|
HC RNP U1 ANTIBODY
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200166
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.35 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$9.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.99
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$8.79
|
| Rate for Payer: BCBS Trust/PPO |
$28.91
|
| Rate for Payer: BCN Commercial |
$27.34
|
| Rate for Payer: BCN Medicare Advantage |
$8.79
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.79
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.23
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PACE Senior Care Partners |
$8.35
|
| Rate for Payer: PACE SWMI |
$8.79
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$8.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Medicare |
$8.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: Railroad Medicare Medicare |
$8.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.79
|
| Rate for Payer: UHC Exchange |
$8.79
|
| Rate for Payer: UHC Medicare Advantage |
$8.79
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$8.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC RNP U1 ANTIBODY
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200166
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: BCBS Trust/PPO |
$28.71
|
| Rate for Payer: BCN Commercial |
$27.18
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC RO GUIDE LOC TARGET VOL TX DEL
|
Facility
|
IP
|
$223.79
|
|
|
Service Code
|
CPT 77387
|
| Hospital Charge Code |
33300061
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$145.46 |
| Max. Negotiated Rate |
$201.41 |
| Rate for Payer: Aetna Commercial |
$190.22
|
| Rate for Payer: BCBS Trust/PPO |
$182.68
|
| Rate for Payer: BCN Commercial |
$172.94
|
| Rate for Payer: Cash Price |
$179.03
|
| Rate for Payer: Cofinity Commercial |
$192.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.03
|
| Rate for Payer: Healthscope Commercial |
$201.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.22
|
| Rate for Payer: Nomi Health Commercial |
$183.51
|
| Rate for Payer: PHP Commercial |
$190.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.46
|
| Rate for Payer: Priority Health HMO/PPO |
$194.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.94
|
| Rate for Payer: UHC Core |
$186.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.84
|
|
|
HC RO GUIDE LOC TARGET VOL TX DEL
|
Facility
|
OP
|
$223.79
|
|
|
Service Code
|
CPT 77387
|
| Hospital Charge Code |
33300061
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$53.15 |
| Max. Negotiated Rate |
$201.41 |
| Rate for Payer: Aetna Commercial |
$190.22
|
| Rate for Payer: Aetna Medicare |
$58.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.93
|
| Rate for Payer: BCBS Complete |
$89.52
|
| Rate for Payer: BCBS MAPPO |
$55.95
|
| Rate for Payer: BCBS Trust/PPO |
$183.98
|
| Rate for Payer: BCN Commercial |
$174.00
|
| Rate for Payer: BCN Medicare Advantage |
$55.95
|
| Rate for Payer: Cash Price |
$179.03
|
| Rate for Payer: Cofinity Commercial |
$192.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.95
|
| Rate for Payer: Healthscope Commercial |
$201.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.22
|
| Rate for Payer: Nomi Health Commercial |
$183.51
|
| Rate for Payer: PACE Senior Care Partners |
$53.15
|
| Rate for Payer: PACE SWMI |
$55.95
|
| Rate for Payer: PHP Commercial |
$190.22
|
| Rate for Payer: PHP Medicare Advantage |
$55.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.46
|
| Rate for Payer: Priority Health HMO/PPO |
$194.70
|
| Rate for Payer: Priority Health Medicare |
$56.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.94
|
| Rate for Payer: Railroad Medicare Medicare |
$55.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.94
|
| Rate for Payer: UHC Core |
$186.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.95
|
| Rate for Payer: UHC Exchange |
$55.95
|
| Rate for Payer: UHC Medicare Advantage |
$55.95
|
| Rate for Payer: VA VA |
$55.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.84
|
|
|
HC RO IMRT DEL COMPLEX
|
Facility
|
IP
|
$3,288.00
|
|
|
Service Code
|
CPT 77386
|
| Hospital Charge Code |
33300051
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,137.20 |
| Max. Negotiated Rate |
$2,959.20 |
| Rate for Payer: Aetna Commercial |
$2,794.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,683.99
|
| Rate for Payer: BCN Commercial |
$2,540.97
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$2,827.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Healthscope Commercial |
$2,959.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: Nomi Health Commercial |
$2,696.16
|
| Rate for Payer: PHP Commercial |
$2,794.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health HMO/PPO |
$2,860.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,202.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,893.44
|
| Rate for Payer: UHC Core |
$2,745.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.00
|
|
|
HC RO IMRT DEL COMPLEX
|
Facility
|
OP
|
$3,288.00
|
|
|
Service Code
|
CPT 77386
|
| Hospital Charge Code |
33300051
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$409.77 |
| Max. Negotiated Rate |
$2,959.20 |
| Rate for Payer: Aetna Commercial |
$2,794.80
|
| Rate for Payer: Aetna Medicare |
$854.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,027.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,027.50
|
| Rate for Payer: BCBS Complete |
$430.29
|
| Rate for Payer: BCBS MAPPO |
$822.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,703.06
|
| Rate for Payer: BCN Commercial |
$2,556.42
|
| Rate for Payer: BCN Medicare Advantage |
$822.00
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$2,827.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$822.00
|
| Rate for Payer: Healthscope Commercial |
$2,959.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.00
|
| Rate for Payer: Mclaren Medicaid |
$409.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$863.10
|
| Rate for Payer: Meridian Medicaid |
$430.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$945.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: Nomi Health Commercial |
$2,696.16
|
| Rate for Payer: PACE Senior Care Partners |
$780.90
|
| Rate for Payer: PACE SWMI |
$822.00
|
| Rate for Payer: PHP Commercial |
$2,794.80
|
| Rate for Payer: PHP Medicare Advantage |
$822.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health HMO/PPO |
$2,860.56
|
| Rate for Payer: Priority Health Medicare |
$830.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,202.96
|
| Rate for Payer: Railroad Medicare Medicare |
$822.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,893.44
|
| Rate for Payer: UHC Core |
$2,745.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$822.00
|
| Rate for Payer: UHC Exchange |
$822.00
|
| Rate for Payer: UHC Medicare Advantage |
$822.00
|
| Rate for Payer: UHCCP Medicaid |
$409.77
|
| Rate for Payer: VA VA |
$822.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.00
|
|
|
HC RO IMRT DEL SIMPLE
|
Facility
|
OP
|
$3,288.00
|
|
|
Service Code
|
CPT 77385
|
| Hospital Charge Code |
33300050
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$409.77 |
| Max. Negotiated Rate |
$2,959.20 |
| Rate for Payer: Aetna Commercial |
$2,794.80
|
| Rate for Payer: Aetna Medicare |
$854.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,027.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,027.50
|
| Rate for Payer: BCBS Complete |
$430.29
|
| Rate for Payer: BCBS MAPPO |
$822.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,703.06
|
| Rate for Payer: BCN Commercial |
$2,556.42
|
| Rate for Payer: BCN Medicare Advantage |
$822.00
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$2,827.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$822.00
|
| Rate for Payer: Healthscope Commercial |
$2,959.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.00
|
| Rate for Payer: Mclaren Medicaid |
$409.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$863.10
|
| Rate for Payer: Meridian Medicaid |
$430.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$945.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: Nomi Health Commercial |
$2,696.16
|
| Rate for Payer: PACE Senior Care Partners |
$780.90
|
| Rate for Payer: PACE SWMI |
$822.00
|
| Rate for Payer: PHP Commercial |
$2,794.80
|
| Rate for Payer: PHP Medicare Advantage |
$822.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$409.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health HMO/PPO |
$2,860.56
|
| Rate for Payer: Priority Health Medicare |
$830.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,202.96
|
| Rate for Payer: Railroad Medicare Medicare |
$822.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,893.44
|
| Rate for Payer: UHC Core |
$2,745.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$822.00
|
| Rate for Payer: UHC Exchange |
$822.00
|
| Rate for Payer: UHC Medicare Advantage |
$822.00
|
| Rate for Payer: UHCCP Medicaid |
$409.77
|
| Rate for Payer: VA VA |
$822.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.00
|
|
|
HC RO IMRT DEL SIMPLE
|
Facility
|
IP
|
$3,288.00
|
|
|
Service Code
|
CPT 77385
|
| Hospital Charge Code |
33300050
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,137.20 |
| Max. Negotiated Rate |
$2,959.20 |
| Rate for Payer: Aetna Commercial |
$2,794.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,683.99
|
| Rate for Payer: BCN Commercial |
$2,540.97
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$2,827.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Healthscope Commercial |
$2,959.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: Nomi Health Commercial |
$2,696.16
|
| Rate for Payer: PHP Commercial |
$2,794.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health HMO/PPO |
$2,860.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,202.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,893.44
|
| Rate for Payer: UHC Core |
$2,745.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.00
|
|
|
HC RO INFUS RADIOACTIVE MATERIAL
|
Facility
|
IP
|
$331.89
|
|
|
Service Code
|
CPT 77750
|
| Hospital Charge Code |
33300042
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$215.73 |
| Max. Negotiated Rate |
$298.70 |
| Rate for Payer: Aetna Commercial |
$282.11
|
| Rate for Payer: BCBS Trust/PPO |
$270.92
|
| Rate for Payer: BCN Commercial |
$256.48
|
| Rate for Payer: Cash Price |
$265.51
|
| Rate for Payer: Cofinity Commercial |
$285.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.51
|
| Rate for Payer: Healthscope Commercial |
$298.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.11
|
| Rate for Payer: Nomi Health Commercial |
$272.15
|
| Rate for Payer: PHP Commercial |
$282.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.73
|
| Rate for Payer: Priority Health HMO/PPO |
$288.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.06
|
| Rate for Payer: UHC Core |
$277.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.92
|
|
|
HC RO INFUS RADIOACTIVE MATERIAL
|
Facility
|
OP
|
$331.89
|
|
|
Service Code
|
CPT 77750
|
| Hospital Charge Code |
33300042
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$78.82 |
| Max. Negotiated Rate |
$298.70 |
| Rate for Payer: Aetna Commercial |
$282.11
|
| Rate for Payer: Aetna Medicare |
$86.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.72
|
| Rate for Payer: BCBS Complete |
$195.62
|
| Rate for Payer: BCBS MAPPO |
$82.97
|
| Rate for Payer: BCBS Trust/PPO |
$272.85
|
| Rate for Payer: BCN Commercial |
$258.04
|
| Rate for Payer: BCN Medicare Advantage |
$82.97
|
| Rate for Payer: Cash Price |
$265.51
|
| Rate for Payer: Cash Price |
$265.51
|
| Rate for Payer: Cofinity Commercial |
$285.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.97
|
| Rate for Payer: Healthscope Commercial |
$298.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.92
|
| Rate for Payer: Mclaren Medicaid |
$186.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.12
|
| Rate for Payer: Meridian Medicaid |
$195.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.11
|
| Rate for Payer: Nomi Health Commercial |
$272.15
|
| Rate for Payer: PACE Senior Care Partners |
$78.82
|
| Rate for Payer: PACE SWMI |
$82.97
|
| Rate for Payer: PHP Commercial |
$282.11
|
| Rate for Payer: PHP Medicare Advantage |
$82.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.73
|
| Rate for Payer: Priority Health HMO/PPO |
$288.74
|
| Rate for Payer: Priority Health Medicare |
$83.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.37
|
| Rate for Payer: Railroad Medicare Medicare |
$82.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.06
|
| Rate for Payer: UHC Core |
$277.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.97
|
| Rate for Payer: UHC Exchange |
$82.97
|
| Rate for Payer: UHC Medicare Advantage |
$82.97
|
| Rate for Payer: UHCCP Medicaid |
$186.29
|
| Rate for Payer: VA VA |
$82.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.92
|
|
|
HC RO INS VAG BRACHTHER DEVICE
|
Facility
|
IP
|
$550.40
|
|
|
Service Code
|
CPT 57156
|
| Hospital Charge Code |
36100444
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$357.76 |
| Max. Negotiated Rate |
$495.36 |
| Rate for Payer: Aetna Commercial |
$467.84
|
| Rate for Payer: BCBS Trust/PPO |
$449.29
|
| Rate for Payer: BCN Commercial |
$425.35
|
| Rate for Payer: Cash Price |
$440.32
|
| Rate for Payer: Cofinity Commercial |
$473.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.32
|
| Rate for Payer: Healthscope Commercial |
$495.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$412.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467.84
|
| Rate for Payer: Nomi Health Commercial |
$451.33
|
| Rate for Payer: PHP Commercial |
$467.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.76
|
| Rate for Payer: Priority Health HMO/PPO |
$478.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$368.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$484.35
|
| Rate for Payer: UHC Core |
$459.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$412.80
|
|
|
HC RO INS VAG BRACHTHER DEVICE
|
Facility
|
OP
|
$550.40
|
|
|
Service Code
|
CPT 57156
|
| Hospital Charge Code |
36100444
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.72 |
| Max. Negotiated Rate |
$495.36 |
| Rate for Payer: Aetna Commercial |
$467.84
|
| Rate for Payer: Aetna Medicare |
$143.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.00
|
| Rate for Payer: BCBS Complete |
$226.27
|
| Rate for Payer: BCBS MAPPO |
$137.60
|
| Rate for Payer: BCBS Trust/PPO |
$452.48
|
| Rate for Payer: BCN Commercial |
$427.94
|
| Rate for Payer: BCN Medicare Advantage |
$137.60
|
| Rate for Payer: Cash Price |
$440.32
|
| Rate for Payer: Cash Price |
$440.32
|
| Rate for Payer: Cofinity Commercial |
$473.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.60
|
| Rate for Payer: Healthscope Commercial |
$495.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$412.80
|
| Rate for Payer: Mclaren Medicaid |
$215.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.48
|
| Rate for Payer: Meridian Medicaid |
$226.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$158.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467.84
|
| Rate for Payer: Nomi Health Commercial |
$451.33
|
| Rate for Payer: PACE Senior Care Partners |
$130.72
|
| Rate for Payer: PACE SWMI |
$137.60
|
| Rate for Payer: PHP Commercial |
$467.84
|
| Rate for Payer: PHP Medicare Advantage |
$137.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.76
|
| Rate for Payer: Priority Health HMO/PPO |
$478.85
|
| Rate for Payer: Priority Health Medicare |
$138.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$368.77
|
| Rate for Payer: Railroad Medicare Medicare |
$137.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$484.35
|
| Rate for Payer: UHC Core |
$459.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.60
|
| Rate for Payer: UHC Exchange |
$137.60
|
| Rate for Payer: UHC Medicare Advantage |
$137.60
|
| Rate for Payer: UHCCP Medicaid |
$215.48
|
| Rate for Payer: VA VA |
$137.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$412.80
|
|
|
HC RO INTRSTI RADELEMENT APPL CMPLX
|
Facility
|
OP
|
$2,837.17
|
|
|
Service Code
|
CPT 77778
|
| Hospital Charge Code |
33300035
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$491.48 |
| Max. Negotiated Rate |
$2,553.45 |
| Rate for Payer: Aetna Commercial |
$2,411.59
|
| Rate for Payer: Aetna Medicare |
$737.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$886.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$886.62
|
| Rate for Payer: BCBS Complete |
$516.09
|
| Rate for Payer: BCBS MAPPO |
$709.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,332.44
|
| Rate for Payer: BCN Commercial |
$2,205.90
|
| Rate for Payer: BCN Medicare Advantage |
$709.29
|
| Rate for Payer: Cash Price |
$2,269.74
|
| Rate for Payer: Cash Price |
$2,269.74
|
| Rate for Payer: Cofinity Commercial |
$2,439.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,269.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$709.29
|
| Rate for Payer: Healthscope Commercial |
$2,553.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,127.88
|
| Rate for Payer: Mclaren Medicaid |
$491.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$744.76
|
| Rate for Payer: Meridian Medicaid |
$516.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$815.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,411.59
|
| Rate for Payer: Nomi Health Commercial |
$2,326.48
|
| Rate for Payer: PACE Senior Care Partners |
$673.83
|
| Rate for Payer: PACE SWMI |
$709.29
|
| Rate for Payer: PHP Commercial |
$2,411.59
|
| Rate for Payer: PHP Medicare Advantage |
$709.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$491.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.16
|
| Rate for Payer: Priority Health HMO/PPO |
$2,468.34
|
| Rate for Payer: Priority Health Medicare |
$716.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,900.90
|
| Rate for Payer: Railroad Medicare Medicare |
$709.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,496.71
|
| Rate for Payer: UHC Core |
$2,369.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$709.29
|
| Rate for Payer: UHC Exchange |
$709.29
|
| Rate for Payer: UHC Medicare Advantage |
$709.29
|
| Rate for Payer: UHCCP Medicaid |
$491.48
|
| Rate for Payer: VA VA |
$709.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,127.88
|
|
|
HC RO INTRSTI RADELEMENT APPL CMPLX
|
Facility
|
IP
|
$2,837.17
|
|
|
Service Code
|
CPT 77778
|
| Hospital Charge Code |
33300035
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,844.16 |
| Max. Negotiated Rate |
$2,553.45 |
| Rate for Payer: Aetna Commercial |
$2,411.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,315.98
|
| Rate for Payer: BCN Commercial |
$2,192.56
|
| Rate for Payer: Cash Price |
$2,269.74
|
| Rate for Payer: Cofinity Commercial |
$2,439.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,269.74
|
| Rate for Payer: Healthscope Commercial |
$2,553.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,127.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,411.59
|
| Rate for Payer: Nomi Health Commercial |
$2,326.48
|
| Rate for Payer: PHP Commercial |
$2,411.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.16
|
| Rate for Payer: Priority Health HMO/PPO |
$2,468.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,900.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,496.71
|
| Rate for Payer: UHC Core |
$2,369.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,127.88
|
|
|
HC RO ISODOSE BRACH CALC SIMPLE
|
Facility
|
IP
|
$234.86
|
|
|
Service Code
|
CPT 77316
|
| Hospital Charge Code |
33300045
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$152.66 |
| Max. Negotiated Rate |
$211.37 |
| Rate for Payer: Aetna Commercial |
$199.63
|
| Rate for Payer: BCBS Trust/PPO |
$191.72
|
| Rate for Payer: BCN Commercial |
$181.50
|
| Rate for Payer: Cash Price |
$187.89
|
| Rate for Payer: Cofinity Commercial |
$201.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.89
|
| Rate for Payer: Healthscope Commercial |
$211.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.63
|
| Rate for Payer: Nomi Health Commercial |
$192.59
|
| Rate for Payer: PHP Commercial |
$199.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.66
|
| Rate for Payer: Priority Health HMO/PPO |
$204.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.68
|
| Rate for Payer: UHC Core |
$196.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.14
|
|
|
HC RO ISODOSE BRACH CALC SIMPLE
|
Facility
|
OP
|
$234.86
|
|
|
Service Code
|
CPT 77316
|
| Hospital Charge Code |
33300045
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$55.78 |
| Max. Negotiated Rate |
$272.30 |
| Rate for Payer: Aetna Commercial |
$199.63
|
| Rate for Payer: Aetna Medicare |
$61.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.39
|
| Rate for Payer: BCBS Complete |
$272.30
|
| Rate for Payer: BCBS MAPPO |
$58.72
|
| Rate for Payer: BCBS Trust/PPO |
$193.08
|
| Rate for Payer: BCN Commercial |
$182.60
|
| Rate for Payer: BCN Medicare Advantage |
$58.72
|
| Rate for Payer: Cash Price |
$187.89
|
| Rate for Payer: Cash Price |
$187.89
|
| Rate for Payer: Cofinity Commercial |
$201.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.72
|
| Rate for Payer: Healthscope Commercial |
$211.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.14
|
| Rate for Payer: Mclaren Medicaid |
$259.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.65
|
| Rate for Payer: Meridian Medicaid |
$272.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.63
|
| Rate for Payer: Nomi Health Commercial |
$192.59
|
| Rate for Payer: PACE Senior Care Partners |
$55.78
|
| Rate for Payer: PACE SWMI |
$58.72
|
| Rate for Payer: PHP Commercial |
$199.63
|
| Rate for Payer: PHP Medicare Advantage |
$58.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.66
|
| Rate for Payer: Priority Health HMO/PPO |
$204.33
|
| Rate for Payer: Priority Health Medicare |
$59.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.36
|
| Rate for Payer: Railroad Medicare Medicare |
$58.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.68
|
| Rate for Payer: UHC Core |
$196.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.72
|
| Rate for Payer: UHC Exchange |
$58.72
|
| Rate for Payer: UHC Medicare Advantage |
$58.72
|
| Rate for Payer: UHCCP Medicaid |
$259.32
|
| Rate for Payer: VA VA |
$58.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.14
|
|
|
HC RO ISODOSE BRACHY CALC COMPLEX
|
Facility
|
IP
|
$684.94
|
|
|
Service Code
|
CPT 77318
|
| Hospital Charge Code |
33300047
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$445.21 |
| Max. Negotiated Rate |
$616.45 |
| Rate for Payer: Aetna Commercial |
$582.20
|
| Rate for Payer: BCBS Trust/PPO |
$559.12
|
| Rate for Payer: BCN Commercial |
$529.32
|
| Rate for Payer: Cash Price |
$547.95
|
| Rate for Payer: Cofinity Commercial |
$589.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.95
|
| Rate for Payer: Healthscope Commercial |
$616.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$513.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$582.20
|
| Rate for Payer: Nomi Health Commercial |
$561.65
|
| Rate for Payer: PHP Commercial |
$582.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.21
|
| Rate for Payer: Priority Health HMO/PPO |
$595.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$458.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$602.75
|
| Rate for Payer: UHC Core |
$571.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$513.70
|
|
|
HC RO ISODOSE BRACHY CALC COMPLEX
|
Facility
|
OP
|
$684.94
|
|
|
Service Code
|
CPT 77318
|
| Hospital Charge Code |
33300047
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$162.67 |
| Max. Negotiated Rate |
$616.45 |
| Rate for Payer: Aetna Commercial |
$582.20
|
| Rate for Payer: Aetna Medicare |
$178.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$214.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$214.04
|
| Rate for Payer: BCBS Complete |
$272.30
|
| Rate for Payer: BCBS MAPPO |
$171.24
|
| Rate for Payer: BCBS Trust/PPO |
$563.09
|
| Rate for Payer: BCN Commercial |
$532.54
|
| Rate for Payer: BCN Medicare Advantage |
$171.24
|
| Rate for Payer: Cash Price |
$547.95
|
| Rate for Payer: Cash Price |
$547.95
|
| Rate for Payer: Cofinity Commercial |
$589.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.24
|
| Rate for Payer: Healthscope Commercial |
$616.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$513.70
|
| Rate for Payer: Mclaren Medicaid |
$259.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.80
|
| Rate for Payer: Meridian Medicaid |
$272.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$196.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$582.20
|
| Rate for Payer: Nomi Health Commercial |
$561.65
|
| Rate for Payer: PACE Senior Care Partners |
$162.67
|
| Rate for Payer: PACE SWMI |
$171.24
|
| Rate for Payer: PHP Commercial |
$582.20
|
| Rate for Payer: PHP Medicare Advantage |
$171.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.21
|
| Rate for Payer: Priority Health HMO/PPO |
$595.90
|
| Rate for Payer: Priority Health Medicare |
$172.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$458.91
|
| Rate for Payer: Railroad Medicare Medicare |
$171.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$602.75
|
| Rate for Payer: UHC Core |
$571.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$171.24
|
| Rate for Payer: UHC Exchange |
$171.24
|
| Rate for Payer: UHC Medicare Advantage |
$171.24
|
| Rate for Payer: UHCCP Medicaid |
$259.32
|
| Rate for Payer: VA VA |
$171.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$513.70
|
|
|
HC RO ISODOSE BRACHY CALC INTRM
|
Facility
|
OP
|
$622.67
|
|
|
Service Code
|
CPT 77317
|
| Hospital Charge Code |
33300046
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$147.88 |
| Max. Negotiated Rate |
$560.40 |
| Rate for Payer: Aetna Commercial |
$529.27
|
| Rate for Payer: Aetna Medicare |
$161.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$194.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$194.58
|
| Rate for Payer: BCBS Complete |
$272.30
|
| Rate for Payer: BCBS MAPPO |
$155.67
|
| Rate for Payer: BCBS Trust/PPO |
$511.90
|
| Rate for Payer: BCN Commercial |
$484.13
|
| Rate for Payer: BCN Medicare Advantage |
$155.67
|
| Rate for Payer: Cash Price |
$498.14
|
| Rate for Payer: Cash Price |
$498.14
|
| Rate for Payer: Cofinity Commercial |
$535.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.67
|
| Rate for Payer: Healthscope Commercial |
$560.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$467.00
|
| Rate for Payer: Mclaren Medicaid |
$259.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.45
|
| Rate for Payer: Meridian Medicaid |
$272.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.27
|
| Rate for Payer: Nomi Health Commercial |
$510.59
|
| Rate for Payer: PACE Senior Care Partners |
$147.88
|
| Rate for Payer: PACE SWMI |
$155.67
|
| Rate for Payer: PHP Commercial |
$529.27
|
| Rate for Payer: PHP Medicare Advantage |
$155.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.74
|
| Rate for Payer: Priority Health HMO/PPO |
$541.72
|
| Rate for Payer: Priority Health Medicare |
$157.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$417.19
|
| Rate for Payer: Railroad Medicare Medicare |
$155.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.95
|
| Rate for Payer: UHC Core |
$519.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.67
|
| Rate for Payer: UHC Exchange |
$155.67
|
| Rate for Payer: UHC Medicare Advantage |
$155.67
|
| Rate for Payer: UHCCP Medicaid |
$259.32
|
| Rate for Payer: VA VA |
$155.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$467.00
|
|
|
HC RO ISODOSE BRACHY CALC INTRM
|
Facility
|
IP
|
$622.67
|
|
|
Service Code
|
CPT 77317
|
| Hospital Charge Code |
33300046
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$404.74 |
| Max. Negotiated Rate |
$560.40 |
| Rate for Payer: Aetna Commercial |
$529.27
|
| Rate for Payer: BCBS Trust/PPO |
$508.29
|
| Rate for Payer: BCN Commercial |
$481.20
|
| Rate for Payer: Cash Price |
$498.14
|
| Rate for Payer: Cofinity Commercial |
$535.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.14
|
| Rate for Payer: Healthscope Commercial |
$560.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$467.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.27
|
| Rate for Payer: Nomi Health Commercial |
$510.59
|
| Rate for Payer: PHP Commercial |
$529.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.74
|
| Rate for Payer: Priority Health HMO/PPO |
$541.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$417.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.95
|
| Rate for Payer: UHC Core |
$519.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$467.00
|
|
|
HC RO ISODOSE TELETHRPY COMPLEX
|
Facility
|
IP
|
$1,157.97
|
|
|
Service Code
|
CPT 77307
|
| Hospital Charge Code |
33300044
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$752.68 |
| Max. Negotiated Rate |
$1,042.17 |
| Rate for Payer: Aetna Commercial |
$984.27
|
| Rate for Payer: BCBS Trust/PPO |
$945.25
|
| Rate for Payer: BCN Commercial |
$894.88
|
| Rate for Payer: Cash Price |
$926.38
|
| Rate for Payer: Cofinity Commercial |
$995.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$926.38
|
| Rate for Payer: Healthscope Commercial |
$1,042.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$868.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$984.27
|
| Rate for Payer: Nomi Health Commercial |
$949.54
|
| Rate for Payer: PHP Commercial |
$984.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$752.68
|
| Rate for Payer: Priority Health HMO/PPO |
$1,007.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$775.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,019.01
|
| Rate for Payer: UHC Core |
$966.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$868.48
|
|
|
HC RO ISODOSE TELETHRPY COMPLEX
|
Facility
|
OP
|
$1,157.97
|
|
|
Service Code
|
CPT 77307
|
| Hospital Charge Code |
33300044
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$259.32 |
| Max. Negotiated Rate |
$1,042.17 |
| Rate for Payer: Aetna Commercial |
$984.27
|
| Rate for Payer: Aetna Medicare |
$301.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.87
|
| Rate for Payer: BCBS Complete |
$272.30
|
| Rate for Payer: BCBS MAPPO |
$289.49
|
| Rate for Payer: BCBS Trust/PPO |
$951.97
|
| Rate for Payer: BCN Commercial |
$900.32
|
| Rate for Payer: BCN Medicare Advantage |
$289.49
|
| Rate for Payer: Cash Price |
$926.38
|
| Rate for Payer: Cash Price |
$926.38
|
| Rate for Payer: Cofinity Commercial |
$995.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$926.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.49
|
| Rate for Payer: Healthscope Commercial |
$1,042.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$868.48
|
| Rate for Payer: Mclaren Medicaid |
$259.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.97
|
| Rate for Payer: Meridian Medicaid |
$272.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$984.27
|
| Rate for Payer: Nomi Health Commercial |
$949.54
|
| Rate for Payer: PACE Senior Care Partners |
$275.02
|
| Rate for Payer: PACE SWMI |
$289.49
|
| Rate for Payer: PHP Commercial |
$984.27
|
| Rate for Payer: PHP Medicare Advantage |
$289.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$752.68
|
| Rate for Payer: Priority Health HMO/PPO |
$1,007.43
|
| Rate for Payer: Priority Health Medicare |
$292.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$775.84
|
| Rate for Payer: Railroad Medicare Medicare |
$289.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,019.01
|
| Rate for Payer: UHC Core |
$966.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.49
|
| Rate for Payer: UHC Exchange |
$289.49
|
| Rate for Payer: UHC Medicare Advantage |
$289.49
|
| Rate for Payer: UHCCP Medicaid |
$259.32
|
| Rate for Payer: VA VA |
$289.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$868.48
|
|
|
HC RO ISODOSE TELETHRPY SIMPLE
|
Facility
|
OP
|
$252.82
|
|
|
Service Code
|
CPT 77306
|
| Hospital Charge Code |
33300043
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$60.04 |
| Max. Negotiated Rate |
$272.30 |
| Rate for Payer: Aetna Commercial |
$214.90
|
| Rate for Payer: Aetna Medicare |
$65.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.01
|
| Rate for Payer: BCBS Complete |
$272.30
|
| Rate for Payer: BCBS MAPPO |
$63.20
|
| Rate for Payer: BCBS Trust/PPO |
$207.84
|
| Rate for Payer: BCN Commercial |
$196.57
|
| Rate for Payer: BCN Medicare Advantage |
$63.20
|
| Rate for Payer: Cash Price |
$202.26
|
| Rate for Payer: Cash Price |
$202.26
|
| Rate for Payer: Cofinity Commercial |
$217.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.20
|
| Rate for Payer: Healthscope Commercial |
$227.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.62
|
| Rate for Payer: Mclaren Medicaid |
$259.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.37
|
| Rate for Payer: Meridian Medicaid |
$272.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.90
|
| Rate for Payer: Nomi Health Commercial |
$207.31
|
| Rate for Payer: PACE Senior Care Partners |
$60.04
|
| Rate for Payer: PACE SWMI |
$63.20
|
| Rate for Payer: PHP Commercial |
$214.90
|
| Rate for Payer: PHP Medicare Advantage |
$63.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.33
|
| Rate for Payer: Priority Health HMO/PPO |
$219.95
|
| Rate for Payer: Priority Health Medicare |
$63.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.39
|
| Rate for Payer: Railroad Medicare Medicare |
$63.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.48
|
| Rate for Payer: UHC Core |
$211.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.20
|
| Rate for Payer: UHC Exchange |
$63.20
|
| Rate for Payer: UHC Medicare Advantage |
$63.20
|
| Rate for Payer: UHCCP Medicaid |
$259.32
|
| Rate for Payer: VA VA |
$63.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.62
|
|
|
HC RO ISODOSE TELETHRPY SIMPLE
|
Facility
|
IP
|
$252.82
|
|
|
Service Code
|
CPT 77306
|
| Hospital Charge Code |
33300043
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$164.33 |
| Max. Negotiated Rate |
$227.54 |
| Rate for Payer: Aetna Commercial |
$214.90
|
| Rate for Payer: BCBS Trust/PPO |
$206.38
|
| Rate for Payer: BCN Commercial |
$195.38
|
| Rate for Payer: Cash Price |
$202.26
|
| Rate for Payer: Cofinity Commercial |
$217.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.26
|
| Rate for Payer: Healthscope Commercial |
$227.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.90
|
| Rate for Payer: Nomi Health Commercial |
$207.31
|
| Rate for Payer: PHP Commercial |
$214.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.33
|
| Rate for Payer: Priority Health HMO/PPO |
$219.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.48
|
| Rate for Payer: UHC Core |
$211.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.62
|
|
|
HC RO LINAC SBRT PER SESSION
|
Facility
|
IP
|
$3,546.01
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300041
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,304.91 |
| Max. Negotiated Rate |
$3,191.41 |
| Rate for Payer: Aetna Commercial |
$3,014.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,894.61
|
| Rate for Payer: BCN Commercial |
$2,740.36
|
| Rate for Payer: Cash Price |
$2,836.81
|
| Rate for Payer: Cofinity Commercial |
$3,049.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,836.81
|
| Rate for Payer: Healthscope Commercial |
$3,191.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,659.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,014.11
|
| Rate for Payer: Nomi Health Commercial |
$2,907.73
|
| Rate for Payer: PHP Commercial |
$3,014.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,304.91
|
| Rate for Payer: Priority Health HMO/PPO |
$3,085.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,375.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,120.49
|
| Rate for Payer: UHC Core |
$2,960.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,659.51
|
|
