|
HC RECOVERY 1 INIT 30 MIN
|
Facility
|
OP
|
$370.68
|
|
| Hospital Charge Code |
71000021
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$88.04 |
| Max. Negotiated Rate |
$333.61 |
| Rate for Payer: Aetna Commercial |
$315.08
|
| Rate for Payer: Aetna Medicare |
$96.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.84
|
| Rate for Payer: BCBS Complete |
$148.27
|
| Rate for Payer: BCBS MAPPO |
$92.67
|
| Rate for Payer: BCBS Trust/PPO |
$304.74
|
| Rate for Payer: BCN Commercial |
$288.20
|
| Rate for Payer: BCN Medicare Advantage |
$92.67
|
| Rate for Payer: Cash Price |
$296.54
|
| Rate for Payer: Cofinity Commercial |
$318.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.67
|
| Rate for Payer: Healthscope Commercial |
$333.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.08
|
| Rate for Payer: Nomi Health Commercial |
$303.96
|
| Rate for Payer: PACE Senior Care Partners |
$88.04
|
| Rate for Payer: PACE SWMI |
$92.67
|
| Rate for Payer: PHP Commercial |
$315.08
|
| Rate for Payer: PHP Medicare Advantage |
$92.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.94
|
| Rate for Payer: Priority Health HMO/PPO |
$322.49
|
| Rate for Payer: Priority Health Medicare |
$93.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$248.36
|
| Rate for Payer: Railroad Medicare Medicare |
$92.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.20
|
| Rate for Payer: UHC Core |
$309.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.67
|
| Rate for Payer: UHC Exchange |
$92.67
|
| Rate for Payer: UHC Medicare Advantage |
$92.67
|
| Rate for Payer: VA VA |
$92.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.01
|
|
|
HC RECOVERY 2 ADD'L 15 MIN
|
Facility
|
OP
|
$183.83
|
|
| Hospital Charge Code |
71000022
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$43.66 |
| Max. Negotiated Rate |
$165.45 |
| Rate for Payer: Aetna Commercial |
$156.26
|
| Rate for Payer: Aetna Medicare |
$47.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.45
|
| Rate for Payer: BCBS Complete |
$73.53
|
| Rate for Payer: BCBS MAPPO |
$45.96
|
| Rate for Payer: BCBS Trust/PPO |
$151.13
|
| Rate for Payer: BCN Commercial |
$142.93
|
| Rate for Payer: BCN Medicare Advantage |
$45.96
|
| Rate for Payer: Cash Price |
$147.06
|
| Rate for Payer: Cofinity Commercial |
$158.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.96
|
| Rate for Payer: Healthscope Commercial |
$165.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.26
|
| Rate for Payer: Nomi Health Commercial |
$150.74
|
| Rate for Payer: PACE Senior Care Partners |
$43.66
|
| Rate for Payer: PACE SWMI |
$45.96
|
| Rate for Payer: PHP Commercial |
$156.26
|
| Rate for Payer: PHP Medicare Advantage |
$45.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.49
|
| Rate for Payer: Priority Health HMO/PPO |
$159.93
|
| Rate for Payer: Priority Health Medicare |
$46.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.17
|
| Rate for Payer: Railroad Medicare Medicare |
$45.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.77
|
| Rate for Payer: UHC Core |
$153.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.96
|
| Rate for Payer: UHC Exchange |
$45.96
|
| Rate for Payer: UHC Medicare Advantage |
$45.96
|
| Rate for Payer: VA VA |
$45.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.87
|
|
|
HC RECOVERY 2 ADD'L 15 MIN
|
Facility
|
IP
|
$183.83
|
|
| Hospital Charge Code |
71000022
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$119.49 |
| Max. Negotiated Rate |
$165.45 |
| Rate for Payer: Aetna Commercial |
$156.26
|
| Rate for Payer: BCBS Trust/PPO |
$150.06
|
| Rate for Payer: BCN Commercial |
$142.06
|
| Rate for Payer: Cash Price |
$147.06
|
| Rate for Payer: Cofinity Commercial |
$158.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.06
|
| Rate for Payer: Healthscope Commercial |
$165.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.26
|
| Rate for Payer: Nomi Health Commercial |
$150.74
|
| Rate for Payer: PHP Commercial |
$156.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.49
|
| Rate for Payer: Priority Health HMO/PPO |
$159.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.77
|
| Rate for Payer: UHC Core |
$153.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.87
|
|
|
HC RECOVERY 2 INIT 30 MIN
|
Facility
|
IP
|
$331.57
|
|
| Hospital Charge Code |
71000023
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$215.52 |
| Max. Negotiated Rate |
$298.41 |
| Rate for Payer: Aetna Commercial |
$281.83
|
| Rate for Payer: BCBS Trust/PPO |
$270.66
|
| Rate for Payer: BCN Commercial |
$256.24
|
| Rate for Payer: Cash Price |
$265.26
|
| Rate for Payer: Cofinity Commercial |
$285.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.26
|
| Rate for Payer: Healthscope Commercial |
$298.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.83
|
| Rate for Payer: Nomi Health Commercial |
$271.89
|
| Rate for Payer: PHP Commercial |
$281.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.52
|
| Rate for Payer: Priority Health HMO/PPO |
$288.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.78
|
| Rate for Payer: UHC Core |
$276.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.68
|
|
|
HC RECOVERY 2 INIT 30 MIN
|
Facility
|
OP
|
$331.57
|
|
| Hospital Charge Code |
71000023
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$78.75 |
| Max. Negotiated Rate |
$298.41 |
| Rate for Payer: Aetna Commercial |
$281.83
|
| Rate for Payer: Aetna Medicare |
$86.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.62
|
| Rate for Payer: BCBS Complete |
$132.63
|
| Rate for Payer: BCBS MAPPO |
$82.89
|
| Rate for Payer: BCBS Trust/PPO |
$272.58
|
| Rate for Payer: BCN Commercial |
$257.80
|
| Rate for Payer: BCN Medicare Advantage |
$82.89
|
| Rate for Payer: Cash Price |
$265.26
|
| Rate for Payer: Cofinity Commercial |
$285.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.89
|
| Rate for Payer: Healthscope Commercial |
$298.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.83
|
| Rate for Payer: Nomi Health Commercial |
$271.89
|
| Rate for Payer: PACE Senior Care Partners |
$78.75
|
| Rate for Payer: PACE SWMI |
$82.89
|
| Rate for Payer: PHP Commercial |
$281.83
|
| Rate for Payer: PHP Medicare Advantage |
$82.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.52
|
| Rate for Payer: Priority Health HMO/PPO |
$288.47
|
| Rate for Payer: Priority Health Medicare |
$83.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.15
|
| Rate for Payer: Railroad Medicare Medicare |
$82.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.78
|
| Rate for Payer: UHC Core |
$276.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.89
|
| Rate for Payer: UHC Exchange |
$82.89
|
| Rate for Payer: UHC Medicare Advantage |
$82.89
|
| Rate for Payer: VA VA |
$82.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.68
|
|
|
HC RECOVERY 3 ADD'L 15 MIN
|
Facility
|
IP
|
$102.17
|
|
| Hospital Charge Code |
71000024
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$66.41 |
| Max. Negotiated Rate |
$91.95 |
| Rate for Payer: Aetna Commercial |
$86.84
|
| Rate for Payer: BCBS Trust/PPO |
$83.40
|
| Rate for Payer: BCN Commercial |
$78.96
|
| Rate for Payer: Cash Price |
$81.74
|
| Rate for Payer: Cofinity Commercial |
$87.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.74
|
| Rate for Payer: Healthscope Commercial |
$91.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.84
|
| Rate for Payer: Nomi Health Commercial |
$83.78
|
| Rate for Payer: PHP Commercial |
$86.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.41
|
| Rate for Payer: Priority Health HMO/PPO |
$88.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.91
|
| Rate for Payer: UHC Core |
$85.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.63
|
|
|
HC RECOVERY 3 ADD'L 15 MIN
|
Facility
|
OP
|
$102.17
|
|
| Hospital Charge Code |
71000024
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$24.27 |
| Max. Negotiated Rate |
$91.95 |
| Rate for Payer: Aetna Commercial |
$86.84
|
| Rate for Payer: Aetna Medicare |
$26.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.93
|
| Rate for Payer: BCBS Complete |
$40.87
|
| Rate for Payer: BCBS MAPPO |
$25.54
|
| Rate for Payer: BCBS Trust/PPO |
$83.99
|
| Rate for Payer: BCN Commercial |
$79.44
|
| Rate for Payer: BCN Medicare Advantage |
$25.54
|
| Rate for Payer: Cash Price |
$81.74
|
| Rate for Payer: Cofinity Commercial |
$87.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.54
|
| Rate for Payer: Healthscope Commercial |
$91.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.84
|
| Rate for Payer: Nomi Health Commercial |
$83.78
|
| Rate for Payer: PACE Senior Care Partners |
$24.27
|
| Rate for Payer: PACE SWMI |
$25.54
|
| Rate for Payer: PHP Commercial |
$86.84
|
| Rate for Payer: PHP Medicare Advantage |
$25.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.41
|
| Rate for Payer: Priority Health HMO/PPO |
$88.89
|
| Rate for Payer: Priority Health Medicare |
$25.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.45
|
| Rate for Payer: Railroad Medicare Medicare |
$25.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.91
|
| Rate for Payer: UHC Core |
$85.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.54
|
| Rate for Payer: UHC Exchange |
$25.54
|
| Rate for Payer: UHC Medicare Advantage |
$25.54
|
| Rate for Payer: VA VA |
$25.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.63
|
|
|
HC RECOVERY 3 INIT 30 MIN
|
Facility
|
IP
|
$206.43
|
|
| Hospital Charge Code |
71000025
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$134.18 |
| Max. Negotiated Rate |
$185.79 |
| Rate for Payer: Aetna Commercial |
$175.47
|
| Rate for Payer: BCBS Trust/PPO |
$168.51
|
| Rate for Payer: BCN Commercial |
$159.53
|
| Rate for Payer: Cash Price |
$165.14
|
| Rate for Payer: Cofinity Commercial |
$177.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.14
|
| Rate for Payer: Healthscope Commercial |
$185.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.47
|
| Rate for Payer: Nomi Health Commercial |
$169.27
|
| Rate for Payer: PHP Commercial |
$175.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.18
|
| Rate for Payer: Priority Health HMO/PPO |
$179.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.66
|
| Rate for Payer: UHC Core |
$172.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.82
|
|
|
HC RECOVERY 3 INIT 30 MIN
|
Facility
|
OP
|
$206.43
|
|
| Hospital Charge Code |
71000025
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$49.03 |
| Max. Negotiated Rate |
$185.79 |
| Rate for Payer: Aetna Commercial |
$175.47
|
| Rate for Payer: Aetna Medicare |
$53.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.51
|
| Rate for Payer: BCBS Complete |
$82.57
|
| Rate for Payer: BCBS MAPPO |
$51.61
|
| Rate for Payer: BCBS Trust/PPO |
$169.71
|
| Rate for Payer: BCN Commercial |
$160.50
|
| Rate for Payer: BCN Medicare Advantage |
$51.61
|
| Rate for Payer: Cash Price |
$165.14
|
| Rate for Payer: Cofinity Commercial |
$177.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.61
|
| Rate for Payer: Healthscope Commercial |
$185.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.47
|
| Rate for Payer: Nomi Health Commercial |
$169.27
|
| Rate for Payer: PACE Senior Care Partners |
$49.03
|
| Rate for Payer: PACE SWMI |
$51.61
|
| Rate for Payer: PHP Commercial |
$175.47
|
| Rate for Payer: PHP Medicare Advantage |
$51.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.18
|
| Rate for Payer: Priority Health HMO/PPO |
$179.59
|
| Rate for Payer: Priority Health Medicare |
$52.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.31
|
| Rate for Payer: Railroad Medicare Medicare |
$51.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.66
|
| Rate for Payer: UHC Core |
$172.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.61
|
| Rate for Payer: UHC Exchange |
$51.61
|
| Rate for Payer: UHC Medicare Advantage |
$51.61
|
| Rate for Payer: VA VA |
$51.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.82
|
|
|
HC RECOVERY PHASE 1 COMPLEX BASE CHARGE
|
Facility
|
OP
|
$116.00
|
|
| Hospital Charge Code |
71000039
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$27.55 |
| Max. Negotiated Rate |
$104.40 |
| Rate for Payer: Aetna Commercial |
$98.60
|
| Rate for Payer: Aetna Medicare |
$30.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.25
|
| Rate for Payer: BCBS Complete |
$46.40
|
| Rate for Payer: BCBS MAPPO |
$29.00
|
| Rate for Payer: BCBS Trust/PPO |
$95.36
|
| Rate for Payer: BCN Commercial |
$90.19
|
| Rate for Payer: BCN Medicare Advantage |
$29.00
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cofinity Commercial |
$99.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.00
|
| Rate for Payer: Healthscope Commercial |
$104.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.60
|
| Rate for Payer: Nomi Health Commercial |
$95.12
|
| Rate for Payer: PACE Senior Care Partners |
$27.55
|
| Rate for Payer: PACE SWMI |
$29.00
|
| Rate for Payer: PHP Commercial |
$98.60
|
| Rate for Payer: PHP Medicare Advantage |
$29.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.40
|
| Rate for Payer: Priority Health HMO/PPO |
$100.92
|
| Rate for Payer: Priority Health Medicare |
$29.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.72
|
| Rate for Payer: Railroad Medicare Medicare |
$29.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.08
|
| Rate for Payer: UHC Core |
$96.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.00
|
| Rate for Payer: UHC Exchange |
$29.00
|
| Rate for Payer: UHC Medicare Advantage |
$29.00
|
| Rate for Payer: VA VA |
$29.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.00
|
|
|
HC RECOVERY PHASE 1 COMPLEX BASE CHARGE
|
Facility
|
IP
|
$116.00
|
|
| Hospital Charge Code |
71000039
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$104.40 |
| Rate for Payer: Aetna Commercial |
$98.60
|
| Rate for Payer: BCBS Trust/PPO |
$94.69
|
| Rate for Payer: BCN Commercial |
$89.64
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cofinity Commercial |
$99.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.80
|
| Rate for Payer: Healthscope Commercial |
$104.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.60
|
| Rate for Payer: Nomi Health Commercial |
$95.12
|
| Rate for Payer: PHP Commercial |
$98.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.40
|
| Rate for Payer: Priority Health HMO/PPO |
$100.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.08
|
| Rate for Payer: UHC Core |
$96.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.00
|
|
|
HC RECOVERY PHASE 1 COMPLEX EA MIN CHARGE
|
Facility
|
OP
|
$15.00
|
|
| Hospital Charge Code |
71000034
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Aetna Commercial |
$12.75
|
| Rate for Payer: Aetna Medicare |
$3.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.69
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS MAPPO |
$3.75
|
| Rate for Payer: BCBS Trust/PPO |
$12.33
|
| Rate for Payer: BCN Commercial |
$11.66
|
| Rate for Payer: BCN Medicare Advantage |
$3.75
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$12.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.75
|
| Rate for Payer: Healthscope Commercial |
$13.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.75
|
| Rate for Payer: Nomi Health Commercial |
$12.30
|
| Rate for Payer: PACE Senior Care Partners |
$3.56
|
| Rate for Payer: PACE SWMI |
$3.75
|
| Rate for Payer: PHP Commercial |
$12.75
|
| Rate for Payer: PHP Medicare Advantage |
$3.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
| Rate for Payer: Priority Health HMO/PPO |
$13.05
|
| Rate for Payer: Priority Health Medicare |
$3.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.20
|
| Rate for Payer: UHC Core |
$12.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.75
|
| Rate for Payer: UHC Exchange |
$3.75
|
| Rate for Payer: UHC Medicare Advantage |
$3.75
|
| Rate for Payer: VA VA |
$3.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.25
|
|
|
HC RECOVERY PHASE 1 COMPLEX EA MIN CHARGE
|
Facility
|
IP
|
$15.00
|
|
| Hospital Charge Code |
71000034
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Aetna Commercial |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$12.24
|
| Rate for Payer: BCN Commercial |
$11.59
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$12.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.00
|
| Rate for Payer: Healthscope Commercial |
$13.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.75
|
| Rate for Payer: Nomi Health Commercial |
$12.30
|
| Rate for Payer: PHP Commercial |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
| Rate for Payer: Priority Health HMO/PPO |
$13.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.20
|
| Rate for Payer: UHC Core |
$12.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.25
|
|
|
HC RECOVERY PHASE 1 STANDARD BASE CHARGE
|
Facility
|
IP
|
$97.00
|
|
| Hospital Charge Code |
71000035
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$63.05 |
| Max. Negotiated Rate |
$87.30 |
| Rate for Payer: Aetna Commercial |
$82.45
|
| Rate for Payer: BCBS Trust/PPO |
$79.18
|
| Rate for Payer: BCN Commercial |
$74.96
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$83.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.60
|
| Rate for Payer: Healthscope Commercial |
$87.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.45
|
| Rate for Payer: Nomi Health Commercial |
$79.54
|
| Rate for Payer: PHP Commercial |
$82.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health HMO/PPO |
$84.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.36
|
| Rate for Payer: UHC Core |
$81.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.75
|
|
|
HC RECOVERY PHASE 1 STANDARD BASE CHARGE
|
Facility
|
OP
|
$97.00
|
|
| Hospital Charge Code |
71000035
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$23.04 |
| Max. Negotiated Rate |
$87.30 |
| Rate for Payer: Aetna Commercial |
$82.45
|
| Rate for Payer: Aetna Medicare |
$25.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.31
|
| Rate for Payer: BCBS Complete |
$38.80
|
| Rate for Payer: BCBS MAPPO |
$24.25
|
| Rate for Payer: BCBS Trust/PPO |
$79.74
|
| Rate for Payer: BCN Commercial |
$75.42
|
| Rate for Payer: BCN Medicare Advantage |
$24.25
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$83.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.25
|
| Rate for Payer: Healthscope Commercial |
$87.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.45
|
| Rate for Payer: Nomi Health Commercial |
$79.54
|
| Rate for Payer: PACE Senior Care Partners |
$23.04
|
| Rate for Payer: PACE SWMI |
$24.25
|
| Rate for Payer: PHP Commercial |
$82.45
|
| Rate for Payer: PHP Medicare Advantage |
$24.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health HMO/PPO |
$84.39
|
| Rate for Payer: Priority Health Medicare |
$24.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.99
|
| Rate for Payer: Railroad Medicare Medicare |
$24.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.36
|
| Rate for Payer: UHC Core |
$81.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.25
|
| Rate for Payer: UHC Exchange |
$24.25
|
| Rate for Payer: UHC Medicare Advantage |
$24.25
|
| Rate for Payer: VA VA |
$24.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.75
|
|
|
HC RECOVERY PHASE 1 STANDARD EA MIN CHARGE
|
Facility
|
OP
|
$12.00
|
|
| Hospital Charge Code |
71000036
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$2.85 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Aetna Commercial |
$10.20
|
| Rate for Payer: Aetna Medicare |
$3.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.75
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: BCBS MAPPO |
$3.00
|
| Rate for Payer: BCBS Trust/PPO |
$9.87
|
| Rate for Payer: BCN Commercial |
$9.33
|
| Rate for Payer: BCN Medicare Advantage |
$3.00
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$10.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.00
|
| Rate for Payer: Healthscope Commercial |
$10.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.20
|
| Rate for Payer: Nomi Health Commercial |
$9.84
|
| Rate for Payer: PACE Senior Care Partners |
$2.85
|
| Rate for Payer: PACE SWMI |
$3.00
|
| Rate for Payer: PHP Commercial |
$10.20
|
| Rate for Payer: PHP Medicare Advantage |
$3.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.80
|
| Rate for Payer: Priority Health HMO/PPO |
$10.44
|
| Rate for Payer: Priority Health Medicare |
$3.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.04
|
| Rate for Payer: Railroad Medicare Medicare |
$3.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.56
|
| Rate for Payer: UHC Core |
$10.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.00
|
| Rate for Payer: UHC Exchange |
$3.00
|
| Rate for Payer: UHC Medicare Advantage |
$3.00
|
| Rate for Payer: VA VA |
$3.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.00
|
|
|
HC RECOVERY PHASE 1 STANDARD EA MIN CHARGE
|
Facility
|
IP
|
$12.00
|
|
| Hospital Charge Code |
71000036
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Aetna Commercial |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$9.80
|
| Rate for Payer: BCN Commercial |
$9.27
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$10.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.60
|
| Rate for Payer: Healthscope Commercial |
$10.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.20
|
| Rate for Payer: Nomi Health Commercial |
$9.84
|
| Rate for Payer: PHP Commercial |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.80
|
| Rate for Payer: Priority Health HMO/PPO |
$10.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.56
|
| Rate for Payer: UHC Core |
$10.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.00
|
|
|
HC RECOVERY PHASE 2 EA MIN CHARGE
|
Facility
|
IP
|
$9.00
|
|
| Hospital Charge Code |
71000037
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$5.85 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna Commercial |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$7.35
|
| Rate for Payer: BCN Commercial |
$6.96
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$7.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.20
|
| Rate for Payer: Healthscope Commercial |
$8.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.65
|
| Rate for Payer: Nomi Health Commercial |
$7.38
|
| Rate for Payer: PHP Commercial |
$7.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.85
|
| Rate for Payer: Priority Health HMO/PPO |
$7.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.92
|
| Rate for Payer: UHC Core |
$7.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.75
|
|
|
HC RECOVERY PHASE 2 EA MIN CHARGE
|
Facility
|
OP
|
$9.00
|
|
| Hospital Charge Code |
71000037
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$2.14 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna Commercial |
$7.65
|
| Rate for Payer: Aetna Medicare |
$2.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.81
|
| Rate for Payer: BCBS Complete |
$3.60
|
| Rate for Payer: BCBS MAPPO |
$2.25
|
| Rate for Payer: BCBS Trust/PPO |
$7.40
|
| Rate for Payer: BCN Commercial |
$7.00
|
| Rate for Payer: BCN Medicare Advantage |
$2.25
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$7.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.25
|
| Rate for Payer: Healthscope Commercial |
$8.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.65
|
| Rate for Payer: Nomi Health Commercial |
$7.38
|
| Rate for Payer: PACE Senior Care Partners |
$2.14
|
| Rate for Payer: PACE SWMI |
$2.25
|
| Rate for Payer: PHP Commercial |
$7.65
|
| Rate for Payer: PHP Medicare Advantage |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.85
|
| Rate for Payer: Priority Health HMO/PPO |
$7.83
|
| Rate for Payer: Priority Health Medicare |
$2.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.03
|
| Rate for Payer: Railroad Medicare Medicare |
$2.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.92
|
| Rate for Payer: UHC Core |
$7.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.25
|
| Rate for Payer: UHC Exchange |
$2.25
|
| Rate for Payer: UHC Medicare Advantage |
$2.25
|
| Rate for Payer: VA VA |
$2.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.75
|
|
|
HC RED CEDAR IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200099
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC RED CEDAR IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200099
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC RED CELL GENO MI BLD
|
Facility
|
IP
|
$302.94
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
31000135
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$196.91 |
| Max. Negotiated Rate |
$272.65 |
| Rate for Payer: Aetna Commercial |
$257.50
|
| Rate for Payer: BCBS Trust/PPO |
$247.29
|
| Rate for Payer: BCN Commercial |
$234.11
|
| Rate for Payer: Cash Price |
$242.35
|
| Rate for Payer: Cofinity Commercial |
$260.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.35
|
| Rate for Payer: Healthscope Commercial |
$272.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.50
|
| Rate for Payer: Nomi Health Commercial |
$248.41
|
| Rate for Payer: PHP Commercial |
$257.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.91
|
| Rate for Payer: Priority Health HMO/PPO |
$263.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$202.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.59
|
| Rate for Payer: UHC Core |
$252.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.20
|
|
|
HC RED CELL GENO MI BLD
|
Facility
|
OP
|
$302.94
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
31000135
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$71.95 |
| Max. Negotiated Rate |
$272.65 |
| Rate for Payer: Aetna Commercial |
$257.50
|
| Rate for Payer: Aetna Medicare |
$78.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.67
|
| Rate for Payer: BCBS Complete |
$140.60
|
| Rate for Payer: BCBS MAPPO |
$75.74
|
| Rate for Payer: BCBS Trust/PPO |
$249.05
|
| Rate for Payer: BCN Commercial |
$235.54
|
| Rate for Payer: BCN Medicare Advantage |
$75.74
|
| Rate for Payer: Cash Price |
$242.35
|
| Rate for Payer: Cash Price |
$242.35
|
| Rate for Payer: Cofinity Commercial |
$260.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.74
|
| Rate for Payer: Healthscope Commercial |
$272.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.20
|
| Rate for Payer: Mclaren Medicaid |
$133.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.52
|
| Rate for Payer: Meridian Medicaid |
$140.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.50
|
| Rate for Payer: Nomi Health Commercial |
$248.41
|
| Rate for Payer: PACE Senior Care Partners |
$71.95
|
| Rate for Payer: PACE SWMI |
$75.74
|
| Rate for Payer: PHP Commercial |
$257.50
|
| Rate for Payer: PHP Medicare Advantage |
$75.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.91
|
| Rate for Payer: Priority Health HMO/PPO |
$263.56
|
| Rate for Payer: Priority Health Medicare |
$76.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$202.97
|
| Rate for Payer: Railroad Medicare Medicare |
$75.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.59
|
| Rate for Payer: UHC Core |
$252.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.74
|
| Rate for Payer: UHC Exchange |
$75.74
|
| Rate for Payer: UHC Medicare Advantage |
$75.74
|
| Rate for Payer: UHCCP Medicaid |
$133.90
|
| Rate for Payer: VA VA |
$75.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.20
|
|
|
HC RED CELL GENO MI BLD CMPT
|
Facility
|
OP
|
$218.10
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
31000136
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$51.80 |
| Max. Negotiated Rate |
$196.29 |
| Rate for Payer: Aetna Commercial |
$185.38
|
| Rate for Payer: Aetna Medicare |
$56.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.16
|
| Rate for Payer: BCBS Complete |
$87.24
|
| Rate for Payer: BCBS MAPPO |
$54.52
|
| Rate for Payer: BCBS Trust/PPO |
$179.30
|
| Rate for Payer: BCN Commercial |
$169.57
|
| Rate for Payer: BCN Medicare Advantage |
$54.52
|
| Rate for Payer: Cash Price |
$174.48
|
| Rate for Payer: Cofinity Commercial |
$187.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.52
|
| Rate for Payer: Healthscope Commercial |
$196.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.38
|
| Rate for Payer: Nomi Health Commercial |
$178.84
|
| Rate for Payer: PACE Senior Care Partners |
$51.80
|
| Rate for Payer: PACE SWMI |
$54.52
|
| Rate for Payer: PHP Commercial |
$185.38
|
| Rate for Payer: PHP Medicare Advantage |
$54.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.76
|
| Rate for Payer: Priority Health HMO/PPO |
$189.75
|
| Rate for Payer: Priority Health Medicare |
$55.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.13
|
| Rate for Payer: Railroad Medicare Medicare |
$54.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.93
|
| Rate for Payer: UHC Core |
$182.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.52
|
| Rate for Payer: UHC Exchange |
$54.52
|
| Rate for Payer: UHC Medicare Advantage |
$54.52
|
| Rate for Payer: VA VA |
$54.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.58
|
|
|
HC RED CELL GENO MI BLD CMPT
|
Facility
|
IP
|
$218.10
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
31000136
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$141.76 |
| Max. Negotiated Rate |
$196.29 |
| Rate for Payer: Aetna Commercial |
$185.38
|
| Rate for Payer: BCBS Trust/PPO |
$178.04
|
| Rate for Payer: BCN Commercial |
$168.55
|
| Rate for Payer: Cash Price |
$174.48
|
| Rate for Payer: Cofinity Commercial |
$187.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.48
|
| Rate for Payer: Healthscope Commercial |
$196.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.38
|
| Rate for Payer: Nomi Health Commercial |
$178.84
|
| Rate for Payer: PHP Commercial |
$185.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.76
|
| Rate for Payer: Priority Health HMO/PPO |
$189.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.93
|
| Rate for Payer: UHC Core |
$182.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.58
|
|
