|
HC XR WRIST BIL 2 VW
|
Facility
|
OP
|
$291.84
|
|
|
Service Code
|
CPT 73100
|
| Hospital Charge Code |
32000081
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna Medicare |
$75.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.20
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$72.96
|
| Rate for Payer: BCBS Trust/PPO |
$239.92
|
| Rate for Payer: BCN Commercial |
$226.91
|
| Rate for Payer: BCN Medicare Advantage |
$72.96
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.96
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.61
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: PACE Senior Care Partners |
$69.31
|
| Rate for Payer: PACE SWMI |
$72.96
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: PHP Medicare Advantage |
$72.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO |
$253.90
|
| Rate for Payer: Priority Health Medicare |
$73.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.53
|
| Rate for Payer: Railroad Medicare Medicare |
$72.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.82
|
| Rate for Payer: UHC Core |
$243.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.96
|
| Rate for Payer: UHC Exchange |
$72.96
|
| Rate for Payer: UHC Medicare Advantage |
$72.96
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$72.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC XR WRIST BIL 2 VW
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 73100
|
| Hospital Charge Code |
32000081
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$189.70 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: BCBS Trust/PPO |
$238.23
|
| Rate for Payer: BCN Commercial |
$225.53
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$239.31
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO |
$253.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.82
|
| Rate for Payer: UHC Core |
$243.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC XR WRIST BIL MIN 3 VW
|
Facility
|
IP
|
$451.65
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000083
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$293.57 |
| Max. Negotiated Rate |
$406.48 |
| Rate for Payer: Aetna Commercial |
$383.90
|
| Rate for Payer: BCBS Trust/PPO |
$368.68
|
| Rate for Payer: BCN Commercial |
$349.04
|
| Rate for Payer: Cash Price |
$361.32
|
| Rate for Payer: Cofinity Commercial |
$388.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$361.32
|
| Rate for Payer: Healthscope Commercial |
$406.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$383.90
|
| Rate for Payer: Nomi Health Commercial |
$370.35
|
| Rate for Payer: PHP Commercial |
$383.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.57
|
| Rate for Payer: Priority Health HMO/PPO |
$392.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$302.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.45
|
| Rate for Payer: UHC Core |
$377.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.74
|
|
|
HC XR WRIST BIL MIN 3 VW
|
Facility
|
OP
|
$451.65
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000083
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$406.48 |
| Rate for Payer: Aetna Commercial |
$383.90
|
| Rate for Payer: Aetna Medicare |
$117.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.14
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$112.91
|
| Rate for Payer: BCBS Trust/PPO |
$371.30
|
| Rate for Payer: BCN Commercial |
$351.16
|
| Rate for Payer: BCN Medicare Advantage |
$112.91
|
| Rate for Payer: Cash Price |
$361.32
|
| Rate for Payer: Cash Price |
$361.32
|
| Rate for Payer: Cofinity Commercial |
$388.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$361.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.91
|
| Rate for Payer: Healthscope Commercial |
$406.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$338.74
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.56
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$383.90
|
| Rate for Payer: Nomi Health Commercial |
$370.35
|
| Rate for Payer: PACE Senior Care Partners |
$107.27
|
| Rate for Payer: PACE SWMI |
$112.91
|
| Rate for Payer: PHP Commercial |
$383.90
|
| Rate for Payer: PHP Medicare Advantage |
$112.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.57
|
| Rate for Payer: Priority Health HMO/PPO |
$392.94
|
| Rate for Payer: Priority Health Medicare |
$114.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$302.61
|
| Rate for Payer: Railroad Medicare Medicare |
$112.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.45
|
| Rate for Payer: UHC Core |
$377.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.91
|
| Rate for Payer: UHC Exchange |
$112.91
|
| Rate for Payer: UHC Medicare Advantage |
$112.91
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$112.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$338.74
|
|
|
HC XR WRIST MIN 3 VW
|
Facility
|
OP
|
$408.20
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000082
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.37 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna Medicare |
$106.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$127.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$127.56
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$102.05
|
| Rate for Payer: BCBS Trust/PPO |
$335.58
|
| Rate for Payer: BCN Commercial |
$317.38
|
| Rate for Payer: BCN Medicare Advantage |
$102.05
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.05
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.15
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: Nomi Health Commercial |
$334.72
|
| Rate for Payer: PACE Senior Care Partners |
$96.95
|
| Rate for Payer: PACE SWMI |
$102.05
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: PHP Medicare Advantage |
$102.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health HMO/PPO |
$355.13
|
| Rate for Payer: Priority Health Medicare |
$103.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.49
|
| Rate for Payer: Railroad Medicare Medicare |
$102.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.22
|
| Rate for Payer: UHC Core |
$340.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.05
|
| Rate for Payer: UHC Exchange |
$102.05
|
| Rate for Payer: UHC Medicare Advantage |
$102.05
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$102.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XR WRIST MIN 3 VW
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000082
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$265.33 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: BCBS Trust/PPO |
$333.21
|
| Rate for Payer: BCN Commercial |
$315.46
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: Nomi Health Commercial |
$334.72
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health HMO/PPO |
$355.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.22
|
| Rate for Payer: UHC Core |
$340.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XTRASORB 6X9 EACH
|
Facility
|
OP
|
$16.26
|
|
| Hospital Charge Code |
27200293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$14.63 |
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: Aetna Medicare |
$4.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.08
|
| Rate for Payer: BCBS Complete |
$6.50
|
| Rate for Payer: BCBS MAPPO |
$4.06
|
| Rate for Payer: BCBS Trust/PPO |
$13.37
|
| Rate for Payer: BCN Commercial |
$12.64
|
| Rate for Payer: BCN Medicare Advantage |
$4.06
|
| Rate for Payer: Cash Price |
$13.01
|
| Rate for Payer: Cofinity Commercial |
$13.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.06
|
| Rate for Payer: Healthscope Commercial |
$14.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.82
|
| Rate for Payer: Nomi Health Commercial |
$13.33
|
| Rate for Payer: PACE Senior Care Partners |
$3.86
|
| Rate for Payer: PACE SWMI |
$4.06
|
| Rate for Payer: PHP Commercial |
$13.82
|
| Rate for Payer: PHP Medicare Advantage |
$4.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.57
|
| Rate for Payer: Priority Health HMO/PPO |
$14.15
|
| Rate for Payer: Priority Health Medicare |
$4.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.89
|
| Rate for Payer: Railroad Medicare Medicare |
$4.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.31
|
| Rate for Payer: UHC Core |
$13.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.06
|
| Rate for Payer: UHC Exchange |
$4.06
|
| Rate for Payer: UHC Medicare Advantage |
$4.06
|
| Rate for Payer: VA VA |
$4.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.20
|
|
|
HC XTRASORB 6X9 EACH
|
Facility
|
IP
|
$16.26
|
|
| Hospital Charge Code |
27200293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.57 |
| Max. Negotiated Rate |
$14.63 |
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: BCBS Trust/PPO |
$13.27
|
| Rate for Payer: BCN Commercial |
$12.57
|
| Rate for Payer: Cash Price |
$13.01
|
| Rate for Payer: Cofinity Commercial |
$13.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$14.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.82
|
| Rate for Payer: Nomi Health Commercial |
$13.33
|
| Rate for Payer: PHP Commercial |
$13.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.57
|
| Rate for Payer: Priority Health HMO/PPO |
$14.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.31
|
| Rate for Payer: UHC Core |
$13.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.20
|
|
|
HC Y ADAPTER WITH VENT
|
Facility
|
OP
|
$53.58
|
|
| Hospital Charge Code |
27006702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.73 |
| Max. Negotiated Rate |
$48.22 |
| Rate for Payer: Aetna Commercial |
$45.54
|
| Rate for Payer: Aetna Medicare |
$13.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.74
|
| Rate for Payer: BCBS Complete |
$21.43
|
| Rate for Payer: BCBS MAPPO |
$13.40
|
| Rate for Payer: BCBS Trust/PPO |
$44.05
|
| Rate for Payer: BCN Commercial |
$41.66
|
| Rate for Payer: BCN Medicare Advantage |
$13.40
|
| Rate for Payer: Cash Price |
$42.86
|
| Rate for Payer: Cofinity Commercial |
$46.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.40
|
| Rate for Payer: Healthscope Commercial |
$48.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.54
|
| Rate for Payer: Nomi Health Commercial |
$43.94
|
| Rate for Payer: PACE Senior Care Partners |
$12.73
|
| Rate for Payer: PACE SWMI |
$13.40
|
| Rate for Payer: PHP Commercial |
$45.54
|
| Rate for Payer: PHP Medicare Advantage |
$13.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.83
|
| Rate for Payer: Priority Health HMO/PPO |
$46.61
|
| Rate for Payer: Priority Health Medicare |
$13.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.90
|
| Rate for Payer: Railroad Medicare Medicare |
$13.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.15
|
| Rate for Payer: UHC Core |
$44.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.40
|
| Rate for Payer: UHC Exchange |
$13.40
|
| Rate for Payer: UHC Medicare Advantage |
$13.40
|
| Rate for Payer: VA VA |
$13.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.18
|
|
|
HC Y ADAPTER WITH VENT
|
Facility
|
IP
|
$53.58
|
|
| Hospital Charge Code |
27006702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$34.83 |
| Max. Negotiated Rate |
$48.22 |
| Rate for Payer: Aetna Commercial |
$45.54
|
| Rate for Payer: BCBS Trust/PPO |
$43.74
|
| Rate for Payer: BCN Commercial |
$41.41
|
| Rate for Payer: Cash Price |
$42.86
|
| Rate for Payer: Cofinity Commercial |
$46.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.86
|
| Rate for Payer: Healthscope Commercial |
$48.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.54
|
| Rate for Payer: Nomi Health Commercial |
$43.94
|
| Rate for Payer: PHP Commercial |
$45.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.83
|
| Rate for Payer: Priority Health HMO/PPO |
$46.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.15
|
| Rate for Payer: UHC Core |
$44.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.18
|
|
|
HC YEAST BREWERS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200111
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC YEAST BREWERS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200111
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC YELLOW DOCK IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200112
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC YELLOW DOCK IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200112
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC YELLOW HORNET IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC YELLOW HORNET IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$19.62
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
IP
|
$42.08
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.35 |
| Max. Negotiated Rate |
$37.87 |
| Rate for Payer: Aetna Commercial |
$35.77
|
| Rate for Payer: BCBS Trust/PPO |
$34.35
|
| Rate for Payer: BCN Commercial |
$32.52
|
| Rate for Payer: Cash Price |
$33.66
|
| Rate for Payer: Cofinity Commercial |
$36.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.66
|
| Rate for Payer: Healthscope Commercial |
$37.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.77
|
| Rate for Payer: Nomi Health Commercial |
$34.51
|
| Rate for Payer: PHP Commercial |
$35.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.35
|
| Rate for Payer: Priority Health HMO/PPO |
$36.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.03
|
| Rate for Payer: UHC Core |
$35.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.56
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
OP
|
$42.08
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$37.87 |
| Rate for Payer: Aetna Commercial |
$35.77
|
| Rate for Payer: Aetna Medicare |
$10.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.15
|
| Rate for Payer: BCBS Complete |
$16.83
|
| Rate for Payer: BCBS MAPPO |
$10.52
|
| Rate for Payer: BCBS Trust/PPO |
$34.59
|
| Rate for Payer: BCN Commercial |
$32.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.52
|
| Rate for Payer: Cash Price |
$33.66
|
| Rate for Payer: Cofinity Commercial |
$36.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.52
|
| Rate for Payer: Healthscope Commercial |
$37.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.77
|
| Rate for Payer: Nomi Health Commercial |
$34.51
|
| Rate for Payer: PACE Senior Care Partners |
$9.99
|
| Rate for Payer: PACE SWMI |
$10.52
|
| Rate for Payer: PHP Commercial |
$35.77
|
| Rate for Payer: PHP Medicare Advantage |
$10.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.35
|
| Rate for Payer: Priority Health HMO/PPO |
$36.61
|
| Rate for Payer: Priority Health Medicare |
$10.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.19
|
| Rate for Payer: Railroad Medicare Medicare |
$10.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.03
|
| Rate for Payer: UHC Core |
$35.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.52
|
| Rate for Payer: UHC Exchange |
$10.52
|
| Rate for Payer: UHC Medicare Advantage |
$10.52
|
| Rate for Payer: VA VA |
$10.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.56
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
OP
|
$50,779.51
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,060.13 |
| Max. Negotiated Rate |
$45,701.56 |
| Rate for Payer: Aetna Commercial |
$43,162.58
|
| Rate for Payer: Aetna Medicare |
$13,202.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,868.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,868.60
|
| Rate for Payer: BCBS Complete |
$13,006.27
|
| Rate for Payer: BCBS MAPPO |
$12,694.88
|
| Rate for Payer: BCBS Trust/PPO |
$41,745.84
|
| Rate for Payer: BCN Commercial |
$39,481.07
|
| Rate for Payer: BCN Medicare Advantage |
$12,694.88
|
| Rate for Payer: Cash Price |
$40,623.61
|
| Rate for Payer: Cash Price |
$40,623.61
|
| Rate for Payer: Cofinity Commercial |
$43,670.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,623.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,694.88
|
| Rate for Payer: Healthscope Commercial |
$45,701.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,084.63
|
| Rate for Payer: Mclaren Medicaid |
$12,386.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13,329.62
|
| Rate for Payer: Meridian Medicaid |
$13,006.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,599.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,162.58
|
| Rate for Payer: Nomi Health Commercial |
$41,639.20
|
| Rate for Payer: PACE Senior Care Partners |
$12,060.13
|
| Rate for Payer: PACE SWMI |
$12,694.88
|
| Rate for Payer: PHP Commercial |
$43,162.58
|
| Rate for Payer: PHP Medicare Advantage |
$12,694.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,386.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33,006.68
|
| Rate for Payer: Priority Health HMO/PPO |
$44,178.17
|
| Rate for Payer: Priority Health Medicare |
$12,821.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34,022.27
|
| Rate for Payer: Railroad Medicare Medicare |
$12,694.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,685.97
|
| Rate for Payer: UHC Core |
$42,400.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,694.88
|
| Rate for Payer: UHC Exchange |
$12,694.88
|
| Rate for Payer: UHC Medicare Advantage |
$12,694.88
|
| Rate for Payer: UHCCP Medicaid |
$12,386.11
|
| Rate for Payer: VA VA |
$12,694.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,084.63
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
IP
|
$50,779.51
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33,006.68 |
| Max. Negotiated Rate |
$45,701.56 |
| Rate for Payer: Aetna Commercial |
$43,162.58
|
| Rate for Payer: BCBS Trust/PPO |
$41,451.31
|
| Rate for Payer: BCN Commercial |
$39,242.41
|
| Rate for Payer: Cash Price |
$40,623.61
|
| Rate for Payer: Cofinity Commercial |
$43,670.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,623.61
|
| Rate for Payer: Healthscope Commercial |
$45,701.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,084.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,162.58
|
| Rate for Payer: Nomi Health Commercial |
$41,639.20
|
| Rate for Payer: PHP Commercial |
$43,162.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33,006.68
|
| Rate for Payer: Priority Health HMO/PPO |
$44,178.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34,022.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,685.97
|
| Rate for Payer: UHC Core |
$42,400.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,084.63
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
OP
|
$41.82
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Aetna Commercial |
$35.55
|
| Rate for Payer: Aetna Medicare |
$10.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.07
|
| Rate for Payer: BCBS Complete |
$16.73
|
| Rate for Payer: BCBS MAPPO |
$10.46
|
| Rate for Payer: BCBS Trust/PPO |
$34.38
|
| Rate for Payer: BCN Commercial |
$32.52
|
| Rate for Payer: BCN Medicare Advantage |
$10.46
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.46
|
| Rate for Payer: Healthscope Commercial |
$37.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.55
|
| Rate for Payer: Nomi Health Commercial |
$34.29
|
| Rate for Payer: PACE Senior Care Partners |
$9.93
|
| Rate for Payer: PACE SWMI |
$10.46
|
| Rate for Payer: PHP Commercial |
$35.55
|
| Rate for Payer: PHP Medicare Advantage |
$10.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.18
|
| Rate for Payer: Priority Health HMO/PPO |
$36.38
|
| Rate for Payer: Priority Health Medicare |
$10.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.02
|
| Rate for Payer: Railroad Medicare Medicare |
$10.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.80
|
| Rate for Payer: UHC Core |
$34.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.46
|
| Rate for Payer: UHC Exchange |
$10.46
|
| Rate for Payer: UHC Medicare Advantage |
$10.46
|
| Rate for Payer: VA VA |
$10.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.36
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
IP
|
$41.82
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.18 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Aetna Commercial |
$35.55
|
| Rate for Payer: BCBS Trust/PPO |
$34.14
|
| Rate for Payer: BCN Commercial |
$32.32
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$37.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.55
|
| Rate for Payer: Nomi Health Commercial |
$34.29
|
| Rate for Payer: PHP Commercial |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.18
|
| Rate for Payer: Priority Health HMO/PPO |
$36.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.80
|
| Rate for Payer: UHC Core |
$34.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.36
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
OP
|
$204.86
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.65 |
| Max. Negotiated Rate |
$184.37 |
| Rate for Payer: Aetna Commercial |
$174.13
|
| Rate for Payer: Aetna Medicare |
$53.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.02
|
| Rate for Payer: BCBS Complete |
$81.94
|
| Rate for Payer: BCBS MAPPO |
$51.22
|
| Rate for Payer: BCBS Trust/PPO |
$168.42
|
| Rate for Payer: BCN Commercial |
$159.28
|
| Rate for Payer: BCN Medicare Advantage |
$51.22
|
| Rate for Payer: Cash Price |
$163.89
|
| Rate for Payer: Cofinity Commercial |
$176.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.22
|
| Rate for Payer: Healthscope Commercial |
$184.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.13
|
| Rate for Payer: Nomi Health Commercial |
$167.99
|
| Rate for Payer: PACE Senior Care Partners |
$48.65
|
| Rate for Payer: PACE SWMI |
$51.22
|
| Rate for Payer: PHP Commercial |
$174.13
|
| Rate for Payer: PHP Medicare Advantage |
$51.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.16
|
| Rate for Payer: Priority Health HMO/PPO |
$178.23
|
| Rate for Payer: Priority Health Medicare |
$51.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.26
|
| Rate for Payer: Railroad Medicare Medicare |
$51.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.28
|
| Rate for Payer: UHC Core |
$171.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.22
|
| Rate for Payer: UHC Exchange |
$51.22
|
| Rate for Payer: UHC Medicare Advantage |
$51.22
|
| Rate for Payer: VA VA |
$51.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.64
|
|
