|
HC XR WRIST BIL 2 VW
|
Facility
|
IP
|
$297.68
|
|
|
Service Code
|
CPT 73100
|
| Hospital Charge Code |
32000081
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$207.19 |
| Max. Negotiated Rate |
$267.91 |
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: BCBS Trust/PPO |
$245.85
|
| Rate for Payer: BCN Commercial |
$245.85
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Commercial |
$256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$244.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PHP Commercial |
$253.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$258.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.96
|
| Rate for Payer: UHC Core |
$248.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.26
|
|
|
HC XR WRIST BIL MIN 3 VW
|
Facility
|
IP
|
$460.68
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000083
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$320.63 |
| Max. Negotiated Rate |
$414.61 |
| Rate for Payer: Aetna Commercial |
$391.58
|
| Rate for Payer: BCBS Trust/PPO |
$380.48
|
| Rate for Payer: BCN Commercial |
$380.48
|
| Rate for Payer: Cash Price |
$368.54
|
| Rate for Payer: Cofinity Commercial |
$396.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.54
|
| Rate for Payer: Healthscope Commercial |
$414.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.58
|
| Rate for Payer: Nomi Health Commercial |
$377.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.51
|
| Rate for Payer: PHP Commercial |
$391.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$400.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$320.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.40
|
| Rate for Payer: UHC Core |
$384.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.51
|
|
|
HC XR WRIST BIL MIN 3 VW
|
Facility
|
OP
|
$460.68
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000083
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$81.22 |
| Max. Negotiated Rate |
$414.61 |
| Rate for Payer: Aetna Commercial |
$391.58
|
| Rate for Payer: Aetna Medicare |
$119.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$143.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$143.96
|
| Rate for Payer: BCBS Complete |
$85.27
|
| Rate for Payer: BCBS MAPPO |
$115.17
|
| Rate for Payer: BCBS Trust/PPO |
$378.73
|
| Rate for Payer: BCN Commercial |
$378.73
|
| Rate for Payer: BCN Medicare Advantage |
$115.17
|
| Rate for Payer: Cash Price |
$368.54
|
| Rate for Payer: Cofinity Commercial |
$396.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.17
|
| Rate for Payer: Healthscope Commercial |
$414.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.51
|
| Rate for Payer: Mclaren Medicaid |
$81.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.93
|
| Rate for Payer: Meridian Medicaid |
$85.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$132.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$126.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.58
|
| Rate for Payer: Nomi Health Commercial |
$377.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.51
|
| Rate for Payer: PACE Senior Care Partners |
$109.41
|
| Rate for Payer: PACE SWMI |
$115.17
|
| Rate for Payer: PHP Commercial |
$391.58
|
| Rate for Payer: PHP Medicare Advantage |
$115.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$400.79
|
| Rate for Payer: Priority Health Medicare |
$116.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$320.63
|
| Rate for Payer: Railroad Medicare Medicare |
$115.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$405.40
|
| Rate for Payer: UHC Core |
$384.67
|
| Rate for Payer: UHC Exchange |
$115.17
|
| Rate for Payer: UHC Medicaid |
$81.22
|
| Rate for Payer: UHC Medicare Advantage |
$115.17
|
| Rate for Payer: UHCCP Medicaid |
$81.22
|
| Rate for Payer: VA VA |
$115.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.51
|
|
|
HC XR WRIST MIN 3 VW
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000082
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$289.79 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: BCBS Trust/PPO |
$343.87
|
| Rate for Payer: BCN Commercial |
$343.87
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$341.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.40
|
| Rate for Payer: UHC Core |
$347.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC XR WRIST MIN 3 VW
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000082
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$73.40 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna Medicare |
$108.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.11
|
| Rate for Payer: BCBS Complete |
$77.07
|
| Rate for Payer: BCBS MAPPO |
$104.09
|
| Rate for Payer: BCBS Trust/PPO |
$342.29
|
| Rate for Payer: BCN Commercial |
$342.29
|
| Rate for Payer: BCN Medicare Advantage |
$104.09
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Mclaren Medicaid |
$73.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.29
|
| Rate for Payer: Meridian Medicaid |
$77.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$341.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PACE Senior Care Partners |
$98.89
|
| Rate for Payer: PACE SWMI |
$104.09
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: PHP Medicare Advantage |
$104.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.23
|
| Rate for Payer: Priority Health Medicare |
$105.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.79
|
| Rate for Payer: Railroad Medicare Medicare |
$104.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.40
|
| Rate for Payer: UHC Core |
$347.66
|
| Rate for Payer: UHC Exchange |
$104.09
|
| Rate for Payer: UHC Medicaid |
$73.40
|
| Rate for Payer: UHC Medicare Advantage |
$104.09
|
| Rate for Payer: UHCCP Medicaid |
$73.40
|
| Rate for Payer: VA VA |
$104.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC XTRASORB 6X9 EACH
|
Facility
|
OP
|
$16.59
|
|
| Hospital Charge Code |
27200293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.92 |
| Max. Negotiated Rate |
$14.93 |
| Rate for Payer: Aetna Commercial |
$14.10
|
| Rate for Payer: Aetna Medicare |
$4.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.18
|
| Rate for Payer: BCBS Complete |
$3.07
|
| Rate for Payer: BCBS MAPPO |
$4.15
|
| Rate for Payer: BCBS Trust/PPO |
$13.64
|
| Rate for Payer: BCN Commercial |
$13.64
|
| Rate for Payer: BCN Medicare Advantage |
$4.15
|
| Rate for Payer: Cash Price |
$13.27
|
| Rate for Payer: Cofinity Commercial |
$14.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.15
|
| Rate for Payer: Healthscope Commercial |
$14.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.44
|
| Rate for Payer: Mclaren Medicaid |
$2.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.35
|
| Rate for Payer: Meridian Medicaid |
$3.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.10
|
| Rate for Payer: Nomi Health Commercial |
$13.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.44
|
| Rate for Payer: PACE Senior Care Partners |
$3.94
|
| Rate for Payer: PACE SWMI |
$4.15
|
| Rate for Payer: PHP Commercial |
$14.10
|
| Rate for Payer: PHP Medicare Advantage |
$4.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.43
|
| Rate for Payer: Priority Health Medicare |
$4.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.55
|
| Rate for Payer: Railroad Medicare Medicare |
$4.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.60
|
| Rate for Payer: UHC Core |
$13.85
|
| Rate for Payer: UHC Exchange |
$4.15
|
| Rate for Payer: UHC Medicaid |
$2.92
|
| Rate for Payer: UHC Medicare Advantage |
$4.15
|
| Rate for Payer: UHCCP Medicaid |
$2.92
|
| Rate for Payer: VA VA |
$4.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.44
|
|
|
HC XTRASORB 6X9 EACH
|
Facility
|
IP
|
$16.59
|
|
| Hospital Charge Code |
27200293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.55 |
| Max. Negotiated Rate |
$14.93 |
| Rate for Payer: Aetna Commercial |
$14.10
|
| Rate for Payer: BCBS Trust/PPO |
$13.70
|
| Rate for Payer: BCN Commercial |
$13.70
|
| Rate for Payer: Cash Price |
$13.27
|
| Rate for Payer: Cofinity Commercial |
$14.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$14.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.10
|
| Rate for Payer: Nomi Health Commercial |
$13.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.44
|
| Rate for Payer: PHP Commercial |
$14.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.60
|
| Rate for Payer: UHC Core |
$13.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.44
|
|
|
HC Y ADAPTER WITH VENT
|
Facility
|
IP
|
$54.65
|
|
| Hospital Charge Code |
27006702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.04 |
| Max. Negotiated Rate |
$49.19 |
| Rate for Payer: Aetna Commercial |
$46.45
|
| Rate for Payer: BCBS Trust/PPO |
$45.14
|
| Rate for Payer: BCN Commercial |
$45.14
|
| Rate for Payer: Cash Price |
$43.72
|
| Rate for Payer: Cofinity Commercial |
$47.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.72
|
| Rate for Payer: Healthscope Commercial |
$49.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.45
|
| Rate for Payer: Nomi Health Commercial |
$44.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.99
|
| Rate for Payer: PHP Commercial |
$46.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.09
|
| Rate for Payer: UHC Core |
$45.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.99
|
|
|
HC Y ADAPTER WITH VENT
|
Facility
|
OP
|
$54.65
|
|
| Hospital Charge Code |
27006702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.63 |
| Max. Negotiated Rate |
$49.19 |
| Rate for Payer: Aetna Commercial |
$46.45
|
| Rate for Payer: Aetna Medicare |
$14.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.08
|
| Rate for Payer: BCBS Complete |
$10.12
|
| Rate for Payer: BCBS MAPPO |
$13.66
|
| Rate for Payer: BCBS Trust/PPO |
$44.93
|
| Rate for Payer: BCN Commercial |
$44.93
|
| Rate for Payer: BCN Medicare Advantage |
$13.66
|
| Rate for Payer: Cash Price |
$43.72
|
| Rate for Payer: Cofinity Commercial |
$47.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.66
|
| Rate for Payer: Healthscope Commercial |
$49.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.99
|
| Rate for Payer: Mclaren Medicaid |
$9.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.35
|
| Rate for Payer: Meridian Medicaid |
$10.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.45
|
| Rate for Payer: Nomi Health Commercial |
$44.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.99
|
| Rate for Payer: PACE Senior Care Partners |
$12.98
|
| Rate for Payer: PACE SWMI |
$13.66
|
| Rate for Payer: PHP Commercial |
$46.45
|
| Rate for Payer: PHP Medicare Advantage |
$13.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.55
|
| Rate for Payer: Priority Health Medicare |
$13.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.04
|
| Rate for Payer: Railroad Medicare Medicare |
$13.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.09
|
| Rate for Payer: UHC Core |
$45.63
|
| Rate for Payer: UHC Exchange |
$13.66
|
| Rate for Payer: UHC Medicaid |
$9.63
|
| Rate for Payer: UHC Medicare Advantage |
$13.66
|
| Rate for Payer: UHCCP Medicaid |
$9.63
|
| Rate for Payer: VA VA |
$13.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.99
|
|
|
HC YEAST BREWERS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200111
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC YEAST BREWERS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200111
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC YELLOW DOCK IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200112
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC YELLOW DOCK IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200112
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC YELLOW HORNET IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC YELLOW HORNET IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
OP
|
$42.92
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.57 |
| Max. Negotiated Rate |
$38.63 |
| Rate for Payer: Aetna Commercial |
$36.48
|
| Rate for Payer: Aetna Medicare |
$11.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.41
|
| Rate for Payer: BCBS Complete |
$7.94
|
| Rate for Payer: BCBS MAPPO |
$10.73
|
| Rate for Payer: BCBS Trust/PPO |
$35.28
|
| Rate for Payer: BCN Commercial |
$35.28
|
| Rate for Payer: BCN Medicare Advantage |
$10.73
|
| Rate for Payer: Cash Price |
$34.34
|
| Rate for Payer: Cofinity Commercial |
$36.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.73
|
| Rate for Payer: Healthscope Commercial |
$38.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.19
|
| Rate for Payer: Mclaren Medicaid |
$7.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.27
|
| Rate for Payer: Meridian Medicaid |
$7.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.48
|
| Rate for Payer: Nomi Health Commercial |
$35.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.19
|
| Rate for Payer: PACE Senior Care Partners |
$10.19
|
| Rate for Payer: PACE SWMI |
$10.73
|
| Rate for Payer: PHP Commercial |
$36.48
|
| Rate for Payer: PHP Medicare Advantage |
$10.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.34
|
| Rate for Payer: Priority Health Medicare |
$10.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.87
|
| Rate for Payer: Railroad Medicare Medicare |
$10.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.77
|
| Rate for Payer: UHC Core |
$35.84
|
| Rate for Payer: UHC Exchange |
$10.73
|
| Rate for Payer: UHC Medicaid |
$7.57
|
| Rate for Payer: UHC Medicare Advantage |
$10.73
|
| Rate for Payer: UHCCP Medicaid |
$7.57
|
| Rate for Payer: VA VA |
$10.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.19
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
IP
|
$42.92
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$29.87 |
| Max. Negotiated Rate |
$38.63 |
| Rate for Payer: Aetna Commercial |
$36.48
|
| Rate for Payer: BCBS Trust/PPO |
$35.45
|
| Rate for Payer: BCN Commercial |
$35.45
|
| Rate for Payer: Cash Price |
$34.34
|
| Rate for Payer: Cofinity Commercial |
$36.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.34
|
| Rate for Payer: Healthscope Commercial |
$38.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.48
|
| Rate for Payer: Nomi Health Commercial |
$35.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.19
|
| Rate for Payer: PHP Commercial |
$36.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.77
|
| Rate for Payer: UHC Core |
$35.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.19
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
OP
|
$51,795.10
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,131.48 |
| Max. Negotiated Rate |
$46,615.59 |
| Rate for Payer: Aetna Commercial |
$44,025.83
|
| Rate for Payer: Aetna Medicare |
$13,466.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,185.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,185.97
|
| Rate for Payer: BCBS Complete |
$9,587.27
|
| Rate for Payer: BCBS MAPPO |
$12,948.77
|
| Rate for Payer: BCBS Trust/PPO |
$42,580.75
|
| Rate for Payer: BCN Commercial |
$42,580.75
|
| Rate for Payer: BCN Medicare Advantage |
$12,948.77
|
| Rate for Payer: Cash Price |
$41,436.08
|
| Rate for Payer: Cofinity Commercial |
$44,543.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41,436.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,948.77
|
| Rate for Payer: Healthscope Commercial |
$46,615.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,846.32
|
| Rate for Payer: Mclaren Medicaid |
$9,131.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,596.21
|
| Rate for Payer: Meridian Medicaid |
$9,587.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,891.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$14,243.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44,025.83
|
| Rate for Payer: Nomi Health Commercial |
$42,471.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,846.32
|
| Rate for Payer: PACE Senior Care Partners |
$12,301.34
|
| Rate for Payer: PACE SWMI |
$12,948.77
|
| Rate for Payer: PHP Commercial |
$44,025.83
|
| Rate for Payer: PHP Medicare Advantage |
$12,948.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,131.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45,061.74
|
| Rate for Payer: Priority Health Medicare |
$13,078.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36,049.39
|
| Rate for Payer: Railroad Medicare Medicare |
$12,948.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45,579.69
|
| Rate for Payer: UHC Core |
$43,248.91
|
| Rate for Payer: UHC Exchange |
$12,948.77
|
| Rate for Payer: UHC Medicaid |
$9,131.48
|
| Rate for Payer: UHC Medicare Advantage |
$12,948.77
|
| Rate for Payer: UHCCP Medicaid |
$9,131.48
|
| Rate for Payer: VA VA |
$12,948.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,846.32
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
IP
|
$51,795.10
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36,049.39 |
| Max. Negotiated Rate |
$46,615.59 |
| Rate for Payer: Aetna Commercial |
$44,025.83
|
| Rate for Payer: BCBS Trust/PPO |
$42,777.57
|
| Rate for Payer: BCN Commercial |
$42,777.57
|
| Rate for Payer: Cash Price |
$41,436.08
|
| Rate for Payer: Cofinity Commercial |
$44,543.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41,436.08
|
| Rate for Payer: Healthscope Commercial |
$46,615.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,846.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44,025.83
|
| Rate for Payer: Nomi Health Commercial |
$42,471.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,846.32
|
| Rate for Payer: PHP Commercial |
$44,025.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45,061.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36,049.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45,579.69
|
| Rate for Payer: UHC Core |
$43,248.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,846.32
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
IP
|
$42.66
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$29.69 |
| Max. Negotiated Rate |
$38.39 |
| Rate for Payer: Aetna Commercial |
$36.26
|
| Rate for Payer: BCBS Trust/PPO |
$35.23
|
| Rate for Payer: BCN Commercial |
$35.23
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.13
|
| Rate for Payer: Healthscope Commercial |
$38.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.26
|
| Rate for Payer: Nomi Health Commercial |
$34.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.00
|
| Rate for Payer: PHP Commercial |
$36.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.54
|
| Rate for Payer: UHC Core |
$35.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.00
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
OP
|
$42.66
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.52 |
| Max. Negotiated Rate |
$38.39 |
| Rate for Payer: Aetna Commercial |
$36.26
|
| Rate for Payer: Aetna Medicare |
$11.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.33
|
| Rate for Payer: BCBS Complete |
$7.90
|
| Rate for Payer: BCBS MAPPO |
$10.66
|
| Rate for Payer: BCBS Trust/PPO |
$35.07
|
| Rate for Payer: BCN Commercial |
$35.07
|
| Rate for Payer: BCN Medicare Advantage |
$10.66
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.66
|
| Rate for Payer: Healthscope Commercial |
$38.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.00
|
| Rate for Payer: Mclaren Medicaid |
$7.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.20
|
| Rate for Payer: Meridian Medicaid |
$7.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.26
|
| Rate for Payer: Nomi Health Commercial |
$34.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.00
|
| Rate for Payer: PACE Senior Care Partners |
$10.13
|
| Rate for Payer: PACE SWMI |
$10.66
|
| Rate for Payer: PHP Commercial |
$36.26
|
| Rate for Payer: PHP Medicare Advantage |
$10.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.11
|
| Rate for Payer: Priority Health Medicare |
$10.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.69
|
| Rate for Payer: Railroad Medicare Medicare |
$10.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.54
|
| Rate for Payer: UHC Core |
$35.62
|
| Rate for Payer: UHC Exchange |
$10.66
|
| Rate for Payer: UHC Medicaid |
$7.52
|
| Rate for Payer: UHC Medicare Advantage |
$10.66
|
| Rate for Payer: UHCCP Medicaid |
$7.52
|
| Rate for Payer: VA VA |
$10.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.00
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
OP
|
$208.96
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.84 |
| Max. Negotiated Rate |
$188.06 |
| Rate for Payer: Aetna Commercial |
$177.62
|
| Rate for Payer: Aetna Medicare |
$54.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.30
|
| Rate for Payer: BCBS Complete |
$38.68
|
| Rate for Payer: BCBS MAPPO |
$52.24
|
| Rate for Payer: BCBS Trust/PPO |
$171.79
|
| Rate for Payer: BCN Commercial |
$171.79
|
| Rate for Payer: BCN Medicare Advantage |
$52.24
|
| Rate for Payer: Cash Price |
$167.17
|
| Rate for Payer: Cofinity Commercial |
$179.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.24
|
| Rate for Payer: Healthscope Commercial |
$188.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.72
|
| Rate for Payer: Mclaren Medicaid |
$36.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.85
|
| Rate for Payer: Meridian Medicaid |
$38.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.62
|
| Rate for Payer: Nomi Health Commercial |
$171.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.72
|
| Rate for Payer: PACE Senior Care Partners |
$49.63
|
| Rate for Payer: PACE SWMI |
$52.24
|
| Rate for Payer: PHP Commercial |
$177.62
|
| Rate for Payer: PHP Medicare Advantage |
$52.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$181.80
|
| Rate for Payer: Priority Health Medicare |
$52.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.44
|
| Rate for Payer: Railroad Medicare Medicare |
$52.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.88
|
| Rate for Payer: UHC Core |
$174.48
|
| Rate for Payer: UHC Exchange |
$52.24
|
| Rate for Payer: UHC Medicaid |
$36.84
|
| Rate for Payer: UHC Medicare Advantage |
$52.24
|
| Rate for Payer: UHCCP Medicaid |
$36.84
|
| Rate for Payer: VA VA |
$52.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.72
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
IP
|
$208.96
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$145.44 |
| Max. Negotiated Rate |
$188.06 |
| Rate for Payer: Aetna Commercial |
$177.62
|
| Rate for Payer: BCBS Trust/PPO |
$172.58
|
| Rate for Payer: BCN Commercial |
$172.58
|
| Rate for Payer: Cash Price |
$167.17
|
| Rate for Payer: Cofinity Commercial |
$179.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.17
|
| Rate for Payer: Healthscope Commercial |
$188.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.62
|
| Rate for Payer: Nomi Health Commercial |
$171.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.72
|
| Rate for Payer: PHP Commercial |
$177.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$181.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.88
|
| Rate for Payer: UHC Core |
$174.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.72
|
|
