|
HC ARCTIC SUN TORSO/LEG PADS
|
Facility
|
OP
|
$2,530.24
|
|
| Hospital Charge Code |
27000610
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$600.93 |
| Max. Negotiated Rate |
$2,277.22 |
| Rate for Payer: Aetna Commercial |
$2,150.70
|
| Rate for Payer: Aetna Medicare |
$657.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$790.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$790.70
|
| Rate for Payer: BCBS Complete |
$1,012.10
|
| Rate for Payer: BCBS MAPPO |
$632.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,967.26
|
| Rate for Payer: BCN Commercial |
$1,967.26
|
| Rate for Payer: BCN Medicare Advantage |
$632.56
|
| Rate for Payer: Cash Price |
$2,024.19
|
| Rate for Payer: Cofinity Commercial |
$2,176.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,024.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$632.56
|
| Rate for Payer: Healthscope Commercial |
$2,277.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,897.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$664.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$727.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,150.70
|
| Rate for Payer: PACE Senior Care Partners |
$600.93
|
| Rate for Payer: PACE SWMI |
$632.56
|
| Rate for Payer: PHP Commercial |
$2,150.70
|
| Rate for Payer: PHP Medicare Advantage |
$632.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,771.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,201.31
|
| Rate for Payer: Priority Health Medicare |
$632.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,543.19
|
| Rate for Payer: Railroad Medicare Medicare |
$632.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,226.61
|
| Rate for Payer: UHC Core |
$2,112.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$632.56
|
| Rate for Payer: UHC Medicare Advantage |
$651.54
|
| Rate for Payer: VA VA |
$632.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,897.68
|
|
|
HC ARCTIC SUN UNIVERSAL PAD
|
Facility
|
OP
|
$1,096.44
|
|
| Hospital Charge Code |
27000617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$260.40 |
| Max. Negotiated Rate |
$986.80 |
| Rate for Payer: Aetna Commercial |
$931.97
|
| Rate for Payer: Aetna Medicare |
$285.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$342.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$342.64
|
| Rate for Payer: BCBS Complete |
$438.58
|
| Rate for Payer: BCBS MAPPO |
$274.11
|
| Rate for Payer: BCBS Trust/PPO |
$852.48
|
| Rate for Payer: BCN Commercial |
$852.48
|
| Rate for Payer: BCN Medicare Advantage |
$274.11
|
| Rate for Payer: Cash Price |
$877.15
|
| Rate for Payer: Cofinity Commercial |
$942.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.11
|
| Rate for Payer: Healthscope Commercial |
$986.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$287.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$315.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$931.97
|
| Rate for Payer: PACE Senior Care Partners |
$260.40
|
| Rate for Payer: PACE SWMI |
$274.11
|
| Rate for Payer: PHP Commercial |
$931.97
|
| Rate for Payer: PHP Medicare Advantage |
$274.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$953.90
|
| Rate for Payer: Priority Health Medicare |
$274.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$668.72
|
| Rate for Payer: Railroad Medicare Medicare |
$274.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$964.87
|
| Rate for Payer: UHC Core |
$915.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$274.11
|
| Rate for Payer: UHC Medicare Advantage |
$282.33
|
| Rate for Payer: VA VA |
$274.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.33
|
|
|
HC ARCTIC SUN UNIVERSAL PAD
|
Facility
|
IP
|
$1,096.44
|
|
| Hospital Charge Code |
27000617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$668.72 |
| Max. Negotiated Rate |
$986.80 |
| Rate for Payer: Aetna Commercial |
$931.97
|
| Rate for Payer: BCBS Trust/PPO |
$847.33
|
| Rate for Payer: BCN Commercial |
$847.33
|
| Rate for Payer: Cash Price |
$877.15
|
| Rate for Payer: Cofinity Commercial |
$942.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.15
|
| Rate for Payer: Healthscope Commercial |
$986.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$931.97
|
| Rate for Payer: PHP Commercial |
$931.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$767.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$953.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$668.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$964.87
|
| Rate for Payer: UHC Core |
$915.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.33
|
|
|
HC ARGON PLASMA COAGULATION
|
Facility
|
OP
|
$1,823.62
|
|
| Hospital Charge Code |
36000007
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$433.11 |
| Max. Negotiated Rate |
$1,641.26 |
| Rate for Payer: Aetna Commercial |
$1,550.08
|
| Rate for Payer: Aetna Medicare |
$474.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$569.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$569.88
|
| Rate for Payer: BCBS Complete |
$729.45
|
| Rate for Payer: BCBS MAPPO |
$455.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,417.86
|
| Rate for Payer: BCN Commercial |
$1,417.86
|
| Rate for Payer: BCN Medicare Advantage |
$455.90
|
| Rate for Payer: Cash Price |
$1,458.90
|
| Rate for Payer: Cofinity Commercial |
$1,568.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,458.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$455.90
|
| Rate for Payer: Healthscope Commercial |
$1,641.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,367.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$478.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$524.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,550.08
|
| Rate for Payer: PACE Senior Care Partners |
$433.11
|
| Rate for Payer: PACE SWMI |
$455.90
|
| Rate for Payer: PHP Commercial |
$1,550.08
|
| Rate for Payer: PHP Medicare Advantage |
$455.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,276.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,586.55
|
| Rate for Payer: Priority Health Medicare |
$455.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,112.23
|
| Rate for Payer: Railroad Medicare Medicare |
$455.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,604.79
|
| Rate for Payer: UHC Core |
$1,522.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$455.90
|
| Rate for Payer: UHC Medicare Advantage |
$469.58
|
| Rate for Payer: VA VA |
$455.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,367.72
|
|
|
HC ARGON PLASMA COAGULATION
|
Facility
|
IP
|
$1,823.62
|
|
| Hospital Charge Code |
36000007
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,112.23 |
| Max. Negotiated Rate |
$1,641.26 |
| Rate for Payer: Aetna Commercial |
$1,550.08
|
| Rate for Payer: BCBS Trust/PPO |
$1,409.29
|
| Rate for Payer: BCN Commercial |
$1,409.29
|
| Rate for Payer: Cash Price |
$1,458.90
|
| Rate for Payer: Cofinity Commercial |
$1,568.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,458.90
|
| Rate for Payer: Healthscope Commercial |
$1,641.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,367.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,550.08
|
| Rate for Payer: PHP Commercial |
$1,550.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,276.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,586.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,112.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,604.79
|
| Rate for Payer: UHC Core |
$1,522.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,367.72
|
|
|
HC ARISTA HEMOSTAT
|
Facility
|
IP
|
$1,119.28
|
|
| Hospital Charge Code |
27200111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$682.65 |
| Max. Negotiated Rate |
$1,007.35 |
| Rate for Payer: Aetna Commercial |
$951.39
|
| Rate for Payer: BCBS Trust/PPO |
$864.98
|
| Rate for Payer: BCN Commercial |
$864.98
|
| Rate for Payer: Cash Price |
$895.42
|
| Rate for Payer: Cofinity Commercial |
$962.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.42
|
| Rate for Payer: Healthscope Commercial |
$1,007.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$839.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$951.39
|
| Rate for Payer: PHP Commercial |
$951.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$973.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$682.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.97
|
| Rate for Payer: UHC Core |
$934.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$839.46
|
|
|
HC ARISTA HEMOSTAT
|
Facility
|
OP
|
$1,119.28
|
|
| Hospital Charge Code |
27200111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$265.83 |
| Max. Negotiated Rate |
$1,007.35 |
| Rate for Payer: Aetna Commercial |
$951.39
|
| Rate for Payer: Aetna Medicare |
$291.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$349.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$349.78
|
| Rate for Payer: BCBS Complete |
$447.71
|
| Rate for Payer: BCBS MAPPO |
$279.82
|
| Rate for Payer: BCBS Trust/PPO |
$870.24
|
| Rate for Payer: BCN Commercial |
$870.24
|
| Rate for Payer: BCN Medicare Advantage |
$279.82
|
| Rate for Payer: Cash Price |
$895.42
|
| Rate for Payer: Cofinity Commercial |
$962.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.82
|
| Rate for Payer: Healthscope Commercial |
$1,007.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$839.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$293.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$321.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$951.39
|
| Rate for Payer: PACE Senior Care Partners |
$265.83
|
| Rate for Payer: PACE SWMI |
$279.82
|
| Rate for Payer: PHP Commercial |
$951.39
|
| Rate for Payer: PHP Medicare Advantage |
$279.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$783.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$973.77
|
| Rate for Payer: Priority Health Medicare |
$279.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$682.65
|
| Rate for Payer: Railroad Medicare Medicare |
$279.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$984.97
|
| Rate for Payer: UHC Core |
$934.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.82
|
| Rate for Payer: UHC Medicare Advantage |
$288.21
|
| Rate for Payer: VA VA |
$279.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$839.46
|
|
|
HC ARRAY COMPARATIVE GENOMIC ACGH
|
Facility
|
IP
|
$1,565.70
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
31000094
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$954.92 |
| Max. Negotiated Rate |
$1,409.13 |
| Rate for Payer: Aetna Commercial |
$1,330.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,209.97
|
| Rate for Payer: BCN Commercial |
$1,209.97
|
| Rate for Payer: Cash Price |
$1,252.56
|
| Rate for Payer: Cofinity Commercial |
$1,346.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,252.56
|
| Rate for Payer: Healthscope Commercial |
$1,409.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,174.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,330.84
|
| Rate for Payer: PHP Commercial |
$1,330.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,095.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,362.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$954.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,377.82
|
| Rate for Payer: UHC Core |
$1,307.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,174.28
|
|
|
HC ARRAY COMPARATIVE GENOMIC ACGH
|
Facility
|
OP
|
$1,565.70
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
31000094
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$371.85 |
| Max. Negotiated Rate |
$1,409.13 |
| Rate for Payer: Aetna Commercial |
$1,330.84
|
| Rate for Payer: Aetna Medicare |
$407.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.28
|
| Rate for Payer: BCBS Complete |
$697.41
|
| Rate for Payer: BCBS MAPPO |
$391.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,217.33
|
| Rate for Payer: BCN Commercial |
$1,217.33
|
| Rate for Payer: BCN Medicare Advantage |
$391.42
|
| Rate for Payer: Cash Price |
$1,252.56
|
| Rate for Payer: Cash Price |
$1,252.56
|
| Rate for Payer: Cofinity Commercial |
$1,346.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,252.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.42
|
| Rate for Payer: Healthscope Commercial |
$1,409.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,174.28
|
| Rate for Payer: Mclaren Medicaid |
$664.20
|
| Rate for Payer: Meridian Medicaid |
$697.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$411.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,330.84
|
| Rate for Payer: PACE Senior Care Partners |
$371.85
|
| Rate for Payer: PACE SWMI |
$391.42
|
| Rate for Payer: PHP Commercial |
$1,330.84
|
| Rate for Payer: PHP Medicare Advantage |
$391.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,095.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,362.16
|
| Rate for Payer: Priority Health Medicare |
$391.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$954.92
|
| Rate for Payer: Railroad Medicare Medicare |
$391.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,377.82
|
| Rate for Payer: UHC Core |
$1,307.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.42
|
| Rate for Payer: UHC Medicare Advantage |
$403.17
|
| Rate for Payer: VA VA |
$391.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,174.28
|
|
|
HC ARRAY COMPARATIVE GENOMIC CMPT
|
Facility
|
OP
|
$1,385.00
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
31000061
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.55 |
| Max. Negotiated Rate |
$1,246.50 |
| Rate for Payer: Aetna Commercial |
$1,177.25
|
| Rate for Payer: Aetna Medicare |
$360.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$432.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$432.81
|
| Rate for Payer: BCBS Complete |
$37.33
|
| Rate for Payer: BCBS MAPPO |
$346.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,076.84
|
| Rate for Payer: BCN Commercial |
$1,076.84
|
| Rate for Payer: BCN Medicare Advantage |
$346.25
|
| Rate for Payer: Cash Price |
$1,108.00
|
| Rate for Payer: Cash Price |
$1,108.00
|
| Rate for Payer: Cofinity Commercial |
$1,191.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,108.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$346.25
|
| Rate for Payer: Healthscope Commercial |
$1,246.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,038.75
|
| Rate for Payer: Mclaren Medicaid |
$35.55
|
| Rate for Payer: Meridian Medicaid |
$37.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$363.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$398.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,177.25
|
| Rate for Payer: PACE Senior Care Partners |
$328.94
|
| Rate for Payer: PACE SWMI |
$346.25
|
| Rate for Payer: PHP Commercial |
$1,177.25
|
| Rate for Payer: PHP Medicare Advantage |
$346.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$969.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,204.95
|
| Rate for Payer: Priority Health Medicare |
$346.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$844.71
|
| Rate for Payer: Railroad Medicare Medicare |
$346.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,218.80
|
| Rate for Payer: UHC Core |
$1,156.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$346.25
|
| Rate for Payer: UHC Medicare Advantage |
$356.64
|
| Rate for Payer: VA VA |
$346.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,038.75
|
|
|
HC ARRAY COMPARATIVE GENOMIC CMPT
|
Facility
|
IP
|
$1,385.00
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
31000061
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$844.71 |
| Max. Negotiated Rate |
$1,246.50 |
| Rate for Payer: Aetna Commercial |
$1,177.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,070.33
|
| Rate for Payer: BCN Commercial |
$1,070.33
|
| Rate for Payer: Cash Price |
$1,108.00
|
| Rate for Payer: Cofinity Commercial |
$1,191.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,108.00
|
| Rate for Payer: Healthscope Commercial |
$1,246.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,038.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,177.25
|
| Rate for Payer: PHP Commercial |
$1,177.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$969.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,204.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$844.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,218.80
|
| Rate for Payer: UHC Core |
$1,156.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,038.75
|
|
|
HC ARSENIC
|
Facility
|
IP
|
$192.20
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$117.22 |
| Max. Negotiated Rate |
$172.98 |
| Rate for Payer: Aetna Commercial |
$163.37
|
| Rate for Payer: BCBS Trust/PPO |
$148.53
|
| Rate for Payer: BCN Commercial |
$148.53
|
| Rate for Payer: Cash Price |
$153.76
|
| Rate for Payer: Cofinity Commercial |
$165.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.76
|
| Rate for Payer: Healthscope Commercial |
$172.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.37
|
| Rate for Payer: PHP Commercial |
$163.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.14
|
| Rate for Payer: UHC Core |
$160.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.15
|
|
|
HC ARSENIC
|
Facility
|
OP
|
$192.20
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$172.98 |
| Rate for Payer: Aetna Commercial |
$163.37
|
| Rate for Payer: Aetna Medicare |
$49.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.06
|
| Rate for Payer: BCBS Complete |
$14.70
|
| Rate for Payer: BCBS MAPPO |
$48.05
|
| Rate for Payer: BCBS Trust/PPO |
$149.44
|
| Rate for Payer: BCN Commercial |
$149.44
|
| Rate for Payer: BCN Medicare Advantage |
$48.05
|
| Rate for Payer: Cash Price |
$153.76
|
| Rate for Payer: Cash Price |
$153.76
|
| Rate for Payer: Cofinity Commercial |
$165.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.05
|
| Rate for Payer: Healthscope Commercial |
$172.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.15
|
| Rate for Payer: Mclaren Medicaid |
$14.00
|
| Rate for Payer: Meridian Medicaid |
$14.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.37
|
| Rate for Payer: PACE Senior Care Partners |
$45.65
|
| Rate for Payer: PACE SWMI |
$48.05
|
| Rate for Payer: PHP Commercial |
$163.37
|
| Rate for Payer: PHP Medicare Advantage |
$48.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.21
|
| Rate for Payer: Priority Health Medicare |
$48.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.22
|
| Rate for Payer: Railroad Medicare Medicare |
$48.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.14
|
| Rate for Payer: UHC Core |
$160.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.05
|
| Rate for Payer: UHC Medicare Advantage |
$49.49
|
| Rate for Payer: VA VA |
$48.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.15
|
|
|
HC ARSENIC 24HR U
|
Facility
|
IP
|
$112.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100679
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.31 |
| Max. Negotiated Rate |
$100.80 |
| Rate for Payer: Aetna Commercial |
$95.20
|
| Rate for Payer: BCBS Trust/PPO |
$86.55
|
| Rate for Payer: BCN Commercial |
$86.55
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$96.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.60
|
| Rate for Payer: Healthscope Commercial |
$100.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$95.20
|
| Rate for Payer: PHP Commercial |
$95.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.56
|
| Rate for Payer: UHC Core |
$93.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.00
|
|
|
HC ARSENIC 24HR U
|
Facility
|
OP
|
$112.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100679
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$100.80 |
| Rate for Payer: Aetna Commercial |
$95.20
|
| Rate for Payer: Aetna Medicare |
$29.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.00
|
| Rate for Payer: BCBS Complete |
$14.70
|
| Rate for Payer: BCBS MAPPO |
$28.00
|
| Rate for Payer: BCBS Trust/PPO |
$87.08
|
| Rate for Payer: BCN Commercial |
$87.08
|
| Rate for Payer: BCN Medicare Advantage |
$28.00
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$96.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.00
|
| Rate for Payer: Healthscope Commercial |
$100.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.00
|
| Rate for Payer: Mclaren Medicaid |
$14.00
|
| Rate for Payer: Meridian Medicaid |
$14.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$95.20
|
| Rate for Payer: PACE Senior Care Partners |
$26.60
|
| Rate for Payer: PACE SWMI |
$28.00
|
| Rate for Payer: PHP Commercial |
$95.20
|
| Rate for Payer: PHP Medicare Advantage |
$28.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.44
|
| Rate for Payer: Priority Health Medicare |
$28.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.31
|
| Rate for Payer: Railroad Medicare Medicare |
$28.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.56
|
| Rate for Payer: UHC Core |
$93.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.00
|
| Rate for Payer: UHC Medicare Advantage |
$28.84
|
| Rate for Payer: VA VA |
$28.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.00
|
|
|
HC ARSENIC URINE
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$57.60 |
| Rate for Payer: Aetna Commercial |
$54.40
|
| Rate for Payer: Aetna Medicare |
$16.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.00
|
| Rate for Payer: BCBS Complete |
$14.70
|
| Rate for Payer: BCBS MAPPO |
$16.00
|
| Rate for Payer: BCBS Trust/PPO |
$49.76
|
| Rate for Payer: BCN Commercial |
$49.76
|
| Rate for Payer: BCN Medicare Advantage |
$16.00
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$55.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.00
|
| Rate for Payer: Healthscope Commercial |
$57.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.00
|
| Rate for Payer: Mclaren Medicaid |
$14.00
|
| Rate for Payer: Meridian Medicaid |
$14.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.40
|
| Rate for Payer: PACE Senior Care Partners |
$15.20
|
| Rate for Payer: PACE SWMI |
$16.00
|
| Rate for Payer: PHP Commercial |
$54.40
|
| Rate for Payer: PHP Medicare Advantage |
$16.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.68
|
| Rate for Payer: Priority Health Medicare |
$16.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.03
|
| Rate for Payer: Railroad Medicare Medicare |
$16.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.32
|
| Rate for Payer: UHC Core |
$53.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.00
|
| Rate for Payer: UHC Medicare Advantage |
$16.48
|
| Rate for Payer: VA VA |
$16.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.00
|
|
|
HC ARSENIC URINE
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.03 |
| Max. Negotiated Rate |
$57.60 |
| Rate for Payer: Aetna Commercial |
$54.40
|
| Rate for Payer: BCBS Trust/PPO |
$49.46
|
| Rate for Payer: BCN Commercial |
$49.46
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$55.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.20
|
| Rate for Payer: Healthscope Commercial |
$57.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.40
|
| Rate for Payer: PHP Commercial |
$54.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.32
|
| Rate for Payer: UHC Core |
$53.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.00
|
|
|
HC ART CATH INSERT
|
Facility
|
IP
|
$443.83
|
|
| Hospital Charge Code |
45000029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$270.69 |
| Max. Negotiated Rate |
$399.45 |
| Rate for Payer: Aetna Commercial |
$377.26
|
| Rate for Payer: BCBS Trust/PPO |
$342.99
|
| Rate for Payer: BCN Commercial |
$342.99
|
| Rate for Payer: Cash Price |
$355.06
|
| Rate for Payer: Cofinity Commercial |
$381.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$355.06
|
| Rate for Payer: Healthscope Commercial |
$399.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$332.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$377.26
|
| Rate for Payer: PHP Commercial |
$377.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$310.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$386.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$270.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$390.57
|
| Rate for Payer: UHC Core |
$370.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$332.87
|
|
|
HC ART CATH INSERT
|
Facility
|
OP
|
$443.83
|
|
| Hospital Charge Code |
45000029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$105.41 |
| Max. Negotiated Rate |
$399.45 |
| Rate for Payer: Aetna Commercial |
$377.26
|
| Rate for Payer: Aetna Medicare |
$115.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$138.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$138.70
|
| Rate for Payer: BCBS Complete |
$177.53
|
| Rate for Payer: BCBS MAPPO |
$110.96
|
| Rate for Payer: BCBS Trust/PPO |
$345.08
|
| Rate for Payer: BCN Commercial |
$345.08
|
| Rate for Payer: BCN Medicare Advantage |
$110.96
|
| Rate for Payer: Cash Price |
$355.06
|
| Rate for Payer: Cofinity Commercial |
$381.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$355.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.96
|
| Rate for Payer: Healthscope Commercial |
$399.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$332.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$116.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$127.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$377.26
|
| Rate for Payer: PACE Senior Care Partners |
$105.41
|
| Rate for Payer: PACE SWMI |
$110.96
|
| Rate for Payer: PHP Commercial |
$377.26
|
| Rate for Payer: PHP Medicare Advantage |
$110.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$310.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$386.13
|
| Rate for Payer: Priority Health Medicare |
$110.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$270.69
|
| Rate for Payer: Railroad Medicare Medicare |
$110.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$390.57
|
| Rate for Payer: UHC Core |
$370.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.96
|
| Rate for Payer: UHC Medicare Advantage |
$114.29
|
| Rate for Payer: VA VA |
$110.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$332.87
|
|
|
HC ARTERIAL DUPLEX IMAG BIL LOWER EXTREMITY
|
Facility
|
OP
|
$1,556.97
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100007
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,401.27 |
| Rate for Payer: Aetna Commercial |
$1,323.42
|
| Rate for Payer: Aetna Medicare |
$404.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$486.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$486.55
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$389.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,210.54
|
| Rate for Payer: BCN Commercial |
$1,210.54
|
| Rate for Payer: BCN Medicare Advantage |
$389.24
|
| Rate for Payer: Cash Price |
$1,245.58
|
| Rate for Payer: Cash Price |
$1,245.58
|
| Rate for Payer: Cofinity Commercial |
$1,338.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,245.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.24
|
| Rate for Payer: Healthscope Commercial |
$1,401.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,167.73
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$408.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$447.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,323.42
|
| Rate for Payer: PACE Senior Care Partners |
$369.78
|
| Rate for Payer: PACE SWMI |
$389.24
|
| Rate for Payer: PHP Commercial |
$1,323.42
|
| Rate for Payer: PHP Medicare Advantage |
$389.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,089.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,354.56
|
| Rate for Payer: Priority Health Medicare |
$389.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$949.60
|
| Rate for Payer: Railroad Medicare Medicare |
$389.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,370.13
|
| Rate for Payer: UHC Core |
$1,300.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.24
|
| Rate for Payer: UHC Medicare Advantage |
$400.92
|
| Rate for Payer: VA VA |
$389.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,167.73
|
|
|
HC ARTERIAL DUPLEX IMAG BIL LOWER EXTREMITY
|
Facility
|
IP
|
$1,556.97
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100007
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$949.60 |
| Max. Negotiated Rate |
$1,401.27 |
| Rate for Payer: Aetna Commercial |
$1,323.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,203.23
|
| Rate for Payer: BCN Commercial |
$1,203.23
|
| Rate for Payer: Cash Price |
$1,245.58
|
| Rate for Payer: Cofinity Commercial |
$1,338.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,245.58
|
| Rate for Payer: Healthscope Commercial |
$1,401.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,167.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,323.42
|
| Rate for Payer: PHP Commercial |
$1,323.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,089.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,354.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$949.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,370.13
|
| Rate for Payer: UHC Core |
$1,300.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,167.73
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
IP
|
$1,283.23
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$782.64 |
| Max. Negotiated Rate |
$1,154.91 |
| Rate for Payer: Aetna Commercial |
$1,090.75
|
| Rate for Payer: BCBS Trust/PPO |
$991.68
|
| Rate for Payer: BCN Commercial |
$991.68
|
| Rate for Payer: Cash Price |
$1,026.58
|
| Rate for Payer: Cofinity Commercial |
$1,103.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,026.58
|
| Rate for Payer: Healthscope Commercial |
$1,154.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$962.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,090.75
|
| Rate for Payer: PHP Commercial |
$1,090.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,116.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$782.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,129.24
|
| Rate for Payer: UHC Core |
$1,071.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$962.42
|
|
|
HC ARTERIAL DUPLEX IMAG BIL UPPER EXTREMITY
|
Facility
|
OP
|
$1,283.23
|
|
|
Service Code
|
CPT 93930
|
| Hospital Charge Code |
92100008
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$160.74 |
| Max. Negotiated Rate |
$1,154.91 |
| Rate for Payer: Aetna Commercial |
$1,090.75
|
| Rate for Payer: Aetna Medicare |
$333.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$401.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$401.01
|
| Rate for Payer: BCBS Complete |
$168.78
|
| Rate for Payer: BCBS MAPPO |
$320.81
|
| Rate for Payer: BCBS Trust/PPO |
$997.71
|
| Rate for Payer: BCN Commercial |
$997.71
|
| Rate for Payer: BCN Medicare Advantage |
$320.81
|
| Rate for Payer: Cash Price |
$1,026.58
|
| Rate for Payer: Cash Price |
$1,026.58
|
| Rate for Payer: Cofinity Commercial |
$1,103.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,026.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.81
|
| Rate for Payer: Healthscope Commercial |
$1,154.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$962.42
|
| Rate for Payer: Mclaren Medicaid |
$160.74
|
| Rate for Payer: Meridian Medicaid |
$168.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$336.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$368.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,090.75
|
| Rate for Payer: PACE Senior Care Partners |
$304.77
|
| Rate for Payer: PACE SWMI |
$320.81
|
| Rate for Payer: PHP Commercial |
$1,090.75
|
| Rate for Payer: PHP Medicare Advantage |
$320.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$160.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$898.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,116.41
|
| Rate for Payer: Priority Health Medicare |
$320.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$782.64
|
| Rate for Payer: Railroad Medicare Medicare |
$320.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,129.24
|
| Rate for Payer: UHC Core |
$1,071.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.81
|
| Rate for Payer: UHC Medicare Advantage |
$330.43
|
| Rate for Payer: VA VA |
$320.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$962.42
|
|
|
HC ARTERIAL PUNCTURE
|
Facility
|
OP
|
$129.42
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$116.48 |
| Rate for Payer: Aetna Commercial |
$110.01
|
| Rate for Payer: Aetna Medicare |
$33.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.44
|
| Rate for Payer: BCBS Complete |
$87.99
|
| Rate for Payer: BCBS MAPPO |
$32.36
|
| Rate for Payer: BCBS Trust/PPO |
$100.62
|
| Rate for Payer: BCN Commercial |
$100.62
|
| Rate for Payer: BCN Medicare Advantage |
$32.36
|
| Rate for Payer: Cash Price |
$103.54
|
| Rate for Payer: Cash Price |
$103.54
|
| Rate for Payer: Cofinity Commercial |
$111.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.36
|
| Rate for Payer: Healthscope Commercial |
$116.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.06
|
| Rate for Payer: Mclaren Medicaid |
$83.80
|
| Rate for Payer: Meridian Medicaid |
$87.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.01
|
| Rate for Payer: PACE Senior Care Partners |
$30.74
|
| Rate for Payer: PACE SWMI |
$32.36
|
| Rate for Payer: PHP Commercial |
$110.01
|
| Rate for Payer: PHP Medicare Advantage |
$32.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.60
|
| Rate for Payer: Priority Health Medicare |
$32.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.93
|
| Rate for Payer: Railroad Medicare Medicare |
$32.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.89
|
| Rate for Payer: UHC Core |
$108.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.36
|
| Rate for Payer: UHC Medicare Advantage |
$33.33
|
| Rate for Payer: VA VA |
$32.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.06
|
|
|
HC ARTERIAL PUNCTURE
|
Facility
|
IP
|
$129.42
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
36100442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$78.93 |
| Max. Negotiated Rate |
$116.48 |
| Rate for Payer: Aetna Commercial |
$110.01
|
| Rate for Payer: BCBS Trust/PPO |
$100.02
|
| Rate for Payer: BCN Commercial |
$100.02
|
| Rate for Payer: Cash Price |
$103.54
|
| Rate for Payer: Cofinity Commercial |
$111.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.54
|
| Rate for Payer: Healthscope Commercial |
$116.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.01
|
| Rate for Payer: PHP Commercial |
$110.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.89
|
| Rate for Payer: UHC Core |
$108.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.06
|
|
