|
HC Z HEMODIALYSIS BARD
|
Facility
|
OP
|
$1,614.79
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$284.69 |
| Max. Negotiated Rate |
$1,453.31 |
| Rate for Payer: Aetna Commercial |
$1,372.57
|
| Rate for Payer: Aetna Medicare |
$419.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$504.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$504.62
|
| Rate for Payer: BCBS Complete |
$298.90
|
| Rate for Payer: BCBS MAPPO |
$403.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,327.52
|
| Rate for Payer: BCN Commercial |
$1,327.52
|
| Rate for Payer: BCN Medicare Advantage |
$403.70
|
| Rate for Payer: Cash Price |
$1,291.83
|
| Rate for Payer: Cofinity Commercial |
$1,388.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.70
|
| Rate for Payer: Healthscope Commercial |
$1,453.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,211.09
|
| Rate for Payer: Mclaren Medicaid |
$284.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.88
|
| Rate for Payer: Meridian Medicaid |
$298.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$464.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$444.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,372.57
|
| Rate for Payer: Nomi Health Commercial |
$1,324.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,211.09
|
| Rate for Payer: PACE Senior Care Partners |
$383.51
|
| Rate for Payer: PACE SWMI |
$403.70
|
| Rate for Payer: PHP Commercial |
$1,372.57
|
| Rate for Payer: PHP Medicare Advantage |
$403.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,404.87
|
| Rate for Payer: Priority Health Medicare |
$407.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,123.89
|
| Rate for Payer: Railroad Medicare Medicare |
$403.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,421.02
|
| Rate for Payer: UHC Core |
$1,348.35
|
| Rate for Payer: UHC Exchange |
$403.70
|
| Rate for Payer: UHC Medicaid |
$284.69
|
| Rate for Payer: UHC Medicare Advantage |
$403.70
|
| Rate for Payer: UHCCP Medicaid |
$284.69
|
| Rate for Payer: VA VA |
$403.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,211.09
|
|
|
HC Z HYPERGLIDE OCCL BALLOON C
|
Facility
|
OP
|
$2,263.31
|
|
|
Service Code
|
HCPCS C2628
|
| Hospital Charge Code |
27200089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$399.02 |
| Max. Negotiated Rate |
$2,036.98 |
| Rate for Payer: Aetna Commercial |
$1,923.81
|
| Rate for Payer: Aetna Medicare |
$588.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$707.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$707.28
|
| Rate for Payer: BCBS Complete |
$418.94
|
| Rate for Payer: BCBS MAPPO |
$565.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,860.67
|
| Rate for Payer: BCN Commercial |
$1,860.67
|
| Rate for Payer: BCN Medicare Advantage |
$565.83
|
| Rate for Payer: Cash Price |
$1,810.65
|
| Rate for Payer: Cofinity Commercial |
$1,946.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,810.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$565.83
|
| Rate for Payer: Healthscope Commercial |
$2,036.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,697.48
|
| Rate for Payer: Mclaren Medicaid |
$399.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$594.12
|
| Rate for Payer: Meridian Medicaid |
$418.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$650.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$622.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,923.81
|
| Rate for Payer: Nomi Health Commercial |
$1,855.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,697.48
|
| Rate for Payer: PACE Senior Care Partners |
$537.54
|
| Rate for Payer: PACE SWMI |
$565.83
|
| Rate for Payer: PHP Commercial |
$1,923.81
|
| Rate for Payer: PHP Medicare Advantage |
$565.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$399.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,969.08
|
| Rate for Payer: Priority Health Medicare |
$571.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,575.26
|
| Rate for Payer: Railroad Medicare Medicare |
$565.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,991.71
|
| Rate for Payer: UHC Core |
$1,889.86
|
| Rate for Payer: UHC Exchange |
$565.83
|
| Rate for Payer: UHC Medicaid |
$399.02
|
| Rate for Payer: UHC Medicare Advantage |
$565.83
|
| Rate for Payer: UHCCP Medicaid |
$399.02
|
| Rate for Payer: VA VA |
$565.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,697.48
|
|
|
HC Z HYPERGLIDE OCCL BALLOON C
|
Facility
|
IP
|
$2,263.31
|
|
|
Service Code
|
HCPCS C2628
|
| Hospital Charge Code |
27200089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,575.26 |
| Max. Negotiated Rate |
$2,036.98 |
| Rate for Payer: Aetna Commercial |
$1,923.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,869.27
|
| Rate for Payer: BCN Commercial |
$1,869.27
|
| Rate for Payer: Cash Price |
$1,810.65
|
| Rate for Payer: Cofinity Commercial |
$1,946.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,810.65
|
| Rate for Payer: Healthscope Commercial |
$2,036.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,697.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,923.81
|
| Rate for Payer: Nomi Health Commercial |
$1,855.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,697.48
|
| Rate for Payer: PHP Commercial |
$1,923.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,969.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,575.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,991.71
|
| Rate for Payer: UHC Core |
$1,889.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,697.48
|
|
|
HC ZIKA VIRUS MAC ELISA IGM
|
Facility
|
IP
|
$191.43
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000148
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$133.24 |
| Max. Negotiated Rate |
$172.29 |
| Rate for Payer: Aetna Commercial |
$162.72
|
| Rate for Payer: BCBS Trust/PPO |
$158.10
|
| Rate for Payer: BCN Commercial |
$158.10
|
| Rate for Payer: Cash Price |
$153.14
|
| Rate for Payer: Cofinity Commercial |
$164.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.14
|
| Rate for Payer: Healthscope Commercial |
$172.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.72
|
| Rate for Payer: Nomi Health Commercial |
$156.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.57
|
| Rate for Payer: PHP Commercial |
$162.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$166.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.46
|
| Rate for Payer: UHC Core |
$159.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.57
|
|
|
HC ZIKA VIRUS MAC ELISA IGM
|
Facility
|
OP
|
$191.43
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000148
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.75 |
| Max. Negotiated Rate |
$172.29 |
| Rate for Payer: Aetna Commercial |
$162.72
|
| Rate for Payer: Aetna Medicare |
$49.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.82
|
| Rate for Payer: BCBS Complete |
$35.43
|
| Rate for Payer: BCBS MAPPO |
$47.86
|
| Rate for Payer: BCBS Trust/PPO |
$157.37
|
| Rate for Payer: BCN Commercial |
$157.37
|
| Rate for Payer: BCN Medicare Advantage |
$47.86
|
| Rate for Payer: Cash Price |
$153.14
|
| Rate for Payer: Cofinity Commercial |
$164.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.86
|
| Rate for Payer: Healthscope Commercial |
$172.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.57
|
| Rate for Payer: Mclaren Medicaid |
$33.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.25
|
| Rate for Payer: Meridian Medicaid |
$35.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.72
|
| Rate for Payer: Nomi Health Commercial |
$156.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.57
|
| Rate for Payer: PACE Senior Care Partners |
$45.46
|
| Rate for Payer: PACE SWMI |
$47.86
|
| Rate for Payer: PHP Commercial |
$162.72
|
| Rate for Payer: PHP Medicare Advantage |
$47.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$166.54
|
| Rate for Payer: Priority Health Medicare |
$48.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.24
|
| Rate for Payer: Railroad Medicare Medicare |
$47.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.46
|
| Rate for Payer: UHC Core |
$159.84
|
| Rate for Payer: UHC Exchange |
$47.86
|
| Rate for Payer: UHC Medicaid |
$33.75
|
| Rate for Payer: UHC Medicare Advantage |
$47.86
|
| Rate for Payer: UHCCP Medicaid |
$33.75
|
| Rate for Payer: VA VA |
$47.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.57
|
|
|
HC ZIKA VIRUS, PCR, SERUM
|
Facility
|
IP
|
$265.30
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000150
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$184.65 |
| Max. Negotiated Rate |
$238.77 |
| Rate for Payer: Aetna Commercial |
$225.50
|
| Rate for Payer: BCBS Trust/PPO |
$219.11
|
| Rate for Payer: BCN Commercial |
$219.11
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Commercial |
$228.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Healthscope Commercial |
$238.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Nomi Health Commercial |
$217.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: PHP Commercial |
$225.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$230.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.46
|
| Rate for Payer: UHC Core |
$221.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.97
|
|
|
HC ZIKA VIRUS, PCR, SERUM
|
Facility
|
OP
|
$265.30
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000150
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$46.77 |
| Max. Negotiated Rate |
$238.77 |
| Rate for Payer: Aetna Commercial |
$225.50
|
| Rate for Payer: Aetna Medicare |
$68.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.91
|
| Rate for Payer: BCBS Complete |
$49.11
|
| Rate for Payer: BCBS MAPPO |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$218.10
|
| Rate for Payer: BCN Commercial |
$218.10
|
| Rate for Payer: BCN Medicare Advantage |
$66.33
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Commercial |
$228.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.33
|
| Rate for Payer: Healthscope Commercial |
$238.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.97
|
| Rate for Payer: Mclaren Medicaid |
$46.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.64
|
| Rate for Payer: Meridian Medicaid |
$49.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Nomi Health Commercial |
$217.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: PACE Senior Care Partners |
$63.01
|
| Rate for Payer: PACE SWMI |
$66.33
|
| Rate for Payer: PHP Commercial |
$225.50
|
| Rate for Payer: PHP Medicare Advantage |
$66.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$230.81
|
| Rate for Payer: Priority Health Medicare |
$66.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.65
|
| Rate for Payer: Railroad Medicare Medicare |
$66.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.46
|
| Rate for Payer: UHC Core |
$221.53
|
| Rate for Payer: UHC Exchange |
$66.33
|
| Rate for Payer: UHC Medicaid |
$46.77
|
| Rate for Payer: UHC Medicare Advantage |
$66.33
|
| Rate for Payer: UHCCP Medicaid |
$46.77
|
| Rate for Payer: VA VA |
$66.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.97
|
|
|
HC ZIKA VIRUS, PCR, URINE
|
Facility
|
OP
|
$265.30
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000151
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$46.77 |
| Max. Negotiated Rate |
$238.77 |
| Rate for Payer: Aetna Commercial |
$225.50
|
| Rate for Payer: Aetna Medicare |
$68.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.91
|
| Rate for Payer: BCBS Complete |
$49.11
|
| Rate for Payer: BCBS MAPPO |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$218.10
|
| Rate for Payer: BCN Commercial |
$218.10
|
| Rate for Payer: BCN Medicare Advantage |
$66.33
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Commercial |
$228.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.33
|
| Rate for Payer: Healthscope Commercial |
$238.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.97
|
| Rate for Payer: Mclaren Medicaid |
$46.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.64
|
| Rate for Payer: Meridian Medicaid |
$49.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Nomi Health Commercial |
$217.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: PACE Senior Care Partners |
$63.01
|
| Rate for Payer: PACE SWMI |
$66.33
|
| Rate for Payer: PHP Commercial |
$225.50
|
| Rate for Payer: PHP Medicare Advantage |
$66.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$230.81
|
| Rate for Payer: Priority Health Medicare |
$66.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.65
|
| Rate for Payer: Railroad Medicare Medicare |
$66.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.46
|
| Rate for Payer: UHC Core |
$221.53
|
| Rate for Payer: UHC Exchange |
$66.33
|
| Rate for Payer: UHC Medicaid |
$46.77
|
| Rate for Payer: UHC Medicare Advantage |
$66.33
|
| Rate for Payer: UHCCP Medicaid |
$46.77
|
| Rate for Payer: VA VA |
$66.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.97
|
|
|
HC ZIKA VIRUS, PCR, URINE
|
Facility
|
IP
|
$265.30
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000151
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$184.65 |
| Max. Negotiated Rate |
$238.77 |
| Rate for Payer: Aetna Commercial |
$225.50
|
| Rate for Payer: BCBS Trust/PPO |
$219.11
|
| Rate for Payer: BCN Commercial |
$219.11
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Commercial |
$228.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Healthscope Commercial |
$238.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Nomi Health Commercial |
$217.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: PHP Commercial |
$225.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$230.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.46
|
| Rate for Payer: UHC Core |
$221.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.97
|
|
|
HC Z IMPLANTABLE PORT
|
Facility
|
OP
|
$3,160.38
|
|
|
Service Code
|
HCPCS C1788
|
| Hospital Charge Code |
27800039
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$557.17 |
| Max. Negotiated Rate |
$2,844.34 |
| Rate for Payer: Aetna Commercial |
$2,686.32
|
| Rate for Payer: Aetna Medicare |
$821.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$987.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$987.62
|
| Rate for Payer: BCBS Complete |
$584.99
|
| Rate for Payer: BCBS MAPPO |
$790.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,598.15
|
| Rate for Payer: BCN Commercial |
$2,598.15
|
| Rate for Payer: BCN Medicare Advantage |
$790.10
|
| Rate for Payer: Cash Price |
$2,528.30
|
| Rate for Payer: Cofinity Commercial |
$2,717.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,528.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$790.10
|
| Rate for Payer: Healthscope Commercial |
$2,844.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,370.28
|
| Rate for Payer: Mclaren Medicaid |
$557.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$829.60
|
| Rate for Payer: Meridian Medicaid |
$584.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$908.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$869.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,686.32
|
| Rate for Payer: Nomi Health Commercial |
$2,591.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,370.28
|
| Rate for Payer: PACE Senior Care Partners |
$750.59
|
| Rate for Payer: PACE SWMI |
$790.10
|
| Rate for Payer: PHP Commercial |
$2,686.32
|
| Rate for Payer: PHP Medicare Advantage |
$790.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$557.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,749.53
|
| Rate for Payer: Priority Health Medicare |
$798.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,199.62
|
| Rate for Payer: Railroad Medicare Medicare |
$790.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,781.13
|
| Rate for Payer: UHC Core |
$2,638.92
|
| Rate for Payer: UHC Exchange |
$790.10
|
| Rate for Payer: UHC Medicaid |
$557.17
|
| Rate for Payer: UHC Medicare Advantage |
$790.10
|
| Rate for Payer: UHCCP Medicaid |
$557.17
|
| Rate for Payer: VA VA |
$790.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,370.28
|
|
|
HC Z IMPLANTABLE PORT
|
Facility
|
IP
|
$3,160.38
|
|
|
Service Code
|
HCPCS C1788
|
| Hospital Charge Code |
27800039
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,199.62 |
| Max. Negotiated Rate |
$2,844.34 |
| Rate for Payer: Aetna Commercial |
$2,686.32
|
| Rate for Payer: BCBS Trust/PPO |
$2,610.16
|
| Rate for Payer: BCN Commercial |
$2,610.16
|
| Rate for Payer: Cash Price |
$2,528.30
|
| Rate for Payer: Cofinity Commercial |
$2,717.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,528.30
|
| Rate for Payer: Healthscope Commercial |
$2,844.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,370.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,686.32
|
| Rate for Payer: Nomi Health Commercial |
$2,591.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,370.28
|
| Rate for Payer: PHP Commercial |
$2,686.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,749.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,199.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,781.13
|
| Rate for Payer: UHC Core |
$2,638.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,370.28
|
|
|
HC ZINC LEVEL
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100462
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.99 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: Aetna Medicare |
$13.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.93
|
| Rate for Payer: BCBS Complete |
$9.44
|
| Rate for Payer: BCBS MAPPO |
$12.74
|
| Rate for Payer: BCBS Trust/PPO |
$41.91
|
| Rate for Payer: BCN Commercial |
$41.91
|
| Rate for Payer: BCN Medicare Advantage |
$12.74
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$43.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.23
|
| Rate for Payer: Mclaren Medicaid |
$8.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.38
|
| Rate for Payer: Meridian Medicaid |
$9.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.23
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.74
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: PHP Medicare Advantage |
$12.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.35
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.48
|
| Rate for Payer: Railroad Medicare Medicare |
$12.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.86
|
| Rate for Payer: UHC Core |
$42.57
|
| Rate for Payer: UHC Exchange |
$12.74
|
| Rate for Payer: UHC Medicaid |
$8.99
|
| Rate for Payer: UHC Medicare Advantage |
$12.74
|
| Rate for Payer: UHCCP Medicaid |
$8.99
|
| Rate for Payer: VA VA |
$12.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.23
|
|
|
HC ZINC LEVEL
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100462
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.48 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: BCBS Trust/PPO |
$42.10
|
| Rate for Payer: BCN Commercial |
$42.10
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$43.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$41.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.23
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.86
|
| Rate for Payer: UHC Core |
$42.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.23
|
|
|
HC ZINC TRANSPORTER T8
|
Facility
|
IP
|
$459.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200514
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$319.46 |
| Max. Negotiated Rate |
$413.10 |
| Rate for Payer: Aetna Commercial |
$390.15
|
| Rate for Payer: BCBS Trust/PPO |
$379.09
|
| Rate for Payer: BCN Commercial |
$379.09
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cofinity Commercial |
$394.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.20
|
| Rate for Payer: Healthscope Commercial |
$413.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.15
|
| Rate for Payer: Nomi Health Commercial |
$376.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$344.25
|
| Rate for Payer: PHP Commercial |
$390.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$399.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$319.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.92
|
| Rate for Payer: UHC Core |
$383.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.25
|
|
|
HC ZINC TRANSPORTER T8
|
Facility
|
OP
|
$459.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200514
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$80.92 |
| Max. Negotiated Rate |
$413.10 |
| Rate for Payer: Aetna Commercial |
$390.15
|
| Rate for Payer: Aetna Medicare |
$119.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$143.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$143.44
|
| Rate for Payer: BCBS Complete |
$84.96
|
| Rate for Payer: BCBS MAPPO |
$114.75
|
| Rate for Payer: BCBS Trust/PPO |
$377.34
|
| Rate for Payer: BCN Commercial |
$377.34
|
| Rate for Payer: BCN Medicare Advantage |
$114.75
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cofinity Commercial |
$394.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.75
|
| Rate for Payer: Healthscope Commercial |
$413.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.25
|
| Rate for Payer: Mclaren Medicaid |
$80.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.49
|
| Rate for Payer: Meridian Medicaid |
$84.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$131.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$126.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.15
|
| Rate for Payer: Nomi Health Commercial |
$376.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$344.25
|
| Rate for Payer: PACE Senior Care Partners |
$109.01
|
| Rate for Payer: PACE SWMI |
$114.75
|
| Rate for Payer: PHP Commercial |
$390.15
|
| Rate for Payer: PHP Medicare Advantage |
$114.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$399.33
|
| Rate for Payer: Priority Health Medicare |
$115.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$319.46
|
| Rate for Payer: Railroad Medicare Medicare |
$114.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$403.92
|
| Rate for Payer: UHC Core |
$383.26
|
| Rate for Payer: UHC Exchange |
$114.75
|
| Rate for Payer: UHC Medicaid |
$80.92
|
| Rate for Payer: UHC Medicare Advantage |
$114.75
|
| Rate for Payer: UHCCP Medicaid |
$80.92
|
| Rate for Payer: VA VA |
$114.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.25
|
|
|
HC ZINC URINE
|
Facility
|
OP
|
$71.37
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100463
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.58 |
| Max. Negotiated Rate |
$64.23 |
| Rate for Payer: Aetna Commercial |
$60.66
|
| Rate for Payer: Aetna Medicare |
$18.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.30
|
| Rate for Payer: BCBS Complete |
$13.21
|
| Rate for Payer: BCBS MAPPO |
$17.84
|
| Rate for Payer: BCBS Trust/PPO |
$58.67
|
| Rate for Payer: BCN Commercial |
$58.67
|
| Rate for Payer: BCN Medicare Advantage |
$17.84
|
| Rate for Payer: Cash Price |
$57.10
|
| Rate for Payer: Cofinity Commercial |
$61.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.84
|
| Rate for Payer: Healthscope Commercial |
$64.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.53
|
| Rate for Payer: Mclaren Medicaid |
$12.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.73
|
| Rate for Payer: Meridian Medicaid |
$13.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.66
|
| Rate for Payer: Nomi Health Commercial |
$58.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.53
|
| Rate for Payer: PACE Senior Care Partners |
$16.95
|
| Rate for Payer: PACE SWMI |
$17.84
|
| Rate for Payer: PHP Commercial |
$60.66
|
| Rate for Payer: PHP Medicare Advantage |
$17.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.09
|
| Rate for Payer: Priority Health Medicare |
$18.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.67
|
| Rate for Payer: Railroad Medicare Medicare |
$17.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.81
|
| Rate for Payer: UHC Core |
$59.59
|
| Rate for Payer: UHC Exchange |
$17.84
|
| Rate for Payer: UHC Medicaid |
$12.58
|
| Rate for Payer: UHC Medicare Advantage |
$17.84
|
| Rate for Payer: UHCCP Medicaid |
$12.58
|
| Rate for Payer: VA VA |
$17.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.53
|
|
|
HC ZINC URINE
|
Facility
|
IP
|
$71.37
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100463
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.67 |
| Max. Negotiated Rate |
$64.23 |
| Rate for Payer: Aetna Commercial |
$60.66
|
| Rate for Payer: BCBS Trust/PPO |
$58.94
|
| Rate for Payer: BCN Commercial |
$58.94
|
| Rate for Payer: Cash Price |
$57.10
|
| Rate for Payer: Cofinity Commercial |
$61.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.10
|
| Rate for Payer: Healthscope Commercial |
$64.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.66
|
| Rate for Payer: Nomi Health Commercial |
$58.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.53
|
| Rate for Payer: PHP Commercial |
$60.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.81
|
| Rate for Payer: UHC Core |
$59.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.53
|
|
|
HC Z INFUSION WIRE
|
Facility
|
IP
|
$892.35
|
|
| Hospital Charge Code |
62100001
|
|
Hospital Revenue Code
|
621
|
| Min. Negotiated Rate |
$621.08 |
| Max. Negotiated Rate |
$803.12 |
| Rate for Payer: Aetna Commercial |
$758.50
|
| Rate for Payer: BCBS Trust/PPO |
$736.99
|
| Rate for Payer: BCN Commercial |
$736.99
|
| Rate for Payer: Cash Price |
$713.88
|
| Rate for Payer: Cofinity Commercial |
$767.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$713.88
|
| Rate for Payer: Healthscope Commercial |
$803.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$669.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$758.50
|
| Rate for Payer: Nomi Health Commercial |
$731.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$669.26
|
| Rate for Payer: PHP Commercial |
$758.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$776.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$621.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$785.27
|
| Rate for Payer: UHC Core |
$745.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$669.26
|
|
|
HC Z INFUSION WIRE
|
Facility
|
OP
|
$892.35
|
|
| Hospital Charge Code |
62100001
|
|
Hospital Revenue Code
|
621
|
| Min. Negotiated Rate |
$157.32 |
| Max. Negotiated Rate |
$803.12 |
| Rate for Payer: Aetna Commercial |
$758.50
|
| Rate for Payer: Aetna Medicare |
$232.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$278.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$278.86
|
| Rate for Payer: BCBS Complete |
$165.17
|
| Rate for Payer: BCBS MAPPO |
$223.09
|
| Rate for Payer: BCBS Trust/PPO |
$733.60
|
| Rate for Payer: BCN Commercial |
$733.60
|
| Rate for Payer: BCN Medicare Advantage |
$223.09
|
| Rate for Payer: Cash Price |
$713.88
|
| Rate for Payer: Cofinity Commercial |
$767.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$713.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.09
|
| Rate for Payer: Healthscope Commercial |
$803.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$669.26
|
| Rate for Payer: Mclaren Medicaid |
$157.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$234.24
|
| Rate for Payer: Meridian Medicaid |
$165.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$256.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$245.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$758.50
|
| Rate for Payer: Nomi Health Commercial |
$731.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$669.26
|
| Rate for Payer: PACE Senior Care Partners |
$211.93
|
| Rate for Payer: PACE SWMI |
$223.09
|
| Rate for Payer: PHP Commercial |
$758.50
|
| Rate for Payer: PHP Medicare Advantage |
$223.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$776.34
|
| Rate for Payer: Priority Health Medicare |
$225.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$621.08
|
| Rate for Payer: Railroad Medicare Medicare |
$223.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$785.27
|
| Rate for Payer: UHC Core |
$745.11
|
| Rate for Payer: UHC Exchange |
$223.09
|
| Rate for Payer: UHC Medicaid |
$157.32
|
| Rate for Payer: UHC Medicare Advantage |
$223.09
|
| Rate for Payer: UHCCP Medicaid |
$157.32
|
| Rate for Payer: VA VA |
$223.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$669.26
|
|
|
HC Z INTRACRANIAL STENT
|
Facility
|
OP
|
$13,401.24
|
|
| Hospital Charge Code |
27800049
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,362.64 |
| Max. Negotiated Rate |
$12,061.12 |
| Rate for Payer: Aetna Commercial |
$11,391.05
|
| Rate for Payer: Aetna Medicare |
$3,484.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,187.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,187.89
|
| Rate for Payer: BCBS Complete |
$2,480.57
|
| Rate for Payer: BCBS MAPPO |
$3,350.31
|
| Rate for Payer: BCBS Trust/PPO |
$11,017.16
|
| Rate for Payer: BCN Commercial |
$11,017.16
|
| Rate for Payer: BCN Medicare Advantage |
$3,350.31
|
| Rate for Payer: Cash Price |
$10,720.99
|
| Rate for Payer: Cofinity Commercial |
$11,525.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,720.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,350.31
|
| Rate for Payer: Healthscope Commercial |
$12,061.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,050.93
|
| Rate for Payer: Mclaren Medicaid |
$2,362.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,517.83
|
| Rate for Payer: Meridian Medicaid |
$2,480.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,852.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,685.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,391.05
|
| Rate for Payer: Nomi Health Commercial |
$10,989.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,050.93
|
| Rate for Payer: PACE Senior Care Partners |
$3,182.79
|
| Rate for Payer: PACE SWMI |
$3,350.31
|
| Rate for Payer: PHP Commercial |
$11,391.05
|
| Rate for Payer: PHP Medicare Advantage |
$3,350.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,362.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,659.08
|
| Rate for Payer: Priority Health Medicare |
$3,383.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,327.26
|
| Rate for Payer: Railroad Medicare Medicare |
$3,350.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,793.09
|
| Rate for Payer: UHC Core |
$11,190.04
|
| Rate for Payer: UHC Exchange |
$3,350.31
|
| Rate for Payer: UHC Medicaid |
$2,362.64
|
| Rate for Payer: UHC Medicare Advantage |
$3,350.31
|
| Rate for Payer: UHCCP Medicaid |
$2,362.64
|
| Rate for Payer: VA VA |
$3,350.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,050.93
|
|
|
HC Z INTRACRANIAL STENT
|
Facility
|
IP
|
$13,401.24
|
|
| Hospital Charge Code |
27800049
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,327.26 |
| Max. Negotiated Rate |
$12,061.12 |
| Rate for Payer: Aetna Commercial |
$11,391.05
|
| Rate for Payer: BCBS Trust/PPO |
$11,068.08
|
| Rate for Payer: BCN Commercial |
$11,068.08
|
| Rate for Payer: Cash Price |
$10,720.99
|
| Rate for Payer: Cofinity Commercial |
$11,525.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,720.99
|
| Rate for Payer: Healthscope Commercial |
$12,061.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,050.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,391.05
|
| Rate for Payer: Nomi Health Commercial |
$10,989.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,050.93
|
| Rate for Payer: PHP Commercial |
$11,391.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,659.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,327.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,793.09
|
| Rate for Payer: UHC Core |
$11,190.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,050.93
|
|
|
HC Z INTRODUCER SHEATH
|
Facility
|
OP
|
$335.84
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200090
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.21 |
| Max. Negotiated Rate |
$302.26 |
| Rate for Payer: Aetna Commercial |
$285.46
|
| Rate for Payer: Aetna Medicare |
$87.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.95
|
| Rate for Payer: BCBS Complete |
$62.16
|
| Rate for Payer: BCBS MAPPO |
$83.96
|
| Rate for Payer: BCBS Trust/PPO |
$276.09
|
| Rate for Payer: BCN Commercial |
$276.09
|
| Rate for Payer: BCN Medicare Advantage |
$83.96
|
| Rate for Payer: Cash Price |
$268.67
|
| Rate for Payer: Cofinity Commercial |
$288.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.96
|
| Rate for Payer: Healthscope Commercial |
$302.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.88
|
| Rate for Payer: Mclaren Medicaid |
$59.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.16
|
| Rate for Payer: Meridian Medicaid |
$62.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.46
|
| Rate for Payer: Nomi Health Commercial |
$275.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.88
|
| Rate for Payer: PACE Senior Care Partners |
$79.76
|
| Rate for Payer: PACE SWMI |
$83.96
|
| Rate for Payer: PHP Commercial |
$285.46
|
| Rate for Payer: PHP Medicare Advantage |
$83.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$292.18
|
| Rate for Payer: Priority Health Medicare |
$84.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.74
|
| Rate for Payer: Railroad Medicare Medicare |
$83.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.54
|
| Rate for Payer: UHC Core |
$280.43
|
| Rate for Payer: UHC Exchange |
$83.96
|
| Rate for Payer: UHC Medicaid |
$59.21
|
| Rate for Payer: UHC Medicare Advantage |
$83.96
|
| Rate for Payer: UHCCP Medicaid |
$59.21
|
| Rate for Payer: VA VA |
$83.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.88
|
|
|
HC Z INTRODUCER SHEATH
|
Facility
|
IP
|
$335.84
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200090
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$233.74 |
| Max. Negotiated Rate |
$302.26 |
| Rate for Payer: Aetna Commercial |
$285.46
|
| Rate for Payer: BCBS Trust/PPO |
$277.37
|
| Rate for Payer: BCN Commercial |
$277.37
|
| Rate for Payer: Cash Price |
$268.67
|
| Rate for Payer: Cofinity Commercial |
$288.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.67
|
| Rate for Payer: Healthscope Commercial |
$302.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.46
|
| Rate for Payer: Nomi Health Commercial |
$275.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.88
|
| Rate for Payer: PHP Commercial |
$285.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$292.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$233.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.54
|
| Rate for Payer: UHC Core |
$280.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.88
|
|
|
HC Z ITERPRET VISCERAL PTRA
|
Facility
|
OP
|
$3,851.00
|
|
| Hospital Charge Code |
32000272
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$678.93 |
| Max. Negotiated Rate |
$3,465.90 |
| Rate for Payer: Aetna Commercial |
$3,273.35
|
| Rate for Payer: Aetna Medicare |
$1,001.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,203.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,203.44
|
| Rate for Payer: BCBS Complete |
$712.82
|
| Rate for Payer: BCBS MAPPO |
$962.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,165.91
|
| Rate for Payer: BCN Commercial |
$3,165.91
|
| Rate for Payer: BCN Medicare Advantage |
$962.75
|
| Rate for Payer: Cash Price |
$3,080.80
|
| Rate for Payer: Cofinity Commercial |
$3,311.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,080.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$962.75
|
| Rate for Payer: Healthscope Commercial |
$3,465.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,888.25
|
| Rate for Payer: Mclaren Medicaid |
$678.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,010.89
|
| Rate for Payer: Meridian Medicaid |
$712.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,107.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,059.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,273.35
|
| Rate for Payer: Nomi Health Commercial |
$3,157.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,888.25
|
| Rate for Payer: PACE Senior Care Partners |
$914.61
|
| Rate for Payer: PACE SWMI |
$962.75
|
| Rate for Payer: PHP Commercial |
$3,273.35
|
| Rate for Payer: PHP Medicare Advantage |
$962.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$678.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,350.37
|
| Rate for Payer: Priority Health Medicare |
$972.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,680.30
|
| Rate for Payer: Railroad Medicare Medicare |
$962.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,388.88
|
| Rate for Payer: UHC Core |
$3,215.59
|
| Rate for Payer: UHC Exchange |
$962.75
|
| Rate for Payer: UHC Medicaid |
$678.93
|
| Rate for Payer: UHC Medicare Advantage |
$962.75
|
| Rate for Payer: UHCCP Medicaid |
$678.93
|
| Rate for Payer: VA VA |
$962.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,888.25
|
|
|
HC Z ITERPRET VISCERAL PTRA
|
Facility
|
IP
|
$3,851.00
|
|
| Hospital Charge Code |
32000272
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,680.30 |
| Max. Negotiated Rate |
$3,465.90 |
| Rate for Payer: Aetna Commercial |
$3,273.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,180.54
|
| Rate for Payer: BCN Commercial |
$3,180.54
|
| Rate for Payer: Cash Price |
$3,080.80
|
| Rate for Payer: Cofinity Commercial |
$3,311.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,080.80
|
| Rate for Payer: Healthscope Commercial |
$3,465.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,888.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,273.35
|
| Rate for Payer: Nomi Health Commercial |
$3,157.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,888.25
|
| Rate for Payer: PHP Commercial |
$3,273.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,350.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,680.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,388.88
|
| Rate for Payer: UHC Core |
$3,215.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,888.25
|
|
