|
HC SRS CRANIAL LESION LIN ACC
|
Facility
|
OP
|
$3,163.46
|
|
|
Service Code
|
CPT 77372
|
| Hospital Charge Code |
33300032
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$557.72 |
| Max. Negotiated Rate |
$2,847.11 |
| Rate for Payer: Aetna Commercial |
$2,688.94
|
| Rate for Payer: Aetna Medicare |
$822.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$988.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$988.58
|
| Rate for Payer: BCBS Complete |
$585.56
|
| Rate for Payer: BCBS MAPPO |
$790.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,600.68
|
| Rate for Payer: BCN Commercial |
$2,600.68
|
| Rate for Payer: BCN Medicare Advantage |
$790.87
|
| 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: Health Alliance Plan Medicare Advantage |
$790.87
|
| Rate for Payer: Healthscope Commercial |
$2,847.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,372.59
|
| Rate for Payer: Mclaren Medicaid |
$557.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$830.41
|
| Rate for Payer: Meridian Medicaid |
$585.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$909.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$869.95
|
| 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: PACE Senior Care Partners |
$751.32
|
| Rate for Payer: PACE SWMI |
$790.87
|
| Rate for Payer: PHP Commercial |
$2,688.94
|
| Rate for Payer: PHP Medicare Advantage |
$790.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$557.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,752.21
|
| Rate for Payer: Priority Health Medicare |
$798.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,201.77
|
| Rate for Payer: Railroad Medicare Medicare |
$790.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,783.84
|
| Rate for Payer: UHC Core |
$2,641.49
|
| Rate for Payer: UHC Exchange |
$790.87
|
| Rate for Payer: UHC Medicaid |
$557.72
|
| Rate for Payer: UHC Medicare Advantage |
$790.87
|
| Rate for Payer: UHCCP Medicaid |
$557.72
|
| Rate for Payer: VA VA |
$790.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,372.59
|
|
|
HC SRT UP TO 5 FRACTIONS
|
Facility
|
IP
|
$5,412.16
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300018
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$3,766.86 |
| Max. Negotiated Rate |
$4,870.94 |
| Rate for Payer: Aetna Commercial |
$4,600.34
|
| Rate for Payer: BCBS Trust/PPO |
$4,469.90
|
| Rate for Payer: BCN Commercial |
$4,469.90
|
| Rate for Payer: Cash Price |
$4,329.73
|
| Rate for Payer: Cofinity Commercial |
$4,654.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,329.73
|
| Rate for Payer: Healthscope Commercial |
$4,870.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,059.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,600.34
|
| Rate for Payer: Nomi Health Commercial |
$4,437.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,059.12
|
| Rate for Payer: PHP Commercial |
$4,600.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,708.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,766.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,762.70
|
| Rate for Payer: UHC Core |
$4,519.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,059.12
|
|
|
HC SRT UP TO 5 FRACTIONS
|
Facility
|
OP
|
$5,412.16
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300018
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$954.16 |
| Max. Negotiated Rate |
$4,870.94 |
| Rate for Payer: Aetna Commercial |
$4,600.34
|
| Rate for Payer: Aetna Medicare |
$1,407.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,691.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,691.30
|
| Rate for Payer: BCBS Complete |
$1,001.79
|
| Rate for Payer: BCBS MAPPO |
$1,353.04
|
| Rate for Payer: BCBS Trust/PPO |
$4,449.34
|
| Rate for Payer: BCN Commercial |
$4,449.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,353.04
|
| Rate for Payer: Cash Price |
$4,329.73
|
| Rate for Payer: Cofinity Commercial |
$4,654.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,329.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,353.04
|
| Rate for Payer: Healthscope Commercial |
$4,870.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,059.12
|
| Rate for Payer: Mclaren Medicaid |
$954.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,420.69
|
| Rate for Payer: Meridian Medicaid |
$1,001.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,556.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,488.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,600.34
|
| Rate for Payer: Nomi Health Commercial |
$4,437.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,059.12
|
| Rate for Payer: PACE Senior Care Partners |
$1,285.39
|
| Rate for Payer: PACE SWMI |
$1,353.04
|
| Rate for Payer: PHP Commercial |
$4,600.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,353.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$954.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,708.58
|
| Rate for Payer: Priority Health Medicare |
$1,366.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,766.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,353.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,762.70
|
| Rate for Payer: UHC Core |
$4,519.15
|
| Rate for Payer: UHC Exchange |
$1,353.04
|
| Rate for Payer: UHC Medicaid |
$954.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,353.04
|
| Rate for Payer: UHCCP Medicaid |
$954.16
|
| Rate for Payer: VA VA |
$1,353.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,059.12
|
|
|
HC SS2PC SPECIAL STAIN (BILL ONLY)
|
Facility
|
OP
|
$114.44
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31200007
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$20.18 |
| Max. Negotiated Rate |
$103.00 |
| Rate for Payer: Aetna Commercial |
$97.27
|
| Rate for Payer: Aetna Medicare |
$29.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.76
|
| Rate for Payer: BCBS Complete |
$21.18
|
| Rate for Payer: BCBS MAPPO |
$28.61
|
| Rate for Payer: BCBS Trust/PPO |
$94.08
|
| Rate for Payer: BCN Commercial |
$94.08
|
| Rate for Payer: BCN Medicare Advantage |
$28.61
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Commercial |
$98.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.61
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.83
|
| Rate for Payer: Mclaren Medicaid |
$20.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.04
|
| Rate for Payer: Meridian Medicaid |
$21.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Nomi Health Commercial |
$93.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.83
|
| Rate for Payer: PACE Senior Care Partners |
$27.18
|
| Rate for Payer: PACE SWMI |
$28.61
|
| Rate for Payer: PHP Commercial |
$97.27
|
| Rate for Payer: PHP Medicare Advantage |
$28.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.56
|
| Rate for Payer: Priority Health Medicare |
$28.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.65
|
| Rate for Payer: Railroad Medicare Medicare |
$28.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.71
|
| Rate for Payer: UHC Core |
$95.56
|
| Rate for Payer: UHC Exchange |
$28.61
|
| Rate for Payer: UHC Medicaid |
$20.18
|
| Rate for Payer: UHC Medicare Advantage |
$28.61
|
| Rate for Payer: UHCCP Medicaid |
$20.18
|
| Rate for Payer: VA VA |
$28.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.83
|
|
|
HC SS2PC SPECIAL STAIN (BILL ONLY)
|
Facility
|
IP
|
$114.44
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31200007
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$79.65 |
| Max. Negotiated Rate |
$103.00 |
| Rate for Payer: Aetna Commercial |
$97.27
|
| Rate for Payer: BCBS Trust/PPO |
$94.52
|
| Rate for Payer: BCN Commercial |
$94.52
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Commercial |
$98.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Nomi Health Commercial |
$93.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.83
|
| Rate for Payer: PHP Commercial |
$97.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$99.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$79.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.71
|
| Rate for Payer: UHC Core |
$95.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.83
|
|
|
HC STABILIZERS HEART ESTECH
|
Facility
|
IP
|
$951.97
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$662.57 |
| Max. Negotiated Rate |
$856.77 |
| Rate for Payer: Aetna Commercial |
$809.17
|
| Rate for Payer: BCBS Trust/PPO |
$786.23
|
| Rate for Payer: BCN Commercial |
$786.23
|
| Rate for Payer: Cash Price |
$761.58
|
| Rate for Payer: Cofinity Commercial |
$818.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.58
|
| Rate for Payer: Healthscope Commercial |
$856.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.17
|
| Rate for Payer: Nomi Health Commercial |
$780.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$713.98
|
| Rate for Payer: PHP Commercial |
$809.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$828.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$662.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$837.73
|
| Rate for Payer: UHC Core |
$794.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.98
|
|
|
HC STABILIZERS HEART ESTECH
|
Facility
|
OP
|
$951.97
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$167.83 |
| Max. Negotiated Rate |
$856.77 |
| Rate for Payer: Aetna Commercial |
$809.17
|
| Rate for Payer: Aetna Medicare |
$247.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.49
|
| Rate for Payer: BCBS Complete |
$176.21
|
| Rate for Payer: BCBS MAPPO |
$237.99
|
| Rate for Payer: BCBS Trust/PPO |
$782.61
|
| Rate for Payer: BCN Commercial |
$782.61
|
| Rate for Payer: BCN Medicare Advantage |
$237.99
|
| Rate for Payer: Cash Price |
$761.58
|
| Rate for Payer: Cofinity Commercial |
$818.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.99
|
| Rate for Payer: Healthscope Commercial |
$856.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.98
|
| Rate for Payer: Mclaren Medicaid |
$167.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.89
|
| Rate for Payer: Meridian Medicaid |
$176.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.17
|
| Rate for Payer: Nomi Health Commercial |
$780.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$713.98
|
| Rate for Payer: PACE Senior Care Partners |
$226.09
|
| Rate for Payer: PACE SWMI |
$237.99
|
| Rate for Payer: PHP Commercial |
$809.17
|
| Rate for Payer: PHP Medicare Advantage |
$237.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$828.21
|
| Rate for Payer: Priority Health Medicare |
$240.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$662.57
|
| Rate for Payer: Railroad Medicare Medicare |
$237.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$837.73
|
| Rate for Payer: UHC Core |
$794.89
|
| Rate for Payer: UHC Exchange |
$237.99
|
| Rate for Payer: UHC Medicaid |
$167.83
|
| Rate for Payer: UHC Medicare Advantage |
$237.99
|
| Rate for Payer: UHCCP Medicaid |
$167.83
|
| Rate for Payer: VA VA |
$237.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.98
|
|
|
HC STACLOT LA.
|
Facility
|
IP
|
$151.90
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
30500085
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$105.72 |
| Max. Negotiated Rate |
$136.71 |
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: BCBS Trust/PPO |
$125.45
|
| Rate for Payer: BCN Commercial |
$125.45
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$130.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: PHP Commercial |
$129.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.67
|
| Rate for Payer: UHC Core |
$126.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.92
|
|
|
HC STACLOT LA.
|
Facility
|
OP
|
$151.90
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
30500085
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$26.78 |
| Max. Negotiated Rate |
$136.71 |
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: Aetna Medicare |
$39.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.47
|
| Rate for Payer: BCBS Complete |
$28.12
|
| Rate for Payer: BCBS MAPPO |
$37.98
|
| Rate for Payer: BCBS Trust/PPO |
$124.88
|
| Rate for Payer: BCN Commercial |
$124.88
|
| Rate for Payer: BCN Medicare Advantage |
$37.98
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$130.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.98
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.92
|
| Rate for Payer: Mclaren Medicaid |
$26.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.87
|
| Rate for Payer: Meridian Medicaid |
$28.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: PACE Senior Care Partners |
$36.08
|
| Rate for Payer: PACE SWMI |
$37.98
|
| Rate for Payer: PHP Commercial |
$129.12
|
| Rate for Payer: PHP Medicare Advantage |
$37.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.15
|
| Rate for Payer: Priority Health Medicare |
$38.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.72
|
| Rate for Payer: Railroad Medicare Medicare |
$37.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.67
|
| Rate for Payer: UHC Core |
$126.84
|
| Rate for Payer: UHC Exchange |
$37.98
|
| Rate for Payer: UHC Medicaid |
$26.78
|
| Rate for Payer: UHC Medicare Advantage |
$37.98
|
| Rate for Payer: UHCCP Medicaid |
$26.78
|
| Rate for Payer: VA VA |
$37.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.92
|
|
|
HC STANDBY OPEN HEART/TAVR
|
Facility
|
IP
|
$2,465.99
|
|
| Hospital Charge Code |
27000151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,716.33 |
| Max. Negotiated Rate |
$2,219.39 |
| Rate for Payer: Aetna Commercial |
$2,096.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,036.66
|
| Rate for Payer: BCN Commercial |
$2,036.66
|
| Rate for Payer: Cash Price |
$1,972.79
|
| Rate for Payer: Cofinity Commercial |
$2,120.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,972.79
|
| Rate for Payer: Healthscope Commercial |
$2,219.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,849.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,096.09
|
| Rate for Payer: Nomi Health Commercial |
$2,022.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,849.49
|
| Rate for Payer: PHP Commercial |
$2,096.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,145.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,716.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,170.07
|
| Rate for Payer: UHC Core |
$2,059.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,849.49
|
|
|
HC STANDBY OPEN HEART/TAVR
|
Facility
|
OP
|
$2,465.99
|
|
| Hospital Charge Code |
27000151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$434.75 |
| Max. Negotiated Rate |
$2,219.39 |
| Rate for Payer: Aetna Commercial |
$2,096.09
|
| Rate for Payer: Aetna Medicare |
$641.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$770.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$770.62
|
| Rate for Payer: BCBS Complete |
$456.45
|
| Rate for Payer: BCBS MAPPO |
$616.50
|
| Rate for Payer: BCBS Trust/PPO |
$2,027.29
|
| Rate for Payer: BCN Commercial |
$2,027.29
|
| Rate for Payer: BCN Medicare Advantage |
$616.50
|
| Rate for Payer: Cash Price |
$1,972.79
|
| Rate for Payer: Cofinity Commercial |
$2,120.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,972.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.50
|
| Rate for Payer: Healthscope Commercial |
$2,219.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,849.49
|
| Rate for Payer: Mclaren Medicaid |
$434.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$647.32
|
| Rate for Payer: Meridian Medicaid |
$456.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$708.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$678.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,096.09
|
| Rate for Payer: Nomi Health Commercial |
$2,022.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,849.49
|
| Rate for Payer: PACE Senior Care Partners |
$585.67
|
| Rate for Payer: PACE SWMI |
$616.50
|
| Rate for Payer: PHP Commercial |
$2,096.09
|
| Rate for Payer: PHP Medicare Advantage |
$616.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,145.41
|
| Rate for Payer: Priority Health Medicare |
$622.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,716.33
|
| Rate for Payer: Railroad Medicare Medicare |
$616.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,170.07
|
| Rate for Payer: UHC Core |
$2,059.10
|
| Rate for Payer: UHC Exchange |
$616.50
|
| Rate for Payer: UHC Medicaid |
$434.75
|
| Rate for Payer: UHC Medicare Advantage |
$616.50
|
| Rate for Payer: UHCCP Medicaid |
$434.75
|
| Rate for Payer: VA VA |
$616.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,849.49
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR
|
Facility
|
OP
|
$57.22
|
|
|
Service Code
|
CPT 87640
|
| Hospital Charge Code |
30600263
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna Medicare |
$14.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.88
|
| Rate for Payer: BCBS Complete |
$10.59
|
| Rate for Payer: BCBS MAPPO |
$14.30
|
| Rate for Payer: BCBS Trust/PPO |
$47.04
|
| Rate for Payer: BCN Commercial |
$47.04
|
| Rate for Payer: BCN Medicare Advantage |
$14.30
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.30
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Mclaren Medicaid |
$10.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.02
|
| Rate for Payer: Meridian Medicaid |
$10.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.91
|
| Rate for Payer: PACE Senior Care Partners |
$13.59
|
| Rate for Payer: PACE SWMI |
$14.30
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: PHP Medicare Advantage |
$14.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.78
|
| Rate for Payer: Priority Health Medicare |
$14.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.83
|
| Rate for Payer: Railroad Medicare Medicare |
$14.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.35
|
| Rate for Payer: UHC Core |
$47.78
|
| Rate for Payer: UHC Exchange |
$14.30
|
| Rate for Payer: UHC Medicaid |
$10.09
|
| Rate for Payer: UHC Medicare Advantage |
$14.30
|
| Rate for Payer: UHCCP Medicaid |
$10.09
|
| Rate for Payer: VA VA |
$14.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR
|
Facility
|
IP
|
$57.22
|
|
|
Service Code
|
CPT 87640
|
| Hospital Charge Code |
30600263
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.83 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: BCBS Trust/PPO |
$47.26
|
| Rate for Payer: BCN Commercial |
$47.26
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$46.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.91
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.35
|
| Rate for Payer: UHC Core |
$47.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR METHICILLIN RESISTANT
|
Facility
|
OP
|
$62.82
|
|
|
Service Code
|
CPT 87641
|
| Hospital Charge Code |
30600264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: Aetna Medicare |
$16.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.63
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS MAPPO |
$15.71
|
| Rate for Payer: BCBS Trust/PPO |
$51.64
|
| Rate for Payer: BCN Commercial |
$51.64
|
| Rate for Payer: BCN Medicare Advantage |
$15.71
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Mclaren Medicaid |
$11.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.49
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PACE Senior Care Partners |
$14.92
|
| Rate for Payer: PACE SWMI |
$15.71
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: PHP Medicare Advantage |
$15.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.65
|
| Rate for Payer: Priority Health Medicare |
$15.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.72
|
| Rate for Payer: Railroad Medicare Medicare |
$15.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.28
|
| Rate for Payer: UHC Core |
$52.45
|
| Rate for Payer: UHC Exchange |
$15.71
|
| Rate for Payer: UHC Medicaid |
$11.08
|
| Rate for Payer: UHC Medicare Advantage |
$15.71
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: VA VA |
$15.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR METHICILLIN RESISTANT
|
Facility
|
IP
|
$62.82
|
|
|
Service Code
|
CPT 87641
|
| Hospital Charge Code |
30600264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.72 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: BCBS Trust/PPO |
$51.88
|
| Rate for Payer: BCN Commercial |
$51.88
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$51.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.28
|
| Rate for Payer: UHC Core |
$52.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC STATLOCK
|
Facility
|
OP
|
$146.56
|
|
| Hospital Charge Code |
27000152
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$25.84 |
| Max. Negotiated Rate |
$131.90 |
| Rate for Payer: Aetna Commercial |
$124.58
|
| Rate for Payer: Aetna Medicare |
$38.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.80
|
| Rate for Payer: BCBS Complete |
$27.13
|
| Rate for Payer: BCBS MAPPO |
$36.64
|
| Rate for Payer: BCBS Trust/PPO |
$120.49
|
| Rate for Payer: BCN Commercial |
$120.49
|
| Rate for Payer: BCN Medicare Advantage |
$36.64
|
| Rate for Payer: Cash Price |
$117.25
|
| Rate for Payer: Cofinity Commercial |
$126.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.64
|
| Rate for Payer: Healthscope Commercial |
$131.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.92
|
| Rate for Payer: Mclaren Medicaid |
$25.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.47
|
| Rate for Payer: Meridian Medicaid |
$27.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.58
|
| Rate for Payer: Nomi Health Commercial |
$120.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.92
|
| Rate for Payer: PACE Senior Care Partners |
$34.81
|
| Rate for Payer: PACE SWMI |
$36.64
|
| Rate for Payer: PHP Commercial |
$124.58
|
| Rate for Payer: PHP Medicare Advantage |
$36.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$127.51
|
| Rate for Payer: Priority Health Medicare |
$37.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.01
|
| Rate for Payer: Railroad Medicare Medicare |
$36.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.97
|
| Rate for Payer: UHC Core |
$122.38
|
| Rate for Payer: UHC Exchange |
$36.64
|
| Rate for Payer: UHC Medicaid |
$25.84
|
| Rate for Payer: UHC Medicare Advantage |
$36.64
|
| Rate for Payer: UHCCP Medicaid |
$25.84
|
| Rate for Payer: VA VA |
$36.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.92
|
|
|
HC STATLOCK
|
Facility
|
IP
|
$146.56
|
|
| Hospital Charge Code |
27000152
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$102.01 |
| Max. Negotiated Rate |
$131.90 |
| Rate for Payer: Aetna Commercial |
$124.58
|
| Rate for Payer: BCBS Trust/PPO |
$121.04
|
| Rate for Payer: BCN Commercial |
$121.04
|
| Rate for Payer: Cash Price |
$117.25
|
| Rate for Payer: Cofinity Commercial |
$126.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.25
|
| Rate for Payer: Healthscope Commercial |
$131.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.58
|
| Rate for Payer: Nomi Health Commercial |
$120.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.92
|
| Rate for Payer: PHP Commercial |
$124.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$127.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.97
|
| Rate for Payer: UHC Core |
$122.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.92
|
|
|
HC STENGER TEST PURE TONE
|
Facility
|
IP
|
$35.37
|
|
|
Service Code
|
CPT 92565
|
| Hospital Charge Code |
76100500
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$24.62 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: BCBS Trust/PPO |
$29.21
|
| Rate for Payer: BCN Commercial |
$29.21
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.53
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$30.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.13
|
| Rate for Payer: UHC Core |
$29.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC STENGER TEST PURE TONE
|
Facility
|
OP
|
$35.37
|
|
|
Service Code
|
CPT 92565
|
| Hospital Charge Code |
76100500
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$6.24 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna Medicare |
$9.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.05
|
| Rate for Payer: BCBS Complete |
$6.55
|
| Rate for Payer: BCBS MAPPO |
$8.84
|
| Rate for Payer: BCBS Trust/PPO |
$29.08
|
| Rate for Payer: BCN Commercial |
$29.08
|
| Rate for Payer: BCN Medicare Advantage |
$8.84
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.84
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Mclaren Medicaid |
$6.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.28
|
| Rate for Payer: Meridian Medicaid |
$6.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.53
|
| Rate for Payer: PACE Senior Care Partners |
$8.40
|
| Rate for Payer: PACE SWMI |
$8.84
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: PHP Medicare Advantage |
$8.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$30.77
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.62
|
| Rate for Payer: Railroad Medicare Medicare |
$8.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.13
|
| Rate for Payer: UHC Core |
$29.53
|
| Rate for Payer: UHC Exchange |
$8.84
|
| Rate for Payer: UHC Medicaid |
$6.24
|
| Rate for Payer: UHC Medicare Advantage |
$8.84
|
| Rate for Payer: UHCCP Medicaid |
$6.24
|
| Rate for Payer: VA VA |
$8.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC STENGER TEST SPEECH
|
Facility
|
IP
|
$1,478.41
|
|
|
Service Code
|
CPT 92577
|
| Hospital Charge Code |
76100488
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,028.97 |
| Max. Negotiated Rate |
$1,330.57 |
| Rate for Payer: Aetna Commercial |
$1,256.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,221.02
|
| Rate for Payer: BCN Commercial |
$1,221.02
|
| Rate for Payer: Cash Price |
$1,182.73
|
| Rate for Payer: Cofinity Commercial |
$1,271.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,182.73
|
| Rate for Payer: Healthscope Commercial |
$1,330.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,108.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,256.65
|
| Rate for Payer: Nomi Health Commercial |
$1,212.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,108.81
|
| Rate for Payer: PHP Commercial |
$1,256.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,286.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,028.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,301.00
|
| Rate for Payer: UHC Core |
$1,234.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,108.81
|
|
|
HC STENGER TEST SPEECH
|
Facility
|
OP
|
$1,478.41
|
|
|
Service Code
|
CPT 92577
|
| Hospital Charge Code |
76100488
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$260.64 |
| Max. Negotiated Rate |
$1,330.57 |
| Rate for Payer: Aetna Commercial |
$1,256.65
|
| Rate for Payer: Aetna Medicare |
$384.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$462.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$462.00
|
| Rate for Payer: BCBS Complete |
$273.65
|
| Rate for Payer: BCBS MAPPO |
$369.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,215.40
|
| Rate for Payer: BCN Commercial |
$1,215.40
|
| Rate for Payer: BCN Medicare Advantage |
$369.60
|
| Rate for Payer: Cash Price |
$1,182.73
|
| Rate for Payer: Cofinity Commercial |
$1,271.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,182.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$369.60
|
| Rate for Payer: Healthscope Commercial |
$1,330.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,108.81
|
| Rate for Payer: Mclaren Medicaid |
$260.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$388.08
|
| Rate for Payer: Meridian Medicaid |
$273.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$425.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$406.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,256.65
|
| Rate for Payer: Nomi Health Commercial |
$1,212.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,108.81
|
| Rate for Payer: PACE Senior Care Partners |
$351.12
|
| Rate for Payer: PACE SWMI |
$369.60
|
| Rate for Payer: PHP Commercial |
$1,256.65
|
| Rate for Payer: PHP Medicare Advantage |
$369.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,286.22
|
| Rate for Payer: Priority Health Medicare |
$373.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,028.97
|
| Rate for Payer: Railroad Medicare Medicare |
$369.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,301.00
|
| Rate for Payer: UHC Core |
$1,234.47
|
| Rate for Payer: UHC Exchange |
$369.60
|
| Rate for Payer: UHC Medicaid |
$260.64
|
| Rate for Payer: UHC Medicare Advantage |
$369.60
|
| Rate for Payer: UHCCP Medicaid |
$260.64
|
| Rate for Payer: VA VA |
$369.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,108.81
|
|
|
HC STENT
|
Facility
|
OP
|
$972.22
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800030
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$171.40 |
| Max. Negotiated Rate |
$875.00 |
| Rate for Payer: Aetna Commercial |
$826.39
|
| Rate for Payer: Aetna Medicare |
$252.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$303.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$303.82
|
| Rate for Payer: BCBS Complete |
$179.96
|
| Rate for Payer: BCBS MAPPO |
$243.06
|
| Rate for Payer: BCBS Trust/PPO |
$799.26
|
| Rate for Payer: BCN Commercial |
$799.26
|
| Rate for Payer: BCN Medicare Advantage |
$243.06
|
| Rate for Payer: Cash Price |
$777.78
|
| Rate for Payer: Cofinity Commercial |
$836.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$243.06
|
| Rate for Payer: Healthscope Commercial |
$875.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$729.16
|
| Rate for Payer: Mclaren Medicaid |
$171.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$255.21
|
| Rate for Payer: Meridian Medicaid |
$179.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$279.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$267.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$826.39
|
| Rate for Payer: Nomi Health Commercial |
$797.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$729.16
|
| Rate for Payer: PACE Senior Care Partners |
$230.90
|
| Rate for Payer: PACE SWMI |
$243.06
|
| Rate for Payer: PHP Commercial |
$826.39
|
| Rate for Payer: PHP Medicare Advantage |
$243.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$845.83
|
| Rate for Payer: Priority Health Medicare |
$245.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$676.67
|
| Rate for Payer: Railroad Medicare Medicare |
$243.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$855.55
|
| Rate for Payer: UHC Core |
$811.80
|
| Rate for Payer: UHC Exchange |
$243.06
|
| Rate for Payer: UHC Medicaid |
$171.40
|
| Rate for Payer: UHC Medicare Advantage |
$243.06
|
| Rate for Payer: UHCCP Medicaid |
$171.40
|
| Rate for Payer: VA VA |
$243.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$729.16
|
|
|
HC STENT
|
Facility
|
IP
|
$972.22
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800030
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$676.67 |
| Max. Negotiated Rate |
$875.00 |
| Rate for Payer: Aetna Commercial |
$826.39
|
| Rate for Payer: BCBS Trust/PPO |
$802.96
|
| Rate for Payer: BCN Commercial |
$802.96
|
| Rate for Payer: Cash Price |
$777.78
|
| Rate for Payer: Cofinity Commercial |
$836.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$777.78
|
| Rate for Payer: Healthscope Commercial |
$875.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$729.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$826.39
|
| Rate for Payer: Nomi Health Commercial |
$797.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$729.16
|
| Rate for Payer: PHP Commercial |
$826.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$845.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$676.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$855.55
|
| Rate for Payer: UHC Core |
$811.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$729.16
|
|
|
HC STENT ADD.BRANCH
|
Facility
|
OP
|
$17,350.78
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
48100074
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,058.94 |
| Max. Negotiated Rate |
$15,615.70 |
| Rate for Payer: Aetna Commercial |
$14,748.16
|
| Rate for Payer: Aetna Medicare |
$4,511.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,422.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,422.12
|
| Rate for Payer: BCBS Complete |
$3,211.63
|
| Rate for Payer: BCBS MAPPO |
$4,337.69
|
| Rate for Payer: BCBS Trust/PPO |
$14,264.08
|
| Rate for Payer: BCN Commercial |
$14,264.08
|
| Rate for Payer: BCN Medicare Advantage |
$4,337.69
|
| Rate for Payer: Cash Price |
$13,880.62
|
| Rate for Payer: Cofinity Commercial |
$14,921.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,880.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,337.69
|
| Rate for Payer: Healthscope Commercial |
$15,615.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,013.08
|
| Rate for Payer: Mclaren Medicaid |
$3,058.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,554.58
|
| Rate for Payer: Meridian Medicaid |
$3,211.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,988.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,771.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,748.16
|
| Rate for Payer: Nomi Health Commercial |
$14,227.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,013.08
|
| Rate for Payer: PACE Senior Care Partners |
$4,120.81
|
| Rate for Payer: PACE SWMI |
$4,337.69
|
| Rate for Payer: PHP Commercial |
$14,748.16
|
| Rate for Payer: PHP Medicare Advantage |
$4,337.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,058.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15,095.18
|
| Rate for Payer: Priority Health Medicare |
$4,381.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,076.14
|
| Rate for Payer: Railroad Medicare Medicare |
$4,337.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,268.69
|
| Rate for Payer: UHC Core |
$14,487.90
|
| Rate for Payer: UHC Exchange |
$4,337.69
|
| Rate for Payer: UHC Medicaid |
$3,058.94
|
| Rate for Payer: UHC Medicare Advantage |
$4,337.69
|
| Rate for Payer: UHCCP Medicaid |
$3,058.94
|
| Rate for Payer: VA VA |
$4,337.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,013.08
|
|
|
HC STENT ADD.BRANCH
|
Facility
|
IP
|
$17,350.78
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
48100074
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,076.14 |
| Max. Negotiated Rate |
$15,615.70 |
| Rate for Payer: Aetna Commercial |
$14,748.16
|
| Rate for Payer: BCBS Trust/PPO |
$14,330.01
|
| Rate for Payer: BCN Commercial |
$14,330.01
|
| Rate for Payer: Cash Price |
$13,880.62
|
| Rate for Payer: Cofinity Commercial |
$14,921.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,880.62
|
| Rate for Payer: Healthscope Commercial |
$15,615.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,013.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,748.16
|
| Rate for Payer: Nomi Health Commercial |
$14,227.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,013.08
|
| Rate for Payer: PHP Commercial |
$14,748.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15,095.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12,076.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,268.69
|
| Rate for Payer: UHC Core |
$14,487.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,013.08
|
|
