|
HC SQ ICD
|
Facility
|
IP
|
$56,418.24
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36,671.86 |
| Max. Negotiated Rate |
$50,776.42 |
| Rate for Payer: Aetna Commercial |
$47,955.50
|
| Rate for Payer: BCBS Trust/PPO |
$46,054.21
|
| Rate for Payer: BCN Commercial |
$43,600.02
|
| Rate for Payer: Cash Price |
$45,134.59
|
| Rate for Payer: Cofinity Commercial |
$48,519.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45,134.59
|
| Rate for Payer: Healthscope Commercial |
$50,776.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42,313.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47,955.50
|
| Rate for Payer: Nomi Health Commercial |
$46,262.96
|
| Rate for Payer: PHP Commercial |
$47,955.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36,671.86
|
| Rate for Payer: Priority Health HMO/PPO |
$49,083.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37,800.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,648.05
|
| Rate for Payer: UHC Core |
$47,109.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42,313.68
|
|
|
HC SQ ICD
|
Facility
|
OP
|
$56,418.24
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,399.33 |
| Max. Negotiated Rate |
$50,776.42 |
| Rate for Payer: Aetna Commercial |
$47,955.50
|
| Rate for Payer: Aetna Medicare |
$14,668.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,630.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,630.70
|
| Rate for Payer: BCBS Complete |
$22,567.30
|
| Rate for Payer: BCBS MAPPO |
$14,104.56
|
| Rate for Payer: BCBS Trust/PPO |
$46,381.44
|
| Rate for Payer: BCN Commercial |
$43,865.18
|
| Rate for Payer: BCN Medicare Advantage |
$14,104.56
|
| Rate for Payer: Cash Price |
$45,134.59
|
| Rate for Payer: Cofinity Commercial |
$48,519.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45,134.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14,104.56
|
| Rate for Payer: Healthscope Commercial |
$50,776.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42,313.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14,809.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16,220.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47,955.50
|
| Rate for Payer: Nomi Health Commercial |
$46,262.96
|
| Rate for Payer: PACE Senior Care Partners |
$13,399.33
|
| Rate for Payer: PACE SWMI |
$14,104.56
|
| Rate for Payer: PHP Commercial |
$47,955.50
|
| Rate for Payer: PHP Medicare Advantage |
$14,104.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36,671.86
|
| Rate for Payer: Priority Health HMO/PPO |
$49,083.87
|
| Rate for Payer: Priority Health Medicare |
$14,245.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37,800.22
|
| Rate for Payer: Railroad Medicare Medicare |
$14,104.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,648.05
|
| Rate for Payer: UHC Core |
$47,109.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$14,104.56
|
| Rate for Payer: UHC Exchange |
$14,104.56
|
| Rate for Payer: UHC Medicare Advantage |
$14,104.56
|
| Rate for Payer: VA VA |
$14,104.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42,313.68
|
|
|
HC SQ ICD LEAD
|
Facility
|
IP
|
$14,662.50
|
|
|
Service Code
|
HCPCS C1896
|
| Hospital Charge Code |
27800123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,530.62 |
| Max. Negotiated Rate |
$13,196.25 |
| Rate for Payer: Aetna Commercial |
$12,463.12
|
| Rate for Payer: BCBS Trust/PPO |
$11,969.00
|
| Rate for Payer: BCN Commercial |
$11,331.18
|
| Rate for Payer: Cash Price |
$11,730.00
|
| Rate for Payer: Cofinity Commercial |
$12,609.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,730.00
|
| Rate for Payer: Healthscope Commercial |
$13,196.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,996.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,463.12
|
| Rate for Payer: Nomi Health Commercial |
$12,023.25
|
| Rate for Payer: PHP Commercial |
$12,463.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,530.62
|
| Rate for Payer: Priority Health HMO/PPO |
$12,756.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,823.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,903.00
|
| Rate for Payer: UHC Core |
$12,243.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,996.88
|
|
|
HC SQ ICD LEAD
|
Facility
|
OP
|
$14,662.50
|
|
|
Service Code
|
HCPCS C1896
|
| Hospital Charge Code |
27800123
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,482.34 |
| Max. Negotiated Rate |
$13,196.25 |
| Rate for Payer: Aetna Commercial |
$12,463.12
|
| Rate for Payer: Aetna Medicare |
$3,812.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,582.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,582.03
|
| Rate for Payer: BCBS Complete |
$5,865.00
|
| Rate for Payer: BCBS MAPPO |
$3,665.62
|
| Rate for Payer: BCBS Trust/PPO |
$12,054.04
|
| Rate for Payer: BCN Commercial |
$11,400.09
|
| Rate for Payer: BCN Medicare Advantage |
$3,665.62
|
| Rate for Payer: Cash Price |
$11,730.00
|
| Rate for Payer: Cofinity Commercial |
$12,609.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,730.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,665.62
|
| Rate for Payer: Healthscope Commercial |
$13,196.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,996.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,848.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,215.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,463.12
|
| Rate for Payer: Nomi Health Commercial |
$12,023.25
|
| Rate for Payer: PACE Senior Care Partners |
$3,482.34
|
| Rate for Payer: PACE SWMI |
$3,665.62
|
| Rate for Payer: PHP Commercial |
$12,463.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,665.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,530.62
|
| Rate for Payer: Priority Health HMO/PPO |
$12,756.38
|
| Rate for Payer: Priority Health Medicare |
$3,702.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,823.88
|
| Rate for Payer: Railroad Medicare Medicare |
$3,665.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,903.00
|
| Rate for Payer: UHC Core |
$12,243.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,665.62
|
| Rate for Payer: UHC Exchange |
$3,665.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,665.62
|
| Rate for Payer: VA VA |
$3,665.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,996.88
|
|
|
HC SQ IM CHEMO HORMONAL
|
Facility
|
IP
|
$246.51
|
|
|
Service Code
|
CPT 96402
|
| Hospital Charge Code |
33100002
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$160.23 |
| Max. Negotiated Rate |
$221.86 |
| Rate for Payer: Aetna Commercial |
$209.53
|
| Rate for Payer: BCBS Trust/PPO |
$201.23
|
| Rate for Payer: BCN Commercial |
$190.50
|
| Rate for Payer: Cash Price |
$197.21
|
| Rate for Payer: Cofinity Commercial |
$212.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.21
|
| Rate for Payer: Healthscope Commercial |
$221.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.53
|
| Rate for Payer: Nomi Health Commercial |
$202.14
|
| Rate for Payer: PHP Commercial |
$209.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.23
|
| Rate for Payer: Priority Health HMO/PPO |
$214.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.93
|
| Rate for Payer: UHC Core |
$205.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.88
|
|
|
HC SQ IM CHEMO HORMONAL
|
Facility
|
OP
|
$246.51
|
|
|
Service Code
|
CPT 96402
|
| Hospital Charge Code |
33100002
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$51.46 |
| Max. Negotiated Rate |
$221.86 |
| Rate for Payer: Aetna Commercial |
$209.53
|
| Rate for Payer: Aetna Medicare |
$64.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.03
|
| Rate for Payer: BCBS Complete |
$54.03
|
| Rate for Payer: BCBS MAPPO |
$61.63
|
| Rate for Payer: BCBS Trust/PPO |
$202.66
|
| Rate for Payer: BCN Commercial |
$191.66
|
| Rate for Payer: BCN Medicare Advantage |
$61.63
|
| Rate for Payer: Cash Price |
$197.21
|
| Rate for Payer: Cash Price |
$197.21
|
| Rate for Payer: Cofinity Commercial |
$212.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.63
|
| Rate for Payer: Healthscope Commercial |
$221.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.88
|
| Rate for Payer: Mclaren Medicaid |
$51.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.71
|
| Rate for Payer: Meridian Medicaid |
$54.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$209.53
|
| Rate for Payer: Nomi Health Commercial |
$202.14
|
| Rate for Payer: PACE Senior Care Partners |
$58.55
|
| Rate for Payer: PACE SWMI |
$61.63
|
| Rate for Payer: PHP Commercial |
$209.53
|
| Rate for Payer: PHP Medicare Advantage |
$61.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.23
|
| Rate for Payer: Priority Health HMO/PPO |
$214.46
|
| Rate for Payer: Priority Health Medicare |
$62.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.16
|
| Rate for Payer: Railroad Medicare Medicare |
$61.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.93
|
| Rate for Payer: UHC Core |
$205.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.63
|
| Rate for Payer: UHC Exchange |
$61.63
|
| Rate for Payer: UHC Medicare Advantage |
$61.63
|
| Rate for Payer: UHCCP Medicaid |
$51.46
|
| Rate for Payer: VA VA |
$61.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.88
|
|
|
HC SQ IM CHEMO NON-HORMONAL
|
Facility
|
OP
|
$498.94
|
|
|
Service Code
|
CPT 96401
|
| Hospital Charge Code |
33100001
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$51.46 |
| Max. Negotiated Rate |
$449.05 |
| Rate for Payer: Aetna Commercial |
$424.10
|
| Rate for Payer: Aetna Medicare |
$129.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$155.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$155.92
|
| Rate for Payer: BCBS Complete |
$54.03
|
| Rate for Payer: BCBS MAPPO |
$124.73
|
| Rate for Payer: BCBS Trust/PPO |
$410.18
|
| Rate for Payer: BCN Commercial |
$387.93
|
| Rate for Payer: BCN Medicare Advantage |
$124.73
|
| Rate for Payer: Cash Price |
$399.15
|
| Rate for Payer: Cash Price |
$399.15
|
| Rate for Payer: Cofinity Commercial |
$429.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.73
|
| Rate for Payer: Healthscope Commercial |
$449.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.20
|
| Rate for Payer: Mclaren Medicaid |
$51.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.97
|
| Rate for Payer: Meridian Medicaid |
$54.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.10
|
| Rate for Payer: Nomi Health Commercial |
$409.13
|
| Rate for Payer: PACE Senior Care Partners |
$118.50
|
| Rate for Payer: PACE SWMI |
$124.73
|
| Rate for Payer: PHP Commercial |
$424.10
|
| Rate for Payer: PHP Medicare Advantage |
$124.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.31
|
| Rate for Payer: Priority Health HMO/PPO |
$434.08
|
| Rate for Payer: Priority Health Medicare |
$125.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$334.29
|
| Rate for Payer: Railroad Medicare Medicare |
$124.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.07
|
| Rate for Payer: UHC Core |
$416.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.73
|
| Rate for Payer: UHC Exchange |
$124.73
|
| Rate for Payer: UHC Medicare Advantage |
$124.73
|
| Rate for Payer: UHCCP Medicaid |
$51.46
|
| Rate for Payer: VA VA |
$124.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.20
|
|
|
HC SQ IM CHEMO NON-HORMONAL
|
Facility
|
IP
|
$498.94
|
|
|
Service Code
|
CPT 96401
|
| Hospital Charge Code |
33100001
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$324.31 |
| Max. Negotiated Rate |
$449.05 |
| Rate for Payer: Aetna Commercial |
$424.10
|
| Rate for Payer: BCBS Trust/PPO |
$407.28
|
| Rate for Payer: BCN Commercial |
$385.58
|
| Rate for Payer: Cash Price |
$399.15
|
| Rate for Payer: Cofinity Commercial |
$429.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.15
|
| Rate for Payer: Healthscope Commercial |
$449.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.10
|
| Rate for Payer: Nomi Health Commercial |
$409.13
|
| Rate for Payer: PHP Commercial |
$424.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.31
|
| Rate for Payer: Priority Health HMO/PPO |
$434.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$334.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.07
|
| Rate for Payer: UHC Core |
$416.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.20
|
|
|
HC SQ OR IM INJECTION
|
Facility
|
IP
|
$149.79
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
51000003
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$97.36 |
| Max. Negotiated Rate |
$134.81 |
| Rate for Payer: Aetna Commercial |
$127.32
|
| Rate for Payer: BCBS Trust/PPO |
$122.27
|
| Rate for Payer: BCN Commercial |
$115.76
|
| Rate for Payer: Cash Price |
$119.83
|
| Rate for Payer: Cofinity Commercial |
$128.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.83
|
| Rate for Payer: Healthscope Commercial |
$134.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.32
|
| Rate for Payer: Nomi Health Commercial |
$122.83
|
| Rate for Payer: PHP Commercial |
$127.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.36
|
| Rate for Payer: Priority Health HMO/PPO |
$130.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.82
|
| Rate for Payer: UHC Core |
$125.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.34
|
|
|
HC SQ OR IM INJECTION
|
Facility
|
OP
|
$149.79
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
51000003
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$35.58 |
| Max. Negotiated Rate |
$134.81 |
| Rate for Payer: Aetna Commercial |
$127.32
|
| Rate for Payer: Aetna Medicare |
$38.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.81
|
| Rate for Payer: BCBS Complete |
$54.03
|
| Rate for Payer: BCBS MAPPO |
$37.45
|
| Rate for Payer: BCBS Trust/PPO |
$123.14
|
| Rate for Payer: BCN Commercial |
$116.46
|
| Rate for Payer: BCN Medicare Advantage |
$37.45
|
| Rate for Payer: Cash Price |
$119.83
|
| Rate for Payer: Cash Price |
$119.83
|
| Rate for Payer: Cofinity Commercial |
$128.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.45
|
| Rate for Payer: Healthscope Commercial |
$134.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.34
|
| Rate for Payer: Mclaren Medicaid |
$51.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.32
|
| Rate for Payer: Meridian Medicaid |
$54.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.32
|
| Rate for Payer: Nomi Health Commercial |
$122.83
|
| Rate for Payer: PACE Senior Care Partners |
$35.58
|
| Rate for Payer: PACE SWMI |
$37.45
|
| Rate for Payer: PHP Commercial |
$127.32
|
| Rate for Payer: PHP Medicare Advantage |
$37.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.36
|
| Rate for Payer: Priority Health HMO/PPO |
$130.32
|
| Rate for Payer: Priority Health Medicare |
$37.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$100.36
|
| Rate for Payer: Railroad Medicare Medicare |
$37.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.82
|
| Rate for Payer: UHC Core |
$125.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.45
|
| Rate for Payer: UHC Exchange |
$37.45
|
| Rate for Payer: UHC Medicare Advantage |
$37.45
|
| Rate for Payer: UHCCP Medicaid |
$51.46
|
| Rate for Payer: VA VA |
$37.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.34
|
|
|
HC SRA, LMWH
|
Facility
|
IP
|
$332.93
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$216.40 |
| Max. Negotiated Rate |
$299.64 |
| Rate for Payer: Aetna Commercial |
$282.99
|
| Rate for Payer: BCBS Trust/PPO |
$271.77
|
| Rate for Payer: BCN Commercial |
$257.29
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cofinity Commercial |
$286.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.34
|
| Rate for Payer: Healthscope Commercial |
$299.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.99
|
| Rate for Payer: Nomi Health Commercial |
$273.00
|
| Rate for Payer: PHP Commercial |
$282.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.40
|
| Rate for Payer: Priority Health HMO/PPO |
$289.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$223.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.98
|
| Rate for Payer: UHC Core |
$278.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.70
|
|
|
HC SRA, LMWH
|
Facility
|
OP
|
$332.93
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$299.64 |
| Rate for Payer: Aetna Commercial |
$282.99
|
| Rate for Payer: Aetna Medicare |
$86.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.04
|
| Rate for Payer: BCBS Complete |
$13.95
|
| Rate for Payer: BCBS MAPPO |
$83.23
|
| Rate for Payer: BCBS Trust/PPO |
$273.70
|
| Rate for Payer: BCN Commercial |
$258.85
|
| Rate for Payer: BCN Medicare Advantage |
$83.23
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cofinity Commercial |
$286.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$299.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.70
|
| Rate for Payer: Mclaren Medicaid |
$13.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.39
|
| Rate for Payer: Meridian Medicaid |
$13.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.99
|
| Rate for Payer: Nomi Health Commercial |
$273.00
|
| Rate for Payer: PACE Senior Care Partners |
$79.07
|
| Rate for Payer: PACE SWMI |
$83.23
|
| Rate for Payer: PHP Commercial |
$282.99
|
| Rate for Payer: PHP Medicare Advantage |
$83.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.40
|
| Rate for Payer: Priority Health HMO/PPO |
$289.65
|
| Rate for Payer: Priority Health Medicare |
$84.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$223.06
|
| Rate for Payer: Railroad Medicare Medicare |
$83.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.98
|
| Rate for Payer: UHC Core |
$278.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.23
|
| Rate for Payer: UHC Exchange |
$83.23
|
| Rate for Payer: UHC Medicare Advantage |
$83.23
|
| Rate for Payer: UHCCP Medicaid |
$13.28
|
| Rate for Payer: VA VA |
$83.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.70
|
|
|
HC SRS CRANIAL LESION LIN ACC
|
Facility
|
OP
|
$3,101.43
|
|
|
Service Code
|
CPT 77372
|
| Hospital Charge Code |
33300032
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$736.59 |
| Max. Negotiated Rate |
$5,803.70 |
| Rate for Payer: Aetna Commercial |
$2,636.22
|
| Rate for Payer: Aetna Medicare |
$806.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$969.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$969.20
|
| Rate for Payer: BCBS Complete |
$5,803.70
|
| Rate for Payer: BCBS MAPPO |
$775.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,549.69
|
| Rate for Payer: BCN Commercial |
$2,411.36
|
| Rate for Payer: BCN Medicare Advantage |
$775.36
|
| Rate for Payer: Cash Price |
$2,481.14
|
| Rate for Payer: Cash Price |
$2,481.14
|
| Rate for Payer: Cofinity Commercial |
$2,667.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,481.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.36
|
| Rate for Payer: Healthscope Commercial |
$2,791.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,326.07
|
| Rate for Payer: Mclaren Medicaid |
$5,526.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$814.13
|
| Rate for Payer: Meridian Medicaid |
$5,803.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$891.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,636.22
|
| Rate for Payer: Nomi Health Commercial |
$2,543.17
|
| Rate for Payer: PACE Senior Care Partners |
$736.59
|
| Rate for Payer: PACE SWMI |
$775.36
|
| Rate for Payer: PHP Commercial |
$2,636.22
|
| Rate for Payer: PHP Medicare Advantage |
$775.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,526.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.93
|
| Rate for Payer: Priority Health HMO/PPO |
$2,698.24
|
| Rate for Payer: Priority Health Medicare |
$783.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,077.96
|
| Rate for Payer: Railroad Medicare Medicare |
$775.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,729.26
|
| Rate for Payer: UHC Core |
$2,589.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.36
|
| Rate for Payer: UHC Exchange |
$775.36
|
| Rate for Payer: UHC Medicare Advantage |
$775.36
|
| Rate for Payer: UHCCP Medicaid |
$5,526.97
|
| Rate for Payer: VA VA |
$775.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,326.07
|
|
|
HC SRS CRANIAL LESION LIN ACC
|
Facility
|
IP
|
$3,101.43
|
|
|
Service Code
|
CPT 77372
|
| Hospital Charge Code |
33300032
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,015.93 |
| Max. Negotiated Rate |
$2,791.29 |
| Rate for Payer: Aetna Commercial |
$2,636.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,531.70
|
| Rate for Payer: BCN Commercial |
$2,396.79
|
| Rate for Payer: Cash Price |
$2,481.14
|
| Rate for Payer: Cofinity Commercial |
$2,667.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,481.14
|
| Rate for Payer: Healthscope Commercial |
$2,791.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,326.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,636.22
|
| Rate for Payer: Nomi Health Commercial |
$2,543.17
|
| Rate for Payer: PHP Commercial |
$2,636.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,015.93
|
| Rate for Payer: Priority Health HMO/PPO |
$2,698.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,077.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,729.26
|
| Rate for Payer: UHC Core |
$2,589.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,326.07
|
|
|
HC SRT UP TO 5 FRACTIONS
|
Facility
|
OP
|
$5,306.04
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300018
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,260.18 |
| Max. Negotiated Rate |
$4,775.44 |
| Rate for Payer: Aetna Commercial |
$4,510.13
|
| Rate for Payer: Aetna Medicare |
$1,379.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,658.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,658.14
|
| Rate for Payer: BCBS Complete |
$1,333.09
|
| Rate for Payer: BCBS MAPPO |
$1,326.51
|
| Rate for Payer: BCBS Trust/PPO |
$4,362.10
|
| Rate for Payer: BCN Commercial |
$4,125.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,326.51
|
| Rate for Payer: Cash Price |
$4,244.83
|
| Rate for Payer: Cash Price |
$4,244.83
|
| Rate for Payer: Cofinity Commercial |
$4,563.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,244.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,326.51
|
| Rate for Payer: Healthscope Commercial |
$4,775.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,979.53
|
| Rate for Payer: Mclaren Medicaid |
$1,269.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,392.84
|
| Rate for Payer: Meridian Medicaid |
$1,333.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,525.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,510.13
|
| Rate for Payer: Nomi Health Commercial |
$4,350.95
|
| Rate for Payer: PACE Senior Care Partners |
$1,260.18
|
| Rate for Payer: PACE SWMI |
$1,326.51
|
| Rate for Payer: PHP Commercial |
$4,510.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,326.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,269.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,448.93
|
| Rate for Payer: Priority Health HMO/PPO |
$4,616.25
|
| Rate for Payer: Priority Health Medicare |
$1,339.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,555.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,326.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,669.32
|
| Rate for Payer: UHC Core |
$4,430.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,326.51
|
| Rate for Payer: UHC Exchange |
$1,326.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,326.51
|
| Rate for Payer: UHCCP Medicaid |
$1,269.52
|
| Rate for Payer: VA VA |
$1,326.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,979.53
|
|
|
HC SRT UP TO 5 FRACTIONS
|
Facility
|
IP
|
$5,306.04
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300018
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$3,448.93 |
| Max. Negotiated Rate |
$4,775.44 |
| Rate for Payer: Aetna Commercial |
$4,510.13
|
| Rate for Payer: BCBS Trust/PPO |
$4,331.32
|
| Rate for Payer: BCN Commercial |
$4,100.51
|
| Rate for Payer: Cash Price |
$4,244.83
|
| Rate for Payer: Cofinity Commercial |
$4,563.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,244.83
|
| Rate for Payer: Healthscope Commercial |
$4,775.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,979.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,510.13
|
| Rate for Payer: Nomi Health Commercial |
$4,350.95
|
| Rate for Payer: PHP Commercial |
$4,510.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,448.93
|
| Rate for Payer: Priority Health HMO/PPO |
$4,616.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,555.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,669.32
|
| Rate for Payer: UHC Core |
$4,430.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,979.53
|
|
|
HC SS2PC SPECIAL STAIN (BILL ONLY)
|
Facility
|
OP
|
$112.20
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31200007
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$26.65 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: Aetna Medicare |
$29.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.06
|
| Rate for Payer: BCBS Complete |
$97.86
|
| Rate for Payer: BCBS MAPPO |
$28.05
|
| Rate for Payer: BCBS Trust/PPO |
$92.24
|
| Rate for Payer: BCN Commercial |
$87.24
|
| Rate for Payer: BCN Medicare Advantage |
$28.05
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.05
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.15
|
| Rate for Payer: Mclaren Medicaid |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.45
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$92.00
|
| Rate for Payer: PACE Senior Care Partners |
$26.65
|
| Rate for Payer: PACE SWMI |
$28.05
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: PHP Medicare Advantage |
$28.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: Priority Health HMO/PPO |
$97.61
|
| Rate for Payer: Priority Health Medicare |
$28.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.17
|
| Rate for Payer: Railroad Medicare Medicare |
$28.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.74
|
| Rate for Payer: UHC Core |
$93.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.05
|
| Rate for Payer: UHC Exchange |
$28.05
|
| Rate for Payer: UHC Medicare Advantage |
$28.05
|
| Rate for Payer: UHCCP Medicaid |
$93.19
|
| Rate for Payer: VA VA |
$28.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.15
|
|
|
HC SS2PC SPECIAL STAIN (BILL ONLY)
|
Facility
|
IP
|
$112.20
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31200007
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$72.93 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: BCBS Trust/PPO |
$91.59
|
| Rate for Payer: BCN Commercial |
$86.71
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$92.00
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: Priority Health HMO/PPO |
$97.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.74
|
| Rate for Payer: UHC Core |
$93.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.15
|
|
|
HC STABILIZERS HEART ESTECH
|
Facility
|
IP
|
$933.30
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$606.64 |
| Max. Negotiated Rate |
$839.97 |
| Rate for Payer: Aetna Commercial |
$793.30
|
| Rate for Payer: BCBS Trust/PPO |
$761.85
|
| Rate for Payer: BCN Commercial |
$721.25
|
| Rate for Payer: Cash Price |
$746.64
|
| Rate for Payer: Cofinity Commercial |
$802.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$746.64
|
| Rate for Payer: Healthscope Commercial |
$839.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$699.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$793.30
|
| Rate for Payer: Nomi Health Commercial |
$765.31
|
| Rate for Payer: PHP Commercial |
$793.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.64
|
| Rate for Payer: Priority Health HMO/PPO |
$811.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$625.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$821.30
|
| Rate for Payer: UHC Core |
$779.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$699.98
|
|
|
HC STABILIZERS HEART ESTECH
|
Facility
|
OP
|
$933.30
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$221.66 |
| Max. Negotiated Rate |
$839.97 |
| Rate for Payer: Aetna Commercial |
$793.30
|
| Rate for Payer: Aetna Medicare |
$242.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$291.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$291.66
|
| Rate for Payer: BCBS Complete |
$373.32
|
| Rate for Payer: BCBS MAPPO |
$233.32
|
| Rate for Payer: BCBS Trust/PPO |
$767.27
|
| Rate for Payer: BCN Commercial |
$725.64
|
| Rate for Payer: BCN Medicare Advantage |
$233.32
|
| Rate for Payer: Cash Price |
$746.64
|
| Rate for Payer: Cofinity Commercial |
$802.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$746.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.32
|
| Rate for Payer: Healthscope Commercial |
$839.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$699.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$268.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$793.30
|
| Rate for Payer: Nomi Health Commercial |
$765.31
|
| Rate for Payer: PACE Senior Care Partners |
$221.66
|
| Rate for Payer: PACE SWMI |
$233.32
|
| Rate for Payer: PHP Commercial |
$793.30
|
| Rate for Payer: PHP Medicare Advantage |
$233.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.64
|
| Rate for Payer: Priority Health HMO/PPO |
$811.97
|
| Rate for Payer: Priority Health Medicare |
$235.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$625.31
|
| Rate for Payer: Railroad Medicare Medicare |
$233.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$821.30
|
| Rate for Payer: UHC Core |
$779.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.32
|
| Rate for Payer: UHC Exchange |
$233.32
|
| Rate for Payer: UHC Medicare Advantage |
$233.32
|
| Rate for Payer: VA VA |
$233.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$699.98
|
|
|
HC STACLOT LA.
|
Facility
|
OP
|
$148.92
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
30500085
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$134.03 |
| Rate for Payer: Aetna Commercial |
$126.58
|
| Rate for Payer: Aetna Medicare |
$38.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.54
|
| Rate for Payer: BCBS Complete |
$13.65
|
| Rate for Payer: BCBS MAPPO |
$37.23
|
| Rate for Payer: BCBS Trust/PPO |
$122.43
|
| Rate for Payer: BCN Commercial |
$115.79
|
| Rate for Payer: BCN Medicare Advantage |
$37.23
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$128.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.23
|
| Rate for Payer: Healthscope Commercial |
$134.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.69
|
| Rate for Payer: Mclaren Medicaid |
$13.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.09
|
| Rate for Payer: Meridian Medicaid |
$13.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$122.11
|
| Rate for Payer: PACE Senior Care Partners |
$35.37
|
| Rate for Payer: PACE SWMI |
$37.23
|
| Rate for Payer: PHP Commercial |
$126.58
|
| Rate for Payer: PHP Medicare Advantage |
$37.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: Priority Health HMO/PPO |
$129.56
|
| Rate for Payer: Priority Health Medicare |
$37.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.78
|
| Rate for Payer: Railroad Medicare Medicare |
$37.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.05
|
| Rate for Payer: UHC Core |
$124.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.23
|
| Rate for Payer: UHC Exchange |
$37.23
|
| Rate for Payer: UHC Medicare Advantage |
$37.23
|
| Rate for Payer: UHCCP Medicaid |
$13.00
|
| Rate for Payer: VA VA |
$37.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.69
|
|
|
HC STACLOT LA.
|
Facility
|
IP
|
$148.92
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
30500085
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$134.03 |
| Rate for Payer: Aetna Commercial |
$126.58
|
| Rate for Payer: BCBS Trust/PPO |
$121.56
|
| Rate for Payer: BCN Commercial |
$115.09
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$128.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Healthscope Commercial |
$134.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$122.11
|
| Rate for Payer: PHP Commercial |
$126.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: Priority Health HMO/PPO |
$129.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.05
|
| Rate for Payer: UHC Core |
$124.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.69
|
|
|
HC STANDBY OPEN HEART/TAVR
|
Facility
|
OP
|
$2,417.64
|
|
| Hospital Charge Code |
27000151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$574.19 |
| Max. Negotiated Rate |
$2,175.88 |
| Rate for Payer: Aetna Commercial |
$2,054.99
|
| Rate for Payer: Aetna Medicare |
$628.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$755.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$755.51
|
| Rate for Payer: BCBS Complete |
$967.06
|
| Rate for Payer: BCBS MAPPO |
$604.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,987.54
|
| Rate for Payer: BCN Commercial |
$1,879.72
|
| Rate for Payer: BCN Medicare Advantage |
$604.41
|
| Rate for Payer: Cash Price |
$1,934.11
|
| Rate for Payer: Cofinity Commercial |
$2,079.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,934.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$604.41
|
| Rate for Payer: Healthscope Commercial |
$2,175.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,813.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$634.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$695.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,054.99
|
| Rate for Payer: Nomi Health Commercial |
$1,982.46
|
| Rate for Payer: PACE Senior Care Partners |
$574.19
|
| Rate for Payer: PACE SWMI |
$604.41
|
| Rate for Payer: PHP Commercial |
$2,054.99
|
| Rate for Payer: PHP Medicare Advantage |
$604.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,571.47
|
| Rate for Payer: Priority Health HMO/PPO |
$2,103.35
|
| Rate for Payer: Priority Health Medicare |
$610.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,619.82
|
| Rate for Payer: Railroad Medicare Medicare |
$604.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,127.52
|
| Rate for Payer: UHC Core |
$2,018.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$604.41
|
| Rate for Payer: UHC Exchange |
$604.41
|
| Rate for Payer: UHC Medicare Advantage |
$604.41
|
| Rate for Payer: VA VA |
$604.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,813.23
|
|
|
HC STANDBY OPEN HEART/TAVR
|
Facility
|
IP
|
$2,417.64
|
|
| Hospital Charge Code |
27000151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,571.47 |
| Max. Negotiated Rate |
$2,175.88 |
| Rate for Payer: Aetna Commercial |
$2,054.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,973.52
|
| Rate for Payer: BCN Commercial |
$1,868.35
|
| Rate for Payer: Cash Price |
$1,934.11
|
| Rate for Payer: Cofinity Commercial |
$2,079.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,934.11
|
| Rate for Payer: Healthscope Commercial |
$2,175.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,813.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,054.99
|
| Rate for Payer: Nomi Health Commercial |
$1,982.46
|
| Rate for Payer: PHP Commercial |
$2,054.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,571.47
|
| Rate for Payer: Priority Health HMO/PPO |
$2,103.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,619.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,127.52
|
| Rate for Payer: UHC Core |
$2,018.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,813.23
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR
|
Facility
|
OP
|
$56.10
|
|
|
Service Code
|
CPT 87640
|
| Hospital Charge Code |
30600263
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.32 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna Commercial |
$47.69
|
| Rate for Payer: Aetna Medicare |
$14.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.53
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$14.03
|
| Rate for Payer: BCBS Trust/PPO |
$46.12
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$14.03
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.03
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.08
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.73
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.69
|
| Rate for Payer: Nomi Health Commercial |
$46.00
|
| Rate for Payer: PACE Senior Care Partners |
$13.32
|
| Rate for Payer: PACE SWMI |
$14.03
|
| Rate for Payer: PHP Commercial |
$47.69
|
| Rate for Payer: PHP Medicare Advantage |
$14.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.47
|
| Rate for Payer: Priority Health HMO/PPO |
$48.81
|
| Rate for Payer: Priority Health Medicare |
$14.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.59
|
| Rate for Payer: Railroad Medicare Medicare |
$14.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.37
|
| Rate for Payer: UHC Core |
$46.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.03
|
| Rate for Payer: UHC Exchange |
$14.03
|
| Rate for Payer: UHC Medicare Advantage |
$14.03
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$14.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.08
|
|
