|
HC SP Z ANGIO SUPERSEL ECT RENAL BIL
|
Facility
|
IP
|
$3,926.47
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
36100350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,732.82 |
| Max. Negotiated Rate |
$3,533.82 |
| Rate for Payer: Aetna Commercial |
$3,337.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,242.87
|
| Rate for Payer: BCN Commercial |
$3,242.87
|
| Rate for Payer: Cash Price |
$3,141.18
|
| Rate for Payer: Cofinity Commercial |
$3,376.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,141.18
|
| Rate for Payer: Healthscope Commercial |
$3,533.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,944.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,337.50
|
| Rate for Payer: Nomi Health Commercial |
$3,219.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,944.85
|
| Rate for Payer: PHP Commercial |
$3,337.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,416.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,732.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,455.29
|
| Rate for Payer: UHC Core |
$3,278.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,944.85
|
|
|
HC SP Z ANGIO SUPERSEL ECT RENAL BIL
|
Facility
|
OP
|
$3,926.47
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
36100350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$692.24 |
| Max. Negotiated Rate |
$3,533.82 |
| Rate for Payer: Aetna Commercial |
$3,337.50
|
| Rate for Payer: Aetna Medicare |
$1,020.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,227.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,227.02
|
| Rate for Payer: BCBS Complete |
$726.79
|
| Rate for Payer: BCBS MAPPO |
$981.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,227.95
|
| Rate for Payer: BCN Commercial |
$3,227.95
|
| Rate for Payer: BCN Medicare Advantage |
$981.62
|
| Rate for Payer: Cash Price |
$3,141.18
|
| Rate for Payer: Cofinity Commercial |
$3,376.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,141.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$981.62
|
| Rate for Payer: Healthscope Commercial |
$3,533.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,944.85
|
| Rate for Payer: Mclaren Medicaid |
$692.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,030.70
|
| Rate for Payer: Meridian Medicaid |
$726.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,128.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,079.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,337.50
|
| Rate for Payer: Nomi Health Commercial |
$3,219.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,944.85
|
| Rate for Payer: PACE Senior Care Partners |
$932.54
|
| Rate for Payer: PACE SWMI |
$981.62
|
| Rate for Payer: PHP Commercial |
$3,337.50
|
| Rate for Payer: PHP Medicare Advantage |
$981.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,416.03
|
| Rate for Payer: Priority Health Medicare |
$991.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,732.82
|
| Rate for Payer: Railroad Medicare Medicare |
$981.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,455.29
|
| Rate for Payer: UHC Core |
$3,278.60
|
| Rate for Payer: UHC Exchange |
$981.62
|
| Rate for Payer: UHC Medicaid |
$692.24
|
| Rate for Payer: UHC Medicare Advantage |
$981.62
|
| Rate for Payer: UHCCP Medicaid |
$692.24
|
| Rate for Payer: VA VA |
$981.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,944.85
|
|
|
HC SP Z ANGIO SUPERSELECT RENAL UNI
|
Facility
|
OP
|
$3,926.47
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
36100349
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$692.24 |
| Max. Negotiated Rate |
$3,533.82 |
| Rate for Payer: Aetna Commercial |
$3,337.50
|
| Rate for Payer: Aetna Medicare |
$1,020.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,227.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,227.02
|
| Rate for Payer: BCBS Complete |
$726.79
|
| Rate for Payer: BCBS MAPPO |
$981.62
|
| Rate for Payer: BCBS Trust/PPO |
$3,227.95
|
| Rate for Payer: BCN Commercial |
$3,227.95
|
| Rate for Payer: BCN Medicare Advantage |
$981.62
|
| Rate for Payer: Cash Price |
$3,141.18
|
| Rate for Payer: Cofinity Commercial |
$3,376.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,141.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$981.62
|
| Rate for Payer: Healthscope Commercial |
$3,533.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,944.85
|
| Rate for Payer: Mclaren Medicaid |
$692.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,030.70
|
| Rate for Payer: Meridian Medicaid |
$726.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,128.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,079.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,337.50
|
| Rate for Payer: Nomi Health Commercial |
$3,219.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,944.85
|
| Rate for Payer: PACE Senior Care Partners |
$932.54
|
| Rate for Payer: PACE SWMI |
$981.62
|
| Rate for Payer: PHP Commercial |
$3,337.50
|
| Rate for Payer: PHP Medicare Advantage |
$981.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$692.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,416.03
|
| Rate for Payer: Priority Health Medicare |
$991.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,732.82
|
| Rate for Payer: Railroad Medicare Medicare |
$981.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,455.29
|
| Rate for Payer: UHC Core |
$3,278.60
|
| Rate for Payer: UHC Exchange |
$981.62
|
| Rate for Payer: UHC Medicaid |
$692.24
|
| Rate for Payer: UHC Medicare Advantage |
$981.62
|
| Rate for Payer: UHCCP Medicaid |
$692.24
|
| Rate for Payer: VA VA |
$981.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,944.85
|
|
|
HC SP Z ANGIO SUPERSELECT RENAL UNI
|
Facility
|
IP
|
$3,926.47
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
36100349
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,732.82 |
| Max. Negotiated Rate |
$3,533.82 |
| Rate for Payer: Aetna Commercial |
$3,337.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,242.87
|
| Rate for Payer: BCN Commercial |
$3,242.87
|
| Rate for Payer: Cash Price |
$3,141.18
|
| Rate for Payer: Cofinity Commercial |
$3,376.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,141.18
|
| Rate for Payer: Healthscope Commercial |
$3,533.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,944.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,337.50
|
| Rate for Payer: Nomi Health Commercial |
$3,219.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,944.85
|
| Rate for Payer: PHP Commercial |
$3,337.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,416.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,732.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,455.29
|
| Rate for Payer: UHC Core |
$3,278.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,944.85
|
|
|
HC SP Z EMBOLIZATION COIL BODY
|
Facility
|
IP
|
$422.82
|
|
| Hospital Charge Code |
27800058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.28 |
| Max. Negotiated Rate |
$380.54 |
| Rate for Payer: Aetna Commercial |
$359.40
|
| Rate for Payer: BCBS Trust/PPO |
$349.21
|
| Rate for Payer: BCN Commercial |
$349.21
|
| Rate for Payer: Cash Price |
$338.26
|
| Rate for Payer: Cofinity Commercial |
$363.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.26
|
| Rate for Payer: Healthscope Commercial |
$380.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.40
|
| Rate for Payer: Nomi Health Commercial |
$346.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$317.12
|
| Rate for Payer: PHP Commercial |
$359.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$367.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.08
|
| Rate for Payer: UHC Core |
$353.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.12
|
|
|
HC SP Z EMBOLIZATION COIL BODY
|
Facility
|
OP
|
$422.82
|
|
| Hospital Charge Code |
27800058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$74.54 |
| Max. Negotiated Rate |
$380.54 |
| Rate for Payer: Aetna Commercial |
$359.40
|
| Rate for Payer: Aetna Medicare |
$109.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$132.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$132.13
|
| Rate for Payer: BCBS Complete |
$78.26
|
| Rate for Payer: BCBS MAPPO |
$105.70
|
| Rate for Payer: BCBS Trust/PPO |
$347.60
|
| Rate for Payer: BCN Commercial |
$347.60
|
| Rate for Payer: BCN Medicare Advantage |
$105.70
|
| Rate for Payer: Cash Price |
$338.26
|
| Rate for Payer: Cofinity Commercial |
$363.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.70
|
| Rate for Payer: Healthscope Commercial |
$380.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.12
|
| Rate for Payer: Mclaren Medicaid |
$74.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.99
|
| Rate for Payer: Meridian Medicaid |
$78.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$116.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.40
|
| Rate for Payer: Nomi Health Commercial |
$346.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$317.12
|
| Rate for Payer: PACE Senior Care Partners |
$100.42
|
| Rate for Payer: PACE SWMI |
$105.70
|
| Rate for Payer: PHP Commercial |
$359.40
|
| Rate for Payer: PHP Medicare Advantage |
$105.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$367.85
|
| Rate for Payer: Priority Health Medicare |
$106.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$294.28
|
| Rate for Payer: Railroad Medicare Medicare |
$105.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$372.08
|
| Rate for Payer: UHC Core |
$353.05
|
| Rate for Payer: UHC Exchange |
$105.70
|
| Rate for Payer: UHC Medicaid |
$74.54
|
| Rate for Payer: UHC Medicare Advantage |
$105.70
|
| Rate for Payer: UHCCP Medicaid |
$74.54
|
| Rate for Payer: VA VA |
$105.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.12
|
|
|
HC SP Z EMBOLIZATION SPHERES
|
Facility
|
OP
|
$1,044.59
|
|
| Hospital Charge Code |
27800057
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$184.16 |
| Max. Negotiated Rate |
$940.13 |
| Rate for Payer: Aetna Commercial |
$887.90
|
| Rate for Payer: Aetna Medicare |
$271.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$326.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$326.43
|
| Rate for Payer: BCBS Complete |
$193.35
|
| Rate for Payer: BCBS MAPPO |
$261.15
|
| Rate for Payer: BCBS Trust/PPO |
$858.76
|
| Rate for Payer: BCN Commercial |
$858.76
|
| Rate for Payer: BCN Medicare Advantage |
$261.15
|
| Rate for Payer: Cash Price |
$835.67
|
| Rate for Payer: Cofinity Commercial |
$898.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$261.15
|
| Rate for Payer: Healthscope Commercial |
$940.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$783.44
|
| Rate for Payer: Mclaren Medicaid |
$184.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$274.20
|
| Rate for Payer: Meridian Medicaid |
$193.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$300.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$287.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$887.90
|
| Rate for Payer: Nomi Health Commercial |
$856.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$783.44
|
| Rate for Payer: PACE Senior Care Partners |
$248.09
|
| Rate for Payer: PACE SWMI |
$261.15
|
| Rate for Payer: PHP Commercial |
$887.90
|
| Rate for Payer: PHP Medicare Advantage |
$261.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$184.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$908.79
|
| Rate for Payer: Priority Health Medicare |
$263.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$727.03
|
| Rate for Payer: Railroad Medicare Medicare |
$261.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$919.24
|
| Rate for Payer: UHC Core |
$872.23
|
| Rate for Payer: UHC Exchange |
$261.15
|
| Rate for Payer: UHC Medicaid |
$184.16
|
| Rate for Payer: UHC Medicare Advantage |
$261.15
|
| Rate for Payer: UHCCP Medicaid |
$184.16
|
| Rate for Payer: VA VA |
$261.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$783.44
|
|
|
HC SP Z EMBOLIZATION SPHERES
|
Facility
|
IP
|
$1,044.59
|
|
| Hospital Charge Code |
27800057
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$727.03 |
| Max. Negotiated Rate |
$940.13 |
| Rate for Payer: Aetna Commercial |
$887.90
|
| Rate for Payer: BCBS Trust/PPO |
$862.73
|
| Rate for Payer: BCN Commercial |
$862.73
|
| Rate for Payer: Cash Price |
$835.67
|
| Rate for Payer: Cofinity Commercial |
$898.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.67
|
| Rate for Payer: Healthscope Commercial |
$940.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$783.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$887.90
|
| Rate for Payer: Nomi Health Commercial |
$856.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$783.44
|
| Rate for Payer: PHP Commercial |
$887.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$908.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$727.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$919.24
|
| Rate for Payer: UHC Core |
$872.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$783.44
|
|
|
HC SP Z SEL CATH SEG SUBSEG PULM ART
|
Facility
|
OP
|
$1,303.18
|
|
|
Service Code
|
CPT 36015
|
| Hospital Charge Code |
36100318
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$229.75 |
| Max. Negotiated Rate |
$1,172.86 |
| Rate for Payer: Aetna Commercial |
$1,107.70
|
| Rate for Payer: Aetna Medicare |
$338.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$407.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$407.24
|
| Rate for Payer: BCBS Complete |
$241.22
|
| Rate for Payer: BCBS MAPPO |
$325.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,071.34
|
| Rate for Payer: BCN Commercial |
$1,071.34
|
| Rate for Payer: BCN Medicare Advantage |
$325.80
|
| Rate for Payer: Cash Price |
$1,042.54
|
| Rate for Payer: Cofinity Commercial |
$1,120.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,042.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$325.80
|
| Rate for Payer: Healthscope Commercial |
$1,172.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$977.38
|
| Rate for Payer: Mclaren Medicaid |
$229.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$342.08
|
| Rate for Payer: Meridian Medicaid |
$241.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$374.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$358.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,107.70
|
| Rate for Payer: Nomi Health Commercial |
$1,068.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$977.38
|
| Rate for Payer: PACE Senior Care Partners |
$309.51
|
| Rate for Payer: PACE SWMI |
$325.80
|
| Rate for Payer: PHP Commercial |
$1,107.70
|
| Rate for Payer: PHP Medicare Advantage |
$325.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,133.77
|
| Rate for Payer: Priority Health Medicare |
$329.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$907.01
|
| Rate for Payer: Railroad Medicare Medicare |
$325.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,146.80
|
| Rate for Payer: UHC Core |
$1,088.16
|
| Rate for Payer: UHC Exchange |
$325.80
|
| Rate for Payer: UHC Medicaid |
$229.75
|
| Rate for Payer: UHC Medicare Advantage |
$325.80
|
| Rate for Payer: UHCCP Medicaid |
$229.75
|
| Rate for Payer: VA VA |
$325.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$977.38
|
|
|
HC SP Z SEL CATH SEG SUBSEG PULM ART
|
Facility
|
IP
|
$1,303.18
|
|
|
Service Code
|
CPT 36015
|
| Hospital Charge Code |
36100318
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$907.01 |
| Max. Negotiated Rate |
$1,172.86 |
| Rate for Payer: Aetna Commercial |
$1,107.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,076.30
|
| Rate for Payer: BCN Commercial |
$1,076.30
|
| Rate for Payer: Cash Price |
$1,042.54
|
| Rate for Payer: Cofinity Commercial |
$1,120.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,042.54
|
| Rate for Payer: Healthscope Commercial |
$1,172.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$977.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,107.70
|
| Rate for Payer: Nomi Health Commercial |
$1,068.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$977.38
|
| Rate for Payer: PHP Commercial |
$1,107.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,133.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$907.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,146.80
|
| Rate for Payer: UHC Core |
$1,088.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$977.38
|
|
|
HC SP Z TRUE FILL
|
Facility
|
IP
|
$6,892.15
|
|
| Hospital Charge Code |
27800059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,796.94 |
| Max. Negotiated Rate |
$6,202.94 |
| Rate for Payer: Aetna Commercial |
$5,858.33
|
| Rate for Payer: BCBS Trust/PPO |
$5,692.23
|
| Rate for Payer: BCN Commercial |
$5,692.23
|
| Rate for Payer: Cash Price |
$5,513.72
|
| Rate for Payer: Cofinity Commercial |
$5,927.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,513.72
|
| Rate for Payer: Healthscope Commercial |
$6,202.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,169.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,858.33
|
| Rate for Payer: Nomi Health Commercial |
$5,651.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,169.11
|
| Rate for Payer: PHP Commercial |
$5,858.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,996.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,796.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,065.09
|
| Rate for Payer: UHC Core |
$5,754.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,169.11
|
|
|
HC SP Z TRUE FILL
|
Facility
|
OP
|
$6,892.15
|
|
| Hospital Charge Code |
27800059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,215.09 |
| Max. Negotiated Rate |
$6,202.94 |
| Rate for Payer: Aetna Commercial |
$5,858.33
|
| Rate for Payer: Aetna Medicare |
$1,791.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,153.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,153.80
|
| Rate for Payer: BCBS Complete |
$1,275.74
|
| Rate for Payer: BCBS MAPPO |
$1,723.04
|
| Rate for Payer: BCBS Trust/PPO |
$5,666.04
|
| Rate for Payer: BCN Commercial |
$5,666.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,723.04
|
| Rate for Payer: Cash Price |
$5,513.72
|
| Rate for Payer: Cofinity Commercial |
$5,927.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,513.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,723.04
|
| Rate for Payer: Healthscope Commercial |
$6,202.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,169.11
|
| Rate for Payer: Mclaren Medicaid |
$1,215.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,809.19
|
| Rate for Payer: Meridian Medicaid |
$1,275.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,981.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,895.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,858.33
|
| Rate for Payer: Nomi Health Commercial |
$5,651.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,169.11
|
| Rate for Payer: PACE Senior Care Partners |
$1,636.89
|
| Rate for Payer: PACE SWMI |
$1,723.04
|
| Rate for Payer: PHP Commercial |
$5,858.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,723.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,215.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,996.17
|
| Rate for Payer: Priority Health Medicare |
$1,740.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,796.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,723.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,065.09
|
| Rate for Payer: UHC Core |
$5,754.95
|
| Rate for Payer: UHC Exchange |
$1,723.04
|
| Rate for Payer: UHC Medicaid |
$1,215.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,723.04
|
| Rate for Payer: UHCCP Medicaid |
$1,215.09
|
| Rate for Payer: VA VA |
$1,723.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,169.11
|
|
|
HC SQ ICD
|
Facility
|
OP
|
$57,546.60
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,145.47 |
| Max. Negotiated Rate |
$51,791.94 |
| Rate for Payer: Aetna Commercial |
$48,914.61
|
| Rate for Payer: Aetna Medicare |
$14,962.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,983.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,983.31
|
| Rate for Payer: BCBS Complete |
$10,651.88
|
| Rate for Payer: BCBS MAPPO |
$14,386.65
|
| Rate for Payer: BCBS Trust/PPO |
$47,309.06
|
| Rate for Payer: BCN Commercial |
$47,309.06
|
| Rate for Payer: BCN Medicare Advantage |
$14,386.65
|
| Rate for Payer: Cash Price |
$46,037.28
|
| Rate for Payer: Cofinity Commercial |
$49,490.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46,037.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,386.65
|
| Rate for Payer: Healthscope Commercial |
$51,791.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43,159.95
|
| Rate for Payer: Mclaren Medicaid |
$10,145.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15,105.98
|
| Rate for Payer: Meridian Medicaid |
$10,651.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,544.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$15,825.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48,914.61
|
| Rate for Payer: Nomi Health Commercial |
$47,188.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43,159.95
|
| Rate for Payer: PACE Senior Care Partners |
$13,667.32
|
| Rate for Payer: PACE SWMI |
$14,386.65
|
| Rate for Payer: PHP Commercial |
$48,914.61
|
| Rate for Payer: PHP Medicare Advantage |
$14,386.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,145.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50,065.54
|
| Rate for Payer: Priority Health Medicare |
$14,530.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40,052.43
|
| Rate for Payer: Railroad Medicare Medicare |
$14,386.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50,641.01
|
| Rate for Payer: UHC Core |
$48,051.41
|
| Rate for Payer: UHC Exchange |
$14,386.65
|
| Rate for Payer: UHC Medicaid |
$10,145.47
|
| Rate for Payer: UHC Medicare Advantage |
$14,386.65
|
| Rate for Payer: UHCCP Medicaid |
$10,145.47
|
| Rate for Payer: VA VA |
$14,386.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43,159.95
|
|
|
HC SQ ICD
|
Facility
|
IP
|
$57,546.60
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$40,052.43 |
| Max. Negotiated Rate |
$51,791.94 |
| Rate for Payer: Aetna Commercial |
$48,914.61
|
| Rate for Payer: BCBS Trust/PPO |
$47,527.74
|
| Rate for Payer: BCN Commercial |
$47,527.74
|
| Rate for Payer: Cash Price |
$46,037.28
|
| Rate for Payer: Cofinity Commercial |
$49,490.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46,037.28
|
| Rate for Payer: Healthscope Commercial |
$51,791.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43,159.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48,914.61
|
| Rate for Payer: Nomi Health Commercial |
$47,188.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43,159.95
|
| Rate for Payer: PHP Commercial |
$48,914.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50,065.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40,052.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50,641.01
|
| Rate for Payer: UHC Core |
$48,051.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43,159.95
|
|
|
HC SQ ICD LEAD
|
Facility
|
OP
|
$14,955.75
|
|
|
Service Code
|
HCPCS C1896
|
| Hospital Charge Code |
27800123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,636.70 |
| Max. Negotiated Rate |
$13,460.17 |
| Rate for Payer: Aetna Commercial |
$12,712.39
|
| Rate for Payer: Aetna Medicare |
$3,888.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,673.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,673.67
|
| Rate for Payer: BCBS Complete |
$2,768.31
|
| Rate for Payer: BCBS MAPPO |
$3,738.94
|
| Rate for Payer: BCBS Trust/PPO |
$12,295.12
|
| Rate for Payer: BCN Commercial |
$12,295.12
|
| Rate for Payer: BCN Medicare Advantage |
$3,738.94
|
| Rate for Payer: Cash Price |
$11,964.60
|
| Rate for Payer: Cofinity Commercial |
$12,861.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,964.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,738.94
|
| Rate for Payer: Healthscope Commercial |
$13,460.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,216.81
|
| Rate for Payer: Mclaren Medicaid |
$2,636.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,925.88
|
| Rate for Payer: Meridian Medicaid |
$2,768.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,299.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,112.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,712.39
|
| Rate for Payer: Nomi Health Commercial |
$12,263.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,216.81
|
| Rate for Payer: PACE Senior Care Partners |
$3,551.99
|
| Rate for Payer: PACE SWMI |
$3,738.94
|
| Rate for Payer: PHP Commercial |
$12,712.39
|
| Rate for Payer: PHP Medicare Advantage |
$3,738.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,636.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13,011.50
|
| Rate for Payer: Priority Health Medicare |
$3,776.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,409.20
|
| Rate for Payer: Railroad Medicare Medicare |
$3,738.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,161.06
|
| Rate for Payer: UHC Core |
$12,488.05
|
| Rate for Payer: UHC Exchange |
$3,738.94
|
| Rate for Payer: UHC Medicaid |
$2,636.70
|
| Rate for Payer: UHC Medicare Advantage |
$3,738.94
|
| Rate for Payer: UHCCP Medicaid |
$2,636.70
|
| Rate for Payer: VA VA |
$3,738.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,216.81
|
|
|
HC SQ ICD LEAD
|
Facility
|
IP
|
$14,955.75
|
|
|
Service Code
|
HCPCS C1896
|
| Hospital Charge Code |
27800123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10,409.20 |
| Max. Negotiated Rate |
$13,460.17 |
| Rate for Payer: Aetna Commercial |
$12,712.39
|
| Rate for Payer: BCBS Trust/PPO |
$12,351.95
|
| Rate for Payer: BCN Commercial |
$12,351.95
|
| Rate for Payer: Cash Price |
$11,964.60
|
| Rate for Payer: Cofinity Commercial |
$12,861.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,964.60
|
| Rate for Payer: Healthscope Commercial |
$13,460.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,216.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,712.39
|
| Rate for Payer: Nomi Health Commercial |
$12,263.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,216.81
|
| Rate for Payer: PHP Commercial |
$12,712.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$13,011.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10,409.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,161.06
|
| Rate for Payer: UHC Core |
$12,488.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,216.81
|
|
|
HC SQ IM CHEMO HORMONAL
|
Facility
|
IP
|
$251.44
|
|
|
Service Code
|
CPT 96402
|
| Hospital Charge Code |
33100002
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$226.30 |
| Rate for Payer: Aetna Commercial |
$213.72
|
| Rate for Payer: BCBS Trust/PPO |
$207.66
|
| Rate for Payer: BCN Commercial |
$207.66
|
| Rate for Payer: Cash Price |
$201.15
|
| Rate for Payer: Cofinity Commercial |
$216.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.15
|
| Rate for Payer: Healthscope Commercial |
$226.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.72
|
| Rate for Payer: Nomi Health Commercial |
$206.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$188.58
|
| Rate for Payer: PHP Commercial |
$213.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$218.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.27
|
| Rate for Payer: UHC Core |
$209.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.58
|
|
|
HC SQ IM CHEMO HORMONAL
|
Facility
|
OP
|
$251.44
|
|
|
Service Code
|
CPT 96402
|
| Hospital Charge Code |
33100002
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$44.33 |
| Max. Negotiated Rate |
$226.30 |
| Rate for Payer: Aetna Commercial |
$213.72
|
| Rate for Payer: Aetna Medicare |
$65.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.58
|
| Rate for Payer: BCBS Complete |
$46.54
|
| Rate for Payer: BCBS MAPPO |
$62.86
|
| Rate for Payer: BCBS Trust/PPO |
$206.71
|
| Rate for Payer: BCN Commercial |
$206.71
|
| Rate for Payer: BCN Medicare Advantage |
$62.86
|
| Rate for Payer: Cash Price |
$201.15
|
| Rate for Payer: Cofinity Commercial |
$216.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.86
|
| Rate for Payer: Healthscope Commercial |
$226.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.58
|
| Rate for Payer: Mclaren Medicaid |
$44.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.00
|
| Rate for Payer: Meridian Medicaid |
$46.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.72
|
| Rate for Payer: Nomi Health Commercial |
$206.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$188.58
|
| Rate for Payer: PACE Senior Care Partners |
$59.72
|
| Rate for Payer: PACE SWMI |
$62.86
|
| Rate for Payer: PHP Commercial |
$213.72
|
| Rate for Payer: PHP Medicare Advantage |
$62.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$218.75
|
| Rate for Payer: Priority Health Medicare |
$63.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$175.00
|
| Rate for Payer: Railroad Medicare Medicare |
$62.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$221.27
|
| Rate for Payer: UHC Core |
$209.95
|
| Rate for Payer: UHC Exchange |
$62.86
|
| Rate for Payer: UHC Medicaid |
$44.33
|
| Rate for Payer: UHC Medicare Advantage |
$62.86
|
| Rate for Payer: UHCCP Medicaid |
$44.33
|
| Rate for Payer: VA VA |
$62.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.58
|
|
|
HC SQ IM CHEMO NON-HORMONAL
|
Facility
|
OP
|
$508.92
|
|
|
Service Code
|
CPT 96401
|
| Hospital Charge Code |
33100001
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$89.72 |
| Max. Negotiated Rate |
$458.03 |
| Rate for Payer: Aetna Commercial |
$432.58
|
| Rate for Payer: Aetna Medicare |
$132.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$159.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$159.04
|
| Rate for Payer: BCBS Complete |
$94.20
|
| Rate for Payer: BCBS MAPPO |
$127.23
|
| Rate for Payer: BCBS Trust/PPO |
$418.38
|
| Rate for Payer: BCN Commercial |
$418.38
|
| Rate for Payer: BCN Medicare Advantage |
$127.23
|
| Rate for Payer: Cash Price |
$407.14
|
| Rate for Payer: Cofinity Commercial |
$437.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$407.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.23
|
| Rate for Payer: Healthscope Commercial |
$458.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.69
|
| Rate for Payer: Mclaren Medicaid |
$89.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.59
|
| Rate for Payer: Meridian Medicaid |
$94.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.58
|
| Rate for Payer: Nomi Health Commercial |
$417.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.69
|
| Rate for Payer: PACE Senior Care Partners |
$120.87
|
| Rate for Payer: PACE SWMI |
$127.23
|
| Rate for Payer: PHP Commercial |
$432.58
|
| Rate for Payer: PHP Medicare Advantage |
$127.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$442.76
|
| Rate for Payer: Priority Health Medicare |
$128.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$354.21
|
| Rate for Payer: Railroad Medicare Medicare |
$127.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.85
|
| Rate for Payer: UHC Core |
$424.95
|
| Rate for Payer: UHC Exchange |
$127.23
|
| Rate for Payer: UHC Medicaid |
$89.72
|
| Rate for Payer: UHC Medicare Advantage |
$127.23
|
| Rate for Payer: UHCCP Medicaid |
$89.72
|
| Rate for Payer: VA VA |
$127.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.69
|
|
|
HC SQ IM CHEMO NON-HORMONAL
|
Facility
|
IP
|
$508.92
|
|
|
Service Code
|
CPT 96401
|
| Hospital Charge Code |
33100001
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$354.21 |
| Max. Negotiated Rate |
$458.03 |
| Rate for Payer: Aetna Commercial |
$432.58
|
| Rate for Payer: BCBS Trust/PPO |
$420.32
|
| Rate for Payer: BCN Commercial |
$420.32
|
| Rate for Payer: Cash Price |
$407.14
|
| Rate for Payer: Cofinity Commercial |
$437.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$407.14
|
| Rate for Payer: Healthscope Commercial |
$458.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.58
|
| Rate for Payer: Nomi Health Commercial |
$417.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.69
|
| Rate for Payer: PHP Commercial |
$432.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$442.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$354.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.85
|
| Rate for Payer: UHC Core |
$424.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.69
|
|
|
HC SQ OR IM INJECTION
|
Facility
|
OP
|
$152.79
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
51000003
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$26.94 |
| Max. Negotiated Rate |
$137.51 |
| Rate for Payer: Aetna Commercial |
$129.87
|
| Rate for Payer: Aetna Medicare |
$39.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.75
|
| Rate for Payer: BCBS Complete |
$28.28
|
| Rate for Payer: BCBS MAPPO |
$38.20
|
| Rate for Payer: BCBS Trust/PPO |
$125.61
|
| Rate for Payer: BCN Commercial |
$125.61
|
| Rate for Payer: BCN Medicare Advantage |
$38.20
|
| Rate for Payer: Cash Price |
$122.23
|
| Rate for Payer: Cofinity Commercial |
$131.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.20
|
| Rate for Payer: Healthscope Commercial |
$137.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.59
|
| Rate for Payer: Mclaren Medicaid |
$26.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.11
|
| Rate for Payer: Meridian Medicaid |
$28.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.87
|
| Rate for Payer: Nomi Health Commercial |
$125.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.59
|
| Rate for Payer: PACE Senior Care Partners |
$36.29
|
| Rate for Payer: PACE SWMI |
$38.20
|
| Rate for Payer: PHP Commercial |
$129.87
|
| Rate for Payer: PHP Medicare Advantage |
$38.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.93
|
| Rate for Payer: Priority Health Medicare |
$38.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.34
|
| Rate for Payer: Railroad Medicare Medicare |
$38.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.46
|
| Rate for Payer: UHC Core |
$127.58
|
| Rate for Payer: UHC Exchange |
$38.20
|
| Rate for Payer: UHC Medicaid |
$26.94
|
| Rate for Payer: UHC Medicare Advantage |
$38.20
|
| Rate for Payer: UHCCP Medicaid |
$26.94
|
| Rate for Payer: VA VA |
$38.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.59
|
|
|
HC SQ OR IM INJECTION
|
Facility
|
IP
|
$152.79
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
51000003
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$106.34 |
| Max. Negotiated Rate |
$137.51 |
| Rate for Payer: Aetna Commercial |
$129.87
|
| Rate for Payer: BCBS Trust/PPO |
$126.19
|
| Rate for Payer: BCN Commercial |
$126.19
|
| Rate for Payer: Cash Price |
$122.23
|
| Rate for Payer: Cofinity Commercial |
$131.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.23
|
| Rate for Payer: Healthscope Commercial |
$137.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.87
|
| Rate for Payer: Nomi Health Commercial |
$125.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.59
|
| Rate for Payer: PHP Commercial |
$129.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.46
|
| Rate for Payer: UHC Core |
$127.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.59
|
|
|
HC SRA, LMWH
|
Facility
|
IP
|
$339.59
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$236.35 |
| Max. Negotiated Rate |
$305.63 |
| Rate for Payer: Aetna Commercial |
$288.65
|
| Rate for Payer: BCBS Trust/PPO |
$280.47
|
| Rate for Payer: BCN Commercial |
$280.47
|
| Rate for Payer: Cash Price |
$271.67
|
| Rate for Payer: Cofinity Commercial |
$292.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.67
|
| Rate for Payer: Healthscope Commercial |
$305.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$254.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.65
|
| Rate for Payer: Nomi Health Commercial |
$278.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$254.69
|
| Rate for Payer: PHP Commercial |
$288.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$295.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$236.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.84
|
| Rate for Payer: UHC Core |
$283.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$254.69
|
|
|
HC SRA, LMWH
|
Facility
|
OP
|
$339.59
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$59.87 |
| Max. Negotiated Rate |
$305.63 |
| Rate for Payer: Aetna Commercial |
$288.65
|
| Rate for Payer: Aetna Medicare |
$88.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.12
|
| Rate for Payer: BCBS Complete |
$62.86
|
| Rate for Payer: BCBS MAPPO |
$84.90
|
| Rate for Payer: BCBS Trust/PPO |
$279.18
|
| Rate for Payer: BCN Commercial |
$279.18
|
| Rate for Payer: BCN Medicare Advantage |
$84.90
|
| Rate for Payer: Cash Price |
$271.67
|
| Rate for Payer: Cofinity Commercial |
$292.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$305.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$254.69
|
| Rate for Payer: Mclaren Medicaid |
$59.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.14
|
| Rate for Payer: Meridian Medicaid |
$62.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.65
|
| Rate for Payer: Nomi Health Commercial |
$278.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$254.69
|
| Rate for Payer: PACE Senior Care Partners |
$80.65
|
| Rate for Payer: PACE SWMI |
$84.90
|
| Rate for Payer: PHP Commercial |
$288.65
|
| Rate for Payer: PHP Medicare Advantage |
$84.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$295.44
|
| Rate for Payer: Priority Health Medicare |
$85.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$236.35
|
| Rate for Payer: Railroad Medicare Medicare |
$84.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.84
|
| Rate for Payer: UHC Core |
$283.56
|
| Rate for Payer: UHC Exchange |
$84.90
|
| Rate for Payer: UHC Medicaid |
$59.87
|
| Rate for Payer: UHC Medicare Advantage |
$84.90
|
| Rate for Payer: UHCCP Medicaid |
$59.87
|
| Rate for Payer: VA VA |
$84.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$254.69
|
|
|
HC SRS CRANIAL LESION LIN ACC
|
Facility
|
IP
|
$3,163.46
|
|
|
Service Code
|
CPT 77372
|
| Hospital Charge Code |
33300032
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,201.77 |
| Max. Negotiated Rate |
$2,847.11 |
| Rate for Payer: Aetna Commercial |
$2,688.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,612.70
|
| Rate for Payer: BCN Commercial |
$2,612.70
|
| Rate for Payer: Cash Price |
$2,530.77
|
| Rate for Payer: Cofinity Commercial |
$2,720.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,530.77
|
| Rate for Payer: Healthscope Commercial |
$2,847.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,372.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,688.94
|
| Rate for Payer: Nomi Health Commercial |
$2,594.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,372.59
|
| Rate for Payer: PHP Commercial |
$2,688.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,752.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,201.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,783.84
|
| Rate for Payer: UHC Core |
$2,641.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,372.59
|
|
