|
HC VERT AUG W MECH DEV LUMB 1ST
|
Facility
|
OP
|
$11,830.21
|
|
|
Service Code
|
CPT 22514
|
| Hospital Charge Code |
36100468
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,085.67 |
| Max. Negotiated Rate |
$10,647.19 |
| Rate for Payer: Aetna Commercial |
$10,055.68
|
| Rate for Payer: Aetna Medicare |
$3,075.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,696.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,696.94
|
| Rate for Payer: BCBS Complete |
$2,189.77
|
| Rate for Payer: BCBS MAPPO |
$2,957.55
|
| Rate for Payer: BCBS Trust/PPO |
$9,725.62
|
| Rate for Payer: BCN Commercial |
$9,725.62
|
| Rate for Payer: BCN Medicare Advantage |
$2,957.55
|
| Rate for Payer: Cash Price |
$9,464.17
|
| Rate for Payer: Cofinity Commercial |
$10,173.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,464.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,957.55
|
| Rate for Payer: Healthscope Commercial |
$10,647.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,872.66
|
| Rate for Payer: Mclaren Medicaid |
$2,085.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,105.43
|
| Rate for Payer: Meridian Medicaid |
$2,189.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,401.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,253.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,055.68
|
| Rate for Payer: Nomi Health Commercial |
$9,700.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,872.66
|
| Rate for Payer: PACE Senior Care Partners |
$2,809.67
|
| Rate for Payer: PACE SWMI |
$2,957.55
|
| Rate for Payer: PHP Commercial |
$10,055.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,957.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,085.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,292.28
|
| Rate for Payer: Priority Health Medicare |
$2,987.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,233.83
|
| Rate for Payer: Railroad Medicare Medicare |
$2,957.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,410.58
|
| Rate for Payer: UHC Core |
$9,878.23
|
| Rate for Payer: UHC Exchange |
$2,957.55
|
| Rate for Payer: UHC Medicaid |
$2,085.67
|
| Rate for Payer: UHC Medicare Advantage |
$2,957.55
|
| Rate for Payer: UHCCP Medicaid |
$2,085.67
|
| Rate for Payer: VA VA |
$2,957.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,872.66
|
|
|
HC VERT AUG W MECH DEV THOR 1ST
|
Facility
|
OP
|
$11,679.94
|
|
|
Service Code
|
CPT 22513
|
| Hospital Charge Code |
36100467
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,059.17 |
| Max. Negotiated Rate |
$10,511.95 |
| Rate for Payer: Aetna Commercial |
$9,927.95
|
| Rate for Payer: Aetna Medicare |
$3,036.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,649.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,649.98
|
| Rate for Payer: BCBS Complete |
$2,161.96
|
| Rate for Payer: BCBS MAPPO |
$2,919.99
|
| Rate for Payer: BCBS Trust/PPO |
$9,602.08
|
| Rate for Payer: BCN Commercial |
$9,602.08
|
| Rate for Payer: BCN Medicare Advantage |
$2,919.99
|
| Rate for Payer: Cash Price |
$9,343.95
|
| Rate for Payer: Cofinity Commercial |
$10,044.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,343.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,919.99
|
| Rate for Payer: Healthscope Commercial |
$10,511.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,759.95
|
| Rate for Payer: Mclaren Medicaid |
$2,059.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,065.98
|
| Rate for Payer: Meridian Medicaid |
$2,161.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,357.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,211.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,927.95
|
| Rate for Payer: Nomi Health Commercial |
$9,577.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,759.95
|
| Rate for Payer: PACE Senior Care Partners |
$2,773.99
|
| Rate for Payer: PACE SWMI |
$2,919.99
|
| Rate for Payer: PHP Commercial |
$9,927.95
|
| Rate for Payer: PHP Medicare Advantage |
$2,919.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,059.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,161.55
|
| Rate for Payer: Priority Health Medicare |
$2,949.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,129.24
|
| Rate for Payer: Railroad Medicare Medicare |
$2,919.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,278.35
|
| Rate for Payer: UHC Core |
$9,752.75
|
| Rate for Payer: UHC Exchange |
$2,919.99
|
| Rate for Payer: UHC Medicaid |
$2,059.17
|
| Rate for Payer: UHC Medicare Advantage |
$2,919.99
|
| Rate for Payer: UHCCP Medicaid |
$2,059.17
|
| Rate for Payer: VA VA |
$2,919.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,759.95
|
|
|
HC VERT AUG W MECH DEV THOR 1ST
|
Facility
|
IP
|
$11,679.94
|
|
|
Service Code
|
CPT 22513
|
| Hospital Charge Code |
36100467
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,129.24 |
| Max. Negotiated Rate |
$10,511.95 |
| Rate for Payer: Aetna Commercial |
$9,927.95
|
| Rate for Payer: BCBS Trust/PPO |
$9,646.46
|
| Rate for Payer: BCN Commercial |
$9,646.46
|
| Rate for Payer: Cash Price |
$9,343.95
|
| Rate for Payer: Cofinity Commercial |
$10,044.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,343.95
|
| Rate for Payer: Healthscope Commercial |
$10,511.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,759.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,927.95
|
| Rate for Payer: Nomi Health Commercial |
$9,577.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,759.95
|
| Rate for Payer: PHP Commercial |
$9,927.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,161.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,129.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,278.35
|
| Rate for Payer: UHC Core |
$9,752.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,759.95
|
|
|
HC VERTEBROPLASTY CEMENT
|
Facility
|
OP
|
$1,276.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$224.97 |
| Max. Negotiated Rate |
$1,148.44 |
| Rate for Payer: Aetna Commercial |
$1,084.63
|
| Rate for Payer: Aetna Medicare |
$331.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$398.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$398.76
|
| Rate for Payer: BCBS Complete |
$236.20
|
| Rate for Payer: BCBS MAPPO |
$319.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.03
|
| Rate for Payer: BCN Commercial |
$1,049.03
|
| Rate for Payer: BCN Medicare Advantage |
$319.01
|
| Rate for Payer: Cash Price |
$1,020.83
|
| Rate for Payer: Cofinity Commercial |
$1,097.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.01
|
| Rate for Payer: Healthscope Commercial |
$1,148.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$957.03
|
| Rate for Payer: Mclaren Medicaid |
$224.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.96
|
| Rate for Payer: Meridian Medicaid |
$236.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$366.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$350.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,084.63
|
| Rate for Payer: Nomi Health Commercial |
$1,046.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$957.03
|
| Rate for Payer: PACE Senior Care Partners |
$303.06
|
| Rate for Payer: PACE SWMI |
$319.01
|
| Rate for Payer: PHP Commercial |
$1,084.63
|
| Rate for Payer: PHP Medicare Advantage |
$319.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,110.15
|
| Rate for Payer: Priority Health Medicare |
$322.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$888.12
|
| Rate for Payer: Railroad Medicare Medicare |
$319.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,122.92
|
| Rate for Payer: UHC Core |
$1,065.49
|
| Rate for Payer: UHC Exchange |
$319.01
|
| Rate for Payer: UHC Medicaid |
$224.97
|
| Rate for Payer: UHC Medicare Advantage |
$319.01
|
| Rate for Payer: UHCCP Medicaid |
$224.97
|
| Rate for Payer: VA VA |
$319.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$957.03
|
|
|
HC VERTEBROPLASTY CEMENT
|
Facility
|
IP
|
$1,276.04
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$888.12 |
| Max. Negotiated Rate |
$1,148.44 |
| Rate for Payer: Aetna Commercial |
$1,084.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,053.88
|
| Rate for Payer: BCN Commercial |
$1,053.88
|
| Rate for Payer: Cash Price |
$1,020.83
|
| Rate for Payer: Cofinity Commercial |
$1,097.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.83
|
| Rate for Payer: Healthscope Commercial |
$1,148.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$957.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,084.63
|
| Rate for Payer: Nomi Health Commercial |
$1,046.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$957.03
|
| Rate for Payer: PHP Commercial |
$1,084.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,110.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$888.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,122.92
|
| Rate for Payer: UHC Core |
$1,065.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$957.03
|
|
|
HC VERTEBROPLASTY SACRUM BIL W WO BONE BX AND IMAGING
|
Facility
|
IP
|
$6,388.10
|
|
|
Service Code
|
CPT 0201T
|
| Hospital Charge Code |
36100298
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,446.12 |
| Max. Negotiated Rate |
$5,749.29 |
| Rate for Payer: Aetna Commercial |
$5,429.89
|
| Rate for Payer: BCBS Trust/PPO |
$5,275.93
|
| Rate for Payer: BCN Commercial |
$5,275.93
|
| Rate for Payer: Cash Price |
$5,110.48
|
| Rate for Payer: Cofinity Commercial |
$5,493.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,110.48
|
| Rate for Payer: Healthscope Commercial |
$5,749.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,791.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,429.89
|
| Rate for Payer: Nomi Health Commercial |
$5,238.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,791.07
|
| Rate for Payer: PHP Commercial |
$5,429.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,557.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,446.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,621.53
|
| Rate for Payer: UHC Core |
$5,334.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,791.07
|
|
|
HC VERTEBROPLASTY SACRUM BIL W WO BONE BX AND IMAGING
|
Facility
|
OP
|
$6,388.10
|
|
|
Service Code
|
CPT 0201T
|
| Hospital Charge Code |
36100298
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,126.22 |
| Max. Negotiated Rate |
$5,749.29 |
| Rate for Payer: Aetna Commercial |
$5,429.89
|
| Rate for Payer: Aetna Medicare |
$1,660.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,996.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,996.28
|
| Rate for Payer: BCBS Complete |
$1,182.44
|
| Rate for Payer: BCBS MAPPO |
$1,597.03
|
| Rate for Payer: BCBS Trust/PPO |
$5,251.66
|
| Rate for Payer: BCN Commercial |
$5,251.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,597.03
|
| Rate for Payer: Cash Price |
$5,110.48
|
| Rate for Payer: Cofinity Commercial |
$5,493.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,110.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,597.03
|
| Rate for Payer: Healthscope Commercial |
$5,749.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,791.07
|
| Rate for Payer: Mclaren Medicaid |
$1,126.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,676.88
|
| Rate for Payer: Meridian Medicaid |
$1,182.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,836.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,756.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,429.89
|
| Rate for Payer: Nomi Health Commercial |
$5,238.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,791.07
|
| Rate for Payer: PACE Senior Care Partners |
$1,517.17
|
| Rate for Payer: PACE SWMI |
$1,597.03
|
| Rate for Payer: PHP Commercial |
$5,429.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,597.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,126.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,557.65
|
| Rate for Payer: Priority Health Medicare |
$1,613.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,446.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,597.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,621.53
|
| Rate for Payer: UHC Core |
$5,334.06
|
| Rate for Payer: UHC Exchange |
$1,597.03
|
| Rate for Payer: UHC Medicaid |
$1,126.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,597.03
|
| Rate for Payer: UHCCP Medicaid |
$1,126.22
|
| Rate for Payer: VA VA |
$1,597.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,791.07
|
|
|
HC VERTEBROPLASTY SACRUM UNI W WO BONE BX AND IMAGING
|
Facility
|
IP
|
$5,110.48
|
|
|
Service Code
|
CPT 0200T
|
| Hospital Charge Code |
36100299
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,556.89 |
| Max. Negotiated Rate |
$4,599.43 |
| Rate for Payer: Aetna Commercial |
$4,343.91
|
| Rate for Payer: BCBS Trust/PPO |
$4,220.75
|
| Rate for Payer: BCN Commercial |
$4,220.75
|
| Rate for Payer: Cash Price |
$4,088.38
|
| Rate for Payer: Cofinity Commercial |
$4,395.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,088.38
|
| Rate for Payer: Healthscope Commercial |
$4,599.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,832.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,343.91
|
| Rate for Payer: Nomi Health Commercial |
$4,190.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,832.86
|
| Rate for Payer: PHP Commercial |
$4,343.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,446.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,556.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,497.22
|
| Rate for Payer: UHC Core |
$4,267.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,832.86
|
|
|
HC VERTEBROPLASTY SACRUM UNI W WO BONE BX AND IMAGING
|
Facility
|
OP
|
$5,110.48
|
|
|
Service Code
|
CPT 0200T
|
| Hospital Charge Code |
36100299
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$900.98 |
| Max. Negotiated Rate |
$4,599.43 |
| Rate for Payer: Aetna Commercial |
$4,343.91
|
| Rate for Payer: Aetna Medicare |
$1,328.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,597.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,597.03
|
| Rate for Payer: BCBS Complete |
$945.95
|
| Rate for Payer: BCBS MAPPO |
$1,277.62
|
| Rate for Payer: BCBS Trust/PPO |
$4,201.33
|
| Rate for Payer: BCN Commercial |
$4,201.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,277.62
|
| Rate for Payer: Cash Price |
$4,088.38
|
| Rate for Payer: Cofinity Commercial |
$4,395.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,088.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,277.62
|
| Rate for Payer: Healthscope Commercial |
$4,599.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,832.86
|
| Rate for Payer: Mclaren Medicaid |
$900.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,341.50
|
| Rate for Payer: Meridian Medicaid |
$945.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,469.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,405.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,343.91
|
| Rate for Payer: Nomi Health Commercial |
$4,190.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,832.86
|
| Rate for Payer: PACE Senior Care Partners |
$1,213.74
|
| Rate for Payer: PACE SWMI |
$1,277.62
|
| Rate for Payer: PHP Commercial |
$4,343.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,277.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$900.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$4,446.12
|
| Rate for Payer: Priority Health Medicare |
$1,290.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,556.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,277.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,497.22
|
| Rate for Payer: UHC Core |
$4,267.25
|
| Rate for Payer: UHC Exchange |
$1,277.62
|
| Rate for Payer: UHC Medicaid |
$900.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,277.62
|
| Rate for Payer: UHCCP Medicaid |
$900.98
|
| Rate for Payer: VA VA |
$1,277.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,832.86
|
|
|
HC VEST SUPPLY
|
Facility
|
OP
|
$474.00
|
|
| Hospital Charge Code |
27000169
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$83.57 |
| Max. Negotiated Rate |
$426.60 |
| Rate for Payer: Aetna Commercial |
$402.90
|
| Rate for Payer: Aetna Medicare |
$123.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$148.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$148.12
|
| Rate for Payer: BCBS Complete |
$87.74
|
| Rate for Payer: BCBS MAPPO |
$118.50
|
| Rate for Payer: BCBS Trust/PPO |
$389.68
|
| Rate for Payer: BCN Commercial |
$389.68
|
| Rate for Payer: BCN Medicare Advantage |
$118.50
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cofinity Commercial |
$407.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$379.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.50
|
| Rate for Payer: Healthscope Commercial |
$426.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$355.50
|
| Rate for Payer: Mclaren Medicaid |
$83.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.42
|
| Rate for Payer: Meridian Medicaid |
$87.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$136.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.90
|
| Rate for Payer: Nomi Health Commercial |
$388.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$355.50
|
| Rate for Payer: PACE Senior Care Partners |
$112.58
|
| Rate for Payer: PACE SWMI |
$118.50
|
| Rate for Payer: PHP Commercial |
$402.90
|
| Rate for Payer: PHP Medicare Advantage |
$118.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$412.38
|
| Rate for Payer: Priority Health Medicare |
$119.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.90
|
| Rate for Payer: Railroad Medicare Medicare |
$118.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$417.12
|
| Rate for Payer: UHC Core |
$395.79
|
| Rate for Payer: UHC Exchange |
$118.50
|
| Rate for Payer: UHC Medicaid |
$83.57
|
| Rate for Payer: UHC Medicare Advantage |
$118.50
|
| Rate for Payer: UHCCP Medicaid |
$83.57
|
| Rate for Payer: VA VA |
$118.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$355.50
|
|
|
HC VEST SUPPLY
|
Facility
|
IP
|
$474.00
|
|
| Hospital Charge Code |
27000169
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$329.90 |
| Max. Negotiated Rate |
$426.60 |
| Rate for Payer: Aetna Commercial |
$402.90
|
| Rate for Payer: BCBS Trust/PPO |
$391.48
|
| Rate for Payer: BCN Commercial |
$391.48
|
| Rate for Payer: Cash Price |
$379.20
|
| Rate for Payer: Cofinity Commercial |
$407.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$379.20
|
| Rate for Payer: Healthscope Commercial |
$426.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$355.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$402.90
|
| Rate for Payer: Nomi Health Commercial |
$388.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$355.50
|
| Rate for Payer: PHP Commercial |
$402.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$412.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$329.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$417.12
|
| Rate for Payer: UHC Core |
$395.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$355.50
|
|
|
HC VIABAHN 2
|
Facility
|
IP
|
$8,276.28
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,760.29 |
| Max. Negotiated Rate |
$7,448.65 |
| Rate for Payer: Aetna Commercial |
$7,034.84
|
| Rate for Payer: BCBS Trust/PPO |
$6,835.38
|
| Rate for Payer: BCN Commercial |
$6,835.38
|
| Rate for Payer: Cash Price |
$6,621.02
|
| Rate for Payer: Cofinity Commercial |
$7,117.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,621.02
|
| Rate for Payer: Healthscope Commercial |
$7,448.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,207.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,034.84
|
| Rate for Payer: Nomi Health Commercial |
$6,786.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,207.21
|
| Rate for Payer: PHP Commercial |
$7,034.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,200.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,760.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,283.13
|
| Rate for Payer: UHC Core |
$6,910.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,207.21
|
|
|
HC VIABAHN 2
|
Facility
|
OP
|
$8,276.28
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,459.11 |
| Max. Negotiated Rate |
$7,448.65 |
| Rate for Payer: Aetna Commercial |
$7,034.84
|
| Rate for Payer: Aetna Medicare |
$2,151.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,586.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,586.34
|
| Rate for Payer: BCBS Complete |
$1,531.94
|
| Rate for Payer: BCBS MAPPO |
$2,069.07
|
| Rate for Payer: BCBS Trust/PPO |
$6,803.93
|
| Rate for Payer: BCN Commercial |
$6,803.93
|
| Rate for Payer: BCN Medicare Advantage |
$2,069.07
|
| Rate for Payer: Cash Price |
$6,621.02
|
| Rate for Payer: Cofinity Commercial |
$7,117.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,621.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,069.07
|
| Rate for Payer: Healthscope Commercial |
$7,448.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,207.21
|
| Rate for Payer: Mclaren Medicaid |
$1,459.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,172.52
|
| Rate for Payer: Meridian Medicaid |
$1,531.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,379.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,275.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,034.84
|
| Rate for Payer: Nomi Health Commercial |
$6,786.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,207.21
|
| Rate for Payer: PACE Senior Care Partners |
$1,965.62
|
| Rate for Payer: PACE SWMI |
$2,069.07
|
| Rate for Payer: PHP Commercial |
$7,034.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,069.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,459.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,200.36
|
| Rate for Payer: Priority Health Medicare |
$2,089.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,760.29
|
| Rate for Payer: Railroad Medicare Medicare |
$2,069.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,283.13
|
| Rate for Payer: UHC Core |
$6,910.69
|
| Rate for Payer: UHC Exchange |
$2,069.07
|
| Rate for Payer: UHC Medicaid |
$1,459.11
|
| Rate for Payer: UHC Medicare Advantage |
$2,069.07
|
| Rate for Payer: UHCCP Medicaid |
$1,459.11
|
| Rate for Payer: VA VA |
$2,069.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,207.21
|
|
|
HC VISCOSITY
|
Facility
|
OP
|
$72.17
|
|
|
Service Code
|
CPT 85810
|
| Hospital Charge Code |
30500065
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.72 |
| Max. Negotiated Rate |
$64.95 |
| Rate for Payer: Aetna Commercial |
$61.34
|
| Rate for Payer: Aetna Medicare |
$18.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.55
|
| Rate for Payer: BCBS Complete |
$13.36
|
| Rate for Payer: BCBS MAPPO |
$18.04
|
| Rate for Payer: BCBS Trust/PPO |
$59.33
|
| Rate for Payer: BCN Commercial |
$59.33
|
| Rate for Payer: BCN Medicare Advantage |
$18.04
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$62.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.04
|
| Rate for Payer: Healthscope Commercial |
$64.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.13
|
| Rate for Payer: Mclaren Medicaid |
$12.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.94
|
| Rate for Payer: Meridian Medicaid |
$13.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PACE Senior Care Partners |
$17.14
|
| Rate for Payer: PACE SWMI |
$18.04
|
| Rate for Payer: PHP Commercial |
$61.34
|
| Rate for Payer: PHP Medicare Advantage |
$18.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.79
|
| Rate for Payer: Priority Health Medicare |
$18.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.23
|
| Rate for Payer: Railroad Medicare Medicare |
$18.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.51
|
| Rate for Payer: UHC Core |
$60.26
|
| Rate for Payer: UHC Exchange |
$18.04
|
| Rate for Payer: UHC Medicaid |
$12.72
|
| Rate for Payer: UHC Medicare Advantage |
$18.04
|
| Rate for Payer: UHCCP Medicaid |
$12.72
|
| Rate for Payer: VA VA |
$18.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.13
|
|
|
HC VISCOSITY
|
Facility
|
IP
|
$72.17
|
|
|
Service Code
|
CPT 85810
|
| Hospital Charge Code |
30500065
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$50.23 |
| Max. Negotiated Rate |
$64.95 |
| Rate for Payer: Aetna Commercial |
$61.34
|
| Rate for Payer: BCBS Trust/PPO |
$59.61
|
| Rate for Payer: BCN Commercial |
$59.61
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Commercial |
$62.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Healthscope Commercial |
$64.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$59.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PHP Commercial |
$61.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.51
|
| Rate for Payer: UHC Core |
$60.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.13
|
|
|
HC VISIPAQUE 320 PER ML
|
Facility
|
OP
|
$2.90
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600019
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.51 |
| Max. Negotiated Rate |
$2.61 |
| Rate for Payer: Aetna Commercial |
$2.46
|
| Rate for Payer: Aetna Medicare |
$0.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.91
|
| Rate for Payer: BCBS Complete |
$0.54
|
| Rate for Payer: BCBS MAPPO |
$0.73
|
| Rate for Payer: BCBS Trust/PPO |
$2.38
|
| Rate for Payer: BCN Commercial |
$2.38
|
| Rate for Payer: BCN Medicare Advantage |
$0.73
|
| Rate for Payer: Cash Price |
$2.32
|
| Rate for Payer: Cofinity Commercial |
$2.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.73
|
| Rate for Payer: Healthscope Commercial |
$2.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.17
|
| Rate for Payer: Mclaren Medicaid |
$0.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.76
|
| Rate for Payer: Meridian Medicaid |
$0.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.46
|
| Rate for Payer: Nomi Health Commercial |
$2.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.17
|
| Rate for Payer: PACE Senior Care Partners |
$0.69
|
| Rate for Payer: PACE SWMI |
$0.73
|
| Rate for Payer: PHP Commercial |
$2.46
|
| Rate for Payer: PHP Medicare Advantage |
$0.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.52
|
| Rate for Payer: Priority Health Medicare |
$0.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.02
|
| Rate for Payer: Railroad Medicare Medicare |
$0.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.55
|
| Rate for Payer: UHC Core |
$2.42
|
| Rate for Payer: UHC Exchange |
$0.73
|
| Rate for Payer: UHC Medicaid |
$0.51
|
| Rate for Payer: UHC Medicare Advantage |
$0.73
|
| Rate for Payer: UHCCP Medicaid |
$0.51
|
| Rate for Payer: VA VA |
$0.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.17
|
|
|
HC VISIPAQUE 320 PER ML
|
Facility
|
IP
|
$2.90
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600019
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$2.61 |
| Rate for Payer: Aetna Commercial |
$2.46
|
| Rate for Payer: BCBS Trust/PPO |
$2.40
|
| Rate for Payer: BCN Commercial |
$2.40
|
| Rate for Payer: Cash Price |
$2.32
|
| Rate for Payer: Cofinity Commercial |
$2.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.32
|
| Rate for Payer: Healthscope Commercial |
$2.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.46
|
| Rate for Payer: Nomi Health Commercial |
$2.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.17
|
| Rate for Payer: PHP Commercial |
$2.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.55
|
| Rate for Payer: UHC Core |
$2.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.17
|
|
|
HC VISUAL ACUITY SCREEN
|
Facility
|
IP
|
$40.52
|
|
|
Service Code
|
CPT 99173
|
| Hospital Charge Code |
51000099
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$28.20 |
| Max. Negotiated Rate |
$36.47 |
| Rate for Payer: Aetna Commercial |
$34.44
|
| Rate for Payer: BCBS Trust/PPO |
$33.47
|
| Rate for Payer: BCN Commercial |
$33.47
|
| Rate for Payer: Cash Price |
$32.42
|
| Rate for Payer: Cofinity Commercial |
$34.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.42
|
| Rate for Payer: Healthscope Commercial |
$36.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.44
|
| Rate for Payer: Nomi Health Commercial |
$33.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.39
|
| Rate for Payer: PHP Commercial |
$34.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.66
|
| Rate for Payer: UHC Core |
$33.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.39
|
|
|
HC VISUAL ACUITY SCREEN
|
Facility
|
OP
|
$40.52
|
|
|
Service Code
|
CPT 99173
|
| Hospital Charge Code |
51000099
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.14 |
| Max. Negotiated Rate |
$36.47 |
| Rate for Payer: Aetna Commercial |
$34.44
|
| Rate for Payer: Aetna Medicare |
$10.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.66
|
| Rate for Payer: BCBS Complete |
$7.50
|
| Rate for Payer: BCBS MAPPO |
$10.13
|
| Rate for Payer: BCBS Trust/PPO |
$33.31
|
| Rate for Payer: BCN Commercial |
$33.31
|
| Rate for Payer: BCN Medicare Advantage |
$10.13
|
| Rate for Payer: Cash Price |
$32.42
|
| Rate for Payer: Cofinity Commercial |
$34.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.13
|
| Rate for Payer: Healthscope Commercial |
$36.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.39
|
| Rate for Payer: Mclaren Medicaid |
$7.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.64
|
| Rate for Payer: Meridian Medicaid |
$7.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.44
|
| Rate for Payer: Nomi Health Commercial |
$33.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.39
|
| Rate for Payer: PACE Senior Care Partners |
$9.62
|
| Rate for Payer: PACE SWMI |
$10.13
|
| Rate for Payer: PHP Commercial |
$34.44
|
| Rate for Payer: PHP Medicare Advantage |
$10.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.25
|
| Rate for Payer: Priority Health Medicare |
$10.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.20
|
| Rate for Payer: Railroad Medicare Medicare |
$10.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.66
|
| Rate for Payer: UHC Core |
$33.83
|
| Rate for Payer: UHC Exchange |
$10.13
|
| Rate for Payer: UHC Medicaid |
$7.14
|
| Rate for Payer: UHC Medicare Advantage |
$10.13
|
| Rate for Payer: UHCCP Medicaid |
$7.14
|
| Rate for Payer: VA VA |
$10.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.39
|
|
|
HC VISUAL AUDIOMETRY VRA
|
Facility
|
OP
|
$216.41
|
|
|
Service Code
|
CPT 92579
|
| Hospital Charge Code |
47100013
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$38.15 |
| Max. Negotiated Rate |
$194.77 |
| Rate for Payer: Aetna Commercial |
$183.95
|
| Rate for Payer: Aetna Medicare |
$56.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.63
|
| Rate for Payer: BCBS Complete |
$40.06
|
| Rate for Payer: BCBS MAPPO |
$54.10
|
| Rate for Payer: BCBS Trust/PPO |
$177.91
|
| Rate for Payer: BCN Commercial |
$177.91
|
| Rate for Payer: BCN Medicare Advantage |
$54.10
|
| Rate for Payer: Cash Price |
$173.13
|
| Rate for Payer: Cofinity Commercial |
$186.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$194.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.31
|
| Rate for Payer: Mclaren Medicaid |
$38.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.81
|
| Rate for Payer: Meridian Medicaid |
$40.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.95
|
| Rate for Payer: Nomi Health Commercial |
$177.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.31
|
| Rate for Payer: PACE Senior Care Partners |
$51.40
|
| Rate for Payer: PACE SWMI |
$54.10
|
| Rate for Payer: PHP Commercial |
$183.95
|
| Rate for Payer: PHP Medicare Advantage |
$54.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$188.28
|
| Rate for Payer: Priority Health Medicare |
$54.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.62
|
| Rate for Payer: Railroad Medicare Medicare |
$54.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.44
|
| Rate for Payer: UHC Core |
$180.70
|
| Rate for Payer: UHC Exchange |
$54.10
|
| Rate for Payer: UHC Medicaid |
$38.15
|
| Rate for Payer: UHC Medicare Advantage |
$54.10
|
| Rate for Payer: UHCCP Medicaid |
$38.15
|
| Rate for Payer: VA VA |
$54.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.31
|
|
|
HC VISUAL AUDIOMETRY VRA
|
Facility
|
IP
|
$216.41
|
|
|
Service Code
|
CPT 92579
|
| Hospital Charge Code |
47100013
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$150.62 |
| Max. Negotiated Rate |
$194.77 |
| Rate for Payer: Aetna Commercial |
$183.95
|
| Rate for Payer: BCBS Trust/PPO |
$178.73
|
| Rate for Payer: BCN Commercial |
$178.73
|
| Rate for Payer: Cash Price |
$173.13
|
| Rate for Payer: Cofinity Commercial |
$186.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.13
|
| Rate for Payer: Healthscope Commercial |
$194.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.95
|
| Rate for Payer: Nomi Health Commercial |
$177.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.31
|
| Rate for Payer: PHP Commercial |
$183.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$188.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.44
|
| Rate for Payer: UHC Core |
$180.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.31
|
|
|
HC VITAL CAPACITY
|
Facility
|
OP
|
$273.41
|
|
|
Service Code
|
CPT 94150
|
| Hospital Charge Code |
46000016
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$246.07 |
| Rate for Payer: Aetna Commercial |
$232.40
|
| Rate for Payer: Aetna Medicare |
$71.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.44
|
| Rate for Payer: BCBS Complete |
$50.61
|
| Rate for Payer: BCBS MAPPO |
$68.35
|
| Rate for Payer: BCBS Trust/PPO |
$224.77
|
| Rate for Payer: BCN Commercial |
$224.77
|
| Rate for Payer: BCN Medicare Advantage |
$68.35
|
| Rate for Payer: Cash Price |
$218.73
|
| Rate for Payer: Cofinity Commercial |
$235.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.35
|
| Rate for Payer: Healthscope Commercial |
$246.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.06
|
| Rate for Payer: Mclaren Medicaid |
$48.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.77
|
| Rate for Payer: Meridian Medicaid |
$50.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$75.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.40
|
| Rate for Payer: Nomi Health Commercial |
$224.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$205.06
|
| Rate for Payer: PACE Senior Care Partners |
$64.93
|
| Rate for Payer: PACE SWMI |
$68.35
|
| Rate for Payer: PHP Commercial |
$232.40
|
| Rate for Payer: PHP Medicare Advantage |
$68.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$237.87
|
| Rate for Payer: Priority Health Medicare |
$69.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$190.29
|
| Rate for Payer: Railroad Medicare Medicare |
$68.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.60
|
| Rate for Payer: UHC Core |
$228.30
|
| Rate for Payer: UHC Exchange |
$68.35
|
| Rate for Payer: UHC Medicaid |
$48.20
|
| Rate for Payer: UHC Medicare Advantage |
$68.35
|
| Rate for Payer: UHCCP Medicaid |
$48.20
|
| Rate for Payer: VA VA |
$68.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.06
|
|
|
HC VITAL CAPACITY
|
Facility
|
IP
|
$273.41
|
|
|
Service Code
|
CPT 94150
|
| Hospital Charge Code |
46000016
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$190.29 |
| Max. Negotiated Rate |
$246.07 |
| Rate for Payer: Aetna Commercial |
$232.40
|
| Rate for Payer: BCBS Trust/PPO |
$225.81
|
| Rate for Payer: BCN Commercial |
$225.81
|
| Rate for Payer: Cash Price |
$218.73
|
| Rate for Payer: Cofinity Commercial |
$235.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.73
|
| Rate for Payer: Healthscope Commercial |
$246.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.40
|
| Rate for Payer: Nomi Health Commercial |
$224.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$205.06
|
| Rate for Payer: PHP Commercial |
$232.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$237.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$190.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.60
|
| Rate for Payer: UHC Core |
$228.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.06
|
|
|
HC VITAMIN A LEVEL
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 84590
|
| Hospital Charge Code |
30100458
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.24 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: BCBS Trust/PPO |
$39.44
|
| Rate for Payer: BCN Commercial |
$39.44
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC VITAMIN A LEVEL
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 84590
|
| Hospital Charge Code |
30100458
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.42 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$12.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.93
|
| Rate for Payer: BCBS Complete |
$8.84
|
| Rate for Payer: BCBS MAPPO |
$11.94
|
| Rate for Payer: BCBS Trust/PPO |
$39.26
|
| Rate for Payer: BCN Commercial |
$39.26
|
| Rate for Payer: BCN Medicare Advantage |
$11.94
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Mclaren Medicaid |
$8.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.54
|
| Rate for Payer: Meridian Medicaid |
$8.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Senior Care Partners |
$11.34
|
| Rate for Payer: PACE SWMI |
$11.94
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$11.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Medicare |
$12.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.24
|
| Rate for Payer: Railroad Medicare Medicare |
$11.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: UHC Exchange |
$11.94
|
| Rate for Payer: UHC Medicaid |
$8.42
|
| Rate for Payer: UHC Medicare Advantage |
$11.94
|
| Rate for Payer: UHCCP Medicaid |
$8.42
|
| Rate for Payer: VA VA |
$11.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
