| Max. Negotiated Rate |
$2,060.64 |
| Rate for Payer: Aetna Commercial |
$1,946.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,890.98
|
| Rate for Payer: BCN Commercial |
$1,890.98
|
| Rate for Payer: Cash Price |
$1,831.68
|
| Rate for Payer: Cofinity Commercial |
$1,969.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,831.68
|
| Rate for Payer: Healthscope Commercial |
$2,060.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,717.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,946.16
|
| Rate for Payer: Nomi Health Commercial |
$1,877.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,717.20
|
| Rate for Payer: PHP Commercial |
$1,946.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,991.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,593.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,014.85
|
| Rate for Payer: UHC Core |
$1,911.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,717.20
|
|
|
HC REMOVAL DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$350.20
|
|
|
Service Code
|
CPT 11982
|
| Hospital Charge Code |
76100143
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$243.74 |
| Max. Negotiated Rate |
$315.18 |
| Rate for Payer: Aetna Commercial |
$297.67
|
| Rate for Payer: BCBS Trust/PPO |
$289.23
|
| Rate for Payer: BCN Commercial |
$289.23
|
| Rate for Payer: Cash Price |
$280.16
|
| Rate for Payer: Cofinity Commercial |
$301.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.16
|
| Rate for Payer: Healthscope Commercial |
$315.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$297.67
|
| Rate for Payer: Nomi Health Commercial |
$287.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.65
|
| Rate for Payer: PHP Commercial |
$297.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$304.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$243.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.18
|
| Rate for Payer: UHC Core |
$292.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.65
|
|
